Bouquets to Jeff Kennett and the Beyond Blue organisation for their clear and appropriate condemnation of the actions, or rather inactions, of Dr Philip Nitschke in relation to the suicide death of a Perth man in the story that ran on the ABC's 7:30 report a little over a week ago.
According to the media reports and to Dr Nitschke's twitter feed, he is basing his defence, in part at least, on his claim that there is such a thing as rational suicide.
The idea that suicide can be somehow a rational choice is not new. In fact, an organisation exists in the UK called the 'Society for Rational Old Age Suicide' and there has been one study that I am aware of that canvasses the issue.
When we think of suicide we commonly understand that people who contemplate ending their lives will be viewing their problems through a very dark lens that does not, at that time, offer them any hope or possibility that what troubles them could be dealt with in a less dramatic fashion.
But there is always hope; there is always some other solution. Time, good counselling, talking to family and friends, taking exercise and a good night's rest can all help us see past those solitary, dark moments. We can all help.
Some years ago now, my work with homeless and at risk youth gave me a very clear window into this issue. That's why I'm so grateful for the work of Beyond Blue and other suicide prevention organisations. Suicidal people can often appear to be quite rational; their plan and their reasoning behind it, quite compelling. Were we to have accepted the assertion that any of these people should simply be left unchallenged and unsupported because they could put up a calm and cogent argument for their actions we would have been abandoning them in their time of deepest need. The intuitive assessment that suicide should be shunned and is never the only option is natural, normal and something hardwired into humanity. Thank goodness!
And while the argument about whether or not someone can be genuinely rational is, intuitively false – an oxymoron as one commentator put it – it is largely academic and should not be brought to bear upon suicide prevention nor our natural responses to those in need. The message would be a dangerous one and bears within it the distinct possibility of an implied endorsement of some suicides.
Think about it. At the end of this article and of every story on this subject we've grown to expect that responsible media will always carry a closing line saying something like: "If this article troubles you, phone…….. for confidential help." If Dr Nitschke's argument holds true, would public policy then demand that we add something like: "Unless you consider yourself rational; in which case contact Exit on…."? Yes, I know an example in extremis but I think it makes the point.
That the public commentary has focussed on the WA man is understandable in as much as he had direct contact with Dr Nitschke. But the ABC's story also told of the suicide death of a 25 year old Victorian man who used the services of Exit to purchase information and thereby, a prohibited substance to end his own life. Nitschke's defence here that the man lied about his age on a tick box on an Exit website is as ludicrous as is Exit's self-imposed supposed lower age limit of 50 years for such services.
Dr Nitschke has consistently maintained that every adult should have access to the means to their own end. The faux lower limit, in light of this, seems more about trying to soften the public perception of this macabre death industry than it does about any corporate sense of public duty.
It is this supposed right-to-die that is the false over-arching philosophy by which the death of a young person can be somehow 'rationalised' by Nitschke and Exit. In 2010, in response to a Victorian Institute of Forensic Medicine Report showing that two thirds of deaths in the preceding decade using the Exit drug-of-choice, Nembutal, were for people under the age of 50 with nearly one-third being younger than 40 and six being in their 20s, Nitschke said: ''There will be some casualties … but this has to be balanced with the growing pool of older people who feel immense wellbeing from having access to this information.'' Tell that to the families of the two men featured in the 7:30 Report! Suicide prevention should never accept the notion of acceptable casualties!
And herein lies a bigger question which suicide prevention organisations and the Australian public generally need to come to terms with: How is it that we have somehow grown to accept that it's okay for older people to seek to end their lives; that there's somehow a distinction to be made about access to suicide methods and suicide ideation, generally, based upon age?
This notion that somehow 'older people…feel immense wellbeing' from having the means to kill themselves is very odd indeed. Certainly, studies on people who have accessed suicide methods in Oregon under their legalised suicide system do point to this as an outcome for some. But if we apply the same general thinking towards people who are suicidal as described earlier (and I argue that we should), we should be thinking clearly about the reality that there is always another way past presenting difficulties and dilemmas – even if these problems ultimately include advancing age or a difficult prognosis.
We should be preventing suicide by treating every suicidal person with equal respect and act the same in every case. If not, then aren't we at risk of failing people in the same way as Nitschke's cry for the recognition of rational suicide would?
It's about time this macabre and clandestine industry was subject to public scrutiny.
Paul is also Vice Chair of the International Euthanasia Prevention Coalition