Reuters: Is it a basic human right for people to decide how and when they die -and should the law be changed to legalise euthanasia and assisted suicide? Nitschke: I believe competent adults have a right to end their life at the time of their choosing. The law recognises this and suicide is not a crime. However, the law does not allow for advice or help to be provided for those unable to end their lives themselves. I believe there is a need to change the law so that help can be provided to those who, because of unrelievable suffering, require assistance to end their lives. Dorenbos: There is no right to choose to die. The so-called right to die is an anti-social, self-destructive idea for cowards (and haters of mankind). The right thing to do is to protect life. If a law is changed to legalise euthanasia then all human life is no longer protected by law.
Reuters: Euthanasia attracts massive media coverage across the world, but how common is it and has demand been rising in recent years? Nitschke: A practice which attracts heavy legal sanction is notoriously difficult to study and quantify. Over the years several strategies have been developed that allow one to skirt the law. For example, doctors often help people to die by slowly increasing levels of morphine, claiming their prime intention is the relief of suffering, not to cause the death of the patient. Demand for help to die, or at least demand for access to information so that those suffering can end their lives themselves, has been rising steadily in the clinics I run. Dorenbos: The massive media coverage means that the fight for life and death is a major issue. However, as far as we know, there is no drastic rise in demand for euthanasia. We cannot know the facts because doctors are still not willing to report their cases.
Reuters: Would legalised euthanasia lessen respect for human life, leading to a slippery slope where vulnerable people of all groups are at risk? Nitschke: Those who argue against legislation fearing a "slippery slope" believe that what may eventuate from such change will be worse than the problems we confront now. I think this is unlikely, but recognise there is no easy way of providing reassurance. To do nothing condones the current inequity where the rich and powerful can almost always get help to die while the poor don't have this option. Clearly, any new legislative initiative needs to be monitored carefully so that evidence of a slippery slope can be detected and corrected, and, if necessary, even repealed. Dorenbos: Legalised euthanasia is void of all respect for human life. It is not the beginning of a slippery slope, it is already very much downhill. Each person who is considering whether to kill themselves, or asking to be killed by euthanasia, is by definition a vulnerable person. When the law allows killing, the objective law, that it is a basic human right that each person's life is protected under law, is changed for subjective legislation.
Reuters: Can the law provide sufficient safeguards against patients' relatives or doctors performing euthanasia against someone's will? Nitschke: The legislative models are clear. The patient has to be of sound mind and able to request help to die right to the end. If it is done "against the patient's will" it will also be against the law and murder is being committed. Generally, those using this argument say that those suffering will be "pressured" into "doing the right thing" and that there will be no way of knowing whether the decision to die is being obtained through coercion. Such arguments patronise the elderly. Dorenbos: Euthanasia is not safe. How can one be killed 'safely'? The question not only mention doctors but also patients' relatives as 'performing euthanasia.' Even by suggesting that relatives as well as doctors might perform euthanasia we are further down the slippery slope. The phrasing of the Dutch euthanasia law provides evidence that everyone's life is at risk. It is not surprising that the UN Human Rights Commission is worried about the protection of life in Holland.
Reuters: In a recent survey of UK doctors for the Times newspaper in London, 15 percent said they had helped a patient die at the patient's request. If euthanasia happens anyway, would legislation be a sensible step? Nitschke: Yes, of course. Current practice is unregulated and unchecked. There are no safeguards. Whether you get help to die is determined by money and social class and has nothing to do with need. Legislation restores equity and allows for monitoring. Dorenbos: If you have a law relating to life and death and there are numerous trespasses against that law and nothing is done about it, you have a serious legal, social and constitutional problem. Trespasses of a law can never be a sound foundation for a new law. That is legalised lawlessness.
Reuters: Would it damage the delicate patient-doctor relationship based on the long-held principle that doctors should "first do no harm". Nitschke: Quite the opposite. The current situation, where doctors have access to information (and lethal drugs) so that they or their families never need worry about a difficult death, leads to disquiet and resentment from other groups in society. For the medical profession to actively lobby to prevent legislation, while they themselves are the beneficiaries of the current system, has damaged the doctor-patient relationship. Dorenbos: The question answers itself. The doctor never should execute euthanasia. It is killing a person and not curing them.
Reuters: Where do religious and moral arguments fit into this debate? Nitschke: From the patient's perspective, they have come to terms with the religious and moral aspects of their request to die and feel comfortable with this. From the point of view of someone being asked to help end a patient's suffering, one has to look closely at one's own beliefs. On the four occasions I was legally able to administer a lethal injection I chose to set up a machine so that the patient could initiate the process. To me this was significant; I would fight for a patient's right to die at the time of their choosing, but this did not mean that I was prepared to administer the lethal drug. If a lucid patient can (and they almost always can) initiate the process that will end their lives then they should. Dorenbos: Everybody has a world view. To exclude one particular world view would be an unfair way to try to win a debate. This is especially grave in a debate about life and death-issues. Everybody has either a deistic, theistic, agnostic or atheistic world view.
Reuters: Opponents say there is no such thing as "dying with dignity" and that doctor-assisted deaths are fraught with difficulties - are they right? Nitschke: I have been involved in the process of helping terminally ill people in an environment where there is legislative protection and (as we now have) an environment where there is no lawful way of helping. To my mind it was infinitely better when there was a law that protected doctors and empowered patients. Dorenbos: Proponents of euthanasia indeed speak about compassion, peace, dignity. These are in fact moral and religious words. However, killing has nothing to do with dignity. A society that declares killing as a form of dignity is destroying its foundation of a civil society. Human dignity is about life, love and mutual respect in every circumstance. When Jesus Christ came to this earth and showed compassion he healed people. Mother Teresa showed compassion by feeding the poor, treating them with dignity.
Reuters: Has the Netherlands situation shown the way forward for the rest of the world? Nitschke: The slow and responsible way the Dutch approached the issue of voluntary euthanasia provides a model for the rest of the developed world. Decades of decriminalisation before the introduction of legislation allowed the issue to be fully considered and understood by the population. It also provided the opportunity for careful study so that any evidence of a developing "slippery slope" would emerge. When legislation was finally introduced, it then reflected the views of a society interested in openly addressing important contemporary issues. Dorenbos: The Netherlands euthanasia situation has highlighted how essential it is to protect human life. The bottom line of the debate is that the pro-death euthanasia movement promotes the right to die. This is nothing to do with suffering and illness. It is the promotion of an idea and ideology, a "belief". It is essential to discuss the issue of life and death from the point of view what kind of civil society we want to have. The Netherlands is an alarm clock to wake up the rest of the world.
For contact: Bert P. Dorenbos, President Cry for Life, (Schreeuw om Leven) Ruitersweg 35-37, 1211 KT Hilversum, The Netherlands Ph. +31 35 6244352; fax +31 35 6249141; e-mail info@schreeuwomleven.nl; www.schreeuwomleven.nl