Exit Podcast - The Good Death
By Philip Nitschke
Exit Podcast - The Good DeathApr 19, 2021
Exit Podcast No 24 - The Huib Drion Letter: 30 Years Later
Drion argued that all older people should have a right to terminate their lives at a time of their choosing. He argued that this was a separate social need to that of euthanasia for the seriously ill.
Drion bemoaned that older people like himself were ill-equipped to take this step in way that was peaceful and dignified. He noted that while doctors and pharmacists had access to the means, everyone else would be forced to jumping in a canal or in front of train; methods that he said did not bear thinking about.
Fast forward to today and recent weeks have seen the arrest of the chairman of Dutch organisation CLW. Listeners may remember this is the group behind the Middel X powder (covered in the August Podcast); the group that is attempting to force Dutch law to take account of the need of older, rational adults and their right to a self determined death.
This podcast is wide-ranging and both celebrates and comiserates the Drion letter: what does progress look like and are we there yet?
Exit Podcast No 23 - The Azide Wars
The Azide Wars have come about with the advent in the Netherlands of Middel X as an end of life method.
As a country where voluntary euthanasia has long been legal, there has been a groundswell of discontentment amongst older people who resent having to ask doctors for help to die.
Addressing this souring mood has been activist group CLW who have strongly advocated the use of Middel X, an available, legal inorganic salt they claim provides individuals with a reliable end of life option.
In opposition has been the Dutch Medical Association and prominent right to die activists such as Dutch psychiatrist Boudewijn Chabot who argue that Middel X is a dangerous substance that does not provide the peaceful and reliable death that CLW claim.
The August 2021 PPeH update focuses on the Azide Wars and presents collected data and eye witness accounts so you can draw your own conclusion.
Read more at www.peacefulpill.com
Exit Podcast No 22 - Retrospective: Philip Nitschke reflects on 25 years of political activism
The May 2021 Exit Podcast (note name change) features an interview with Philip Nitschke as he reflects on the highs / lows of 25+ years of end of life political activism including the effect on his work of his move to the Netherlands, how it feels to be politically persecuted, major turning points in the debate and where the next generation of activists will come from and who they are.
Doxit No 21 - The Push Back: Towards a New Human Rights-based Focus
In early April, Dutch activist group, CLW launched legal action against the Dutch state arguing that the prohibition on assisted suicide and assisted suicide drugs should be abolished. These should be abolished because they prevent self-determination at the end of life. If self-determination is a fundamental human right, they argued that a nation State that keeps the right un-exercisable makes the right a false one and the State is acting unlawfully.
The Dutch have taken their lead from recent constitutional court decisions in Germany and Austria which confirm that self-determination is a human right that the government should not interfere in. What is more, self-determination at the end of life exists irrespective of age and health/ illness status. This is to say that all people of sound mind have the right to determine when and how they die; they don't need a doctor to give permission or tell them how.
Doxit No 20 - Katie Engelhart's new book The Inevitable
Exit first met Katie Englehart about 5 years ago when she was part of the production team behind the Vice documentary, Time to Die.
After 4 years of filming, Vice had footage on just about everyone that Philip Nitschke had met. It was via this immersion that Engelhart would change mediums, and bring the stories of 3 Exit members into her written word.
The Inevitable: Dispatches on the Right to Die is as weighty as an academic tomb, but as engaging and easy to read as a popular biography.
The strength of the book is the stories of the lives that it tells; each on a different theme.
We meet Exit Members Avril Henry who is old, Maia Calloway whose body is failing her due to MS and Adam Maier-Clayton who has some serious and chronic mental illnesses. We also meet Debra Koosed who is losing her mind to dementia.
Engelhart follows each of these people as they negotiate their way to a peaceful end.
She incorporates two doctors working in the field, for good measure: Lonny Shavelson who is one of the talents behind the the lethal drug mixtures, highlighted in February's Doxit Podcast and yours truly, Philip Nitschke.
To read The Inevitable is to be better informed. To listen to this podcast is to be the fly behind the fly on the wall ...
Exit Podcast No 19 - The USA Lethal Mixtures
Since the scarcity of Nembutal - the best end of life drug - in the US due to both its prohibitive price and the refusal of EU drug manufacturers to sell the drug in that country (because of objections to its use in capital punishment), other alternatives have needed to be examined by doctors working under death with dignity laws.
In this Doxit Podcast, Peaceful Pill Handbook authors, Philip Nitschke and Fiona Stewart, discuss the evolution and emergence of the USA Lethal Drug Mixtures.
The alternative multi-drug compounds provide a reliable, peaceful death for a fraction of the price of Nembutal.
Their refinement over the years means that they provide a very good alternative to Nembutal. Full details of the current 5-Drug protocol, D-DMAPh and their use as effective DIY agents in published in the Feb21 update of The Peaceful Pill eHandbook
Doxit No 18 - Premedication & Potentiation
In this week's Doxit Podcast we discuss the January 2021 update to the Peaceful Pill eHandbook which focuses on the two issues of premedication and potentiation and the role both play in a peaceful and reliable death.
Potentiation of lethal drugs is relevant if one has old drugs or substances or if they are from dubious sources or if they have been stored for a long time. Potentiators are also the drugs that bring about sedation, ensuring a more acceptable ‘sleep while you die’ process.
Doxit No 17 - 2020 Looking Forward/ Looking Back
The year that was thanks to COVID-19 but it was not all bad news. Exit’s Doxit Podcast ‘Looking Back Looking Forward’ reflects on the good and the bad to come out of the pandemic experience. For example, like so many organisations around the world, Exit moved our core operations online. Face to face workshops were abandoned in preference of Zoom workshops. Four, fully-online 4 hour meetings were held between June and October across different global time zones.
The NuTech 2020 conference was also held entirely online in September. In retrospect, it seems perfect practice to have live-streamed the last two NuTech meets in 2017 and 2018 (in addition to in-room attendance). The step to virtual was never going to be too hard!
But COVID-19 also generated the odd good development. Not only did Donald Trump tell the world about Chloroquine (albeit as a life-preserver rather than ‘ender’), but developers created new anti-viral devices; helmets which may well be valuable when it comes to the use of gases for a peaceful and reliable end of life choice (more to come in the PPeH).
The first Doxit Podcast for 2021 examines these issues and more; including our forthcoming Exit Mini Monthly Workshops – Snippets – which commence online Wednesday 3 February at 21.00 GMT. Registrations will open Sunday 10 January.
Doxit Podcast No 16 - Australian/ NZ Legal Wave of Change
From 25 years ago when voluntary euthanasia for the terminally ill was so controversial that the Federal Government of Australia used a hitherto unknown section of the Australian Constitution (s122) to overturn the Northern Territory's Rights of the Terminally Ill Act to today when politicians can't act fast enough getting behind assisted dying laws as a show of compassion and humanity, the right to die has come a long way.
And so 2020 draws to a close with New Zealand finally passing a binding referendum that will see an End of Life Choice Act introduced in that country while Queensland makes Dying with Dignity an election promise. Meanwhile in Tasmania, politicians are falling over themselves as defenders of human rights at the end of life.
This Doxit Podcast discusses the pros/ cons of a medicalised legislative model, in terms of who is served and who is excluded from eligibility, asking is this the best way forward?
Doxit Podcast No 15 - Physiology of a Good Death - why it works & how!
In this Doxit Podcast we explore the physiology behind the good death.
Taking the recent new Peaceful Pill eHandbook chapter on 'Death Physiology' as our starting point, we discuss the science behind the efficacy of some methods as distinct from others (eg. Nembutal over Opiates) and consider how each strategy discussed in the book falls into one of four categories of hypoxia: hypoxic, hypermic, ischemic & histotoxic.
In understanding better how the different methods work on the body, there can be increased confidence in the efficacy of a method to provide a peaceful and reliable Exit at a time of one's choosing.
Podcast No 14 - A Letter from Ireland with Tom Curran
Exit first met Tom Curran in 2008 when he attended our initial Irish workshop at the Seomra Spraoi anarchist collective in Dublin (because no other booked venue would host the public meeting and workshop): such was the controversy surrounding assisted suicide/ assisted dying in Ireland. Fast forward a decade, and Tom has become the legitimate face of the Irish right to die movement.
A director of Exit International, Tom's commitment stems from the experience of his late partner, Marie Flemming who died in 2013 after suffering for many years from MS. In recent weeks, the Irish Parliament has voted to progress a Dying with Dignity Bill concerning assisted suicide to the committee stage. Listen to Tom's journey over the past decade and his instrumental role in pushing for a law for people with a 'life-limiting' condition.
Podcast No 13 - NuTech 2020 Conference Program for Sat 26 Sept: a sneek peak!
The NuTech Conference was held on Saturday 26 September with a 100% online program, drawing speakers from the Netherlands, US, France, Australia, Scotland & more.
NuTech is the only global group to explore the possibilities offered by new technologies in regard to a peaceful and reliable death, instead of doctor-administered voluntary assisted dying.
This year's NuTech conference theme is the 'Dementia Dilemma'.
Keynote speakers such as Marije de Haas, Bert Keizer and Michael Laufer explored the role of implanted switches as it relates to dementia patients (eg. The Plug). French investigative researcher Guillaume Coudray took on the Nitrite debate while Hugh Wynne will talk 'nitro foam frenzy'. US Medical Aid In Dying (MAID) physician, Lonny Shavelson, explained the science & logic behind the new D-DMA drug mixtures, Philip Nitschke unveiled Sarco X, Ted Ballou & John Todd talked gases and Richard Avocet featured his R2D Debreather. Feminist activist Kinga Jelinska warned how to avoid reinventing the wheel, while Neal Nicol examined new technologies in bio body disposal.
NuTech Website is at Nutech2020.com
Doxit No 12 - In Conversation with Professor Sean Davison
In 2011, Sean Davison pleaded guilty to the attempted murder of his mother (who was dying of cancer). He helped her to die when her hunger strike failed. Sean served 5 months home detention in New Zealand for his compassion.
In 2020, Sean entered a plea bargain of guilty to the murders of three seriously ill/ disabled men in South Africa. He is currently serving 3 years house arrest in Cape Town.
Sean Davison is the Founder of Dignity South Africa and President of the World Federation of Right to Die Societies.
Sean has had an extraordinarily bad run of luck when it comes to the law (and other authorities, eg. NZ Medical Board).
In December 2020, Sean wrote to the New Zealand Prime Minister Jacinda Ardern to request a pardon on behalf of all New Zealanders who carry a criminal conviction for helping a member of their family, someone they loved very much, to die with dignity.
Sean has requested the pardon in light of the outcome of the 2020 New Zealand referendum on assisted dying which saw overwhelming (65%) support for voluntary assisted dying via the End of Life Act in New Zealand.
Listen to Sean in conversation with Fiona Stewart on this week's Doxit Podcast.
Doxit No 11 - Sarco X Euthanasia Capsule Arrives
Sarco X is a 3D-printed euthanasia capsule that provides a peaceful and reliable death.
First exhibited at the Amsterdam Funeral Fair in 2018 and then at Venice Design in 2019 and Cube Design Museum in 2020, the latest iteration of the Sarco - Sarco X - has recently undergone its final lab testing at Haarlem in the Netherlands and is now ready for use.
The Sarco works by creating a hypoxic (low oxygen) environment. It is 3D-printed in order to ensure it is lawful (you can print your own). The plans will be made available in due course in The Peaceful Pill eHandbook.
Sarco is fully portable so it can be taken to a location of one's choosing. It is beautiful to look at because dying - like living - can be an occasion for reflection, peace and even celebration.
See more at Sarco.design
Doxit No 10 - Is a Nembutal Death 'Cruel & Unusual'?
In this week's Podcast, we discuss the controversial use of Nembutal in capital punishment executions in the US.
In particular, we examine the argument that prisoners have recently presented to US Courts that death by pentobarbital injection causes flash pulmonary edema. Flash pulmonary edema, they say, constitutes cruel & unusual punishment. And cruel & unusual punishment is prohibited under the 8th Amendment of the US Constitution.
Does Nembutal cause 'flash pulmonary edema' & is this a problem?
Is Nembutal still the best drug for a peaceful/ reliable death?
The second issue discussed is the global move to re-categorise Nembutal, so Veterinarians are less likely to die from an overdose.
Finally, this week Exit launches our new Stop Scams website at www.nembutalscams.com
Doxit No9: Do You Need a Doctor?
This week's Doxit Podcast examines the topic of the medicalisation of death.
Whereas once a death was the domain of religion, and suicide was considered a sin against God, more recently the public discourse on suicide has medicalised the act, treating it as a mental illness. No rational person could ever wish to end their life, regardless of the reason.
In this week's discussion, Philip Nitschke and Fiona Stewart question the semantics surrounding rational/ irrational suicide/ Voluntary Assisted Dying/ Medical Aid In Dying, drawing in particular on a recent article by Anita Hannig in the journal Cultural Anthropology (Vol. 34, Issue 1, pp. 53–77).
They explore how a death under a right to die law, is more an instance of the person/ patient gaining State (and medical) authorisation, than the person having any real authority over their life, and death.
DIY end of life strategies are the only effective means by which one's autonomy and agency can be preserved.
Doxit No8: Miscarriage - The Story of Graham Morant
In 2018, Graham Morant was found guilty of inciting (and assisting)his wife Jenny to suicide. This is the first case where a charge of incitement to suicide has led to a conviction. Graham received 6 years for assisting Jenny's suicide and 10 years for inciting. These sentences were to be served concurrently.
At the time of his trial the Court was unaware of a series of emails that Jenny Morant had sent to Exit, pleading for help in her plan to suicide. She described her husband as unhelpful and unwilling to help her; a very different story to how Graham was portrayed in court. These emails became the basis for Graham's appeal against his convictions and sentence.
In June 2020, however, the Queensland Court of Appeal concluded that the email woulds not have altered the decision of the jury. This podcast reviews this bizarre decision and looks at it in the context of this hitherto little known crime of incitement to suicide.
Jenny Morant had undergone unsuccessful spinal surgery (following many years of osteoporosis). The legacy of the surgery left her living in constant pain for which there was no relief. Interestingly, sadly, Jenny would not have qualified for Queensland's anticipated voluntary assisted dying bill which the Queensland Labor Government plans to introduce following their 2020 re-election victory.
Doxit No7: The R2D Debreather, more on the lethal salts, plus CNN story on Cindy Shepler & her trip to Pegasos
This week we pick up on two of the issues covered in this month's June update to the Peaceful Pill eHandbook (Nitrite & the Debreather) and discuss the recent CNN article on ME/ CFS sufferer, Cindy Shepler and her VAD at Pegasos in December last year.
The R2D Debreather is a device that enables a person to end their own life by breathing air within a closed system. Normal respiration (breathing) consumes the oxygen in the closed system. The ‘by-product’ of the respiration, carbon dioxide (CO2), is continuously removed (scrubbed) from the recirculated air.
As the oxygen level drops, the person experiences a soporific, and almost intoxicating sensation. This leads to a peaceful loss of consciousness and death. The death is peaceful because the DeBreather removes exhaled carbon dioxide.
The DeBreather has been about for many years however it was not until a new model was revealed at NuTech 2017 and its subsequent productionin 2020 that it has really 'come into its own'.
Podcast No 6: The Rise & Fall of Chloroquine
Long before President Trump touted that chloroquine would be the ‘game changer’ in the fight against COVID-19, this under-rated and useful end of life drug was making something of a comeback since it was first promoted by the French suicide manual Suicide Mode d’Emploi in 1982.
The ready availability of this anti-malarial has contributed to its growing use as a means of providing a reliable death. Cambodian despot, Pol Pot, is believed to have used chloroquine (in conjunction with Valium) on the eve of the announcement by the Khmer Rouge that they planned to hand him over to international authorities for trial.
First synthesised in the 1930s as a substitute for naturally produced quinine, the drug was found to be effective against malaria. However, its widespread use was delayed until after the Second World War, because of concerns over the drug’s narrow therapeutic range. Ie. a side-effect was death.
This Podcast is based on the June 2020 update to the Peaceful Pill Handbook. Chloroquine is now a much-discussed drug following Donald Trump's claim to be taking chloroquine to protect him from COVID-19. The scientific jury is still out on its impact on coronavirus symptoms.
Check out the June 2020 update to the Peaceful Pill eHandbook at www.peacefulpillhandbook.com
Doxit Podcast No 5: Lethal Salts Part II
This Podcast continues the discussion of the Lethal Salts by taking a look at a number of eye witness accounts and teasing out some of the elements of the Exit RPA Test - the Reliability, Peacefulness, Availability Test as it is discussed and used in The Peaceful Pill eHandbook.
Doxit Podcast No 4: Lethal Salts & the Law
In some ways the Lethal Salts have remained under the right-to-die radar. But are they the new Drion pill? Are they the new peaceful pill? What does the law have to say on these relatively freely available lethal substances? And what of a clamp-down to prevent public access?
Some even suggest that the Lethal Salts may start to be used by the Swiss assisted suicide services, especially should the current drug, pentobarbital (Nembutal), become to difficult to readily source.
Doxit Podcast No 3: Happy Hypoxia in the Age of COVID & Dementia & Advance Directives in the Netherlands
This week we take the lead from the plethora of news reports on 'happy hypoxia' vis a vis COVID-19 and a good death.
The term ‘happy hypoxia’ first gained attention in early 2020 during the COVID-19 pandemic. Some people whose lungs were severely affected by the virus (so that oxygen could not readily cross into the blood), were found to be hypoxic. However, these patients were not particularly distressed.
Happy hypoxia has also been associated with deaths resulting from lung infections and pneumonia.
When William Osler (one of the founders of the Johns Hopkins Hospital) described in 1892, a death from pneumonia as ‘the old person’s friend’, it was happy hypoxia that he was referring to.
Happy hypoxia depends on cerebral oxygen levels dropping to lethal levels, while avoiding any increase in carbon dioxide (with the associated distressing symptoms).
The second topic of this Podcast is the recent Dutch Supreme Court decision that confirmed that doctors should act upon an advance directive that contains a person's wish for euthanasia in the context of advanced dementia.
Euthanasia in the context of dementia or is a controversial subject. In the vast majority of jurisdictions that have some form of voluntary assisted dying laws, a person who has dementia will be expressly excluded from being able to seek help.
This is not the case in the Netherlands or Belgium.
Doxit Podcast No 2: Advance Directives in the Time of COVID
The COVID pandemic has brought new urgency to end of life planning, as far as Advance Directives go.
The arrival of COVID-19 reinforces the need for everyone to prepare a legally-recognised advance directive document and arrange the appointment of a legal representative (eg. guardian, proxy, agent, etc.).
An advance directive can outline the nature of one’s desired end of life care, (and a guardian can advocate on our behalf) should we become unable to communicate this for ourselves.
A deteriorating situation with a COVID pneumonia can quickly place you in the position of having to make a decision as to what level of medical intervention you want.
The existence of a legally-drafted advance directive and appointment of a legally-sanctioned person to represent you, could well protect you from a prolonged and undignified death in an ICU.
Such a document, and such an agent, can also ensure that scarce medical resources are freed up for those who more welcome them (and who may be more likely to benefit from them).
This makes the decision-making easier for the medical staff involved.
Doxit Podcast No 1: Covid-19 & the Good Death
Podcast No 1 addresses the April 2020 COVID-19 Update to the Peaceful Pill eHandbook, examining issues such as COVID-19 pneumonia, active & passive ventilation, the 'game changer' of chloroquine, developments to the Sarco project and more.