So-called 'rational suicide' is an oxymoron.
Two of Australia's most well known and effective suicide prevention organisations today condemned the actions of Dr Philip Nitschke in supporting the suicide death of a healthy 45 year old Australian man a few months ago.
Nitschke had claimed that, in his opinion, the decision by Nigel Brayley to kill himself was rational and, when challenged about this by an ABC reporter as to why he didn't counsel the man to seek help, simply responded. "We don't do that."
Chairman of Beyond Blue and former Premier of Victoria, Jeff Kennett, said that Nitschke's actions were 'reprehensible' adding that his actions were, 'a gross breach of his Hippocratic Oath as a doctor, and offensive to all standards of common decency.'
Yesterday, HOPE director, Paul Russell, called for a national inquiry into Dr Nitschke and the operation of Exit International.
Kennett, a supporter of euthanasia also called for an investigation.
"As a long-time supporter of euthanasia for the terminally ill, for those for whom the dignity of life has been lost, and under special conditions, I believe Dr Nitschke's latest act has crossed the line of decency and professional conduct."He has done his more general cause for euthanasia a great deal of harm.
"I trust the appropriate Medical Board or Boards, and Governments will move quickly to investigate Dr Nitschke's latest act. He has done society a great disservice, and in my opinion should no longer be registered to practise as a medical professional."
Suicide, all suicide, is a tragedy. People contemplate suicide because they see it as the only answer to their problems. This is never the case; there are always alternatives. At HOPE we include assisted suicide and it's close relation, euthanasia here also because we don't see that there's a real difference of fact. People who seek assisted suicide or euthanasia see their death as the only option. Again this is never the case. That's why, while we support to work of beyond Blue and it's chairman, Mr Kennett, we feel that his support for euthanasia is a mixed message.
The Black Dog Institute also spoke out against Dr Nitschke in an article strangely called: Suicide should never be seen as euthanasia. They make a false distinction between euthanasia and suicide when they say that, "Unlike euthanasia, suicide is most often not a choice made by someone of free will." Studies show that depression is common in requests for euthanasia and also that choice is not always evident.
Their article concludes wisely:
"According to Dr Nitschke, people who can converse “insightfully” about their decision must be making a rational decision. This is not the case. It is entirely possible, and very common, for people living with depression to act “normally” and hide their condition from even their closest friends and family. People experiencing suicidal thoughts are very capable of making intricate plans and can be cognisant of how they implement them.
"Suicide results from of the combination of vulnerability, capability and a triggering episode.
"By taking this stance, Dr Nitschke is increasing capability by providing direct access to means and thus has significantly raised the probability of suicide in the community."
Black Dog spokesperson Dr Caryl Barnes told ABC News that the Institute may make a formal complaint to the Australian Health Practitioner Regulation Agency (AHPRA), which supervises the registration of doctors qualified to practice.
Dr Barnes says as a psychiatrist, she is "absolutely horrified and appalled" that Dr Nitschke did not recommend counselling.
"I think this gentleman, from my reading, was suffering from most likely a clinical depression and he had an opportunity to be directed towards help and wasn't done so," Dr Barnes said.
"As a medical practitioner, I think he [Dr Nitschke] had an obligation to direct him towards medical help and to encourage him to seek help and to get him screened for a clinical depression."
Nitschke admitted, in the same interview: "Maybe I'm not trained well enough but in my opinion they are not psychiatrically ill ... they've made a clear decision that now's the time they wish to die."
The same article closed with references both to the euthanasia bill before the Senate and the impossibility of anyone confirming rationality via email:
Psychiatrist Dr Chris Ryan says many people who want to end their lives are depressed and do not have the capacity to make decisions.
Dr Ryan says it would be "almost impossible to make that sort of assessment over email".
The Greens have a bill before Federal Parliament to make euthanasia legal for the terminally ill only.
But Dr Ryan, who is on the board of Dying with Dignity, says Dr Nitschke may have set back the campaign for voluntary euthanasia.
Whether these stories set back the euthanasia cause or not is beside the point and misses the point that two young men are dead who needn't have died and two families are grieving who shouldn't be.
The addition of 'voluntary' in front of the word 'euthanasia' disguises the reality that euthanasia can equally be a cry from seemingly rational 'insightful' people to end their lives when, in reality, they may be depressed and see no other way out. Being vulnerable they are more likely to be open to suggestion. There is always this possibility that their 'choice' is really no choice at all. In the end, the only real difference may be that one dies at their own hand whilst the other is killed. stopping euthanasia should, therefore, be part of the work of every anti-suicide organisation.
Certainly, the law treats euthanasia and suicide differently because of this involvement of a third party. But to somehow separate the issues in terms of rationality and choice in consideration of the risk to vulnerable people lacks logic.
At the end of every segment or article on euthanasia or suicide, broadcasters run a tagline about where to get help if feeling suicidal or depressed as a result of the story. Should we now be modifying this clear and unambiguous message by adding a line that says: if you're rational, or have a serious illness ring Exit. For all other suicidal thoughts ring...