It's a numbers game

We reported recently that Dr Nitschke, director of Exit International has been given 48 hours within which to convince the Medical Board of Australia that it should not suspend his medical practice certificate.

Originally we understood that there were up to half-a-dozen complaints against the behaviour of Dr Nitschke before the Medical Board. We now understand that the number could actually be double that amount.

Nitschke gave an interview to Vice Media concerning the public furore over the death of a 45 year old man who was in email contact with Nitschke before his death. Complaints from the AMA in Western Australia and from the suicide prevention organisation, Beyond Blue seem to hinge upon the claim that Nitschke had a duty fo care to this man to urge him to seek help. He did not.

NItschke has claimed that the man was not depressed and that a person can decide to end thier life 'rationally'. While there is academic literature on the subject, the reality has been questioned. More than that, we contend that accepting the possibility of rational suicide would be detremental to the public policy on suicide prevention.

In the interview (repeated in part below) Nitschke makes in clear once more that this suposed lower age limit for his Exit workshops is a sham and the focus is on business (We try to get as many people to these meetings as we can.)

Not sick, not old but, supposedly of sound mind. How on earth could anyone attest to the mental state of 100 or more people who turn up to an Exit workshop?

Vice Media's Julian Morgan's asked some direct questions:

Why didn't you try to stop him? You're not a psychologist. How did you know he was sane?
Oh come on. I'm a doctor. You're not, and certainly the 7:30 Report journalist wasn't. And she came to the conclusion that he was depressed based on an interview. Anyway, this idea that only a psychologist can decide whether a person should receive information brings out the worst elements of medical paternalism. This idea that unless you're a very experienced psychologist, absolutely anyone could be harboring a yet-to-be diagnosed psychiatric malady is rubbish. I am also a person who can decide if someone is of sound mind, and Nigel was.

Why do you get to decide?
Why do I get to decide? I simply said he could stay. I didn't chuck him out of the meeting. Is that a decision? We try to get as many people to these meetings as we can. That's all.

It seems that you're saying you don't need a psychologist to determine whether someone can receive suicide information. So where is the age cut-off? What is the safety net that you speak about?

Well, we say 50, but that's an arbitrary benchmark. It makes sense for every adult to know how to end their life. I don't just mean when you're 50, 40, or 35. Everybody should have access to this information.

Even if they're not sick?
Oh, hell no. In fact, do it before you're sick. Once you leave it until you're sick, then you're leaving it up to that point where you might need assistance and then you'll really run into trouble with the law. Plan ahead while you're not sick.

So let's say a young person who is perfectly healthy but suicidal comes to you. They should have access to suicide info?
Of sound mind is the criteria. If they then lapse into depression after that diagnosis, that's a risk, but it's not a good reason to be unprepared. And people say that could happen to someone, so therefore no one should have access to this information.

Sanity aside, Brayley was being investigated for murder. Doesn't his suicide get in the way of justice?
Well, I don't think you can tell someone to stay alive to face 20 years of jail if he doesn't want to. He made that decision. Should we have stopped him from making that decision because we wanted him to rot in prison? I don't know. That's a very hard question to answer.

Do you now regret having anything to do with him?
Oh, only because of the media reports. And especially the ABC. In the case of Nigel, I simply talked to him and he decided he was going to get his own drugs. As was pointed out, Nigel was a person who loved guns. If he hadn't taken his Nembutal, he would have shot himself or hung himself. He was not going to jail.

Nitschke had earlier said that Brayley was a 'serial killer'; now he seems to be trying to find a way to diminish his involvement.

The trouble is, if it is about numbers; about everyone having access, there will be casualities. A business case with a risk assessment! You've got to be joking!