Nitschke’s obscure views on ‘rational suicide’ have left him with a destroyed medical licence, severe financial damage and many enemies, but he has no regrets

Philip Nitschke: I don’t judge people at all if they want to die

It took 25 years for the medical authorities to silence euthanasia advocate and former doctor Philip Nitschke.

But his withdrawal from media commentary and promotion of voluntary euthanasia was short-lived, lasting just four weeks.

Last month, in a public act of defiance against the Medical Board of Australia, Nitshchke, 68, burned his medical registration and ended his career as a doctor so that he would be able to continue running workshops for those over 50 about how to die peacefully.

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Nitschke has pushed the boundaries of what the hippocratic oath allowed him to do as a doctor by arguing for voluntary euthanasia throughout his career and, in more recent years, by promoting rational suicide – the difficult idea that someone does not have to be terminally ill or depressed to want to die.

“You must be able to control the time at which you die,” he tells Guardian Australia.

“That should be an essential human right. In other words, you don’t have to be sick to qualify for voluntary euthanasia. Everybody qualifies. I see too many people now who want to die for social reasons, not medical reasons.

“They may not be my reasons. They may not be yours. But they are certainly the individual’s.”

In pushing this belief, Nitschke has drawn the ire of the authorities and his medical peers, particularly psychiatrists. This unease culminated in revelations last year that he did not refer Perth man Nigel Brayley, 45, to a psychiatrist after Brayley emailed him to say he wanted to die.

“He said, ‘Do you want a copy of my suicide note?’ and I said, ‘Yes please’,” Nitschke recalls.

Brayley died after taking the powerful barbiturate Nembutal, which Nitschke has written a handbook on how to obtain (it is illegal to possess or distribute the drug in Australia).

A series of emails between the two were revealed by the ABC’s 7.30 program in July last year. Pressed to explain why he did not refer Brayley to a psychiatrist, Nitschke said Brayley had not seemed depressed, and had made a rational decision to die, which he had no right to stand in the way of.

But the Medical Board of Australia disagreed, using their emergency powers to suspend Nitschke’s medical registration. They argued that Nitschke had an obligation to refer Brayley to a psychiatrist, even though Brayley was not his patient.



The medical board, I have almost no respect for them Philip Nitschke

Nitschke, accustomed to controversy, expected some push-back. But he never believed the case against him would progress as far as it did.

“I certainly didn’t anticipate the use of their emergency powers,” Nitschke says. “The medical board, I have almost no respect for them. I can see them sitting around in their little board rooms and saying, ‘We better do something’. What for?

“Because I didn’t bloody send Nigel Brayley off to a psychiatrist.”

Nitschke says he did not know at the time of his correspondence with Brayley that Brayley was a suspect in the death of his former wife and disappearance of a former girlfriend.

Now he believes the prospect of going to jail was behind Brayley’s decision to die, which he says only adds to his argument that Brayley made a rational and informed choice – Nitschke believes all prisoners facing a life sentence without parole should be given the option.

And for a moment, it seemed as though Nitschke would be off the hook. In July, Darwin’s supreme court agreed that he was not obliged to refer Brayley to a psychiatrist given he was not his treating doctor, and overturned the emergency suspension of his medical licence.

Philip Nitschke banned from promoting voluntary euthanasia as a doctor Read more

But there were other charges against Nitschke that the medical board then pursued; among them that he had failed to take adequate notes about his patients, and that he had treated a patient in South Australia when he was registered only in the Northern Territory.

“We were celebrating the supreme court decision, and then straight away, along comes another 12 charges they had and were effectively sitting on,” Nitschke says. “I looked through them and said; ‘Oh hell’.”

It wasn’t so much the charges that bothered him, Nitschke says, but his feeling that the medical board was always going to find something to pursue him over.

He admits guilt over most of the additional charges, but describes them as mostly “trivial” and “slap-on-the-wrist” offences.

He believes he would have been able to get away with them or would have been issued only minor penalties if he had faced the medical board in the courts.

But he had run out of money, despite having crowd-funding to cover some of his previous legal costs. And the barrister who had been assisting him pro bono, Peter Nugent, died in March.

“He was terminally ill with bowel cancer, and had lethal drugs, but we had thought his condition was stable, and he had not mentioned to me any recent deterioration as he was preparing for the supreme court appeal,” Nitschke says.

“I have assumed it to be suicide using Nembutal, but his widow has not provided me with the autopsy results that I have asked her for.”

Following a mediation process between Nitschke and the medical board regarding the additional charges, he was offered an ultimatum.

The charges against him would be dropped and he could keep practising medicine.

In return, he would have to agree to 26 conditions being placed on his practising, which would make it impossible for him to continue his euthanasia advocacy and workshops, or to remain president of the pro-voluntary euthanasia group he founded, Exit International.

Philip Nitschke burns medical certificate and says he will promote euthanasia Read more

In October, Nitschke accepted the conditions in order to keep his medical registration, as he lacked the funds to fight the charges in court, even though he believes he would have won. It seemed as though his two decades of advocacy for the euthanasia movement had come to an end.

“It had already cost us a lot, more than $300,000, and it had also cost us a lot in terms of time,” Nitschke says. “You don’t really have time to do what you want to do if you’re embroiled in one of these protracted legal battles.”

Exit International then surveyed its 2,000 Australian members to ask them what they wanted Nitschke to do next, since his position as president of the organisation had been made untenable by his decision to remain a doctor.

About 1,100 members replied, Nitshke says.

“And 99.5% said, ‘We want you to continue the workshops. We want you to be able to discuss Nembutal, we want this information.’

“And more than 95% said, ‘I do not want to be referred to a mental health professional simply because I talked to you about the possibility of ending my life’.”

It was enough to convince Nitschke that his future was in the voluntary euthanasia and rational suicide movements rather than medicine. And that was when he burned his registration.

He says he has no regrets.

I don’t judge people at all if they want to die. That’s their business Philip Nitschke

“It made me feel at least that it was my assertive act, that I was the one making the decision, saying, ‘Your conditions are so onerous and offensive, and to my mind flies so much in the face of what I would consider as good medical practice, that I don’t want to be part of your club’,” he says.

“In some ways I kind of like the fact it’s brought the issue out in such a big way to make a clear statement about what I think is wrong with the medical profession.

“I don’t think I’m wrong, it’s not like I’m feeling, ‘Oh God, I shouldn’t have done that’.”

The loss of his registration has had little impact on Nitschke’s day-to-day life.

He hasn’t practised as a doctor in a structured way for the past decade, he says, his time taken up travelling overseas to learn from countries where assisted euthanasia is more accepted, and running workshops on voluntary euthanasia and assisted suicide around the world. This is how he has primarily earned a living.

The movement has taken up most of his time since 1995, when the Northern Territory became the first jurisdiction in the world to pass laws allowing a doctor to end the life of a terminally ill patient at the patient’s request. Four did so in the two-year period the legislation was in effect before being overturned by the federal government. All four were Nitschke’s patients.

As his efforts on euthanasia increased, Nitschke says, he was seeing patients “rarely, very rarely”.

And when interactions did go from giving advice to a member of the public into patient territory, Nitschke admits; “It wasn’t the usual doctor-patient relationship.”

“They were people who were making contact with me, describing situations, and saying; ‘What are their options [for voluntary euthanasia] and having me then explain the law to them’,” he says.

Asked if he ever kept notes, he replies, “Sometimes”.

“If it ever got to what seemed to be a formal relationship, then I had to,” he says.

“They [the medical board] said the notes weren’t good enough, and perhaps they weren’t. But certainly there were notes kept.

“But when people ring up, and this happens every day, and calls come in from all over the world, then I do spend some time explaining to them the risks of obtaining Nembutal, or assisting someone to obtain it.”

It’s clear that even Nitschke is unsure at what point these conversations crossed into doctor-patient relationship territory. Nitshke fears that in the past, some of these conversations might have been tapped.

He still hasn’t had his mobile phone returned following a raid on his clinic in South Australia in August last year, when detectives were searching for Nembutal.

“When people start talking and saying, ‘I have this drug’, I say, ‘I think it’s a good idea we don’t continue this conversation and we have to make plans to talk elsewhere’.”

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Nitschke has little regard for the rules when they interfere with his view of what is right. Asked if he has any friends or mentors within the Australian medical profession, he admits “not really”. Even his sister does not have much to do with him any more because of his views, he says.

While he still owns a house in the Northern Territory, Nitschke spends much of his time overseas working with doctors and campaigners in countries such as Switzerland and Germany, where assisted suicide is legal. Next year, he will hold Australia’s first rational suicide conference at the state library in Melbourne.

Thanks to his views on rational suicide, he has been ostracised even by voluntary euthanasia supporters, who feel he has done more harm to the euthanasia movement than good. Dying With Dignity Victoria, whose patrons include the barrister and human rights advocate Julian Burnside, make a point on their website of saying they have no affiliation with Nitschke.

Just as public debate in Australia appears ready to engage more rigorously with euthanasia and at least consider legislation similar to that first adopted by the Northern Territory, Nitschke pushes the boundaries beyond what people, and certainly politicians, are ready for.

Facebook Twitter Pinterest Philip Nitschke conducts a voluntary euthanasia public meeting and workshop in London. Photograph: Linda Nylind for the Guardian

In May, following much lobbying from the Greens MP Colleen Hartland, Victoria became the first parliament in many years to launch an inquiry into state laws around end-of-life choices, with a report expected to be handed down next year. But rational suicide will not be within its scope.

Nitschke has little interest in current debate about how legislation can be changed to allow the terminally ill to end their life. If any legislation is introduced, he says it will no doubt include the provision that a patient will first have to consult a psychiatrist to ensure they aren’t clinically depressed. And he is sceptical that this is always necessary.

“The debate in Australia has become too small now,” he says.

“I don’t judge people at all if they want to die. That’s their business, and I don’t sit around trying to judge their ideas if they are rational and they are an adult.

“I hope in 50 years, they’ll see me as someone on the side of right, but perhaps just a little too early. I think right now, the medical profession are still very much anchored in ideas from the past.”

• In Australia, the crisis support service Lifeline is on 13 11 14. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In the UK, the Samaritans can be contacted on 116 123. Hotlines in other countries can be found here