Friday, November 14, 2014

Philip Nitschke (Dr Death) on trial in Darwin Australia.

The following is an excerpt from the article by Paul Russell, the director of HOPE: preventing euthanasia & assisted suicide and Vice Chair of the Euthanasia Prevention Coalition International, titled: Three Days in Darwin, concerning the Philip Nitschke trial.

Paul Russell
By Paul Russell

Nitschke’s defence during the Darwin appeal revolved around his claim that he was not Nigel Brayley’s doctor and had therefore no obligation to try and dissuade him from suicide and that, in his assessment, Brayley was rational in his decision.

(Nigel Brayley died by suicide, after contacting Nitschke for advice).

The Guardian framed Nitschke’s defence:
“The Medical Board claims Nitschke should have intervened when Brayley emailed Nitschke outlining his intention to end his own life. Nitschke’s lawyers maintain he was never Brayley’s doctor, did not counsel him, and that the suspension was based on the board’s dislike of his views and work on voluntary euthanasia.” 
“Nugent (Nitschke’s defence counsel) said in his opening submission that the case was about “the dangerous idea [of] whether a person who is contemplating rational suicide ought to be required by a medical doctor not to do so”. 
“He said the tribunal needed to consider if there was such a concept as rational suicide, and if it accepted that, then what it meant for a doctor’s professional obligations to a person who was not their patient. 
“What – if any – duty does a person who is a doctor but not in a doctor-patient relationship, owe that person?” said Nugent. 
“As a matter of law and logic … it depends on whether the [suicidal] ideation is rational or irrational,” he said. “It’s clear from the material that Mr Brayley was contemplating a rational suicide.”
Counsel for the Medical Board, Lisa Chapman, countered, claiming that Nitschke ‘misses the point’:
“One thing on which Mr Nitschke has remained consistent is that he obtained scant info about Mr Brayley before Mr Brayley died,” she said. 
She said any attempt by Nitschke to diagnose Brayley posthumously based on information he had since received was leading the tribunal down a path that was not the focus of the hearing. 
“Today is not a debate about voluntary euthanasia … or rational suicide. It’s not a debate about the role of the medical profession in regard to voluntary euthanasia or rational suicide,” Chapman said. 
“This is a very precisely focused interim hearing in regard to Mr Nitschke’s conduct regarding Mr Brayley.” 
“That’s why it’s so important. He did nothing.” 
Chapman said it was important to understand the level at which Dr Nitschke provided advice to people and the likelihood that his conduct would occur again. 
“Namely, failing to respond to that clear intention of suicide by a middle-aged man with no terminal illness, other than saying [in an emailed reply]: ‘I look forward to receiving your final statement’.”
Chapman made it clear that the Medical Board’s actions were not about the issue of euthanasia and assisted suicide. This seems to be a comment designed to ensure that neither the AMA (which opposes euthanasia and assisted suicide) nor the Medical Board are acting out a political agenda. ...

There is no escaping the question of vulnerability and the effect that mental illness and depression has on the ability of individuals to make a rational judgement that is totally absent anything that might distort their judgement or compel them towards the finality of suicide or euthanasia.

It has been revealed that Nigel Brayley’s main stated reason for wanting to suicide was ‘the ongoing harassment of the WA police, crimes squad and…one particular detective’ over his wife’s death, says The Guardian. Brayley was being investigated over the death of his wife and there were suggestions that he may have also had some involvement in an earlier death. Brayley’s reasoning would naturally have involved a significant fear of incarceration and humiliation. In September Nitschke himself advocated for assisted suicide provisions for prisoners facing long-term incarceration, suggesting that a jail term was the, ‘equivalent to torture’.

The question remains about how Nitschke or anyone else for that matter can come to a determination that a request for suicide or euthanasia is entirely ‘rational’. This raises additional concerns for suicide prevention where the very idea that someone might be able to make a rational decision to suicide could act upon a suicidal person in such a way as to diminish whatever reservations that might remain about their course of action. As I observed in July when this matter first surfaced, will we now need to end media stories, like this one, with an additional caution to the usual helpline advice: ‘but if you’re rational, call Exit International’?

Nitschke defended his view about ‘rational’ suicide by claiming that the Medical Board was operating from a kind of paternalism:

"The board's view is based on the simple premise that the doctor knows best," he said.

It may have escaped Mr Nitschke, but there’s a deep irony here: hasn’t he simply replaced ‘doctor knows best’ with ‘former doctor knows best’?

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