I’ve arrived forty-five minutes early and already fifty of the folding chairs are taken. No one can tell me for sure how many British members there are, but Exit HQ estimates there are probably about 1,000, and whenever Philip travels to the UK to give his practical suicide workshops as many as 200 people pay to come to see him. Philip is on the other side of the world today, but he’s very much the most powerful person in the room. There’s a trestle table with books for sale, all written by Philip. There’s his autobiography, Damned If I Do, for £25; his first book, a philosophical treatise entitled Killing Me Softly, for £22; and The Peaceful Pill Handbook, his practical guide to different suicide methods, for £20 – although Exit recommends you take out a two-year subscription to the regularly updated online eHandbook, for £67.50. You can fill in a green form to order nitrogen from one of Philip’s companies, a key component of one of his recommended methods. Each cylinder costs £465. That’s on top of membership fees, which start at £62 a year.
But the people in the audience look like they can afford these prices. They are a noticeably homogenous group: white, middle class, equally split between male and female. They are what Philip calls ‘baby-boomer types who are used to getting their own way’ – retired professionals, educated and independent; lively, animated, and afraid of what a life prolonged by modern medicine might mean for them. Several are already filling in the nitrogen order forms.
I take a seat on the end of the front row. The meeting hall doubles as a dance rehearsal space and there’s a large mirror at one end of the room. People try to avoid staring at their own reflections as they wait for Lesley to begin.
In an old pair of Converse, a purple checked shirt and glasses, Lesley is a reluctant master of ceremonies. She is sixty-four, a mother and grandmother, and until two months ago she made her living designing cake-decorating tools. (Her website is full of mesmerizing videos of her piping perfect rows of royal icing pearls onto fondant-covered wedding cake tiers.) When she accepted the Exit job she was supposed to be answering the phones for five hours a week, but they never stopped ringing, so it soon became four days of paid work. In practice, she’s working seven days a week, her cakes neglected.
She’s printed a handout from her home computer with the agenda for today’s discussion. It’s decorated with cartoon images of a man in a hard hat lugging a green gas canister, a Jack Russell dog in sunglasses with a Martini glass in his paw, and four multicoloured pills with arms and legs who are holding hands and dancing.
As soon as she takes the floor it’s clear that no one cares about the agenda Lesley has prepared. Hands shoot up, and all anyone wants to know is where they can buy Nembutal, the barbiturate pentobarbital that has achieved almost mythical status in these circles. Almost every suicide method imaginable is either painful, or unreliable, or undignified, or prolonged, or puts innocent bystanders in danger. Nembutal is the only thing that comes anywhere near to fulfilling the fantasy of sending a person to ‘sleep’. It’s the solution that patients drink at Dignitas, the overdose that killed Marilyn Monroe, the injection your dog gets when it’s put down, and the one-time drug of choice for death row executions, until the Danish pharmaceutical company, Lundbeck, who manufactures it, stopped supplying American prisons in 2011.
There are large quantities of Nembutal within a few miles of wherever you are now, in every vet’s practice, but it’s a controlled substance, illegal to sell or possess privately almost everywhere in the world. You risk a prison sentence if you are caught buying it, and every year people who have never broken the law in their lives before are arrested for Nembutal possession. In April 2016, police raided the Devon cottage of Avril Henry, an eighty-one-year-old retired academic and Exit member, after a tip-off from Interpol. They seized what they thought was her stash of Nembutal, but they only found half. Avril drank the rest a couple of days later, fearing they would return and take that too, dying earlier than she had ever intended.
A year ago, Lesley gave a glass of Nembutal to her best friend, who had been living with multiple sclerosis for twenty-seven years, and watched her die after taking it.
‘We had a Plan A and a Plan B,’ Lesley tells the audience. ‘I wouldn’t let her down. I know she would be eternally grateful, and I certainly am that I found Philip and Exit.’
Plan A worked, but it wasn’t easy. Instead of being the elixir of the perfect death, Lesley says Nembutal was grimmer and slower than expected. She doesn’t go into details, but it sounds like this was not a good way to go. And Lesley’s life was turned upside down by assisting her friend’s death.
‘I wouldn’t recommend it,’ she says simply. ‘I would recommend that you do it yourself.’
In theory, you can order Nembutal online from shady vets in Latin America, China and South-East Asia who don’t ask questions, and The Peaceful Pill eHandbook keeps members updated on the current most promising regions. I try to imagine the ladies and gentlemen here buying bitcoin and surfing the dark web and I can’t quite manage it. But many have already tried. When a woman in a pink pashmina brings up the problems she’s been having with some previously amenable suppliers, there’s a loud murmur of agreement. Trusted sources seem to be drying up. Nembutal isn’t the solution it’s supposed to be.
So Lesley talks us through Plan B: the Exit Bag. I’ll spare you the precise details of what that is exactly, save to say it involves entirely legal components – a plastic bag, some tubing, a nitrogen cylinder and a few other things – and it sounds appalling.
There’s one of the £465 cylinders of compressed nitrogen behind Lesley – grey, with a green diamond. It comes from Max Dog, a company Philip set up ostensibly to supply gases for people who want to brew their own beer, but a legal disclaimer on the Max Dog website says its products are only for those aged fifty and over who have never been diagnosed with a mental disorder. Max Dog regulators, which allow customers to control the flow of gas out of the canister, are sold separately. They cost £325 each.
‘If you fill in the form, will it all be delivered to you?’ asks a man with spectacles on a string around his neck.
‘No,’ Lesley says carefully. ‘You have to buy all the parts separately and assemble it yourself.’
She knows very well that Exit can’t provide people with a complete suicide kit, but it looks like you’ll need a chemistry degree to put it together.
‘Can you get any of it cheaper elsewhere?’ asks another man, staring at the prices on the green leaflet.
‘You can, if you want to cut off the lifeblood of Exit,’ Lesley answers coolly. ‘Anyone can buy the component parts in the UK, but if we don’t support Exit they are going to go under. With Max Dog, you don’t need a backstory.’ A ripple of nods flows through the audience.
Lesley hands some bits of the kit around the audience for people to play with. It’s all very jolly. They weigh up the heaviness of the metal regulator. Someone passes a bit of flaccid tubing to the woman beside him and they giggle awkwardly at each other.
As I watch them breaking the ice with their pieces of suicide equipment, all I can think is, Has it really come to this? Are people so desperate to be in control of their deaths that they are prepared to die this way – and be found this way, alone and cold, with their head inside a bag? How can this be considered a ‘good’ death, a ‘better’ way to go? The alternative option – Nembutal – means that people who would never dream of going near illegal drugs would have to become drug traffickers, shelling out hundreds of pounds into the ether in the hope that whatever they are sent, if it arrives at all, is actually what it’s supposed to be, and that Interpol won’t break down their door if it is. How can the desire to have a ‘good’ death have led to these strategies?
British people don’t have the right to die. ‘Self-murder’ became a crime under English common law in the mid-thirteenth century, and suicide was only decriminalized in 1961. Assisting another person to end their life is still a crime, and carries a maximum penalty of fourteen years in prison. In 2
015, MPs overwhelmingly rejected a bill that would have allowed people with six months or less left to live to be helped to die under the care of two doctors, even though polls show that 84 per cent of the British public want the right to die.
But across the world, the right to die is becoming enshrined in law, whether it is through voluntary euthanasia (ending someone’s life to stop their suffering, at their request), assisted dying (helping to end the life of a person with only months left to live, at their request) or assisted suicide (giving someone the means to end their own life). Switzerland has allowed assisted suicide since 1942, and around 350 British people have travelled to the Dignitas clinic in Zurich to die there. Euthanasia has been legal in the Netherlands since 2001, in Belgium since 2002 and in Luxembourg since 2008, and encompasses ‘unbearable’ mental as well as physical suffering in those countries, meaning that alcoholics and people with severe depression are included among those legally helped to die (around 4 per cent of all deaths in the Netherlands arise from euthanasia). In North America, assisted dying became legal in Oregon in 1997, in the State of Washington in 2008, and in California and Canada in 2016.
At a time when people are living longer and not necessarily better, facing an old age where they are more likely than ever to be living with chronic, painful and debilitating conditions, dementia, loss of independence and dignity, it might feel like there is a clamour for the right to die in more affluent countries, and a domino effect that means it’s going to be inevitable everywhere one day. But wherever it is legal, the right to die depends on the approval of doctors and psychiatrists. It gives the medical profession more power than ever, at a time when – from climate change to vaccinations to Brexit – ordinary people are rejecting authority and turning away from experts. Why defer to people with a few letters after their names, when you can find all you need online?
People don’t join Exit for the right to die; they are seeking total control over their own deaths. Faced with the uncertain future that comes with getting old, they don’t want to abdicate their self-determination to anyone else. Philip Nitschke is the only medical doctor prepared to hand over the control to them. No check-up, no terminal diagnosis required. Just a declaration of age, and a credit card.
The Exit UK inaugural chapter meeting winds up after a couple of hours, but it hasn’t been long enough for many of the members. There’s discussion of doing a whole-day meeting next time. ‘We could bring our own lunch,’ someone suggests. There’s applause for Lesley at the end. She’s visibly relieved that it’s over: her smile is warm and broad now, and she thanks me for coming along.
A gaggle of Exit members gathers around me, eager to share stories of what brought them here. Anne is a retired academic; she has arthritis, but she’s otherwise well. ‘I’ve had a good innings and I’ll be seventy-five in a couple of months,’ she tells me. ‘Gradually I’m being closed off, can’t do this, can’t do that, and I can see the trajectory of my life: I’ll become more of a nuisance to everybody else, and there will be more visits to hospital, more pain and unpleasantness.’
‘Do you have any experience of firearms?’ a man called Brian asks me. He’s a retired police officer, American-Irish, and eighty years old, although he looks little more than sixty. ‘About forty years ago we had one of the lads who was an officer – he put the gun in his mouth and shot himself, but he’s still alive to this day in a wheelchair.’ He shudders. Guns aren’t the solution for people who seek the perfect death. But I don’t think bags and controlled substances necessarily are either.
Christopher, a seventy-seven-year-old retired architect, wishes he could get his hands on Nembutal. ‘I’m always hoping I’ll come along and they’ll say, “Good news – it’s available from Lidl.” Or a nice gift pack from Waitrose. They never do,’ he says, deadpan.
When life expectancy was lower and infant mortality higher, death was part of life; we were confronted with it on a far too regular basis. In 1945 most deaths occurred at home, but by 1980 just 17 per cent did. We can now expect to live with barely any experience of death, until we reach an age where it looms upon us. It is more frightening than it has ever been. There is a huge market for whoever can promise a painless, dignified and controlled death. So long as they can actually deliver it.
* * *
Philip is hard to get hold of at the moment; he is busy in court in Australia, fighting for the return of his medical licence. The Medical Board of Australia used emergency powers to suspend him after a man called Nigel Brayley attended one of his workshops in Perth and later emailed Philip directly for advice. Philip didn’t know it then, but Brayley was under investigation for the possible murder of his ex-wife and the disappearance of his girlfriend. He killed himself with Chinese Nembutal before charges could be brought.
Every few years, Philip makes headlines for one reason or another. He once called for prisoners sentenced to life without parole to be given the option of killing themselves. A few years ago he announced plans for a ‘Death Ship’ that would take people on a cruise into international waters, where he could euthanize them outside of any legal jurisdiction. Nothing ever came of it, apart from publicity. Stories like this have earned him the nickname ‘Dr Death’.
The anti-euthanasia group Care Not Killing has described him as ‘an extremist and self-publicist’. Not Dead Yet, a British alliance of disabled people opposed to the right to die, say he ‘is not only playing on people’s emotions, but he is profiting from them.’ Dignity in Dying, which campaigns in favour of assisted dying, believes Philip’s workshops are ‘irresponsible and potentially dangerous’.
He’s always embraced the notoriety, but the business with Brayley might be one controversy too far for him. Even before he lost his licence Philip spent hardly any of his time treating patients in his GP practice – for years, he has been far too busy with Exit – but he needs his medical registration back. How can he be Dr Death if he isn’t a doctor?
While I try to fix a time to talk to Philip, I get messages from David. Lots of them. David had approached me as I was leaving the Exit meeting to ask for my number because he didn’t want to speak to me in front of everyone else. David isn’t his real name. He doesn’t want his three kids to know what he’s planning with Exit. None of his friends or family know. He needs someone to speak to. ‘It’s been very much a solo journey,’ he says.
David is fifty-five, separated, and living in Berkshire. He worked abroad for a decade but came back to the UK recently after he started having chronic digestive problems that no one has yet been able to diagnose. It doesn’t seem life-threatening, but it’s unpleasant enough to stop him from working.
‘The thought has come up on numerous occasions of, Wouldn’t it be easy – no, not easy, that’s the wrong word. Why bother continuing if it ain’t working?’ he tells me on the phone. ‘I believe everything is a choice, and I also see it as a choice that at any time in life you can go, “Hmmm, I don’t want to play this game anymore; I think I’ll move on.” So I got very interested in the method of doing it.’
Google brought him to Exit. ‘When I first heard about the bag, I was absolutely horrified,’ he says, ‘but when I did a little bit more research into it, it seems the most simple and straightforward.’ You breathe in nitrogen, he explains – ‘there’s no gasping or anything’ – you just pass out, and then die within a couple of minutes. With a bag over your head. Nembutal isn’t for him because he doesn’t like the idea of having to drink anti-emetic medicine beforehand to stop him from throwing it up, and he doesn’t want to rely on the Chinese suppliers that currently corner the market. ‘I have trust issues with China – you don’t know what you’re getting,’ he says.
‘There’s a Nembutal purity test kit sold by Exit, which is expensive. I have to say, anything you do buy through Exit – probably reasonably so, because they do have their expenses – is pretty damned expensive,’ he remarks. He’s worked out that you can ‘self-deliver’ most of the bag kit for a fraction of what Exit cha
rge. ‘That’s not to criticize. It’s a business, however you look at it, but I don’t for a second think they are exploiting people for profit. I guess if you want it on a plate, if you want Christmas delivered, you have to pay for it.’
It’s funny David should mention Christmas. In a marketing drive of questionable taste, Exit recently initiated a Black Friday deal offering an extra six months free for new subscribers to the eHandbook. I’ve been on their mailing list ever since my first contact with Exit HQ and every few weeks there’s a new email with offers, or cautionary tales of those who’ve gone off-message and bought things from someone Philip hasn’t sanctioned. ‘We have said it before and we will say it again. Online Nembutal Scammers are EVERYWHERE!’ one email reads. ‘If you are trying to use the open internet to buy Nembutal, you are 99.9% likely to be scammed of your money. You may be threatened & even black-mailed. The Peaceful Pill eHandbook is the only book to continually monitor what is happening online.’ In this journey into the great unknown, only the products Philip controls appear to be endorsed as reliable and safe.
But Philip’s approval is worth paying for, David thinks. ‘I see Philip Nitschke as an amazing character. He’s under an awful amount of pressure and I don’t know what drives him, but the more of his stuff that I watch, I can’t fault him.’
He pauses. ‘It’s really cool that I can actually talk to someone about this. I appreciate it.’
Finally there is relief in his voice. Up to now, David has sounded full of despair.
‘You don’t know what’s making you ill, so you don’t know if you have a terminal illness,’ I say. ‘Do you really want to be making all these preparations now?’
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