The deaths caused uproar and much hand-wringing in America. Michigan had no law against assisted suicide at the time of Janet Adkins’ death, so there was nothing to charge Kervorkian with, although attempts were made to bring murder charges against him. Most of his patients were not terminally ill, and autopsies showed that at least five were in good physical health at the time of their death. The thing that made Kervorkian so elusive was that it was his machines that killed his patients. Their deaths became depersonalized, no one’s responsibility. With that came the promise of a clean, controlled death, even if the mechanism used to deliver it was messy, and the decision to seek it often chaotic.
Kervorkian’s downfall only came when he left his machines at home. In 1999, he directly administered a lethal injection to Thomas Youk, a fifty-two-year-old in the final stages of motor neurone disease. Kervorkian was getting cocky: he videoed Youk’s last moments and can be heard on the tape daring the authorities to stop him from euthanizing again. They rose to the challenge and charged him with second-degree murder, and he served eight years of a ten- to twenty-five-year jail sentence when he was in his seventies. He developed liver cancer and died from a blood clot in 2011, aged eighty-three – in hospital, surrounded by doctors, without the help of any death machine.
To his supporters, Kervorkian was a hero and a renaissance man. He played jazz flute and organ, and released an album of his instrumental compositions in 1997, entitled A Very Still Life. He painted in garish oils, depicting everything from Johann Sebastian Bach to gruesome decapitated heads streaming with blood, and gave his paintings titles like Coma, Fever, Nausea and Paralysis. (Some of his canvases were auctioned after his death, with an asking price of $45,000.) He walked the red carpet with Al Pacino, who won an Emmy and a Golden Globe for his portrayal of Kervorkian in 2010’s You Don’t Know Jack. He was an attention-seeker who got the notoriety he craved.
Not content with being ‘the other Dr Death’, Philip desires an even greater legacy. By entering the field only a few years later, he has an advantage Kervorkian could only have dreamed of: instead of springs, clips and clothes pegs, Philip has computers.
* * *
Are you certain you understand that if you proceed and press the Yes button on the next screen you will die?
The words on the blue-tinged screen are centred to hover over two virtual, clickable buttons: No to the left, Yes to the right.
Click Yes, and you are taken to another screen:
In 15 seconds you will be given a lethal injection…
Press Yes to proceed.
Click Yes, and after fifteen seconds there is a rhythmic pumping sound. The screen goes black, except for one word:
Exit
This is the last word Bob Dent, Janet Mills, Bill W. and Valerie P. ever read. When they clicked the final Yes button, a lethal dose of Nembutal was delivered into their veins. They were the four people Philip helped to die in 1996 and 1997, in the nine months assisted suicide was legal for terminally ill people in the Northern Territory. Their lives were ended by Deliverance, a machine Philip invented and built, which is now in the collection of London’s Science Museum.
The screen belongs to the grey Toshiba laptop Philip also used to check his emails and surf the internet. It’s battered and grubby, already three years old in 1996. It was wired up to a small, hard-shelled, plastic suitcase lined with insulating foam. Inside the case lay a tangle of red and black wires, transparent tubes, valves, pumps, a pressure gauge and several syringes, including one large one which was connected to the very long, very sharp needle that Philip put into his patients.
Deliverance was actually the name of the software Philip had written, which he described at the time as ‘a program for subject-controlled medically-assisted suicide’, but he came to refer to the entire device as the Deliverance machine. The Rights of the Terminally Ill Act would have allowed him to administer Nembutal directly himself but, perhaps with Kervorkian firmly in his mind, he chose to design an eye-catching contraption to do it instead.
Philip held a press conference shortly after he used it for the first time on 22 September 1996. His patient – Bob – was sixty-six and terminally ill with prostate cancer. ‘We shared a meal and we shared a drink, and then he indicated that he wanted to proceed,’ Philip told the assembled journalists. Then he read out a statement from Bob: ‘My own pain is made worse by watching my wife suffering as she cares for me, bathing me, drying me, cleaning up after my accidents in the middle of the night and watching my life fade away.’ Bob’s death wasn’t just about Bob; it was about the burden Bob had become as he lost control of himself.
The other deaths followed quickly. Janet, fifty-two, had a rare and disfiguring form of skin cancer and had been given nine months to live. Bill was sixty-nine and had terminal stomach cancer. Valerie, seventy, had breast cancer; her death was Philip’s last legal assisted suicide, and his most controversial – by her own admission, Valerie had had good palliative care and was suffering ‘no symptoms’, but he helped her die anyway.
Philip has posted an interview of himself on his Vimeo page, filmed a few years after the law was overturned. He sits at his desk in a light blue Hawaiian shirt festooned with bright palm trees, unbuttoned to reveal a smattering of greying chest hair. He is reminiscing about his time using Deliverance, in front of a wall plastered with newspaper headlines about him.
‘I felt the responsibility weighing pretty heavily on my shoulders,’ he says. ‘I would go around there, had my little case, had the machine, you couldn’t just forget something and say you had to go home, or “Can we do it tomorrow?” or something. People had decided that was the day they were going to die. I had to, in a sense, make that come true. I had to make it possible, make it work. And the expectation I found almost crippling.’
Philip didn’t relish assisting suicide the way Kervorkian seemed to. He did not want the responsibility of making sure it all worked when the time came. Using a computer on his patient’s lap, instead of a syringe between his own fingers, allowed him some kind of distance from the act he was committing, but it wasn’t enough. Lesley’s words from the Exit meeting echo in my head: I wouldn’t recommend it. I would recommend that you do it yourself.
Philip’s next inventions allowed Exit members to do just that. Launched in December 2002, the CoGen machine was a carbon monoxide generator consisting of a canister, an intravenous drip bag and nasal prongs to inhale the gas. Strong but commonly available acids were combined within the canister to produce carbon monoxide, killing whoever inhaled it in only one or two breaths, Philip promised. At Exit meetings, Philip swore anyone could make it using a Vegemite jar and materials you could buy legally for around $50. ‘It’s not rocket science,’ he told the Sydney Morning Herald at the time. ‘Anyone who has done high school chemistry can build one of these machines.’ But no one is ever reported to have died using the CoGen. Messing about with strong acids is dangerous. Carbon monoxide is a poison, and anyone planning to kill themselves this way might easily kill whoever found their body, too.
When the CoGen failed to take off, Philip developed the infamous Exit Bag, which was supposed to require even less scientific wherewithal, and uses oxygen deprivation rather than poison to kill you. But there cannot be an ick factor greater than the one generated by the idea of spending your final moments suffocating inside a plastic bag. Philip knew even then that the Exit Bag made people squirm. Neither of these devices could top the Deliverance machine, with its high-tech allure, its neatness, its stability. Software seemed to confer a certain dignity on proceedings that simple chemistry and mechanics could not.
* * *
In July 2015, eight months after I met Lesley at the Exit meeting in Covent Garden, Philip emails me to say he’s coming to London. We finally meet in the chic Airbnb he is renting in Hackney. Sumptuous oil paintings in gold frames cover the walls; there are white wooden shutters on the windows and whitewashed floorboards. He’s in green shorts and another of his trademark su
mmer shirts, brash against the impeccably tasteful white sofa.
His wife, Fiona, is trying to keep their beloved and overweight Jack Russell, Henny Penny, from disturbing us, but I’m feeling unsettled anyway. My mind races with thoughts of all the people who have died because of the man with bare knees next to me. There is no way he could quantify them, even if he wanted to. And there is something mercurial about Philip that is even more striking in person, an aloofness that makes me feel like I have to get every answer I can from him during these few moments I have in his presence, as if he’s going to disappear into the ether soon, or decide he doesn’t want to talk to me again.
Plus, Philip has strange reasons for being in the UK this time. He’s gearing up for a one-man stand-up comedy show at the Edinburgh Fringe Festival. He’s calling it Dicing with Dr Death. He’s bursting to tell me all about it.
‘Twenty days in a row, with one night off, running from six to seven, at a very nice venue called The Caves – home, it turns out, of the notorious killers Burke and Hare, the body snatchers who used to feed corpses to the Edinburgh medical school,’ he says, like a carnival barker. ‘A nice nexus there between crime, death and medical schools, which I will certainly be drawing upon.’
I hadn’t really pegged Philip as a comedian. He definitely knows how to put on a show: his workshops and press conferences all seem to have been performances, to an extent, and yes, comedy resides in the darkest of places. But Philip? Funny? I’m not sure. There are practical reasons for this career shift, of course: Philip’s medical licence is still suspended. Exit members have donated $250,000 to his legal fund, but the case remains ongoing.
He isn’t bothered. ‘It’s an indication of authority. If you’re getting information out which is so accurate that the state decides to deregister you, people will know that’s good information.’
‘So it’s given you clout?’
‘It has given me status.’
The comedy show will be a way of giving suicide advice, he tells me, in a climate probably too hot for him to hold his usual annual London workshop. Audience members will sign some kind of disclaimer before the show starts, but Philip has no way of checking they really are of sound mind.
His act will have an unforgettable centrepiece. It’s called Destiny. ‘After much research and development over the years, we’ve finally got a machine which will allow a person to take their own life quite easily,’ he enthuses. ‘I will show the audience that this is the way of the future.’
Destiny is set up on a table to our left. Philip has been calling it ‘Son of Deliverance’ on Twitter, but it’s more like the love child of Deliverance and the Mercitron: Philip developed it after discussions with Neal Nicol, Kervorkian’s long-time friend and associate, and it uses the same compressed carbon monoxide/nitrogen mixture used in the Mercitron. Destiny consists of a familiar hard-shelled, plastic suitcase lined with insulating foam, containing a small black Raspberry Pi microprocessor, connected to a canister of Max Dog-branded gas and some nasal prongs. The microprocessor can be operated using a smartphone app or any HDMI screen, and it asks identical questions to the Deliverance software (the words ‘lethal injection’ are replaced by ‘lethal gas’). There’s also a finger cuff to measure the heart rate and oxygen saturation of the person using it; when these both drop to zero, the microprocessor turns the gas off. The prototype has been paid for out of targeted donations from Exit members keen to try the device themselves, Philip tells me. The death machine has truly entered the crowdfunding/smartphone age.
‘A member of the audience will come up and try the machine – not using the gas that the real machine will use, using an innocent enough gas – but they will see all of the process. When they press that button, they will feel that the gas will start to flow, and that their heart rate starts to falter. It will be interesting.’
Philip says Destiny will be available to Exit members and The Peaceful Pill eHandbook subscribers for £200 once his Edinburgh run is finished. All the component parts are legal, but they will have to be bought separately: the app and microprocessor from Exit, the nitrogen from Max Dog, and the nasal prongs from anywhere you like (you can get a set for just over a quid on Amazon). Just like the Exit Bag, assembly looks likely to be a costly and bewildering process, but one with enough legal loopholes to protect the man who designed it.
‘The law is flat out trying to keep up with what’s happening with technology. It’s like trying to shut the stable door after the horse has well and truly bolted. It may well be that those much talked about changes to legislation will come in. But it won’t affect the growth of Exit.’
When the Edinburgh reviews come out a few weeks later, they are mixed. The Daily Telegraph gives it one star. ‘Witlessly infantile,’ its critic says. ‘The most lamentable slab of self-publicity masquerading as a bona fide show.’ This doesn’t stop Philip taking an ‘Australianized’ version of the show to the Melbourne Comedy Festival. The Sydney Morning Herald critic likes it a little bit more, giving it two and a half stars. ‘Laughs were sparing,’ he writes.
It is not enough for Philip to give up his day job, but he does that anyway. When the Medical Board of Australia announces it will remove his suspension to practice, Philip calls a press conference and sets fire to his newly reinstated medical licence in front of the assembled cameras. ‘Today, and with considerable sadness, I announce the end of that twenty-five-year medical career,’ he declares. Within a few months he has left Australia for good, for a new life in the Netherlands.
* * *
It is four years before I see Philip again. My messages remain unanswered, my calls ignored. But I’m still on the Exit mailing list, so every few weeks I get an email warning me about suspect Nembutal bought from unapproved sources, unfair fees at Dignitas, how progressive the Netherlands is compared to Australia, and forthcoming Exit meetings. Lesley has been replaced as Exit’s UK coordinator and appears to have fallen off the radar. So has the Destiny machine: after all the fanfare and press coverage that accompanied its Edinburgh debut there is little mention of Destiny afterwards, and certainly no invitation for members to purchase it.
But then an email arrives calling for proposals to be delivered at a conference Philip is convening in Toronto. It’s called NuTech, and it will ‘bring together experts from around the world to discuss new technological initiatives to make easier a peaceful elective DIY death’. NuTech is nothing new – it was founded in 1999 by Philip and the euthanasia campaigners Derek Humphry, Rob Neils and John Hofsess, and has taken place every few years ever since – but it has always been an invitation-only event: you have to be a right to die advocate, doctor, pharmacist or engineer to attend. This year is the first time parts of the conference will be live-streamed on the internet. And, also for the first time, there will be a competition to find the very best death machine. ‘A $5,000 cash prize has been established – made possible by a generous bequest to Exit International – to an innovative proposal that advances the use of technology in a DIY peaceful, reliable solution,’ the email reads.
Over the coming months, details begin to emerge about the proposals they’ll discuss at NuTech. There’s a monstrous-looking contraption called the ReBreather-DeBreather, designed by an American team, which is a padded mask connected to corrugated tubes that go into a blue wheelie suitcase. There’s the equally ugly Australian GULPS Monoxide Generator – a small oxygen mask connected to a jerry can and some jars containing formic and sulphuric acid. (It’s clearly inspired by the CoGen, and comes with the same problems associated with carbon monoxide poisoning and strong acids.) There’s even a ‘euthanasia rollercoaster’, designed by the Lithuanian engineer and artist Julijonas Urbonas, which would kill its passengers ‘with elegance and euphoria’ by exposing them to extreme G-force for one minute, over seven loop-the-loops.
Then something lands in my inbox a week before the Toronto conference, and I finally understand what Philip has been up to in the Netherlands, and why he suddenly wants to
open NuTech up to the public. It’s a press release, entitled ‘Canadian launch of world-first 3D Printed Euthanasia Machine’. Philip has a new device to unveil. He’s calling it Sarco. And it makes every death machine ever invented to date look like a joke.
‘Developed in the Netherlands by Exit Director Dr Philip Nitschke and Engineer Alexander Bannink, the machine was designed so that it can be 3D printed and assembled in any location,’ it reads. ‘On reclining in the capsule, activation uses liquid nitrogen to rapidly drop the oxygen level, and a peaceful death will result in just a few minutes. The capsule can then be detached from the Sarco machine and used as a coffin.’ Sarco is a sarcophagus: the coffin that will kill you.
There are some concept pictures of a pearly-white Sarco on an empty beach, angled towards the sunrise, bathed in golden rays. This is no Heath Robinson or Rube Goldberg machine, cobbled together from spare parts. Sarco looks like a vehicle worthy of James Bond or Batman, a spaceship that will transport its user into the next dimension. The capsule is long, curved and opalescent like a mussel shell, tilted and slightly asymmetrical, with a brown-tinted transparent window. Sarco is glamorous. In the next Exit newsletter, Philip says it promises ‘a peaceful, even euphoric death’ with ‘style and elegance’.
If the Deliverance and Thanatron machines separated death from the person who was assisting it, Sarco is the device that does away with assisted suicide altogether. If you download a death machine and kill yourself with it, how accountable can anyone else really be? Philip won’t have to ship anything at all. He will be completely removed from the people who use his invention. As he writes in the Exit newsletter, ‘No need to break the law. No need to import hard to get drugs over the internet. No doctor required.’
Sex Robots and Vegan Meat Page 27