“I understand [technology] as important in democratizing the process and demedicalizing it,” says Nitschke, adding that Sarco’s work does not depend on highly restricted drugs. “So all of these issues are ways to make the process fairer.”
In Switzerland, where Sarco was used, Nitschke’s arguments about access to assisted suicide were not particularly radical. Residents and visitors now have access to assisted suicide, even if they are not terminally ill. But in Nitschke’s home country of the Netherlands, Sarco reflects an ongoing debate about the place of assisted suicide in a medical system that dictates that only people facing excruciating suffering or an incurable condition can proceed. Nitschke also believes the promise of machines is to take the burden off the doctor. “I’m passionate about a person’s right to have access to assisted dying, but I don’t see why they should turn me into a murderer,” says Nitschke, who received his medical degree in 1989.
Theo Boer, who spent nine years evaluating thousands of cases of assisted suicide on behalf of the Dutch government, disagrees that guards are a bad thing. “We can’t just leave this on the market,” he says, “because it’s dangerous.” Still, he’s more sympathetic to Nitschke’s point that doctors shouldn’t be burdened with emotional distress in countries where assisted suicide it is legal. “Although what it does is strange, it contributes to a much-needed discussion in the Netherlands about whether or not we need this serious involvement of doctors,” says Boer, who is now a professor of health ethics at the Theological University of Groningen.
“We can’t burden the doctor with solving all our problems,” he says.
For three decades, Nietzsche was an agitator in the debate on the right to die. “He’s a provocateur,” says Michael Cholby, professor of philosophy at the University of Edinburgh and founder of the International Association for the Philosophy of Death and Dying. Cholby is skeptical about whether Sarco will ever normalize, but he believes Nitschke’s creation, even if it may seem irresponsible to some, raises important questions. “It’s trying to catalyze a perhaps difficult conversation about people’s right to access suicide technology,” he says.
Now 77, Nietzsche first explored the idea of delegating assisted suicide to machines in the 1990s. After Australia’s Northern Territory became the first jurisdiction in the world to legalize the process, Nitschke was preoccupied with the risk of people seeing him or his colleagues as “some evil doctor giving lethal injections to a dying patient who doesn’t know what’s going on,” he says .
