The Peaceful Pill Handbook

Philip Nitschke and Fiona Stewart
available as a regularly updated e-book since 2008

reviewed by Mira de Vries

This controversial book is about empowerment: giving one control of his/her own life and death. The first three chapters are dedicated to explaining the need. The rest is direct, honest, and practical information, such as which means are feasible, how to access or manufacture and store them, and how to deal with legal issues. It also provides tips for matters as how to avoid Internet scams and how to open packages if you suffer from arthritis.

The authors address their readers as intelligent and responsible adults, capable of making their own decisions. They are concerned with helping those who wish to terminate their lives because of intolerable disease, pain, or disability. Nowhere in the book is suicide advocated or glorified. They argue that there is no evidence that providing information about options for terminating life leads to a rise in the suicide rate. On the contrary, knowledge, not ignorance, about one's choices promotes a longer, happier life, they state.

They experience that many of the people interested in the information they provide have no intention of using it anytime in the near future. "Far from pushing people towards suicide, establishing one's options helps people stop worrying, and get on with living better." Such people are planning for the future similarly to the way they plan by writing a will, appointing executors, and prepaying for their funeral. "For those with terminal illness, being back in control can be pretty satisfying given the adversity which surrounds."

The authors make clear that the main obstacle to self-determination at the end of life is the law. Governments treat life as state property which may be tampered with only by state-approved professionals. In those countries that have euthanasia laws, those laws, instead of empowering sick and frail people, place control in the hands of doctors tasked with establishing eligibility. Although both authors are physicians, they question whether death is a medical event, and whether the medical profession should be given the role of arbiter of who has the right to die with dignity and who does not. Euthanasia -- meaning that a physician ends his/her patient's life - is applied widely, but not acknowledged. "Known commonly as the 'doctor's loophole' slow euthanasia allows a doctor to end a patient's life by slowly increasing the amount of a pain-killing drug." Legally this is not considered euthanasia but rather pain management. "While slow euthanasia is relatively common, few doctors will ever admit their involvement." The authors repeatedly bemoan the role of psychiatrists in frustrating self-determination.

The authors also posit that the State is behaving in a way that is not only cruel, but inequitable and unjust because those with money and connections will always be better resourced and able to access restricted drugs than those who are less well off. They cite Drion, famous in the Netherlands for proposing a suicide pill, who "questioned the logic of why he, a retired judge, should not have the same ready access to a dignified death as his doctor friends." Their book, they say, intends to restore the balance. However, through no fault of theirs, this goal is not achieved. The information and methods in their book remain available only to the well-off and well-connected. Someone living on a meager pension or disability allowance will not have the financial means to travel to Mexico or Switzerland, even if his/her health will allow it. Nor is ordering a drug for hundreds of dollars through the Internet within everyone's reach. The book itself, by the way, doesn't come cheap either. While the information in it can provide a solution for a few individuals, that solution remains out of reach for most people seeking it.

The authors concur with MeTZelf about the feasibility of lifting legal restrictions on pharmaceutical products, at least the ones that concern their topic.

For further information about the subjects covered by this book, Wikipedia is a succinct but reasonable source.

Copyright MeTZelf