Portents of death take many forms, but an Australian doctor in a Hawaiian shirt is probably not one you'd immediately expect. However, with his "Deliverance Machine" in tow and a lab coat over his floral prints, Dr Philip Nitschke is as real a harbinger as any scythe-wielder.
Nitschke, a voluntary euthanasia and assisted suicide activist from Australia, has become known as one of the "Dr Deaths": licensed medical professionals who support what Nitschke describes as "rational suicide" – the freedom to end your own life if you want to. Controversy surrounded Nitschke – as it has every Dr Death – following the suspension, and then return, of his medical license after the death of Nigel Brayley. But he has maintained his medical license and his strong beliefs in the ideas he teaches through his group Exit International and their series of public workshops. This August, Nitschke decided to try something slightly different to his normal international seminars: he wrote a comedy show.
"Dicing With Dr Death" had the sort of media frenzy around it any other Edinburgh Fringe stand-up would kill a man for. The show received a wide spectrum of reviews, being called "about as funny as an undertaker's convention" by The Times and "engaging and highly thought-provoking" by Threeweeks. Nitschke's controversial subject matter, and the council's attempts to prevent parts of his act, earned articles in major news outlets. Katie Hopkins even attended and volunteered to be strapped into the Deliverance Machine, a contraption designed to kill users with a cocktail of nitrogen and carbon monoxide after a series of death-affirming questions. And as MPs get set to debate the Assisted Dying Bill – which would allow doctors to help terminally ill patients end their lives in some circumstances – in the House of Commons this week, Nitschke's show couldn't have been more timely.
This isn't your standard comedy show, and Dr Nitschke was the first to say it when I sat down with him in a small, neat flat with a small, neat lawn just off Edinburgh's Botanical Gardens, before his 12th performance. "I don't know how it rates in terms of laughs-per-minute in pure comedy terms," he says. "It's about giving people information in an entertaining way." He's right: it's not a show designed to keep you laughing until you cry. Although there are some deeply funny anecdotes, such as the woman who used her affair with a vet to secure fatal medication for her dying husband, Nitschke is far more at home putting an intelligent and witty spin on the taboo of death rather than cracking gag after gag.
It's a technique, Nitschke says, that began in Exit International's workshops. "What I noticed was it's a much more successful event if one can introduce humour. And it seems to work – audiences respond well to humour about this somewhat dark issue."
Exit International have held workshops all over the world, including Glasgow and Edinburgh, and can be attended by upwards of 300 people. Another was planned for the end of the month, but has been delayed. At these workshops, according to the Exit website, the first hour-and-a-half is a discussion of the history of voluntary euthanasia. This is followed by a closed workshop for a more detailed look at how best to go about finding the right resources for ending your life.
These crowds seem to match a rise in the number of people travelling abroad to seek help with dying in facilities like Dignitas in Switzerland. A study released last year in the Journal of Medical Ethics revealed that not only have the numbers doubled from 2009 to 2012, but that only Germans are more active in seeking assistance to die than Brits. It is, however, worth noting that Dignitas is only one of the options Nitschke suggests for ending your life, alongside the lethal barbiturates Nembutal or Lethabarb. Nitschke's teachings have a particular focus on nations like Britain, America and Australia, because he wants to dispel the idea he considers central to Western medicinal practice: that, as he says, "the holy grail is, in effect, immortality".
"The groups of people I've been talking to in these workshops over the years have a certain cynicism towards medicine and this idea of prolonging life at all costs," explained Nitschke, who takes exception to the idea death should be something so feared. "We partition [death] away from children, and the age at which somebody sees their first dead body goes up every year," he said, comparing it to his experiences working with Australian aboriginal communities, where death is far more mundane.
Although he has sometimes done talks in places that are not entirely in the Western medical tradition – one in Hong Kong, screened in China, and discussions in Singapore and the UAE – his audiences even then are Westernised. "If you move [my workshops] into aboriginal culture, say," Nitschke said, "there would be no interest."
The move to comedy was partially inspired by talks with Mel Moon, a comedian with an incurable illness who previously approached Exit International, and a discussion she and Nitschke had about a collaboration. It ended, she said, because "he wanted to focus on the death side of things, but [Nitschke and his partner] didn't want to focus on life". Although she believes no nationality escapes a morbid fascination with death, Britons might be particularly tightly-laced when it comes to rational suicide. That said, discussions in the House of Lords concerning Lord Falconer's assisted suicide bill in 2014 showed an even amount of support and opposition, and surveys in the last five years show the majority of people support legalisation.
Moon says she chose to do her biographical show her way because she wanted to provide "something personal to make it more palatable for people", versus Nitschke's more lecture-like format, which she respects but thinks lacks warmth.
That's the fine balancing act Nitschke attempts: humour as not just a sugaring of the peaceful pill, but as a way of deconstructing Western medicinal notions. The Fringe means a younger, perhaps less invested audience, but he still thinks it's worth dispelling the gloom for this younger demographic. "The whole effort of Western society is to distance itself from the concept of death," he said. "Even getting 20-year-olds thinking about their own deaths is not an easy matter. But when they get to thinking about it at the end of the show, at least it's crossed their minds."
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