BMJ 2002;324:871 ( 13 April )
Christopher Zinn Sydney
A woman with terminal bowel cancer who reopened the euthanasia debate in Australia by going public with her plans to commit suicide may change her mind after all.
Nancy Crick, who has been experiencing chronic pain, vomiting, and diarrhoea, said she might reconsider her decision if the palliative care and pain relief treatment offered by a Queensland hospital made her life more tolerable.
The 70 year old great grandmother, an unapologetic chain smoker, has detailed her suffering and wish to die in a website, which has solicited more than 15 000 email messages of support from around the world.
On the website she wrote: "Compassionate vets will not let this [indignity and pain] happen; they gently euthanase our animals. Why then is it so unreasonable to expect compassionate doctors to do the same for human beings?"
Euthanasia advocate Dr Philip Nitschke confirmed that treatment at St Vincent’s, a private hospital on the Gold Coast, south of Brisbane, was helping with some of her worst symptoms. He said that although he would not be embarrassed if she changed her mind, he expected his critics would use it against him.
He said Mrs Crick was taking morphine and was using a fentanyl patch, a synthetic morphine, for her stomach pain from the cancer, but her vomiting and diarrhoea continued.
"She is optimistic and hopeful that this might be an ongoing thing that might lead her ultimately to receive a quality of life which is much more acceptable and certainly better than one which she would prefer to death, which has been the case prior to this," he said.
Mrs Crick, whose cancer was diagnosed three years ago, had planned to take her life later this month with 20 friends by her side.
The neighbouring Northern Territory became the first place in the world to legalise euthanasia with the Rights of the Terminally Ill Act in 1996, but the law was overturned by the federal government nine months later. Euthanasia is illegal in Queensland. Dr Nitschke said that if the treatment was not effective Mrs Crick’s suicide might be videotaped to protect from prosecution the 20 family members and friends who witness the death.
"There is a discussion among the 20 people that it might be a good idea to have some film record just to demonstrate that none actually physically assists her," he said.
Mrs Crick’s wish to commit suicide has provoked controversy. She has denied accepting money from media organisations to film her death and was angered by alleged police attempts to intercept her mail to search for the sedative Nembutal (pentobarbital), which she has publicly sought to use to take her life.
Her solicitor, Terry O’Gorman, said Mrs Crick had a legal right to possess Nembutal, which was not prohibited under the Drugs Misuse Act. But anyone who mailed her the drug to help her take her life could be legally liable.
Queensland Right to Life president Donna Purcell said Dr Nitschke was using Mrs Crick as a publicity stunt and called on the police to check whether the patient had received Nembutal, and if so how.
Dr Nitschke confirmed that the Australian Medical Association had invited
him to address its May annual conference on the euthanasia debate, an invitation
he had accepted despite resigning from the association in the mid-1990s
over the issue.
© BMJ 2002