Suicide Implants and Pods: Quandaries of ‘Choice’ at the End of Life

COMMENTARY: The entire logic of “choice” in connection with euthanasia requires more flexibility than an Olympic gymnast.

Sarco, a device created for euthanasia invented by Philip Nitschke.
Sarco, a device created for euthanasia invented by Philip Nitschke. (photo: Ratel / CC BY-SA 4.0)

Philip Nitschke, the Australian proponent of euthanasia, wants to be the Thomas Edison of euthanasia. He’s busy inventing new ways to kill yourself.

Two of Nitschke’s latest inventions are the “pod” and a suicide implant.

The pod, called “Sarco,” looks like a small spaceship or cockpit. A person gets in, closes the hatch, and switches it on. Oxygen is pumped out, nitrogen flows in, causing death.

According to The New York Times, Nitschke designed Sarco because he wants to make euthanasia totally autonomous. In most places where euthanasia is legal, it takes the form of “physician-assisted” killing, i.e., a doctor providing a lethal dose of some drug to the would-be suicide. Nitschke wants to cut doctors out of the picture and make suicide a solo job.

Reasons for that vary. Real physicians have moral objections to killing, and so have had to be dragooned by local law or medical bodies into “assisting” in “medical-aid-in-dying.” Others may be less ethically squeamish but more litigation averse. Some are concerned about the “social justice” side of the problem: People not living in euthanasia-friendly locales have their “right to die” abridged. Finally, for real believers like Nitschke, the issue is ideological: Suicide is the ultimate personal choice, and he wants no other factors interfering with it.

But even euthanasia advocates have second thoughts about Sarco. What if somebody inadvertently gets trapped in a pod, like a baby or an incompetent person? Nitschke insists he has built-in safeguards: You have to sign in vocally and orally acknowledge the legal disclaimer read to you before the machine turns on. (The machine also films your death, in case there are any questions). But we all know programs fail.

Other euthanasia proponents don’t like the isolation of the person killing himself. One pro-death group, Life Circle (which identifies “Catholics” as “enemies”) dislikes Sarco because “there is no human warmth with this method.”  

Nitschke hopes to market Sarco in Switzerland, where pro-euthanasia laws are relatively permissive. His aim is to make Sarco plans available so that anybody with a 3D printer can produce his own death pod.

Just in case you think Nitschke plans on kicking back and relaxing after his “pod,” Britain’s Independent reports he’s now talking about an automatic implant to cause death at a fixed future point. The device would be implanted and preset to trigger at a scheduled future date. 

The rationale for the device? It also places the doctor more remotely to the actual suicide (though, unlike the self-printable pod, one would seem to require the need for some sort of medical technician to place the implant). His driving force, however, is to ensure that people don’t short-circuit someone’s stated desire to kill himself.

Nitschke fears that a person who has previously declared an intention to die but then is overcome with degenerative brain disease would have that wish frustrated by family or physicians that ignore a stated will-to-die or determine the patient is no longer capable of making such decisions. Nitschke even suggests that the implant have a regular warning device that requires the person to shut it off in order to establish a track record of intended suicide that would not then be impaired If the person lost his mental capacities. 

The Australian admits the implant is only on the drawing board. He admits there are technical barriers to overcome. But the idea’s there. And the parallels to abortion are eerie.

When Roe was first decided, Justice Harry Blackmun structured abortion around a decision of a woman in consultation with her physician (who, obviously, often found nonmedical reasons for abortion). 

Pro-abortion advocates always found the medical caveat as interfering with the pure, pristine “right” of “my body, my choice” and the physician’s role found downgraded when Casey reconstructed Roe. Since then, pro-abortionists have argued that states cannot restrict abortions because it further limits doctors willing to perform them. They’ve pushed for mandatory abortion training in medical school. And they pin hopes on abortion pills that can be disseminated across state lines and push doctors further out of the picture.

Nitschke clearly hopes Sarco will overcome jurisdictional restrictions on euthanasia by making your personal death pod as near as the internet and a 3D printer. (Will Facebook, Amazon or Twitter restrict access? Will we have options, like gassing, followed by alkaline hydrolysis and flush for the ecologically minded?)

Bypassing restrictions would please LifeCircle. The group is concerned Switzerland gets a bad reputation for “death tourism.” LifeCircle’s solution? If everybody legalized suicide, nobody would have to travel for it.

Nitschke would avoid the problem of legalization: He would just use the global marketplace to bypass local restrictions, knowing full well there will be a sufficient mass of local advocates to facilitate such circumvention.

Of course, the entire logic of “choice” in connection with euthanasia requires more flexibility than Simone Biles. The New York Times’ article about Sarco or the Independent on suicide implants is couched in the language of “choice” but includes a disclaimer at the bottom telling the reader to get help if you are suicidal. So, is suicide good or not?

LifeCircle wants “human warmth” while you kill yourself, i.e., social approval and blessing. But, over in Germany, the same folks that want a warm-and-cuddly death for you don’t want to risk it themselves: According to the Verein Sterbehilfe, the German Euthanasia Association, no COVID shot, no suicide. We don’t want our helpers going your way.

Whatever happens in the Supreme Court’s abortion case, Mississippi v. Jackson Women’s Health, the pressure for euthanasia will also likely grow, especially in aging societies. The process will likely be pushed amidst confusion about “choice” — choice of medical practitioners not to kill, “choice” of a person voiced long ago and under different conditions, choices of family members, and the ultimate contradiction: “choice” that excludes all future choices (but makes an eternal one).