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A euthanasia device is a machine engineered to allow an individual to die quickly with minimal pain. The most common devices are those designed to help terminally ill people die by voluntary euthanasia or assisted suicide without prolonged pain. They may be operated by a second party, such as a physician, or by the person wishing to die. There is an ongoing debate on the ethics of euthanasia and the use of euthanasia devices.
Invented by Dr. Jack Kevorkian, this device involved an individual pushing a button that released drugs or chemicals that would end their own life. Two deaths were assisted by means of this device, which delivered the euthanizing drugs mechanically through an IV. Kevorkian called it a "Thanatron" or death machine (see Thanatos).
It had three canisters or bottles mounted on a metal frame, about 6 inches (150 mm) wide by 18 inches (460 mm) high. Each bottle had a syringe that connected to a single IV line in the person's arm. The first bottle contained ordinary saline, or salt water. Another contained a sleep-inducing barbiturate called sodium thiopental, and the third a lethal mixture of potassium chloride, which immediately stopped the heart, and pancuronium bromide, a paralytic medication to prevent spasms during the dying process. (These are the three drugs administered in the lethal injection execution protocol, but in the execution protocol, the pancuronium bromide is administered before the potassium chloride.)
- Kevorkian or an assistant begins the saline solution flow.
- The person who wants to die must deliver the barbiturates by throwing a switch, pushing a button or pulling a string.
- After that, either a timer or a mechanical device triggered by the person's falling arm as the drugs take effect starts the lethal drug flowing. The idea is for the deadly chemicals to enter the bloodstream only after the person is asleep. Death usually occurred within two minutes.
Kevorkian assisted others with a device that employed a gas mask fed by a canister of carbon monoxide which was called "Mercitron" (mercy machine). This became necessary because Kevorkian's medical license had been revoked after the first two deaths, and he could no longer have legal access to the substances required for the "Thanatron". It was a rudimentary device consisting of a canister of carbon monoxide attached to a face mask with a tube. A valve must be released to start the gas flowing. Depending on the person's disability, a makeshift handle may be attached to the valve to make it easier to turn. Or, with the valve in the "open" position, a clip or clothespin could be clamped on the tubing. Pulling it off allows the gas to flow. By Kevorkian's estimates, this method took 10 minutes or longer. Sometimes he encouraged people to take sedatives or muscle relaxants to keep them calm as they breathed deeply of the gas.
Carbon monoxide is hazardous to others who may discover the body (family, medical workers, police).
The Deliverance Machine was invented by Dr. Philip Nitschke. Software—titled Deliverance—on a notebook computer asked a patient a series of questions intended to confirm their intent to die. If the patient answered affirmatively to all of the questions, the injection of a lethal amount of barbiturates was triggered.
The following three questions were displayed on the laptop screen; each required the patient to click a "Yes" button to proceed:
- Are you aware that if you go ahead to the last screen and press the "Yes" button, you will be given a lethal dose of medications and die?
- Are you certain you understand that if you proceed and press the "Yes" button on the next screen that you will die?
- In 15 seconds you will be given a lethal injection ... press “Yes” to proceed.
In an interview, Nitschke gave several reasons for developing the machine. Even if it had been legal for a doctor to give a lethal injection, Nitschke preferred that the patient be in control of the administration of the drugs. The Deliverance Machine also allowed a patient to be alone with their family during the euthanasia process, by reducing the role of a physician in it.
Exit International's euthanasia device
The Exit International euthanasia device was invented by Dr Philip Nitschke in 2008. It uses a canister of nitrogen, a plastic suicide bag, and a plastic tube with one end attached to the gas canister and the other fixed inside the bag by a tie held by adhesive tape. Inhaling the pure nitrogen, patients lose consciousness immediately (in approximately 12 seconds) and die a few minutes later. Dr Nitschke said the suicide device will prolong the lives of the terminally ill by making them feel in control of their future. "That idea of giving people access to a means of feeling that they're back in control of this issue is actually a way of prolonging life. It may seem paradoxical, but what we find is when people feel that they're back in control, they're less likely to do desperate things."
The basic principle of autoeuthanasia by anoxia was first described in the book Final Exit by Derek Humphry in 1991. The original methodology was devised, using helium, by the NuTech group — engineers, physicians, divers and others, a small number of people first assembled in 1998 under the leadership of John Hofsess, Philip Nitschke, and Derek Humphry.
In December 2008, Nitschke described the new device/method as a modification of the "Exit Bag plus helium" method described in The Peaceful Pill Handbook. Helium was replaced by a cylinder of compressed nitrogen and a regulator that supplies around 10 litres per minute into a suicide bag. This has some advantages over the helium method:
- Larger amounts of nitrogen are available and flow rates last longer.
- The gas is more physiologically inert, with no chance of adverse reaction (helium is reported to cause some twitching during death);
- If there is any leakage in the period of storage of the cylinder, it can be topped up to the recommended 2,800 kPa (400 psi). Helium party balloon cylinders cannot be refilled and must be discarded if leaks occur;
- If helium is used, new autopsy tests can detect it, unlike nitrogen.
The principle behind the effectiveness of the device is oxygen deprivation that leads to hypoxia, asphyxia and death within minutes. Deprivation of oxygen in the presence of carbon dioxide creates panic and a sense of suffocation (the hypercapnic alarm response), and struggling even when unconscious, whereas anoxia in the presence of an inert gas, like nitrogen, helium or argon, does not.
Close contact with an enclosed inert gas is lethal because it flushes oxygen from the body, but released into the open air, it quickly disperses, and is safe for others. It is neither flammable nor explosive. Close contact with the gas is achieved in Humphry's book by enclosing the head in a suicide bag — a strong, clear plastic bag of dimensions 22 by 36 inches (560 by 910 mm), secured around the neck by a strap. In all cases, the inert gas is fed into the bag by plastic tubing.
Suicides using this method are well documented in the literature. In the study Asphyxial suicide with helium and a plastic bag (Ogden et al.), the authors describe a typical case history, in which an elderly cancer sufferer used a clear plastic bag was secured over her head, an industrial refillable helium tank and a plastic hose attached to the tank valve and plastic bag. The deceased’s skin color was unremarkable, and there were no external signs of poisoning. Toxicologic examination of blood and urine for therapeutic and abused substances did not reveal data of significance. The study notes that when a person breathes inside a plastic bag filled with helium, unconsciousness will occur almost immediately, and death will ensue in minutes.
- Risser, D; Bönsch, A; Schneider, B (1995). "Should coroners be able to recognize unintentional carbon monoxide-related deaths immediately at the death scene?". Journal of forensic sciences 40 (4): 596–8. PMID 7595295.
- "Death by Computer - WSJ.com". online.wsj.com. Retrieved 2009-01-06.
- Bauer-Maglin, Nan; Donna Marie Perry (2010). Final Acts: Death, Dying, and the Choices We Make. Rutgers University Press. p. 275. ISBN 9780813546285.
- http://www.nationalreview.com/interrogatory/interrogatory060501.shtml Euthanasia Sets Sail An interview with Philip Nitschke, the other “Dr. Death.” By Kathryn Jean Lopez, NR associate editor June 5, 2001
- Wheatley, Kim (2008-12-16). "AdelaideNow... New death device to be launched in Adelaide". www.news.com.au. Retrieved 2008-12-19.
- Nitschke (MD), Philip; Fiona Stewart (MD) (2007). The Peaceful Pill eHandbook. USA: Exit International. p. 51. ISBN 0-9788788-2-5.
- Goldfrank, Lewis; Neal Flomenbaum; Robert S. Hoffman; Mary Ann Howland; Neal A. Lewin; Lewis S. Nelson (2006). Goldfrank's Toxicologic Emergencies. McGraw-Hill Professional. p. 1675. ISBN 0-07-136001-8.
- "Nitschke's suicide machine slammed - ABC News (Australian Broadcasting Corporation)". www.abc.net.au. Retrieved 2008-12-19.
- Humphry, Derek (1991). Final Exit: the Practicalities of Self-Deliverance and Assisted Suicide for the Dying. New York: Delta Trade Paperback. ISBN 0-385-33653-5.
- "The many ways to hasten death". World Federation of Right to Die Societies. Retrieved 2008-12-26.
- "Test detects suicides from natural deaths - ABC News (Australian Broadcasting Corporation)". www.abc.net.au. Retrieved 2010-01-15.
- Humphry, D. 1991: "...a small strap, which reaches around the neck and can be fastened with Velcro at either end, or strong ribbon, which goes around the neck with Velcro sewn into the ends, or even ties easily into a knot. Large rubber bands or panty hose firmly but not harshly around the neck will do. It does not have to be completely airtight"
- Ogden, Russel D.; Wooten, Rae H. (September 2002). "Asphyxial Suicide with Helium and a Plastic Bag". American Journal of Forensic Medicine & Pathology 23 (3): 234–7. doi:10.1097/01.PAF.0000022963.33157.9B. PMID 12198347.