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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 his or her 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 muscle relaxant 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 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 This became necessary because Kevorkian's medical license had been revoked after the first two deaths, and he could no longer have legal access to the substances required for the "Thanatron".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 Philip Nitschke. It consisted of a notebook computer and software titled "Deliverance", which asks the patient a series of questions, and automatically administers a lethal injection of barbiturates if the correct answers are made.
The following three questions were displayed on the laptop screen and required the patient to click the "Yes" button in order to proceed:
In an interview, Dr. Nitschke named several reasons why he developed the machine. Even if it would have been legally possible for a doctor to administer a lethal injection, he preferred that the patient initiate the process. The machine also allowed a doctor to leave the patient with the family when the button was pushed.
The Exit International euthanasia device was invented by Dr Philip Nitschke in 2008. It used an ordinary barbecue gas bottle filled with nitrogen, a plastic suicide bag, and some plastic tubing with one end attached to the gas canister and the other fixed inside the bag by a tie held by adhesive tape. In December 2008, Nitschke released details of the euthanasia device to the media. His new device/method is a modification of the "Exit Bag plus helium" method described in The Peaceful Pill Handbook. Instead of using a pre-packaged disposable cylinder of helium, he suggested filling purchased empty LPG cylinders (rated at 3300 kPa) with compressed nitrogen and then regulating this with a jet assembly to give a flow of around 10 litres per minute into the standard plastic "Exit Bag". This equipment has some small advantages over the helium method:
Nitschke called it "flawless" and "undetectable", saying the new process uses ordinary household products available from hardware stores. Inhaling the pure nitrogen, patients lose consciousness immediately (in approximately 12 seconds) and die a few minutes later.
Nitschke said: "So it's extremely quick and there are no drugs. Importantly this doesn't fail – it's reliable, peaceful, available and with the additional benefit of undetectability." However, Nitschke commented in 2010 that if helium is used, new autopsy tests can detect it.
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. The basic principle of autoeuthanasia by anoxia was first described in the book Final Exit by Derek Humphry in 1991, although the newer technique that uses inert gases to reduce time taken to die to about five minutes was first discussed in the third edition of Humphry's book. 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. Nitschke's innovation is the use of a hardware store barbecue gas canister, although in his book The Peaceful Pill eHandbook, he mentions the use of disposable helium canisters, used for inflating party balloons.
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, or by using a product available from the Canadian Right to Die Society called the "EXIT bag", which has a sewn-in Velcro collar and fastened-in, flexible plastic tubing. 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 the following case history:
This death occurred in September 2000, in South Carolina. The deceased was a 60-year-old white woman with a diagnosis of adenoid cystic carcinoma that had spread to the eye, causing double vision. ... Her husband discovered her on the living room floor approximately 2 hours after she was last seen alive. She wore a surgical mask over her face, and a clear plastic bag was secured over her head. ... Next to her body was an industrial refillable tank labeled “helium.” A clear plastic hose was attached to the tank valve and led to the plastic bag. Also at the scene were the book Final Exit, Final Exit: The Video, and the Spring 2000 Hemlock Society Newsletter, which included an article on helium and plastic bag suicide. The decedent appeared to have diligently followed the instructions in these materials. ... 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 .... When a person breathes inside a plastic bag filled with helium, unconsciousness will occur almost immediately, and death will ensue in minutes.
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 in desperate ways and people are always doing desperate things in desperate ways and ending their lives."