This week we pick up on two of the issues covered in this month's June update to the Peaceful Pill eHandbook (Nitrite & the Debreather) and discuss the recent CNN article on ME/ CFS sufferer, Cindy Shepler and her VAD at Pegasos in December last year. 

The R2D Debreather is a device that enables a person to end their own life by breathing air within a closed system. Normal respiration (breathing) consumes the oxygen in the closed system. The ‘by-product’ of the respiration, carbon dioxide (CO2), is continuously removed (scrubbed) from the recirculated air. 

As the oxygen level drops, the person experiences a soporific, and almost intoxicating sensation. This leads to a peaceful loss of consciousness and death. The death is peaceful because the DeBreather removes exhaled carbon dioxide. 

The DeBreather has been about for many years however it was not until a new model was revealed at NuTech 2017 and its subsequent productionin 2020 that it has really 'come into its own'.

Long before President Trump touted that chloroquine would be the ‘game changer’ in the fight against COVID-19, this under-rated and useful end of life drug was making something of a comeback since it was first promoted by the French suicide manual Suicide Mode d’Emploi in 1982.

The ready availability of this anti-malarial has contributed to its growing use as a means of providing a reliable death. Cambodian despot, Pol Pot, is believed to have used chloroquine (in conjunction with Valium) on the eve of the announcement by the Khmer Rouge that they planned to hand him over to international authorities for trial.

First synthesised in the 1930s as a substitute for naturally produced quinine, the drug was found to be effective against malaria. However, its widespread use was delayed until after the Second World War, because of concerns over the drug’s narrow therapeutic range. Ie. a side-effect was death.

This Podcast is based on the June 2020 update to the Peaceful Pill Handbook. Chloroquine is now a much-discussed drug following Donald Trump's claim to be taking chloroquine to protect him from COVID-19. The scientific jury is still out on its impact on coronavirus symptoms.

Check out the June 2020 update to the Peaceful Pill eHandbook at www.peacefulpillhandbook.com

This Podcast continues the discussion of the Lethal Salts by taking a look at a number of eye witness accounts and teasing out some of the elements of the Exit RPA Test - the Reliability, Peacefulness, Availability Test as it is discussed and used in The Peaceful Pill eHandbook.

In some ways the Lethal Salts have remained under the right-to-die radar. But are they the new Drion pill? Are they the new peaceful pill? What does the law have to say on these relatively freely available lethal substances? And what of a clamp-down to prevent public access?

Some even suggest that the Lethal Salts may start to be used by the Swiss assisted suicide services, especially should the current drug, pentobarbital (Nembutal), become to difficult to readily source.

This week we take the lead from the plethora of news reports on 'happy hypoxia' vis a vis COVID-19 and a good death. 

The term ‘happy hypoxia’ first gained attention in early 2020 during the COVID-19 pandemic. Some people whose lungs were severely affected by the virus (so that oxygen could not readily cross into the blood), were found to be hypoxic. However, these patients were not particularly distressed.

Happy hypoxia has also been associated with deaths resulting from lung infections and pneumonia. 

When William Osler (one of the founders of the Johns Hopkins Hospital) described in 1892, a death from pneumonia as ‘the old person’s friend’, it was happy hypoxia that he was referring to. 

Happy hypoxia depends on cerebral oxygen levels dropping to lethal levels, while avoiding any increase in carbon dioxide (with the associated distressing symptoms).

The second topic of this Podcast is the recent Dutch Supreme Court decision that confirmed that doctors should act upon an advance directive that contains a person's wish for euthanasia in the context of advanced dementia.

Euthanasia in the context of dementia or is a controversial subject. In the vast majority of jurisdictions that have some form of voluntary assisted dying laws, a person who has dementia will be expressly excluded from being able to seek help.

This is not the case in the Netherlands or Belgium.

The COVID pandemic has brought new urgency to end of life planning, as far as Advance Directives go.  

The arrival of COVID-19 reinforces the need for everyone to prepare a legally-recognised advance directive document and arrange the appointment of a legal representative (eg. guardian, proxy, agent, etc.). 

An advance directive can outline the nature of one’s desired end of life care, (and a guardian can advocate on our behalf) should we become unable to communicate this for ourselves. 

A deteriorating situation with a COVID pneumonia can quickly place you in the position of having to make a decision as to what level of medical intervention you want. 

The existence of a legally-drafted advance directive and appointment of a legally-sanctioned person to represent you, could well protect you from a prolonged and undignified death in an ICU. 

Such a document, and such an agent, can also ensure that scarce medical resources are freed up for those who more welcome them (and who may be more likely to benefit from them). 

This makes the decision-making easier for the medical staff involved.

The Doxit Podcasts is a series of discussions about a good death: focused on the monthly updates to the Peaceful Pill eHandbook & global news / developments on assisted suicide etc. 

Podcast No 1 addresses the April 2020 COVID-19 Update to the Peaceful Pill eHandbook, examining  issues such as COVID-19 pneumonia, active & passive ventilation, the 'game changer' of chloroquine, developments to the Sarco project and more.