Euthanasia advocate Fiona Stewart on life, death and her husband Philip Nitschke. By Ceridwen Dovey.

Philip Nitschke’s wife, Fiona Stewart, on being the ’woman behind the man’

The day before I was meant to meet Fiona Stewart in Sydney, her husband, Philip Nitschke, founder of the Australian pro-euthanasia organisation Exit International, was served papers, and she cancelled her trip to stay in their home town of Darwin. The following week, Nitschke’s medical registration was suspended by the Medical Board of Australia because of allegations he had not referred 45-year-old Nigel Brayley to a mental health professional after Brayley had informed him he planned to take his own life. Nitschke responded that he had no duty of care since he was not Brayley’s attending physician, and that Brayley’s death could perhaps be considered a “rational suicide” in response to his fear of being investigated as a suspect in the murder of his ex-wife and the disappearance of his ex-girlfriend.

The idea was not to focus on Nitschke at all in this piece. I wanted to know more about Fiona Stewart, his partner of 13 years, co-author with him of the controversial The Peaceful Pill Handbook, a DIY guide to dying with dignity that is banned in Australia. But the media storm surrounding Nitschke made it impossible to profile Stewart without reference to her husband.

Stewart claims she is accustomed to this by now, though she playfully describes herself as “the woman behind the man”. She will soon be stepping out from behind the scenes to take a more prominent public role, however. “I’m going to stand as a candidate for the Voluntary Euthanasia Party in the Victorian election,” she told me over email. “I’m usually not a background person at all – in my 30s I became the poster child for Gen X career women after I founded the consumer complaints start-up notgoodenough.org. Philip has been the face of voluntary euthanasia for so long that the media has no interest in talking to anyone else. When that changes – if that changes – I’ve got much to say based on years of listening and learning.”

Much of that learning has been in her role as a public health sociologist with a PhD from La Trobe University. “I’ve always had a sociological imagination – or a bullshit detector, as one of my professors put it,” she says. “I come to voluntary euthanasia from a feminist point of view, as a logical extension of my belief in personal autonomy. It should be no one else’s business what I choose to do with my body and my life.” 

She made a decision not to have children a while ago, before meeting Nitschke. They work long hours, but 7 o’clock every night, wherever they are, is happy hour, and they both know to finish up what they’re doing by then. “When we’re not travelling, Philip turns my side of the bed down, puts the bedside light on, makes it inviting. It makes me feel loved.” Stewart says they have no problems working together, though she’s more measured these days. “I’ve gone from hothead to thinking more like a lawyer.”  

The reason for this change is that a few years ago, despite her already extensive academic record, Stewart enrolled to study law at Charles Darwin University. She has been awarded a distinction for her honours research thesis on rational suicide and testamentary capacity – a person’s legal and mental capacity to make a valid will. She chose this topic because she has long been bewildered by the public discomfort with the concept of rational suicide, which is by no means a new or even very controversial idea in sociological, psychological, medical and legal academic literature, or in law.

For example, a study by the American Medical Association and American Psychiatric Association in the 1990s created six categories to explain why an individual might suicide: “rational” (to escape pain), “reaction” (after a loss), “vengeful” (to hurt or punish somebody else), “psychotic” (delusion fulfilment), “manipulative” (to thwart another person’s wishes) or “accidental”. This doesn’t mean rational suicide is any less emotive, but to claim that it can’t exist does a disservice to the complex thinking that has been done around this topic. After all, suicide prevention initiatives only became possible once it had become accepted that suicide had a sociological and psychological basis. 

In her thesis, Stewart also questions the assumption that mental wellness and suicide ideation can’t go hand in hand for the swelling ranks of the “rational elderly” and the terminally ill. She observes that the legal interpretation of suicide in Australia contradicts the dominant biomedical understanding of suicide as being inextricably linked to mental illness. The law in Australia generally makes no assumed linkage between mental illness and attempted suicide. In other words, in deciding whether the legal will and testament of somebody who has killed themselves should be considered valid or invalid, Australian courts today still mostly decline to accept that attempted suicide reflects mental illness – and therefore testamentary incapacity. 

Stewart’s husband is once again in the news, in relation to the death of Max Bromson, a South Australian senate candidate for the Voluntary Euthanasia Party and member of Exit International. After suffering from bone cancer for five years, 67-year-old Bromson took Nembutal (checked for purity in Nitschke’s Adelaide clinic) surrounded by his brother and sister and his two adult children. Bromson left a note and filmed himself taking the Nembutal to prove he acted alone. His family members were there because they did not want him to die alone, and said that his passing was dignified and peaceful – but they and Nitschke have been cautioned by police that they may face charges of assisting his suicide.

Stewart connects the voluntary euthanasia movement to the massive shift in how we conceive of ageing and death now that the average human lifespan is almost 30 years longer than it was a century ago: we can all expect to be held hostage to the indignities and suffering of old age for a much larger chunk of our mature lives. She hopes her work can contribute to an acceptance of rational suicide under certain conditions. “For the very old and the very sick,” she says, “it can be experienced as a stigmatising act to have their desire for a peaceful, elected death put down to mental illness or depression rather than accepted as a valid existential option.”

Ceridwen Dovey is a member of Exit International.

This article was first published in the print edition of The Saturday Paper on Aug 23, 2014 as "Exit clause".

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Ceridwen Dovey is a Sydney-based writer. Her latest novel is Life After Truth.