June 17, 2009 -- In a drab church hall in Brighton, on England's southern coast, Dr. Philip Nitschke explains how to kill oneself using a plastic bag.
"If you did just get a bag and put it over your head," he tells the crowd of 60 or so, "it doesn't take long before you'd find it very, very unpleasant. That's not how this method works."
Nitschke then plays a video that outlines his preferred method. The video has an upbeat soundtrack and is presented by an elderly lady called Nurse Betty.
"We've chosen a large-size oven bag," she explains with a smile. "Mainly because that fits all size heads, small and big."
Some in today's crowd are terminally ill, but most aren't. Not yet, anyway. Nitschke runs an organization called Exit International and advises people to plan ahead because they might want to kill themselves one day.
Nitschke, a straight-talking Australian who studied at the University of Adelaide, Flinders University and Sydney University, has been investigated by police and hounded by protesters for years. He admits that he pushes the limits of the law.
Nitschke, 61, was detained last month at London's Heathrow Airport for 11 hours on his way to Brighton. Immigration officials eventually decided that Nitschke merely provides information about suicide and does not encourage people to take their own lives. Encouraging suicide is illegal in Britain and most other places.
But Nitschke was allowed into Britain carrying drug-testing kits. Using one of the kits, a potentially suicidal person can make sure that the drugs he or she plans to use are strong enough to kill. Nitschke also brought with him the "exit bag" and assorted paraphernalia used to demonstrate killing oneself with a plastic bag and helium.
"We tell them about how they can control the gas flow using a fitting that fits onto a cylinder of helium," Nitschke says just before his Brighton meeting. He says that without his information, most people wouldn't know how to gas themselves efficiently. "That's true," he says. "They'd probably go out and hang themselves. This is peaceful, it's quick, it works."
'Dr. Death': The Virtues of Planning Ahead
Most people at the Brighton meeting are not terminally ill and do not plan to kill themselves anytime soon. But they're taking Nitschke's advice and planning ahead.
"I've come out of this meeting extremely heartened, knowing that there are options should I ever decide to bow out," one man says.
"I've seen both my parents go fairly nastily," another one says. "I don't want to go the same way."
Nitschke says, "Look, the premier drug for ending life is Nembutal, the barbiturate," which is the drug that his kits are designed to test. "There should be a bright-blue color change. If there is, you know you're dealing with Nembutal."
He lifts a syringe out of the small plastic box adorned with the Exit International logo. "By the slow addition of the component in the third ampoule here, the amount needed to turn it back into a colorless liquid gives you an idea of what the strength of the Nembutal must have been in this bottle."
This, Nitschke argues, is information and not encouragement. He plans to sell the kits on the Internet for about $50. "It's not illegal," he says. "There's nothing illegal about this kit. It's a testing-drug kit."
Nembutal was once commonly used to treat insomnia. It's not available over the counter in the United States anymore, but the FDA-approved human uses include treatment of seizures and as a short-term hypnotic. And veterinarians use it as an anaesthetic and to euthanize sick animals.
Marilyn Monroe and others died from Nembutal overdoses.
The drug is, however, available in Mexican pet stores over the counter. Nitschke has accompanied terminally ill patients on trips to buy it. At closed workshops -- open only to those who pay a fee of about $40, are older than 50 and of sound mind -- Nitschke gets into the details.
"You have to think, what happens if I vomit?" he says. "There's a lot of knowledge involved and I suppose over the years I've acquired a lot of it."
Nitschke was the first doctor in the modern world to legally kill his patients. In 1996, Australia's Northern Territory, his home state, legalized doctor-assisted suicide.
'Dr. Death': The Right to Die
"I built a machine," he says. "They pressed a button on the machine, the machine delivered the drugs and they died in the arms of the persons they loved."
In all, Nitschke helped four people die before the law was overturned. "People said, 'Sunday is the day I want to die," he says. "Come around and make that possible.'"
Nitschke says he never questions what he is doing. "I mean, I knew I was doing the right thing," says Nitschke, who says he's not religious.
Now that the practice is illegal in his home state, Nitschke has hit the worldwide lecture circuit -- he's due in the United States later this year -- providing suicide tips and campaigning for the right to die.
Euthanasia, in some form, is legal only in Thailand, Switzerland, Luxembourg, Belgium and Holland, as well as Washington State and Oregon. And only the terminally ill qualify in most of those places. Not so to join Exit International.
"It doesn't have to be serious disease," Nitschke says. "It doesn't have to be pain. I think we should respect the right of rational adults to make this choice."
His support of death for rational adults like Lisette Nigot, a healthy Australian woman who decided when she turned 80 that enough was enough and she would kill herself, has alienated more moderate elements in the pro-euthanasia movement.
"I was saying things like, 'Why don't you go on a world cruise? Why don't you write a book?'" Nitschke says. "She ended up saying, 'Why don't you mind your own business. What I want from you, Philip, is technical information.' So I gave her the information and she died."
Nitschke admits his information could fall into the wrong hands.
"Now, we do not knowingly give information to people who are psychiatrically impaired," says Nitschke, who attempts screen people at the meetings. "Now, some people might come along to my workshops and they might not declare this and they might get access to information, they might ultimately harm themselves. And people argue that because that could happen, no one should get the information."
But Nitschke argues that those who want it, those who need it and those who are of sound mind have the right to be given detailed instructions on how to kill themselves, quickly, peacefully, legally.