Danse Macabre: All Watched Over By Machines of Mortal Grace
- Justin Teerlinck
- Apr 10
- 10 min read
As an occupational therapist, my expertise is centered on helping people have meaningful, fulfilled lives. Dying is an inevitable part of everyone’s life experience. Recent years have seen a shift in the way Americans view death. While still controversial, euthanasia (specifically, assisted-suicide and physician-assisted suicide) is more accepted than when it was a frontline culture war subject in the late 1980s. Broader access to hospice, palliative care, advance directives, and the advent of death doulas are also signs of a shift in attitude. Lengthening life-spans coupled with advances in life-sustaining medical technology force us to decide between a life well-lived versus life-at-all-costs. Facing mortality helps people make empowered choices about the kind of life — and death — they want. Acknowledging our end provides a lens through which we can create meaning, clarify our values, and utilize them to create our own definition of quality of life.
When combined with empowered personal choice, knowledge, and agency, the contemplation of death can enrich lives already being lived. Right to die and euthanasia advocacy makes the issue of personal choice its lodestar. However, the same sociocultural forces that enable personal choice are a double-edged sword.
In North America, we are accustomed to viewing personal choice as inherently ennobling, as a signifier of freedom itself. Personal choice, opportunity, and variety are also the hallmarks of our consumer-driven, capitalist society. Ever more sophisticated forms of marketing, social engineering, and manipulation by the corporate world force us to consider whether the decisions we make are really ours to own — or if they are merely the actions we were maneuvered into taking on behalf of some other entity’s agenda. In other words, does choice actually exist, or merely the illusion thereof?
Decades ago, in her classic muckraking expose The American Way of Death, Jessica Mitford warned us of the capitalist forces at work in one of our most sacred domains. She wrote about the myriad ways in which the death industry uses our fears of death to sell their expensive products to people in mourning, and the euphemisms the industry used to create cognitive dissonance, and whitewash their actions. Now, in addition to selling death industry products, the industry — in collaboration with for-profit health care — is poised to begin commodifying death itself.
The Sarcopod (a portmanteau of sarcophagus and pod) is a euthanasia device (also called a “suicide pod”) created in 2019 in a collaboration between Australian ex-physician Philip Nitschke and Dutch industrial designer Alexander Bannink. It was designed to cause death by hypoxia. The air we typically breath contains about 20% oxygen and 80% nitrogen. The Sarcopod’s designers created a system whereby a button is depressed and within minutes, the pod fills with gaseous nitrogen (sourced from a liquid nitrogen tank). When one is drowning or otherwise deprived of oxygen, a primitive survival reflex known as the Mammalian Dive Response (or chemoreflex) is triggered by the buildup of carbon dioxide in the blood.
This reflex causes humans to involuntarily gasp for air. One of the most hazardous Navy SEAL training exercises involves overcoming this response while underwater, as an instructor interferes with the SEAL candidate’s SCUBA breathing apparatus. If the SEAL candidate swims to the surface to take a breath, they fail. If they do not, they risk death unless they can fight off their instructor and untangle their underwater breathing gear before losing consciousness.
This scenario illustrates why death by oxygen deprivation can be rapid, but painful and terrifying. The Sarcopod’s makers “solved” this problem by creating a system which deprives the suicidal person of oxygen while preventing carbon dioxide from building up in their blood, thus causing them to become unconscious from oxygen starvation without pain or panic.
The Sarcopod was not only designed to offer a fast, pain-free death, but a cool one as well. It’s colorful, stylized design was a deliberate attempt to make suicide sexy. Its inventors went to great lengths to develop a death machine that is convenient, futuristic-looking, and even has a window, so that its one-and-done users can have a last view of the outside world before entering the great beyond.
The aesthetics of the Sarcopod remind me of the loud, fast, obnoxiously sporty motorcycles which were ubiquitous when I was a kid, derided as “crotch rockets,” the vehicle of choice for bored or insecure adrenaline junkies with something to prove. The Sarcopod’s inventor took care to create a device he felt would have mass market appeal. The Sarcopod has been featured in numerous museums, displays, and art exhibitions. This is not coincidence. In a HuffPost article, the inventor explains how he was inspired by the dystopian cult classic Soylent Green. He also romanticizes death by hypoxia, as provided by his machine, calling it a euphoric experience.
In the United States, active euthanasia (a.k.a. assisted suicide or physician-assisted suicide) is legal in ten states and the District of Columbia. In Canada, it is legal nationwide. Recently, a report noted that 1 in 20 Canadians now die by assisted suicide via the MAID (Medical Assistance in Dying) law. Many ideologically progressive health care professionals rightly believe government should support body autonomy, personal choice, and personal freedom. Corollary to that, a case can be made that it should also support (without encouraging) peoples’ right to self-harm and right to die on their own terms.
But there was something else in the report that might disturb compassionate health care professionals. Almost 650 people said that loneliness was the main reason they chose death, as noted on a survey taken by participants in Canada’s active euthanasia program. While this view represented only a small percentage of the overall number of participants in the Canadian death system, every person who chose euthanasia did so at least in part because of a loss of meaning or feared loss of meaning in their lives, according to the survey. Most people listed in the report also had cancer or other terminal illness.
What does it say about the world we have created when the citizens of a peaceful, wealthy, stable, post-industrial nation like Canada lose all hope and meaning in their lives? And what are the implications for a country like mine (U.S.) where we share a similar culture? The capitalist values our nations adhere to affect every aspect of our lives, including our most personal choices to live or die. And inhumanity is built into our systems. When people seek death because of loneliness and despair, the cause of death on their post-mortem paperwork should list those as causes — not suicide.
Euthanasia technologies like the Sarcopod force us to wonder how long it will be before death becomes an assembly-line, factory process, managed by machines? Will this process be led by profit-motivated bureaucrats who enlist medical doctors with lucrative incentives to justify, and evangelize the process? Why not? This has been the long-standing practice of the pharmaceutical and medical device industries. The terrifying lesson proffered by the Sarcopod’s inventor is how easy it is for people to conflate a dignified death with a convenient death.
But is a pain-free death on demand in a chic-looking, futuristic machine automatically “dignified”…or humane? Does dying inside a haute couture art object honor the sacredness of human life, or does it profane the enigma, the pathos, the ephemeral state of being which is the human lifespan? Is a “euphoric” death an end we should be encouraged to seek? Perhaps, if it is self-sought, but it could also become an end that market forces will eventually train us to seek, so that someone else can profit by our deaths. A health care industry whose operating principle is “delay, deny, defend,” has much to gain from the unnatural termination of high-maintenance/high-cost patients closer to the end of their lives than the beginning.
I fear that, instead of asking these questions or discussing them, some death advocates supply their own definition of death with dignity, and do so after failing to scrutinize the biases that underpin the assumptions they make. I think it fair to question the sanity as well as the scruples of those who idealize death, and I think it fair to rigorously examine the motives of anyone who desires to make death on demand an easy, convenient process.
Let me be clear, I and my fellow health care professionals have an ethical duty to ensure the people in our care have had the opportunity to have a good life, before we begin offering death as a final safe haven. This perspective does not conflict with the duty we have to offer people freedom of choice and body autonomy. The goals of having a good life and having a good death are mutually reinforcing, not mutually exclusive.
Responsible, thoughtful health care professionals have an obligation to consider more than just the wishes of the individuals we treat. We must also consider the potential harms, abuses, and misapplications of tools that, in the right hands, could ease pain and suffering. Unfortunately, from the discourse I have seen, the vision of death advocates is quite limited. Idealism and good intentions are inadequate substitutes for rational consideration of how medicine and health care aims can be warped and perverted by the sociocultural forces that govern our relationship to money and power.
Death industry leaders with profits in mind will pursue their interests by offering the pretense of compassionate solutions for our deepest fears. By deluging us with soothing platitudes and propaganda designed to manipulate us into believing that inhumanity is humane, they will try to convince us to embrace what most people would find morally repugnant: namely that it is acceptable for efficiency and cost-effectiveness to drive death-industry product development and implementation — to frame it in language the robber barons who own our world would comprehend.
In a world where help, medical and mental health treatment are unavailable because of one’s socioeconomic status or withheld to bolster insurance company profits, there are serious ethical challenges to making active-euthanasia convenient, and accessible. Is it even possible for people to freely choose death with dignity when they have been denied the option of life with dignity? What constitutes death with dignity is personal; there is no universal definition. Life saddles some people with circumstances that are unbearable, and for those people, death may be a release.
For many others — most of us, really — life often deals us a blow that feels unbearable in the moment. That blow can take the form of physical or mental anguish, but with (and oftentimes without) adequate social support, we survive, we heal, we grow as a result of adversity, pain, and because our traumatic experiences — not in spite of them. We should not seek, nor revel in suffering, but it is the pain, the trials, and adversities we overcome that make us fully human. Their denial leaves us vulnerable to capitalists who would peddle our own deaths to us, charge us for the service, and call it noble. This is the very definition of dystopia; it’s not surprising that the Sarcopod’s inventors were inspired by a cult classic dystopian film.
Americans at the end of the first quarter of the 21st Century live in an era of learned hopelessness, prolonged adolescence and decadent infantilization. We celebrate fragility and giving up. Instead of promoting resiliency and challenging self-destructive behaviors, many therapists and other health care providers reinforce hopelessness by venerating trauma and victimhood, by encouraging vulnerable people to create identities surrounding their victimization. We have even created a pseudo-scientific nomenclature to promote victimhood mentality: microaggressions, generational trauma, safe spaces, trigger warnings. These concepts are all monuments to fragility that do nothing to promote agency, autonomy, or equality. Our culture equips us to either worship suffering, or flee from it headlong. Neither of these extremes are constructive or healthy.
I raise the issue of fragility in our cultural milieu because it directly correlates to opportunities for the death industry and other bad actors to exploit current and future generations. Further, we must ask what happens to the flimsy guardrails in place designed to protect vulnerable people — people with disabilities, children, and older adults — if an autocratic regime comes to power? What would an totalitarian regime do with a widespread convenient, efficient death apparatus which is represented as providing humane and pain free death to any who request it?
Sadly, we already have the answer. The world has witnessed the Nazi Aktion T4 program and its horrific “streamlining” of the deaths of thousands of vulnerable people with disabilities. The Nazis referred to anyone who did not actively contribute to its engine of hate as “useless eaters.” It completed its plans to murder people with disabilities not through night-time Gestapo raids, or other organs of state-sponsored terror, but through physicians acting on orders from the state. The Reich executed these victims in hospitals. The Aktion program provides a chilling historic example of enthusiastic compliance with ideologically-driven, assembly-line murder. It also offers a telling — and very rare — example of ordinary people: parents, ministers, priests, judges and even children successfully resisting a Third Reich social policy.
To readers who reject this example as too extreme — despite the obvious parallels between Nazi and capitalist ideologies — consider this: The injustice of the application of the death penalty in the United States has created outcry, with some countries refusing to sell the U.S. the drugs required to conduct execution by lethal injection. Widespread acceptance of these machines of mortal grace will further enlarge the contexts in which they are used — to nefarious ends as well compassionate ones. Technologies like the Sarcopod — designed to empower — could easily be deployed as an instrument of oppression. Instead of spurring American society to reform its justice system, the Sarcopod (whose design plans are free and open-source) will offer the pretense of a “humane” death to condemned inmates. The claim of a pain-free execution is irrelevant to the larger question of justice, but that will not stop it’s use as a defense by the prison-industrial complex.
It is not the euthanasia advocacy lobby we must fear, but those who will exploit the concept of euthanasia for far more sinister ends. Normalizing death-on-demand will influence an already-corrupt system to further prioritize giving people an easy exit from life. People would be better served by a health care system that facilitates the necessary work of creating a just, humane society where people are valued and life is worth living. Speaking again as an occupational therapist, I can affirm that we already posses the tools to perform the task of creating meaning from our patients’ suffering — if only we had the will and the backing of the state to do so.
Justin Teerlinck. Copyright 2025. All Rights Reserved.
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