WHY IS euthanasia campaigner Dr Philip Nitschke helping so many women to die? Last Thursday Nancy Crick, a Gold Coast grandmother, was the latest woman to be bowled over by Dr Nitschke's bed-side manner.

Last year cancer victim Norma Hall, of Sydney, was assisted by Dr Nitschke to die. Now a woman in Melbourne with motor neurone disease, 53-year-old Sandy Williamson, has told 60 Minutes that she wants his help. A Brisbane woman named Georgia also wants a helping hand.

Dr Nitschke's career seems to be following a pattern set by another doctor with a death machine, Jack Kevorkian, who is now doing time in a Michigan jail for murder. Between 1990 and 1997, Dr Kevorkian helped 93 people in the United States to die - and women outnumbered men two to one.

The death of Mrs Crick is further evidence that the big losers from legalised euthanasia will be ailing elderly women. Last year, psychologist Dr Silvia Sara Canetto, of Colorado State University, surveyed more than three decades of mercy-killing in the records of the Hemlock Society, a voluntary euthanasia group in the US. She found that most of the time it was women who ended up as victims.

"Many women do not have the resources, the sense of entitlement or the power and freedom to make the choice they desire, especially when they are sick or disabled," she says.

Canetto says the preponderance of women in mercy-killing cases may be related to broader social patterns of devaluing women's lives.

An American hospice nurse, Nancy Valko, backed up Canetto's research with her own experience. "When a man was dying, it was not unusual to see the wife and even ex-wives, as well as other family, at the bedside. In contrast, it was just about as common to see a dying woman who was divorced and alone," says Valko. Nor is it surprising that Nancy Crick did not actually have the bowel cancer that was supposedly the cause of her unbearable pain. This, too, fits into a pattern of euthanasia deaths.

Professor Kalman Kaplan, of the University of Illinois Medical School, surveyed mercy killing incidents in the United States and the Netherlands in a recent issue of the journal Ethics and Medicine. In most cases, autopsies found no evident physical cause for their pain, he said. Psychological or emotional pain was the real trigger for their death. "For example, a typical man choosing physician-assisted suicide may be suffering from terminal lung cancer and be in a great deal of physical pain," he writes.

"A typical woman choosing physician-assisted suicide may be somewhat disabled from chronic multiple sclerosis and, as a result, see her marriage break up and her economic situation deteriorate. Her pain may be just as intense as that of the man described above but emerging from a partially psychosocial source."

Sick and disabled women, it seems, feel more of a burden than sick and disabled men. For the first time in their lives they have to depend on care-givers rather than providing the care-giving themselves. Their diminished sense of self-worth may lead them to ask for death. In Oregon, one of the few places where doctors like Philip Nitschke can operate, 63 per cent of the people who died in cases of doctor-assisted suicide feared being a burden on family, friends, or care-givers.

So what is pushing Dr Nitschke's female patients over the line? More than pain, it is probably loneliness, isolation and lack of support in an increasingly individualistic society.

The more publicity euthanasia receives through stunts like Nancy Crick's death, the more we foster negative attitudes about old age and disability. More and more grandmothers will think that their families would be better off without them. Instead of a campaign for mercy killing, we need a campaign for merciful care in women's twilight years.

Michael Cook is the editor of an e-mail newsletter, Australasian Bioethics Information.