Assisted suicide: 10 years of dying at Dignitas

 
Dr Anne Turner died in 2006 at Dignitas, accompanied by her son Edward Dr Anne Turner, pictured with her son Edward, died at Dignitas in 2006

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Ten years ago a British man with terminal cancer travelled to Switzerland and drank a lethal solution of barbiturates to end his life, with his son and daughter by his side.

He was the first of more than 180 Britons to be assisted to die at Dignitas, a Swiss organisation founded in 1998 which helps people with terminal and incurable illnesses to end their own lives.

While euthanasia and assisted suicide are illegal in the UK, other countries, like Switzerland, do permit assisted suicide in specific circumstances - and Dignitas is the only Swiss facility to accept foreigners.

Start Quote

The first duty of the law is to protect its citizens”

End Quote Dr Peter Saunders Care Not Killing

As a result, Dignitas has seen an average of 18 British citizens coming through its door each year since 2002 and many have chosen to be very open about what compelled them to travel abroad to die.

Having control over the timing of their death and avoiding a painful, lingering end have been the over-riding wishes of people like Dr Anne Turner, Peter Smedley and Jackie Meacock as they made their final journey to Zurich.

For those who travelled with them, there was always the fear of prosecution but, to date, no-one who accompanied any of the 182 Britons has been prosecuted.

Motivations

In the decade since, the debate over the 'right to die' has been played out through the high-profile court cases of Diane Pretty, Debbie Purdy and recently Tony Nicklinson - all of whom wanted assistance to die.

Peter Williams

CASE STUDY: PETER WILLIAMS

Peter was a pilot, flying long and short haul, and he had a degree in engineering.

He was intelligent, focused and energetic, says his sister Lynne.

"That made it very difficult to accompany him to Dignitas but when someone you love has such a clear objective, you want to support him."

Peter was 63 when he died at Dignitas in July 2012. His wife Linda was with him too.

"He had progressive supranuclear palsy and had been unwell for three or four years," says Lynne.

"He knew he would have to stand indignities that he wasn't prepared to go through. His choice was to complete his life under his terms. A miserable demise was not for him.

"He researched everything about Dignitas and organised it all. He was worried that someone would try to stop him."

Peter wanted to still be mentally competent and able to swallow by the time he got to the clinic.

"That meant he died before he needed to. He wanted to be well enough to make the journey."

In February 2010, the Director of Public Prosecutions issued new guidelines to clarify who could face prosecution for assisting in another person's suicide.

He said a range of factors should be taken into account including the motivations of the person assisting and the victim's ability to reach a clear and informed decision about their suicide.

Sarah Wootton, chief executive of Dignity in Dying, which campaigns for a change in the law to allow assisted dying, said the new guidelines "were a watershed moment".

"At heart, people should not be prosecuted for compassionate assistance. We have to think about what is criminal and what is not."

Others, including disability campaigners, said the guidelines were dangerous and could lead to disabled people being pressured to end their lives.

But these guidelines did not change UK law in any way. The Suicide Act of 1961 still makes anyone who aids and abets the suicide of another person liable to imprisonment for a maximum of 14 years.

Choice on care

Healthcare professionals will still be prosecuted for offering assistance to patients who want to die, and doctors' bodies such as the British Medical Association, the Royal College of General Practitioners and the Association for Palliative Medicine want it that way.

A 2006 survey of members of The Royal College of Physicians found that more than 70% were against a change in the law on assisted dying.

The focus, they say, should be on improving care for those approaching the end of life. The government responded in 2008 by publishing an End of Life Care Strategy covering adults in England which aimed to provide people with more choice about where they would like to live and die.

But Wootton says the law is inflexible as it stands.

Ending life

"Parliament has turned a blind eye for 10 years as Britons travel abroad to die. In line with public opinion the law must change to allow people the choice of a doctor-assisted death at home and within upfront safeguards.

"Politicians have outsourced the problem to Switzerland."

LAW AROUND THE UK

  • In England and Wales it is an offence to encourage or assist a suicide or a suicide attempt.
  • The law is almost identical in Northern Ireland.
  • In Scotland there is no specific law on assisted suicide, although in theory someone could be prosecuted under homicide legislation.

However, Dr Peter Saunders, campaign director of Care Not Killing, says out of all deaths in the UK each year the numbers travelling to Switzerland to die "are really a very small trickle".

"The British media give huge publicity to the cases which do occur and make it seem more prevalent than it is - but in fact the numbers are very small."

In the last four years, the yearly rate at which UK people travel to Dignitas has not increased - and that is important, he says.

"There will always be a small number of determined individuals who will regard their lives as not worth living. But do you change the law for that small number of people?

"The first duty of the law is to protect its citizens - and that may mean that some determined people may not get what they want."

Flagbearer

Some want to see a distinction made in law between mercy killing and murder so that people like Jane Nicklinson could have helped her husband Tony, who had locked-in syndrome, to die at home.

Sir Terry Pratchett pictured in 2011 Sir Terry Pratchett was diagnosed with a form of Alzheimer's in 2008

Novelist Sir Terry Pratchett, who was diagnosed with Alzheimer's in 2008 and is a supporter of assisted death, has become a flagbearer for the crusade to change the law.

He took part in a BBC Two documentary film which followed the final days of a 71-year-old British man who travelled to Dignitas in Switzerland to die.

Earlier this year, the Commission on Assisted Dying, an independent body set up with funding from Sir Terry Pratchett among others, looked in detail at the issue of assisted dying.

It concluded that any changes to the law would have to be balanced with giving people access to high quality end of life care and protecting the vulnerable in society. At the same time it said people should be provided with greater choice and control regarding how and when they die.

Next year a bill on assisted dying will be tabled in the House of Lords.

More debate

But is there any real likelihood the law could change?

Dr Saunders says Care Not Killing will continue to oppose a change to the law, alongside the medical profession and disability rights groups.

"The 1961 Suicide Act still fits a purpose. It continues to provide a strong deterrent. It gives discretion in hard cases too. It's clear and fair."

Looking ahead, Dignity in Dying predicts that a lot more countries will move to legalise assisted dying. Belgium, Luxembourg and the Netherlands have introduced legislation to allow assisted dying. France and Spain are currently considering a reform of their laws.

The model Wootton prefers is one that has been in place in the US state of Oregon for 15 years, which permits doctor-assisted dying. It gives terminally ill, mentally competent people the option of an assisted death.

A decade on from the first British assisted suicide at the now well-known Swiss organisation on a featureless commercial estate outside Zurich, the law has not changed but the debate rages on.

 

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  • rate this
    +6

    Comment number 47.

    Great to see this debate on the beeb :) For anyone who would like to know more please google Dignity in Dying. And a comment to L_CM = You are wrong. I have Primary Progressive MS and there are no treatments for me. As to the relief of pain = I have drugs that knock me out, to the point of only being able to sit in a chair and dribble. But have to work 30 hours a week to live. Quality of life? Ha!

  • rate this
    +10

    Comment number 46.

    We have fabulous Palliative care in the UK. I should know I'm one of the many specialist nurses that aim to deliver it. For some Dignitas will be the only option but for the majority there are many others. Ceiling of interventions, direction of care and advanced care planning all assist people to make informed ADVANCED decisions. Get your clear wishes on paper...surely it's not rocket science?!

  • rate this
    +5

    Comment number 45.

    I have a terminal illness. I am in constant pain which is daily getting worse.
    If I had the funds I would most certainly arrange my demise with Dignitas - at present my only other option is to attempt to end matters on my own so that my loved ones do not face the prospect of prosecution.
    If I were a dog I would be put down so that I did not suffer!

  • rate this
    +3

    Comment number 44.

    I am a Catholic and have once listened to a priest's speach about the wrongness of ending life due to incurable illness etc. I must say he failed to convince me. The problem with the debate is that each side always uses only the kinds of examples and cases to support their view. The priest stayed completely away from people in great pain suffering from incurable end stage cancers.

  • rate this
    +3

    Comment number 43.

    I don't understand how the legal stance completely changes when your on a life support machine!
    My Stepdad was on life support and in pain and the doctors in the UK were only too happy to turn the machine off and let him die with dignity.!
    Whats the difference?

  • rate this
    +2

    Comment number 42.

    And what of those with chronic mental illness? Should UK law ever permit euthanasia, it would only be granted to those in constant physical pain. Yet again, psychological suffering is dismissed as something benign and insignificant. We're just supposed to graciously take ineffective drugs and accept an entire lifetime of suffering and being treated as third class citizens.

  • rate this
    0

    Comment number 41.

    I think that people may be looking at this too much from a personal perspective when what we should actually be doing is seeing this from a legal one. How do you change the law to allow assisted suicide? Is everybody entitled to it, as surely a right is something that everybody should have? Or if it is only a select few then is this not discrimination and who decides on those that are entitled?

  • rate this
    +10

    Comment number 40.

    9 times out of 10 I would guess that people who oppose assisted suicide have never had to watch a terminally ill loved one writhe in pain and plead for an end to it all. It would never be a soft option for all concerned to venture to a Dignitas style clinic. I can't imagine a more difficult decision to make or accept. The God Giveth Life brigade are truly ignorant.

  • rate this
    +9

    Comment number 39.

    As somebody else put, the main limiting factor on this is the cost of travel to Switzerland, and the return of the deceased, afterwards.
    I watched my wife fading away painfully, from cancer, exactly one year ago yesterday, and if possible, I would have helped her on her way, rather than suffer the agony of slow multiple organ failure - that morphine couldn't touch.

  • rate this
    +4

    Comment number 38.

    Dear government ... Its my life not yours and I will choose if I want to end it ... I do not wish to suffer needlessly as so many people do due to your outdated attitudes
    Thank you

  • Comment number 37.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +7

    Comment number 36.

    If this law ever does gets changed I plead for one thing - ending life is a not a task ever given to doctors. When I see the person in the white coat I want to know that he or she is always striving to save my life. And when the man in the black coat arrives he is there to end it. A clear black and white position and not a muddy shade of grey where misplaced trust leads to a wrong choice.

  • rate this
    -61

    Comment number 35.

    Most illnesses today are "manageable" even when a patient comes to the end of his / her life. Most of the physical pain is also manageable. No offense euthanasia to me is really not that much different than commit suicide. Some people in this world would do anything to survive. My father the day before he died he still said that he would fight. Not being a prude but life itself is precious.

  • rate this
    +61

    Comment number 34.

    At the present time, the law advocates that a person with certain conditions should die a slow, agonising death, fighting for breath until blessed release. If I did that to a dog I would rightly be prosecuted for causing unnecessary suffering. We can make many decisions about our lives, but not to say when it has effectively ended. Why Not?

  • rate this
    +5

    Comment number 33.

    Dignitas has highlighted the desire of many terminally ill patients' preference to die sooner and efficiently rather than wait for an end by other means.
    It would reduce the no. of botched suicides amongst the terminally ill too.

  • rate this
    -3

    Comment number 32.

    Why do I not have the right to choose when I die if I have a terminal. decease? I would rather do that than face a long slow death. I do not have a right to choose my time but if the Labour controlled National Assembly of Wales get their way they will be able to take my organs unless I have opted out. You should have to opt IN to such a scheme

  • rate this
    +6

    Comment number 31.

    I would say this to Dr Saunders. A lot more would go to Dignitas to die if they could afford to do so.Everyone is born to die,but it is a fundamental human right to choose the time and place to depart when one knows the future is suffering & indignity. "Do no harm" doctors promise when taking their oath, but that is exactly what they are doing when refusing to help terminal patients.

  • rate this
    +4

    Comment number 30.

    Are we not hypocrites in exporting assisted dying to Dignitas because we haven't the moral courage to admit there are those facing a painful and sometimes long-lasting ending who, if they decide want a dignified death instead, have no other choice than to travel abroad? And that's if they can afford it. Of course there can be safeguards. We're supposed to be a compassionate nation.

  • rate this
    +7

    Comment number 29.

    With the demise of religion, it will only be a matter of time before a UK version of Dignitas springs into life. As Aristotle said: the function of a human being is to lead a flourishing life of moderation and to actualize one's potential. Once one is unable to do this, the reason for holding on to life becomes more unclear, despite the rantings of a non existent God (see Dawkins tmrw on More 4).

  • rate this
    +4

    Comment number 28.

    It is shameful that people have to go abroad to die, rather than do so in their homes. UK laws need changing to permit those wishing to die to do so when, where and how they choose. It's their life, no-one else's, so powerful religious bodies should shut up and allow compassion and humanity to rule decision-making and administration of the lethal drug. All this talk about God is nonsense.

 

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