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
    -72

    Comment number 147.

    We can all see the logic in this, but the problem is as St Paul states "We are not our own property" We are created by God, and thus we are children of eternity. What is 70 odd years against eternity? We know there is Heaven and Hell after this mortal life, there is the last judgement. To take your own life is against the law of God and Man , you risk hell not just by default, but by will

  • rate this
    +8

    Comment number 146.

    No one has the right to judge decisions made by people who have no quality of life due to science of today keeping them so called 'alive.' Bringing religion into it not helpful for the individual concerned. This Swiss based organisation offers a peaceful end to an otherwise vegetative painful existence which is certainly not life as we would want it to be. Not for me or anyone else to judge.

  • rate this
    0

    Comment number 145.

    The debate continues and that is all. Absolutely nothing has changed.

  • rate this
    +7

    Comment number 144.

    The NHS don't want to cure you the local authority doesn't want to assist you to live yet it is illegal to take your own life. My mother died in a filthy NHS hospital in great pain, I only hope when my time comes I can get to a more enlightened country like Switzerland .

  • rate this
    +1

    Comment number 143.

    to 'thelostdot' - re. the liverpool care pathway. this does not involve stopping food and drink and watching people die as you imply. It is a framework by which inappropriate investigations and treatments are stopped (ie. those which are not working) and comfort takes precedence. If the patient wants to eat and drink - fine. Also, pain relief is given as much as the patient requests or needs it.

  • rate this
    -7

    Comment number 142.

    @138.Andy_Pandy1968

    You don't seem to have grasped my point. I am concerned that, ultimately, the decision about euthanasia may come down to funding.

    The development of good palliative care could be held back as it is more expensive than a shot of lethal drugs.

    Euthanasia is a political and financial issue. It's naive to ignore that in my view.

  • rate this
    +1

    Comment number 141.

    @126 yellowsandydog If the people at Dignitas have any suspicion that you've been "persuaded" into going there, they will not administer that dose.

    Anyone persuading you into killing yourself would do better to help you in the UK - it costs quite a lot to go to to Dignitas and takes organisation. If they're doing it for the money, it's cheaper to "help" you here.

  • rate this
    0

    Comment number 140.

    We must not forget about the emotional perception of the patient, dying person, because he/she has her own vision about her struggle. I write about that on my blog, http://kissyousoftly.com I mention the studies of Dr. Elisabeth Kubler-Ross that give us a profound insight of what is happening in their minds...

  • rate this
    +1

    Comment number 139.

    "129.thelostdot

    I will never forget the man I saw in horrible agony, dying many years ago, who couldn't be given painkillers "because he might get addicted"."

    Things are changing now, there are doctors and nurse practitioners specialising in palliative care. There is also the Liverpool Care Pathway.

  • rate this
    +2

    Comment number 138.

    133. Polly8122

    I do not want the manner of my going decided by a govt cutting health funding whilst bombing children with drones in the 3rd world.

    =

    This isnt a discussion about bombing children with drones in the 3rd world.

    However, if you dont want a Govt associated with this affecting your life, that rules out Labour, Liberal & Tory, so perhaps you should migrate to Switzerland?

  • rate this
    0

    Comment number 137.

    The current system is bad.

    You can't have anyone help you swallow a lethal dose. You can't have anyone buy it for you. It's hard even to find information on what that dose is. Let your loved ones know that you intend suicide and they might be prosecuted for not stopping you.

    So - kill yourself whilst you're still healthy enough to manage unassisted and strong enough to try several times.

  • rate this
    -4

    Comment number 136.

    If anyone ever persuades me to make "a short trip to Switzerland" I will come back and haunt them.

  • rate this
    +5

    Comment number 135.

    to 75.Cecren: I find your argument a bit sick. A lack of palliative care in the UK and euthanasia are 2 entirely separate issues, and any lack of palliative care has to be addressed and solved as such. You don't seem to see it that way, and if you are supporting euthanasia because of the lack of palliative care, then you should not be allowed anywhere near patients.

  • rate this
    0

    Comment number 134.

    Surely the problem for the medical profession is the very fine line between providing medication that relieves intense pain and the injection that while relieving pain also causes the death of the patient. Pain avoidance is right. Currently providing the same medication to produce death is wrong.

  • rate this
    -1

    Comment number 133.

    123.Andy_Pandy1968

    "What a disgusting way to talk."

    I sincerely apologise if my seeming flippancy has caused offence. I am genuinely worried about the legalisation of euthanasia. I too shall die one day, the cause of death will not be 'good health'.

    But I do not want the manner of my going decided by a govt cutting health funding whilst bombing children with drones in the 3rd world.

  • rate this
    +2

    Comment number 132.

    If we had better laws on assisted dying, then we might get better palliative care as well - at the moment the choice is suffer a lot, or hope that you get whatever the over-stretched and under-funded hospice movement can provide.

    If it looked as though people were being driven to assisted suicide because the palliative care wasn't available, perhaps more resources would go into hospices.

  • rate this
    +4

    Comment number 131.

    I'm generally against people ending their own lives, but in recent cases in the courts where there is no coercion, no release from their terminal condition... I don't see why they shouldn't be allowed to die when they choose.

    As long as there are appropriate safeguards and a proper hearing into why someone wants to end their life, then why shouldn't they be able to?

  • rate this
    +3

    Comment number 130.

    109.Colin100
    35 Minutes ago
    It's good of the Swiss to provide this bumping-off facility.
    =====
    Bump implies force, NO force is being applied, it is self choice

  • rate this
    +2

    Comment number 129.

    I will never forget the man I saw in horrible agony, dying many years ago, who couldn't be given painkillers "because he might get addicted". Who is the state puting in charge of these things? Thick and no understanding! Did she think he would suddenly become not bed riddden, and get off down to Soho to keep his habit (controlled strictly, by nurses, he died 2 weeks later) going? Such poor insight

  • rate this
    -2

    Comment number 128.

    123 Andy Pandy 1968" What a disgusting way to talk." Have you actually ever had to deal with death and dying? I would prefer somebody who is blunt and honest any day to somebody who puts me through terrible suffering and cruelty, because they don't want to be blunt. I'll say somehing else about Morphine, the amount some junkies can stand woud kill many human beings. What max dose?

 

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