The right to choose death

The right to choose death
By Jeremy Laurance, Health Editor
Published: 08 May 2007
Independent UK

The number of Britons with a terminal illness who are opting to die in a Swiss clinic has doubled in a year. Is it time for the law to change so they can end their lives in Britain?

In protest at what they see as Britain's outdated euthanasia laws, patients from the UK are flocking to the Dignitas clinic in Zurich where they are promised a dignified death.

Latest figures show 34 people have made the journey since January 2006 compared with an average of 14 a year between January 2003 and January 2006. In all, 76 Britons have been helped to take their own lives by drinking a mixture of barbiturates prepared by doctors at the clinic.

The trend will give added impetus to the campaign to change the law in Britain to give terminally ill patients the right to choose how and when they end their lives. Surveys show four out of five people in the UK would support a form of assisted suicide similar to that offered at the Dignitas clinic, but three attempts to change the law since 2003 have failed.

Dignitas was set up in 1998 by Ludwig Minelli, a Swiss human rights lawyer, to help people "live and die with dignity". The first known British patient to visit the clinic was Reginald Crew, a 74-year-old former car worker from Liverpool with motor neurone disease, who ended his life there in January in 2003. One unnamed Briton had gone there to die earlier. In Britain the penalty for assisting a suicide is up to 14 years in prison. Many relatives and friends who have travelled with terminally ill patients to Zurich have lived in fear of prosecution afterwards.

Rosie Brocklehurst, of Dignity in Dying, formerly the Voluntary Euthanasia Society, which campaigns for a change to the law in the UK, said: "It is appalling that the current law in the UK means that terminally ill British people who want to end their lives are being forced to travel to a strange country to do so. Their lives are being ended more prematurely than would otherwise be necessary because they have to be able to travel."

Sheila Soul-Gray, a university administrator from east London, made the journey with her family and ended her life at Dignitas last December. Aged 53, she had terminal colon cancer and viewed the opportunity of release from her suffering with "extraordinary relief", according to her husband, Martyn.

Mr Soul-Gray, a teacher, said: "I felt cross we had to make this difficult journey, in public. Sheila would have preferred to die at home in familiar surroundings with her things around her as we all would. That would have been by far the best. It should be an absolute human right."

The acceleration in the numbers of people going to Switzerland was revealed by Dignity in Dying, to mark the fifth anniversary this week (11 May) of the death of Diane Pretty, who campaigned for the right to euthanasia. She fought a two-year legal battle to win immunity from prosecution for her husband, Brian, should he help her to commit suicide.

Mrs Pretty had motor neurone disease, a degenerative condition which left her confined to a wheelchair and threatened to condemn her to a painful and distressing death. The Director of Public Prosecutions agreed that Mrs Pretty and her family were experiencing "terrible suffering" but refused to grant her immunity. Mrs Pretty appealed but lost her case before the Law Lords and, subsequently, in the European Court of Human Rights. She died in a hospice near her home two weeks after her case was thrown out. A spokeswoman for Dignity in Dying said Brian Pretty had been upset by the way some Christian groups had claimed she died a peaceful death. "The truth is that before she was heavily sedated [at the end] Diane had anything but a peaceful last few days and was in a great deal of pain," he said.

Surveys show that many people, especially those with religious convictions, claim they do not fear death and would never end their own lives prematurely. But doctors point out that death is a process, not an event, and for those with terminal diseases it may involve a period of pain and suffering which is hard to bear. Although palliative medicine has advanced to the point where most (but not all) terminally ill patients can be helped to die peacefully, some want to shorten the process and die with dignity.

Terminally ill patients wishing to travel to Switzerland from the UK must first become members of Dignitas and then supply detailed paperwork, including medical records, to satisfy the doctors at the clinic that there is no hope of recovery and their decision has been taken freely and without coercion.

Once they arrive at the clinic - in an anonymous apartment block in a Zurich suburb - they are given a private medical consultation in which they can express any last-minute doubts - before the cocktail of barbiturates is prepared.

The patient then drinks the cocktail, using a straw if they are too disabled to raise the glass to their lips, so that the fatal dose of drugs is self-administered. This distinguishes assisted suicide, which is not a criminal offence in Switzerland as it is in Britain, from euthanasia, where the fatal dose is administered by the doctor. Minutes after drinking the cocktail the patient slips into a sleep followed rapidly by coma and death.

The last attempt to change the law in Britain sought to legalise assisted suicide for terminallyill patients with less than six months to live. The Assisted Dying for the Terminally Ill bill sponsored by Lord Joffe was defeated one year ago on May 12 2006. Lord Joffe said at the time that he was committed to bringing the bill back.

Assisted death the Swiss way

Dignitas clinic hit the headlines soon after it was founded in the late 1990s. One of only a few Swiss assisted suicide organisations which takes clients from abroad, the controversy surrounding it has not stopped a steady stream of terminally ill patients choosing it as the place where they wish to die.

Discreetly situated in a block of studio flats in a residential suburb of Zurich, Dignitas takes advantage of Switzerland's liberal laws on assisted suicide, which say that a person can only be prosecuted if they are acting out of self-interest. Staff interpret this to mean that anyone who assists suicide altruistically cannot be prosecuted. Its specialist staff all work as volunteers to ensure there can be no conflict of interest. Once patients become members - and before they arrive for their final visit - staff carry out detailed discussions to ascertain whether their declarations have been unduly influenced by others. Once a decision to carry out the procedure has been made, the patient travels to Zurich and is taken to one of the clinic's flats. Staff then administer a lethal does of barbiturates.