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31 July 2009

Should the law make it easier for us to help the terminally ill die?

We all hate to see our loved ones suffer. But these two women (Ruth Dudley Edwards and Jenni Murray), drawing on personal experience, reach very different conclusions on assisted suicide:

No, says Ruth Dudley Edwards

Of course we all harbour fears of ending our lives in the grip of some dreadful, painful, incapacitating disease.

We would have hearts of stone if we did not deeply sympathise with Debbie Purdy, whose body is ravaged by multiple sclerosis and who wants to be able to die in Switzerland at a time of her choice with her husband Omar holding her hand.

I certainly believe that if this happened, the law should turn a blind eye. But even so, I believe the Law Lords are wrong to rule that the law on assisted suicide should be clarified, for it takes us further down a slippery and dangerous slope.

Sometimes fudge is better than clarity, for if the Director of Public Prosecutions lays down specific guidelines for circumstances in which he will not prosecute those helping others to kill themselves, it will make assisted suicide easier.

And we should be seeking not to facilitate suicide, but to help the old and the ill to die well and with dignity.

Not with Dignitas. It was the disability rights campaigner Lady Campbell - a woman with a love of life despite the fact that she has suffered all her life from the degenerative spinal muscular atrophy and needs a ventilator to breath - who saw off an attempt earlier this summer by the former Lord Chancellor, Lord Falconer, to grant immunity from prosecution to those accompanying people going abroad to kill themselves.

This judgment has given that campaign wings. Now Falconer and his supporters will try again.

I learned how one should deal with death from my friend Alexis. A successful lawyer with a loving wife, a big family, innumerable friends and everything to live for, he decided when he was diagnosed with terminal cancer that he would try to make his dying life-enhancing for others.

He succeeded in this triumphantly. Alexis laughed as he had always laughed, and rather than dwelling on the sadness of death, he reminisced about the joy of life with his family and friends, and gave us his dying as a gift.

In living he had been no saint; in dying he was an inspiration. At his funeral, I promised myself that whatever cards fate dealt me towards the end of my life, I would try to play them as Alexis did.

Of course, if it gets rough, I will not be able to live up to his standards, but I'll give it a try.

Had Alexis instead decided to spare himself pain and everyone else distress by packing himself off to a suicide clinic, his legacy would have been different. The message would have been that when life gets tough, you quit.

Poor Jade Goody was about as far away as you could get from cultivated Alexis, but in her uncouth way she had the same aspiration and lived up to it.

She could have taken herself off to Dignitas, but she determined that she would use her illness to give her children a decent future.

Rather than rail against fate, she taught her fans about love and courage. Her refusal to wear a wig was a triumph for honesty. And in the way she planned her determinedly vulgar funeral, she showed what a fine quality it is to be able to laugh at yourself.

There can be no doubting the good intentions of many campaigners, but that's no justification for blundering into making bad laws because of hard cases.

Yes, today there is rejoicing among the 800 or so Britons queuing up to die at the Dignitas clinic in Switzerland.

There will also be nods of approval from a public that has been swayed by sentimental arguments about putting people out of their misery.

But just think about the reality of what may be ahead. Don't people understand that once the law in effect licenses people to assist suicide abroad, there will be a powerful case to be made for legalising it at home?

Why is it only the rich who can choose the time of their death, will be the egalitarian cry?

The NHS should lay on the service for free. And before we know where we are, the pro-euthanasia lobby will be in full cry.

Inexorably, old and sick people will no longer have an excuse not to kill themselves for the sake of their children.

This ruling, cries the chief executive of Dignity In Dying, 'distinguishes between maliciously encouraging someone to commit suicide and compassionately supporting someone's decision to die.'

You try telling that to a vulnerable old person who believes her children will think her selfish to stay alive.

We always fall succour to the thin end of the wedge. Allowing abortion in exceptional circumstances under the Abortion Act of 1967, for example, turned it into the free-for-all we have now, with children being exterminated in the womb at 28 weeks if they have a club foot or a cleft palate.

More recently, Labour introduced the Human Embryo and Fertilisation Bill, which will remove the need for a father in IVF treatment, allow the selection of embryos to create 'saviour siblings' who can provide sparepart tissue for an older sibling, and legalise the creation of 'human-admixed embryos' - a euphemistic term for 'animal-human hybrids'.

Laws which trample over the sanctity of human life will inevitably have unforeseen consequences.

It is not possible to sanitise humanity as one might airbrush a photograph, and rid ourselves of suffering.

We all know that without some physical or mental suffering during our lives we would learn nothing.

A human being who has never felt grief or pain has not lived. It is in learning how to deal with the hard parts of life that you truly appreciate the good.

Like anyone else, I want to alleviate unnecessary suffering, but what I cannot understand is why so little attention and so few resources are applied to palliative medicine and proper nursing.

No more than I will forget Alexis, will I forget my young friend Margaret, and the peace and love that surrounded her in the hospice where she died of a brain tumour.

Nor will I forget the sadness I felt gripping the hands of my friend Gordon as he died of gangrene in a noisy, dirty ward, and how much I wanted him to die, for that was the only way his suffering could end.

Why can we not get care for the elderly and the ill right? Rather than helping dispose of human beings before their time, why are we not turning our attention to improving hospices and making palliative care and the approach of death more acceptable?

The political Establishment's generation of baby-boomers are bequeathing to their children and grandchildren a mountain of debt.

Do they really want a part of their legacy to be the message that the old and ill, rather than being valued and cherished, should be smilingly shown the door?

Yes, says Jenni Murray

My mother was the one who persuaded me that assisted suicide was the only humane course of action when debilitating and incurable illnesses strike.

Polls are said to reveal that 80 per cent of the British population agree with her and 40 per cent of doctors want the law changed.

I can hardly begin to describe the heartbreaking sense of powerlessness suffered by a loving only child as she sits at the bedside of a once active, independent parent who daily begs in a hoarse whisper: 'Please Jen, help me. I want to die.' Over and over and over again.

My mother fell seriously ill in 2006. She had Parkinson's disease, a debilitating condition which affected her ability to walk and do all the things she had loved - stirring the Christmas pudding, rolling out pastry, making intricate cards, dusting, hoovering, keeping an immaculate house - everything that gave her pleasure in her retirement.

Her once animated face became blank. The drugs that helped reduce the shaking would sometimes cause terrifying hallucinations and furious tempers, but she, and we, bore it all with courageous resignation.

And there was joy to be had in the affection of her little dog, my father's constant vigilance and the delight of seeing her adored grandsons.

But as the disease progressed, the walking ended, she was unable to go to the bathroom, or wash, or dress herself. It became difficult to eat or drink and she lay helpless in bed in constant pain.

And that's when she wanted to die. I didn't know where to begin. I have no medical knowledge and no way of getting hold of the drugs that would be certain to ease her into oblivion.

The doctors froze at the very mention of the words 'assisted suicide'. To me, assisted suicide is different from euthanasia.

It must be clear that they have not been subject to coercion before being given the means to make their exit with dignity.

'Without some physical or mental suffering during our lives we would learn nothing'

There was no question of coercion and my mother was sufficiently sound in mind to know she wanted to die.

But the Dignitas clinic in Switzerland wasn't an option. It was by now impossible for her to travel such a distance and she was anxious that, if we were to manage it, my father should know nothing about it.

She feared he would stop us. I said there was nothing I could do. She said she couldn't believe someone of my ability couldn't get hold of the drugs and said she could take them herself if I could help with the water.

By now she was forced to drink from the type of cup we use for babies - she hated it.

I explained I would be prosecuted for assisting suicide and could go down for 14 years.

She urged me just to put a pillow over her face and managed a hollow chuckle when I explained murder would carry an even heavier sentence. 'You'd do it for a dog,' she said.

Assisted suicide: Renowned British conductor Sir Edward Downes and his wife Joan chose to die at the Dignitas clinic

Eventually, she fell silent and I watched my mother take a month to slowly starve to death.

Parkinson's kills by paralysing the swallow reflex. My father saw the wife he loved become skeletal before finding release from her suffering.

I have no doubt that the law in this country should not be qualified to allow relatives to be sure they will avoid prosecution by accompanying a loved one to a clinic in Switzerland.It should be changed completely to enable individuals such as my mother to make their choice and be helped here, in their own country, surrounded by loved ones.

Some 800 British people are said to be making plans for assisted suicide, but it is an option only for those who have the money, the mobility and the know-how to take the option.

I don't hold with the opposition's 'opening of floodgates' argument. In the few enlightened places where assisted suicide has been made legal - Switzerland, the Netherlands and Oregon in the U.S. - there is no evidence of a rush to take up the option.

None has reported any verification of the scare stories about heartless relatives bullying their elderly into untimely dispatch.

After the experience of my mother, I have made what preparation I can. I have a living will which states I require no life-prolonging treatment in the case of conditions such as Alzheimer's.

I have no desire to be a burden to my sons, but more importantly, I have no desire to live a humiliatingly dependent existence.

What's wrong with wanting to shuffle off this mortal coil if you are no longer the person you wanted to be, and is it so reprehensible to want to lighten the load of your children?

I have also asked not be resuscitated in the case of debilitating stroke or heart attack and I would go to Switzerland if I had to.

I have friends and family who would support me. My mother's doctor could not have made greater efforts to alleviate her suffering.

But it was not only the pain that made my mother want to choose her own time to go. It was the humiliation of her dependence and her fear of what the writer, Diana Athill, a hearty 91-year-old, described to me as her greatest dread - a disagreeable death.

My mother's was long, drawn out and unnecessary. She deserved better. We all do.


© Ruth Dudley Edwards