Mary Dejevsky

Why the law on assisted dying must change

Esther Rantzen’s decision to join the campaign to legalise assisted dying, in the light of uncertainty about her cancer prognosis, has rekindled and broadened a debate that has been simmering for many years. 

Talking on the latest BBC Today podcast, Rantzen disclosed that she had recently joined Dignitas, the Swiss organisation that helps people who are terminally ill to end their lives. Now 83, the television broadcaster and founder of Childline and Silverline, said that her cancer was now being treated with what she called a miracle drug, but that if it didn’t work, then she wanted to be able to end her life while she is still able to without exposing her family to prosecution, were they to accompany her to Switzerland. 

This is the whole point of the UK campaign to legalise assisted dying. Supporters don’t just want people to be able to end their lives at a time of their choosing, but to be able to seek help to do it legally, without having to go abroad and without leaving their nearest and dearest, or indeed anyone they tell beforehand, to the risk of prosecution in the UK courts. 

Rantzen speaks, as she has always done, with the assurance of someone who knows her own mind and wants others to know it, too. I come to this from an entirely personal and less public perspective. My late husband had Parkinson’s. He was of a secular cast of mind, and from the earliest months of the diagnosis (when he was still in his forties), he was adamant that he did not want to hang around as his faculties withered and died. His mother had had Parkinson’s; both of us knew what it entailed. He joined Dignitas, signed petitions and left a bequest. 

In the early years, his Parkinson’s was well controlled with the standard drugs. As the disease took its inexorable course, so he needed more medication and the medication produces side effects to the point where it is hard to disentangle cause and effect. 

At that stage, he still had ample determination and was adept with the internet. He researched the options, discovered a trial being conducted at the Frenchay Hospital in Bristol, underwent all sorts of tests, and became one of the first  in the UK to benefit from a procedure known as Deep Brain Stimulation, designed for Parkinson’s patients with mobility, rather than tremor, as the main problem. 

DBS has since been refined. But at the time, in 2008, this was a hugely invasive brain operation lasting many hours. He was well aware of the risks, but he was quite clear in his mind that, in terms of conventional treatments, he had reached the end of the road. It was this or nothing. At least, there was no agonising for me. He was going to do it. Full stop. 

The operation, I would say, gave him at least six years of greatly improved quality of life. It was far from transformative, but he was more mobile, took a keen interest in current affairs, enjoyed travelling and was able to resume writing. Gradually, though, the inevitable deterioration set in, whether from the natural course of Parkinson’s, or as effects of the DBS – I think it is still not entirely clear which. He found it ever harder to speak and lost the dexterity that had given him an escape route via his computer. 

He had kept up his contributions to Dignitas and left me in no doubt that, as and when, he would choose the Swiss option over further decline. And I left him in no doubt that I would take him, should the time come – and defend myself in court if need be. 

As it happened, all of this was pre-empted when he suffered a sudden cardiac arrest, and could not be revived. Earlier that day, he had been enjoying examining Norman tombs;  for a mediaeval historian, it was a good way to go, and completely bypassed the moral quandary about assisted dying. 

As this week has shown, however, the dilemma for very many people is still there – and I find it ever harder to accept the soothing words of the medics, when they insist that pain control and palliative care are now so advanced that everyone can be made ‘comfortable’, as a prelude to a ‘good death’.  Really? And what makes someone else’s definition of ‘comfortable’ – for days, maybe weeks – preferable to being able to bow out when you judge the time to be right? 

All that said, I am not convinced that assisted dying is something amenable to prescriptions, at least not to legal prescriptions. The danger that legalisation will place added pressure on those who are very old or very ill to end their lives prematurely is real – with an added element being the cost of social care in England. 

It is surely wrong for a now largely secular state to make criminals of those who are doing no more than help a parent or a partner

Beliefs differ and are deeply held. While my husband was a fierce supporter of assisted dying, a cousin of mine, a retired vicar, who has lived with motor neurone disease for more than 20 years, is as fervent an advocate on the other side. I respect the sanctity of life arguments, whether they derive from religious conviction or not. I appreciate, but do not share, the idea that to legalise assisted dying would send a message about the worth, or lack of it, that our society places on people with disabilities. 

In the end, the best that can probably be hoped for on the ethical dilemma is agreement to differ. But would it really not be possible to licence a Dignitas closer to home for those who make an informed choice. At present, only those with the financial means and the physical capacity to make the journey have any choice, and still those who accompany them or know of their plans may be liable to prosecution. 

That may suit the powers-that-be as well as opponents of assisted dying in that it limits the take-up, and so perhaps the opportunities for abuses. But it is surely wrong for a now largely secular state to make criminals of those who are doing no more than help a parent or a partner fulfil their last wishes. This is where the law needs to change, and acknowledge a right to choose – at the end of life, too