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Daily Mail Online
27 May 2015

A death dividing Britain: It's such an emotive issue - Was this father of three girls right to take his life at a Swiss clinic? Here, three writers give their different views

by Ruth Dudley Edwards

Jeffrey Spector was obviously a good, intelligent man, and I understand why he made the decision to kill himself. But I regret that he did.

I’ve been thinking a great deal about death over the past few months, as one of my closest friends has been coming to terms with her son’s terminal illness.

An ultra-fit soldier, brave, loving and witty, Drew had recovered from cancer once, but when it returned it was virulent.

The debilitating and painful treatment did no good; he became paralysed and, a couple of weeks ago, in his 30s, he died with his wife and his mother holding his hands.

My friend’s anguish is terrible, yet she has drawn strength from her pride in her son and his wife, and the moments of joy they shared even in the last weeks of his life.


Jeffrey Spector (pictured with his wife Elaine and three daughters Keleigh, Courtney, and Camryn) travelled to an assisted suicide clinic in Zurich, Switzerland, to take his life six years after being diagnosed with a tumour

‘Drew taught us how to die,’ she told me.

I remembered often during that time, as I have done for decades, what I owe my friend Alexis, who after being diagnosed with terminal cancer in the Eighties, showed his family and friends how grace, humour and selflessness could make dying a positive experience.

And there was my dear friend Bairbre, who in her late 40s, yellow from cancer, lay propped up in her hospital bed telling her friends how much they had contributed to her life and how grateful she was to have known us.

Every day, by their example, innumerable people like Drew, Alexis and Bairbre give others priceless gifts of hope and courage.

Mr Spector had bravely coped for six years with an inoperable tumour entwined with his spinal cord, but as his condition deteriorated he was afraid he might suddenly wake up unable to move and speak.

He didn’t want to be a burden on his beloved wife and three daughters. They begged him to stay alive, but he decided otherwise.

Lord Falconer, the Shadow Lord Chancellor, popped up on BBC Radio 4’s World At One yesterday saying that he will reintroduce his Bill legalising assisted suicide at the first opportunity.

He is airily convinced that he has built in the necessary safeguards to stop people jumping the gun, and to ensure that no one gets reluctantly persuaded into dying against their will.

It is an easy, populist argument to make, but that doesn’t make it right.

As Rob George, a professor of palliative care, said on the same programme, the introduction of assisted suicide, euthanasia, call it what you will, sends out to the terminally ill and the disabled the message that they are surplus to requirements.

Lord Falconer has been unmoved by the terrifying evidence from abroad about how quickly euthanasia can become the norm.


Father-of-three Mr Spector, an advertising executive, was diagnosed with the tumour six years ago and told it was inoperable because of the way it was entwined with his spine. Despite treatment, it continued to grow


Mr Spector, 54, travelled to the assisted suicide clinic Dignitas in Zurich, Switzerland (pictured) last week

In 2007, six years after it was legalised in the Netherlands, Theo Boer, a Dutch professor of ethics, wrote that the number of cases remained low and the experiment had been a success.

‘There doesn’t need to be a slippery slope when it comes to euthanasia,’ he said then. Last year, he confessed that he had been terribly wrong: since 2008, the numbers have increased by 15 per cent annually.

Not only was euthanasia ‘on the way to become a “default” mode of dying for cancer patients,’ he said, but it was increasingly being provided for people with mental problems, dementia and even for people who were old, lonely or bereaved.

‘Don’t go there,’ he warned our Parliament, as did inspirational disabled people such as Jane Campbell, who was born with spinal muscular atrophy, a genetic disease that causes progressive lack of movement, and uses a wheelchair and often a ventilator.

Lady Campbell, a peer who has had a wonderful life, told the House of Lords: ‘If I should ever seek death, when my progressive condition challenges me, I want to guarantee that you are there supporting my continued life and its value.’
Of course, we all want a ‘good’ death. We may differ about whether we want to die suddenly or would rather have time to deal with unfinished business and say goodbye to those we love. But we would like our lives to end in a way that is good for us and for those around us.

Yet, in truth, there are few of us that don’t secretly fear we might have to endure a long period of discomfort, humiliation and suffering before the end.

"Of course, we all want a ‘good’ death. We may differ about whether we want to die suddenly or would rather have time to deal with unfinished business and say goodbye to those we love. But we would like our lives to end in a way that is good for us and for those around us."
By Ruth Dudley Edwards

Who would not be frightened by the recent report by Julie Mellor, the Parliamentary and Health Service Ombudsman, about how the NHS so often fails when it comes to end-of-life care? Around half a million people die every year in England and Wales, and the Ombudsman reckons about 350,000 of those deaths can be predicted.

We need to write our living wills, tell our nearest and dearest what our wishes are, and make up our minds how much medical intervention we want if our condition is terminal.

We would prefer not to die before our time, but we certainly don’t want pointless treatment when our time is up. We want to be comfortable and, if possible, pain-free, and in a fit state to communicate in our last days with those we love.
We want to die at home or in a hospice rather than in a noisy ward begging for help.

Surely a major priority for the NHS needs to be palliative care, which most sick people need and the majority of us will need in the end. Rather than focusing on how we can be helped to kill ourselves, it would be better if politicians talked more about the contribution the old, the disabled and the mentally ill can make to society.

Maybe if Jeffrey Spector had known Baroness Campbell he might have decided to live.
‘To die will be an awfully big adventure,’ said Peter Pan. It will happen to us all, even doctors, nurses and politicians.

Can we not make it a good and positive experience that takes the fear out of dying for the next generation?


Truth is we doctors help the sick on their way every day

By Dr Max Pemberton

To me, the sad aspect of Jeffrey Spector’s story — aside from the tragedy of having cancer so young — is that he had to travel to Switzerland to end his life as he wished.

That’s because assisted suicide is illegal in Britain — though campaigners want the law changed to allow doctors to prescribe a lethal dose for terminally ill patients with less than six months to live.

The idea of medical professionals helping people to end their own lives is, understandably, highly emotive — and it is only proper that I declare not just a professional interest in this topic, but also a very personal one.

My grandmother’s death certificate gives as cause of death ‘septic shock, pneumonia and metastatic lung cancer’.
However, this is not why she died. She was killed by a nurse.

Yet what the nurse did was perfectly legal, and, indeed, precisely according to the wishes of my gran as she had made clear to us before she was admitted to hospital.


The Suicide Act 1961 makes it a criminal offence to assist or encourage suicide in Britain and families who help their loved ones to die face potential prosecution of up to 14 years in jail (file picture, posed by model)

 

Once there, as she became increasingly confused and unresponsive, a consultant came to visit us, her relatives, for ‘the talk’.

As a doctor myself, it was strange to be on the receiving end for once. He used euphemistic phrases such as ‘keeping her comfortable’, but it was clear what was really being said: there would come a point when, in order to ensure she was not suffering, larger doses of the painkiller morphine would be used — which has the side-effect of depressing a patient’s breathing.

Eventually, her breathing would stop altogether.

In essence, he was checking with us that we realised that when the time came, they would kill her.

Of course, he never said this in such terms, but we understood what was being implied.

Sure enough, later that day, as she became increasingly restless and was clearly becoming distressed, a nurse came in and administered a dose of morphine.

However, it didn’t appear to have the desired effect and my gran remained in discomfort.

‘We could give her another dose but . . .’ said the nurse, his voice trailing off. My sister and I, who were present, understood what he was saying and nodded. ‘We promised her she wouldn’t die in pain,’ we said.

Our grandmother had watched her mother die a horrifying death from throat cancer, choking constantly as her swallowing function began to fail. When she herself was diagnosed with cancer, she was terrified at the thought of suffering like that.

"It seems utterly cruel what we expect people to put up with — suffering that we would not make an animal endure."
Dr Max Pemberton

We had promised her she wouldn’t, and as we sat there that day at her bedside, with the nurse explaining that they could administer more morphine but it might kill her, we didn’t need to give it a second thought.

Another dose was duly administered. Five minutes later, she stopped breathing.

The truth is there was nothing even remotely unusual about the end of her life: such scenes are played out up and down the country, day in and day out.

So, when it comes to discussing assisted suicide and Dignitas, we need to be honest about what’s already happening. One of the main arguments against a change in the law is that it would be the thin end of the wedge and lead to many more assisted suicides.

But doctors are already helping people — such as my gran — on their way as they face death. And I’m glad that they do.

I refuse to accept the argument that improvements in pain relief mean that there is no medical justification for ending life prematurely. I’ve seen lots of people die, and in many cases I would have chosen suicide rather than the prolonged, tortured end that some of these patients faced.

Besides, it’s not just the physical pain that some find unbearable. Sometimes it’s the loss of dignity or independence — and who are we to say that it should be borne?

It seems utterly cruel what we expect people to put up with — suffering that we would not make an animal endure.

Of course, I share the concerns that any legalised forms of assisted suicide could be open to abuse by people seeking to gain financially from a patient’s death. I believe, though, that with the right safeguards, we can ensure this doesn’t happen.

There is no straightforward answer — but in my heart, I feel that everyone should have the kind of peaceful, dignified death that my gran had.


I hope I'd have the courage to do the same

By Bel Mooney

The shock of that phone call will stay with me for ever. A close acquaintance rang to say that two mutual friends of ours, a wonderful husband and wife team as loved for their charitable generosity as for their terrific parties, had travelled to Dignitas to end their own lives.

They were in their 70s and seriously ill — a fact they had kept secret from their wider group of friends — and had chosen to die together, holding hands, rather than watch each other deteriorate, and know one would be left alone in physical and mental misery.

Like Jeffrey Spector, they were accompanied on their final journey by their adult children, a son and daughter, who were loving and supportive, even though they were about to lose both parents at once.

It’s almost impossible to imagine the anguish of those last family discussions when the fatal decision was being made and later, when it was time to say goodbye. But of this I have no doubt: the decision my friends took was truthful and — yes — noble.


Lord Falconer (pictured) has revealed he wants to re-introduce the Assisted Dying Bill in the new Parliament

They knew just how sweet life is, and refused to let death slowly deprive them of all that sweetness, all independence, all dignity.

A few months later, their son and daughter celebrated them with a lunch party in their splendid house, and we raised glasses of their finest wine (one of their passions) to toast two brave and merry souls.

Deeply moved to be in their home for the last time, and remembering how they had always chosen to live with gusto, I thought what a pity it was that they’d been forced to travel to a grim foreign clinic to exercise their right to choose death.
That is why I support Lord Falconer’s Assisted Dying Bill.

The purpose of the Bill is to enable competent adults in Britain who are terminally ill to request assistance to end their own lives in this country. I simply do not see why such suffering people should be driven abroad, when they would like to die at home, under proper medical supervision.

I do not believe there is anything especially moral in an intellectual or religious arrogance that is willing to condemn others to go on suffering the direst agony.

Over the years many people have written to my advice column to tell me they are so unhappy they ‘don’t see the point in going on’, and I always hold up my hand to those in danger of succumbing to psychological despair and say: ‘Stop!’

"I do not believe that law or religion has the right to judge those who wish to take their own lives because of terminal illness or intolerable pain."
Bel Mooney

And I am lost in admiration for those truly heroic individuals who, despite terrible pain through illness, want to eke out every last second with their loved ones. I bow my head before those who endure the struggle and still hold on.

Yet I do not believe that law or religion has the right to judge those who wish to take their own lives because of terminal illness or intolerable pain.

This is certainly not to say that the lives of those who are facing chronic disability (like Jeffrey Spector) are worthless and should not be fought for. Of course not!

My late brother lived through five decades of chronic disability, and every day I admired his courage. Yet had he lost that courage and sincerely wanted to die, I would have wished him that respite. A human being must surely have the right to say: ‘No more.’

After all, a patient suffering from terminal cancer can decide to refuse any more intervention — and in that sense, choose not to prolong life.

For example, the actress Lynda Bellingham decided there comes a point when you have to refuse to continue with what’s called the ‘battle’ against cancer, and enjoy the life that’s left.

This was also the case with a friend of ours last year: unable to face more chemotherapy, she chose to let the illness take its course, telling me (as we sat over lunch for the last time) that she didn’t want to become a pitiful creature.
‘That’s not real life,’ she said. Enough was enough.

However, Lynda Bellingham and my friend did have to endure terrible pain at the end of their lives, and there’s much work to be done in the field of palliative care.

I wish those moralisers who condemn the ‘right to die’ would use their energy to agitate for the care of the dying to be improved.

In the past 45 years, suicide rates all over the world have increased by 60 per cent — perhaps because the old religious prohibitions have all but disappeared. It used to be a crime against God to kill yourself; now people argue that it can be the ultimate act of self-determination.

This is what I believe. Therefore, I hope I would have the courage to choose the moment to go — while still possessing the mental power and physical strength to hold out my arms to my family and tell them how much I love them.

Ruth Dudley Edwards

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