A Moving Subject

The Dignitas euthanasia clinic in Zurich, Switzerland

Writing as a sufferer of incurable cancer, I know my last days on Earth as Mortal Man will be extremely painful, akin to having a knitting needle stuck into my body slowly, every so often. If I have made any implacable enemies in life I can be sure they will allow that differents points of my anatomy, allowing themselves a smile but forgetting, the same fate may very well await them. For me, morphine will be on hand to flood life with a calmness not known before, the injections courtesy of a registered carer, perpetual sleep the consequence. This is known as palliative care.

The word “euthanasia” itself comes from the Greek words “eu” (good) and “thanatos” (death). Those who are against assisted dying forget that every day, a nurse somewhere in a hospital or a hospice or a home, guide us slowly, humanely and quiety into that long night. I would not want it any other way. The alternative is to sit under a hedge like a dying animal until the heart takes no more and stops beating. I would describe help at the end, dying with dignity, a death devoutly to be preferred to screaming out in agonising torment, distressed family waiting for the inevitable.

The debate on assisted death has reignited in Scotland. It should not be a morbid subject. Unless the current first minister, Humza Yousaf delays provision, a new bill to legalise assisted dying in Scotland is due to be published by the Scottish parliament later this year, in a fresh attempt by its supporters to get the measure enacted for the first time in the UK. Islam, like Judaism and mainstream Christianity, proscribes suicide. 

The YouGov poll for the campaign group Dignity in Dying found that 77% of Scots supported the measure, with 12% of those questioned opposing it. Its findings also suggested attitudes have shifted in favour of the legalisation among those with a religious faith, even though it conflicted with most religious teachings. I’d like us to imitate Mexicans and have a Day of the Dead celebration every year, remembering our ancestors. I digress.

Liam McArthur, the Scottish Liberal Democrat MSP who is tabling the bill, said these findings, which echo other recent polls, proved the measures were widely supported. “We know that excellent palliative care is the right path for the majority of dying people but there are also those who face a bad death, dying in great distress,” he said. “Tightly safeguarded and compassionate assisted dying laws not only give dying people what they need but protect all other groups as well.”

A civilised country should offer the individual the right to choose how and where they wish to leave this place rather than endure extreme pain, immobility and loss of bodily functions. Of course, there are people who take the opposite view. But I return to my original point, circular fashion; we have a kind of assisted route already in existence. Why not legitimalise the process for those who want to end it all? Some object on religous grounds, some on the argument that there is always hope, a cure on the horizon, some on the fear death by officialdom might stray into wider grounds, such as just wanting out of a modern world of emails, television trivia, advertising, computers and supermarket ready meals.

For those who know little of Dignitas, the Swiss clinic for assisted suicide, it provides the final (expensive!) days to people who are suicidally depressed, terminally ill or in the grip of a degenerative neurological disease. Once they have achieved the aim of ending their lives police officers and undertakers get involved. The procedure is uncomplicated. When you are ready to die you send Dignitas copies of your medical records with a letter explaining why things have become intolerable. This information is dispatched to one of Dignitas’s affiliated doctors. He or she considers the request on the basis of your medical history whether or not they are ready to write a prescription for the fatal dose. If the doctor agrees in principle, a ‘green light’ is given to the member and they can contact staff at the Dignitas HQ, who will schedule a date.

I have to add that seeing photographs of the inside of the place it’s clear no money has been spared to make the sparse rooms look cheap and decidely like a run-down back-packer’s hostel. I am sure, if such a place was established in a tranquil, beautiful rural area of the Highlands, we Scots could do a better job of matching the interior with the exterior.

The number of desperate people making the journey to this clinic increases every year. Between 1998 and 2022 over 550 UK citizens ended their lives with the help of Dignitas. While the UK has long resisted attempts to change the law on assisted suicide, a number of high-profile supporters of change have flocked to the cause in recent years, including novelist Ian McEwan, former Archbishop of Canterbury Lord Carey and actor Hugh Grant. The 2015 bill composed by former UK Lord Chancellor Lord Falconer’s (Assisted Dying Bill) failed to gain enough support in the House of Lords. An independent Scotland might take a different view.

Here are a few examples of the casualties of disease who fear less the dying, than swimming against a powerful current that wears down their resistance.

Theresa George

Theresa George, known to most as Ani, says she has no fear of dying but does have a fear of how she dies. She has a degenerative, incurable condition, and when her defences are down, the upsurge of stress and anxiety can at times feel overwhelming. “I can have panic attacks,” she said. “All of my effort at this point is on trying to keep a positive mental attitude and enjoying what life I have left.”

George, 63, has lived for 20 years on the west coast of North Uist in the Outer Hebrides with her partner, Maire Coniglio. Originally from Maine in New England, George had been working in home care when late last year she was diagnosed with motor neurone disease. “When I came home and told my partner, she said ‘No, no, no, it can’t be that,’” George recalled.

The progressive disease began with loss of mobility in her left ankle and foot; it spread to affect her leg and now her left side is subject to tremors and weakness. A trained massage therapist, George now uses a motorised wheelchair. Living with accelerating physical deterioration, she has the very real fear of “being trapped in my own body”, she said. “I’m slowly watching myself deteriorate, really, and it just brings up all that anxiety and fear and the stress of it all. I don’t have a fear of dying but I do have a fear of how I die – I think most people can relate to that.“I don’t want to die but more so, I don’t want to suffer.”

George considered travelling to the Dignitas assisted dying clinic in Zurich. Faced with the significant costs of doing so – estimated by the pro-assisted dying campaign group Dignity in Dying at about £15,000 – and the logistics of travelling there, she quickly dropped the idea. For her, dying at home on her own terms would be far preferable than the added stress of dying in an anonymous room abroad. “To have that at home, with people that you love around you, that would be amazing,” George said.

Suzie McAllister

Suzie McAllister, 47, a primary school teacher in Fort William, empathises. She cared for her husband, Colin, a very fit and active climber and kayaker, as he died in enormous pain from an aggressive and untreatable stomach tumour earlier this year. The sedatives and pain relief he was given simply failed to alleviate his suffering and distress, she said. The cancer made it impossible for him to eat. He would wake up crying out in pain. For McAllister, it is incomprehensible the law cannot allow someone in that degree of pain to voluntarily end their suffering. Colin considered Dignitas; towards the end, he pleaded for her to find the drugs to end his life on the internet.

“He had no control, no right to choose, and that’s what made him angry” she said. “You can’t tell me that the way Colin died was moral in any way. The autonomy, the will of the patient, has to be considered. “It wasn’t tolerable, not for me having to watch it and certainly not for him.”

Sir Edward Downes

In 2009, one of Britain’s most respected conductors, Sir Edward Downes, and his wife, Joan, ended their lives together at the clinic. Edward, 85, who was knighted in 1991, was almost blind and Joan, 74, was his full-time carer. He had a long and distinguished career with the BBC Philharmonic and the Royal Opera House, and conducted the inaugural performance at Sydney Opera House. The couple’s children, Caractacus and Boudicca, said their parents had “died peacefully, and under circumstances of their own choosing”.

Robert Cowie

Helen Cowie told a radio chat show how she helped her son Robert, 33, kill himself after he was left paralysed from the neck down. Cowie, of Cardonald in Glasgow, told BBC Radio Scotland’s Call Kaye programme how her son went to Dignitas in October and “had a very peaceful ending”. Cowie said her son was once a “big fit healthy boy” who went training four times a week. He was reportedly paralysed in a swimming accident three years ago.

“His life was terrible. He suffered every single day. He couldn’t do anything for himself but sit there. He was just a head and just didn’t want to be like that any more.We were in Zurich for four days with my three sons and his friend, and one of my sons said it was the happiest he had seen his brother in three years. I would rather have been able to do it in this country. That really upsets me that I had to take my son to Switzerland, and I had to leave his body there and wait for the ashes to come back. It should be allowed here, but not willy-nilly to everybody. It should be investigated hard because you have to be in a sane mind to have it done.”

Summary

The author Terry Prachett died of Altzheimer’s disease. He was a patron of the English charity Dignity in Dying. It campaigns for a change in England’s law to allow assisted dying. The organisation’s chief executive, Sarah Wootton, said: “At the heart of the assisted dying debate is choice and protection. People suffer at the end of life. People take difficult decisions about their own deaths. As uncomfortable as it may be we need to face up to the reality of what is going on, both at home and abroad.”

NOTES

The individuals exampled here were chosen by myself, Jamie Grieson, journalist, and Severin Carrell, the Guardian’s Scottish editor.

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