Disability

Restricting assisted dying to the terminally ill would be ‘totally arbitrary’, says disabled journalist Melanie Reid

Award-winning journalist of the Times’ Spinal Column and author of The World I Fell Out Of Melanie Reid MBE, has criticised attempts to limit assisted dying for those with only six months left to live, in a filmed interview shown at an online event jointly hosted by My Death, My Decision and Friends at the End.

In an interview with My Death, My Decision’s Chair, Trevor Moore, Melanie explored how her attitudes towards assisted dying had changed following an accident ten years ago which left her a tetraplegic. Melanie explained that whilst she had always supported personal autonomy, assisted dying had become all the more important to her after her accident, because if the option existed she would be able to live a happier life; secure in the knowledge that if her pain ever became unbearable she would be able to end it. 

Responding to the criticism of disability rights organisations, Melanie said that no two people experience disability in the same way and that whilst some people may not want the option of an assisted death, that does not permit organisations – even those purporting to speak on her behalf – the right to say at what point her life is liveable, endurable, or enjoyable. Adding that robust safeguards can be created to protect those who may be perceived as vulnerable, she said: 

‘I have very little control in my life in the sense that I am fairly powerless. When you end up paralysed and in a wheelchair, you lose a lot of your power, authority, or agency. That power that I have, that bit of control, that knowledge that my fate will not be decided by anyone else and that I can choose the time of a good death; surely that is the one bit of agency that I am entitled to?’ 

Following the showing of the interview the Chair of My Death, My Decision, Trevor Moore and the Chief Executive of Friends at the End, Amanda Ward, also answered a series of questions, ranging from safeguards which could be incorporated into future legislation, whether attitudes may have shifted since 2015, and barriers to future legal reform. 

NOTES:

For the full recording of the event, visit: https://www.youtube.com/watch?v=XEQUSuUZhy0

For the full recording of Melanie Reid’s interview with Trevor Moore, visit: https://www.youtube.com/watch?v=F4B6Drn0E1Y

For a transcript of Melanie Reid’s interview with Trevor Moore, visit: https://www.mydeath-mydecision.org.uk/wp-content/uploads/2020/05/Trevor-Moore-in-conversation-with-Melanie-Reid-Transcript.docx

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Belgian Paralympian chooses to end her life with medical assistance

MDMD has been following the story of Marieke Vervoort, the medal-winning paralympic athlete, since she announced her intention to end her life when she felt the time was right for her. Many papers, including The Guardian and The Mail have reported her death by euthanasia on 22nd October 2019. Marieke had endured unbearable pain as a result of the degenerative condition Reflex Sympathetic Dystrophy, an incurable illness which can cause a burning sensation within the limbs, which even the best palliative care could not alleviate.

It is interesting to contrast the approach of palliative care options in Belgium with those in the UK. Marieke’s palliative care doctor gave her the best pain relief he could, but he could also provide euthanasia when asked. In this country that is impossible due to the law preventing medical assistance to hasten death. Instead, when asked how to avoid incurable suffering in the case of dementia, (and by implication other conditions such as Marieke’s where death could not be caused by refusing treatment), Baroness Finlay, Professor of Palliative Medicine at Cardiff University and a long-standing opponent of medically assisted dying, said “there’s no law against committing suicide”. How does she think one could do this? “There are people ordering drugs over the internet now and taking overdoses”, was her response. Attempting to wash their hands of the problem of incurable suffering, and pointing to unsafe and illegal suicide alternatives is not an acceptable position for the palliative care community. The law in Belgium allows palliative care there to set a much better example.

In an earlier interview, when Marieke had obtained papers authorising her assisted death, she said:

“Those papers give me a lot of peace of mind because I know when it’s enough for me, I have those papers… If I didn’t have those papers, I think I’d have done suicide already. I think there will be fewer suicides when every country has the law of euthanasia. … I hope everybody sees that this is not murder, but it makes people live longer.”

The fact that Marieke delayed her death for 3 years since publicly stating her intention to take the option available to her, clearly demonstrates this point. It shows that she took a long time to carefully consider her decision and to ensure that she lived her life as long as she could tolerate, with the help of the best that palliative care could offer. A recent report highlights the extent to which palliative care in the UK fails to relieve suffering at end of life – “17 people per day will suffer as they die”.

The BBC have an in depth interview with Marieke available on-line, recorded in 2016, where she discusses her sporting achievements, the challenges of living with her disability, and her clear wish to eventually have a medically assisted death.

In response to Marieke’s death Christian Today and The Independent Catholic News quote Gordon Macdonald, chief executive of Care Not Killing, who said “It is extremely sad news that Ms Vervoort has chosen to end her life this way, but her death highlights how the right to die has become a duty to die in both Belgium and their near neighbours in the Netherlands.” Really? A Duty? On what basis does he reach that conclusion? On the contrary, it seems clear from her interviews and quotes that far from feeling a “duty to die”, the euthanasia law in Belgium enabled Marieke to live for longer than she might have otherwise, and with the comfort of knowing that a peaceful death was available when she eventually needed it. Gordon Macdonald, in not welcoming the compassion available under Belgian palliative care in extreme situations like this, seems to be saying that Marieke had a “duty to suffer for longer”. MDMD together with the vast majority of the public, consider this position to be callous and medieval.

Graham Spiers, writing in the Times, who also comes from a Christian background, demonstrates a much more compassionate attitude when he says “The Church remains largely against assisted suicide, and with well meaning, but the prolonged, ceaseless, acute suffering of people has made it an impossible argument to sustain. To those, like Vervoort, who despite medicine’s best efforts, were often in excruciating pain, the Church was saying: ‘Bear with it. Hang in there. Don’t deny God. See it through.’ It is an abhorrent stance to adopt.” Fortunately, at least a few Christian leaders agree with Graham Spiers’ view, including Desmond Tutu, the ex Archbishop of Canterbury, George Carey and MDMD Patron and General Synod Member Rev Rosie Harper. Importantly, both George Carey and Rosie Harper recognise that assisted dying should be available for people who are suffering incurably, even if they are not terminally ill – people like Tony Nicklinson, Omid T, MDMD patron and campaigner Paul Lamb and of course, Marieke Vervoort. None of these people would be helped by an assisted dying law which only helped those with a life expectancy of 6 months or less – that criterion too has become “an impossible argument to sustain” and is “an abhorrent stance to adopt”, as Marieke Vervoort’s case demonstrates and as MDMD has always argued.

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Exclusive Interview with Andi Reiss, Film Director, and personal friend of Omid

MDMD’s Campaigns and Communications Manager, Keiron McCabe, spoke exclusively with “Endgame” director Andi Reiss about Omid’s journey. Andi was present at Omid’s medically assisted suicide in Switzerland.

Photo: Omid and Andi, shortly before Omid’s death at Lifecircle Switzerland. Photo credit: Andi Reiss

How did you first become interested in the issues around Assisted Dying?

My mother died in 2010 whilst in the UK. Although she had been on a clinical trial and lived for over 19 additional good years, I eventually witnessed the indignity of her death first hand. That’s when I first started to think and examine the process of Assisted Dying in this country. It’s also why I wanted to direct a documentary examining these issues in more depth than anyone had done before.

And how did you find out about Omid’s case?

About two years ago I approached My Death, My Decision’s coordinator Phil Cheatle about the Endgame film and the issues surrounding Assisted Dying. Phil and everyone at MDMD were great and that’s how I first found out about Omid. I got to know Omid over the filming of Endgame. But it was more than that, I spent a lot of time with Omid and Omid wasn’t just someone I was following for a documentary, Omid was my friend.

I realise you were with Omid and spent some time with him when he went to Lifecircle for medically assisted Suicide. What was Omid’s mood and atmosphere when he decided to end his life?

It’s hard to emphasise enough, just how much anguish and pain Omid was in before he visited Lifecircle. I’ve known Omid for over two years now and words simply can’t describe it. It’s quite an extraordinary thing. No one can fully comprehend that the day you are going to die could be one of the best days of your life.

The mood at Lifecircle was joyous! I’d never seen Omid so excited, happy and calm. He looked incredibly relaxed and was very peaceful. It was extraordinary. It might be hard to understand, but when someone becomes incurably sick and life becomes totally hopeless, making that choice is empowering. Omid’s life had become at the behest of everyone. He couldn’t do anything for himself anymore. So knowing that you can lean over and switch the valve and go to sleep within one minute is pure empowerment.

Endgame is scheduled for a screening on Tuesday 9th October 2018 in Jersey. Further information can be found at: www.endgamemovie.uk

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Omid Ends his life at Lifecircle in Switzerland

Omid T: A Legacy of Bravery, Compassion and Empowerment

Photo: Omid and Dr Erika Preisig at Lifecircle, shortly before his medically assisted death. Photo Credit – Andi Reiss

I’m glad you’re here; thank you, thank you for everyone’s support – Omid (1964 – 2018)

On October 4th 2018, assisted dying campaigner, Omid T chose to end his life by a medically assisted suicide at Lifecircle near Basle, Switzerland. Although Omid was still awaiting the outcome of his landmark legal case, Omid’s suffering prevented him from waiting any longer. His death was reported in the Sun and the Daily Mail, among others. Omid’s lawyer has updated his CrowdJustice webpage accordingly. His lawyer Saimo Chahal said “I saw him shortly before he went to Switzerland and he told me that he could not bear living any longer and wanted nothing to get in the way of him having a peaceful and dignified death.” MDMD’s exclusive interview with documentary film maker Andi Reiss who was present when Omid ended his life is available here.

Unlike Noel Conway, who has launched a separate legal case to permit assisted dying for those terminally ill, Omid’s case sought to secure the right to a dignified death for all mentally competent adults, facing years of unbearable and incurable suffering.

Omid would not have benefited from Noel Conway’s appeal or the assisted dying bill put forward by Rob Marris in 2015. Living with Multiple Systems Atrophy (MSA) since 2014, Omid did not have six or fewer months left to live.

Over 18 months MSA increasingly robbed Omid of the dignity he deserved. First he lost his independence and then his motor functions. Omid’s life became increasingly intolerable for him and eventually he became virtually unable to move and had very limited ability to communicate. Yet Omid retained his mental capacity and was still able to persistently communicate his desire for a medically assisted death, something denied by UK law. Unfortunately palliative care was inadequate for Omid and his life became unbearable, despite being in a high quality care home. On a previous occasion he attempted and failed to end his life unaided. He needed medical assistance. The circumstances which Omid was forced to search for his peaceful end in Switzerland, is a tragedy. Although he was eventually able to obtain a medically assisted death abroad, it took a lot of time to arrange, and put his family through a lot of additional trauma – hardly the good death he wished for.

Debilitating medical conditions like Omid’s do not have to mean that someone cannot live a life they feel is worthwhile. It is up to the person themselves to form their own view. With the right support some can and do live fulfilling lives, despite the medical situations they have to endure. However this is not always possible. Omid is one clear example. It is not the medical condition alone which makes a life intolerable, it is in part also the way the individual is able to react to it. Some people, quite understandably, decide that for them their life is complete or cut short, and they wish to have a peaceful death rather than continue to suffer. Nobody, especially not those considered to be vulnerable, should be pressured or coerced into requesting an assisted death, but equally, nobody should be pressured or coerced into having to suffer against their will, nor be forced to continue to suffer by law, when that suffering is unacceptable to them, incurable, and they simply wish for a peaceful medically assisted death.

Without a change in the law to legalise assisted dying for people like Omid, the doctor patient relationship is badly broken at a time when it is most needed. Suffers like Omid deserve better. They need independent professionals to discuss their wish for an assisted death with; to ensure they have carefully considered every alternative; and, if no acceptable alternative is available, to provide medical help to die.

Omid’s legal case follows on from Debbie Purdy, Tony Nicklinson and others. In his summing up of the Nicklinson case, Lord Neuberger, then President of the Supreme Court said “There seems to me to be significantly more justification in assisting people to die if they have the prospect of living for many years a life that they regarded as valueless, miserable and often painful, than if they have only a few months left to live”.  This exactly sums up Omid’s situation. The UK medical, legal and political systems all failed him. We hope his efforts to change the UK system will eventually bear fruit.

MDMD offers sympathy to Omid’s family for their loss; gratitude to Omid for his efforts to challenge the law; and thanks, on Omid’s behalf, to his family and friends who showed the compassion necessary to help him end his life as peacefully as possible under very difficult circumstances.

The outcome of Omid’s case is expected soon. How the case will progress now depends on this ruling and on whether another person in a similar position is willing to carry the case forward. Omid’s lawyer would like to hear from anyone who might want to continue the case.

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Economist Essay Series on Assisted Dying

The Economist is publishing a series of essays by those involved in the Assisted Dying debate. We are delighted that one of the invited authors is Dr. Michael Irwin, MDMD’s founder and now a patron. Michael’s piece describes the five occasions where he has been present at an assisted suicide in Switzerland.

All the essays are well worth reading. The series keeps a balance between those in favour of a change in the law, and those opposed.

Steven Fletcher gives the perspective from someone who is severely disabled. Steven, a quadriplegic since he was 21, disabled from the neck down after a motor accident, was a member of the Canadian parliament, including five years as a cabinet minister. As a backbench MP he “introduced the private members’ bills into parliament that ultimately resulted in the changes in the law that ended the prohibition on medical assistance in dying in Canada.” He ends by saying “Dying with dignity is the greatest shift in morality in Canada in this generation. As long as the shift is in the context of empathy, compassion, choice, hope and common sense other countries should learn from our example.”

Another particularly informative essay, also from Canada, is from Ellen Wiebe, a doctor who says she has “provided about 150 assisted deaths”. Talking about this role from the doctor’s perspective she says “an important part of being a good doctor is helping our patients have a good death, but the only person who can define a good death is the person dying.” (For a discussion of what is meant by a “good death” see our article here.)

This article is in stark contrast to the essay from Ilora Finlay, a crossbench peer in the House of Lords, professor of palliative care, and leading critic of attempts to legalise assisted dying in the UK. Baroness Finlay argues that a change in the law is not necessary and that we have a lot of choice already, in particular a choice to refuse life prolonging treatment, relying on doctors to provide “analgesia and other measures to relieve distress”. Unfortunately that can fall far short of a “good death”, as defined by the dying person. This is especially so when accompanied by the fear of what may happen, coupled with the inability to do anything about it. The option of a medically assisted death, as part of the palliative care process, would alleviate that fear and help prevent early suicides both in the UK and in Switzerland.

Baroness Finlay also says that, due to improved palliative care, “for most people in Britain today, dying does not mean an agonising death, but a gentle ebbing away of life.” MDMD agrees that palliative care helps ensure a good death for many, and we fully support better palliative care provision. However, our fear is for those who fall outside “most people”, and also for those whose idea of a good death is not “a gentle ebbing away of life” – especially if this is protracted, unpleasant, and undignified as can so often be the case, particularly for those facing advancing dementia and other degenerative conditions.

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Scottish Parliament removes time limit in definition of “terminally ill”

MDMD are delighted to learn that the Scottish parliament has removed any time limit from its definition of “terminally ill” in their Social Security (Scotland) Act 2018.  The story was reported by the BBC and the Guardian.

The Guardian article states “There were a number of significant last-minute amendments to the legislation, including the removal of any time limit on terminal illness. It was brought by the social security minister, Jeane Freeman, after senior medical professionals called for its inclusion. Current rules for disability benefits and universal credit say a patient must have six months or less to live before their illness is classed as terminal.

In the debates over right-to-die legislation, “terminal illness” is also one of the possible criteria that has been considered, and is used in some jurisdictions such as Oregon and other US states where assisted dying is legal, (but not closer to home in Switzerland, the Netherlands or Belgium). In the right-to-die context in the UK the medical community have argued that a 6-month criterion is impossible for them to accurately determine, and would make the working of right-to-die legislation impossible for them. It is good to see this medical argument now being applied to other uses of the 6-month criterion, if only limited to Scotland at present.

The relevant wording from the Scottish Act is “… an individual is to be regarded as having a terminal illness for the purpose of determining entitlement to disability assistance if, having had regard to [guidelines issued by the Chief Medical Officer], it is the clinical judgement of a registered medical practitioner that the individual has a progressive disease that can reasonably be expected to cause the individual’s death.”

Given that dementia is the leading cause of death in England and Wales, it seems clear that dementia should now qualify as a “terminal illness” in Scotland, for this legislation, at least by the time that it seriously impacts a person’s ability to live independently. MDMD has always argued that dementia should be considered an acceptable reason for requesting a medically assisted suicide, by someone who still retains mental capacity, and that consequently any six-month criterion is too restrictive. The change in interpretation of “terminally ill” in Scotland is a small sign of movement towards a better understanding of this issue. We hope that in England and Wales, senior medical professionals will follow their Scottish counterparts in causing a similar redefinition.

We hope that those organisations campaigning for a change in the law on assisted dying in Scotland will now broaden their campaign to fully embrace the new Scottish definition of “terminally ill”, if their policy does not currently endorse this. This would help gain the support from those in the medical community in Scotland who argued for the redefinition.

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MS Sufferer Colin Campbell’s deferred assisted death raises important questions about help for the disabled

In April 2017 MS sufferer Colin Campbell publicly stated his intention to end his life in Switzerland on June 15th 2017. Due to the intervention of fellow MS sufferer Rona Tynan, and the alternatives and assistance she helped him consider, Colin has deferred his appointment in Switzerland.

In October 2017 a BBC story and podcast discusses why Colin changed his mind. Colin is clear that he has deferred his Swiss appointment, rather than cancelled it, and Rona agrees that she supports assisted dying and respects Colin’s decision. One of the participants in the discussion was Mik Scarlet, a member of Not Dead Yet UK, a group of disabled people who oppose assisted suicide. Mik makes some very important points. “You can’t say you’ve made an informed decision if you don’t know about scooters or care plans.” He goes on to say “I do believe that eventually we will get assisted dying”, but he points out that this should not be permitted until all possible alternatives have been considered – including the services which may be able to make someone’s quality of life acceptable to them again, and the support to help them adjust to changed circumstances. He continues, “…then when people do get to the point when they want to die they got there at a point where it is real. It is not because they are not supported and they are not being helped.”

MDMD agrees with Mik on this. One of the problems with the legislation as it is today, is that people are taking their own life, either on their own, or with medical help in Switzerland, without necessarily having the full support that could make their quality of life acceptable to them again. Colin Campbell’s case suggests that many others may be suffering unnecessarily due to lack of access to available services.

Exactly what level of support is available, at the time it is needed, is of course down to politicians, social services, NICE, and ultimately to us, the voters. Demand is always likely to be higher than the state can provide. Whether the support available at the time it is needed is sufficient for the individual concerned, is a personal decision. But until there is a change in the law and people are encouraged to seek help before ending their life, tragic early deaths are bound to occur out of ignorance of the help available.

Importantly, when accepting help, people need to have the confidence that their end of life wishes will be respected in future – even if for them, a good death, means a medically assisted one. Without a change in the law, there is a risk that in accepting help, the ability to end one’s life unaided will be lost. This can give rise to a real fear of being trapped in a system that can’t help in the way the person wishes. This is another reason why today some people, even when well informed of available options, may choose to end their life too soon, while they still can, knowing that no one can legally help them later.

Where MDMD and some of those opposed to a change in the law may differ, is that to MDMD it is not acceptable for people suffering to be denied a good death now, in the hope of better care services at some distant unspecified point in the future, long after they have died unpleasantly. People need to make decisions about their lives, and their deaths, now, in the situations they find themselves – having fully considered all the options currently available. A well designed assisted dying law and activation procedure can help ensure that people who choose an assisted death do make a well informed choice. The present law does not do that and needs to be changed. With such a law in place, no one need suffer against their will. As care and support for incurably ill and dying people then continues to improve, we can anticipate that this could cause some people to delay or not request the assisted dying option.

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Ironically, the option of euthanasia can prolong life, and its quality.

A new BBC report has been published on Belgian paralympian Marieke Vervoort who has obtained papers authorising her euthanasia. She has suffered from a progressive, incurable spinal condition, for 16 years. The report describes her severe pain which is not fully controllable by medication. A video clip shows her suffering. The story follows an earlier report last September.

Her case demonstrates how a supportive, professional approach to palliative care can include the possibility of euthanasia, in a country where it is a legal option. When Marieke felt suicidal, due to her incurable condition, she was referred to a palliative care expert who discussed the option of euthanasia with her. The knowledge that she could end her life in a peaceful manner at a time she chose, gave her the ability to carry on – perhaps prolonging her life by avoiding a suicide, and certainly improving its quality.

“If I didn’t have those papers [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][permitting euthanasia], I wouldn’t have been able to go into the Paralympics. I was a very depressed person – I was thinking about how I was going to kill myself … It’s thanks to those papers that I’m still living.”

“With euthanasia you’re sure that you will have a soft, beautiful death.”

In contrast, in the UK there is no legal option of medically assisted suicide or voluntary euthanasia. As a result, doctors cannot discuss it meaningfully, so people like Marieke cannot get the consultation they need. This aspect of the doctor patient relationship is broken. Instead people are driven to consider other ways of ending their lives, possibly earlier than they would wish, while they are still able. Options include going to one of the Swiss organisations that can offer assisted suicide to foreigners, or unassisted suicide. Both these options have many disadvantages. We need a more compassionate approach in this country.

It is important to point out that this case is another example of someone who is not terminally ill, in the sense of having a life expectancy of six months or less. Because of this, the approach taken by Dignity in Dying would not help people like Marieke as that proposal restricts assisted dying to people with a six month life expectancy or less – an approach that was rejected by the House of Commons in September 2015. Marieke’s story is another example of why MDMD do not support the six month criterion.

It is only when assisted suicide or euthanasia is a legal option that palliative care can offer the full range of options a person may want, together with meaningful independent professional consultation to help the patient reach the best decision for them. The irony, demonstrated so clearly by Marieke Vervoort, is that the possibility of a medically assisted death can actually prolong life. And not only that – it can improve the quality of life during the remaining time, helping to reduce understandable depression and anxiety, and eventually bring about a “soft, beautiful death” – the sort of good death some people want.

MDMD wish Marieke Vervoort the best death she can have, on her terms, when she chooses. We are very grateful that she has shared her story with the media to help publicise these important issues. We hope that one day the choices that have helped Marieke will be available to help people in the UK.

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Belgian Paralympian wants Euthanasia… but not yet.

The BBC report the case of Marieke Vervoort who has a degenerative muscle disease and won silver in the 2016 paralympics. She has made it clear that she wants Euthanasia in the future, at the time of her choosing. This is an example of the Extended Advance Decision idea being proposed by MDMD.

How assisted dying might affect disabled people has been a long standing concern of those opposed to a change in the law. In Belgium, which has the one of the most liberal assisted dying laws in the world, there is no suggestion that Marieke Vervoort, is either “vulnerable” or has been pressured into her view, which comes from the fact that she “suffers from a degenerative muscle disease that causes constant pain, seizures, paralysis in her legs and leaves her barely able to sleep.”

However, comedian and disability rights activist Liz Carr, responding in the Guardian, accuses the right-to-die movement of encouraging disabled people to end their lives. “Rather than telling us we have everything to live for – and we do – we are helped to the proverbial cliff edge and offered a push.”

Nothing could be further from the truth. Right-to-die campaigners support everyone, regardless of age or disability, to live as long, as full, and as enjoyable a life as they can. It is only when someone finds their quality of life permanently below the minimum level they are able to tolerate that assisted dying should be an option – and only an option – after long and careful consideration by the person them self. Why should any of us be forced to continue our life, against our carefully considered wishes, when our situation is incurable, and for us, intolerable? This is especially true in the case of someone like Marieke Vervoort who has put on record her wish that when the time is right for her, she would like euthanasia. This demonstrates that she has carefully weighed up the issues and that, for her, for now, she has decided her life is still worth living. Fortunately for her she lives in a country humane enough to give her the “good death” she seeks, when she wants it. In the UK neither abled nor disabled people are treated with that compassionate respect.

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Lord Rix changes his mind in support of legalised euthanasia

In 2006 Lord Rix, who was president of Mencap, voted against an assisted dying bill in the House of Lords. Now, aged 92, and terminally ill himself, he has changed his mind, and has called on the speaker of the House of Lords to open the debate again: “I can only ask that once again the House of Lords brings the UK up to date by allowing legal euthanasia after all other avenues have been pursued. Please raise the question again in the House of Lords so that people like me do not continue to suffer untold misery for want of a kind alternative.”

What changed his mind? “As a dying man, who has been dying now for several weeks, I am only too conscious that the laws of this country make it impossible for people like me to be helped on their way, even though the family is supportive of this position and everything that needs to be done has been dealt with. Unhappily, my body seems to be constructed in such a way that it keeps me alive in great discomfort when all I want is to be allowed to slip into a sleep, peacefully, legally and without any threat to the medical or nursing profession. I am sure there are many others like me who having finished with life wish their life to finish.”

Daily Telegraph Report

Daily Mail Report

His phrase referring to people like him “who having finished with life wish their life to finish” is a clear example of the MDMD description of a completed life.

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