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A dignified death

Watch Dr Michael Irwin describe his life of campaigning for legalising assisted dying
Well I’ve been campaigning to change the law in the UK for last 25 years, to make it possible for a competent adult, who’s suffering unbearably, to have a medical assistance in ending their lives. This to me is a basic importance of showing personal autonomy, of being in control. And it is basically good humanism to kind of follow those kind of concepts.
I mean, I can remember going back many years. I was a newly qualified doctor in 1956. I was a house physician at the Prince of Wales Hospital in North London. We had a patient there in his late 40s, who had extensive cancer of the lungs, and we told him that no further treatment was possible.
He said: ‘Well, what can you do to help me?’ And talking with the consultant and with the ward sister, with him and his wife very frankly, we said ‘What we can do is to increase the medication you’re having for pain control.’ He fully agreed to this, and so he had these injections of morphine. We didn’t have diamorphine in those days, but it was morphine, and these were given on an increasing basis over the next 48 hours, and then he died. Now whether he died because of the morphine injections, or because of his underlying cancer, one will never know. But this was regarded as good, normal hospital medical practice in those days.
Nowadays it is possible for someone in the UK, who becomes terminally ill, which means likely to die within six months, or someone who is suffering unbearably from various medical conditions, who still is mentally competent to take a decision about how their life should end. It’s possible for that person to go to Switzerland. That is the only country in the world where foreigners can go and receive a doctor-assisted suicide, if they qualify according to Swiss law. Now I have accompanied, over the last 15 years or so, five people who have gone to Switzerland. I can still remember as if it was yesterday when I went with them.
For example, the first person I accompanied was a woman from Glasgow called May Murphy. She was in her 70s, she was a widow, she had multiple systems atrophy, and she was bedridden, and she was determined that she did not want to continue with this awful condition. So together we went to Switzerland and I can remember how relaxed she was on the journey. For example, on the plane she turned to me, she was eating a sandwich, and she said ‘You know, I have perhaps this as my last supper, I only have one disciple with me’.
And when we landed at the airport in Zurich, and the cabin crew always say ‘Well, we wish you a safe onward journey’, in a very loud voice she said ‘If only you knew where I was going!’ And just before she drank the fatal substance, Nembutal, which would end her life, she kind of made a little toast to her son and myself, and thanked us very much for being with her, and drank the liquid, and in a matter of five minutes, she was in a coma, and she had died within 20 minutes in her son’s arms. It was a most dignified and responsible end of one’s life.
She was in control, this is what she wanted, and she had all the medical reasons to end her life.
For me the most important reason to have a ‘right to die’ law in the UK, to make it possible for someone to ask a doctor’s help to end their life, is that this is a basic human right. It’s a matter of personal autonomy. ‘It’s my body, my decision’ is a simple way to answer it. And you can quote the various articles in the European Convention on Human Rights or the United Nations Declaration on Human Rights, which state that this should be a matter of personal choice.

Dr Michael Irwin was Medical Director of the UN in New York, and is a long-time campaigner for assisted dying. In 2009 he established what is now called My Death, My Decision, which campaigns to change the law in the UK so that mentally competent people who are terminally ill or incurably suffering are legally allowed to receive assistance to die. He is a Patron of Humanists UK, which campaigns to the same end.

Humanists typically support the right to an assisted death for those who are of sound mind and are terminally ill or incurably suffering and have a clear and settled wish to die. Below, Richy Thompson, Director of Public Affairs and Policy at Humanists UK, sketches out some of the recent history of UK-based campaigning on this issue.

Campaigning for assisted dying

The trend towards legal recognition of assisted dying around the globe is clear – but in the UK there is definitely still some way to go. The Netherlands, Belgium, Luxembourg, and Switzerland have all long recognised assisted dying for both terminally ill and incurably suffering people. They have been joined since 2015 by Canada, and, for terminally ill people, eight states in the US plus Washington DC and the Australian state of Victoria.

In England and Wales, there have been repeated attempts to change the law through the courts and through Parliament. These have relied on article 8 of the European Convention on Human Rights (‘Everyone has the right to respect for his private and family life’). Most humanists have come to the view that it is possible to change the law for such individuals whilst providing adequate safeguards to ensure no-one is coerced into ending their life against their wishes. Humanists UK has therefore supported all such initiatives in Parliament and intervened in all recent court cases in support of a change in the law.

Tony and Jane Nicklinson and Paul Lamb

In 2012, Tony Nicklinson took a case to change the law. Tony had locked-in syndrome, and challenged through the courts the fact that he wasn’t allowed assistance to die.

He lost at the High Court, and subsequently died. So his wife Jane took over appealing his case, as did Paul Lamb, who is not entirely locked in but is severely physically immobile and in constant pain. Humanists UK intervened in support of the Nicklinsons and Paul, meaning it became an interested party to the case.

In 2014 Jane and Paul lost their case at the Supreme Court. Nine judges heard the case, meaning five were required for a majority. Two of them were willing to declare in Jane and Paul’s favour then and there, and four were against it. The remaining three, however, thought that with as high-profile an ethical debate as this one, Parliament should, first of all, have a chance to decide what the law should say – and only if Parliament rejects the issue again would they be open to considering it. They did so, in part, in the knowledge that Lord Falconer had, at the time, a private members’ bill on the subject in the House of Lords.

Parliamentary bills

However, while this bill passed its second reading, that was as far as it got. It progressed no further, not because it was voted down, but because the Government didn’t support it, and so refused to schedule enough time for it to be fully debated. And, at any rate, the bill only sought to change the law for terminally ill people, when both Tony and Paul were not terminally ill but incurably suffering.

In 2015, Rob Marris MP brought a private members’ bill in the House of Commons. The Bill was in the same format as Lord Falconer’s. It was voted down at first reading by 330 to 118.

Noel Conway and Omid T

With Parliament having made it clear that it wouldn’t give any legal recognition to assisted dying, the way became clear once more for fresh court cases.

Noel Conway has motor neurone disease and Omid T had multiple systems atrophy. However, both of their cases failed as well, for different reasons. Noel Conway lost his case at the High Court and Court of Appeal, and was refused permission to appeal to the Supreme Court – in part because he needs a ventilator, so it was deemed he could end his own life fairly easily by removing it. While before Omid’s case got very far, he decided his suffering was unbearable, so he travelled to Switzerland to die.

Paul returns to court

In May 2019, Paul Lamb announced that, following the failure of the previous cases, he intends to return to court to have his case heard again. He does not face either of the problems that Noel and Omid did. As of June, he is awaiting permission from the Court for his case to be heard.

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Humanist Lives, with Alice Roberts

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