Religious views

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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‘Endgame’ Documentary on Assisted Dying Available Online

Endgame is a documentary made over 18 months in 2017/8 by independent film maker Andi Reiss. It has been shown, with much praise, at many film festivals and at independent venues. He has now made it available to view on his Vimeo site. A link is embedded at the bottom of this page.

The film, which lasts 65 minutes, follows the stories of Marie, Omid and Alex: three people contemplating a medically assisted suicide in Switzerland. At points the viewing is harrowing and highly emotional – please take that as a warning and have tissues to hand if you watch it!

The documentary asks hard questions and interviews people central to the debate including: Saimo Chahal, (Lawyer for Omid and previously Tony Nicklinson); Richard Huxtable, (Professor of Medical Ethics and Law, Bristol University); Dr Erika Preisig, (Lifecircle) and Rt Rev Lee Rayfield (Bishop of Swindon).

The final section of the film shows Marie and Omid ending their lives at Lifecircle in Switzerland. The in-depth interviews with them immediately prior to them ending their lives are particularly striking. The footage starkly contrasts, on the one hand the joy and gratitude of two people able to peacefully end their suffering after a long period of careful consideration, but on the other hand, the inevitable sadness at loss of life. Omid clearly found happiness in his final interview, the day before he ended his life. The cries of those he left behind speak for themselves.

Another important aspect of the film is that it shows the speed and ease of the intravenous method of medically assisted suicide used at Lifecircle. By controlling a valve, the patient knowingly takes the final step themselves, clearly making this an act of assisted suicide rather than voluntary euthanasia, but because there is no oral ingestion the death is quick and predictable. Dr Preisig has previously told MDMD that using this method the time taken to die is “always the same, 30 seconds to fall asleep, and 4 minutes to die. No coughing, no vomiting, no pain at all”. This contrasts with the possibility of many hours with oral methods, as demonstrated in a recent BBC2 documentary which showed a case in California which took 7.5 hrs.

The tragedy of Omid’s death, which movingly ends the film, is not that Omid chose to end his life. Instead, the tragedy is that Omid’s legal challenge failed and that his eventual medically assisted suicide in Switzerland was so difficult for him to arrange, causing him prolonged suffering he wanted to avoid. It also put his grieving friends and family at risk of prosecution under the UK’s assisted suicide law.

Marie and Omid considered all their alternative options carefully. MDMD strongly advocates good palliative care but recognises that the option of assisted dying is essential for some people for whom even the best palliative alternatives are inadequate.

MDMD’s work will not be complete until this type of peaceful “good death” is integrated into improved palliative care in the UK. Currently the option is only available in the UK to a fortunate and determined few who manage to arrange it in Switzerland. Outsourcing medically assisted dying to another country should only be be seen as a temporary stopgap, pending a compassionate, safe law to permit medically assisted dying for people like Marie, Omid and Alex in the UK, after full and open discussion with their UK doctors. Many of the problems with the current UK arrangement are discussed here and in this study.



Endgame 65 min Oct 2018 from Andi Reiss & Yellow Media Group on Vimeo.

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New Jersey Legalises Assisted Dying

On 12th April 2019 the Governor of the US state of New Jersey, Phil Murphy, signed a bill into law which allows assisted suicide for those who have mental capacity, are terminally ill, and are within six months of dying. The law is based on a similar law in Oregon which has been in force for over 20 years.

New Jersey is the 8th US state to pass this form of legislation, following Oregon (1994); Washington (2004); Vermont (2014); California (2016); Colorado (2016); Washington DC (2017) and Hawaii (2018). The addition of New Jersey, brings the US population with access to assisted dying to almost 70 million – over 20% (1 in 5) of the total population of the USA. (Assisted dying is also permitted in Montana, though this is by virtue of a court ruling rather than legislation.)

In signing the New Jersey Bill, Governor Murphy, a Catholic, is quoted as saying:

“After careful consideration, internal reflection and prayer, I have concluded that, while my faith may lead me to a particular decision for myself, as a public official I cannot deny this alternative to those who may reach a different conclusion.”

“I believe this choice is a personal one and, therefore, signing this legislation is the decision that best respects the freedom and humanity of all New Jersey residents.”

MDMD applauds Governor Murphy for taking this position and sharing his reasoning. It was clearly a difficult personal decision for him, but in putting respect for the autonomy of others above his personal beliefs he demonstrates an important principle that others of faith should follow. His decision also shows compassion for those who need to use this law to enable them to have what for them is a good death.

As an organisation, MDMD welcomes supporters of all faiths and none. We respect the values, choices and traditions of others to make their own end-of-life decisions for themselves. We plead for the type of reciprocal respect and understanding which Governor Murphy has shown in passing this legislation. Unfortunately, many religious leaders and organisations do not share Governor Murphy’s tolerance of other people’s views. Two recent examples of this, concerning the renewed attempt to change the law in Scotland, appear in articles published by the Scottish Catholic Observer and the Christian Institute. It is unfortunate that these bodies fail to show the compassion and respect demanded by 93% of the UK population – a figure which demonstrates just how out of touch the views of those opposed to change are.

Although MDMD welcomes the New Jersey law as a first step towards a more humane approach to dying in the 21st century, we believe that the “Oregon model” approach has significant limitations. Most significantly the 6 month terminal illness criterion excludes many people who quite rationally long for medical assistance to die. In addition, there are concerns over the support and counselling given to those who choose to make use of the law, and the process by which assisted dying drugs are administered. These issues were demonstrated in a Louis Theroux documentary shown on BBC2 in November 2018. MDMD are pleased that these issues are now actively being reviewed in Oregon.

Despite these reservations, the new law in New Jersey is another clear sign of the progress being made by right-to-die campaigners around the world. Progress that, we hope, will one day reach the UK – which is looking increasingly backward on the issue.

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Lord Carey explains his change of mind on Assisted Dying

In a short Radio 4 programme in the series “Why I Changed My Mind”, broadcast on 18th Sept 2017, former archbishop of Canterbury, Lord Carey, explains why, in 2014, he changed his mind on assisted dying.

You can listen to it here.

It is most interesting to hear Lord Carey explain that it was the case of Tony Nicklinson that caused him to change his mind. Tony Nicklinson suffered from locked in syndrome and was not terminally ill. He might have lived for many years if he hadn’t refused food and liquid following the failure of his legal challenge in 2014. In Lord Carey’s opinion it is not just incurable physical pain, but also autonomy, existential suffering and lack of dignity, that can justify assisted dying. In this respect, MDMD agree with him. We admire his courage in changing his view and speaking out. We hope that his action will convince others to re-think their position as well.

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Protecting Vulnerable People

We were interested to see an article on the Christian Institute website about MDMD, claiming that we “lobby for legal protections to be removed from vulnerable people”. Nothing could be further from the truth. MDMD is concerned that any right-to-die legislation should fully protect vulnerable people.

We suggest that the author read our proposals for extending advanced decisions which would allow assisted dying for those who wish it, but still provide vulnerable people with the same protection as they have today. This is much stronger protection for vulnerable people than previous proposals for right-to-die legislation and deserves to be seriously considered.

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Archbishop Desmond Tutu: I want the option of an assisted death

On his 85th birthday Archbishop Desmond Tutu wrote an opinion piece in the Washington Post where he goes further than his previous position of supporting assisted dying. He now states that when his time comes, he would like this option for himself.

The article includes many important quotes, perhaps the most significant, given his position, is:

“In refusing dying people the right to die with dignity, we fail to demonstrate the compassion that lies at the heart of Christian values.”

It is interesting that Archbishop Tutu manages to reconcile his belief in the sanctity of life with his call for legalised assisted dying, and with his personal wish for the option of an assisted death. MDMD hope that other faith leaders will follow the example set by Archbishop Tutu and Lord Carey in publicly supporting assisted dying, and thereby demonstrating compassion for those at the end of life, rather than perpetuating unnecessary, unwanted, suffering.

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