Living with dying
Thoughts about suicide, assisted dying and euthanasia
When people find out that they have a terminal illness they often feel depressed (see 'Roller coaster feelings'). Some of the people we talked to said that when they discovered they were going to die they had considered suicide to 'get it over with'. Two people had attempted to kill themselves. One man, for example, had survived an overdose. He had then looked at the Internet and put together a bottle of tablets that would end his life, which he said he would use if things ever became unbearable.
He has put together a bottle of pills so that he can end his life if it becomes unbearable.
Why the Great Escape?
Well you go back to the Steve McQueen and the hero bit, but there is a bottle of tablets that I have put together myself that I know will end my life. The chances of me actually taking it is very, very small but I have to have that ultimate control. That ultimate sanction that I can decide because one of my fears is that if I am in too much pain and I am too miserable and every day is a living hell then may be I don't want to be around any more. And I will make that decision.
Would you call that euthanasia?
No. I would call that taking a practical step to doing something. It's not euthanasia because euthanasia is taken by others. It's dealt with by other people. This will be something that I will do myself. And having researched on the internet as to what the drugs that I put together will do I am quite confident that it will do what it needs to do.
Have you got an opinion about euthanasia?
Yes I do have an opinion on euthanasia. Euthanasia per se I am against. I don't believe it's the right of anybody else to terminate somebody else's life. However the people that have motor neurone disease, the people that have MS and are in excruciating pain, a lot worse than the pain that I have, they should be able, in conjunction with their partner, to decide that enough is enough and that they should be able to take their own life.
A woman with breast cancer had also tried to kill herself, but regretted the upset this had caused her family. She didn't think she would try again, but liked the idea of having a pill to end her life if she 'got to the end of the line' and was in a lot of pain. She said that if she ever considered suicide again she would tell the family first.
She likes the idea of a pill she could take to end her life if she were in pain and clearly dying.
There's a big debate about that isn't there, euthanasia and -
- mercy killing.
Yes. It's very difficult if you can't do it yourself but I think you cannot put that sort of pressure on one of your nearest and dearest to do it for you. I can understand why the people go out to Switzerland where somebody they don't know can give them the fatal overdose. But I still think you're putting pressure on somebody else to do something, for you.
Have you ever thought what you might do in a situation like that?
I think I'd just have to get on with it quite honestly, and I think if I was going to do it myself I think I would have to tell my family as well and get them to agree. If it got to that it would have to be at a point where I could see there was no return, that there was nothing could be done and it was just down hill and it was just going to be pain and then the death at the end of it. To just go quietly to sleep and just lose all that pain and angst. It really does appeal. I must admit.
Talking to other people and recognising that there would still be good things in life were sometimes described as reasons to keep going despite suicidal feelings. Some people told their doctors how they felt and started to take anti-depressants, which helped them to feel better.
When we were talking to people for this site there had been several high profile discussions of assisted death, including the case of Diane Pretty (a woman with MND) who had appealed to the European court of human rights. Many people discussed their view of euthanasia. The word euthanasia (from Greek) literally means a 'good death' or death without suffering, though some people use the word to mean 'mercy killing'. UK law does not allow assisted death, but some other countries do permit doctors to help people to die in carefully controlled circumstances. Charlotte was working in Holland, when her uncle, who was aged 76, had an assisted death. Physician assisted suicide is legal in Holland but must be done under strict rules.
Charlotte visited her uncle, who lived in Holland. He was seriously ill with cancer. She was...
And he lived at that point on his own because his wife, my Aunt had died that year previously. And he has five children, my cousins. And so what they decided to do was that they would try and support him being at home. And I think there was other hospitals; I mean staff who would come in during the day but they decided to have a rota to stay with him overnight,
The family yeah. And because I was, happened to be Holland at that time I said yeah I’d very much like to come and volunteer to take part in doing that.
So it just so happened that I had volunteered to do that on this Friday night and had arrived after work that I was doing to be greeted by my Uncle as I opened the door, saying, “Hello Charlotte, lovely to see you. I’ve decided to die tomorrow.”
Her uncles GP and another doctor agreed that her uncle had good reasons for wanting an assisted...
Not that I had been aware of, but perhaps I think he probably had been thinking about it and it may well be that he’d discussed it previously with my cousin, who didn’t seem all that surprised about it. So what had happened prior to my arriving that day was that they had organised for his GP to come and visit him, because in Holland the arrangement was that if you need, wanted an assisted death that you had to have at least two doctors come and talk with you. His GP had known him for a very long time and I think had seen him all the way through the illness, I think he’d only been ill during that, that year, but was pretty ill. And so his GP had come to see him and had agreed that he, you know that there wasn’t any more treatment. He was refusing any more treatment. He was quite, quite ill and felt that he had good grounds for wanting an assisted death.
And then they’d organised for another doctor to come and meet and talk with him also who had agreed that as well. So they had both signed, because I think you have to sign something, they had to give agreement that this could go ahead and they had agreed that that would be the case and that it had been arranged that he, that the GP would come and do the assisted dying with him the following morning at 11 o’clock in the morning.
As Charlottes cousins gathered in the sitting room, her uncle talked about his furniture and his...
So we had quite a chance to talk about it together my cousins and I. And then in the morning my Uncle, we got him out of bed, we helped him to the sitting room and he said, he said, “Well if there’s anything you want to ask me, you know this is the time.”
Charlottes uncle said good-bye to her and her cousins and then the GP gave him the lethal...
And then we were all back in the room and he said, “Okay, I think it’s time for me to say goodbye to each of you then.” And so each of us went up and he said something to everyone. And one of my cousins got very upset about it and he said to him, he said, “I know, I know it’s very upsetting for you, but for me this is the right thing to do. And I’ve wanted to do this for quite some time. And it just feels like the right time for me to do that.” And to each of us, and then he wished each person very well for the future and well for their children and, and then he, and then when everybody had had a turn he said to the GP, “Okay, please do it now.” And so the GP then gave him the injection and it was a very quick death actually. I can’t imagine, I mean I know time goes slow when something like that happens, but I think he probably died in about 30 seconds to a minute. It seemed very fast.
Charlotte does not think that her uncle was religious or that he was sure that there would be...
Did he have any sort of spiritual beliefs do you know?
Some of the people we talked to had witnessed other people's experiences and become convinced that people should have a right to choose when to end their lives. Most mentioned the moral complexities and the dangers of abuse but could not see the point of causing further suffering. As one young man put it, 'I don't believe in suicide but if someone's dying and they know they're dying and they've only got x amount of months, let 'em go happy. Why let them suffer?'
A woman with chronic obstructive lung disease wished that euthanasia were legal in the UK. She anticipated a time when her quality of life would be so poor that she might want to die. She said that it would be nice for her to have her family around her when she died, but didn't want any of the family involved in her death because she didn't want them to get into trouble with the law.
She would like to die with her family around her, but if she commits suicide she plans to die alone.
Because you're going to take control?
Have you talked to anyone else about that?
Yes I've talked to my GP about it. He wishes I lived in another country because that decision would be helped.
Mmm. This is something I talked about to your friend this morning, and we talked about the Government's national policy on it,
On assisted suicide and euthanasia,
And how there's a lot of debate at the moment about this,
And I wondered like if you were in control of legislation what would you say should happen?
It has to be really carefully dealt with. I think that you have to really look into it seriously, whether this is the right thing for the right person because I think there is the risk it might be abused. But with myself if the legislation was there then it would be nicer for me so I'm not on my own which I know I will be because I don't want any of the family here when it happens.
Why don't you want anyone with you?
Because I don't want them involved, I don't want them to get in trouble.
You don't want them to get into trouble?
No. Which is a tough one.
But I shall concentrate on the day we've had out beforehand.
Will you explain it to them in a letter or...
I've done it already yes. I've already written a poem to be read out at my funeral. I've written a letter to both my children. In the letter I've told them if they've ever been angry with me and they're feeling guilty please don't because it's no more angry than I felt at myself. I've given them permission to be cross at the end which I think is going to be important for them because they will be angry, they will be cross. They'll be hurt, they'll want to know, they'll be in denial that it's happened.
You've thought about it so deeply and so thoroughly haven't you?
Yes I've, I have because I wanted to stay in control.
Well thank you for telling me all that because it's such an important,
Aspect of everything isn't it?
And anybody like me tries with difficulty to put myself in your shoes.
No one can but respect what you said.
Yes. I think if some of these ministers and politicians who are against euthanasia, I often wonder if it was their life or their wife or mother how they'd feel then. I don't like my child
Others also thought that UK law should be changed to allow euthanasia for those with terminal illness. A woman who had seen her mother die in great pain and with loss of dignity said that it would be a comfort to know that if she were dying she could say goodbye to her children and be given an overdose of morphine.
Describes her mother's final illness and hopes that the law will change to allow euthanasia so...
It's a topical subject at the moment isn't it?
Yes, yes. I think I would love it, if I could, it would be a comfort to me to think that when I've come to a point where I'm clearly dying, I'm not, you know, there is no further treatment available for me and I am... if I am in lots of discomfort.
I would like to be able to say, 'Can you get my kids to come and see me and maybe," I don't know, my friend [name] that's a minister and "Say goodbye". And then can you just do it to... what has to be done. Give me an overdose of morphine or whatever it is. Because actually my Mum was in hospital for about three months before she died. And she had sort of raging osteoporosis having taken lots of steroids for another condition. She was in terrible pain and she had made a living will actually.
They had to give her so much morphine in the last few weeks, to be honest she was talking rubbish and coming up with ideas. She told us there was something she wanted to tell me and that she had murdered twelve children. And I said, ''Oh Mum, you know that is your mind playing tricks because of the drugs. You haven't murdered anybody'.
But she still insisted that she had. And I don't... I just wish that she could have gone a month or two earlier before she went through all that indignity that is dying really. And I would feel the same about myself. You know, I do (think) that life is very precious and it's a wonderful world and I want to stay in it as long as I can providing I have some quality of life and as far as I am concerned, you know, clearly there has to be legal agreement and so on but I do hope that some legislation comes in before my time is up.
Can you tell me more what you think the word and the experience of dignity means?
Yes. It's in kind of practical ways I think. I can remember my Mum being sort of hoicked out of bed and she couldn't stand herself, and plonked on a commode behind the curtains and then her visitors would arrive and she would be... she was with it enough to be terribly embarrassed.
I just think when you've come to that stage, only you know when that is, how bad that has to be. You don't need to go through those sort of physical indignities of you know, throwing up, being smelly, being incontinent, whatever it might be. I don't really think about that kind of thing but that would be depressing.
A man with multiple sclerosis had worked in a nursing home and had seen people die in pain. He felt strongly that pressure should be put on members of parliament to get them to change the law, so that if he could no longer enjoy life he could be 'put to sleep'.
Thinks that pressure should be put on parliament to change the law on euthanasia.
Yes I do. Yes I have a strong opinion about that. First of all I believe that it is everybody's right to die as it is their right to live. Now there comes a time I'm sure in my own mind that a person, providing they are in their right mind when they decide, not when it perhaps happens but when they decide, has the right to die.
Now I would like to think that if something happens to me that I become completely incapable of enjoying life then I would want someone to do to me what they would do to any ordinary animal. They would if it was a dog and it was suffering and in pain and couldn't be a dog anymore, you would say 'oh pity' and you would take the dog to the vet. I would hope that I could be taken to a doctor or the doctor would come to me, or would be allowed to and would be able to just put me to sleep, because I think life is only tolerable if you're alive.
Now what is being alive, now you know, what is being alive? Being alive, for example, being alive is being, for me, is being me. When I'm no longer me what am I? I'm a vegetable and I don't want to be that I don't want to be here when that happens. We've got to bring pressure on our members of parliament. Maybe not individually because we haven't got the effort or we don't like feel like it, but our various... like I belong to the local MS society.
I belong to the national MS society, we should bring pressure on them to bring pressure in making it law because, it's not right for everybody, I understand that, that's why I say it could only be done by someone when they're in their right mind and once they've done that they obviously knew what they were doing and what they were thinking but there are people, I suppose people with strong Christian conviction, convictions who believe that's wrong.I understand that and if that's what they want but I hate this. It's not very pleasant seeing someone dying and they've got two or three days left to live and they're dying in utter pain and even the strongest painkiller's not touching them. Through their unconsciousness they're suffering and you can't and you're just keeping them three days longer, a week longer and what are they doing, they're suffering, terrible.
Many people we talked to had spent time in a hospice, either in the day centre or as an in-patient. They all spoke very highly of the care they received and many enjoyed their experiences (see 'Hospice day care' and 'Hospice in-patient care'). However, one woman had spent a month in a hospice and had seen nine women die. It had not been a pleasant experience. She hoped she would be able to find a way to put herself “to sleep” when the time came, and she said she would be grateful if someone else could help her.
Having seen others die she hopes that when she nears death she will be able to end her life with...
It's was bad luck really in a way for me that I spent that month in the hospice really bad luck because I've seen it first hand where as in the past I could only guess at I suppose what it could be like at the end and its not a pleasant prospect and if I could just take enough of something to put myself to sleep for good. I would happily do it and... If somebody wants, you know wanted to help me... if somebody was brave enough to help me I'd be grateful to them.
Well some countries are introducing, it as a policy, aren't they? So it is being...
Yes I know but I haven't read anything about it. I mean I've seen the headlines from time to time somebody went to the European court didn't they for the right to die? I can't remember what the outcome was now.
But it's a way of people having control isn't it?
Yes, I was gonna say it's almost a nonsense if we can't decide what to do with our life at the end isn't it? Why should a judge be able to say no I can't kill myself if I want to?
When you said it was bad luck to be in the hospice then, do you mean because there were that number of people who were coming to the end of their lives?
I think so, the nursing staff kept saying to me, 'It's just unfortunate that you're here at this time'. It just happened to be a bad time for them apparently, but it wasn't pleasant. It wasn't a pleasant experience for me.
A woman with motor neurone disease also wanted the law changed so that if she became a 'total cabbage' someone could help her to die. She believed her husband had suffered unnecessarily and did not want the same for herself. Like several others she said that laws on euthanasia are made by 'people who are able-bodied', who 'don't have a clue'.
Thinks euthanasia should be available and the law should be changed.
Because there's been a lot in newspapers and television about this, hasn't it?
Yes. If I thought I would be a total cabbage for years on end, I would sell up and go to Switzerland if I could find someone to take me.
That's what the discussion's been about, hasn't it?
About how when people become so dependent they need help, assistance, don't they?
Yes, more than that, more. I don't see how you should not have assistance. Obviously, if your GP or someone can't do it or wouldn't do it, I respect them but I think somewhere along the line someone should help you. What is the point? What is the point? You're suffering unnecessarily and the cost is... you can end up with the cost... the costs are astronomical and there's no point because there's no end to it.
In some countries, I think it's Scandinavia, it's different, isn't it?
Yes. And Holland there is. My grandson lives in Holland so I know.
Why do you think it's happened in those countries and not in ours?
Because we so drag our feet here, that's why. I mean it's all judgement by people who are able-bodied and they don't have a clue.
When talking about their personal situation several people said that they found that the wish for euthanasia gave rise to a conflict within them that they found hard to sort out. Some people discussed the moral complexity of the situation. Many pointed out that it would be unfair to prosecute a caring partner who had helped with a suicide, although one man said that relatives might want a sick person to die and so encourage euthanasia. A few people said it was important that each case should be judged on its own merit.
Thinks that euthanasia is a very complex issue and that every case should be judged on its own...
Well no, but I have my own thoughts on it obviously as far as I'm concerned with euthanasia... the thing that would concern me- very much is the abuse of it. It could be used in the wrong way therefore I think it requires a lot of careful thought because as we said earlier different people have different ideas and treat things in a different way. To deliberately let someone die or even assist them to die that a very difficult question, my mind goes back to, what was the ladies name Mrs Penny, was it?
Diane Pretty that's the one yeah. I found that very moving. She went to Switzerland didn't she and was talk about prosecuting her husband? I've never heard any more. Well to prosecute her husband I think that's a miscarriage of justice to be honest.
So in a way your kind of in support of that?
Yes, in a way yes. I am because of... I think it depends on the individuals again doesn't it? I mean I think Diane trusted her husband to the ends of the earth I mean what he was doing was of her request so I think the possibilities there were zero but obviously there would be circumstances where abuse could take place. It's got to be... Very, very difficult one that.
As you say it is very complex?
Very complex. I think you've got to judge each case on it's own merit actually and the people involved.
Discusses the complex moral issues involved in euthanasia.
I find euthanasia very difficult. I feel I've made it clear that when I'm in the terminal stages, I would like to have an easy death. I mentioned pain, I'll refer to that again in a minute. I would like an easy death and from that point of view I think I would welcome euthanasia.
Having said that I see all the complications of it and people who are at a stage of illness where they can't speak for themselves, a possibility of somebody wanting to get rid of their relatives, that makes me very nervous so although on the one hand I would like to see it to help me, I'm very hesitant about it, very hesitant.
As a national policy.
As a national policy whereas in Sweden they go now and, is it Sweden? It's one of the Scandinavian countries isn't it and you can go there and arrange, that makes me very uncomfortable you know. Yet on the other hand there was Diane isn't it, with Motor Neurone disease and there, there was that poor women obviously wanted to die and nobody would do anything about it. It's a conflict, I don't know, I can't deal with it, I don't know how you sort it out.
Some people with religious beliefs are strongly opposed to any form of assisted death but some said that it might not always be God's will to prolong life. One Christian had reluctantly concluded that quality of life could be so poor that assisted death would be appropriate, but worried that some might decide to end their lives because they were thinking more about their carer than themselves.
Discusses the complex issues involved in euthanasia and believes that God can help.
Well I wondered what you're views are on that?
Well as I said in the break I've got very mixed feelings on that subject being a Christian person we are told that life is very special and God gives life and God takes life away, but I also believe that there are times and there are cases where I believe that God would not want that person to continue.
Do you mean because of the suffering?
With the... I was just going to say, with the suffering and the... what's the word I want... quality of life which they probably wouldn't have any at all. So I don't think that God would frown upon that happening but of course I mean euthanasia goes for all sorts of things and its not just for terminal illness or anything like that and I think that you've got to be very very careful if if this was made law. Legalised. If the quality of life is such that somebody could live it, all be it very frustrating and then I would, don't think I would like to see euthanasia used in that context. If the quality of life is virtually nil and they have got such an illness diagnosis handicap or whatever, reluctantly I think I would say yes.
You see I mean how do you measure it? What is quality of life for one person is not quality of life for somebody else, and I do wonder sometimes whether you know somebody who does suffer like that perhaps are thinking more about their carers than themselves but they would never let on because they would never want their carer to know.
It's a big ball game.
One argument against euthanasia is that people should not need it if their pain is correctly controlled. A man with prostate cancer had great faith in palliative care and opposed any change in the law, suggesting that euthanasia was “the next stop to murder”. A man who was dying of bladder cancer was sure that pain could be controlled but recognised that the palliative care team might find it hard to ease the suffering of someone with a very debilitating neurological illness.
He believes that pain can be controlled and that euthanasia is the next stop to murder.
And you say that because of your religious faith? Is that right?
In a way, yes it is. It must have been formed by what I believe, but if you sort of ignore the religious side of it, I still don't think that... that's the next stop to murder really. And I don't think people should do that. I've enough faith in the palliative care to feel that people shouldn't have to suffer that much pain. No. I may be wrong. I may be being trite or something but '
No, I don't think so.
But I don't. I can't relate to that, no. That seems wrong.
Last reviewed July 2017.
Last updated August 2014.