Remembering ? Choice in Dying

In view of the question asked in the comments below about the remains of those assisted by Dignitas to die, Elizabeth?s ashes are interred here, in a spot and beneath a stone that Elizabeth herself arranged before she went to Switzerland. Here what remains of me will come to lie someday in the not too distant future. (The photograph itself was taken about 15 minutes ago. It is raining and soggy here in Nova Scotia at the moment, but also lush and green.)

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It was five years ago, almost this very hour, that my beloved wife Elizabeth died in Zurich, Switzerland, with the help of the assisted suicide group Dignitas, founded by Herr Ludwig Minelli. For the kindness of Dignitas, and for the opportunity for Elizabeth to die peacefully, and with the dignity she sought, I will be forever grateful. It was a generous gift, and I feel a debt of gratitude for the kindness of the people at Dignitas, and of the Swiss people generally, for making it possible for Elizabeth to die in a way that accorded with her own sense of how her dying should go ? not as the result of a lack of choice or decisive action on her part,?in a way that?the Roman Catholic Church chooses, in its ignorance and cruelty,?immured in an evil imposed by belief in an evil god,?to call ?natural,? but by her own act, at a time of her own choosing.

One of the things that I remember as I write that dread word ?natural? ? as in?the incantatory religious phrase: ?life from conception to natural death? ??that causes so many people to die in unrelieved misery, is that it is natural for human beings to live and to die as they choose, with careful forethought and planning, and unnatural for them simply to accept, supinely, the fate that is prescribed by their diseases, or any of the other circumstances of their lives. In no other dimension of life are we expected merely to accept things as they come. We use all the cultural means at our disposal to avoid pain, distress and disaster, and yet we are bidden by so many?religious believers ??who, for reasons past understanding, think that only a god can be in control of our dying ??to suffer the pangs of hell, if that should be our portion, rather than considering, as the indecisive Hamlet half thought to himself, whether it would be more noble

??in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles
And by opposing end them.

Elizabeth chose to end her sea of troubles, and while I still mourn the circumstances that led her to that point in her life, she died in a way that was more consistent with her life, than if she had permitted herself to die, years later, as her church prescribed,?in pain and isolation in a paralysed body which would then have served, not her own?purposes, but as a prison, to bind and enslave her in the name of a god. I still hold in contempt those who would have trapped her there, choosing rather to play religious games with language than to help her do as she was resolved to do, taking that last step of her life on her own, just as she had lived it. The death cult of the church condemned her act, told lies about her state of mind when she?died, blamed her physicians for their inadequate care, and dug in their heels, and refused to allow their minds to consider the possibility that she was right, and they were wrong to believe?that we die when god chooses to take us to himself (as the burial office pretends).?As it happens,?Elizabeth?did not have a shred of belief in such?beings. She knew that they were pretences dreamed up by those who misread their experiences, and found that they had the means?at hand to control others?with their dreams and fantasies. She would not be taken in, and so she took control of her own life, and died as she had lived, not in bondage to the folly of faith, but with?the boldness and decisiveness that had marked her life.

A year after Elizabeth died, on the 26th of May, 2008,?I spoke at the annual meeting of Dying with Dignity (Canada), in Toronto. I called?my address ?Dying in Exile?. Here are those words. I include the picture which I took of Elizabeth two weeks before she died, which is mentioned in the first paragraph. Some people said, without knowledge, that she was depressed when she died. Does that picture show a despairing or angst-ridden person, or someone who knew what she was doing, and did it gladly? As it happens, the venue did not allow the showing of pictures, which I had planned to accompany the talk. Let this picture, the last I ever took of Elizabeth, stand in for all?the rest.

Dying in Exile

As I speak you will see images of Elizabeth on the screen. They begin at the beginning, showing a few pictures of her as a baby and as a girl growing up. I provide them as a testimony not only to her beauty, but also to her zest for life. They are an expression of my love for her. Her bright smile and sparkling eyes never left her until the moment she died. A few minutes before she died she was still making jokes and talking animatedly with the man from Dignitas, full of life to the very end. The last picture of all shows Elizabeth in the dress that she wore while she died. The second last shows her in her wheelchair in front of our home, taken exactly one year ago yesterday.

A fortnight later, she was gone. At the time, Arthur Bernhard ? whom some of you will already have met in John Zaritsky?s film, The Suicide Tourist ? remarked how attractive she looked. Elizabeth had worn her favourite dress, and she responded: ?You mean everyone doesn?t get dressed up to do this?? ?No,? he said ? a bit surprised by her forthright manner, I think ? ?as a matter of fact, they don?t.? Elizabeth had come to Switzerland to die with dignity ? as the Dignitas motto has it: Menschenw?rdig Leben, Menschenw?rdig sterben ? To live with dignity, to die with dignity ? and that is indeed how she died, with immense dignity and courage.

I would like nothing better than to talk about Elizabeth, and about what a wonderful person she was. She was incredibly alive, as everyone who knew her will testify; she was radiant; she glowed with an inner fire. It was a privilege to be loved by her, and to have been able to love her in return. Sie war ganz einmalig ? quite unique. But this is not why I am here. I want to speak of dying in exile, for that is how Elizabeth died, and I know that she wanted more than anything for me to tell the story of why she died this way. Elizabeth had a very aggressive form of MS, and the law in Canada was a threat and a distress to her. It made her very afraid of each new symptom, afraid that she would be trapped in her body, without any choices left to make.

Being in control was important to her, and the law robbed her of control, of her autonomy, which, for her, was already a kind of exile from being fully herself. She asked me earnestly to make a contribution to the conversation about assisted dying, so that someday the law might be changed. For many others die in exile too. Some are exiled to a shadow world of unrelenting pain and personal disintegration. Others, like Elizabeth, feel they have no choice but to exile themselves to another country. She felt driven to leave the country she loved, so that she could die in a way that was dignified, and without the prolonged and unnecessary suffering that she feared so much. She also wanted me to be able to be with her, and to hold her as she died. And so she died in exile, earlier than she might otherwise have died, fleeing an unjust law, amongst a people whose language she did not understand, in a country she had never seen, surrounded by strangers, many miles from her family, but accepted there, as she had not been in Canada, as a fully autonomous human being.

Only when we had left Canadian airspace behind, did Elizabeth really feel safe at last. She relaxed, quite noticeably, when the pilot announced that we were over international waters off Newfoundland. She knew then that she could bring her dying, at last, to an end. Canada had become unsafe for her, and only in a foreign land, and in Switzerland alone in the whole world, could she feel secure. The Swiss were very generous and kind, especially the people from Dignitas. Some Swiss, mainly Christian, scorn what Elizabeth did as ?suicide tourism?. It?s a heartless condemnation, and the reason why I very strongly object to the title of John Zaritsky?s documentary film. The Swiss, out of a world full of people, were the only ones kind enough to receive Elizabeth during the last moments of her life, and helped her to leave life with dignity, and as she chose. It was a generous gift. It should not be trivialised.

I was able to be with Elizabeth, and to hold her in my arms, as she died, just as she wished. She did not want to die alone, and though she was in exile, I was with her to the end. The last sensations she had were of her hand caressing mine, and her head resting against my shoulder. It is a comfort to me to know this; but how much greater would the comfort have been, as Elizabeth made her last journey, had we been at home, with friends and family, with the approval and support of the community? Fifteen days from today, it will be one year since the day Elizabeth died ? one year, during which, only for moments, have I felt that I am not myself still in exile.

I think this continuing sense of exile has to do in part with the way that I was greeted on my return. I was also greeted with kindness by Ruth von Fuchs and Donald Babey, and I mean no disrespect to them when I say that being threatened with the long arm of the law was at the time more overwhelming in my vulnerable state than kindness, even though I was convinced of my own innocence in the matter. The news media quickly got the story, thanks to the Euthanasia Prevention Coalition. They?re watching all the time. Elizabeth wanted to start a public discussion, but she never thought, not for a moment ? and it would have troubled her to know ? that the police would have been interested in what she had chosen to do, legally, in another country. Having been exiled to Switzerland, banished from the country she loved, what interest could this country have in her now?

For reasons I do not entirely understand, the police very readily played the role that the Euthanasia Prevention Coalition had scripted for them. Elizabeth and I underestimated the doggedness of the Roman Catholic Church, and other religious interests, wantonly to intrude themselves into the private lives of other people, no matter who, no matter where, when these involve actions which they presumptuously take as their special province to regulate and control.

So not only was Elizabeth exiled to die in another country, surrounded by strangers, but when I returned I was accused of having committed a criminal act, one which, it was menacingly said ? with quite deliberate malice ? was liable to a term of up to 14 years imprisonment. The provisions of this section of the Criminal Code have very seldom been invoked, but the menace was there, and menace was meant. A grave injustice had been done to Elizabeth. The Euthanasia Prevention Coalition sought to add to this by seeking to do me some serious harm, at a time when I was myself quite vulnerable and in pain.

Later, when it became clear that many people were offended by its actions, the Euthanasia Prevention Coalition alleged that they had not accused anyone of wrongdoing. They wanted, they said, merely to ensure that no laws were broken. I believe this to be a lie, concealed behind a wiggle word. But my reason for raising the point here is that Alex Schadenburg quite consciously used Elizabeth?s dying as a pretext for putting some stick about, trying to frighten anyone who might think of doing the same thing. Do anything like this, they were saying, and we?ll make things as difficult for you as we possibly can.

Then they took it a step farther, and sank, to my mind, much lower. What they did, in a way, was to exile Elizabeth a second time. They misrepresented , for their own purposes, what Elizabeth had done. She had made a very conscious and reasoned choice to die with dignity. It was a choice made during the course of many years of suffering, after long, patient thought. Instead of dying over a long period, lying paralysed in a nursing home bed, unable to speak, largely isolated, and in severe pain, she chose, very thoughtfully and deliberately, to hasten her dying. She was in control all the way through. (You really had to know Elizabeth to know what it means to be in control!) However, not content with having hounded her out of the country, these religious zealots treated her with contempt, confirming how unsafe Canada truly was for her. They slandered her good name, slanders and lies that you can still read on Roman Catholic and other so-called ?pro-life? web sites, where, without any basis whatever, Elizabeth is said to have been depressed, even clinically depressed, and that she was not competent to make the decision and to take the course of action that she did. (I ask you to look at the second last picture, taken just two weeks before she left for Z?rich, and then tell me that Elizabeth was in despair or clinically depressed. She believed that her liberation was at hand. She could scarcely wait.)

Of all the things that Alex Schadenburg and his pious thugs did, this was the most hurtful, the most offensive and cruel. The church of old dragged the naked bodies of suicides through the streets; these invidious, self-righteous people tried to turn Elizabeth?s dying into a spectacle, pretending to know that she died needlessly, and uncared for ? someone even helpfully added the word ?abandoned? ? a victim. As Schadenburg says: ?Victims of suicide do not choose death, but rather die out of an extreme feeling of hopelessness that is often related to depression, mental illness or breakdown.? This was not true of Elizabeth, and he had no right to claim that it was.

These people nauseate me, and, yes, clearly, they still make me angry. They are quite prepared to lie and humiliate to make their point. They arouse anxiety where there need be none. They play on the fears of the vulnerable, using them for their own purposes. And they do all this with a confident air of piety and moral rectitude. They will not hesitate to use, as tools of their own beliefs and purposes, those who suffer, and those who are in sorrow. They want to force people like my Elizabeth to suffer, and just to underline this, they said they would do it again. They do not care that people suffer, that they die in excruciating pain. They do not care that those who love them and have cared for them are in sorrow. They care only for their own narrow, dogmatic beliefs. They expected that many others would share them.

They didn?t. In the end, Alex Schadenburg felt he had to write a letter to the Halifax Chronicle Herald ? a bit of damage control ? trying to defend what he had done, claiming that this was a societal issue, not just a matter of individual autonomy. Not once in the whole piece did he mention, as a matter of moral concern, the suffering of those who are dying. He expressed concern only for society at large, that vast amorphous thing that needs protection against people who are dying in misery and want help to die more quickly. His moral regard for human beings is a sham.

Opponents of assisted dying always refer to the ?bigger picture?. If people are able to choose assistance in dying, we?re told, then vulnerable people will be in danger. The disabled, the mentally challenged, the aged, will be candidates for a forced exit from life. Society will soon turn into an all-consuming ?culture of death,? to use John Paul II?s fatuous term. This is the man, recall, who refused the use of condoms even for those infected with AIDS, because, as his advisor on the family said, there are values greater than the value of life itself! His successor has not let him down. Roman Catholics, of course, are not in this alone. Almost all leaders of religious institutions oppose providing assistance in dying to those in great pain. In 2006, the Archbishop of Canterbury strongly opposed the assisted dying bill before the House of Lords; and the Bishop of Durham told people at Easter this year that secularists believe ?that we have a right to kill unborn children and surplus old people.? This is a deliberate confabulation. No one, amongst those who support assistance in dying, think we have a right to kill anyone, let alone ?surplus? old people. Who else speaks of the elderly as ?surplus? except opponents of assisted dying? It?s nothing but a scare tactic, pure and simple, and an outright lie.

Aside from the fact that it depends so much on exaggeration and lies, why does anyone find this argument so compelling? Even supporters of assisted dying stress that they take it very seriously indeed. They need not. The simple truth is that all our concepts have fuzzy boundaries, so it?s not hard to make it look as if, when we do one thing, something similar is likely to happen. It?s called the ?slippery slope argument?, and it?s a logical fallacy. One thing leads to another and then to another, and so on, like a snowball gathering snow. I want to show you that even opponents of assisted dying don?t really take this argument seriously. Neither should we.

In 1975 the Church of England published a report, called Dying Well: a contribution to the euthanasia debate. It was revised and reissued in 2000. In the introduction, written by a contributor to the 2000 revision, we are told that cases of people dying in great pain and distress are so rare that ?most doctors would never see one in a professional lifetime.? (xii) This is simply false, but it gets worse.

I have not the slightest doubt [he writes] that in those most exceptional circumstances, easing the passing of life at the request of the patient would attract the praise, rather than the opprobrium, of the General Medical Council and the courts of law. Society would be singularly misguided, however, [he continues] to change the legal framework for such exceptional cases. (xii)

Gosh! Really? Even if the General Medical Council and the courts would praise such actions? Why not change the law? This, we are told, ?would be likely to make the exceptional cases more common.? (xii) This is an extraordinary claim. What?s the real problem?

To see what the real problem is we must look within the report itself, which actually says that most considerate people would support assisted dying in serious cases. In its own words: ?A case against euthanasia which rested on an absolute prohibition would be seriously weakened by what perhaps the majority of considerate people ? would say about unusual cases.? (24) Doesn?t this just make the case for changing the law stronger? The answer, according to Dying Well, is, no.

In order to show this, they need to find a way to skirt round this vast number of considerate people. (Why do they not call them compassionate, I wonder?) What you should notice in the next quote from the report is how the report very quickly and conveniently scoots past the concern, just expressed, for those in serious suffering, which the report thinks very uncommon. These cases would attract, remember, the sympathy of most considerate people, and the praise of the courts and the General Medical Council. They even go so far as to say that ?the case for euthanasia is at least extremely plausible in these unusual cases.? (24) But then they say this:

It is often expedient to forbid by law acts which are thought morally blameless. Such acts might include some cases of euthanasia, if, although they were held to be morally permissible, the making of them legal were likely to result in practice in the legalizing of other acts as well which the law should be seeking to prevent. (24-25)

Aside from the awkwardness of the language, this is entirely spurious. What the report says is that, even though it would be morally blameless to help someone in terrible suffering to die, if legalising this would lead us to legalise other acts, not so clearly blameless, then the law should forbid such help in dying absolutely. But this is not what they mean. What they really mean is this: If we legalise assisted dying in so-called ?unusual? cases, will we end up treating other cases as unusual, and therefore as legal? It?s a trick question, based on the assumption that this kind of suffering is really very unusual, and they have given us no reason to believe that this is true.

Let?s supppose that we take the question seriously. So, we ask: Is this likely to happen in the case of assisted dying? And the answer is both yes and no (because it?s a trick question after all). The empirical evidence from Oregon and the Netherlands tends to show that this will not happen. But since the writers of the report are not really treating this as an argument anyway, this evidence doesn?t really count. Two assumptions underlie this. First, they demand an entirely unreasonable standard of proof. They say they want ?clear, cogent and conclusive justification? that legalising assisted dying would not lead to ?consequences that we cannot predict and may not desire.? (25; my italics) They do not think such evidence exists, and of course it doesn?t. If you are looking for absolute guarantees, you won?t find them in human life, anywhere. Even scientific theories massively supported by empirical evidence are never conclusively proved. In philosophy, this is called the problem of induction. But second, since they have arguably underestimated the number of so-called ?unusual? cases, their fears are a self-fulfilling prophecy. Legalising assisted dying will extend further than Dying Well thinks it should. But this has nothing whatever to do with slippery slopes; it?s an effect hidden in its presuppositions.

So, why such a high standard of proof? Why the unrealistically low estimate of the number of those who die in great pain and distress? The simple answer? It?s only a pretend argument. They already know all the answers. Dying in unbearable pain and distress is unusual. Legalising assisted dying will spread like the plague.

We can respond to this in several ways. We can acknowledge that our moral boundaries are fuzzy, so that legalisation of assisted dying will have fuzzy boundaries too. That?s okay, because the boundaries are not endlessly fuzzy, so there?s no slope to slide down, and, in any event, it?s not we who need to decide. And this is the absolutely vital point. People almost always look at this from the outside, as though we were asking, ?When may we kill someone?? That?s why everyone opposed to assisted dying thinks that disabled people will fall within the scope of a law permitting assisted dying. But this isn?t the question at all. It?s the person who is dying in pain and distress who must choose. It?s their choice to make. And any law enabling assisted dying must make sure that this is where the choice lies.

Opponents of assisted dying are simply not using the slippery slope as an argument. They only make it look like one, as though they?re really looking at the evidence, by talking about the big picture, reminding us that it?s a societal issue, not an issue of personal autonomy, and then they throw in the slippery slope, just for good measure, and think that will make everyone go all wiggly.

But the truth is that we don?t need to, and we can ignore all the bluster and righteous indignation, because we have something much more important to consider ? that while they?re blustering away like mad people are dying in misery. We all know it. They know it too. Dying Well openly acknowledges it, and thinks that this permits a few extreme cases to be dealt with compassionately on the sly. They?re probably not as rare as all that ? which is why, of course, they warn us about slippery slopes, but calling things unusual does not make them so. In any case, many doctors dare not be compassionate, because people like Alex Schadenburg are watching all the time. So, though Dying Well acknowledges that people die in misery, basically it ignores them and moves on. Are they really as hard-hearted as all that? Yes, I think they are. The response of the religious to Elizabeth?s decision clearly indicates that ? to me, at least.

Most religious leaders apparently think that it is the duty of the dying to face the pains and the travails of dying with moral courage, or something like that. For the religious, the real meaning of pain, suffering and misery lies in a person?s soul. Pain has meaning. If it doesn?t have meaning, then religious belief doesn?t have meaning either. As C.S. Lewis says in his book A Grief Observed, if we were to stop God is his creative work with us, which includes a lot of pain, it would be as though we were to stop a surgeon before he was through, and then, he says, ?all the pain up to that point would have been useless? (60) ? that is, without meaning. So, if it does have meaning, then, to the religious, this means that we have no right to attenuate that meaning by aiding the process of dying. If we can alleviate it, then we should, apparently ? there?s a contradiction lurking here which the religious don?t seem to notice ? but if we can?t, we may not help a person die. The dying must embrace their own pain, and live it out to the bitter end. And if the pain is excruciating and disintegrating, then they must be exiled to that pain and disintegration. That must be an important part of God?s purpose too.

Dying Well even says this, but without the religious overtones, with no beating around the bush: ?? suffering [it says] as exposure to what is beyond one?s voluntary control, suffering as undergoing, even as diminishment, is part of the pattern of becoming human.? (22) I find this incredibly obscene! Where suffering is under our voluntary control, Dying Well does not object to alleviating it. But what they are trying to justify here is the refusal to control, by helping someone die more quickly, pain and suffering that cannot be controlled in any other way. How dare they resort to this kind of ?theologico-babble? at this point? What gives them the right to say, to someone dying in pain and distress: ?This suffering, suffering as undergoing, as diminishment, is a part of becoming human??! How dare they? Remember, this person is not becoming human. This person is dying. And this suffering is under voluntary control, if we allow assistance in dying.

And you know what? Dying people can?t really object. Why not? Because they?re dying or already dead. That?s something that all those principled opponents of assistance in dying can count on. Nobody will be around to tell us how horrible it all was. Elizabeth cannot be here to tell you how horrible it was to die inch by inch, with pain added to pain, and humiliation to humiliation. Not only can she be ignored, her very decisions and actions have been used to discredit her claim to our attention. She?s not here to tell us what it was like. That is why Dying with Dignity and other organisations concerned with the right to die, and dignity in dying, are so vitally important, because they give voice to the voiceless. We have a voice that hundreds, perhaps thousands of people, around this country, this very day, are being denied.

They say that change takes time. That?s true. The first assisted dying bill to come before the House of Lords in Great Britain was in 1936. It was defeated. The most recent one was in 2006 ? seventy years later! It was defeated too. It takes too much time to make changes. How many people are dying, right now, in pain and uncontrollable misery? How many voices, forever stilled, remain unheard?

A South African philosopher recently published a book in which he claims that existence itself is always a great harm. The title of the book, very persuasively argued, is Better Never to Have Been. We may not agree. We may think that there are wonders in life which should be celebrated. We may agree, with D.H. Lawrence, that ?Whatever the unborn and the dead may know, they cannot know the beauty, the marvel of being alive in the flesh.? But, if existence is itself not a great harm, it can nevertheless be a great harm, and it is an offence against humanity and our dignity to deny the right of those suffering from the great harm of dying existence ? as dying sometimes is ? to bring that process more quickly to an end, if that is what they want.

Dying is a part of life, and like any part of our lives, it is something that should be under our own control. It has been suggested to me that we need a new paradigm so that we can accommodate assisted dying. I think this is wrong. We do not need a new paradigm. We need to use the paradigm that we already have, and apply it, as it should be, to situations of dying. It is the medical paradigm. When people are sick, they seek the help of a doctor. When they are dying, there is no reason why one treatment option should not be assistance in hastening the process of dying itself. In fact, this is one of the arguments used in 1936 in the House of Lords to oppose the voluntary euthanasia bill. Doctors already know, it was said, when the time has come to hasten the process of dying. It should be left up to the physician, because it comes within his province, and doctors do not need law in order to help them determine when it is time to help the dying die more quickly. This was repeated several times in the course of the debate.

I am not talking practicalities here. I am not arguing that physicians must be directly involved, but there is no reason why professional help should not be available to help someone get on with their dying, when healing and palliating medicine have done their best. There is no obvious reason why people should suffer, without treatment, the effects of disease. There is also no obvious reason why people should suffer, without help in dying if need be, the effects of dying from particular diseases. No one should be forced to die in ways prescribed by her disease. There is no more warrant for this than there would be for the claim that a person suffering from a disease must suffer all the pains and indignities associated with it without relief. There is no obvious reason why assistance in dying cannot be seen as a legitimate part of care at the end of life for those whose dying has become a torment. The very same principles apply, as physicians in the House of Lords recognised seventy years ago.

Why is it still thought right to exile a person to a shadow world of pain and personal disintegration while she dies? I suggest that it has nothing whatever to do with slippery slopes or other feared social consequences of permitting assistance in dying. The reason lies much deeper than that. Fundamentally ? though I will not argue it here ? it has to do with the place of sickness and pain and dying in religious symbolism and fantasy. It has to do with meaning, and the meaning of pain and death in particular. But dying is a thoroughly natural process. It can be horrible beyond imagination, even if there is no one left to tell the story. In his book, How We Die, Sherwin Nuland says this:

? belief in the probability of death with dignity is our, and society?s, attempt to deal with the reality of what is all too frequently a series of destructive events that involve by their very nature the disintegration of the dying person?s humanity. I have not often seen much dignity in the process by which we die. (xviii)

Notice the contrast between this and Dying Well?s claim that these cases are so unusual that most doctors will never encounter one in a lifetime of practice. Not one! We do not need to put a number on it, but it?s high time that we acknowledged that dying can be a horrifying experience, both for those who are dying and for those who love them, and that this experience is not as rare or unusual as some people say. Besides, whether an experience is horrifying or involves suffering too great to bear is not for someone else to judge. It should be a matter of individual choice whether this dehumanising process is one which is of value, and whether or not it is one which we wish to experience to it?s so-called ?natural? end. No one else should get to make this decision for us. As Ludwig Minelli, the founder of Dignitas says, this is our last right.

In closing, I want to emphasise that nothing that I say here should be taken as a claim that people must hasten their dying, or that they must seek remedies for their illnesses, or have anaesthetic in childbirth or during surgery. People may, if they wish, experience as much pain and misery as their diseases or their treatments will allow or their religious beliefs demand. Nothing that I am saying would forbid or prevent this. But there is no reason, and I mean no reason at all, that people should be forced to die in pain and distress if their own choice is to die in another way. This is a grave injustice, a very grave injustice indeed. It was an injustice that was done to my wife Elizabeth, an injustice that forced her to shorten her life, and to die in exile. It was an injustice made even more malignant by the religious opponents of assisted dying, who went on to profane her memory with their lies. But she died as she chose, on Friday the 8th day of June 2007, with great dignity and courage. She died as she had lived, still full of the joy and wonder of being alive in the flesh until the very end.

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