British Section of the World Federation of Doctors Who Respect Human Life

TO AVOID the legal ban on medically assisted dying, doctors are helping patients starve and dehydrate themselves to death.

The retired GPs have advised patients who are terminally ill, or suffer from a degenerative disease, that they can refuse food and drink if they are unable or unwilling to travel to a Swiss clinic to receive a fatal dose of medication.

The doctors admit the process of starving and dehydrating to death is “horrific” — with one woman being on “hunger strike” for 25 days before she died – but say patients have no alternative as long as euthanasia is illegal in Britain.

The doctors are members of the campaign group Friends at the End (Fate), which lobbies for the introduction of assisted dying in Britain and gives practical advice on suicide.

They warn patients determined to dehydrate themselves to death not to succumb to the temptation to rinse their parched mouths with water or ice, because this merely prolongs the agony.

Tuson’s death in less than a week was relatively swift compared to some patients. Lily, 75, from Scotland, who had advanced motor neurone disease, took 25 days to starve and dehydrate to death, cared for by her family in her own home.

Wilson mentioned the possibility of death by starvation and dehydration to Lily when she called the organisation for suicide advice.

By then Lily had accepted that it would take too long to complete the administrative process necessary to be accepted by one of the Swiss suicide clinics. Her family feared that she would be too disabled to travel by the time she secured an appointment and even incapable of swallowing the lethal barbiturates unaided.

Lily ate her last bite, homemade raspberry ice cream, on a beautiful afternoon in late August last year. Her family hoped she would pass away within days. As the days turned to weeks, however, Lily became distraught. Using a communication aid, she wrote, “You wouldn’t put a dog through this; you would put it down; you would give it a lethal injection.”

Local GPs administered small doses of morphine to combat cramps and a sedative to relieve “emotional anxiety”.

One of her daughters, Jenny, 40, recalls: “That worked well enough until day 18 and day 19. They were two of the most horrific days of my life. By then my mother was suffering from severe dehydration . . . She was howling with anguish.

“At that point we pushed the GPs and the palliative care specialists . . . They agreed to up the dosage of her medication very strongly at that point, so within 24 hours she had slipped into a coma.” It took five further days for her to die.

Wilson, who was in contact with Lily during the 25 days, added: “She took a bit longer to die than expected but then we discovered that she had been sucking ice cubes. She had also been frequently rinsing the mouth with water. I was telling her not to do that. She was prolonging the process by these extra bits of fluid.”

The campaigners believe that starvation and dehydration are the only options for many people. Dr Michael Irwin, a retired GP from Surrey and member of Fate, says he suggested the method to a couple of patients who were terminally ill.

Irwin said: “You have to have a good team of doctors and nurses who are willing to give sedation and respect your wishes by not sneaking in behind someone’s back to give you a glass of water.”

Doctors’ duty

Wilson: suicide advice

Discussing with patients death by dehydration and starvation could put doctors at risk of being struck off, according to the General Medical Council (GMC). A patient should instead be offered counselling or pain management.

If a patient insists on refusing food and drink, however, the GMC says doctors have a duty to relieve the suffering . It allows doctors to prescribe pain relief and sedation and to relieve unpleasant symptoms.

It is illegal to aid and abet a suicide and anyone convicted faces up to 14 years in prison. However, every case is judged on its merits.

No one has ever been prosecuted for helping someone to attend a Swiss suicide clinic and campaigners think it highly unlikely that anyone would be prosecuted for suggesting refusal of food and drink or advising on the best way to do this.