On Australia’s Sunshine Coast, Karl Ropers spent his final moments listening to his closest friend Francoise sing him to sleep, in the garden where he passed many happy hours mending guitars and antiques. But in Brighton, Crispin Ellison was unable to say goodbye to most of his loved ones before he and wife Ilana made a secretive and stressful trip to Swiss clinic Dignitas. Their experiences lay bare the gulf between the options available to people in the UK and millions around the world who now have access to assisted dying.
Hamburg-born Karl was one of around 1,400 people who have accessed voluntary assisted dying (VAD) since it was legalised in Australia. Victoria was the first state to introduce VAD in 2019.
She was there in March 2020 when doctors broke the news he had prostate cancer which had spread to his bones and lymph nodes. The 77-year-old pursued treatments, undergoing chemotherapy and hormone therapy. But after two years, nothing more could be done and Karl’s condition became terminal.
His symptoms worsened until he had no appetite, he was always cold, his vision and hearing were going, and he was doubly incontinent. One day he fell on the stairs and spent a miserable 24 hours in a hospital.
Francoise remembers sitting together in his room with the heating on high, as she read out the subtitles to Turkish films.
Francoise, who previously campaigned for assisted dying, said she was sure Karl would have taken his own life if not for VAD.
She added: Death should be a choice too. If you’re lucky enough to know that you’re going to die, you should be able to do that in a way that pleases you. For Britain to still not have that right is sad. The word dignity is very important. There are horrible deaths out there.
Karl’s peaceful death, at a time and place of his choosing, stands in stark contrast to Crispin’s.
An experienced skier and sailor, Crispin had been diagnosed with motor neurone disease four years earlier, aged 65.
The couple spent a summer traveling the world, then adapted their home and hired a live-in carer when Crispin’s condition deteriorated.
But once he was almost completely paralyzed, Crispin decided he wanted to be in control of the end of his life.
Ilana, 77, said: It was a subject that we both agreed on, about personal freedom, choice, and dignity. So the process of joining Dignitas and planning a painful journey began because we knew that in this country it is not possible to do that. The plans, the stress, and grief of the journey were all marred by huge anxiety and secrecy.
We told very few people among our close friends and family. We even had to keep it secret from the carer who was here 24 hours a day. I thought that she might inform her agency and they would inform the police, and they would stop us going or arrest me.
Ilana and Crispin were both prescribed antidepressants as the strain took a heavy toll.
The need to go abroad – at a cost of more than £10,000 – also meant he had to die earlier than he would otherwise have chosen to.
The couple traveled from their home in Brighton to Zurich with Ilana’s two daughters in August 2019. Crispin drank life-ending medication and died aged 69.
Ilana said: While the law is as it is here, people really suffer. This country is still behind the times on compassion.
As the debate around assisted dying continues to gain traction, stories like Karl’s and Crispin’s highlight the stark contrast between countries that allow the practice and those that don’t.
While Australia has embraced the concept of voluntary assisted dying, providing terminally ill individuals with the choice to end their lives on their own terms, the UK lags behind.
In the UK, discussions surrounding assisted dying have long been controversial and met with resistance. Although public opinion has shifted in recent years, with a majority of Britons now supporting the right to die, legislation has failed to reflect this sentiment.
Proponents argue that the option of assisted dying grants individuals autonomy and allows them to avoid unnecessary suffering. They believe that everyone should have the right to die with dignity, surrounded by loved ones, in a manner of their choosing.
However, opponents cite concerns about the potential for abuse and the sanctity of life. They argue that legalizing assisted dying could have unintended consequences and may undermine palliative care efforts.
The disparity between the options available to individuals like Karl and Crispin raises questions about the state of compassion and end-of-life care in different parts of the world.
As the debate continues, it remains to be seen whether countries like the UK will follow Australia’s lead and provide their citizens with the choice of assisted dying. Despite the progress made in some regions, the road to change remains long and fraught with ethical considerations.
