‘I’d like to die as decently as possible’: top doctor urges euthanasia reform
Doctor who has escorted five other people to their deaths says he is also likely to end his life at Dignitas
Dr Michael Irwin has boarded five planes to Switzerland with somebody who has not come back. In two years’ time, when he is 90, he thinks he may decide he has had what he calls “a completed life”. In which case, the one-way ticket to Dignitas will be for him.
Irwin, a former GP and for 32 years a doctor at the United Nations, mostly in New York where he briefly treated visiting Margaret Thatcher and Nancy Reagan as well as UN staff, agrees he currently has “a very nice life”. Sitting in the sunshine over tea in the courtyard garden of the Royal Over-Seas League in London, backing onto Green Park, it must be hard to contemplate leaving it. He has a UN pension paid in dollars, three daughters and eight grandchildren, a partner whom he calls “my fourth wife though we’re not married” and is on lunching terms with the others.
On a website called Ninety Plus with pictures of setting suns and Brighton and Hove’s crumbling pier, Irwin argues for the availability of doctor-assisted dying for those over that age who feel that they have, as he puts it “reached the stage of a completed life”. It’s for people who feel they have lived enough and do not want to go through the inevitable process of physical decline that further years will bring.
Until he was 55, Irwin was still playing squash. He has been a physically active man whose equally energetic mind has not been much diminished by the years. When asked how he can sit in a beautiful garden and think about seeking death, he thinks for a moment, then says: “The biggest problem I have nowadays is a lack of energy.
“We have some kind of social event like a lunch or a dinner and it gets cancelled. I often think – thank god, I can stay at home with a good book or watch something on TV,” he says.
A lot of people 30 years younger than him might think the same. “Yes but it becomes more of a factor the older you get. So energy is a major thing I feel changing as the time goes by.”
But he says he is also becoming more physically decrepit. He leans heavily on a stick (“You get away with murder. You can always claim a seat on the train”) and has specially built-up shoes.
“I had a car accident about 10 years ago now and had severe damage to the lower part of the spine as well as fracturing my left leg and two ribs and a broken tooth and a fractured sternum and so on. It becomes more and more difficult to walk now. I have very little sensation in my feet. That’s getting worse and worse,” he says. “I know that in time, it will limit one getting around.”
He has been with his partner Angela Farmer, 74, for 20 years now, living between her house in Surrey and his flat in Hove. He used to fly to New York, where his daughters live, every six months but not for the past three years. He now enjoys cruises instead, where he can drive into the port, have his bags taken and there is a mini hospital on board. The last was in the Baltic Sea. The next is Iceland.
He has good genes, he says. His father lived to 90 and his mother to nearly 96. If he lives comfortably to 90 or even 92 he will be pleased, he says. “But the time will come when it’s obvious that the end-stage is going to be pretty soon and I don’t want to hang on to the point of being fully dependent on others.”
Irwin is a former chairman of the Voluntary Euthanasia Society – now called Dignity in Dying. He has escorted five people to their deaths. Very easy and contented deaths, he says. The first in 2005 was May Murphy, 75, who was suffering from multiple system atrophy, a progressive deterioration of the nervous system. As she ate a sandwich on the plane to Zurich from Glasgow, she joked: “Perhaps this is my last meal and I have only one disciple with me.” In the Dignitas flat, she raised her glass of Nembutal in a toast of thanks to Irwin and her son who had joined them there.
The second was Dave Richards, 61, who had Huntington’s disease and gave an interview over dinner to a journalist before flying out. Irwin gave the third, Raymond Cutkelvin who had pancreatic cancer, £1,500 towards the costs of the trip for him and his partner Alan Rees.
Rees became a campaigner and challenged the police to arrest him for his actions, which they did in 2009. They also arrested Irwin, but after 11 months on bail, he was told he would not be charged. The Telegraph ran the headline “Dr Death ruled too old to stand trial”. “Friends wrote asking: what other crimes can you now commit and get away with?” said Irwin.
In 2011, he took a close friend and fellow right-to-die campaigner, Nan Maitland, on the final journey. She was suffering from extensive osteoarthritis and had decided she could no longer do the things she enjoyed. With another friend, Liz Nichols, they had a “wonderful dinner” in Berne and the next day went to the flat belonging not to Dignitas but to another group called EX International, whose members Maitland knew.
“You’ve got to swallow some medication about half an hour before you take the lethal Nembutal to settle the stomach, so she drank that. Then we were sitting around waiting,” said Irwin. “You can imagine. What do you talk about in that last half an hour? That’s when she looked at her fingernails and said, do you have a nail file, Liz?
“I sat next to her when she drank the Nembutal. I had some chocolate to give her because it is a bitter substance. She drank it quickly and I said: ‘Do you want the chocolate? ‘No thank you, it’s not too bad.’ Those were her last words. She was unconscious in five minutes and dead in 20.”
The last trip, in 2016, was to assist a Canadian right-to-die campaigner, John Hofsess, who had prostate cancer. Hofsess used to advise people on “self-deliverance” – DIY methods to use at home. But he chose to have a doctor-assisted suicide when his own time came.
“I think doctors must be involved, in order to get the law changed and to judge someone’s condition is fairly serious and they are mentally competent and to supervise what process is applied to end their life,” says Irwin.
Doctors can help people who choose to die by refusing food and water, says Irwin. When a good friend of his in Oxford decided to die that way, her GP, who was opposed to assisted suicide, agreed to give her medication to alleviate symptoms such as abdominal cramps and insomnia.
A lawyer afterwards wrote on Irwin’s behalf to the regulatory body, the General Medical Council, to find out if that was permitted. “They said yes, as long as you are mentally competent and you want to starve yourself, then your GP is obliged to treat the symptoms that will arise,” he said. Effectively, Irwin says, as long as they are acting in a compassionate way, a doctor is allowed to assist a suicide.
In 1991, the Dutch judge Huib Drion advocated that everyone over 75 should be entitled to a suicide pill if they wanted it. Thirty years on, 90 would be more realistic, Irwin says, as he adds sugar to his tea. “Doctors are the worst hypocrites when it comes to their health,” he says: “I only drink Dubonnet, by the way. In small doses.”
A study in 2009 by Prof Clive Seale of Brunel University estimated that there were about 1,000 cases of voluntary euthanasia in the UK every year and 2,000 more where doctors hastened the end of a terminally ill patient without a request to do so. We should, says Irwin, be legalising what is already happening.
He is in no rush to die, but is more afraid of a paralysing stroke. As a humanist, he says he doesn’t worry about what comes after, because nobody knows. “Let’s just try and make this world a better place. That’s basically to me a humanist approach. I’d be delighted if there was some kind of afterlife. I’d be pleased to meet my parents again. There might be something to campaign for there, as well. But it doesn’t bother me that there’s no existence after you leave this one,” he says.
“Do you know how fast we are moving through space right now? 17 miles per second. When you think about this and the whole vast universe, are we the only tiny little blob in the universe that’s inhabited with strange creatures with two arms and two legs?
“It would be nice to know if there is something else. It’s a curiosity. If I die there is either nothing, which is fine, like a good sleep – or are we are going somewhere else, which would be even more fascinating than this?”