Matter of life and death

"SHAMEFUL, offensive and irresponsible."

Those are the words with which York coroner Donald Coverdale chose to condemn the suicide manual which James and Hilda Bedell used to plan their suicide.

An inquest heard last week how the couple, known as Ted and Nan, took their own lives in a suicide pact in October 2006 because they could not bear to live without each other.

They drank whisky before tying plastic bags around their heads and suffocating in bed at their Strensall home as music played.

The Bedells had meticulously planned their suicide for years, the inquest heard.

Mr Bedell, 81, a war veteran and retired milkman, had been treated for anxiety. He also suffered from loss of balance and trembling hands, which may have been signs of Parkinson's Disease, although they were more likely to have been due to a benign tremor.

Seventy-six-year-old Mrs Bedell's arthritis and osteoporoses had worsened in the months before she died.

The couple left notes for family, friends and neighbours to find in the quiet cul-de-sac where they had lived for 21 years.

They also left behind a manual on the kitchen table detailing how they should go about committing suicide.

It is that book the coroner, Mr Coverdale, described as shameful'.

"I find it deeply offensive in concept and its contents pernicious," he said. "People in pain and distress need comfort and support, not encouragement to destroy their lives."

Suicide has also been high on the national agenda, after seven young people who knew each other in Bridgend, South Wales, killed themselves in the past year in what are feared to be "copycat acts". There has been speculation they may have used the internet to research and discuss suicide.

The Ministry of Justice has said it is looking at taking action against websites that feature suicide as part of a Government review that will report back in March.

While the idea of a suicide pact among teenagers with their lives ahead of them is horrifying, many might have sympathy for an elderly couple who simply could not bear the thought of life alone.

So are there ever any circumstances in which it is right to take your own life - or to assist or advise someone else on how to do so?

The grieving brother

IT IS "really insane" that there should be websites which appear to encourage people to commit suicide, says young York film-maker Kevin Curran.

Kevin feels particularly strongly about it, because in June, 1995 his own brother, Declan, committed suicide by hanging himself in the family home in Clifton, York. He was 15 years old.

Declan had been about to give evidence against a man accused of sexually abusing him. He was also bullied at school.

Kevin has spoken before of the horrendous shock he felt at what Declan did. The emotions are still raw today.

Sometimes, he says, a person gets into a situation where they cannot see a way out.

"It is just wrong to ever encourage somebody to suppose that suicide is ever the best option," he said.

Just as when you are angry, you sometimes say and do things that are not really you, so when you are depressed you can sometimes act irrationally, he said.

But if people could only be helped through that period of depression, they may then be able to see some point in life again. "They need help to try to address the feeling."

Family members left behind after a loved one commits suicide have to live with the devastation for the rest of their lives, he said.

He can understand that elderly couples such as the Bedells, who have spent their lives together, may be terrified of the thought of being left alone. He feels nothing but sympathy and compassion for them But he finds it sickening that a book helped and encouraged them to take their own lives.

"It is fundamentally wrong. There is help available."

The GP

THE whole issue of helping or advising someone on suicide is a legal and ethical minefield, admits York GP Dr David Fair.

He has never been asked by a patient to help them die, he says. The British Medical Association's advice is that doctors should never agree to do so, on both moral and legal grounds.

Nevertheless, he can see valid reasons why somebody might want to end their life - if they were suffering, in pain, or disabled to the point at which they had no quality of life, and no prospect of any.

"My sympathy goes out very strongly to Mr and Mrs Bedell," he said.

He would not blame the authors of the manual that the couple used to plan their death, he said.

If they had not had access to such a book, they "might have tried to kill themselves in a way that caused themselves greater suffering".

Whether to assist someone to commit suicide if approached would be a very difficult decision for a doctor to take, he said.

"You would have to decide what you thought was the lesser of two evils. You might have to accept that a course of action had bad consequences, but that not taking action had worse consequences."

The situation with the teenagers in South Wales was different, he said. There may well be an element of peer pressure at work. It was important that there was support - from families, local councils and the social services - to enable them to resist any such pressure.

The man of God

THERE are "all sorts of concerns and issues" surrounding young people and chat rooms and the sort of "copycat suicides" that appear to have been happening in South Wales, says the Rev Chris Cullwick, of the York Workplace Chaplaincy.

He admits to being very worried about websites that appear to be dedicated to helping people take their own lives.

"These internet chatrooms present a very unbalanced option," he said. "What doesn't happen is really highlighting the resources that are out there to help people. That is concerning."

He had huge understanding and sympathy for the Bedells, Mr Cullwick said.

God would certainly understand their action, he said. "The God I believe in is a God who is infinitely understanding."

Nevertheless, he himself finds it hard to accept suicide as justifiable. "Anyone must have understanding and sympathy with this situation, but at the same time there is very good palliative care in York," he said.

The euthanasia movement

AT 86, Joyce Pickard firmly believes that people should have the right to end their own lives should there come a time when they can no longer live with dignity.

Mrs Pickard, a founder member of the North Yorkshire branch of the Voluntary Euthanasia Society and a former head teacher of The Mount school, knows a number of people who took their own lives, and has huge respect for them.

"If I thought I was ever going to have something where I would be reduced to a cabbage, I should want to end my life with dignity," she said.

"I should not want to be on a life support system. I should want nature to take its course - and if it didn't, I should very much want somebody to help it."

It is tragic that Mr and Mrs Bedell felt they had no choice but to take their lives in the manner they did, says Sarah Wootton, chief executive of charity Dignity In Dying.

But she said a "good death" should be a matter of individual and personal choice.

"Palliative care, regardless of standard, is not always enough to alleviate the constant, unbearable suffering and loss of dignity that some people will experience at the end of their lives.

"Dignity In Dying believe, as do 80 per cent of the British public, that the option of a safe, medically-assisted death should be available to mentally competent adults who have a terminally illness and have less than six months to live."

Mrs Pickard, however, draws a clear distinction between a case such as that of the Bedells, and the possible "copycat suicides" involving teenagers in South Wales.

"I should call that teenage hysteria," she said.

"It is a very serious misuse of an information service the internet that is quite alarming."

The hospice worker

THE philosophy of St Leonard's Hospice, and of the whole hospice movement, is to care for people until they die, said St Leonard's Hospice spokesman David Winpenny.

"We neither prolong life nor seek to shorten it. We are here to bring a quality of care every day to the people who are with us. Our patients and their families tell us that they do achieve a quality of life when they are with us, and that is what we aim to give them."

Suicide and the law

* The law as it stands prohibits any form of aiding or abetting a suicide* Anyone who assists the suicide of another in any way, could face prosecution and up to 14 years in jail* The Assisted Dying for the Terminally Ill (ADTI) Bill was last raised before Parliament in the 2005-6 political year. The Bill was blocked by the House of Lords in May 2006, but plans are to reintroduce a bill- or similar- in the future* Surveys have consistently shown that more than 80 per cent of the UK population support a change in the law to allow medically-assisted dying for terminally-ill, mentally competent adults* A recent Pulse survey found that one third of GPs would be willing to help a terminally-ill patient to die (May 2006)* A General Practitioner (2005) survey found that 51 per cent of GPs supported medically assisted dying for the terminally ill* There is evidence to suggest that assisted dying happens in the medical industry: A survey by Medix-UK found that 45 per cent of doctors believed their colleagues actively helped their patients to die* More than 800 UK citizens are members of Dignitas, the Swiss suicide clinic. Some terminally-ill people see travelling to Dignitas as their only option if they want an assisted death. However, anyone who accompanies them on this journey faces arrest and imprisonment on their return.

Information courtesy of Dignity In Dying