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Assisted dying killed my family Without the right support, relatives suffer

Without robust logistics, ethical assisted dying is impossible (D. Corson/Getty)

Without robust logistics, ethical assisted dying is impossible (D. Corson/Getty)


September 18, 2024   6 mins

In February, I watched my mother be euthanised. I travelled to Australia to see it. She was ready to go: she lived in a care home, and was in terrible pain from spine cancer and terribly embarrassed by her lack of bodily control. 

Yet even though she was prepared, her death would still be messy: both for her and the family she left behind. Tensions between my siblings had escalated over the months, as we negotiated a difficult and stressful process. Let down by the officials who were meant to help us, it would be fair to say that assisted suicide killed my family along with my mother. 

Mine isn’t just a personal tragedy. As euthanasia inches towards legality in Britain, with a private member’s bill on assisted dying potentially being debated in the Commons this month, we must think seriously about the logistics of death. Ignore it and we risk wreathing a nation in trauma — long after bereaved families leave their loved ones behind. For whether a longed-for release or slow and painful menace, death is a painful business. 

The protocols, though, are simple enough. Following the Oregon Dignity in Death Act, passed in 1998, the Volunteer Assisted Dying Act in New South Wales encompasses 11 distinct steps and a host of safeguards. It is only available to over-18s who have an illness that will cause death within 12 months, or is causing suffering that cannot be relieved. Patients must undergo three assessments and write a declaration of their intentions.

Beyond these tight theoretical rules, however, the practicalities of VAD are less proscribed. For one thing, unlike in the US, assisted dying is free. And therefore more accessible. But far more important is the way in which amateur family members are roped into the protocols. My mother, as part of the process, nominated one of my sisters as her Key Person who would help her navigate the path to euthanasia.

This, though, was a difficult emotional burden for my sensitive sister, who struggled with poor health. To make matters worse, she was estranged from my other siblings. My mother selected this sister simply for her own ease. Another, more pragmatic sister had long been Evelyn’s Power of Attorney, but when new papers were drawn up, her name was misspelled and Mum wouldn’t sign incorrect legal documents. Instead of having the papers corrected, and waiting until her daughter could make the six hour-return drive to sign them, Mum was impatient.

Instead, she defaulted to the most convenient solution: her most available child. KP worked part-time, due to her health issues, while my other siblings work full-time. For my part, I live in the UK. At any rate, the newly bestowed Power of Attorney laid the groundwork for my KP sister being named as the primary support person. It was treated as a coup against my other sister who mum had always sought advice from on important matters or during a family crisis. In fact, that sister was the family vault on all serious matters. The animosity from one sister to the other was established years before my birth.

So I was commissioned as an intermediary, offering updates from my mother and KP to the other side of the family. I had also been passing along the various visiting times and dates of my siblings, so they could avoid each other at the care home. It was exhausting.

In theory, this muddle shouldn’t have mattered. After all, the rules also provide each family with a so-called VAD “coordinator”. These professionals are there to guide and support families through the challenging process. Empathy, it goes without saying, is key. 

Alas, these theoretical safeguards were inadequate. After attending a couple of assessments, my sister was struggling to cope. Even the most resilient adult will find it challenging to accompany a parent who is arranging their own death. My mother, for her part, made the process trickier. Evelyn’s dark humour — once funny — was now hurtful as she took to saying that she was “being put down.” 

That ominous sign would soon be echoed elsewhere. In January, Evelyn passed her third and final medical assessment, and was formally granted permission to undergo euthanasia. She was elated. “I feel like a huge weight has been taken off my shoulders,” I remember her telling me, “I haven’t felt this free in years.” She sounded so relieved and happy that of course I wondered whether she would go ahead with it. But the date was set. February 22, 2024, the wheels were set in motion — and the trouble really started. 

In January, I took a flight from Heathrow to Chicago for a research assignment, in the belief that she would not go ahead with it. Between long flights and epic time differences, my role as intermediary collapsed, as my sister refused to share information with the other side of the family. Soon enough, I received frantic phone calls from other siblings desperate for crucial information. It seems that information is power and that information was being tightly held.

Now, my KP sister and one of her adult children had started to tell me when I could and couldn’t call my mother. They had established themselves as Mum’s guardians. Of course, I ignored their instructions, and Evelyn was annoyed by their interference — but ultimately did nothing to intervene.

I know, of course, that many families are dysfunctional — and VAD can’t be blamed for our internal squabbles. Yet the shallow, inflexible support offered families makes a miserable process far worse, triggering sleepless nights and agony for all of us. 

“The shallow, inflexible support offered families makes a miserable process far worse, triggering sleepless nights and agony for all of us.”

Then, on February 15, just a week before she was due to die, staff shortages meant the date had to be postponed. A tough woman, not given to weeping, she crumbled. She could not stop crying. She was terrified of dying and had psychologically prepared herself for it, only to be undone by a bureaucratic bungle. Again, I asked her on the telephone why she was going ahead with it when she was clearly afraid. “I’m more terrified of living,” she told me. 

The delay, though, did offer me the opportunity to say goodbye. So I flew out with my daughter, Ava, to Sydney. And my mother was fascinated by the granddaughter she hadn’t seen in so many years. I sat on the bed watching, mesmerised as they laughed and exchanged ideas. The deep interest Mum showed in Ava’s life made it even harder for me to reconcile her decision to be injected with a lethal dose of barbiturates the following day. The notion that she would be dead in 24 hours had not landed. It would not land.

But my mother was determined. And on February 23, we arrived at the hospital early in the morning. A social worker was assigned who, after a whispered conversation with my KP sister, promptly left the room and didn’t reappear. Unable to sit still, I roamed the sterile corridors until I noticed one of my nieces sitting alone in the public waiting area. Such was her distress I hardly recognised her. The social worker, though, was nowhere to be seen. 

Evelyn arrived at midday, dosed up with painkillers, awake and chatting. Only now did it seem real. When we all entered her room, the VAD coordinator was there, having suddenly reappeared after weeks of silence. There she was at Evelyn’s bedside, acting like nothing had happened. Speaking only to my KP sister and Mum, she merely offered a nod of acknowledgement to the rest of us. As so often, our apparent invisibility felt crippling.  

My mother was oblivious. And after she had whispered a private message of farewell to each person in the room, an anaesthetist ended her life. Just after 1pm on February 23, 2024. Nothing in Evelyn’s life became her like the leaving of it, such was her grace and courage

In 2018, my father-in-law died a merciless death in England. The former country GP had Parkinson’s disease and had been in residential care for several years. When he could still make decisions, he made clear that he did not want to live if he could not eat or drink. Specifically, he refused a feeding tube.

When he was no longer able to swallow his death began. It took five days for him to die of thirst. I remain haunted by the harrowing nature of his departure.

So beyond the beauty of her passing, what have I taken from Evelyn’s death? Would I recommend it? Yes, in a sense I still would. I firmly believe NSW Health has opened a much-needed service for the terminally ill. But the system has a long way to go if it isn’t to destroy an ocean of other families. Even the most cohesive units can fracture under such immense strain. The trauma for our family will never be healed. My KP sister didn’t come to the scattering of my mother’s ashes. And none of my other siblings is in touch with her. Going through the VAD process has turned a once close sisterly bond into something uncomfortable and unwanted.

So as Britain begins its serious discussions over assisted dying, it must obviously consider ethics and morality. But equally important is to create an intelligent, reactive system of euthanasia, which cares for both individuals and their families. Failing to create that risks causing even more suffering — which would be an irony indeed. 


Andrea Dixon is a journalist with 30 years experience. Her investigative reporting has appeared in The Australian, the Daily Telegraph and the Sydney Morning Herald, among other publications.


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Bret Larson
Bret Larson
2 months ago

Once you let assisted death in the slippery slope of big government finding a way to save some money will make sure anyone with a signature will be offing themselves with the help of government funded “healthcare”. Maybe government should stay out of killing people?

Martin M
Martin M
2 months ago
Reply to  Bret Larson

It sounds like the author’s mother was committed to undergoing this process for reasons unconnected with “saving the government money”. I wish opponents of VAD would be honest, and say “I oppose VAD for religious reasons”. Then I might have some respect for them.

UnHerd Reader
UnHerd Reader
2 months ago
Reply to  Martin M

Allow me to oblige.

I believe in the value of all human life from conception to natural death.

My mom had a multi year decline due to dementia after a brain infection that she should have never survived.

Were there challenges? Of course, for her and for those who loved her. But living through those years with her were an expression of the love and regard in which we held her.

I wish we lived in a culture that valued life, warts and all, over death.

Martin M
Martin M
2 months ago
Reply to  UnHerd Reader

Thank you. I respect your opinion (although I myself have a different one).

UnHerd Reader
UnHerd Reader
2 months ago
Reply to  Martin M

I might well agree with most of your analysis. But…
I have a worse example where the illness was depression and addiction. The patient is alive and well now after a deal of expensive therapy yet appeared to have been persuaded by an over zealous clinician.
I don’t really trust bureaucratic processes in the UK public sector to deliver, mercy, love and respect whilst ignoring cost, organ shortages, operational targets and the latest fashions. 2 kidneys and a freed up bed anyone? They failed on Blood and sub-postmasters. All working age so a load of old wrinklies won’t even register.
I have no solution to offer; I’m an amateur. It just bugs me a very great deal that any objections will be swept away and ignored and the “pathway” will be exploited but unchallengeable.

Martin M
Martin M
2 months ago
Reply to  UnHerd Reader

I have worked for the government (admittedly the Australian government, but they are all the same), and I know how hopeless they can be. If I ever find myself in the position of the woman who the article is about, I am going to take the decision to end my life, with or without government support. I consider that decision to be mine and mine alone.

MJ Reid
MJ Reid
2 months ago
Reply to  UnHerd Reader

I watched my partner live through the pain of inoperable cancer. He wanted to come home so he could die with dignity and at a time of his choosing. I couldnt clear the house in order to get a hospital bed in. Finally after many tantrums, I managed to get a hospice bed for him. He was on huge amounts of painkillers and still screaming every time someone touched him. He kept saying “if I was a dog, H would have put me down by now”. H being a friend who is a vet! There was little dignity in his final weeks or in the time of his death no matter how caring the hospice staff were. Us humans deserve the right to die where and when we want in circumstances like this.

Bret Larson
Bret Larson
2 months ago
Reply to  MJ Reid

I feel your pain. However societal cohesion is bigger than a persons pain. My mother was sick for about a year and a half before she died. She had some sort of early Alzheimer’s and she went through hundreds of micro strokes over that time. The macro affect was that her brain would stop working for a while and then she would recover. Each time felt like the last time. My extended family decided to allow me to deal with it alone after a while. I had to shutter my business and take a nine to five job. I should have quit work but that’s hard when you have children and ex wives to feed. Each time the healthcare system felt it was time to move on and in the end her doctor was the one who helped people end it. I had removed all life support and her last dip to oblivion was in a Catholic old folks home she was just moving into on. Saturday morning just as I got there to visit her she was cheyne-stoking as she died. I like to think she was still there and was waiting for us to arrive. But she was definitely fighting till the end. She taught me a lot and her last lesson to choose life stays with me now.

Marcus Glass
Marcus Glass
2 months ago
Reply to  UnHerd Reader

There are far worse things than death. Why fear a natural process so much? My mother died a horrible death from dementia, she was living a recurring nightmare over and over again that left her screaming whenever she had the energy. I would have killed her myself, out of love, for my mother and deep friend. But then I’d been in jail and I had a teenage daughter. We automatically kill pets when they are obviously suffering, but don’t extend that same mercy to to our fellow humans.

Buck Rodgers
Buck Rodgers
2 months ago
Reply to  Martin M

As this article so eloquently demonstrates, the process can be horribly complicated. The undertaking being considered is so far outside the ordinary that it is impossible to predict the effects. Each case will be different.

In my opinion (and that’s all it is), this is a perfect example of the shortcomings of the technocratic system beloved of modern politicians; it is simply beyond the scope of anyone to account for the wreckage caused by this.

Bret Larson
Bret Larson
2 months ago
Reply to  Martin M

Are you calling my comment disingenuous? You perhaps should read it if you I want to comment on it.

Martin M
Martin M
2 months ago
Reply to  Bret Larson

You distrust the government. I get it. However, when my I get to the position in which the writer’s mother was in, I want the opportunity to end my life. I do not see how my doing so is any of your business.

Philip Hanna
Philip Hanna
2 months ago
Reply to  Martin M

Well put. Agree completely.

John Tyler
John Tyler
2 months ago
Reply to  Martin M

I’m against it for spiritual reasons, but also because I see it as the start of a very slippery slope. The two are not mutually exclusive.

Martin M
Martin M
2 months ago
Reply to  John Tyler

The slippery slope to people having control over their lives?

Bret Larson
Bret Larson
2 months ago
Reply to  Martin M

Nobody is an island. Many fragile people take their cue about what they should do from the people around them. And unfortunately I distrust government for valid reason.

jane baker
jane baker
2 months ago
Reply to  Martin M

Who has “control” over their life?

Martin M
Martin M
2 months ago
Reply to  jane baker

Well, I have control over mine.

Emmanuel MARTIN
Emmanuel MARTIN
2 months ago
Reply to  Bret Larson

Considering that the military and police are among the primary functions of every single governement that existed, your sugestions seems quite unapllicable.

Bret Larson
Bret Larson
2 months ago

Police and military aren’t paid to kill people.

Derek Smith
Derek Smith
2 months ago
Reply to  Bret Larson

The military are!

Bret Larson
Bret Larson
2 months ago
Reply to  Derek Smith

Not at all. Maybe you should go talk to somebody in the military to find out if their job is to kill people.

Martin M
Martin M
2 months ago
Reply to  Bret Larson

Not a whole heap of point to a military if it cannot kill people.

Bret Larson
Bret Larson
2 months ago
Reply to  Martin M

You mean use force to protect their country?

Martin M
Martin M
2 months ago
Reply to  Bret Larson

Well, yes. The way one does that is to kill the soldiers of the invading army.

Martin M
Martin M
2 months ago

So, to sum up: A terminally ill woman, who was of sound mind and in significant pain, decided to avail herself of VAD, and did so. Her dysfunctional family made hard work of the process for their own reasons.

Seb Dakin
Seb Dakin
2 months ago
Reply to  Martin M

That was my take away too. The system appears to have worked as well as it could – it was postponed for a day, that’s all. It’s hardly the job of the hospice/hospital/VAD staff to micromanage squabbling siblings.
I totally understand that there would be an immense strain, but, if only for sake of the departing member, it’s for family members to bury their petty differences, not expect ‘the system’ to somehow do it for them.

Brett H
Brett H
2 months ago
Reply to  Seb Dakin

“it was postponed for a day” because of a staff shortage, a small thing in the day-to-day running of a hospital, but huge in terms of an appointment with euthanasia. That staff shortage does suggest the potential for tragic bureaucratic mismanagement further down the line (almost inevitable), something we hear about every day. I’m not sure if I have faith in the government being involved in euthanasia.
Excellent piece of writing, though.

Buck Rodgers
Buck Rodgers
2 months ago
Reply to  Brett H

Exactly. This, of all things, requires flawless execution every time. Which organisation, public or private, can offer that?

Martin M
Martin M
2 months ago
Reply to  Buck Rodgers

Vets manage it when they put animals down.

Peter Johnson
Peter Johnson
2 months ago
Reply to  Brett H

Yes – it is like the physician or mid-wife not showing up for the birth. If the government says social workers will be there to help – then they should be there to help. In Canada there are stories of the people carrying out the death getting impatient with everyone when the soon to be deceased takes too much time saying goodbye.

Billy Bob
Billy Bob
2 months ago
Reply to  Martin M

That’s exactly how I read it to be honest. The actual assisted suicide was largely irrelevant to the article, it was more about a long running family feud

Michael Clarke
Michael Clarke
2 months ago
Reply to  Martin M

It is an impressive piece, very honest and very well written. Ms. Dixon’s family might be no more dysfunctional than the average family but it is clear from reading the piece that euthanasia could cause difficulties for any family. It is an immensely difficult subject that is all too often treated in a cavalier fashion by its supporters. Anyone who is faced with making a decision about euthanasia, including a legislator or a government department, or who is faced with the prospect of a family member opting for euthanasia, should read the piece.

Martin M
Martin M
2 months ago
Reply to  Michael Clarke

Any number of things “could cause difficulties for any family”. In the present case, the problems were those of the family, not of the deceased. She was clear on what she wanted to do.

Xaven Taner
Xaven Taner
2 months ago

I’m in support of suicide and feel the Christian rejection of it has been a disaster. Antiquity is full of stories of noble deaths, either from self sacrifice or when facing a worse death. But no modern state will ever create an intelligent, reactive system of euthanasia, as it only knows how to create processes and procedures, bureaucracies animated by policies, and officials with job descriptions and targets. None of that will nurture or satisfy the needs of people going through the most personal experience a human being can have. Western Modernity has studiously removed any authentic contemplation of death from everyday life. If it now reappears it will only be as an extension of the prevailing ideology of economy and rationalisation.
I’m 43 and think about death – specifically the circumstances under which I would wish to end my life – very frequently. I have no intention if such a situation arises of polluting my final weeks with the scourge of forms and consultations. No-one needs permission to die, the very suggestion is perverse. If a self administered pharmaceutical option isn’t available I’d sooner go full Captain Oates on a winter day in the Lake District than put my fate into the hands of paid death dealers.

Brett H
Brett H
2 months ago
Reply to  Xaven Taner

“polluting my final weeks with the scourge of forms and consultations.”
Very good point. Give me Captain Oates any day.

Ian Barton
Ian Barton
2 months ago
Reply to  Xaven Taner

My family is largely uncluttered with the Western Modernity problem, and I discuss a managed death quite happily with them. My daughter made me promise that I don’t do a self-suicide because of the additional emotional trauma – so assisted suicide will be the option for me when/if the time comes.

Martin M
Martin M
2 months ago
Reply to  Xaven Taner

I very much respect Captain Oates and his decision to “go outside”, but is the Lake District cold enough for that? I have never been there (I live in Australia), but I do note that Oates was in Antarctica at the time.

Billy Bob
Billy Bob
2 months ago
Reply to  Martin M

Couple of days wandering out into the outback will probably produce the same end result

Martin M
Martin M
2 months ago
Reply to  Billy Bob

Freezing to death? It can get a bit nippy overnight, but the outback is not a “cold” place.

Andrew D
Andrew D
2 months ago
Reply to  Martin M

Bloody global warming, you can’t even kill yourself any more

Will Crozier
Will Crozier
2 months ago
Reply to  Andrew D

Best reply ever haha

Martin M
Martin M
2 months ago
Reply to  Andrew D

You probably still can in Antarctica.

Lancashire Lad
Lancashire Lad
2 months ago
Reply to  Martin M

Anyone who’s ever found themselves high on the Lakeland fells when the weather turns (as it is wont to do) could testify that survival requires a speedy descent. It’s not about the temperature, but simple exposure to the elements. It wouldn’t be quick but at least the view on the way up would be great.

Bret Larson
Bret Larson
2 months ago
Reply to  Martin M

Just bring bottle of whiskey and down it. Minus 20 should work fine. I think removing yourself can be the brave choice, however usually it is the easy way out. And I think individuals can make this decision for themselves without the states intervention.

annabel lawson
annabel lawson
2 months ago
Reply to  Xaven Taner

I hear you. However, the hospice option – withholding life-saving intervention – usually achieves the prompt death the patient wants without placing a burden of guilt on relatives, and that guilt can manifest years after the actual event.

Gareth Rees
Gareth Rees
2 months ago

Wow. This is one selfish family it would seem. Adding more stress and distress to the terminally ill mother.

El Uro
El Uro
2 months ago
Reply to  Gareth Rees

Be careful to judge other families.

Martin M
Martin M
2 months ago
Reply to  El Uro

I am absolutely free to judge my family, because I am the only one in it.

jane baker
jane baker
2 months ago
Reply to  Gareth Rees

I thought the Mother sounded monstrously selfish,controlling and manipulative

Ondy Dixon
Ondy Dixon
2 months ago
Reply to  jane baker

You hit the nail on the head, Jane.

Martin M
Martin M
2 months ago
Reply to  jane baker

I thought she sounded sensible and level headed.

Alex Lekas
Alex Lekas
2 months ago

The problem with a rules-based order and rules-based society is that the rules are not perfect, nor can they be made to be. Like some others here, I see a situation that was needlessly complicated by petty family drama.

Peter Johnson
Peter Johnson
2 months ago

You should consider what has happened in Canada and Belgium when looking at these proposals. The Trudeau government was at one point proposing that depressed teenagers should get MAID (Canada’s term for state sanctioned suicide). Given the progressive madness we’ve been through in the last 10 years (autistic 13 year old girls getting mastectomies, defund the police, etc) you should take the slippery slope arguments very seriously. It is only a little hop from grandma can choose to die to grandma really ought to move on now. It is a space rife for abuse by bureaucrats trying to save money and children looking to get their hands on the estate. Looking into the future God help all these childless cat ladies (and male equivalents) when they are 75 with no one to look after them, no money, and no one to advocate for them.

John Hughes
John Hughes
2 months ago
Reply to  Peter Johnson

” Looking into the future God help all these childless cat ladies (and male equivalents) when they are 75 with no one to look after them, no money, and no one to advocate for them.” Yes. Assisted dying for people who have no children or grandchildren, and any relatives they have a long way away and little-seen, will be a major subject in 20 years time, or even less. How do they give consent, who will back this up, and how will the professionals handling the wish to die manage this?

Betsy Arehart
Betsy Arehart
2 months ago
Reply to  Peter Johnson

That will be my situation. Unless my God intervenes.

NEXUS CROSS
NEXUS CROSS
2 months ago
Reply to  Peter Johnson

Better than selfishly having children just so they could be your retirement fund and caretakers.
You do realize that it’s not necessary that children are going to maintain a relationship with you in your old age, right?

Douglas Redmayne
Douglas Redmayne
2 months ago
Reply to  Peter Johnson

Assisted dying is a choice and people will soon be free to make this choice in thevUK with new laws. Quite right too because what they choose is none of your business.

Lang Cleg
Lang Cleg
2 months ago

I just can’t – and frankly don’t want to – get past the principle that the state should be in the business of allowing citizens to be killed.

Bret Larson
Bret Larson
2 months ago

You might find this interesting: https://www.cbc.ca/arts/can-i-get-a-witness-tiff-1.7320476

Kenneth Law murder trial might be of interest for pro death sorts.

jane baker
jane baker
2 months ago

Smiley Dame Death,I only heard uncorroborated rumours about Jimmy Saville,is not going to sign up to be first on the list for State Execution is she. The new crime that merits the Death Penalty will be Old Age,Poverty, Not Fitting In,and being an Economically Inactive Unit. Or to use another phrase – a Useless Eater. Now where have I heard that before.