Watch Claire's Story - Euthanasia: A deadly double standard.

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A deadly double standard – Claire’s Story

Claire grew up in Whangarei, with her parents, two sisters, great friends and weekends at the beach. “We had an idyllic childhood”, she says. The future looked bright. At only seventeen, Claire applied for entry into various design schools. But en route to one in Auckland, her life was changed forever.

That day she ran to the car in which her mum was already waiting. She remembers thinking, “I need to run more”. Ironically, about an hour later her mum fell asleep at the wheel. Within seconds the car went off the road and flipped upside down. She remembered how worried her sister was and realised that her condition was serious when she was airlifted to Auckland Hospital. Scans confirmed she fractured her C5 and C6 vertebrae, leaving her paralysed from the neck down: she would never walk again, let alone run.

Claire recalls, 

“I couldn’t imagine living my life in a wheelchair or not having the use of my arms and hands. So I think I was in disbelief and denial for an awfully long time.” 

“I’d have friends come and visit me and everyone was sort of saying ‘get well’, ‘you’ll be okay’, ‘you’ll be walking’. We just assumed that it would get better… but it didn’t.”

After seven months in hospital Claire moved to Wellington to study design, despite her physical limitations. But just before starting her degree she spiralled into dark depression. The pressure of having to navigate her way alone through everything that came with her disability left her feeling very isolated. She felt that she had no one to talk to and that nobody really understood what she was going through. “All the grief and anger that I felt, I just bottled it up,” she says.

About 18 months after the accident Claire visited her dad in Whangarei for the first time. Overwhelmed by memories of the accident, she set out into the bush by herself and tried to overdose on pills. Fortunately, some people on a nearby bush walk found her and rushed her to hospital. She was already in a coma. Claire remembers waking up two weeks later, angry at being alive.

Claire discovered that she could compensate for her lack of hand movement by using both her hands or her mouth. 

“You know, you just find ways of doing things and that’s what I did. I realised that I could adapt to anything really and if I could do a design degree without any hand movement then I could really achieve a lot. That gave me a big confidence boost.”

After graduating she was delighted to land a design job in Christchurch that eventually became full-time. She loved it. However, when the earthquakes hit, Claire’s world was shaken once more, bringing to the surface her unresolved emotions from the accident.

She had nightmares about the earthquakes and stopped sleeping. Then she tried to dull the pain by working and studying even harder, but just became increasingly exhausted. Once again Claire found herself in a dark place. She just wanted the world to stop.

She attempted suicide on three more occasions and each time she ended up in hospital in a coma. Her body was clearly not ready to give up – even if her mind was.

Determined to find a way to successfully end her life, she started to talk about assisted suicide. A psychologist and a psychiatrist at the suicide outreach clinic validated her suicidal desires and both suggested that she explored assisted suicide in Switzerland. As a high-level tetraplegic she was considered a good candidate. Claire remembers, 

“All they saw was my disability. They didn’t ask me about my lifestyle or my coping mechanisms. It was just, ‘She’s got a broken neck. She can’t move. Why would she want to live?’”

When Claire talked to her family and friends about her interest in assisted suicide they disapproved, but most became more accepting of the idea after the medical professionals gave it validity.

“So instead of committing suicide which seemed like a tragedy, assisted suicide didn’t seem so bad, because it was somebody helping me and it was controlled by the medical profession. And that’s not really something that you can argue with, and certainly, you know. you can’t argue with my broken neck which I was using as an excuse.”

“What I didn’t realise was that it wasn’t my broken neck that was the problem. It was my lifestyle and my coping mechanisms.”

She had convinced herself that death was what she wanted and that it was something others agreed with also. 

“I guess I felt like a burden on society, on my friends and on my family. None of them expressed this idea to me overtly, but I just didn’t feel like I was of any value to anyone.” 

“I’d convince them that I was in an awful lot of pain, that I was suffering. Actually, I just wasn’t facing the reality of the situation which was the fact that I was completely exhausted, overworked and traumatised. But you know, assisted suicide legitimises death and legitimises suicide. And I pretty much had most people in my life on board with my decision to end my life overseas, because it was something that the law had permitted and that made it okay.”

Then an unexpected turn of events followed. She was scheduled to have surgery to stabilise the metal work in her neck. It went really badly. Claire needed to have a screw inserted into her spine and in the process her spinal cord suffered additional damage. Because she lost movement in her triceps and wrists, she also lost her job and career. She was more disabled and in more pain than she had ever been. Physically she was at her lowest point.

Because she had to stop working and had to put everything on hold, she was finally able to rest. The more she rested, the more she slept. She started to reflect on her lifestyle.

A turning point was when she read a book by Barbara Gibson on quality of life. Claire realised, 

“My problems weren’t physical problems as such. It wasn’t my disability that was the problem. It was all the stuff that was manifesting in my head. It was my coping strategy of being busy. I was overwhelmed and I couldn’t cope.” 

“My pain was more related to my psychological state than my physical state. It manifested in a physical way, but it manifested more because I was so tired, because I was stressed. I was exhausted. I was traumatised from the earthquakes.”

For twenty years, and until only three years ago, Claire was an ardent supporter of euthanasia and assisted suicide and wished these were legally available in New Zealand. “In hindsight,” she explains, “I wanted assisted suicide because I wasn’t coping with my life. Now that I’ve put the support in place, I love my life.

“I’m so glad that assisted suicide wasn’t available in New Zealand, because if it were, I wouldn’t be here today. That’s scary for me.”

Claire is convinced that assisted suicide is simply another form of suicide. Depression led her to attempt suicide four times, and it was depression that led her to consider assisted suicide overseas. In both cases the cause and the need were the same. She ponders, “The irony is that we don’t agree with suicide. We’re fighting against our incredibly high rates of suicide and yet at the same time we are saying that assisted suicide is okay. But what’s the difference? How is assisted suicide any different to suicide?”

Claire spoke to a man in Belgium whose mother had euthanasia following a relationship break-up which had left her feeling depressed. The first he heard of his mother’s plans was when he received her death certificate. “This man is traumatised,” Claire reports. He had no opportunity to help his struggling mother or to say goodbye.

Claire is concerned about the fact that euthanasia laws allow a person to request lethal drugs without discussing such a momentous decision with their family. 

“This Bill feeds into the individualistic culture that the majority of New Zealanders have,” she argues.

Claire takes pride in being a member of Ngāpuhi, the Māori heritage on her father’s side. “Māori are about whānau, about the collective, and about making decisions as a group. This Bill negates a lot of those indigenous ideas and values that we hold.”

Having travelled extensively, she noticed that in other countries people offer to help her with her wheelchair, but that it doesn’t happen in New Zealand, even though it is often hard for disabled Kiwis to access transport and buildings. Claire also identified a staunch culture of independence in her home country. “The underlying message is that if you’re not independent, you’re not of value. This puts an enormous amount of stress on someone who can’t be independent anymore.” The emphasis on individual independence contributes to people feeling isolated, vulnerable and without support.

“I find it really disheartening that euthanasia is being presented as an option, because we’re better than that. We’re Kiwis. We’re about kindness. We’re about love. We’re about unity. This Bill suggests otherwise. It says to people who are seriously ill or disabled that they’re of less value.” 

“Instead of saying, ‘Here’s the option for assisted suicide’, we need to offer them support, love and a sense of value,” she recommends.

“Even the simple fact of being presented with the options made possible by this Bill as an idea for me to consider immediately devalues my life. Straight away it makes me feel that if a health professional is providing this to me as an option, then maybe they have got a point. You know, we put doctors on a pedestal. We believe them. We trust them.”

Claire reckons many people, including many medical professionals, are afraid of paralysis and a loss of dignity – of a life like hers. They are afraid of the unknown. They fear the disability that so often accompanies serious illness and assume that a person with a significant disability would have poor good quality of life. 

“The reality is that with the right support I now have a great quality of life and I can do just about anything that anyone else can do. I just do it a bit differently, and actually, I’m okay with that now.” 

“I look at my life now, at how rich it is, and I look at all the experiences I’ve been given. I’ve got a great life. I love my life and I’m really glad I’m here.” 

She has travelled to Milan to model on the catwalk in her wheelchair. Her blog and social media accounts have a large following. She lives in a house that she designed herself and is in a fulfilling relationship with a supportive partner. She is doing a PhD in disability issues and continues to mentor a support group.

“The one thing that came out of being so active on social media,” Claire says, “is that I became aware that people who are different, people who are disabled, people who have been through trauma… they are desperate to be heard. They don’t want to feel alone or isolated. And I do feel that this Bill isolates people.”

She says, “I’m trying to teach people that there’s more to life than one’s disability. Disability is actually a positive, because it gives you skills and experiences you wouldn’t have had otherwise.”

She still goes through ups and downs and sometimes misses her life before the accident, but she makes a point of not dwelling on what’s been. She has learnt to create a life that’s enjoyable and fulfilling. “Mindset is the major player,” she says.

“I’m very humbled when I hear other people’s stories and especially about how much I’ve been able to influence them. You know, it makes me feel really good. It also makes me feel that maybe I still have a lot more to contribute to this world.”

The woman who once wanted her life to stop, has become unstoppable.

Belgian nurse watched euthanasia turn pain management into a death prescription

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Lillian Quinones

The Federalist published an article by Lillian Quinones that is about the experience of a Belgian palliative care nurse. Sadly, this is not a new story but a continuing story.

In 2014, I republished an article by Claire-Marie Le Huu-Etchecopar a French nurse who worked in Brussels for 6 years, and who witnessed many euthanasia deaths. The article - Lifting the veil on euthanasia in Belgium uncovers multiple stories of the abuse of care related to euthanasia.

In 2015 Paul Russell wrote the article Belgium: Euthanasia and Palliative Care, strange bedfellows referring to the political work of Jan Bernheim to implement euthanasia, in Belgium, as part of palliative care.

The article by Lillian Quinones interviews Sophie Druenne, a Belgian palliative care nurse. The article begins with Sophie telling the story of a euthanasia death that didn't "work out."

Upon administering a lethal dose, the doctor left the room. But the patient was not dying. 

“We had to call the practitioner back to tell him that the patient was still alive and that we had to give him an additional injection. And I caught myself laughing in the course of protecting myself from what was happening.” 

Recounting the story to her friends and family outside the hospital, Sophie realized the horror of this situation and began to question Belgium’s so-called social experiment with euthanasia.

Quinones explains how the euthanasia law has expanded, but her questioning of euthanasia is based on the Belgium's integrated palliative care system. She explains:

Historically, palliative care was defined by the anti-euthanasia beliefs of its founder, Cicely Saunders, a British nurse who developed a holistic method of caring for the dying in the 1940s. Witnessing the rise of effective pain management strategies and drugs during her lifetime, she believed that a patient’s request for euthanasia represented a failure to adequately care for the patient’s spiritual, emotional, and social needs.

This medical system failure prompted her to design a method of caring for the dying that attended to those needs alongside the physical ailment, as so often a patient’s euthanasia request actually represents a plea for reconciliation and companionship in the grip of their illness. Saunders also pushed back against the pro-euthanasia autonomy arguments marking her own day, saying, “If you make active euthanasia a right, it soon becomes a duty. The patient, knowing that he or she can die by choice, will soon feel it incumbent to relieve relatives of the ‘burden’ of looking after them. When that stage is reached you have removed the patient’s choice.” 

Nonetheless, Belgium attempts to reconcile Saunders’ standard with their euthanasia laws, which made history again by granting death to three minors last year.

Sophie tells the story of her first experience with the "new ethos" of palliative care.

Sophie remembers first remarking on this shift in ethos when attending to a patient with strong breathing difficulties. At the time, she was working with another nurse, and they called the attending physician in for help. 

“The first reaction of the doctor was to prescribe a triple dose of morphine with the obvious consequence that death would occur,” Sophie said. “Our reaction was to ask the practitioner if he really thought it was a good solution because it didn’t actually look like [death] was the will of the patient, but that this was a strong person fighting for life.” 

Hearing their suggestions, the physician decreased his initial prescription of morphine. The patient died a few hours later, probably as a consequence of her disease. The fact that the practitioner changed his mind so easily indicated to Sophie that his initial prescription wasn’t medically justified. This experience emboldened her to question decisions of practitioners and appeal to the consciences of her colleagues in ethically challenging cases.

Sophie explains how her experience continued in the Oncology unit that she worked at.

As she continued to work in this particular oncology unit, Sophie noticed that the ethical shades of grey were disturbing the medical team as they reacted to the unilateral decisions of the physician to prescribe euthanasia. They expressed their disapproval by pronouncing the phrase “We’re helping people,” in a sarcastic tone, Sophie said.

A Belgian study found that more than 1000 people died by euthanasia without consent in Belgium in 2013.

Sophie explains that she left Belgium to find a place that was equipped to handle pain without euthanasia.

It was not the euthanasia cases per se, however, that moved Sophie to uproot from Belgium and leave behind family and friends. She left in search of an institution where practitioners and medical teams were better equipped to treat suffering. Effective treatment of suffering excludes euthanasia—the “easy solution”—and defies the vision of integrated palliative care. 

Sophie believes that this vision fails because of the contradictory premises of palliative care and euthanasia. The replacement of “first, do no harm” with “first, relieve suffering” reveals IPC as a dominating framework instead of an authentic integration. 

When physicians are given unilateral power to void “first, do no harm” under certain conditions, altruism can lead to involuntary killing. Likewise, the guiding principle of “first, relieve suffering” does not bar death itself as a solution. The advent of IPC tells the latest lesson from Belgium: the normalization of euthanasia installs a new guiding principle for physicians and effectively nullifies the “autonomy at all costs” argument of proponents, by the sheer number of involuntary euthanasia cases.

Sophie is now happy working in palliative care in Paris:

Sophie now works in Paris at a hospital where terminally ill patients are treated with traditional palliative care. She says her experience with cancer treatment in Belgium revealed to her the limits of medicine’s power over suffering, especially mental and existential. 

Sometimes there are no medical solutions, but palliative care offers holistic answers to evaluating the patient’s needs beyond the physical. Speaking as an insider to Europe’s pro-euthanasia fever, Sophie beseeches medical professionals to defend their maxim of “first, do no harm,” lest medical care conflate itself with murder.

In Canada, the Québec Health Minister, has pressured palliative care doctors to participate in euthanasia. A recent Delaware assisted suicide bill defined assisted suicide as part of palliative care.

When palliative care includes killing, it changes palliative care and we all lose the care that we need as we approach death.

Lillian Quinones is a first-year medical student at the Medical College of Wisconsin, Green Bay. She graduated from Hillsdale College with degrees in biochemistry and journalism.

Nancy Elliott: Letter to the Maine Health and Human Services Committee opposing assisted suicide bill.

Please reject assisted suicide bills LD 1313, HPO948.

Nancy Elliott

I am a Former 3 term New Hampshire State Representative, and the Chair of Euthanasia Prevention Coalition USA.

The three groups that are the target for Assisted Suicide are the sick, the elderly and the disabled. While there are many other problems with this kind of law, I am going to focus in on these three.

It is said this is only for the sick and dying. One of the biggest problems is people who qualify for Assisted Suicide are not necessarily dying. Think of a 21-year-old otherwise healthy insulin dependent diabetic. He qualifies if he rejects his insulin. This would be the same for many other people with serious conditions, who take prescription medications. What about all the curable cancers? They qualify. What about the 5% rate of incorrect medical diagnosis? With Assisted Suicide on the table these mistakes can be deadly.

I was at a hearing for Assisted Suicide in Massachusetts a few years back when a gentleman named John Norton gave evidence, that as a young man he was diagnosed with ALS. He stated that had Assisted Suicide been legal at that time he would have used it. A few years in, the disease’s progression just stopped. Now in his late 70’s he stated he has had a great life with children and a grandchild. With Assisted Suicide on the table he would have lost all of that.

Steering is a big deal with all three of the groups that I mentioned. At that same Massachusetts hearing, a doctor stated that Assisted Suicide laws were something he was in favor of. He continued with his points and ended by saying that He felt it was the responsibility for a good doctor “to guide people to make the right choice”. I do not think he intended to say that but, is there any doubt that this pro suicide doctor would try to persuade his patients to follow his wishes concerning their Assisted Suicide.

These laws are abusive in their very nature. To suggest to someone that they should kill themselves is abuse. My husband was terminally ill, and I went to a lot of doctor appointments with him. If medical personnel were to suggest Assisted Suicide to him, he would have been devastated. While he never would have done that, it would be like saying to him, “You are worthless and should die. That is abuse! The proponents say that would never happen, but that did happen to an Oregon woman named Kathryn Judson. She had gone to a doctor’s appointment with her seriously ill husband and exhaustedly sunk into a chair where she overheard the doctor pitching Assisted Suicide to her husband with the clincher, “Think of your wife.” They left and never came back. The husband went on to live another five years.

Next seniors are at risk and very easily fall victim to coercion as the process is very open to that. In most states, heirs can be there for the request and even speak. Anyone can pick up the lethal dose. Once in the house all oversight is gone, there is no witness required at the death. Even if they struggled who would know. If that is not enough, the death certificate is falsified to reflect a natural death. All the information is sealed and unavailable to the public. Even if someone suspected foul play, the death certificate says no crime here. Taking advantage of seniors is epidemic in the US. Look at the case of Thomas Middleton. He made Tami Sawyer his trustee and moved into her home. Within a month he was dead by Oregon’s Assisted Suicide law. Two day after his death Ms. Sawyer listed his house and sold it and deposited the money into three companies she owned with her husband. We will never know how much coercion or foul play took place in this case.

Finally, those with a disability are at risk. Most people that “qualify” for Assisted Suicide at that point in their life have a disability. Many with long term disabilities have been labeled terminal all their lives. Without meds, treatments, and assistance they would not survive. This is about disability. If you have a disability you are encouraged to give up, commit suicide. If, on the other hand, you are young and healthy, you are given suicide counselling. This is discrimination against people with disabilities. Why should they trust that they will not be coerced into Assisted Suicide, when they are already discouraged to seek treatments and are not treated fairly? When you think about it this is a law that is written just for them. It is a “special” carve out, for the sick, elderly and disabled.

In closing, I just want to add that Assisted Suicide has been rejected in over 100 legislative, ballot initiative and judicial attempts in the USA, including my state New Hampshire where it was a bipartisan vote. The more it is studied the more uncomfortable people become with it.

Nancy Elliott
Chair – Euthanasia Prevention Coalition USA

In the Last Ten Years, at Least Nine U.S. States Have Strengthened Their Laws Against Assisted Suicide/Euthanasia

Margaret Dore published this list of legislative and judicial victories to counter the media narrative that the United States is legalizing assisted suicide.

Alabama Governor, Kay Ivy

In the last ten years, at least nine states have strengthened their laws against assisted suicide/euthanasia. They are (alphabetical): 

1. Alabama: In 2017, Alabama enacted the Assisted Suicide Ban Act; 
2. Arizona: In 2014, Arizona strengthened its law against assisted suicide. 
3. Georgia: In 2012, Georgia strengthened its law against assisted suicide. 
4. Idaho: On April 5, 2011, Idaho strengthened its law against assisted suicide. 
5. Louisiana: In 2012, Louisiana strengthened its assisted suicide/euthanasia ban. 
6. New Mexico: In 2016, the New Mexico Supreme Court overturned a lower court decision recognizing a right to physician aid in dying, meaning physician assisted suicide. Physician-assisted suicide is no longer legal in New Mexico. See Morris v. Brandenburg, 376 P.3d 836 (2016). 
7. Ohio: In 2017, Ohio strengthened its law against assisted suicide. See http://codes.ohio.gov/orc/3795 
8. South Dakota: In 2017, the South Dakota Legislature passed Concurrent Resolution 11, opposing physician-assisted suicide. See Bill History. 
9. Utah: In 2018, Utah amended its manslaughter statute to include assisted suicide. For more information, see https://le.utah.gov/~2018/bills/static/HB0086.html and click “status.”

The media promotes the legalization of assisted suicide but it ignores the success in preventing euthanasia and assisted suicide.

Canadian Palliative Care Doctor speaks out against legalizing euthanasia in New Zealand

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

Dr Leonie Herx

Dr Leonie Herx, the President of the Canadian Society of Palliative Care Physicians, spoke out against the legalization of euthanasia in a debate, yesterday, concerning the End of Life Choices bill that is being debated in New Zealand.

A report by Don Satherley published by Newshub reports that Herx urged New Zealander not to legalize euthanasia. Her arguement was based on her experience with euthanasia in Canada. Satherley reports:

Euthanasia has been legal in Canada since 2016, where it's known as medical aid in dying, or MAID. Since then about 8000 have chosen to end their lives this way, Dr Herx says, making up around 1.5 percent of all deaths.

Herx explained that expanding euthanasia is already being pushed. Satherley reported:

"We've had a Superior Court Justice who's said the reasonably foreseeable death clause does not apply - so prognosis is not to be a factor. So anyone with chronic disease, osteoarthritis for example, have been given permission to be euthanised. The Government mandated a taskforce to look at extending the criteria to including mental health."

The Canadian law currently states that their natural death has to be "reasonably foreseeable", ruling out conditions like osteoarthritis and mental health.

It also states they have to be at least 18, but Dr Herx suspects that's about to change.

"The largest children's hospital in Canada - the Toronto Hospital for Sick Children - has already published their guidelines on how euthanasia will occur for mature minors. It includes if the child says they don't want the parent to know, the parent will be informed the child has died after they've received euthanasia."

Dr Herx also says there is discussion on whether to allow advance directives for euthanasia, eg. a person pre-approving their death if they're one day diagnosed with Alzheimer's or dementia and no longer considered sound of mind.

Dr Herx explained that Canadians did not expect to have this experience with euthanasia.

"These are the types of problems that I don't think anyone expected in Canada. It seems you could put a nice fence around it, but once you let the genie out of the bottle, unfortunately you can't put it back in."

"The reality on the ground is very different than this rosy picture that has been portrayed... Learn from Canada's mistakes."

Dr Herx has been working in palliative care for more than 10 years and has become one of Canada's leading palliative care physicians.

Great News: Connecticut rejects assisted suicide again.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

It is great news that Connecticut once again defeated the assisted suicide bill.

Cathy Ludlum, Second Thoughts

There are many people who have worked for many years to continue defeating assisted suicide in Connecticut. A special "shout out" goes to the efforts of the Second Thoughts Connecticut disability rights group.

*Cathy Ludlum: We will be the collateral damage of assisted suicide.

It is unlikely that assisted suicide bill has a chance at passing in the legislative session next year. State Rep. Jonathan Steinberg, a co-chair of the Public Health committee told Jenna Carlesso from the CTMirror:

“strongly held” religious beliefs among lawmakers, coupled with concerns from people with disabilities, prevented the bill from advancing to the House floor.

The bill’s chances of success next year also are low, Steinberg said, since several members are holding firm in their opposition.

“Modifying the bill in and of itself would not necessarily change any votes. So I think we would probably be looking to a new legislature,” he said.

Elaine Kolb with Second Thoughts

Nicole Leonard, reporting for WNRP, interviewed Elaine Kolb from the disability rights group Second Thoughts.

Elaine Kolb, of West Haven, testified last month against the bill as an activist for disability rights and a member of Second Thoughts Connecticut, a grassroots organization that views aid-in-dying as assisted suicide.

She spoke on how the legislation could pose a danger to people with disabilities. Specifically, Kolb said patients and medical professionals may be quick to refer to aid-in-dying without acknowledging what someone with a disability is still capable of doing.

Leonard reported that Kolb intends to remain involved with Second Thoughts and opposing assisted suicide for the rest of her life.

Thank you to everyone who continue to commit to opposing assisted suicide. Unlike the assisted suicide lobby, our leaders are volunteers.

Death lobby debates the term assisted suicide.

The following article was sent to me by someone on the Right to Die list serve.

Should we use the term 'assisted suicide' or a euphemism?

By Derek Humphry

What's in a word? Is saying 'suicide' as in 'assisted suicide' preferable, or is it better to use an euphemism like 'assisted dying'?

From the start in l980 we at the Hemlock Society always bluntly called the medical helping to die procedures 'physician-assisted suicide' and, when carried out alone, 'self-deliverance'. We stressed that we were talking purely about end-of-life choices when terminal, not self-killing for other reasons.

The Associated Press, one of the world's largest news agencies, has a standing policy of always using 'assisted suicide' and forbids euphemisms. Europeans groups continually use 'assisted suicide' and 'euthanasia' without hesitation.

But from around 2000, some persons in the US began to campaign for 'assisted suicide' to be dropped in favor of 'assisted dying' and similar terms. In citizen ballot initiatives the softer term was always used. Common nowadays is Medical Aid in Dying (MAID).

Some of the new sensitivity to the word 'suicide' was caused by Dr Jack Kevorkian's work from l989 onwards. Helping some 130 people to die with his so-called 'suicide machine' was continuously headline news. Medical and public opinion was seriously divided on whether Kevorkian's campaign was a good or a bad thing. His name became a lightning rod.

For legal clarity, the Final Exit Network avoids 'assisted suicide' usage and tends to speak of 'choices in dying'.

Personally, I don't think 'physician-assisted suicide' is a detrimental term in itself. It means a self-chosen death with medical aid. Because we are all surprised and saddened by persons who precipitately kill themselves doesn't -- to me -- make suicide a loaded word. There have been suicides throughout human history; the Bible speaks of four such, without condemnation. As the old clich goes: "Call a spade a spade."

As a writer I use all the terms which are now fashionable because it helps the variety of my prose. Yet in all my communications, if a person uses 'assisted dying' to me then I politely respond with that term.

I have never found that our opponents gained much capital about the words 'assisted suicide' -- just one of their rather lame arguments. But it is true that in opinion polls people are more receptive to voting affirmatively when the term 'medical assisted dying' was used in questions.

As Rebecca Solnit in her book - Men Explain Things to Me says: 'You can use the power of words to bury meaning or to excavate it.'

Derek Humphry is the author of Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying and four other books on choices in dying.