Dame Esther Rantzen has spent a lifetime campaigning. She founded Childline – the counselling service for children – in 1986, launched The Silver Line to help older people combat loneliness in 2013 and has battled numerous causes in between.
But none has been as controversial as her latest cause. Nor as personal. Esther is at the forefront of a campaign to change the law to allow assisted dying for the terminally ill.
This Thursday, MPs get the chance to enter a ballot to introduce a Private Member’s Bill of their choice.
Esther hopes the winner will choose to push for assisted dying. It’s a life-and-death issue for Esther because she herself is dying of lung cancer.
She did not expect to see Christmas last year and confounded everyone – herself included – by celebrating her 84th birthday in June.
Esther Rantzen (pictured in Summer 2020) has issued a plea to MPs to allow a vote on assisted dying
Campaigners for assisted dying gather outside Parliament with a banner reading ‘end unnecessary suffering’ in April this year
When she was told the news that it was terminal in January last year, Esther admits frankly that she was terrified.
She was not scared of death itself, but of how she was going to die. Would she be forced to endure an agonising, undignified death? What would that do to her children? How would they cope with seeing their indomitable mother racked with pain, suffering unspeakable indignities?
‘I could face dying peacefully at home surrounded by the people I love,’ she says. ‘But that’s not always what happens. What terrified me was knowing my loved ones might have to watch me suffering unbearably and could do nothing to help.’
The questions have become increasingly urgent as her cancer progresses. ‘I know from my own experience that watching someone have a bad death obliterates all the happy memories,’ she says. ‘And I don’t want that for my children. I want them to have long-lasting, happy memories of me and our life together. I don’t want them to be traumatised by my painful death.’
Esther is so determined to ensure her children suffer as little as possible that she has, very publicly, joined Dignitas, the assisted dying clinic in Switzerland.
But she is acutely aware that if her family went with her that would put her children – Miriam, 46, Rebecca, 44, and Joshua, 42 – in an invidious position.
If they were there, holding her hand as she died, they would risk prosecution as soon as they got back home.
That’s because there is a blanket prohibition on assisted dying in all forms in the UK. In England and Wales, assisting a suicide is a crime with a maximum sentence of 14 years.
A similar law is in place in Northern Ireland. There is no specific crime of assisting a suicide in Scotland, but it is possible that helping a person to die could lead to prosecution for culpable homicide – in other words, intentionally ending or helping end the life of another.
And already Esther – who conducted this interview via email to preserve her dwindling strength – fears she may be too weak to make the journey alone.
So instead of seeing out her final days quietly, Esther is fighting a battle which is almost certainly too late for her but which she hopes will help others.
‘The law as it stands is a cruel mess,’ she says. ‘I’ve seen my mother, my beloved husband [documentary filmmaker Desmond Wilcox] and my dog, Marmite, all die – and it’s my dog’s death that I envy.
‘Marmite had two breakfasts, a long walk and then a quick end in the arms of his family, never knowing how ill he was. That’s when I realised how much more merciful we are to our pets than we are to the people we love.’
Esther has quietly been in favour of legalising assisted death for decades. Her diagnosis has turned her into a passionate advocate.
‘This issue affects so many people so deeply,’ she says. ‘But I believe the time has come at last to make the choice available to everyone who needs it.’
If the issue isn’t picked up in the forthcoming ballot, there is another opportunity in November – when a Bill introduced by Lord Falconer in the House of Lords gets a second reading. It proposes that terminally ill, mentally competent adults should have the option of assisted dying alongside access to high-quality end-of-life care.
The proposed law would be subject to strict safeguards that have been tried and tested in other countries where assisted dying is already possible.
Lord Falconer, whose proposed bill would make assisted dying available only to people who are terminally ill with a life expectancy of six months or less – and with the agreement of two doctors and a judge
‘Witnessing someone you love or care about dying in agony is traumatic, and can overwhelm other, happy memories’, says Esther Rantzen (pictured in 2018)
Dignitas in Pfaeffikon near Zurick. British membership of Dignitas has increased 80 per cent in the past decade, according to Dignity in Dying
In Switzerland, for example, it has been possible since 1942 to assist in another’s suicide so long as the motive ‘is not selfish’.
Most of the assisted suicides take place at not-for-profit organisations such as Dignitas rather than in state hospitals.
It is the only country which allows non-residents to enter for the purpose of taking their own life.
In Canada, following ‘medical aid in dying’ legislation that was passed in 2016, doctors can both administer a drug to end a patient’s life, or prescribe a drug for a patient to self-administer and end their own life.
In 2022, more than 13,100 people in Canada opted to end their lives this way, which accounted for 4.1 per cent of all deaths in the country.
Assisted death is also possible in the Netherlands, Belgium and, since 2021, New Zealand, for those who have six months or less to live owing to a terminal condition.
Common practice in many of these countries means a patient must be assessed by at least two doctors and a psychiatrist before being allowed to proceed.
Assisted dying is now also possible in Australia. In New South Wales, the most populous state, more than 130 people opted for an assisted death between November 2023 – when it first became possible – and February 2024: 91 of these had the help of a doctor and 41 took self-administered medication.
In the UK, the British Medical Association has dropped its official opposition to law change to one of neutrality.
In June, members of the Royal College of Nursing voted at their annual congress to support the principle of assisted dying.
The House of Lords last debated assisted dying in 2021, where a Private Member’s Bill introduced by Baroness Meacher, a cross-bench peer and honorary president of the campaign organisation Dignity In Dying, passed unopposed at second reading but ran out of time to progress further and had to be abandoned.
MPs last voted on an assisted dying Bill in 2015, where it was defeated after a debate. ‘I know it is a difficult challenge because there are strong feelings on both sides,’ says Esther. ‘However, for many of us, the need for a reform of the present law is urgent. As you grow older, you inevitably lose people close to you.
You learn a great deal about the limits of palliative care. ‘Even with the best care, medicine can sometimes extend life without protecting quality of life. All of us hope for a pain-free death with dignity, but sometimes we aren’t that lucky.
‘Witnessing someone you love or care about dying in agony is traumatic, and can overwhelm other, happy memories.
‘That’s why I believe every survey of the public shows a large majority in favour of legalising assisted dying not to shorten life, but to shorten death.’
And it would appear support for the idea is increasing. According to Dignity In Dying, 75 per cent of the British public now support a change in the law to allow assisted dying.
Meanwhile, it claims that British membership of Dignitas has increased 80 per cent in the past decade – while the cost of travelling to Switzerland for an assisted death is around £10,000 (the sum is just to cover costs).
A petition urging the Government to grant a free vote on assisted dying reached more than 200,000 signatures in April. Pressure is unquestionably mounting. The first-ever Commons inquiry into assisted dying, published by the Health and Social Care Select Committee in February, called on the Government to engage in the debate, with legalisation deemed ‘increasingly likely’ in parts of the UK.
It found that palliative care cannot relieve all suffering and that such care has improved in many jurisdictions that have legalised assisted dying.
It said that UK law is unclear, with doctors lacking guidance on how to support patients considering an assisted death overseas. It also found no evidence of a ‘slippery slope’, meaning assisted dying laws retained their protective powers and didn’t weaken over time.
Esther has been inundated with support. ‘I have heard so many stories, especially from families who have described the good deaths their loved ones experienced when they went to Dignitas, although they were sad that they had to go to Switzerland,’ she says.
‘But it’s the tragic stories that stand out. One that remains with me is the description Jonathan Dimbleby shared of his brother. His death shows just why our criminal law is such a cruel mess.
While Esther Rantzen (pictured in 2021) has quietly been in favour of legalising assisted death for decades. Her diagnosis has turned her into a passionate advocate
Esther Rantzen is cheered by having the prime minister’s personal promise to make time for a parliamentary debate on the issue with a free vote (file photo)
‘Nicholas, a sculptor, was committed to the principle of having the right to die. He had motor neurone disease and, as the illness progressed, he suffered. Nicholas had decided to go to Zurich, but in the end it was just too painful to leave his family. They could not have gone with him, because they would then have been investigated by the police.
‘Of course, I know people may worry that elderly or disabled people may feel pressured.
‘But I would argue that there are now so many countries around the world where assisted dying has been legalised, all of them choosing to incorporate different precautions into their own laws, which means we can use them as evidence and make our own choice. Lord Falconer’s Bill means that assisted dying would only be available to people who are terminally ill with a life expectancy of six months or less – and with the agreement of two doctors and a judge.
‘I think these precautions will protect anyone from being pressured into seeking assisted dying. And it will not apply to mental illness or disability.’
Esther is cheered by having Keir Starmer’s personal promise to make time for a proper parliamentary debate with a free vote.
‘I know he personally supports change,’ she says. ‘As Director of Public Prosecutions, he tried to make sense of the current cruel criminal law. Every single case that arose during his time was referred to him, on his insistence.
‘He said he hoped I’d be alive long enough to see his promise of a debate come true, although, sadly, I don’t believe a new law could come into force in time for me.’
Meanwhile, Esther has a heartfelt message for the MP who wins the ballot on Thursday.
She says: ‘I urge you now to give hope to people like me with a terminal illness. Please give us the confidence of a good death.
‘If you believe part of your role in Parliament is to listen when the public says a change in the law is now urgent, please, please prioritise this crucial life-and-death decision. For some of us, time is running out.’
