A 30-year-old woman who is terminally ill has launched a campaign to overturn Britain's euthanasia laws by compelling her doctors to increase her dose of morphine and let her die.
Kelly Taylor lives in constant pain with a congenital heart defect and a spinal disorder. She says she has struggled with her condition all her life and wants release. She has been told she has a year to live but doctors have been unable to control her pain.
"Enough is enough," she said yesterday. "I don't want to suffer any more. I'm not depressed - I've never been depressed. I am a happy person. But my illness is now at the point where I don't want to deal with it any more."
Her case is believed to be unique in launching a double-pronged challenge to the law that forbids doctors from helping patients to end their lives. She wants the court to rule that doctors may sedate her and then withdraw tube feeding so that she dies.
The only treatment for Mrs Taylor's Eisenmenger's syndrome, which leaves her short of breath, is a heart and lung transplant, but she has become too frail for the operation. Her spinal condition, Klippel-Feil syndrome, restricts her mobility.
Last December, Mrs Taylor, who is looked after at home in Bristol by her husband, Richard, asked her doctors to increase her dose of morphine sharply. She had been receiving monthly prescriptions of the drug, to induce a deep, coma-like state of sedation, so that she no longer felt pain. She also made a living will asking doctors not to feed or hydrate her artificially.
Her doctors - a cardiologist, palliative care consultant and GP from Bristol Royal Infirmary and St Peter's Hospice - refused her request, saying that it amounted to euthanasia.
Mrs Taylor said: "My consultant has told me that he does not expect me to live for another year. In that time I will deteriorate and that deterioration will become quite undignified. I want to avoid that."
Last July, she attempted to starve herself to death but abandoned her effort after 19 days. She also considered going to the Swiss assisted suicide clinic, Dignitas, which has helped more than 60 British patients die. But she disliked the idea of relatives having to face police investigations.
"I don't want to die in a foreign country, I want to die at home. While I have respect for people who go over there, it shouldn't be necessary. We should have a law over here," she said.
Her lawyers, Leigh Day and Co, say her doctors have a duty to provide her with adequate pain control even where it shortens her life. The case is expected to focus on whether increasing the morphine dose can be justified in this way or whether it amounts to an assisted death.
A consultant in palliative care said "terminal sedation" was carried out but only when death was imminent - within a week or two. "This girl is up and about. She may have a terminal diagnosis in the sense that she is not expected to recover but she is not dying. I would find it very difficult to say this was about symptom control."
A judge yesterday ordered a full hearing into the case next month.
What the law says
The doctrine of "double effect" at the centre of this case underpins the care of all terminally ill patients. It applies to patients where increasing the dose of drugs such as morphine may have the effect of hastening their death.
The law says that so long as the doctor can show that their intention was to ease pain rather than hasten death, they are immune from prosecution should the increased dose have a fatal effect.
Mrs Taylor's lawyers argue that she is entitled to receive a massive dose of morphine - in effect, terminal sedation - because her pain is intractable. They intend to cite Article 3 of the European Convention on Human Rights, which prohibits inhuman or degrading treatment, and Article 8, which guarantees the right to respect for private and family life.
Separately, they will argue that once she lapses into a coma under the effects of the drug, her "living will" should take effect. In this, patients can set out what treatment they want, where they are unable to communicate.