Lessons in living from a woman who wants to die

'The medical staff told her what was best for her. She magisterially told them their duty'

Miss B is an exceptional woman. My admiration for her is boundless. For the answers she gave to the judge, barristers and court officials who went to conduct a hearing around her hospital bed last week were at once both rational and sensitive, both lucid and considerate. The more I read the transcript, the more I was moved.

She has carefully considered the near-vegetative state awaiting her since a ruptured blood vessel left her paralysed from the neck down more than a year ago. She concludes that such a life is not worth living. She would rather die. So Miss B has asked her doctors to switch off the ventilator enabling her to breathe. They have refused. The High Court must decide.

She didn't wish to die, did she? No, Miss B would like to recover significantly enough to have a better quality of life. But here comes the rational mind: "I am not convinced from the evidence that that is going to happen, and I find the idea of living like this intolerable."

Would the small improvements that would result if she moved to a rehabilitation unit make a difference? "I do not think it is sufficient for me to want to pursue it."

Why not give it a go to see whether the improvement would be sufficient to cause you to change your mind? Not Miss B. Personally, I would do so, on the grounds that the will to live can overcome great obstacles, and because doctors can be wrong.

But Miss B won't just give it a go. She wants evidence. She wants to measure any improvements that are promised. So she has done what many of us are perversely reluctant to do when our own health is concerned For she has enquired widely about her prospects.

This has meant having discussions with doctors that have "demystified" the whole notion of rehabilitation. It has necessitated analysing the vast amount of information on the internet. She has heard from other quadraplegics who are also ventilated. In sum, her findings must have made her ask wonderingly, in words familiar to her: "O death, where is thy sting?"

She told the court: "I do not make this decision lightly or uninformed... I do understand what it is about." I presume that she has had neither a medical training nor a legal background. Yet on my reading she holds her own with both sets of experts – as indeed a well-trained mind can always do.

Then the court moved on to even more difficult questions. Would she be prepared to take her own life if a mechanism was set up to allow her to turn off the ventilator herself?

"No, it could be seen as suicide. I have a godchild who is struggling with this... to her the notion that her godmother would choose to commit suicide would be painful... because I love her, it matters to me... it is not necessary to put people through that. It is also not necessary for my church to be worrying about whether it was suicide or not."

Nobody asked her why exactly she should worry what people might think of her after her death, but she answered anyway: "because it goes towards your character and your integrity and I think it does matter."

The court applied a further turn of the screw. She was asked whether she could see any coincidence of feeling between her reluctance to be perceived as committing suicide and her doctors' reluctance to be perceived as killing her. She had remarked earlier: "if you are prepared to ventilate someone then you should be prepared to withdraw it." Her reply now was a little gem of a lecture about the duties of people holding responsible positions:

"The way that I see it, I had a job where I was head of department and we would have unusual things that we had never dealt with before – enormous press interest, which had huge ramifications – you deal with them. You are a senior manager and you deal with it. That is my experience. You certainly do not whinge to the client about how difficult it is for you. It is totally inappropriate."

Then immediately came the one question that fell well below the high standard of discourse that Miss B had set: "Do you think that these very strong feelings and understandable feelings, which you have just expressed, are actually getting in the way of you listening to the advice you are getting from people here or generally?"

Miss B dealt with this inanity quite magnificently:

"Quite the contrary. I think people are disabled by their own feelings about this and they have not functioned as well as they should have... that is what I mean about being in professional mode and getting on with the difficult things you have to do."

Miss B is a remarkable person. The medical staff had told her what was best for her. The court came to her bedside to test her. But at the end of the day, she magisterially told them their duty.

"And even the ranks of Tuscany

Could scarce forbear to cheer."

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