Tragic choice of woman who most feared a failed suicide bid

In a spruce, newly-leased town house in Donnybrook, Dublin, last Friday week, the life of a 49-year-old woman came to end. It was a neutral, impersonal setting, and was chosen for that very reason.

The house is normally rented by tourists, overseas academics and professionals looking for somewhere to stay for a few days near the city-centre. For her, however, there was an entirely different motivation: she didn't want her body to be found at home. In death, her family has requested that her name should remain out of the public domain.

To many people, the planning and manner of her death will appear chilling. But to those who knew her it was entirely consistent with what they described as her obsession with suicide in the final years of her life.

Consistent, too, were the other aspects of her plan - her decision to write a suicide note to her doctor, to be published after her death (in the event, the doctor decided not to), her leaving the town house address at her family home so that it would be found after she died, and, controversially, her seeking of assistance to kill herself.

It is not clear exactly when she began that search, although it was at least two months ago.

On Wednesday November 28th 2001, Dr Libby Wilson, a retired Scottish GP, received an e-mail. Dr Wilson runs a pro-euthanasia support group called Friends At The End (FATE) in Glasgow. The e-mail was from an Irishwoman who identified herself only by her first name. "She asked me could I help her to die," Dr Wilson told The Irish Times. "I made it clear there was no question of that whatsoever." The doctor said she tried to dissuade the woman from her intention to take her life, "partly because I recognise depression, as a psychological illness, is potentially treatable". She gave the woman her phone number and told her to call if she wished to talk at a later stage.

The woman had by then already conducted some research into suicide and assisted suicide. She was known to have read Final Exit, a controversial US best-seller on "the practicalities of deliverance and assisted suicide for the dying". She had also contacted pro-euthanasia activists in the US, including the unknown person who directed her to Dr Wilson.

How many more people she may have asked to assist in her suicide is unclear. However, it appears that she eventually received a positive reply from a radical pro-euthanasia group in the US state of Michigan. Gardaí have recovered e-mails between the woman and two individuals from the group in which details of the proposed assisted suicide were discussed. A number of figures were mentioned as regards payment, and gardaí believe a fee in the order of €6,500 per person was agreed.

The woman phoned Dr Wilson and told her of her plans. The doctor said she felt she could not inform anyone else, as she regarded the woman as a patient who was entitled to confidentiality. Dr Wilson did, however, continue to try to dissuade the woman. But, she said, "the lady stonewalled every suggestion".

THIS bears out the experience of others close to the woman, who spoke of the "rational" manner in which she talked about ending her life. "In a way, she was not typical of someone depressed, because she was very positive about what she wanted to do," said Dr Wilson.

As the date of her suicide approached, the woman became more careful when speaking about her plans. "She didn't tell me who she had got to do it, but just said she had got them on the Internet," said Dr Wilson. "She protected me from that information . . . She felt if other people knew what she had gone through, her suffering would not have been in vain."

Five days before her death, however, the woman phoned Dr Wilson in what the doctor described as "a terrible state . . . She was afraid she had put the names and identities of people in the letter". Dr Wilson said she assured the woman that she had not done so. The doctor noted, however, that she had learned enough to be "pretty sure" the woman was going to kill herself with assistance.

The final chapter of the woman's life began with the renting of the town house last Tuesday week, three days before her death. On the same day, she went to Dublin Airport to meet the two men who had come to help kill her. They brought with them some of the equipment needed to effect her death. The rest, she would supply. They hired a car and went to Westport, Co Mayo, for a short holiday, returning to Dublin via Avoca, Co Wicklow.

The two are understood to have stayed in a Dublin hotel on the Thursday night in a Dublin before travelling to the town house on Friday evening, where, in an upstairs bedroom, they helped to set up a mechanism for suicide involving drugs and cutting off the woman's oxygen supply. The mechanism was put together in such a way as to allow the woman herself to perform the final act which would lead to her death.

Why did she have the others help? Dr Wilson said she believed the decision stemmed from the woman's insecurity. "I think she was very lonely. She did not want to be alone," said the doctor. It is also believed that the woman, who was twice married, separated from her husband and had no children, feared the consequences of a failed suicide bid. She was hospitalised for six months after attempting suicide once before and she was said to have dreaded the possibility of being in care for life. Recently, she had been forced to give up her bank job because of her mental illness.

No one can be sure what went on in her mind, although it is believed that she felt an assisted suicide was the only way of guaranteeing her death. It is understood that her wish not to die alone was fulfilled, and the two men stayed with her until she passed away. Gardaí did not detect any haste on their part, and the pair left several fingerprints on the suicide kit and elsewhere in the house.

The two are believed to have slipped out of the premises in the middle of the night. They returned the hire car to Dublin Airport within hours of boarding a flight to Amsterdam, where they stayed for five days before travelling back to the US via London. Two Garda detectives have since gone to Heathrow Airport to study security camera footage in the hope of getting pictures of the men.

NOW that an investigation has begun, the Garda and the Director of Public Prosecutions face a dilemma: if the woman's intention was to die, should others be prosecuted for helping? The law seems definitive on the matter. Under Section 2 of the Criminal Law (Suicide) Act, 1993, anyone who "aids, abets, counsels or procures the suicide of another" is guilty of an offence punishable by up to 14 years' imprisonment.

The DPP does not have discretion over whether to prosecute. However, he can take into consideration a number of matters, including the question of whether it is contrary to "public policy" to initiate a case where public opinion felt it inappropriate. Thus, for instance, if the offender was a relative of the assisted suicide victim, and was shown to have already suffered from the death, the DPP might have scope not to prosecute.

Such scope, however, does not seem to arise in this case, as the offenders were not related to the victim. Nor were they from the jurisdiction, which raises a further question over the possibility of extradition proceedings.

On the face of it, there appears to be no obstacle to such a course of action. Assisted suicide is illegal in all jurisdictions bar two: the Netherlands and the state of Oregon in the US. Belgium is on the brink of becoming the third, having approved a law on euthanasia in its Upper House three months ago. Such jurisdictions, however, provide no safe haven for people who carry out so-called "mercy killings" elsewhere.

In both Holland and Oregon, assisted suicide is legal only where the patient suffers from a terminal physical illness. Thisfact must be independently confirmed by several doctors. The patient must also put their request in writing at least a month before the proposed assisted suicide. Requests are approved only if the patient is of "sound mind". For these reasons, what is believed to have occurred in Dublin last weekend would be illegal in any jurisdiction. The woman in question did not suffer from a terminal physical illness but had severe depression, which psychiatrists would argue can be successfully treated in most cases.

Moreover, in both the Netherlands and Oregon, someone with depression is prohibited from availing of assisted suicide, even if terminally ill, for the very reason that it raises a doubt over their state of mind.

Whether or not prosecutions follow, the Dublin case highlights the question of whether assisted suicide or euthanasia should be decriminalised here. A number of doctors have called for the right to die to be enshrined in law and for greater recognition of a patient's autonomy. But no one, either in Ireland or elsewhere, is openly advocating the decriminalisation of assisted suicide for someone with depression.

While the circumstances of her death may have been unique, the woman's tragic, lonely, desperate choice was all too familiar - as the 400-plus suicides which take place in the Republic each year testify.