Paul Hopkins: Esther's life deserved to have a better death

Esther Rantzen should have been a politician. In fact, the woman, who produced and presented BBC show That's Life! for 21 years and who has died at the age of 86, was a politician if we agree a politician's work is to solve or address relevant and problematic social issues, guided by a conception of doing the right thing.

Britain's Prime Minister Andy Burnham said the veteran broadcaster and campaigner had “changed countless lives”.

That's Life! regularly attracted 20 million viewers for its mixture of in-depth consumer investigations and light-hearted banter. In 1986 Rantzen launched Childline, a counselling service for children and young people and in 2013 she launched Silverline to help elderly people suffering from isolation and loneliness.

Ireland would follow suit with similar organisations.

Later, Rantzen became a prominent campaigner for the legalisation of euthanasia or assisted dying. She had been terminally ill with lung cancer. In December 2023, she revealed she had joined Dignitas, the Swiss assisted dying clinic. But in a statement given to the Press Association just last month, she said that, despite having “spent the money and made the plans” to go to Dignitas, she had since reached the point where she was “too physically fragile to make the journey”. She said the law in the UK must “change and change quickly”, as she renewed her plea ahead of Britain's latest debate and vote on the Terminally Ill Adults/End Of Life Bill.

At the height of its powers, in the 1990s, That's Life! received 15,000 letters a week, letters overwhelmingly addressed directly to Rantzen. What many of the letter writers wouldn’t have been aware of was quite how embattled their hero and saviour was within the corporation she so roundly represented, with the BBC's increasing disquiet over their then biggest star's advocacy for euthanasia.

The passing of Esther Rantzen has raised once more the issue of assisted dying. Our Oireachtas set up a committee of TDs and senators under the Chairmanship of Michael Healy-Rae to consider the issue of assisted dying. That was back in 2024. There has been little update since. The Joint Committee on Assisted Dying had been asked to examine four aspects. First, how assisted dying might work in Ireland; second, the safeguards; third, the “constitutional, legal and ethical” issues; and, fourth, “possible unintended consequences”.

In countries with provisions for 'medical' assisted dying, patients are examined by two doctors to see that specific criteria are met. Those criteria include terminal illness and in some cases a prognosis of limited life expectancy. Those examinations also include the doctors’ opinion that the patient is competent to make a legal decision (’of sound mind’) and that the decision to apply is free and not coerced and that the implications are understood.

This is broadly the situation in most countries. However, there is a view that a normal life events like dying should not be ‘medicalised’. Individuals should be free to determine that their life or suffering is intolerable and with no reasonable prospect of relief and so be able to end their lives within the provisions of the law. The argument is that only the individual can determine whether their life is intolerable and no one else has the right to do so.

This is not the actual practice anywhere except in The Netherlands and Belgium and even then there are other strict conditions that must be met.

Given the high regard in which doctors here are held and their generally close relationship with patients and their families, it would make sense for Ireland to adopt that ‘medical’ model used in most jurisdictions.

Irish Doctors Supporting Medical Assistance in Dying (iDMAiD) are a small but growing group of doctors who support choices for people at the end of their lives. They have a strong belief in individual patient autonomy; that a person approaching the end of their life should be “provided with accessible, high-quality and evidence-based care to minimise suffering and support their wishes”. Every citizen, they argue, should be able to access their choice of medical care, including palliative care and medical assistance in dying.

Their spokesperson tells me: “We will advocate for the introduction of MAiD in Ireland, through public advocacy and workshops with doctors. We want to deliver safe, regulated and high-quality care to our patients, including Assisted Dying. We are committed to developing the educational and professional standards to make this happen.”

As I see it, forcing someone to spend their last months in a painful, undignified limbo is cruel.