From Dark Desires to a Moral Dilemma: Filming Individuals’ Farewell at Dignitas

Fifteen years ago, I found myself in a hospital room in France, watching as doctors administered a sedative to my beloved elder sister before removing the life-sustaining apparatus. I can still feel the tears welling up in my eyes as I recount this painful memory. I miss her every single day.

It was during a riding lesson that Hilary, then 66 years old, was thrown off her horse. Despite wearing a helmet, she suffered a devastating fall that broke her neck at the highest possible point, her C1 vertebra. She managed to survive thanks to the quick actions of her instructor, who performed mouth-to-mouth resuscitation until paramedics arrived. However, once Hilary was stabilized at the nearest hospital, it became evident that she would require mechanical respiration through a tube in her neck for the rest of her life. Not only would she be unable to speak, but she would also be tetraplegic, likely succumbing to pneumonia or another infection within a few years at best.

The doctors asked our family, who had gathered from all over the world, for our input on what Hilary would want, given her inability to communicate her own wishes. By a majority vote of three to one, we agreed that the life that lay ahead for her was not one she would have wanted or accepted. With heavy hearts, we gave the doctors permission to switch off the machines, effectively ending her life. While this may not be considered assisted death in the traditional sense, it is undeniable that our decision led to her funeral a few weeks later. In that sense, we made the choice to end her life.

And now, here I am, standing in a room at Dignitas, an assisted dying facility located on the outskirts of Zurich, Switzerland, capturing the final moments of another woman’s life. This has been an emotional and arduous journey, but I can only hope that it will be worthwhile.

“A Time To Die,” my latest feature documentary, was not my original idea, but when the production company approached me, I didn’t hesitate to accept. I was well aware of the ongoing debate surrounding the controversial issue of whether the current laws on assisted dying should be changed. In England, Wales, and Northern Ireland, assisting someone to die can result in a prison sentence of up to 14 years. However, the Isle of Man recently took a step closer to becoming the first part of the British Isles to legalize assisted dying after its Parliament gave a second reading to an Assisted Dying Bill. In Westminster, Parliament has debated changing the law three times in the past decade, with MPs voting against the legalization of assisted dying in England and Wales in 2015.

Currently, anyone who aids another person in ending their own life is likely to face a police investigation. While the circumstances will be considered when determining whether prosecution is in the public interest, individuals may still be subject to cautionary interviews, have their homes declared crime scenes, and live with the looming threat of a prison sentence for months or even years. All of this occurs during a time when they are already grappling with grief.

This documentary has undoubtedly been one of the most difficult, personal, and emotionally challenging projects I have undertaken in my 50-year career as a war reporter and documentary filmmaker. It delves deep into the lives and deaths of individuals confronted with agonizing choices. People like Dan, a former music teacher now living with multiple sclerosis, who continues to compose music using his tongue and nose movements detected by his computer screen. Dan currently resides with his parents and is in the process of completing his paperwork with Dignitas, which he humorously refers to as his “get-out-of-jail free card.”

We spent time with Di and Trevor, a couple whose retirement dreams of traveling the world were shattered when Trevor was diagnosed with motor neurone disease. Trevor, unable to speak or eat and in constant pain, communicated with me using an iPad. At one point, he displayed the words: “Utter boredom, pain, both actual and emotional.” Despite their circumstances, our contributors graciously allowed us to document their lives, and in some cases, their deaths. I believe this speaks to their belief in our ethical standards, our promise to respect their wishes, and our genuine concern for their well-being.

We were granted rare access to Dignitas, Switzerland’s most well-known assisted dying organization, and through them, we reached out to their 1,300 UK members. Some joined out of sympathy for the cause, others as an insurance policy for a future date, and some due to an immediate desire for an assisted death. We carefully considered the ethical and moral dilemmas surrounding what to show and what not to show, guided not only by Ofcom’s strict regulations but primarily by our participants’ wishes. Kim and Andy, a couple who met at university in Manchester, contacted us and invited us to document their lives following Kim’s diagnosis of progressive supranuclear palsy (PSP), a rare neurological disorder. Kim, a fiercely independent woman throughout her life, was so devastated by her deterioration that she was resolute in her decision to travel to Dignitas. Reduced to using words sparingly, she made her intentions clear: “I will take a drink. I will die – hopefully painlessly.” From the beginning, they were both incredibly open to having us document their entire journey, regardless of the outcome. In fact, we didn’t know if Kim would change her mind until we filmed her family packing up the car. Even then, she could have decided to return home until the moment she finally consumed the drink that would end her life.

I witnessed immense compassion, care, and love among the people who allowed us into the darkest moments of their lives. It is not easy waking up each morning knowing that tears may flow uncontrollably at some point during the day. So why did I embark on this project at an age when most of my peers have retired?

Ultimately, I believed that the best service we could provide to our audience was to present examples of those most affected by the current law, while also honestly highlighting the concerns of those who oppose any change. Kim and Andy were both incredibly willing to allow me to document their journey, however it unfolded.

If we could shed light on the practical aspects of assisted dying, as well as the alternative realities for those who do not have access to it or take matters into their own hands, perhaps it could make a difference in how people understand this issue.

We made an effort to hear from around 150 active supporters of assisted dying and approached numerous opponents to give them a chance to express their views. I was surprised by the limited number of opponents who ultimately agreed to participate. The Archbishop of Canterbury was too busy, two prominent palliative care professors initially seemed willing but then disappeared. A high-profile religious opponent, who had organized several demonstrations against a change in the law, was also too occupied. A GP who held sincere views against a change in the law due to concerns for her predominantly Muslim patients was prohibited by her practice partners from giving an interview. Another consultant was advised by her hospital trust not to take a public stance.

Despite these challenges, we wanted to allow the audience to form their own opinions on the matter. This debate is often driven by anecdotes, some of which are quite harrowing, and used as weapons by those entrenched in their positions…