A marketing manager left tetraplegic after falling awkwardly at home pleaded with doctors to switch off his ventilator machine because he could not bear to be paralysed, an inquest in the UK has heard.
John Patterson, a 40-year-old man paralysed after a freak accident at home caused irreparable damage to his spinal cord, died of respiratory failure in September last year after he told medics not to resuscitate him.
Although 'do not resuscitate orders' for terminally ill and dying patients are common procedure in the United Kingdom's National Health Service, Patterson's case is believed to one of the first in the UK where a patient deemed to be non-terminal and mentally capable of consent has requested life support to be withdrawn.
Whilst assisted dying is illegal in the UK, his withdrawal of consent for treatment meant that medical staff were duty bound to discontinue.
Found by his wife writhing in agony after falling backwards at their home in Aborfield, Berkshire, Patterson was first taken to the Royal Berkshire Hospital in July last year, but was told that his injuries would be life-changing.
With the prospect of living without control of his arms and legs unbearable, able to breathe only through the use of a ventilator, he told doctors that he could not accept living as a tetraplegic - demanding that they withdraw his life support equipment.
Following his request, a review was launched on August 18, which found that Patterson was of sound mind but was likely to remain fully paralysed for the rest of his life.
Giving evidence at Oxford Coroner's, Doctor Stewart McKenzie, a consultant in intensive care medicine and anaesthetics, said that Patterson had refused to "accept living with this level of disability".
"A joint meeting was had with his family and it was explained the physical prognosis was life-long care. It was emphasised that some people are thrust into this way of life do adjust. Patterson remained resolute in his view that he wanted ventilatory support discontinued.
"It was agreed that withdrawal of support was consistent with Patterson's wishes and approved. Support was withdrawn on September 10 and Patterson died peacefully."
In a written statement presented to Oxford Coroner's, his widow, Lauren, described how she had found her 6 ft 7 husband lying "immobile" on their bedroom floor.
"It seemed he had hit the wall and then the bedside table as he fell. He was lying in the corner of the room. I dialled 999 but John could not move at all. He complained of tightness in his breathing and pins and needles.
"He was not visibly bleeding except for a slight nosebleed and he was conscious but woozy."
Delivering a verdict of accidental death, senior coroner Darren Salter said that Patterson's death could not be recorded as "natural cause" due to the nature of the accident and his injuries. The cause of death was given as type two respiratory failure due to spinal injury, and C2 and C3 fractures to the spine.
"We do not know the cause of collapse. It didn't seem it was a trip. It seems it was a dizzy spell or some kind of fainting. It caused serious spinal injury," he added.
Assisted dying around the world
In 2002, the Netherlands became the first country to legalise assisted suicide and euthanasia, but only in specific circumstances, including that the patient's request is made in full consciousness
Belgium followed suit in the same year and legalised voluntary euthanasia, but the law doesn't cover assisted suicide. This was extended in 2014 to terminally ill children suffering beyond medical help
Oregon was the first US state to legalise assisted suicide in 1997 for terminally ill patients, who can request a lethal prescription. Since then Washington and Vermont have followed suit, while courts in Montana and New Mexico ruled in favour of assisted suicide
Home to the Dignitas clinic, Switzerland generally permits assisted suicide if motives are honourable, but voluntary euthanasia is not permitted: it is illegal for a doctor to prescribe and administer a lethal drug
The law is similar to Switzerland, but assisted suicide is only legal if a lethal dose is taken with no help from anyone else - e.g. guiding a hand
Euthanasia is currently illegal in New Zealand as two attempts at passing legislation on legalised euthanasia failed to get through Parliament. It is also illegal to 'aid and abet suicide' under Section 179 of the New Zealand Crimes Act 1961.
- Originally published in Telegraph UK