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Views And Reviews

Why I’ve changed my views on assisted dying

BMJ 2017; 358 doi: (Published 03 August 2017) Cite this as: BMJ 2017;358:j3566
  1. David Nicholl, consultant neurologist
  1. City Hospital, Birmingham, UK
  1. david.nicholl{at}

A change in the law would enable those in the UK faced with a terminal illness the choice of a death with dignity on their own terms

On Thursday 23 March I conducted my usual clinic, but this was like no other day. I knew that at 1.30 pm precisely, one of my closest friends was going to die.

Fabi’s death, at the age of 51, by euthanasia—something that I had been utterly opposed to throughout my career—is legal in Belgium, where she lived. I used to believe that if we got the balance of palliative care right to minimise distress then “assisted dying” was an irrelevance. Fabi’s death reversed my views.

I first met Fabienne “Fabi” Vanheuverbeke in Florida in 1983 on our gap years. With two other foreign exchange students (Tim and Françoise) we formed a lifelong bond. On her return to Belgium, Fabi, then 24, fell ill with a pituitary tumour and then a more widespread disorder—multiple endocrine neoplasia. She developed tumours in her pancreas, stomach, and liver over the next 27 years. In September 2016, I got the call I’d dreaded. She was now terminal, and we must all meet. In November, the four former exchange students …

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