Eight years ago, Jersey resident Lorna Pirozzolo felt a “weird itch” on her breast. When she scratched it she noticed a small lump. Pirozzolo was diagnosed with breast cancer. By 2019, it had reached stage four.
“It’s currently stable, but incurable. It will kill me at some point,” she says.
Last week was “a rough week” for Pirozzolo, who had a lot of pain. She also suffers severe attacks of pancreatitis which cause her so much agony, she ends up in hospital.
“I thought I knew pain, but I didn’t until I got pancreatitis. During one attack, I screamed at a nurse to kill me. I shouldn’t say that, but it’s how I felt.”
READ MORE
Pirozzolo (49), a Scot, has lived for the past 18 years on Jersey, one of the Channel Islands and a British crown dependency. It lies almost 140km (87 miles) off England’s southern coast and just 22km off Normandy.
Following her cancer diagnosis, Pirozzolo became one of the island’s leading campaigners to legalise assisted dying, decried by its opponents as “assisted suicide”.
At the end of last month, almost eight years after the campaign began, the states assembly [parliament] on Jersey voted 32-16 to bring in assisted dying for terminally ill people who have lived on the island for at least 12 months. Pirozzolo felt relief.
“I hope I don’t have to use it. But at least now it will be there as a safety net.”
Jersey’s parliament is the second in the British Isles to pass assisted dying after the Isle of Man, which did so a year ago.
[ UK parliament votes for assisted dying, paving the way for historic law changeOpens in new window ]
Both islands now await royal assent for their legislation from the British king Charles, advised by the UK government. Assent for the Isle of Man’s law is seen as dragging on because of issues identified in London with its drafting. Jersey’s law is more detailed.
As semi-autonomous dependencies, the two island nations can make their own laws but, constitutionally, they are still possessions of the crown, albeit separate from the UK. The king’s sign-off is needed.
Observers warn of the possibility of a “constitutional crisis” if assent is withheld or unreasonably delayed. Both islands want to bring in assisted dying by 2027.
Meanwhile, an attempt in Westminster to pass similar legislation for England and Wales has floundered in controversy in the House of Lords, filibustered to death by its opponents. This week, Scotland’s parliament vigorously debated its own proposal.
With islands on its extremities leading the way, the UK and the territories linked to it are now on a slow, but seemingly definite, march towards giving some citizens the right to choose their own death.
[ Assisted dying: Do we understand it properly?Opens in new window ]
Advocates for change say it is more humane to give terminally ill people power to end their suffering. Opponents say it undermines the sanctity of life and risks the vulnerable being coerced.
While both views abound on Jersey, the island’s temperate process of deliberation is being held up as a model for others to follow.
Dark clouds hover over the politically fractious debate in the UK. But recent blue skies over Jersey seem to mirror its official calm over the tricky issue of assisted dying.
It is a bright weekday morning as Jersey locals, many wearing sunglasses that might be incongruous in Britain at this time of year, busy the handsome streets of Saint Helier, capital of this wealthy island of 105,000.
It is out of tourist season, but Jersey is still vibrant enough with residents including the thousands of workers in the low-tax island’s big banking sector. It has slipped a bit in recent years, but Jersey residents are still on average one-and-a-half times richer than those in the UK – the island has the boutiques and sports cars to prove it.
English is the main language, although Jersey’s proximity to France helps to shape its culture – many of those sipping in cafes speak Jèrriais, a local language.
Jersey’s Anglo-French identity is also apparent in the driving culture. There is a polite Britishness in how Jersey drivers performatively give way, yet an irrepressible francité in how they drive six inches from your back bumper.
[ Assisted dying: ‘If I cannot consent to my own death, who owns my life?’Opens in new window ]
Jersey’s journey to assisted dying began with a 2018 public petition, followed by a 2019 public consultation and a 2021 citizens jury (like an Irish citizen’s assembly) where 78 per cent backed it.
The proposals went through rounds of states assembly voting until the final version passed on February 26th. Legislators kept a two-to-one ratio in favour throughout.
Terminally ill people with six months to live, or 12 months for neurological conditions such as motor neuron disease, will need the independent approval of at least two doctors. In a crucial difference to the UK proposals, a medical professional can help to carry out the act if the person who wants to die cannot administer drugs themselves.
While assisted dying activists won out on February 26th, some on Jersey were devastated. John Stewart-Jones, originally from Merthyr Tydfil in Wales, is a retired GP who has lived on the island for more than 40 years, delivering at least 100 Jersey babies.
He is also a committed Christian, having cofounded the evangelical Freedom church. Up to 400 people worship at its services each Sunday.
As we sit in his front room sipping tea, the pain Stewart-Jones feels at Jersey’s adoption of assisted dying is written across his face as he speaks, softly, of his regret at the decision taken. He says he must reluctantly accept it “as a democrat”.
“But it is so contrary to my moral compass,” he says. “I took the Hippocratic oath. That goes back 2,500 years. It says: ‘First, do no harm’. People mean well with assisted dying, but I fear a slippery slope [to an even more permissive assisted dying system].”
Stewart-Jones feels some campaigners for legal change “instilled fear” in others about the potential for pain at end-of-life. He believes good palliative care is a far better option: “I’ve not seen people rolling around in agony [during palliative care].”
As part of Jersey’s assisted dying decision, a separate vote put a legal obligation on the health minister to provide palliative care for individuals. A further £3 million (€3.5 million) a year is also being set aside for better end-of-life services.
Tom Binet was a businessman and one of the original campaigners for assisted dying in Jersey. Now he is the health minister tasked with bringing it in – Jersey’s parliament is dominated by independent politicians, with no formal government-opposition party system.
Binet lauds the “sensible” calm debate on the island, but his words also lend credence to Stewart-Jones’s fears about a slippery slope. Currently, the law is due to allow only “route one” assisted deaths of the terminally ill, but not “route two” cases for the chronically – but not necessarily terminally – ill.
I ask Binet if route two could ever be brought in. He says it “may or may not be adopted” in future: “I think it likely will at some point, [but] I can’t put a time frame on it.”
Having originally been a campaigner, Binet says he “never expected for one moment” to be the politician to bring it through the assembly. He also looks set to be the health minister who finally gets building going on a long-overdue new £710 million hospital.
The relief over getting these issues resolved is clear in Binet’s chirpy demeanour as he jokes the weather is “always good” in Jersey. “And the politicians are always full of s**t like they are everywhere else. You can quote that. It’s true,” he says, smiling.
Binet used to be minister for infrastructure. He is keen to say that Jersey, where the economy has stalled recently, is not only focused on assisted dying. He says it is also getting its “ducks in a row” to attract more investment after a period of “complacency”.
In the early spring sunshine bathing Jersey’s affluent towns such as St Aubin to the west and, to the east, Gorey, which sits beneath the looming Mont Orgueil castle, it isn’t hard to see how complacency might set in on such a glorious island.
Pirozzolo, meanwhile, doesn’t have the luxury of being complacent with her illness.
“I just want the right to make my own choices. I don’t see why anybody else should get to make them for me.”
