Diane Pretty, who died on Saturday from motor neurone disease, waged a determined but unsuccessful battle for the right to die with her husband's help at a time of her choosing, not choking or gasping for breath.
Her battle was a legal failure. By the time it reached its final stage, on April 29, when the European court of human rights in Strasbourg delivered judgment, a total of 15 judges in Britain and Europe had ruled against her and none in her favour.
Nevertheless, her campaign was a public relations success, drawing sympathy for her plight and raising awareness of the issues surrounding voluntary euthanasia and assisted suicide. A petition for a change in the law on her website after the Strasbourg ruling drew 17,000 signatures in the first week.
The manner of her dying - her husband, Brian, disclosed yesterday that she was in pain towards the end and suffered the breathing problems she had fought so hard to avoid - is bound to provoke further debate. The fact that her legal battle coincided with the high court case of Ms B outlined Mrs Pretty's comparative powerlessness and lack of autonomy. Ms B, equally paralysed but with arguably a better quality of life, was declared free to have the ventilator keeping her alive switched off.
She was simply refusing treatment, not asking, like Mrs Pretty, for someone to help her die. "If I am allowed to decide when and how I die, I will feel that I have wrested some autonomy back and kept hold of my dignity," Mrs Pretty said in November. "That is how I want my family to remember me - as someone who respected the law, and asked in turn that the law respected my rights."
It was not voluntary euthanasia that she sought, but assisted suicide - the right to do what she could have done for herself but for her disabilities.
Paralysed from the neck down, she could not even lift a tablet to her mouth.
Diagnosed with the fatal degenerative disease in November 1999, she was confined to a wheelchair within four months. Her campaign started in June 2000, when Mr Pretty wrote to Tony Blair, saying his wife had "had enough".
In August 2000, backed by the civil rights group Liberty and the Voluntary Euthanasia Society, the Prettys wrote to the director of public prosecutions, David Calvert-Smith, asking for an assurance that Mr Pretty would not be prosecuted for assisting a suicide if he helped his wife to die.
The DPP's refusal was the catalyst for a high court case arguing that the right to life under the Human Rights Act included the right to die. Three high court judges rejected the plea, saying that democratic opinion on the subject of assisted suicide in Britain was "not ready for change". Five law lords agreed and seven judges in Strasbourg ruled that the state's duty to protect Mrs Pretty from inhuman and degrading treatment did not include a duty to protect her from the natural effects of a disease.
Her last message on her website said she was looking for a doctor to help her end her life. Physician assisted suicide is lawful in the Netherlands, in Belgium, and in the US state of Oregon.
In 1996 Annie Lindsell, another motor neurone disease sufferer, went to the high court for a declaration that her GP could administer doses of diamorphine large enough to render her unconscious when her ability to swallow food became affected. She had made an advance directive refusing feeding by tube and did not want to go through the final stages of the disease, possibly choking on her food and unable to speak. She withdrew her application for a declaration when the lawyers for all sides in the case, including a QC for the attorney general, agreed that the course of action she was seeking was acceptable medical practice.
It was covered by the doctrine of "double effect", which allows a doctor to give medication that may be fatal for the purpose of relieving distress, as well as pain, as long as the intention is not to kill the patient. In the end, she died before any drugs were administered.
Chris Davies, Liberal Democrat MEP for the North-west, who supported Mrs Pretty in her legal fight, said her life should be commemorated with an act of parliament creating a legal basis for assisted suicide. "Diane Pretty's courageous battle has highlighted the need for a long overdue reform of the law. The government should introduce legislation to provide for the rights of people suffering unbearable pain and distress with no hope of relief."
