A: Let’s take a walk.

B: Are you sure, you could barely manage to get to the toilet the other day.

A: I’m feeling a bit stronger today.

B: Where do you want to go?

A: Outside. I want to see the normal world.

B: I understand.

A: You may have to help on the stairs, if that’s OK.

B: Of course it is.

B: How do you like it?

A: And this is what it’s come to. He asks me how I find the normal world! As though I am not a part of it.

B: I didn’t mean to be insensitive.

A: Well, as you asked, I find it invigorating, but also sad.

B: Would you rather go back?

A: No, let’s carry on. To the bridge, I want to see the water.

B: Can you make it all the way?

A: We’ve done half. If we turn back now, it’s the same as going to the other side. But let’s wait here. And anyway, I have a question for you.

B: Go ahead.

A: Don’t be angry.

B: How could I be?

A: I want you to imagine something. In fact, you don’t need to imagine it, because it’s happening right now.

B: What is happening right now?

A: This is the way I want it to be.

B: Please, you’re being very enigmatic.

A: This is where I want to die. On this bridge, or under it to be more accurate.

B: You want to jump off this bridge?

A: Precisely.

B: OK, I think I see where you’re going. You are dying in a country that has legalized assisted dying, and now you have had enough and you cannot wait.

A: I’ve had enough for weeks now, ever since the last scan showed that the tumour had grown on chemo. I am officially ‘palliative’, I’ve failed third-line therapy, all the right referrals have been made, the system has surpassed itself, I will be going home tomorrow.

B: But that’s not what you want?

A: It’s not. And I feel like a spoiled child. I’m lucky, I’ve got all the support I could wish for, but there’s only one thing I want and that is to end it.

B: And what exactly do you expect me to do?

A: All I need you to do is kneel on the ground, with one leg, so that the other forms a step – as though you were proposing marriage. I have not got the strength to climb over this barrier from the pavement, but I do have the strength to step onto your knee and then tip myself over. Once I’m on your knee my centre of gravity, what’s left of it anyway, will do the rest.

B: And what about the rest? When you hit the water.

A: I don’t weigh enough to land with much of a bang. Maybe I will thrash about for a minute, but I have things in my pockets to weigh me down.

B: And if someone comes along in a boat to pick you up?

A: I doubt that anyone will react quickly enough. Look, there are only barges and passenger ferries, they’re too big or too slow. And if they do manage to come alongside me, I will make it difficult for them. But that’s not going to happen. Believe me, one lung full of water and I’m a goner. What’s the matter? You look upset.

B: Of course I’m upset.

A: What is it that upsets you? Thinking about me dying or your role in it?

B: That’s a good question. You know damn well I’m not going to help you.

A: I’m relying on you. We’ve been heading towards this point for a long time. Others I have quietly abandoned. I have been ruthless, editing out my visitors.

B: So that’s the reason you’ve been happy to have me visit so frequently, to put me in this position?

A: Yes, I don’t apologize for it.

B: I won’t help you.

A: Then you must explain yourself.

B: How could I help a friend to kill themselves, like this?

A: Too shallow! Come on, I need more! Think, reflect. Assisted dying is legal, right? And you would have agreed to provide the medication, to put it by my bedside. You would do that for me, I believe.

B: Gladly.

A: But not this.

B: No.

A: Then you must justify it. Because this looks like hypocrisy to me.

B: It’s illegal.

A: What do I care? Honestly, what difference does that make to me?

B: Everything. Because when you are gone, when you have sunk to the bottom of the river, I will be left here, on one knee, or looking anxiously into the water. Even if nobody notices you go over, even if we come back at a quieter time when the place is deserted, your disappearance will be traced to me. If your body is found, I will have many questions to answer. If it is not, there will be even more. A curious detective will reconstruct this final walk, they will find evidence that we stood here, we will appear on the edge of some CCTV footage, and he or she will interrogate me, peck away at me. I could try to lie, to say that we were walking side by side when suddenly you launched yourself over the barrier at a predetermined moment, without warning. I rushed after you, leaning forward desperately. Then, I would have to justify my actions or my inaction. It will be forgiven if I do not jump after you, not many people would. But it will not be forgiven if I do not rush around trying to get help, calling 999, or grabbing the nearest police officer. I will have to put on a show, I will have to point down into the water, at your thrashing arms – assuming your reflexes take over and you do not drop like a stone. To avoid further scrutiny I will need to convince everybody that I was taken completely by surprise and did everything I could to save you.

A: It sounds like you have it all thought out already. You do think fast. You can do whatever you need to do, to protect yourself. Because that is what we’re talking about here. Self-protection.

B: Doesn’t that bother you? The welfare of the people who are left behind.

A: It bothers me now, but it won’t bother me later. But we have made progress! Only you will know the truth, and it sounds as though you are smart enough to avoid telling it. I’ve made enough subtle and unsubtle hints over the last few weeks to those who know me, that nobody would be surprised if I chose to jump over. Perhaps my doctor would find it interesting that I had the physical strength, but I doubt anybody will do any experiments with weights and levers to see what is feasible. So good, you have a plan to exonerate yourself. Let’s get on with it.

B: I’m not ready.

A: You’re not ready! This is hilarious.

B: I’m going back. I’m sick of this.

A: So sensitive. Look, I need you to be stronger than this. I cannot do this alone. I don’t need you to do anything active. All I need you to do is kneel down. Perhaps you can pretend to do up a shoelace.

B: Stop it.

A: No, I do not have much time. Soon, I will not be able to walk and even this option will be taken away from me. I will be entirely dependent on the actions of others, beyond mere ‘assistance’. And that is called euthanasia, which is never going to happen. For now at least, I have some agency. But it is time-limited. As a friend I know sympathizes with people like me, your role seems clear. I don’t think it’s acceptable for you to react according to your first emotions. Any emotions that you have experienced in the last few minutes fade to nothing in the shadow of what I have been through since my diagnosis.

B: I get that. Just give me a moment.

A: Sure. I like the view.

B: I’m thinking.

A: About me, or the prosecution you fear. I thought we had dealt with that.

B: I’m asking myself – if I volunteer to be involved in supplying the medications, what is the difference between that and what you ask?

A: Exactly the point I’ve been trying to make.

B: But I need to resolve it. Me, not you. Because after you are gone, and you will be gone either today or in a few weeks, those of us who are not terminally ill will carry a burden. Those of us who agree to be involved will become part of a new pathway in our health system. We will not be occasional prescribers. We know from experience in other countries that the numbers will grow. Someone like me might end up helping hundreds of terminally ill patients during a career. That needs to be anticipated.

A: It’s been done before. There will be support. We are not the first country, as you say.

B: No, but for those of us who have spent their professional lives doing all they can to postpone death, there will be consequences. Perhaps we will be ostracized, called names.

A: That is for your profession and society to sort out.

B: Yes, but you have to realize, if people like me do not feel safe or even appreciated, the law has no one to make it real. This is about more than patients.

A: Very well. You have persuaded me that I need to consider your position with more sympathy, and in more detail. To be honest, I have been so consumed with my own situation that I had not given that aspect much thought.

B: You assumed I would acquiesce immediately?

A: I knew I would have to convince you. But I didn’t think I would have to understand so much.

B: So you see why I cannot help you today?

A: No, I don’t. The principle remains.

B: The assistant needs to be ready too. You have had weeks or months to consider this day, to plan and engineer this situation. The two of us on this bridge. But I have been taken by surprise.

A: Can’t you accelerate yourself through this adjustment? The end is the same.

B: I am trying.

A: And what is it that holds you back?

B: I think it is the proximity.

A: To death?

B: No. It is the thought of the weight of your body on my leg, on my knee, as you take the final leap.

A: That’s pure squeamishness. It is the same, as you accepted, as leaving me a little paper cup of tablets on my bedside table. In fact, it is less. You don’t need to do anything except get in the position. I will do everything else.

B: I don’t want the sensation of your foot on my leg. To be the last person to touch you.

A: And I don’t want to be dying slowly. We are both uncomfortable. Me, due to disease, you, due to … what? Preference? Taste? Is it that shallow? Because morally, you understand, surely, that the request is not controversial. Assisted dying is legal; I am asking for different assistance. No, for you it’s more instinctive. Like the heterosexual prude who winces when a friend speaks about gay sex. Not illegal, not morally wrong, but for the prude, just … not right!

B: I’m not like that. I’m not narrow minded.

A: In matters of death, maybe. You are enlightened enough to supported assisted dying, and even to consider delivering it. But at a remove. Not up close. Not to touch it. Look. We will both find it difficult. But afterwards, I will have what I want, and you will know that you helped me. You need to get over this squeamishness. Is this how you’ll feel when you go through with your first prescription?

B: I will be cushioned by process. There will be documents, signatures … opportunities for patients to change their minds.

A: I get it. You want to be part of a nice team. The comfort of bureaucracy. I understand that. You don’t want to be the only one involved. It is reassuring to know that other people have touched the problem. If it all goes bad, if the outcome is messy, if there is a complaint from a forgotten brother or sister living abroad who turns up horrified about what has been done, you can face it as a group, your legal armour impenetrable. But it seems that we are back in the realms of defensiveness, nervousness … and far, far away from the heart of the matter, which is my suffering, and my choice.

B: We have to find a place in the middle, between your autonomy, or your right to autonomy, and my concerns, and those of others. What you want seems like the most important thing in the world, for you. But hearing me today, you’ve had to realize that the world is equally concerned with those who are not dying.

A: Ah … the elephant in the room rears its trunk. By exercising my own autonomy, I risk the lives of the vulnerable.

B: We have to push this further. The main objection to assisted dying – beyond any religious issues, which we won’t go into now, as they are not relevant to you or me – is based on the risks to the vulnerable. The ones who feel compelled to take this option because they perceive themselves as a burden, or in very rare circumstances, one assumes, you are coerced into this decision by people who will gain from their deaths. Personally, I don’t think the latter risk is that meaningful, but I am concerned that people who don’t have your means, or my means, will find themselves looking up from the bottom of a deep hole, powerless through their illness and the circumstances of their lives.

A: I’m aware of those concerns. Parliament was also aware when it passed the law. But today is about me and my situation.

B: We have to talk about the others. You are all about principles, you’re pushing me into helping you based on principles, but I am telling you that these principles may have wider consequences. Your scope is too narrow.

A: Go on. Tell me about the coerced, and how your assistance to me here, now, influences them.

B: Let’s imagine the bended knee. If it is as simple as you say – a step, a shift in the centre of gravity – we must apply that simplicity to others. See that man coming onto the bridge now. Imagine he has an illness, a diagnosis, but it has not yet sucked the energy out of him. He knows what is coming and he knows that once he stops work his world will begin to collapse around him. For most of his life he has struggled to provide for himself and his family. There is nothing left over at the end of the week. He’s on every social support available. He is a man on the very edge of poverty. And his illness will drag him down, deeper, beyond the reach of society. Sure, there are structures in place to help him, but these do not brighten the image that he has of himself. He sees himself in a black hole of need, a drain on those around him. It is better for him to be dead. That is his view.

A: And I believe it is better for me to be dead. There is no difference there.

B: Listen. He approaches. He eyes the river below and begins to visualize it is as an available option. Like you, he can see past the thrashing and the sense of suffocation. He knows that it will last a minute at most. Then, nothing. Peace. The absence of worry. He’s close now. He has noticed us. He wonders why we are looking at him. But see how he glances at the barrier. Just high enough to put somebody off. If there was no barrier, he would be very tempted to walk off the edge. That voice in his head. But he can’t do that here … the barrier is more than physical. It is a symbol. Ever since he was a child, he was taught not to go near barriers. Not to lean over them. He associates barriers with heights and fear. But look. I have knelt down. I have offered my knee. All he has to do is step up on it and tip forward. He’s five metres away. My knee is a step. It is an invitation. It will be so easy. The fact that somebody has placed a step in front of the barrier makes it acceptable. If it was not acceptable, there would be no step. So why not take advantage of the moment? He can even use my shoulder as a handrail to help him keep balance. Step onto my knee, steady himself, and continue. Over the barrier, into the water. He goes. The splash. Soon, silence. You see?

A: It is what he wanted?

B: Did he, really? Or was it a dark whim?

A: Okay I concede. Lowering the barrier to death creates more death; the wrong people may go over it, or for the wrong reasons. I trust those who passed the law to ensure that they do not. And anyway, from where I’m standing, that may not be a bad thing. The healthy are too hung up on life!

B: Which is perhaps why you, or others who are dying, should not influence the law.

A: It’s imminent death we’re talking about here, allow me some latitude. A decision must be made, right here. Will you? You don’t need all those papers and signatures, you know me. You know that this is a settled desire, that I am not being coerced, that no one is going to gain anything from this, that it is not poverty or deprivation that drives me forward. You know also that my suffering is not a pain that can be medicated, but a larger pain, involving uncertainty, fear that cannot be assuaged, and a natural rebelliousness against fate. I need control, as I have controlled the rest of my life up until this point. For the two of us, on this bridge, it comes down to the principle. Will you kneel and allow me step up? I won’t ask you to hold my hand, to push, even to look. You can close your eyes. What happens afterwards has nothing to do with you. You are not responsible for those details. This is suicide, and it hasn’t been illegal since the 1960s. If I had the strength or the means, I would have done it already, with a gun, with a big bottle of morphine, or something else more imaginative. It is too late now to access what is available in law. I want faster progress.

B: It is not suicide if I help.

A: It’s assisted suicide. Which is legal.

B: Not like this.

A: Ah, we go nowhere.

B: I want to go back to the beginning. To the part that you glossed over. The bit when you hit the water. We need to look closer. At the distress.

A: I would much prefer it to be painless. But if there is distress, I can deal with it.

B: But what about those who see you. They will be traumatized. There are children on this bridge.

A: I can’t arrange everything. It was enough just to get you here.

B: The sense of horror will spread. You will be in the news.

A: Perhaps people need a dose of reality. Death is unpleasant.

B: It is made less where assisted dying is legal.

A: So that society is spared too much ‘horror’. Because honestly, I don’t mind a little bit of discomfort. I’m living with that already. It will be like a normal Monday for me.

B: But not for those you leave behind.

A: We always come back to them.

B: I cannot help you do something that causes acute distress. As a friend, as a doctor.

A: Look past that! Christ!

B: I cannot. Because those who witness it and report it will only see the harm, I mean … the thirty seconds, perhaps more, of asphyxiation.

A: Harm? Harm is what I am begging for. The greatest form of harm … death! That’s the point. The rest is … nothing.

B: I cannot do it.

A: Then your principles mean nothing. Your rationality melts before your fear, or squeamishness, or whatever it is. You don’t have the guts.

B: Maybe that is it. I am a coward. Life is too great a thing … to help take.

A: You, the atheist, saying that! Come on, let’s head back.

B: Me, the doctor. Wait … I’m thinking about the rest of my life–

A: That must be nice.

B: If I don’t do this for you today, you will not be there to chastise me.

A: Correct. I’ll be dead in a few weeks. But you will remember. Perhaps that will be chastisement enough.

B: Guilt fades. Life pushes it to the side and carries on.

A: And that is the crux. This argument is not about what the dying need but what the non-dying are comfortable with. But what none of you seem to realize is this important fact … all the non-dying will go on to die, some slowly and painfully. It is so … so … predictable!

B: I’m sorry the law was not there for you in time.

A: We must go back. I’ll miss the afternoon drug round. That is my life now.

B: You look tired.

A: No, in fact I am invigorated. Maybe, possibly, I could have a go at that barrier on my own. Question: would you try to stop me?

B: Now that is different conversation entirely.