After seeing my sister's anguish I understand why she chose assisted suicide
Shortly before her death by assisted suicide, Caroline March wrote a raw, frank and deeply moving Facebook post outlining her reasons for ending her life. The 31-year-old, a former professional event rider who was paralysed in a cross-country fall, described herself as 'a complete rogue, someone who thrives off spontaneity', who could never be happy without the adrenaline rush of riding her horses or the physical exertion of labouring on her parents' farm.
This wasn't her only option, she conceded, but 'it's a decision I've made which is the best route for me'. Pre-empting those she knew would vehemently disagree, she added: 'No one can truly understand what I have to go through.'
Caroline's death at Pegasos clinic in Switzerland on March 23, 2024 was a devastating outcome her family had hoped desperately to avoid. They had done everything in their power to persuade her that her life was still worth living; that she could build a new existence that was, yes, far different from the one she'd envisaged, but still meaningful. In the end, there was nothing they could do to dissuade her.
'She was strong, independent and very determined,' says her brother Tom, 34, who is currently in the middle of an epic cycling and climbing fundraising challenge in her memory. 'She very much made up her mind and was confident that she didn't want to go on, so I have to respect that.'
Growing up in the Essex countryside, in a family of equestrians – Tom's wife, Piggy March, has represented Great Britain in eventing many times – Caroline had ridden her entire life. By the time of her accident, at Burnham Market on April 16, 2022, she was delighted to be competing at four-star level at events such as Blenheim, Chatsworth and Gatcombe.
Tom describes the fall which transformed her future as 'innocuous', saying: 'I've seen much more dramatic ones on a regular basis, when people get up, dust themselves off and carry on as normal.' But Caroline was knocked unconscious and awoke complaining of an altered sensation in her legs. She was airlifted to Addenbroke's Hospital, Cambridge, where she underwent surgery and it emerged she had suffered lacerations to her liver and fractured two vertebrae in her spine.
It was soon clear that the catastrophic injury had left her paralysed below the waist, but since it wasn't 'complete' – 'She had tiny bits of feeling, but very minimal,' says Tom – Caroline threw herself into rehabilitation at Stoke Mandeville Hospital's specialist spinal injuries centre, determined to overcome it.
'The surgeon who operated on her didn't believe she would walk again, but other doctors were less sure, because people can make progress,' says Tom. 'My approach was to prepare for the worst and hope for the best, but I think Caroline was initially very positive, because she expected that if she worked hard with all the physio, she would be fine.'
The realisation that wouldn't be the case was a gradual dawning over the course of many frustrating months, in which progress refused to materialise. Caroline even flew to the United States for stem cell therapy using her bone marrow, which made no difference – a crushing blow Tom sees as a turning point.
'I think she was fighting what the reality was for quite a long time, before it suddenly hit, like a steam train,' he says. 'She realised, this is what I am.'
Despite their mutual love of horses and the outdoors, brother and sister were always very different characters: Tom level-headed and steady, while Caroline was more emotionally volatile and 'lived totally in the moment'. The amount of planning and help now required for her to go anywhere was anathema to her. 'Her life seemed so much smaller than before,' he says.
Another heartbreaking aspect of her plight was her longing to be a mother. In her Facebook post, she wrote: 'All I ever wanted was a family and I'd have given up everything in an instant for one.' Tom believes it's possible she might still have been able to have children, but says she couldn't reconcile the difference between the kind of mother she'd envisaged being, and the one she could be now. 'In her head, motherhood was running around, playing games with them, and obviously that kind of involvement isn't possible from a wheelchair.'
When she first began raising the possibility of assisted suicide, Tom saw in it echoes of her habit of running away and slamming the door shut as a teenager, as a way to shut down difficult conversations. 'She'd say, 'What's the point of talking about this? I'm not going to be here anyway' which, particularly for my parents, was excruciating to hear.'
Then, as time went on, it became clear a plan was taking shape. Initially, Tom and his parents argued and pleaded with her to reconsider, 'but the harder we tried, the more she pushed back,' he says. He talked Caroline into counselling with a therapist, to no avail. 'My wife, Piggy, spoke to a counsellor who said we couldn't change her mind, we could only be there for her, which helped,' he says.
Caroline seemed matter-of-fact when discussing her plans to go to the clinic, once telling him she couldn't see an equestrian mental health charity which wanted to help, because she had a dentist's appointment. 'I said, 'Why are you going to the dentist when you're saying you won't be here in a month?' She said, 'I have to get my teeth X-rayed so they can identify me when I'm out there.'
'I was shocked, but it made me realise the hoops she was jumping through. You don't just careen into this by accident, it's a very calculated decision. Her confidence in it has given me solace.'
She would tell her loved ones she wasn't depressed; the problem wasn't in her head, but her body – although Tom worried then, and still wonders now, if she was in the despair that was inevitable once she realised her situation was permanent, 'and if, had she waited longer, she might have found a way out'.
Until the last moment, her family were still, understandably, wondering if she could be dissuaded. 'We thought, 'Do we go down the legal route to try to stop her flying?',' he says. 'But the problem wasn't her going to Switzerland, it was that she wanted to. And if we stopped her going, we wouldn't have changed that desire.
'It seemed that there was no real path to keeping our relationship with her until the end without respecting her decision.'
Caroline went to the clinic alone – helping someone travel abroad for assisted suicide is a criminal offence – promising her family that if she changed her mind, she would come home. Saying goodbye was 'surreal' says Tom, who didn't know if he would see her again. 'I hope I never have to do anything like that again,' he says, simply. The change of heart they hoped for didn't come, and she went through with her plan.
The assisted dying Bill of which MPs voted in support last November, and which is currently making its way through Parliament, would not have applied to Caroline had it been passed in time. Only terminally ill adults with less than six months to live will be given the right to die under the proposed legislation.
The volatile debate around the subject reignited ahead of the Scottish Parliament's vote earlier this month for its version, with those in favour citing individual autonomy, an end to suffering and the right to dignity in death, and those opposed arguing it would violate the sanctity of life, cause the potential coercion of vulnerable people and possibly prove a slippery slope leading to involuntary euthanasia.
Tom's views on the assisted dying have, perhaps inevitably, changed since Caroline's death. 'Fundamentally, I find it strange that somebody who doesn't want to live can't choose not to,' he says. 'But now I see more of the nuance and complexity of all the different circumstances people might be in.
'How do you write legislation that deals with all the potential issues that will arise, and decides when it's the right time and when it's not?'
On May 11, he embarked on the Pedal3Peaks Challenge to cycle 800 miles from Balmoral Castle to Windsor Castle, climbing the Three Peaks on the way. He finished the challenge within 100 hours and is raising money for the charity Spinal Research. In the UK, someone is paralysed every two hours as a result of a spinal cord injury.
'If I can be part of another family in the future not having to go through what we have, then that's a phenomenal thing to achieve, and a way to give meaning to what happened to Caroline,' he says.
In the Facebook post she wrote before her death, she quoted the philosopher Alan Watts: 'I'd rather have a short life that is full of what I love doing, than a long life spent in a miserable way.' Now, Tom focusses on his sister as she would want to be remembered: strong and fearless, living and dying on her own terms.
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