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Assisted suicide in the United Kingdom

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Assisted suicide is the ending of one's own life with the assistance of another. Physician-assisted suicide is medical assistance in helping another person end their own life for the purpose of relieving their suffering, and voluntary euthanasia is the act of ending the life of another, also for the purpose of relieving their suffering.[1] The phrase "assisted dying" is often used instead of physician-assisted suicide by proponents of legalisation and the media when used in the context of a medically assisted suicide for the purpose of relieving suffering. "Assisted dying" is also the phrase used by politicians when bills are proposed in parliament.[2] Assisted suicide is illegal under English law.[3]

England and Wales

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Section 2 of the Suicide Act 1961, as originally enacted, provided that it was an offence to "aid, abet, counsel or procure the suicide of another" and that a person who committed this offence was liable to imprisonment for a term not exceeding fourteen years.[4] That section has been amended by the Coroners and Justice Act 2009.

Approximately 46 Britons a year go abroad for physician assisted suicide.[5] Because of the inconsistencies between the law and prosecution Debbie Purdy launched a case to clarify whether or not her husband would risk being prosecuted if he helped her travel to a Dignitas clinic in Switzerland to die.[6] Purdy's case ended on 30 August 2009 with the decision that the Director of Public Prosecutions had to clarify how the Suicide Act 1961 is to be enforced in England and Wales.[7] In a 2010 guidance for prosecutors, the Crown Prosecution Service provided possible scenarios where a prosecution of an assisted suicide case would or would not be in the public interest, including scenarios where victims had "reached a voluntary, clear, settled and informed decision" or "was [not] physically able to undertake the act," among others. Other factors to consider include whether the assister "was... wholly motivated by compassion" and whether the assister had a history of abuse of the victim.[8]

Attempts at reform

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There have been various attempts to introduce legislation to change the legal situation regarding physician-assisted suicide in the United Kingdom.

In 1931 Dr C. Killick Millard, the President of the Society of Medical Officers of Health, proposed a Voluntary Euthanasia (Legislation) Bill for incurable invalids.[9] In 1935, Lord Moynihan and Dr Killick Millard founded the British Voluntary Euthanasia Society (later known as EXIT and now as Dignity in Dying). The first attempt to reform the law in England was in 1936 by Lord Arthur Ponsonby and supported by the Euthanasia Society.

The British Voluntary Euthanasia Society produced A Guide To Self Deliverance[10] giving guidelines on how a person should commit suicide. The UK Attorney General moved to prevent publication, on the grounds that the book violated the Suicide Act 1961 that makes assisted suicide illegal.[11]: 217  Therefore, it was unclear whether the Society could be held accountable for assisting in suicide because of its publication.[12]

In 1969, a Bill was introduced into the House of Lords by Lord Raglan. In 1970, the House of Commons debated the issue. Baroness Wootton introduced a Bill to the Lords in 1976 on the matter of "passive euthanasia".[13]

On 10 December 1997, a vote was taken in the House of Commons on the issue of introducing a Doctor Assisted Dying Bill, proposed by Labour MP Joe Ashton. The bill was defeated by 234 votes to 89.[14]

Between 2003 and 2006, Labour peer Lord Joffe made four attempts to introduce bills that would have legalized physician-assisted suicide and voluntary euthanasia - all were rejected by Parliament.[15]

In June 2012, the British Medical Journal published an editorial arguing that medical organisations like the British Medical Association ought to drop their opposition to assisted dying and take a neutral stance so as to enable Parliament to debate the issue and not have what Raymond Tallis described as a "disproportionate influence on the decision".[16]

In 2014, Labour peer Lord Falconer introduced an Assisted Dying Bill into the House of Lords. The bill proposed that terminally ill patients with a life expectancy of less than six months be given the option of a medically assisted death, subject to legal safeguards. The bill reached committee stage before running out of time in the session.[17]

In 2015, Labour MP Rob Marris introduced an Assisted Dying Bill based on Lord Falconer's proposals the year before. The bill was defeated by 118 votes to 330 on 11 September 2015.[18]

In 2016, Conservative peer Lord Hayward reintroduced the Assisted Dying Bill into the Lords. The bill did not get past the first reading due to the parliamentary session ending.[19]

The question for politicians in Britain today is why do you force your citizens, people in the most terrible circumstances who are determined to end their suffering in a way of their own choosing, to leave their country and travel to Switzerland to exercise their free will?[12]

On 28 January 2020, Lord Falconer again introduced an Assisted Dying Bill into the House of Lords. The bill was similar to the 2014 iteration. The bill did not reach a second reading in the House of Lords.[20]

On 28 September 2020, the British Medical Association restated its position on assisted dying, asserting that the BMA believes no form of assisted suicide should be made legal within the UK.[21] One year later in September 2021, the BMA formally adopted “a neutral position” on physician assisted dying.[22]

On 26 May 2021, Baroness Meacher introduced an Assisted Dying Bill into the House of Lords. The bill was similar to previously read iterations, and did not go beyond a first reading in the House of Lords.[23] Humanists UK welcomed the bill but also criticised it for not addressing the needs of the intolerably suffering who are not terminally ill.[24]

In September 2024, Kim Leadbeater, MP for Spen Valley, was drawn first in the ballot for private members' bills.[25] She announced on 3 October 2024 that she would introduce a bill on assisted dying,[26][27] and on 16 October 2024, the bill was introduced to the House of Commons as the "Terminally Ill Adults (End of Life) Bill".[28] The full text of the bill (as presented for second reading) was published on 11 November 2024.[29]

On 23 October 2024, the Senedd voted against a declaration calling for Westminster to legalise assisted suicide, although the proposed motion put to the Senedd was different to that of bill on assisted dying being debated in Westminster and broader in its reach.[30][31][32] The motion was rejected with 19 in favour, 26 against and 9 abstaining. It was noted the Senedd that the Welsh parliament does not have the power to legalise euthanasia or assisted suicide, and the vote was symbolic.[31]

Scotland

[edit]

Assisted dying in Scots law might constitute murder, culpable homicide or no offence depending on the nature of the assistance. In 1980, the Scottish branch of the British Voluntary Euthanasia Society (now called Exit) broke off from its original society in order to publish How to Die with Dignity,[33] which became the first publication of its kind in the world.[12]

In a 2012 consultation on the Member's Bill proposed by MSP Margo MacDonald, 64% of the members of the public who choose to give comment on the issue rejected the proposals. A similar consultation by the Health and Sport Committee in 2014 came to a different conclusion, with 78% of responses by individuals being supportive of the proposals.[34] Nevertheless, in 2015 a majority of MSPs including the first minister Alex Salmond voted against the bill in the Scottish Parliament, defeating it in its first stage.[35]

In February 2019 a group of MSPs, including previous opponent Kezia Dugdale, formed to attempt to reform assisted dying law in the Scottish Parliament.[36]

In March 2024, the Assisted Dying for Terminally Ill Adults (Scotland) Bill was introduced to the Scottish Parliament by MSP Liam McArthur. If passed, it would allow adults with a terminal illness to end their lives with medical assistance.[37]

On 1 October 2024, Scottish Secretary for Health and Social Care Neil Gray stated that assisted suicide legislation proposed by MSP Liam McArthur earlier the same year was outside the powers of Holyrood, saying "the bill in its current form is outside the legislative competence of the Scottish Parliament”.[38]

Northern Ireland

[edit]

Since health is a devolved matter in the United Kingdom, it would be for the Northern Ireland Assembly to legislate for assisted dying as and when it sees fit. To date, no such bills have been tabled there.

[edit]

There have been multiple challenges to the blanket ban on assisted suicide by people wanting a physician-assisted suicide, both by patients with and without a terminal illness.

In 2001, motor neurone disease sufferer Diane Pretty took her case to the House of Lords, for the right to allow her husband to assist legally in her suicide. The case was dismissed by them, and also subsequently by the European Court of Human Rights in 2002.[39]

In 2008, multiple sclerosis sufferer Debbie Purdy took her case to the House of Lords for clarification on whether her husband would face prosecution on returning from Switzerland, should he help her to travel there for an assisted death. She won, and the Director of Public Prosecutions clarified the likelihood of prosecution in this instance in 2009.[40]

In 2012 a man with locked-in syndrome, Tony Nicklinson, applied to the High Court for the right for a medically assisted death. His case was rejected and he decided to end his life via starvation shortly afterwards. His wife ultimately took his case to the Supreme Court, in R (Nicklinson) v Ministry of Justice, where it was rejected in 2014. The judges did rule however that they have the authority to declare the parliamentary blanket ban on assisted suicide to be incompatible with human rights law.[41]

In 2014, the Director of Public Prosecutions further clarified the likelihood of prosecution against medical professionals. Previously, they were more likely to face assisted suicide prosecution due to their role as care givers. The DPP clarified that only those medical professionals directly involved in providing care to the concerned patient would be more likely to face prosecution.[42] It was said that the clarification was made at the request of the Supreme Court. In 2015, the clarification was subsequently challenged in the High Court by Nikki and Merv Kenward, supported by the Christian Legal Centre,[43] where it was argued that the DPP was making laws as opposed to applying them.[44] The High Court rejected the challenge against the DPP's clarifications,[45] and the Court of Appeal subsequently denied a request to challenge the High Court's decision.[46]

In 2017, retired lecturer Noel Conway brought his case to the High Court for the right for a medically assisted death. He has motor neurone disease and is terminally ill. His case was dismissed by the High Court, by the Court of Appeal in 2018, and ultimately by the Supreme Court at the end of 2018.[47][48] Conway died on 9 June 2021 at the age of 71, after he and his family decided to remove his ventilator that kept him alive.[49]

Also in 2017, a man known as "Omid T" with multiple system atrophy brought a case to the High Court for the right to a medically assisted death. His case is different from Noel Conway's in that he is not terminally ill.[50] In October 2018 Omid ended his life in Switzerland.[51]

In May 2019, a man who became paralysed in a car accident and now lives with excruciating pain, Paul Lamb, began legal proceedings to seek a peaceful death. His case is supported by Humanists UK.[52]

Opinion polls

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A 2015 Populus poll commissioned by the group Dignity in Dying found broad public support for the introduction of assisted dying laws in the United Kingdom. 82% of people supported it, including 86% of people with disabilities.[53]

Another poll showed that 54% of British General Practitioners are either supportive or neutral towards the introduction of assisted dying laws.[54] A similar 2017 poll on Doctors.net.uk published in the BMJ said that 55% of doctors would support it.[55] The BMA, which represents doctors in the UK, adopted a neutral position on assisted dying in September 2021. This followed a vote in which 49% of doctors supported the change.[56]

Assisted dying advocates

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Noel Conway

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Noel Conway was a lecturer from Shrewsbury, England. In 2014, he was diagnosed with motor neurone disease and wanted the right to an assisted death.

All forms of assisted suicide are currently illegal in the United Kingdom, and doctors found to be assisting a suicide can be jailed for up to 14 years, under the Suicide Act 1961. Conway challenged this law in the High Court in 2017 on the grounds of human rights, claiming that the law against physician-assisted suicide in the United Kingdom interferes with his "right to respect for private and family life", protected under Article 8 of the European Convention on Human Rights. His case was supported by Dignity in Dying. On 5 October 2017 the High Court ruled against him.[63][64]

Conway subsequently took his case to the Court of Appeal, which was heard in May 2018. Three judges rejected his case on 27 June 2018. The court stated that Parliament is better placed to rule on the issue and concerns were raised over whether the safeguards proposed by Conway were adequate to protect vulnerable people.[65][66]

Following the decision in the Court of Appeal, Conway announced his intention to take his case to the Supreme Court. This was the first time since 2014 the Supreme Court has considered a case of assisted dying, when they reviewed the case of Tony Nicklinson posthumously. Although Nicklinson's case was ultimately rejected, some statements by the Justices were seen as positive by assisted dying campaigners.[41] However, on 27 November 2018 the Supreme Court rejected the possibility of a full hearing for Conway's case.[48][67]

Conway died on 9 June 2021 at the age of 71, after he and his family decided to remove his ventilator that kept him alive.[68]

Organisations

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The following organisations advocate legalising assisted dying or voluntary euthanasia:

Assisted dying opponents

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Organisations

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See also

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References

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  1. ^ "Euthanasia and assisted suicide". Archived from the original on 16 July 2017. Retrieved 14 September 2018.
  2. ^ "Assisted Dying Bill [HL] 2016-17". Archived from the original on 14 September 2018. Retrieved 14 September 2018.
  3. ^ "Euthanasia and assisted suicide". Archived from the original on 16 July 2017. Retrieved 6 June 2021.
  4. ^ "Don't jail my husband if he helps me to die, pleads MS sufferer". The Independent. 12 September 2008. Archived from the original on 28 February 2017. Retrieved 15 September 2018.
  5. ^ "The true cost: how the uk outsources death to dignitas". The Independent. 28 November 2017. Archived from the original on 6 August 2018. Retrieved 6 August 2018.
  6. ^ https://www.mirror.co.uk/news/latest/2008/10/02/ms-sufferer-launches-assisted-suicide-case-115875-20766954/ Archived 5 December 2008 at the Wayback Machine>
  7. ^ "Debbie Purdy case 'not a green light to assisted suicide' says Baroness Finlay". The Telegraph. 30 July 2009. Archived from the original on 6 August 2018. Retrieved 15 September 2018.
  8. ^ "The CPS : Assisted Suicide Policy". cps.gov.uk. Archived from the original on 8 May 2015. Retrieved 8 April 2015.
  9. ^ Daily Mirror 17 October 1931, p2 "Doctor's Plea for the Right to Easy Death"
  10. ^ Whiting, Raymond (2002). A Natural Right to Die: Twenty-Three Centuries of Debate. Westport, Connecticut. pp. 41. ISBN 9780313314742.{{cite book}}: CS1 maint: location missing publisher (link)
  11. ^ Kemp, Nick (7 September 2002). Merciful Release. Manchester University Press. ISBN 978-0-7190-6124-0. OL 10531689M. 0719061245.
  12. ^ a b c McDougall, Jennifer Fecio; Martha Gorman (2008). Contemporary World Issues: Euthanasia. Santa Barbara, California: ABC-CLIO. pp. 70–73.
  13. ^ Foreword by the Earl of Listowel to Voluntary Euthanasia: Experts Debate the Right to Die eds. A. B. Downing and Barbara Smoker, ISBN 0-7206-0651-9, p. 5
  14. ^ "Commons Hansard Debates text for Wednesday 10 Dec 1997". Archived from the original on 15 September 2018. Retrieved 15 September 2018.
  15. ^ "Assisted Dying Bill - latest". BBC News Online. Archived from the original on 2 December 2019. Retrieved 20 December 2019.
  16. ^ "'Neutrality' call on assisted dying". Birmingham Post. 14 June 2012. Archived from the original on 21 February 2013. Retrieved 14 June 2012.
  17. ^ "Assisted Dying Bill [HL] 2014-15". Archived from the original on 16 November 2018. Retrieved 19 September 2018.
  18. ^ "Assisted Dying Bill: MPs reject 'right to die' law". BBC. 11 September 2015. Archived from the original on 4 October 2018. Retrieved 5 August 2018.
  19. ^ "Assisted Dying Bill [HL] 2016-17". Archived from the original on 14 September 2018. Retrieved 19 September 2018.
  20. ^ "Assisted Dying Bill [HL] - Parliamentary Bills - UK Parliament". bills.parliament.uk. Archived from the original on 29 April 2021. Retrieved 14 March 2021.
  21. ^ Dyson, Mel. "The BMA's position on physician-assisted dying". British Medical Association. Archived from the original on 9 August 2021. Retrieved 14 March 2021.
  22. ^ Patterson, Chris (14 September 2021). "BMA adopts neutral position on physician-assisted dying". British Medical Association. Archived from the original on 15 October 2021. Retrieved 15 December 2021.
  23. ^ "Assisted Dying Bill [HL] - Parliamentary Bills - UK Parliament". bills.parliament.uk. Archived from the original on 21 November 2021. Retrieved 4 June 2021.
  24. ^ "Assisted dying for terminally ill bill passes first Lords stage". Humanists UK. Archived from the original on 4 June 2021. Retrieved 4 June 2021.
  25. ^ "Conservatives lose out in lottery to bring in new laws". BBC News. 5 September 2024. Retrieved 4 October 2024.
  26. ^ Leadbeater, Kim (3 October 2024). "Too many people have been condemned to die in misery and pain. My assisted dying bill can change that". The Guardian. Retrieved 4 October 2024.
  27. ^ "Labour MP in fresh bid to change law on assisted dying". BBC News. 3 October 2024. Retrieved 4 October 2024.
  28. ^ Sherwood, Harriet (16 October 2024). "England and Wales assisted dying bill formally launched in House of Commons". The Guardian. ISSN 0261-3077. Retrieved 16 October 2024.
  29. ^ UK Parliament, Terminally Ill Adults (End of Life) Bill, published on 11 November 2024
  30. ^ "Motion - NDM8656". Welsh Parliament. Retrieved 16 November 2024.
  31. ^ a b "Assisted dying move defeated in Senedd vote". BBC News. 23 October 2024. Retrieved 24 October 2024.
  32. ^ "Assisted dying likely to need Welsh vote, say Labour backbenchers". BBC News. 12 November 2024. Retrieved 16 November 2024.
  33. ^ Mair, G.B.; Scottish Exit (Edinburgh, Scotland) (1980). How to Die with Dignity. Scottish Exit. Archived from the original on 24 June 2016. Retrieved 8 April 2015.
  34. ^ "Assisted Suicide (Scotland) Bill" (PDF). Archived (PDF) from the original on 15 September 2018. Retrieved 14 September 2018.
  35. ^ "MSPs reject Assisted Suicide Scotland Bill". BBC News. 27 May 2015. Archived from the original on 29 October 2018. Retrieved 14 September 2018.
  36. ^ "MSPs seek to change law on assisted dying". The Times. Archived from the original on 25 February 2019. Retrieved 25 February 2019.
  37. ^ Brooks, Libby; correspondent, Libby Brooks Scotland (28 March 2024). "Bill tabled in Scotland could legalise assisted dying for terminally ill adults". The Guardian. ISSN 0261-3077. Retrieved 26 April 2024. {{cite news}}: |last2= has generic name (help)
  38. ^ "Scottish government: Assisted dying bill not in Holyrood's powers". BBC News. 1 October 2024. Retrieved 24 October 2024.
  39. ^ "Diane Pretty dies". BBC. 12 May 2002. Archived from the original on 3 March 2012. Retrieved 21 September 2018.
  40. ^ Hirsch, Afua (30 July 2009). "Debbie Purdy wins 'significant legal victory' on assisted suicide". The Guardian. Archived from the original on 21 September 2018. Retrieved 21 September 2018.
  41. ^ a b "Supreme Court rejects right to die bid but challenges Parliament to review law". The Telegraph. 25 June 2014. Archived from the original on 20 September 2018. Retrieved 20 September 2018.
  42. ^ "Assisted suicide guidelines relaxed by Director of Public Prosecutions". The Telegraph. 16 October 2014. Archived from the original on 25 September 2018. Retrieved 25 September 2018.
  43. ^ "Nikki and Merv Kenward press on after loss". Christian Concern. Retrieved 26 April 2024.
  44. ^ "Assisted suicide guidelines challenged in High Court". The Telegraph. 28 April 2015. Archived from the original on 25 September 2018. Retrieved 25 September 2018.
  45. ^ "High Court allows DPP change in assisted suicide law that makes prosecuting healthcare professionals unlikely". The Tablet. Archived from the original on 26 September 2018. Retrieved 25 September 2018.
  46. ^ "Campaigners fail in High Court challenge over change to assisted dying policy". News & Star. Archived from the original on 26 September 2018. Retrieved 25 September 2018.
  47. ^ "Terminally ill Noel Conway loses challenge to assisted dying ban". The Guardian. 27 June 2018. Archived from the original on 20 September 2018. Retrieved 20 September 2018.
  48. ^ a b "Supreme court rejects request for right-to-die case to be heard". The Guardian. Archived from the original on 27 November 2018. Retrieved 27 November 2018.
  49. ^ "Assisted dying campaigner Noel Conway dies aged 71". BBC News. 11 June 2021. Archived from the original on 11 June 2021. Retrieved 11 June 2021.
  50. ^ "Incurably-ill man's assisted dying case reaches latest High Court stage". Shropshire Star. 7 March 2018. Archived from the original on 20 September 2018. Retrieved 20 September 2018.
  51. ^ "Assisted dying campaigner ends life in Switzerland". Lancashire Telegraph. 4 October 2018. Archived from the original on 5 October 2018. Retrieved 4 October 2018.
  52. ^ "Assisted suicide: Paul Lamb renews bid for right to die". BBC. Archived from the original on 9 May 2019. Retrieved 9 May 2019.
  53. ^ "Dignity in Dying Poll - Populous" (PDF). Archived (PDF) from the original on 8 November 2016. Retrieved 4 August 2018.
  54. ^ "Public Opinion - Dignity in Dying". Archived from the original on 14 May 2019. Retrieved 4 August 2018.
  55. ^ "Assisted dying case 'stronger than ever' with majority of doctors now in support". 7 February 2018. Archived from the original on 15 May 2019. Retrieved 4 August 2018.
  56. ^ Patterson, Chris. "BMA moves to neutral stance on assisted dying". The British Medical Association is the trade union and professional body for doctors in the UK. Retrieved 24 December 2021.
  57. ^ "MP says current law on assisted dying robbed him of time with his father". Sky News. 6 November 2022. Retrieved 7 November 2022.
  58. ^ Gledhill, Ruth (12 June 2014). "Senior CofE priest: Why I am pro assisted dying". Christian Today.
  59. ^ "Sick patients 'need right to die'". BBC News. 15 July 2008. Archived from the original on 12 December 2008. Retrieved 15 September 2018.
  60. ^ "Tony Nicklinson's legal fight for right to die". BBC News. 22 August 2012. Archived from the original on 12 October 2018. Retrieved 15 September 2018.
  61. ^ Irvine, Chris (2 August 2009). "Sir Terry Pratchett: coroner tribunals should be set up for assisted suicide cases". The Telegraph. Archived from the original on 5 August 2009.
  62. ^ "Sir Patrick Stewart: 'Assisted dying must be a fundamental right for us all'". ITV. 14 August 2015. Archived from the original on 5 August 2018. Retrieved 15 September 2018.
  63. ^ "Noel Conway: Terminally ill man loses right-to-die case". BBC News. 5 October 2017. Archived from the original on 20 September 2018. Retrieved 6 August 2018.
  64. ^ R (Conway) v Secretary of State for Justice [2017] EWHC 2447 (Admin), available at http://www.bailii.org/ew/cases/EWHC/Admin/2017/2447.html Archived 18 February 2019 at the Wayback Machine. Retrieved 25 February 2019.
  65. ^ "Noel Conway: Terminally-ill man loses assisted dying challenge". BBC News. 27 June 2018. Archived from the original on 30 June 2018. Retrieved 6 August 2018.
  66. ^ R (Conway) v Secretary of State for Justice [2018] EWCA Civ 1431, available at: http://www.bailii.org/ew/cases/EWCA/Civ/2018/1431.html Archived 15 December 2021 at the Wayback Machine. Retrieved 25 February 2019.
  67. ^ R (Conway) v Secretary of State for Justice (27 November 2018) available at: https://www.supremecourt.uk/docs/r-on-the-application-of-conway-v-secretary-of-state-for-justice-court-order.pdf Archived 27 November 2018 at the Wayback Machine. Retrieved 25 February 2019.
  68. ^ "Assisted dying campaigner Noel Conway dies aged 71". BBC News. 11 June 2021. Archived from the original on 11 June 2021. Retrieved 11 June 2021.
  69. ^ "UK's first Assisted Dying Coalition formed to campaign for millions who want right to die". Politics.co.uk. Archived from the original on 10 February 2019. Retrieved 11 February 2019.
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