A gifted medical student who fell to her death from a Leeds hospital car park after her career hopes were destroyed had expressed a wish to be allowed to die at a suicide clinic.
Ruth Douglas, 22, had made it clear many times she wanted to end her life, but wanted to do it in a "quiet and dignified" method, a Leeds inquest heard.
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Miss Douglas, from Headingley, died after taking her electric wheelchair to the top of the 14-storey car park at Leeds General Infirmary and throwing herself off.
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The trainee doctor suffered from a severe physical disability and was being treated at the Becklin Centre mental health clinic. She had been allowed to go out on an unsupervised shopping trip despite being considered a high suicide risk.
She was found at the bottom of the building by a parking attendant soon after she was "seen to struggle from her chair and disappear over the railings".
On the second day of an inquest into her death, Leeds Coroner's Court heard Miss Douglas had conquered many personal problems to reach her goal to study medicine.
Dr Vivien Deacon, her consultant psychiatrist at the Becklin Centre at the time, said the "extremely bright" young woman had fallen into a deep depression, but the exact reasons remained unclear.
The court was told that a "crisis" in her first year had possibly triggered Miss Douglas's mental health problems, but she had, again, hidden the distress from her family.
The court heard the decision by her nurses to allow her to go out alone on the day of her death in May 2007 was "consistent" with policy and with the voluntary care package she was receiving at the time.
She had spent much of the past three years in the care of mental health services and had tried to kill herself many times.
She had also, at one point, discussed being allowed to die at an assisted suicide clinic, Dignitas.
Recording a suicide verdict, coroner David Hinchliff said it was likely Miss Douglas had used the excuse of the shopping trip as "an opportunity to end her life" and had possibly planned it in advance, even leaving a copy of her will on her bed.
He said her medical history was "peppered" with references to suicide and medical staff looking after her "had to walk a very difficult tightrope" by giving her as much freedom as they could but still protect her.
After the hearing, Mrs Douglas read a poem written by Ruth, and said that was how she wanted her "beautiful and amazing" daughter to be remembered.