Serial killer Donald Neilson had asked prison staff not to keep him alive if his health deteriorated, an inquest has heard.
The 75-year-old was known as ‘The Black Panther’ following a murderous spree, which included gunning down Baxenden sub-postmaster Derek Astin in 1974.
Neilson had been diagnosed with the irreversible muscle-wasting condition motor neurone disease two years before his death last year.
He died on December 18 after being transferred from prison to hospital, suffering from a chest infection and pneumonia.
Coroner William Armstrong said Neilson’s family had been informed of the inquest but chose to stay away.
The Norwich Coroners Court inquest heard Neilson had been a ‘challenging and uncooperative’ patient who had asked medics not to resuscitate him should he suffer a cardiac arrest.
Mr Armstrong said: "At the time of his death he struggled to do even the most basic things and was virtually dependent on other people."
A jury returned a verdict that Neilson died of natural causes. The inquest heard that motor neurone sufferers are particularly vulnerable to chest conditions. Neilson had been moved to Norwich Prison from Full Sutton in East Yorkshire, after being diagnosed with motor neurone disease in 2009.
Claire Watson, offender health commissioner for Norfolk and Waveney NHS, described him as a ‘challenging and uncooperative patient’.
She said: "Prisons aren’t the best place for people who can’t dress themselves and can’t wash themselves. When I spoke to staff they did not think he was as ill as he was so they were quite surprised he died as quickly as he did. But it is not an uncommon way for somebody with motor neurone disease to die.
"Staff at the prison are to be commended for the level of care they provided which was equitable with that he would have received in the community."
Neilson was given four life sentences in 1975 and was one of a small group of notorious prisoners who were told they would spend the rest of their lives behind bars.
In total Neilson shot three sub-postmasters dead during armed robberies between February and November 1974, including Mr Astin.
He also kidnapped 17-year-old heiress Lesley Whittle from her home in Shropshire, leaving a ransom demand for £50,000.
Her body was later found in an underground drainage system, hanging from the bottom of a ladder to which Neilson had secured her by the neck with wire.
Popular Mr Astin was gunned down at Baxenden Post Office on September 6, 1974. He lived there with his wife Marion, then 41, daughter Susan and son Stephen, 10.
Masked and dressed in black, Neilson had broken into the family home through a downstairs window and had gone into an upstairs bedroom.
Mr Astin protected his family by tackling Neilson and pushing him down the stairs, but suffered fatal gunshot wounds.
Neilson was also responsible for about 400 burglaries during a 10-year criminal career and was dubbed ‘The Black Panther’ as a result of witness descriptions of his dark clothing and powerful physique.