Objectives: To investigate why physicians label end-of-life acts as either ‘euthanasia/ending of life’ or ‘alleviation of symptoms/palliative or terminal sedation’, and to study the association of such labelling with intended reporting of these acts. Conclusions: Similar cases are not uniformly labelled. However, a physicians’ label is strongly associated with their willingness to report their acts. Differences in how physicians label similar acts impede complete societal control. Further education and debate could enhance the level of agreement about what is physician-assisted dying, and thus should be reported, and what not.
The House of Lords in Purdy forced the DPP to issue offence-specific guidance on assisted suicide, but Jacqueline A Laing argues that the resulting interim policy adopted last September is unconstitutional, discriminatory and illegal. In July 2009, the law lords in R (on the application of Purdy) v Director of Public Prosecutions [2009] All ER (D) 335 required that the DPP publish guidelines for those contemplating assisting another to commit suicide. The DPP produced a consultation paper (23 September 2009) seeking to achieve a public consensus, albeit outside Parliament, on the factors to be taken into account in determining when not to prosecute assisted suicide. Although the consultation exercise is hailed by proponents of legislative change as a democratic, consensus-building and autonomy-enhancing initiative, there is much to suggest that, on the contrary, the guidance is unconstitutional, arbitrary and at odds with human rights law, properly understood.
This article examines the reporting requirements in four jurisdictions in which assisted dying (euthanasia and/or assisted suicide) is legally regulated: the Netherlands, Belgium, Oregon and Switzerland. These jurisdictions were chosen because each had a substantial amount of empirical evidence available. We assess the available empirical evidence on reporting and what it tells us about the effectiveness of such requirements in encouraging reporting. We also look at the nature of requirements on regulatory bodies to refer cases not meeting the legal criteria to either prosecutorial or disciplinary authorities. We assess the evidence available on the outcomes of reported cases, including the rate of referral and the ultimate disposition of referred cases.