Amongst the latest, and ever-changing, pathways of death and dying, “suicide tourism” presents distinctive ethical, legal and practical challenges. The international media report that citizens from across the world are travelling or seeking to travel to Switzerland, where they hope to be helped to die. In this paper I aim to explore three issues associated with this phenomenon: how to define “suicide tourism” and “assisted suicide tourism”, in which the suicidal individual is helped to travel to take up the option of assisted dying; the (il)legality of assisted suicide tourism, particularly in the English legal system where there has been considerable recent activity; and the ethical dimensions of the practice. I will suggest that the suicide tourist—and specifically any accomplice thereof—risks springing a legal trap, but that there is good reason to prefer a more tolerant policy, premised on compromise and ethical pluralism.
Doctors and healthcare professionals could face a higher risk of prosecution if they help patients take their own lives according to new guidelines published by the Director of Public Prosecutions Keir Starmer QC last week. The ‘Policy for Prosecutors in respect of Cases of Encouraging or Assisting Suicide’ comes seven months after the House of Lords ruling in the Purdy case which required the DPP to clarify its approach to assisted dying. The new guidelines follow a consultation which attached 4,710 responses and replace the interim policy issued in September last year with a set of 16 factors in favour of prosecution and six against. The main thrust of the new policy is that individuals driven by compassion will be unlikely to be prosecuted if this was their guiding motive. Those motivated by gain would be.
Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients.
The total number of deaths studied was 11,704 of which 1517 involved continuous deep sedation. In Dutch hospitals, CDS was significantly less often provided (11%) compared with hospitals in Flanders (20%) and U.K. (17%). In U.K. home settings, CDS was more common (19%) than in Flanders (10%) or NL (8%). In NL in both settings, CDS more often involved benzodiazepines and lasted less than 24 hours. Physicians in Flanders combined CDS with a decision to provide physician-assisted death more often. Overall, men, younger patients, and patients with malignancies were more likely to receive CDS, although this was not always significant within each country. Conclusion Differences in the prevalence of continuous deep sedation appear to reflect complex legal, cultural, and organizational factors more than differences in patients’ characteristics or clinical profiles. Further
The focus of this article is upon compassionate killings, that is, criminal cases where a parent/spouse has killed or assisted to die a child/spouse who was suffering from severe disabilities, debilitating injury, chronic or terminal illness. We argue that the partial defence of diminished responsibility, while appropriate for some cases, fails to acknowledge the compassionate and relational nature of these acts and thus fails to identify the quality of the harm committed. We also argue that the general defences of duress of circumstances and necessity, even if they were to be become available, are inappropriate. Developing the concept of ‘compassion’, which is a consideration in relation to prosecution for assisted suicide, we argue for the introduction of a partial defence of ‘compassionate killing’ which would reduce the offence from murder to manslaughter in recognition of the killing as a responsive, relational act of care.
While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people—‘suicide tourists’—coming to Switzerland, mainly to Zurich, for the sole purpose of committing suicide. Political debate regarding ‘suicide tourism’ is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries. ...