Keir Starmer, the head of the Crown Prosecution Service, is to clarify whether people should be prosecuted for aiding a suicide following a landmark ruling by the Law Lords last week. It had been assumed that this guidance would affect only cases in which friends or relatives helped people to die abroad, such as at the Dignitas clinic in Zurich. However, in an interview with The Daily Telegraph, Mr Starmer said the “broad principles” of his new guidelines would apply equally to acts of assisted suicide planned and carried out at home.
A terminally ill patient confides in you his wish to pursue a path of assisted suicide.1 He asks you for information and support so that he can approach Dignitas and ultimately decide how and when he wishes to die. What would your response be? By providing a forum for discussion and supporting a patient’s decision would a doctor be assisting suicide or helping the patient to make an informed choice? Neither the BMA nor the General Medical Council offers any guidance on how a doctor should respond to a request for information about assisted suicide abroad. In contrast, I was clearly advised by the Medical Protection Society that “UK medical practitioners should refuse any involvement in the case of a patient wishing to discuss assisted dying, including the provision of medical reports or records that a patient might submit to Dignitas.” In addition, providing such information could be construed as constituting a criminal offence under section 2 of the Suicide Act 1961.
The director of public prosecutions (DPP) must spell out clearly his policy on prosecuting people in England and Wales who help friends or relatives go abroad for assisted suicide, the UK’s highest court has ruled. The unanimous judgment from five law lords is a victory for Debbie Purdy, who has primary progressive multiple sclerosis and wants her husband to help her travel to Switzerland—where assisted suicide is lawful—when she decides to die.
Campaigners hailed the guidelines as a victory for common sense. But “right to life” groups said that he had exceeded his authority. Groups from the Law Society to Dignity in Dying insisted that Parliament should still legislate. Mr Starmer said the list of factors weighing in favour or against a prosecution did not mean that assisted suicide was no longer a criminal offence. Lord Falconer of Thoroton, a former Lord Chancellor and the first Justice Secretary, who tried recently to reform the law, hailed the DPP’s guidelines as a “very, very significant step” and said he had “unquestionably changed the law”. “He has done what the law lords ordered him to do — give certainty to people as to what will happen if they decide to help their loved ones to die.”
The Medical Protection Society (MPS) is seeking clarification about the position of doctors who become aware that their patient is considering ending their life in circumstances that might amount to criminal charges. The recent House of Lords decision requiring the Director of Public Prosecutions (DPP) to look at the factors which would be taken into account in deciding whether to bring a prosecution in such cases is helpful. Much of the debate so far has focused on whether relatives or spouses should face prosecution for assisted suicide, but there also needs to be discussion over the difficult position health professionals may find themselves in. Currently, most patients will travel outside the UK, for example to the Swiss clinic Dignitas for an assisted suicide.
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.
The British Medical Association and the General Medical Council have already made it abundantly clear that they want no part in voluntary euthanasia becoming a clinical practice. Now the estimable Royal College of Physicians, the professional body representing over 20,000 physicians that “aims to improve the quality of patient care by continually raising medical standards”, has weighed in with a strongly worded letter to the DPP. “We would go so far as to say”, writes the College’s Registrar, Dr Rodney Burnham, “that any clinician who has been part, in any way, of assisting a suicide death should be subject to prosecution.” Dr Burnham continues: “The trust afforded doctors and nurses in particular gives their views considerable weight with their patients and the public. Clinicians’ duties of care entail active pursuit of alternative solutions to assisted suicide, not its facilitation.”
Sir Terry Pratchett has said he's ready to be a test case for assisted suicide "tribunals" which could give people legal permission to end their lives. The author, who has Alzheimer's, says he wants a tribunal set up to help those with incurable diseases end their lives with help from doctors. A poll for BBC One's Panorama suggests most people support assisted suicide for someone who is terminally ill.
Should those with incurable illnesses be allowed to choose how and when they die? In his Richard Dimbleby lecture, author Terry Pratchett, who has Alzheimer's disease, makes a plea for a common-sense solution. This is an edited extract of Terry Pratchett's Richard Dimbleby lecture, Shaking Hands With Death, which was broadcast on BBC1 on 1 February
The Director of Public Prosecutions, Keir Starmer QC, has today called for final contributions to his public consultation on his interim policy for prosecutors in respect of cases of assisted suicide. He said: "I have already received over 2000 responses from both individuals and organisations since I published my interim policy in September, which I am sure is an indication of the strong views many people hold on this issue. I urge those who may still want to contribute to send their views to my assisted suicide policy team. All the responses will be considered when drafting the final policy." The consultation is due to close at 5:00pm on Wednesday 16 December with the final policy due for publication in spring 2010. Until the final policy is published, the interim policy will be applied to all cases.
Today I am publishing the Crown Prosecution Service’s policy on encouraging or assisting suicide. When it passed the Suicide Act 1961, Parliament specifically required discretion to be exercised in every case and my consent is needed before any prosecution for assisted suicide can be brought. In the case brought by Debbie Purdy last year, the House of Lords understood that. It did not question whether there should be a discretion to prosecute or not. But, accepting that discretion, it required me, as DPP, to “clarify what [my] position is as to the factors that [I] regard as relevant for and against prosecution”.
On 25 February, the Director of Public Prosecutions, Keir Starmer QC, launched the Policy for Prosecutors in respect of cases of Encouraging or Assisting Suicide.
New guidelines over whether people would face prosecution over assisting suicide place closer scrutiny on a suspect's motivation. Director of Public Prosecutions, Keir Starmer, said whether a person acted "wholly compassionately" and not for financial reasons was important. But he made it clear the advice does not represent a change in the law and does not cover so-called mercy killing.
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.
Sir Edward and Lady Downes took their own lives at the Dignitas Clinic in Switzerland on 10 July 2009. Since there was information to suggest that one or both of their children, Mr Caractacus Downes and Ms Boudicca Downes, may have assisted their parents to commit suicide, a police investigation into their acts took place. After a careful review of all the evidence by senior prosecuting lawyers, it has been decided that there is no evidence to support a charge against Ms Downes and that, although there is enough evidence to charge Mr Downes with an offence under section 2(1) of the Suicide Act 1961, a prosecution is not required in the public interest. In relation to Ms Downes, there is no evidence that she undertook any act in England and Wales that could have assisted her parents in committing suicide. Accordingly, there is no evidence to support a prosecution under the Suicide Act 1961.
In a wallet on her kitchen table Debbie Purdy keeps the two pieces of plastic that will enable her to make her final journey. The Visa credit cards — one for her and one for her husband, Omar Puente — have a limit of £7,500. She has not spent a penny because she wants to keep them clear to pay for her death. “We don’t carry them with us because it’s only for use . . .” She stops short of referring specifically to the trip that she plans to make to the Dignitas assisted suicide clinic in Switzerland. “We haven’t really talked about the cards but we both have copies because I am worried that he will need it to get home and stuff like that.” We would not be having this conversation if Ms Purdy, who has multiple sclerosis, had not won a landmark legal victory last year forcing the Director of Public Prosecutions (DPP) to clarify the law on assisted suicide. “I would probably have been dead for six months at this point. It’s terrifying. I love being alive.”