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.
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
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.”
A leading doctors’ organisation has today warned that doctors face a greater risk of prosecution for assisting a patient’s suicide following the publication of the DPP’s final Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide. The Medical Protection Society (MPS) – which provides indemnity, legal and professional support to around half of all doctors in the UK – said that the new policy sends a clear signal that prosecutions are more likely to be brought against healthcare professionals in circumstances where they might have assisted a patient’s suicide. The organisation warned doctors to be extremely cautious when providing help or advice to patients who are considering assisted suicide.
The MDU has grave concerns about how the new policy* on whether or not to prosecute the offence of assisted suicide, will be applied to doctors. “The MDU’s advice to its members remains that doctors approached by patients for advice about suicide should not engage in discussion which assists the patient to that end. Members who are faced with requests for help from patients, including for example the provision of medical reports, should contact us for advice.”
Two people have been arrested on suspicion of assisting the suicide of a disabled man from South Tyneside. Retired engineer Douglas Sinclair, 76, had been suffering from the debilitating disorder multiple system atrophy, his solicitor said. Christopher Potts said Mr Sinclair died in Zurich on 28 July. He arranged his death through the Swiss assisted-suicide organisation Dignitas. The woman and man who were arrested have been bailed as inquiries continue. Mr Sinclair, a father-of-one, had had the condition for two years. He was being cared for at a care home in Jarrow, South Tyneside, when his conditioned worsened earlier this year.
Sir Terry Pratchett, the author, believes doctors should be able to prescribe a take-home suicide kit which would be “close to the ideal” way for terminally ill people to end their lives.
At 63, Pratchett — who has been diagnosed with early-onset Alzheimer's — speaks openly about causing his own death. "I believe everyone should have a good death," he tells NPR's Steve Inskeep. "You know, with your grandchildren around you, a bit of sobbing. Because after all, tears are appropriate on a death bed. And you say goodbye to your loved ones, making certain that one of them has been left behind to look after the shop." Pratchett has become an advocate for legalized assisted suicide in Britain, making him one of many voices in a global debate. Many oppose the practice for religious reasons or because they fear a slippery slope to involuntary euthanasia; but Pratchett has turned the legalization of assisted suicide into something of a personal crusade.
Terminally ill patients who want to commit suicide should be able to receive medical help to die, a government adviser on care for the elderly has said. Martin Green, a dementia expert for the Department of Health, said patients who were too frail to take their own lives were being denied “choice” and “autonomy” because assisted suicide is illegal in the UK. In an interview with The Daily Telegraph, he urged ministers to review the law and suggested that a referendum or a free vote in Parliament should be called to settle policy on the issue. “If you’re going to give people ‘choice’, it should extend to whether or not they want to die,” he said.
A man who is almost completely paralysed is taking legal action in a bid to end his life. His solicitors have told the BBC that they believe his case could have major implications for the way prosecutors in England, Wales and Northern Ireland deal with assisted suicides.
In 2009 the legislature, judges & DPP each turned their attention to issues around assisted suicide. The legislature decided not to change the law. The judges decided the existing law was insufficiently clear & required the DPP to clarify it. The DPP flirted with reforming the law, but then drew back from such a legislative role. His published policy has been considered as a contribution to the regulation of death & dying, & as such has been found wanting. However, considered in the context of the proper roles of Parliament, courts & prosecutors, & seen as an exercise in constitutional restraint, the DPP's approach should be appraised rather differently. From this perspective, the decision of the HL in Purdy raises significant concerns for the legitimacy of decision making in the contested moral issues that arise in healthcare ethics. In our democracy, courts should be wary of usurping legislative authority in areas where the Parliamentary position is clear. …
Sir Terry Pratchett, the fantasy writer who was diagnosed with Alzheimer's in 2008, said yesterday he had started the formal process that could lead to his own assisted suicide at the Dignitas clinic in Switzerland. Pratchett, whose BBC2 film about the subject of assisted suicide is to be shown on BBC2 tomorrow, revealed he had been sent the consent forms requesting a suicide by the clinic and planned to sign them imminently. "The only thing stopping me [signing them] is that I have made this film and I have a bloody book to finish," he said during a question-and-answer session following a screening at the Sheffield documentary festival Doc/Fest. He said that he decided to start the process after making the film Terry Pratchett: Choosing to Die, which shows the moment of death of a motor neurone sufferer, millionaire hotel owner Peter Smedley.
My name is Geraldine McClelland and I have chosen to die today [7 December]. I am 61 years old and am dying from lung and liver cancer, which metastasised from my breast cancer two years ago. The lung cancer is now causing me serious breathing problems, meaning I am largely confined to my flat. I have chosen to travel abroad to die because I can not have the death I want here in the UK. I would like to be able to choose to take medication to end my life if my suffering becomes unbearable for me, at home, with my family and friends around me. But the law in this country prevents me from doing so. As a result I am travelling abroad to take advantage of Switzerland's compassionate law.
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. ...