Assisted dying

Your opinion at the start - stage 1/6

Assisting another person to end their life is forbidden by law in the UK but may not be prosecuted. Is this a good policy, or can we do better?

The Suicide Act 1961 was updated by the Coroners and Justice Act 2009. It is illegal in the UK to assist a suicide. However, the Director of Public Prosecutions (DPP) has discretion over whether a prosecution would be in the public interest.

Read background

Research and writing by Paul Eustice: reviewer Perry Walker

Drag these using the hand symbol () so that they are in order, most preferred at the top

  • Yes
  • Keep the present law, which makes it illegal, with the Crown Prosecution Service using discretion on when to prosecute
  • Only if they are terminally ill
  • No

The Suicide Act 1961 was updated by the Coroners and Justice Act 2009. It is illegal in the UK to assist a suicide. However, the Director of Public Prosecutions (DPP) has discretion over whether a prosecution would be in the public interest.

The law was challenged in 2002 by Diane Pretty. She wanted her husband to assist her in committing suicide without risk of prosecution. The UK courts and the European Court of Human Rights (ECtHR) refused. The CHR said that she has a legal right to life but no ‘right to death’.

In 2009 Debbie Purdy claimed the DPP was infringing her human rights by failing to clarify how the Suicide Act was actually enforced. The House of Lords asked for clarification from the DPP. The Crown Prosecution Service (CPS) published a ‘Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide’.The policy states that prosecution is less likely if “the victim had reached a voluntary, clear, settled and informed decision to commit suicide; the suspect was wholly motivated by compassion”.

The Commons praised the guidance but did not try to change the law. As a result, the individual must now take action on the assumption they might not be prosecuted if their motives and context are deemed acceptable by the CPS.

In 2010 the Scottish Parliament rejected the End of Life Assistance (Scotland) Bill. This would have made it legal toprovide ‘end of life assistance’.In September 2015, a bill on Assisted Dying Bill was heavily rejected in the House of Commons. This would have permitted assisted suicide, but only for someone who is already terminally ill.

Historically, some civilisations have accepted suicide as an honourable way to avoid suffering, including shame or dishonour. Roman, Greek and Japanese cultures permitted it. Pliny the Elder thought the gods provided poisonous plants to facilitate it. Caecina Paetus and Mark Anthony used it to avoid Caesar’s wrath. However, Pythagoras, Plato, Socrates and Aristotle questioned who ‘owned’ the life in question - the citizen, the state or the gods.

There are many ways to seek death and approval can depend very much on circumstance and motivation. All major religions prohibit suicide, although the passive method of starving to death is permitted to Hindu yogis and Jain monks. Buddhist monks have used self-immolation (setting themselves alight) as a form of protest. Jewish practice forbids suicide, although Jewish Zealots in 74CE chose to die at their own hand rather than surrender to the Romans. Islam also forbids suicide, although both Islam and Christianity accept the idea of martyrdom as a route to heaven.

In A.D. 563, the Christian Council of Braga officially condemned suicide. St Augustine thought too many Christians sought martyrdom too willingly. In most of Europe suicide became illegal and those guilty of it were not buried in hallowed ground. It remained illegal in England and Wales until 1961. The Catholic Church still argues that human life belongs to God and we have no right to destroy it. Slowly, attitudes turned from seeing suicide it as a crime to seeing it as an act of desperation. The Samaritans were founded in in 1953 and high rates of attempted suicide now are treated as social problems requiring a sympathetic response. It is socially acceptable to use drugs to remove pain when a person is dying, but illegal to use them to end life to avoid further pain.

Switzerland, The Netherlands, Belgium, and Luxembourg allow assisted suicide but conditions vary (3b p8, p23-24; 3c). In some cases the ‘assister’ must be medically qualified. It is also legal in Colombia and some US states (Oregon, Washington, Montana). The Northern Territory in Australia permitted assisted suicide but the national parliament later overruled their decision.

Some definitions:

‘Euthanasia’ in general means seeking a quiet or easy death and modern usage assumes that is to avoid intolerable suffering. There are several types of euthanasia, described below.

Involuntary euthanasia involves taking a life without permission, much as we put down a sick animal. That is not what this topic is about.

Voluntary euthanasia involves a rational choice to die. It can be a solitary act of suicide, an act which one is assisted by others or a desire to be put to death by others (when physically incapable of acting).The topic is about whether to allow another person to help with suicide, not about allowing them to take another life on their own, even with permission.

The person assisting might be a friend, relative or a medically qualified person.

Non-voluntary euthanasia means the person whose life is ended did not consent at the time (they might be in a coma) but they had previously said they would wish to die under those circumstances. Involuntary euthanasia means the person who dies has never expressed a wish to die. Someone else made the decision for them.Active euthanasia means intervening to bring about death. The topic is not about non-voluntary or involuntary options.

Passive euthanasia means not acting to prevent a death, e.g. starving yourself or not giving food or medicine or resuscitation to a patient.This can be legal under existinglaw, if a patient or next of kin agrees to a notice that says “Do Not Resuscitate” (DNR).

Physician assisted suicide would involve a doctor prescribing a fatal drug a patient takes voluntarily. This might be permitted by the options under debate.

Palliative care is medical intervention to relive suffering rather than offer a cure. Whether at home or in a hospice, it assumes that death will occur, probably soon, and all we can achieve is to make it as painless as possible.

The present position in the UK is that any act that would assist suicide is against the law, but the law may not be enforced if the agent’ motives are acceptable to the Criminal Prosecution Service (CPS). Each citizen has to weigh their own actions by the CPS guidelines then act, wait, and hope not to be arrested.

At the time of writing (July 2014) Lord Falconer’s Bill has had its second reading in the House of Lords and will move on to the committee stage. However, even if passed, it would only legalise assisted suicide for the terminally ill. The question explored below is whether UK law should specifically allow its citizens to help another person to end their life as an act of compassion, whether they are terminally ill or not.

Contact Open Up if you want to know the sources for any part of this background or for the arguments that follow.