The editorial by Ira Byock (1) commenting on the report from van den Block et al (2) correctly says that only 22 cases of euthanasia or physician-assisted suicide (PAS) occurred (1.3% of all 1690 non-sudden deaths), suggesting that this means these actions ‘occur relatively infrequently’. However, there were a further 26 cases of 'life ending drugs without patient request'. Readers should know that this latter category consists of doctors who answered the same question in the same way as the doctors who are counted as having provided euthanasia or PAS, except that in a subsequent question the doctors indicated that the patient had not asked for euthanasia at the time.
Elderly people should be allowed to end their lives with the help of a doctor even if they are not terminally ill, according to a new campaign group that claims to have widespread support. The Society for Old Age Rational Suicide, led by a former GP known as “Dr Death”, says that pensioners should have the human right to declare “enough is enough” and die with dignity.
There is evidence from outside the UK to show that physicians’ religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers & specialist registrars & their attitudes to decisions which commonly must be taken when caring for individuals who are dying. Results showed that consultants’ religion & belief systems differed from those of nurses & the population they served. Consultants & nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration & not withdraw treatment. Nurses were more sympathetic to the idea of PAS for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or PAS.
Results: Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor’s participation in Germany would violate the code of professional medical conduct and might contravene of a doctor’s legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Conclusion: A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.
The Commission on Assisted Dying, set up in September 2010 and chaired by former Lord Chancellor Charles Falconer, has issued its monumental report on assisted dying in England and Wales. The Commission was funded by two supporters of assisted suicide, author Terry Pratchett and businessman Bernard Lewis, and despite reassurances that the running and outcome of the Commission were independent, some individuals and groups opposed to the practice regrettably refused to give evidence to the Commission. Still, the range and quantity of the evidence, which included evidence gathered from international research visits, qualitative interviews and focus groups, commissioned papers, and seminars, is impressive and can be read and watched here.
ACPO lead on homicide responds to the Mail on Sunday making it clear that where we recieve information or intelligence about assisted suicide cases, these investigations are pursued The police service is responsible for investigating cases of encouraging or assisting suicide involving British nationals whether it takes place in the UK or abroad. Whenever we receive information or intelligence about such a case, these investigations are pursued. It is therefore entirely misleading to suggest that ACPO is advising police officers not to investigate deaths abroad (“Assisted suicide 'is legalised' by police: Secret new guidelines from senior officers mean deaths are not investigated”, 24 Feb). The very purpose of such guidance is to assist investigation, by outlining specific considerations for investigators including the legal context and the need to engage with the CPS at earliest stages of an encouraged or assisted suicide inquiry. This is a complex area of investigation and over-si...
The police service is responsible for investigating cases of encouraging or assisting suicide, whether the actual suicide takes place in the UK or abroad and whenever we receive information or intelligence about such a case, these investigations are pursued. Following renewed guidance from the CPS, ACPO has developed specific guidance for police officers investigating such cases. The guidance encourages investigators to engage with the CPS at the very early stages of an encouraged or assisted suicide inquiry. When the police are informed of suicides that have taken place abroad this involves enquiries that lead to consideration of jurisdictional issues which can be complicated by other nations legal systems. Furthermore the progress of any investigation in part relies on the co-operation of foreign police services and agencies. It also requires any UK police force to be able to prove beyond reasonable doubt the circumstances under which the person died and this can be difficult...
An act by an individual ("D") is not to be treated as capable of encouraging or assisting the suicide or attempted suicide of another adult ("T") if— (a) the act is done solely or principally for the purpose of enabling or assisting T to travel to a country or territory in which assisted dying is lawful;
The book strives for as complete and dispassionate a description of the situation as possible and covers in detail: the substantive law applicable to euthanasia, physician-assisted suicide, withholding and withdrawing treatment, use of pain relief in potentially lethal doses, terminal sedation, and termination of life without a request (in particular in the case of newborn babies); the process of legal development that has led to the current state of the law; the system of legal control and its operation in practice; and, the results of empirical research concerning actual medical practice.
Two high court judges rejected Debbie Purdy's request for guidelines from the Director of Public Prosecutions on when assisted suicide cases would be prosecuted, saying it was a matter for parliament and not the courts.
Assisted dying should form part of a good palliative care service for terminally ill people in the United Kingdom, said Ann McPherson, a GP and founder of a new group of medical professionals called Dignity in Dying: Healthcare Professionals for Change (BMJ 2010;341:c5498, doi:10.1136/bmj.c5498). Speaking at a debate hosted by the Medical Journalists’ Association last week on assisted dying and whether the law should be changed, Dr McPherson, who is herself dying from pancreatic cancer, called for the law on assisted dying to be changed in a “narrow way” so that people who are dying and who are able to make the decision on how and when they would like to end their life can do so. “Without a change in the law it will make it much more difficult for some people to have a dignified death, which is what everybody is entitled to,” she said.
Campaigners fear assisted suicide is being legalised by the back door as record numbers of Britons end their lives at Dignitas – while their relatives escape investigation for helping them. The Swiss suicide clinic helped 33 people from this country to die last year – the highest ever annual figure – pushing the total during the past decade close to 250. But police passed only a handful of files to prosecutors over the assistance provided by loved ones, and no one was charged. A police worker even accompanied her mother to Switzerland but faced no sanction. The Association of Chief Police Officers (ACPO) has recently issued new guidelines to every force in the country about how they should investigate assisted suicides. Although the document is restricted, this newspaper has been shown the section that deals with deaths abroad. It highlights how tough such inquiries can be because of the difficulty in obtaining evidence from foreign authorities.
Assisted suicide Some concern has been expressed in the media today about the effect of the CPS's policy for prosecutors in respect of cases of encouraging or assisting suicide. Assisting or encouraging suicide remains a criminal offence. The CPS guidelines do not, and could not, replace the law. While no prosecutions have been brought since the guidelines were issued, each case is considered on its own facts and merits and any inference that the CPS has implemented a blanket policy of not prosecuting for this offence is wrong.
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.
A 46-year-old-man who wants to die after a stroke that left him almost completely paralysed is bringing a groundbreaking legal action that could effectively lead to the legalisation of assisted suicide in the UK. Martin was a fit and active man who enjoyed rugby, cars and socialising with friends in the pub before suffering a brainstem stroke three years ago. Now requiring round-the-clock care, his mobility is limited to moving his eyes and small movements of his head. He communicates by staring at letters on a computer screen which the machine recognises and forms into words spoken by a digitised voice. Martin has been asking to die since six months after the stroke but says he has no one willing to assist him and cannot on his own organise a trip to the Swiss clinic Dignitas, where he could end his life legally. His wife, who chooses to be known as Felicity, says she will be with him if he dies but will not help bring about his death.
People who stand to benefit financially from a person’s death are likely to be the ones prosecuted for assisting a suicide, under guidelines to be issued this week. The law will remain unchanged but new rules will detail the factors that are likely to lead to a prosecution, the Director of Public Prosecutions (DPP) said yesterday. Keir Starmer, QC, drew them up after the law lords backed Debbie Purdy, a multiple sclerosis sufferer who called for a policy statement on whether people who helped someone to kill themselves should be prosecuted. The policy, which will be issued on Wednesday, will aim to clarify when individuals are more likely to be prosecuted or more likely not to be, he said.
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.
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.”
Fergus Walsh | 20:30 UK time, Monday, 19 July 2010 The case of Tony Nicklinson will re-open the debate on assisted dying and so-called "mercy killing". He has locked-in syndrome, following a stroke. Unable to talk, he communicates by blinking or nodding his head. He also has a specially adapted computer with a push-button control. Mr Nicklinson wants his wife to be allowed to inject him with a lethal drugs dose without the fear of her being prosecuted for murder or manslaughter. As the law stands, that seems a vain hope because actively taking a life, even with consent, has always been treated as a crime, leading to a jury trial.
A new campaign by disability rights activists to limit the right to die launches at Westminster on Thursday. The campaign - called Not Dead Yet UK Resistance - will be asking MPs to sign a charter in support of its aims. It says that disabled and terminally ill people should enjoy the same legal protection as everyone else. Those in favour of assisted suicide argue that opposing assisted suicide will condemn terminally-ill people to suffer needlessly. The Not Dead Yet UK's charter includes a commitment to oppose any changes to existing laws which state that assisting a patient to commit suicide is illegal.
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.
The General Medical Council is launching its first ever guidelines on assisted suicide. The new guidelines will help the GMC decide if doctors should face a disciplinary panel if they are alleged to have encouraged or assisted suicide. A draft version is to be subject to a three month public consultation period. The GMC's chief executive, Niall Dickson said "the main message is that assisting suicide is illegal and doctors should have no part of it". The GMC, which is the regulatory authority for doctors, decided to produce the guidelines after the case of a severely paralysed man, which was highlighted by the BBC last summer. The man, given the pseudonym "Martin", told the PM Programme that he wanted to end his life and was taking legal action to try to get advice and help to do so.
A respected graphic artist known for characters such as Judge Dredd has died at the Swiss-based assisted suicide clinic Dignitas, it has been revealed. John Hicklenton, 42, who lived in Brighton, died at Dignitas on 19 March following a 10-year fight with Multiple Sclerosis.
A man with "locked-in syndrome" has begun legal action, asking the director of public prosecutions to clarify the law on so-called mercy killing. Tony Nicklinson, 56, wants his wife to be allowed to help him die without the risk of being prosecuted for murder. Mr Nicklinson, of Chippenham, Wiltshire, communicates by blinking or nodding his head at letters on a board. His lawyers say he is "fed up with life" and does not wish to spend the next 20 years in this condition. According to his legal team, his only lawful means of ending his life is by starvation - refusing food and liquids. His wife Jane says she is prepared to inject him with a lethal dose of drugs, but this would leave her liable to be charged with murder.
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.
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.
Police are trying to establish the circumstances surrounding the death of a Glasgow man whose mother took him to a Swiss clinic to die. Helen Cowie told BBC Scotland's Call Kaye show she helped her son Robert, 33, commit suicide after he was left paralysed from the neck down. Mrs Cowie, of Cardonald, Glasgow, said her son went to Dignitas in October and "had a very peaceful ending". Strathclyde Police said they were not investigating the death at this time. However, a spokesman added: "The matter is being given consideration in an effort to establish the circumstances." Mrs Cowie said her son was paralysed in a swimming accident three years ago.
14 June 2011 Sir Terry Pratchett has said witnessing a man being helped to die for a controversial BBC film has not affected his support for assisted suicide. Sir Terry and director of the documentary, Charlie Russell, joined BBC Breakfast the morning after the film was shown on television.
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.
An Australian doctor stopped at Heathrow Airport when he arrived to hold workshops on euthanasia has been granted leave to stay in UK. Philip Nitschke was interviewed under the Immigration and Asylum Act after arriving from Australia on Saturday. Dr Nitschke plans to hold a workshop in Bournemouth, Dorset, on Tuesday to talk about assisted suicide.
A "considered" and "objective" debate is needed on assisted suicide, the head of the Royal College of Nursing says. It comes after the RCN, which has 400,000 members, shifted its stance on the matter to be neutral.
It is not just friends and family who want clarity about potential criminal prosecutions for helping someone travel abroad for an assisted suicide - doctors too may face criminal proceedings for offering advice or assistance under the current law. In this week's Scrubbing Up, the Medical Defence Union's Dr James Armstrong warns that doctors may be putting their livelihood and liberty on the line by becoming involved.
A woman with multiple sclerosis has begun a High Court challenge to clarify the law on assisted suicide. Debbie Purdy, 45, from Bradford, is considering travelling to Switzerland - where assisted suicide is legal - to end her life. But she fears her husband, Omar Puente, could be prosecuted for going with her when he got back to the UK.
Campaigner Debbie Purdy has called for an "open debate" on assisted suicide laws after her landmark court victory. Prosecutors are to clarify the law after Law Lords backed Ms Purdy's call for formal advice on the legal position of those who help a loved one to die.
The Royal College of Nursing (RCN) has dropped its opposition to the concept of helping patients to commit suicide. The college has now adopted a neutral stance, neither supporting nor opposing a change in the law.
A woman with multiple sclerosis has lost her Appeal Court case to clarify the law on assisted suicide. Debbie Purdy, 45, from Bradford, is considering going to a Swiss clinic to end her life, but fears her husband may be charged on his return to the UK. She wanted clarification of where her husband, Omar Puente would stand legally if he helped her in any way. But Ms Purdy said after the ruling: "I feel that I have won my argument, despite having lost the appeal."
Assisted dying – a summary of the BMA’s position July 2006 At the BMA’s annual conference in Belfast on 29 June 2006, doctors voted by an overwhelming majority against legalising physician assisted suicide and euthanasia. The current policy is therefore that the BMA: (i) believes that the ongoing improvement in palliative care allows patients to die with dignity; (ii) insists that physician-assisted suicide should not be made legal in the UK; (iii) insists that voluntary euthanasia should not be made legal in the UK; (iv) insists that non-voluntary euthanasia should not be made legal in the UK; and, (v) insists that if euthanasia were legalised, there should be a clear demarcation between those doctors who would be involved in it and those who would not.
The BMA has long advised doctors - for moral as well as legal reasons - to avoid actions that might be interpreted as assisting, facilitating or encouraging a suicide attempt. This means not giving patients advice on what constitutes a fatal dose or on anti-emetics in relation to a planned overdose, not suggesting the option of suicide abroad nor writing medical reports specifically to facilitate assisted dying abroad, nor on any other aspects of planning a suicide.
LONDON -- Prosecutors on Thursday said they would consider the issue of motive in cases of assisted suicide before deciding whether to bring charges, in an attempt to clarify how the judiciary will handle an issue that has generated intense controversy in Britain. The new rules do not change the law here -- assisted suicide is still illegal, punishable by up to 14 years in prison -- but they do provide the public with guidance on which cases are likely to be brought to court.
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”.