A step closer to the legalisation of assisted suicide?

5 January 2012 by

Debby Purdy and husband

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.

The report recommends a change in the law, which it deems “inadequate and incoherent”, to allow terminally ill, mentally competent adults to end their lives with the help of two independent doctors.  It does not, therefore, extend to the even more controversial issue of euthanasia, in which the healthcare professional administers the lethal substance, and stays clear of minors and the mentally incapacitated.

In that respect, the report is cautious and pragmatic in its attempt to stimulate a change in the law.  In the eyes of society, the assisted suicide of already-dying competent adults (permitted in Oregon, Switzerland and Luxembourg, for example) is more palatable than the euthanasia of chronically ill children (permitted in the Netherlands).

Further, the practical difference between assisted suicide and non-voluntary euthanasia (i.e., ending the life of an incompetent patient who has not made a decision on the matter) reduces the danger of “slippery slope” arguments.  It is difficult to argue for the presence of a greasy, ominous slope connecting the two practices since a clear demarcation, or step, lies between them:  in assisted suicide, the sufferer takes the lethal drug himself.  It is not physically administered by a third party, as it is in euthanasia.

The law

In England and Wales, assisting suicide is an offence under section 2(1) of the Suicide Act 1961, holding a maximum sentence of 14 years.  The European Court of Human Rights has held, notably in Pretty v UK (2002) 35 E.H.R.R. 1  that although such a blanket ban on assisted suicide engages Article 8 of the Convention, such a ban may be “necessary in a democratic society” for the protection of the rights of others and hence justified under Article 8(2) of the European Convention on Human Rights (the right to private and family life).

This is small comfort for GPs and other healthcare professionals who may well shudder at the prospect of being asked by dying patients for advice on how to end their lives.  A helpful answer may be an unlawful one.  This discomfort and uncertainty, on the part of both doctor and patient, combined with a lack of clarity over when prosecution is warranted (even after the landmark case of R (on the application of Purdy) v DPP, form part of the reason why the report calls for a new statutory framework.

Many people oppose assisted dying not because of any intrinsic immorality but because of the risk of abuse or unwanted societal side-effects.  Whatever the system in place – these people may argue – vulnerable persons, subject to more or less subtle pressures, may feel compelled to die.  Gradually, a right to die would morph into an obligation to die.

Addressing this concern, the report concludes that “it is possible to devise a legal framework that would set out strictly defined circumstances in which terminally ill people could be assisted to die” while protecting vulnerable people.  And so the report suggests a number of safeguards, ranging from medical advice and support to a settled intention to die (i.e., a minimum of 2 weeks from request to assisted death) to the safe storage and transportation of the lethal drugs to the establishment of a national monitoring commission (an independent statutory body reporting o the Department of Health).

Importantly, it acknowledges that assisted suicide must co-exist with high quality health and social care services.  The lawfulness of assisted suicide should not signal the death knell of palliative care.

The report recommends that the decision to permit assisted suicide should rest on health and social care professionals rather than a tribunal or legal body.  However, the report advises that these professionals should not notify patients of the availability of assisted dying.  The rationale for this is clear – it reduces the likelihood of putting undue pressure on the patient – but it sits uneasily with the notion of informed choice and respect for patient autonomy.

The doctor-patient relationship

Another fear about legalising assisted suicide, especially if it requires the involvement of doctors, is that it would alter the doctor-patient relationship.  This is a valid concern but, as Jane O’Brien commented (in her personal capacity rather than as Head of Standards and Ethics at the GMC), other “big seismic changes” such as the Abortion Act 1967 did not cause the heavens to fall.  The profession is, by and large, not polarised about the Abortion Act, and one view is that, with time, assisted suicide would also become accepted, or at least tolerated.  The report also addresses the issues of training and emotional support for healthcare professionals, as well as their right to conscientiously object to assisted suicide.

The report, through focus groups, heard the views of younger, older, terminally ill, and disabled persons.  “Overall”, the report states, “the participants in the two focus groups with disabled people were more likely to be wary of the legalisation of assisted dying […] than participants in the focus groups with older or terminally ill people.  However, despite these concerns, a majority of the disabled participants thought there were some instances in which assisted dying should be permissible”.  Some disabled participants considered the practice morally permissible but opposed a change in the law.

Despite the 415 pages of the report, the authors do not provide details of all aspects of the proposal.  They do not, for example, recommend a clinical protocol or code of practice on the types, doses, or methods of administration of the medication.  However, the report is sufficiently detailed to paint a picture of a world in which assisted suicide is lawful.  It is, in my view, a more humane and less painful world than the current one.  The commission has fulfilled its role.  The ball is now in Parliament’s court.

Daniel Sokol is an Honorary Senior Lecturer in Medical Ethics at Imperial College and a pupil barrister at 1 Crown Office Row.  He is the author of “Doing Clinical Ethics:  A Hands-on Guide for Clinicians and Others”, published by Springer.

Sign up to free human rights updates by email, Facebook, Twitter or RSS

Related posts:

1 comment;

  1. There is a “right to die” because there is no “obligation to live”. Just because we are born and alive doesn’t mean that we have an obligation to anybody to stay alive: http://andreasmoser.wordpress.com/2010/09/15/world-suicide-prevention-day-on-10-september/

Comments are closed.

Welcome to the UKHRB

This blog is run by 1 Crown Office Row barristers' chambers. Subscribe for free updates here. The blog's editorial team is:
Commissioning Editor: Jonathan Metzer
Editorial Team: Rosalind English
Angus McCullough QC David Hart QC
Martin Downs
Jim Duffy

Free email updates

Enter your email address to subscribe to this blog for free and receive weekly notifications of new posts by email.




Aarhus Abortion Abu Qatada Abuse Access to justice adoption AI air pollution air travel ALBA Allergy Al Qaeda Amnesty International animal rights Animals Anne Sacoolas anonymity Article 1 Protocol 1 Article 2 article 3 Article 4 article 5 Article 6 Article 8 Article 9 article 10 Article 11 article 13 Article 14 article 263 TFEU Artificial Intelligence Asbestos Assange assisted suicide asylum asylum seekers Australia autism badgers benefits Bill of Rights biotechnology blogging Bloody Sunday brexit Bribery British Waterways Board care homes Catholic Church Catholicism Chagos Islanders Charter of Fundamental Rights child protection Children children's rights China christianity citizenship civil liberties campaigners civil partnerships climate change clinical negligence closed material procedure Coercion Commission on a Bill of Rights common law communications competition confidentiality consent conservation constitution contact order contact tracing contempt of court Control orders Copyright coronavirus coronavirus act 2020 costs costs budgets Court of Protection covid crime criminal law Cybersecurity Damages data protection death penalty defamation DEFRA deportation deprivation of liberty derogations Detention Dignitas diplomacy diplomatic relations disability disclosure Discrimination disease divorce DNA domestic violence duty of care ECHR ECtHR Education election Employment Environment Equality Act Equality Act 2010 Ethiopia EU EU Charter of Fundamental Rights EU costs EU law European Convention on Human Rights European Court of Human Rights European Court of Justice evidence extradition extraordinary rendition Facebook Facial Recognition Family Fatal Accidents Fertility FGM Finance foreign criminals foreign office foreign policy France freedom of assembly Freedom of Expression freedom of information freedom of speech Gay marriage gay rights Gaza Gender genetics Germany Google Grenfell Gun Control hague convention Harry Dunn Health HIV home office Housing HRLA human rights Human Rights Act human rights news Human Rights Watch Huntington's Disease immigration India Indonesia injunction Inquests insurance international law internet inuit Iran Iraq Ireland islam Israel Italy IVF ivory ban Japan joint enterprise judaism judicial review Judicial Review reform Julian Assange jury trial JUSTICE Justice and Security Bill Law Pod UK legal aid legal aid cuts Leveson Inquiry lgbtq liability Libel Liberty Libya lisbon treaty Lithuania local authorities marriage Media and Censorship mental capacity Mental Capacity Act Mental Health military Ministry of Justice modern slavery morocco murder music Muslim nationality national security naturism neuroscience NHS Northern Ireland nuclear challenges nuisance Obituary ouster clauses parental rights parliamentary expenses scandal patents Pensions Personal Injury physician assisted death Piracy Plagiarism planning planning system Poland Police Politics Pope press prison Prisoners prisoner votes Prisons privacy procurement Professional Discipline Property proportionality prosecutions prostituton Protection of Freedoms Bill Protest Public/Private public access public authorities public inquiries quarantine Radicalisation refugee rehabilitation Reith Lectures Religion RightsInfo right to die right to family life Right to Privacy right to swim riots Roma Romania round-up Round Up Royals Russia saudi arabia Scotland secrecy secret justice Secret trials sexual offence shamima begum Sikhism Smoking social media social workers South Africa Spain special advocates Sports Standing starvation statelessness stem cells stop and search Strasbourg super injunctions Supreme Court Supreme Court of Canada surrogacy surveillance sweatshops Syria Tax technology Terrorism The Round Up tort Torture travel treason treaty accession trial by jury TTIP Turkey Twitter UK Ukraine universal credit universal jurisdiction unlawful detention USA US Supreme Court vicarious liability Wales War Crimes Wars Weekly Round-up Welfare Western Sahara Whistleblowing Wikileaks wildlife wind farms WomenInLaw Worboys wrongful birth YearInReview Zimbabwe


This blog is maintained for information purposes only. It is not intended to be a source of legal advice and must not be relied upon as such. Blog posts reflect the views and opinions of their individual authors, not of chambers as a whole.

Our privacy policy can be found on our ‘subscribe’ page or by clicking here.

%d bloggers like this: