The Director of Public Prosecutions, Keir Starmer QC, launched his interim policy guidance on prosecuting cases of assisted suicide today. It explains for the first time what public interest factors are relevant when deciding whether or not to prosecute the offence of assisted suicide. The guidance is in general terms and not specific to medical practitioners, though of course it can apply to them.
It lists 16 public interest factors in favour of prosecution including that the ‘victim’ was under 18 years of age; that the victim did not have a clear and settled wish to commit suicide; and that the suspect was not wholly motivated by compassion. The DPP identified eight of these 16 factors as potentially carrying less weight, including: that the suspect was not the spouse, partner, close relative, or close personal friend of the victim; that the suspect was paid by the victim for the assistance; or that the suspect was paid to care for the victim in a care/nursing home environment.
Those public interest factors which might weigh against prosecution include the victim having a clear, settled and informed wish to commit suicide; had indicated unequivocally to the suspect that he or she wished to commit suicide; and that the suspect had sought to dissuade the victim.
The new interim policy guidelines follow a decision by the Law Lords in July this year to allow the appeal of Debbie Purdy. Purdy, who has multiple sclerosis, was considering going to Switzerland in order to have an assisted suicide, but was unwilling to expose her husband to the risk of being prosecuted for helping her. The Law Lords unanimously decided that the DPP was required to publish an offence-specific policy identifying the facts and circumstances to be taken into account in deciding whether to give consent to a prosecution.
Purdy’s case was the latest in a series of high profile cases involving patients, often terminally ill, who wished to travel to a jurisdiction where assisted suicide is legal, such as Switzerland. Because in many cases the patient would be unable to travel without help, patients, family members and friend were concerned they might face prosecution for aiding and abetting a suicide. Within the medical profession too, concerns have been raised about the position of doctors who were approached by patients for advice about ending their lives with the help of assisted suicide groups abroad.
And yet, despite what might be seen by some as a softening in approach, it is important to stress that today’s announcement does not change or provide any significant clarification to the Suicide Act 1961. This created a new statutory offence of assisting a suicide, stating that “a person who aids, abets, counsels or procures the suicide of another” may be liable to imprisonment for up to 14 years, although a prosecution may not be brought without the consent of the DPP.
As Keir Starmer made clear in a statement this morning nothing in the DPP’s guidance changes the law in any way: assisting a suicide remains illegal in England, Wales and Northern Ireland. Neither does it give a guarantee that prosecution will not take place.
In addition, the guidelines do not apply to the GMC, which may decide to investigate a doctor’s fitness to practice, whether or not a prosecution is brought.
It follows that the MDU’s guidance to members must remain unchanged. Doctors approached by patients for advice about suicide should not engage in discussion, which assists the patient to that end. Doctors could still face a criminal investigation if alleged to have assisted with the act - even if that assistance was only in the form of advice to the patient.
Members who are faced with requests for help from patients, including for example the provision of medical reports, should contact the MDU for advice.
The DPP has called for public participation in a 12-week consultation on the interim guidelines. The consultation closes on 16 December and the finalised policy is due to be issued in Spring 2010.
Tags: Assisted suicide
