Euthanasia and assisted suicide

The NHS website notes that assisted suicide is illegal under the Suicide Act 1961 and is punishable by up to 14 years' imprisonment (though trying to kill yourself is not a criminal act) and euthanasia is either manslaughter or murder with the maximum penalty being life imprisonment.

Cases

Need to update the following:

R (Purdy) v DPP [2009] UKHL 45 led to the DPP issuing its Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide on 25/2/10. The CPS is consulted on interim guidance from 23/9/09 to 16/12/09. The final guidance was published on 25/2/10.

A challenge to the current criminal law was made, unsuccessfully, in R (Nicklinson) v Ministry of Justice [2013] EWCA Civ 961, [2013] MHLO 65.

Euthanasia was mentioned in Public Guardian v DA [2018] EWCOP 26.

Legislation

The Coroners and Justice Act 2009 amends the law on suicide with effect from 1/2/10. The amendments made by s59 Coroners and Justice Act 2009 to s2 Suicide Act 1961 are explained in MoJ Circular 2010/03 below.

Euthanasia of mentally ill people. Karandeep Sonu Gaind, 'Canada delays expanding medical assistance in dying to include mental illness, but it's still a policy built on quicksand' (The Conversation, 15/12/22) — Amendments to Canada's "medical assistance in dying" ("MAID") law on 17/3/21 stated that those whose only medical condition is a mental illness, and who otherwise meet all eligibility criteria, would not be eligible until 17/3/23. On 15/12/22 the government announced a temporary delay, to allow the healthcare system more time to prepare, and to allow the government more time to consider the February 2023 final report of the Special Joint Committee on Medical Assistance in Dying. This article argues: "When provided to help avoid a painful death for those who are dying, we can distinguish MAID from suicide. Yet when expanded to those seeking death for mental illness, evidence shows MAID becomes indistinguishable from suicide. We cannot differentiate those seeking psychiatric euthanasia from suicidal individuals who resume fulfilling lives after being provided suicide prevention, rather than facilitated death. ... To proceed with the planned changes would have been morally, medically and politically irresponsible. Moving forward, it will be important to ensure our future policies are evidence-based. Fortunately, the situation is not yet irremediable."

Voluntary euthanasia. Anselm Eldergill, 'A time to live, a time to die?' (27/11/24) — In relation to the Terminally Ill Adults (End of Life) Bill 2024, this briefing note argues that "much more careful thought is required before we open this Pandora's Box" and that a more sensible approach, prior to legalising state- and physician-assisted death, would involve a Royal Commission or Law Commission report, or similar, with extensive consultation and reflection, accompanied by a government commitment to place a Bill drafted by the Commission before Parliament on a free vote. Problems mentioned include: (1) there is a risk that changing perceptions of doctors and nurses will undermine trust in them; (2) the 'six-month rule' suggests a degree of prognostic reliability that does not accord with reality; involves a social class bias; means the legislation would not cater for most of the test cases that have come before the courts; and would prolong the suffering of some while allowing others to die for reasons unrelated to life expectancy and even though they are not physically suffering and their death is likely to be painless; (3) a "slippery slope" of extensions may begin; some campaigners see the Bill as a Trojan Horse; the breaking of the taboo would make it less likely that people would oppose dangerous or ill-thought-out extensions; soon it would be sought to extend it to persons with constant and unbearable physical or mental suffering as the result of an incurable condition that cannot be appeased; over time that is likely to be flexibly interpreted by doctors sympathetic to euthanasia or engaged in the new medical speciality of physician-assisted death; it would next be argued that the law is discriminatory (including under the CRPD) because it excludes those who legally lack capacity to decide to die, and because children are excluded; (4) in relation to those with mental health disorders, many people "will wonder whether these out-patients were offered adequate, intensive assisted living ... before being assisted to die"; (5) the Bill is silent on Legal Aid and therefore on whether the new law would in reality be available only to the well-to-do; (6) the High Court judge is not obliged to hear from the person in question (only from a doctor, with the risk that contradictory evidence is not obtained) and there is no right of appeal; (7) no provision is made for the person, or family members, to be supported by a social worker or solicitor, which would be important to allow the person to mitigate potential significant consequences for others and reconsider their decision in the light of those; (8) the drafting is ambiguous in relation to the role of private clinics, but it seems likely that they will provide an independent doctor service including substitute decisions when the original doctor is of the opinion that the conditions for assisted suicide are not met, and the profit element may distort decision-making; (9) there does not appear to be a means by which a doctor who provided a statement that the conditions are met can rescind it; (10) the Bill only applies to England & Wales and so would divide the UK; (11) there appears to be no clear, close scrutiny of assisted suicides after the event, which is required to comply with Article 2.