Catholic bishops in England and Wales warned against people thinking they may be exempt from prosecution in assisting suicide after new guidelines were issued.

The  Director of Public Prosecutions (DPP) set out the guidelines in September in an attempt to bring greater clarity to the thorny issue of prosecution, inviting comments during a consultation period.

Suicide is still against the law in Britain, but the high-profile case of multiple sclerosis sufferer Debbie Purdy, from Bradford, northern England, who has sought clarification on whether her husband would be prosecuted if he helped her go abroad to die, has been an impetus for the guidelines. 

They set out a range of factors influencing whether a person would face prosecution or not. In favour of prosecution would be if there were a financial motive involved, pressure put on the individual into committing suicide and if the person wanting to die was suffering from mental illness.

Factors against prosecution would include whether the suspect was motivated wholly by compassion and was a spouse, partner, close relative or personal friend.

But the Catholic Bishops' Conference of England and Wales said the guidance did not protect the vulnerable such as the disabled, the terminally ill and those prone to carrying out repeated suicide attempts in the form of a shout of help.

They also said it should not assume spouses and partners will always be supportive. "Indeed, crimes of violence are very commonly carried out by someone known to the victim not infrequently within the same family," they said.

While acknowledging the DPP had a difficult job, they said the word "assisting" should be reconsidered in preference for "aiding and abetting", which reflected the law.

They warned against a culture shift in which "assisted suicide" becomes partly "decriminalised" or that the DPP authorises "exceptions to the law".

"This could in turn lead to a much wider range of cases of assisted suicide, even including the facilitation of suicide within the United Kingdom by medical professionals," they said.

A similar line was adopted by the Church of England, which separately issued its response on the same day.

"The Church of England believes that every suicide is a tragedy and that a caring society ought to ensure that anyone considering suicide is able to have ready access to life-affirming and life-enhancing support, counselling and medical and nursing care," it said in a statement.

"It is essential that assisted suicide is never deemed to be acceptable or commendable. Aiding, abetting, counselling or procuring a suicide remains a crime and we are assured that the DPP's guidelines are not intended to or designed to compromise this."

(Photo: Undertakers remove body of an assisted suicide from Dignitas office in Zurich, 20 Jan 2003/Sebastian Derungs)

Switzerland is looking to change the law on assisted suicide to make sure it is only used as a last resort by the terminally ill.  “We have no interest, as a country, in being attractive for suicide tourism,” Justice Minister Eveline Widmer-Schlumpf told a news conference in the capital Berne.

A rise in the number of foreigners seeking to end their lives in Switzerland, and a study last year showing that more and more people seeking assisted suicides in the country do not suffer from a terminal illness, have provoked heated debate.

The cabinet — which is divided on the emotive issue — sent two proposals into the legislative process for consultation, which will last until March 1: one for tighter regulation and the other for an outright ban.

Switzerland’s two main right-to-die groups, Exit and Dignitas, both said they opposed the government proposals and would seek a referendum on the topic if needed.

Read the full story here.

What do you think? Should assisted suicide be liberalised, restricted or banned altogether?

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Pressure is growing in Europe for some form of legalised euthanasia but few governments have gone as far as the Benelux countries in allowing assisted suicide in clearly defined cases. The mix of growing public support for ending lives of the terminally ill or brain dead but continued prohibitions on it in the law has led to some long and hard-fought legal battles in Italy (Eluana Englaro) and in France (Vincent Humbert).

(Photo: Multiple sclerosis sufferer Debbie Purdy, whose case prompted Britain’s new guidelines, 2 June 2009/Stephen Hird)

It has also created a legal and ethical twilight zone where for compassionate reasons the law did not really punish the doctors, nurses or relatives who helped someone die. In France, this became clear in a number of court cases where the person accused of assisted suicide were convicted but got only a short suspended sentence. In Britain, a frequently used way to get around the law has been the so-called “suicide tourism” route to the Dignitas suicide group in Zurich.

Pressed by the Law Lords to clarify British policy, the Director of Public Prosecutions in London has issued guidelines indicating when someone who helps another person to commit suicide might face legal action. At first glace, this may seem like a clarification. But it still leaves enough questions out there to leave the issue shrouded in uncertainty. The reception in London has been mixed. Some commentators say this strikes a sensible balance but others think it’s not enough and parliament has to debate and legislate on it.

The guidelines are listed below and here is our news report explaining the story.

Do you think governments such as Britain’s should take a clear decision to keep the euthanasia ban or scrap it? Or do you think they should leave some leeway, as in the case of these guidelines, to let families make the final decision for relatives who suffer from  terminal illnesses or want to end their lives because of severe and incurable physical disabilities?

(Photo: Undertakers remove body of assisted suicide from Dignitas office in Zurich, 20 Jan 2003/Sebastian Derungs)

Among factors weighing against a prosecution are:

• The victim expressed a clear wish to commit suicide
• The victim asked for assistance in killing themselves
• The victim had a terminal illness or a severe and incurable physical disability; or a severe degenerative physical condition
• Those assisting were wholly motivated by compassion
• The victim was physically unable to undertake the act that constituted assistance
• The act of assistance or influence was judged to be relatively minor

Among factors weighing in favour of prosecution:

• The suicide victim was under 18 years old
• The victim’s capacity to make an informed decision on suicide was affected by illness or learning difficulties
• The victim did not have a terminal illness, nor a severe and incurable physical disability nor a severe degenerative physical condition
• The victim had not unequivocally indicated a wish to kill themselves
• The victim had not personally asked for assistance

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It used to be an issue just for the terminally ill. Now as populations around the world age, governments are increasingly being confronted with the taboo idea of dying as something people can volunteer to do.

“The demand for the option, if not the practice, is growing rapidly,” said Dr. Philip Nitschke, 61, founder and director of the pro-euthanasia group Exit International.

(Photo: Dr. Nitschke shows his ’suicide kit,’ 7 May 2009/Stefan Wermuth)

The Australian doctor — nicknamed Dr Death for his work on suicide — is traveling the world to teach people how to end their lives safely with a suicide drug-testing kit.

Nitschke’s is an extreme view, but as the proportion of older people increases rapidly in countries such as the United States, Australia, Japan, Germany and Britain, the suggestion of an option to escape indignity could spur political tremors. Calls for reform and a legal decision in July forced the British government to promise to clarify the law. Draft guidelines are due this month with a final version by next spring.

While assisted suicide is legal in Switzerland and physician-assisted suicide — where a doctor prescribes a lethal dose the patient may choose to drink — is legal in the State of Washington, Luxembourg, the Netherlands and Oregon, in Britain helping someone commit suicide is a crime that carries a maximum sentence of 14 years in prison.

Read the whole story here.

See also Belgium has significant hike in euthanasia after law.

Here’s a Reuters video about the death of a quadriplegic Australian man who was granted the legal right to refuse food and water in his nursing home.

What do you think? Is there a “right to die?” Should assisted suicide be legal?

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Former Health Secretary Patricia Hewitt is calling for a change in the law, to allow people to take terminally ill patients abroad for assisted suicide without fear of prosecution.

The law may say it is illegal but in practice, those who do assist suicide abroad are not being prosecuted in practice.

The anomaly has been highlighted lately by the case of multiple sclerosis sufferer Debbie Purdy, who lost a legal bid to force the government to clarify the law on assisted suicide to protect her husband from any future action.

Opponents of any change in the law, like Care not Killing say it would open the floodgates and soon lead to a more general euthanasia law. How long would it be before old and terminally ill people might find themselves being encouraged or even forced to take their own lives?

Hewitt's bid to change the law is not likely to be successful, despite cross-party support in the House of Commons. Do you think she is right?

“Suicide tourism” in Switzerland exerts a morbid fascination on the media. The assisted suicide group Dignitas, which opened in 1998, is rarely out of the news, especially in Britain (here are some of the latest stories on Google). In a rare interview last March, its founder Ludwig Minelli said it had helped 840 people to die to date, 60% of them Germans.

Another “right to die” group, Exit, gets less attention abroad because it only deals with Swiss citizens. But it seems to be just as active, if not more so. Founded in 1982, it says it gets 150-180 requests for assisted suicide annually.

There have been several polls showing general public support for these groups — the latest one says 61 percent of the Swiss approve of assisted suicide. But until recently, there has not been any serious study of the people who seek these groups out. Are there patterns in the types of people or their reasons for ending their lives this way?

A new study by the Zurich University of Applied Sciences (ZHAW) has examined 229 official written requests for assisted suicide in Zurich in a search for any significant patterns. Most findings of the study, presented at a European Association of Centres of Medical Ethics (EACME) conference that ended at the weekend in Prague, are not surprising. The candidates cited reasons such as wanting to end suffering or avoiding being a burden on their families. No single motivation stood out as the most frequent.

But there was one statistic that did. Women made up 61.9% of the candidates for assisted suicide considered in the study (64.4% over the total in Zurich from 2001 to 2004) and men only 38.1% of those studied (or 35.6% of the overall total).

“We could not find any pattern to explain why there were so many more women than men,” said Romy Mahrer Imhof, the ZHAW nursing lecturer who presented the study.

They need to study this more.