Assisted suicide is the act of deliberately assisting or encouraging another person to kill themselves. If a relative of a person with a terminal illness obtained strong sedatives, knowing that the person intended to use the sedatives to kill themselves, they may be considered to be assisting suicide . Assisted suicide is not to be confused with euthanasia, the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma . For example, it could be considered euthanasia if a doctor deliberately gave a patient with a terminal illness drugs they do not otherwise need for their comfort, such as an overdose of sedatives or muscle relaxant, with the sole aim of ending their life. In this essay the discussion will be about the legalisation of assisted suicide in the UK.
The current position of the law on assisted killings is laid down in the Suicide Act 1961 states: s 2 (1) (a) and (b) as “an act capable of encouraging or assisting the suicide or attempted suicide of another person”, and when “D's act was intended to encourage or assist suicide or an attempt at suicide”. The consent of Director for Public Prosecutions (DPP) is required before an individual may be prosecuted according to s2(4) of the Suicide Act 1961. Overtime, law-makers have placed the moral consequences of the act over the demands of the people hence, the bills to legalise assisted dying or assisted suicide as it is alternatively called, are thrown out of the parliament.
As assisted suicide is illegal in the UK due to the suicide act 1961, in the case of R (on the application of Pretty) v Director of Public Prosecutions , the applicant’s application, that the s2 of the suicide act infringed with their human rights was refused. The House of Lords held that the right to life under article 2 does not include the right to any particular form of death. The court refused the argument that the refusal of the state to allow assisted suicide was any form of torture or there had been any discrimination on the states part. The court also held that the DPP had no power to undertake that a crime yet to be committed should be immune from prosecution as that was for the parliament to decide. This case was later taken to the ECHR where in Pretty v UK , the Court determined that the facts of the case fell within the domain of Article 8, which was examined in combination with Article 14, focussing on the claim that she was prevented from exercising a right enjoyed by others who could end their lives without assistance because they were not prevented from doing so by any disability. The Court acknowledged that discrimination may entail equal treatment of those in different conditions, but also reiterated that member states have a margin of appreciation in their application of the convention. In this case, the Court found the Suicide Act 1961 a way of the government safe guarding the vulnerable. For these reasons, the Court unanimously found no violation of Article 14 of the Convention, and no violation of Articles 2, 3, 8 and 9.
In the case of R (Conway) v SSJ the claimant, who was terminally ill as a result of suffering from motor neurone disease, wished to have the option of ending his life with the assistance of a medical professional once he had been given a prognosis of six months or less to live. The claimant wanted the courts to use the powers under the s4 of the human rights act to find s2 of the suicide act incompatible with the article 8 of human rights,. The Divisional Court of the Queen’s Bench Division when dismissing the claim held that the legitimate aims which section 2 warranted which were protection of the weak and vulnerable but also protection of the sanctity of life and promotion of trust between doctor and patient, there was a clear association between the s2 and the aims of the article. The claimant appealed. Humanists UK, Care Not Killing and Not Dead Yet UK intervened on the appeal. The appeal was dismissed and it was said that the ban on assisted suicide was “both necessary and proportionate”, the claimant proposed and an alternative statutory scheme. While the protection of weak and vulnerable was a matter of essence when considering the scheme under article 8, the society as whole would reject the legalisation of assisted suicide due to the moral and ethical values. The court held that it was difficult predicting whether someone will live for under six months which was opurposed in the applicants scheme. The court also established there was no common law right to assisted suicide and the legislature had expressed a clear position, not only by the terms of section 2 of the 1961 Act but also by subsequent and relatively recent rejection of legislation similar to that in the proposed scheme, namely “the falconer bill”. The court found there was no error of principle in the reasoning of the Divisional Court.
The compatibility of section 2 with Article 8 was confirmed by the European Court of Human Rights in the case brought in Strasbourg after the domestic Nicklinson and Lamb v United Kingdom for Nicklinson, the court also held that it was up to the UK parliament to make the legislation. As for Lamb, the appellant did not argue for there to be a judicial procedure on when to allow assisted suicide, so they held there had been a failure to exhaust domestic remedies.
Alternatively, when Daniel James’ parents assisted his suicide , the DPP said it was not in the public interest to prosecute Mr. James's parents even though there was sufficient evidence that they had helped their son to end his own life, in breach of the Suicide Act 1961. The case of assisted suicide has taken a new turn especially in the case of Purdy , she took her case to the highest court in the country after the High Court and Court of Appeal held that it was for Parliament, not the courts, to change the law. The Law Lords agreed changes were a matter for Parliament, but upheld Ms Purdy's argument that the DPP should put in writing the factors he regarded as relevant in deciding whether or not to prosecute. In 2014 the Crown Prosecution Service (CPS) published guidance for the prosecutors to acknowledge before prosecution of an assisted suicide case . Issues such as publishing prosecutions guidelines have also being raised and has taken judicially notice in the case of Ross v Lord Advocate under the scot law, The Inner House of the Court of Session upheld the Lord Ordinary’s decision that the refusal to publish such guidance did not violate Article 8 of the ECHR.
The Purdy case has fuelled the debate over assisted suicide. A populous opinion poll around the same time found that over 80% of people wanted doctors to be allowed to help terminally ill patients end their lives , and six out of 10 also wanted to be allowed to help the dying without fear of prosecution. A question that is increasingly being asked is why people who are terminally or incurably ill should have to travel to Switzerland or elsewhere, rather than be able to die at home surrounded by their loved ones. Also, every citizen doesn’t have the financial means to travel abroad. Simply, there is a loophole in the sytem that can only be enjoyed by the people that have the means to go abroad
Assisted killing laws are progressing in other parts of the world and the UK is not part of them . In spite of the decision reached by other countries in Europe and some states in the U.S entrenching the assisted killing law as part of their legislation. Oregon was one of the first places to license doctors to supply lethal drugs to terminally ill people following Oregon’s Death with Dignity Act of 1997 . A number of other jurisdictions, namely Switzerland, Belgium, Holland and Luxembourg all have assisted suicide laws and have managed to devise safeguards – safeguards with regard to which there is little evidence of abuse, if research on the area is to be believed. Why can’t this be done here? It follows that there are several arguments in favour of assisted suicide and also several arguments against it. An accomplishment of the legalisation of assisted killings will be discussed here for example that legalization of physician-assisted dying has not decreased the use of or quality of palliative and hospice care.
The Right to die: There is an urgent need for a culture change in health and social care services to ensure that people’s core rights in end of life care are openly communicated and are supported at all times. When examined in this context, in Gross v. Switzerland , and the Court’s prior case law regarding assisted suicide, shows that the court is inexorably moving towards acceptance of a universal right to die. In the case of Baxter v Montana the court held that there was no public policy against assisted suicide as consent was raised as a defence at the trial similarly, In R (Nickilson) V Minister of justice the plaintiff sought to exercise his Right to die, the court rejected his contention he also argued in the high court that his right to private life was disrupted.
Both Montana and Nickilsons’ cases are at par with each other and it is unjust that the courts judgment on the matter varies from that of the US, the courts position infringes on the patient rights to an assisted death.
Protection of vulnerable groups: Lord Judge CJ, in Nicklinson in the Court of Appeal, had called Parliament ‘the conscience of the nations’. The court in Conway held that ‘the legitimacy of Parliament deciding to maintain such a clear line that people should not seek to intervene to hasten the death of a human is not open to serious doubt’ (para [112]). The House of Lords in Nicklinson and the European Court of Human Rights in Pretty had accepted that the blanket ban on assisted suicide was a proportionate way to protect the weak and the vulnerable
In carter V Canada the supreme court of Canada, unanimously agreed that criminal laws prohibiting assistance in dying goes against the right to life, liberty and security of a person under section 7 of the Canadian Charter of Rights and Freedoms in a manner not justified under section 1 of the charter, afterwards, the courts adjusted the law in relation to suicide and assisted killings. . Conversely in the UK, the court rejected Andrew Barclay’s application owing to the section.2 of the suicide Act 1961 .
Encouraging Organ Transplant: In Belgium, a woman exercised her Right to assisted suicide and expressed in her will for her organs to be harvested and donated. Currently, all three recipients are enjoying a normal life, this demonstrates that assisted suicide can be viewed from an ethical, legal and a practical point of view especially in countries where assisted suicide is legal. In the case of Britain, David Shaw the executive chair of Euthanasia Prevention Coalition, commented on organ donation saying, “organ donation and assisted suicide is the last gift to humanity”.
Death with Dignity: In the case of R (Conway) v SSJ, the court of appeal rejected a judicial review brought by the plaintiff with the support of dignity in dying, challenging the current position on assisted dying. On the other hand, in 2009, The Death with Dignity Act went into effect in the US . "Parliamentarians across the UK have rightly rejected attempts to introduce assisted suicide and euthanasia 10 times since 2003 out of concern for public safety, including in 2015 when the House of Commons overwhelmingly voted against any change in the law" in Koch v. Germany Mr. Ulrich Koch, complains for the refusal by the German administration to give to his late wife authorization to obtain a lethal substance in order to commit suicide. The couple introduced a complaint before the German Courts, who ultimately rejected their claims Meanwhile, Brittany Maynard ended her life under Oregon’s death with dignity Act.
Some of the arguments against assisted suicide are.
Death tourism: Death tourism began to be reported in the media in 1998 when Dignitas opened their clinic in Switzerland, although active killing of another person even upon request remains a criminal offence in Switzerland , it is lawful to assist a person to kill himself insofar as there are no selfish reasons involved . But how do you determine if there is selfish reasons involved E.g. relatives from a). Not administering care b). Inheriting the deceased estate. Assisted suicide is only unambiguously lawful for foreigners in Switzerland and even so only Dignitas will assist your suicide without a residency permit. It was reported that Andrew Barclay spent 10,000 pounds to go to Switzerland and end his life and his wife may face the wrath of the law for aiding and abetting. This is an unnecessary hardship that could have been avoided simply by obeying the law. While people see an opportunity to die, there is business going on and death tourism is a dangerous journey and you should be greatly discouraged.
One central concern about efforts to legalise assisted suicide is that it erodes respect for human life . Recognising intrinsic and equal dignity of human life underlines the plain readings of the Universal Declaration of Human Rights, the European Convention of Human Right and other International Instruments that arose from a period in history that saw the enactment of laws and regulations once thought to be progressive yet was used as an instrument for abuse and gross injustice moreover, several sacred traditions forbid it. In an interview, Ludwig Minelli head of Dignitas when asked if he can assist a healthy person die he said and I quote “Of course, For instance a very old person who is healthy but has some difficulties especially because of old age, having no relatives nor friends, Why should we say no?”
Legalisation of euthanasia has led to a severe decline in the quality of care for terminally-ill patients in Holland and it is likely the legalisation of assisted suicide would have the same consequences. Some of the opponents of Physician Assisted Suicide (PAS) are doctors themselves who believe that patients considering taking their own lives this way still have the chance to be persuaded to decide on living and by making them comfortable and giving them palliative treatment.
Additionally, the most worrying consequence of legislating on assisted suicide is that it becomes an option. At the moment it isn't really a choice for people. If it becomes a choice then it seems logical that the number of people opting to follow this path will increase year upon year; as it becomes a more socially acceptable choice. I believe the criteria will be relaxed and eventually people who are dependent on others will view assisted suicide as an option, which could have ulterior motives such as inheritance. Or if they don't meet the criteria they will commit suicide of their own accord for the same reason; that society has allowed it to be a viable option. This is the real travesty that I believe would be a consequence of legislating for assisted suicide.
Attempted suicide is considered as a sign of mental illness . Also as humans we tend to change our perception from time to time. There could be situations where one has decided to go ahead with assisted suicide but changed their mind, however they find it difficult to inform their family members due to being seen as a burden or undecisive. This can result in people being killed without their contentment. So many times in life we make decisions that we regret, this could be one of them but unfortunately there isn’t a chance to realise. Fortunately, the current law namely the Suicide Act 1961 is the state’s way of protecting its citizens.
Conclusion
As we can distinguish from the case law on assisted suicide, a pattern can be established that the judges are not strictly against assisted suicide but are respecting parliamentary supremacy. The parliament is representative of the views of the population. If they rejected “the Falconer Bill” that shows their view on it. The current system protects the weak and vulnerable and goes in hand with Article 2 of the ECHR.