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Informal legal change on assisted suicide: the policy for prosecutors

Published online by Cambridge University Press:  02 January 2018

Penney Lewis
Penney Lewis*
Affiliation:
King's College London
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Abstract

Following the House of Lords' decision in Purdy, the Director of Public Prosecutions issued an interim policy for prosecutors setting out the factors to be considered when deciding whether a prosecution in an assisted suicide case is in the public interest. This paper considers the interim policy, the subsequent public consultation and the resulting final policy. Key aspects of the policy are examined, including the condition of the victim, the decision to commit suicide and the role of organised or professional assistance. The inclusion of assisted suicides which take place within England and Wales makes the informal legal change realised by the policy more significant than was originally anticipated.

Type
Research Article
Information
Legal Studies , Volume 31 , Issue 1 , March 2011 , pp. 119 - 134
Copyright
Copyright © Society of Legal Scholars 2011

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References

1 R (Purdy) v Director of Public Prosecutions [2009] UKHL 45, [2010] AC 345 at [56]. See Suicide Act 1961, s 2(4) requiring the DPP's consent to prosecution.

2 Ibid, at [101].

3 Ibid, at [86].

4 DPP, Decision on Prosecution – The Death By Suicide of Daniel James (9 December 2008), available at http://www.cps.gov.uk/news/articles/death_by_suicide_of_daniel_james/.

5 Purdy, above n 1, at [65] per Baroness Hale.

6 Ibid, at [53].

7 DPP, Interim Policy for Prosecutors in respect of Cases of Assisted Suicide (September 2009), available at http://www.cps.gov.uk/consultations/as_index.html.

8 Ibid, paras 9–13. See also DPP, Code for Crown Prosecutors (February 2010) paras 4.5–4.9, available at http://www.cps.gov.uk/publications/docs/code2010english.pdf.

9 Code for Crown Prosecutors, ibid, para 4.10. See also Purdy, above n 1, at [44].

10 Interim Policy, above n 7, paras 20 and 22.

11 DPP, Policy for Prosecutors in respect of Cases of Assisted Suicide (February 2010) (Final Policy) para 4.7, available at http://www.cps.gov.uk/publications/prosecution/assisted_suicide_policy.pdf.

12 Interim Policy, above n 7, para 5.

13 Purdy, above n 1, at [54].

14 Ibid, at [63]–[69], [82]–[87] and [100]–[106].

15 An earlier version was factor 7 against prosecution in the interim policy.

16 DPP, Statement regarding the deaths of Sir Edward and Lady Downes (19 March 2010), available at http://www.cps.gov.uk/news/press_statements/the_death_of_sir_edward_and_lady_downes/.

17 See Medical Protection Society Clinicians Need Clarification on Assisted Suicide says Leading Doctors' Body (12 August 2009), available at http://www.medicalprotection.org/uk/press-releases/Clinicians-need-clarification-on-assisted-suicide-says-mps; Medical Protection Society Healthcare Professionals are at a Greater Risk of Prosecution for Assisting Suicide Following new DPP Guidelines says Leading Doctors' Group (8 March 2010), available at http://www.medicalprotection.org/uk/press-release/Healthcare-professionals-at-greater-risk-of-prosecution-for-assisting-suicide-following-new-DPP-guidelines-says-mps; Medical Defence Union MDU's Concerns over CPS's New Assisted Suicide Policy (25 February 2010), available at http://www.the-mdu.com/section_GPs_and_primary_care_professionals/topnav_News_3/hidden_Article.asp?articleID=2143.

18 ‘Lawyers seek clarification on role of UK doctors in assisted suicide’ (2009) 339 BMJ 3275; Dyer, C ‘Doctors face greater risk of prosecution than the public for assisting suicide’ (2010) 340 BMJ 1167.CrossRefGoogle Scholar

19 I submitted a response to the consultation exercise which contained (although in a different form) comments on many of the issues raised here in relation to the interim policy, as well as comments on a number of other issues which are not discussed here. See P Lewis Consultation Response, available at http://ssrn.com/abstract=1583439.

20 Government, Hm Code of Practice on Consultation (London: BRE, 2008) para 3, available at http://www.berr.gov.uk/files/file47158.pdf Google Scholar, reproduced on the Interim Policy consultation website, above n 7.

21 For a critique of the use of the word ‘victim’ to describe the person who has committed or attempted suicide, see Lewis, above n 19, para 1.1. As the term is used throughout the CPS documentation, I have used it here.

22 Some examples of possible causes for an impairment of capacity are found in para 4.12 of the Mental Capacity Act 2005 Code of Practice (2007).

23 Code of Practice on Consultation, above n 20, para 3.

24 See, eg, CPS Public Consultation Exercise on the Interim Policy for Prosecutors in respect of Cases of Assisted Suicide Issued by the Director of Public Prosecutions: Summary of Responses (February 2010) paras 2.3–2.5, available at http://www.cps.gov.uk/consultations/as_responses.pdf.

25 Code of Practice on Consultation, above n 20, para 6.1 (emphasis added).

26 Summary of Responses, above n 24, para 7.6.

27 Lewis, above n 19, para 9.1.

28 Ibid, para 5.5.

29 Death With Dignity Act, ss 1.01(11) and 3.10.

30 Death with Dignity Act, RCW 70.245.010(11), 70.245.130.

31 See Adams, M and Nys, H ‘Euthanasia in the low countries: comparative reflections on the Belgian and Dutch Euthanasia Act’ in Schotsmans, P and Meulenbergs, T (eds) Euthanasia and Palliative Care in the Low Countries (Leuven: Peeters, 2005) p 5 at pp 11–12Google Scholar; Griffiths, J, Weyers, H and Adams, M Euthanasia and Law in Europe (Oxford: Hart, 2008) pp 312–313.Google Scholar In the Netherlands there has been a recent evolution in thinking of the Regional Review Committees away from a requirement that the doctor who provides euthanasia must be the patient's treating physician: Legemaate, J De zorgverlening rond het levenseinde: een literatuurstudie naar begripsomschrijvingen en zorgvuldigheidseisen (Utrecht: KNMG, 2005) p 49 Google Scholar; Griffiths et al, ibid, pp 79 and 93–94.

32 Including me. See Lewis, above n 19, para 9.4.

33 See Kurzer, P Markets and Moral Regulation: Cultural Change in the European Union (Cambridge: Cambridge University Press, 2001) pp 175–180.CrossRefGoogle Scholar

34 S Fischer et al ‘Suicide assisted by two Swiss right-to-die organisations’ (2008) 34 Journal of Medical Ethics 810, Table 1.

35 L De Uriarte ‘La opción mexicana’ Reforma (Mexico) (19 May 2008) 1 at 4; ‘Tijuana: parada al paraíso’ Reforma (Mexico) (19 May 2008) 4; ‘Lecciones para “bien morir”’ Reforma (Mexico) (20 May 2008) 4; ‘Sólo les queda México’ Reforma (Mexico) (21 May 2008) 4. All at http://www.exitinternational.net/documents/reforma.pdf.

36 These sections expand on and refine some of the views first aired in two short pieces published as ‘Unfinished Business’ (2009) 153:37 Solicitors Journal 11 and ‘Out of focus’ (2010) 154:9 Solicitors Journal 10.

37 Oregon Death With Dignity Act, s 1.01(12); Washington Death with Dignity Act, RCW 70.245.010(13).

38 ‘Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2001, s 2(1)(b)’ (2001) 8 European Journal of Health Law 183.

39 ‘Act on Euthanasia of May 28 2002, s 3§1’ (2003) 10 European Journal of Health Law 329. The relevant provision in the Luxembourg statute is almost identical to the Belgian provision. Loi du 16 mars 2009 sur l'euthanasie et l'assistance au suicide, art 1, available at http://www.legilux.public.lu/leg/a/archives/2009/0046/a046.pdf#page=7.

40 Purdy, above n 1, at [68].

41 Summary of Responses, above n 24, paras 2.10 and 6.14–6.17.

42 I examine this issue in Lewis, P Assisted Dying and Legal Change (Oxford: Oxford University Press, 2007) pp 37–40.CrossRefGoogle Scholar

43 Grisso, T and Appelbaum, Ps ‘the MacArthur Treatment Competence Study, Iii: abilities of patients to consent to psychiatric and medical treatments’ (1995) 19 Law and Human Behavior 149 CrossRefGoogle Scholar; Vollmann, J et al ‘Competence of mentally ill patients: a comparative empirical study’ (2003) 33 Psychological Medicine 1463.CrossRefGoogle Scholar

44 This factor was briefly mentioned in the Downes case, although it does not appear to have weighed very heavily in favour of prosecution. See above n 16.

45 In 2009, though, there were no such cases reported to the Regional Review Committees. Regionale toetsingscommissies euthanasie Jaarverslag 2009 (June 2010) p 6, available at http://www.euthanasiecommissie.nl/doc/pdf/Jaarverlsag%20RTE%202009_def_23204.pdf.

46 Lewis, above n 42, pp 78–81, 99–101 and 124–127.

47 Federal Department of Justice and Police Organised Assisted Suicide to be Regulated: Federal Council Presents Two Options for Consultation (28 October 2009), available at http://www.ejpd.admin.ch/ejpd/en/home/dokumentation/mi/2009/2009-10-28.html.

48 This factor would have gone some way to providing a palliative filter. See Lewis, P ‘Euthanasia in Belgium five years after legalisation’ (2009) 16 European Journal of Health Law 125 at 134–136.CrossRefGoogle Scholar

49 House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill Report, HL Paper 86-I (2005) [269(c)(vi)], available at http://www.publications.parliament.uk/pa/ld200405/ldselect/ldasdy/86/86i.pdf.

50 Massion, J ‘L'Exception euthanasique en droit Belge’ (2005) 124 Louvain Médical 238 at 243.Google Scholar

51 Griffiths et al, above n 31, pp 91–93.

52 Lewis, above n 48, n 24.

53 Lewis, above n 42, p 127.

54 Swiss Penal Code, art 115.

55 Guillod, O and Schmidt, A ‘Assisted suicide under Swiss law’ (2005) 12 European Journal of Health Law 25 at 29.CrossRefGoogle Scholar

56 See G Bosshard ‘Switzerland’ in Griffiths et al, above n 31, ch 16.

57 See Fischer et al, above n 34.

58 Federal Department of Justice and Police Assistance organisée au suicide: examen approfondi des solutions envisageables et de la nécessité d'une nouvelle réglementation fédérale (15 May 2009) p 7, available at http://www.bj.admin.ch/content/dam/data/gesellschaft/gesetzgebung/sterbehilfe/ber-org-suizidhilfe-f.pdf. Also available in German: Organisierte Suizidhilfe: Vertiefte Abklärungen zu Handlungsoptionen und -bedarf des Bundesgesetzgebers, available at http://www.bj.admin.ch/content/dam/data/gesellschaft/gesetzgebung/sterbehilfe/ber-org-suizidhilfe-d.pdf; and Italian: Assistenza organizzata al suicidio: analisi approfondita delle possibilità e della necessità di intervenire sul piano legislativo, available at http://www.bj.admin.ch/content/dam/data/gesellschaft/gesetzgebung/sterbehilfe/ber-org-suizidhilfe-i.pdf.

59 See above n 47.

60 Hurst, Sa and Mauron, A ‘Assisted suicide and euthanasia in Switzerland: allowing a role for non-physicians’ (2003) 326 BMJ 271 CrossRefGoogle Scholar; Fischer et al, above n 34; Bosshard, above n 56.

61 Factor 10 in favour of prosecution could also be grouped with these factors. See above, text accompanying n 44.

62 Summary of Response s, above n 24, para 3.3.

63 Ibid, paras 3.6–3.7.

64 Horder, J Excusing Crime (Oxford: Oxford University Press, 2007) p 228.CrossRefGoogle Scholar

65 Ibid.

66 Interim Policy, above n 7, factor 6 against prosecution, factor 10 in favour of prosecution.

67 Summary of Responses, above n 24, paras 6.18–6.20.

68 See, eg, DPP, The Suicide of Mr Raymond Cutkelvin – Decision on Prosecution (25 June 2010), available at http://www.cps.gov.uk/news/articles/the_suicide_of_mr_raymond_cutkelvin_decision_on_prosecution/index.html; DPP, No Charges following Death of Caroline Loder (16 August 2010), available at http://www.cps.gov.uk/news/press_statements/cps_statement_on_decision_in_relation_to_doctor_elisabeth_wilson/.

69 Lewis, above n 42, pp 76–81.

70 RS Magnusson Angels of Death – Exploring the Euthanasia Underground (New Haven, CT: Yale University Press, 2002) pp 202–10.

71 BBC Panorama, I Helped My Daughter Die (1 February 2010), available at http://www.bbc.co.uk/programmes/b00qs930#synopsis.

72 See Oregon Death With Dignity Act, s 3.03; Washington Death with Dignity Act, RCW 70.245.060.

73 Jamison, S ‘When drugs fail: assisted deaths and not-so-lethal drugs’ in Battin, Mp and Lipman, Ag (eds) Drug Use in Assisted Suicide and Euthanasia (Binghamton, NY: Pharmaceutical Products Press, 1996) p 223 at p 241.Google Scholar See also Jamison, S Final Acts of Love: Families, Friends, and Assisted Dying (New York: GP Putnam, 1995).Google Scholar

74 See, eg, McLachlan, Hv ‘Assisted suicide and the killing of people? Maybe. Physician-assisted suicide and the killing of patients? No: the rejection of Shaw's new perspective on euthanasia’ (2010) 36 Journal of Medical Ethics 306.CrossRefGoogle Scholar

75 See, eg, the Netherlands (Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2001, s 20A); Belgium (Act on Euthanasia of May 28 2002, ss 3§1 and 4§2); Luxembourg (Loi du 16 mars 2009 sur l'euthanasie et l'assistance au suicide, art 1); Oregon (Death With Dignity Act, s 3.01) and Washington (Death with Dignity Act, RCW 70.245.040).

76 Faber-Langendoen, K and Karlawish, Jht ‘Should assisted suicide be only physician assisted?’ (2000) 132 Annals of Internal Medicine 482 at 486.CrossRefGoogle Scholar

77 See, eg, Switzerland (Penal Code, art 115).

78 See, eg, Finlay, Ig, Wheatley, Vj and Izdebski, C ‘the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill: implications for specialist palliative care’ (2005) 19 Palliative Medicine 444 at 450.CrossRefGoogle Scholar

79 See Final Policy, above n 11, factors 11 and 12 in favour of prosecution.

80 See above, text accompanying nn 66–68.

81 Magnusson, above n 70, p 203.

82 Final Policy, above n 11, factor 6 in favour of prosecution, factor 2 against prosecution.

83 Ibid, factor 9 in favour of prosecution.

84 See Summary of Responses, above n 24, para 6.6.

85 Ibid, Table 6.

86 Horder, above n 64, p 225. See above, text accompanying nn 64–69.

87 Lewis, above n 42.

88 Rodriguez v British Columbia (Attorney-General) [1993] 3 SCR 519.

89 Vacco v Quill (1997) 521 US 793; Washington v Glucksberg (1997) 521 US 702. More recently, see Baxter v State (2009) 354 Mont 234, 224 P3d 1211.

90 R (Pretty) v Director of Public Prosecutions [2002] 1 AC 800; Pretty v UK (2002) 35 EHRR 1.

91 Comité Consultatif National d'Ethique Fin de vie, arrêt de vie, euthanasie no 63 (27 January 2000), available at http://www.ccne-ethique.fr/docs/fr/avis063.pdf; also available in English: End of Life, Ending Life, Euthanasia, available at http://www.ccne-ethique.fr/docs/en/avis063.pdf.

92 See above, text accompanying nn 12–14.

93 Lewis, above n 42, pp 83–97.

94 Final Policy, above n 11, factor 6 in favour of prosecution, factor 2 against prosecution.

95 Lewis, above n 42, pp 137 and 146.

96 Ibid, pp 112 and 146. See also, Blum, L ‘Compassion’ in Rorty, Ao (ed) Explaining Emotions (Berkeley, CA: University of California Press, 1980) p 507 at p 509Google Scholar; van Zyl, L Death and Compassion: A Virtue-Based Approach to Euthanasia (Aldershot: Ashgate, 2000) p 165.Google Scholar

97 Above n 54.

98 ‘Some respondents commented on the adoption of the word “compassion”, indicating that they considered that the Interim Policy misused it’: Summary of Responses, above n 24, para 2.14.

99 Ibid, para 2.15.

100 See Lewis, above n 42, pp 138–149.

101 Ibid, pp 153–157.

102 Final Policy, above n 11, para 5. See also Summary of Responses, above n 24, paras 10.9–10.17.

103 Cuperus-Bosma, Jm et al ‘Physician-assisted death: policy-making by the Assembly of Prosecutors General in the Netherlands’ (1997) 4 European Journal of Health Law 225 CrossRefGoogle Scholar; Cuperus-Bosma, Jm et al ‘Assessment of physician-assisted death by members of the public prosecution in the Netherlands’ (1999) Journal of Medical Ethics 8.CrossRefGoogle Scholar

104 See Lewis, above n 42, pp 76–83, 99–101, 124–127 and 136.

105 Ibid, pp 95–97; Otlowski, M Voluntary Euthanasia and the Common Law (Oxford: Oxford University Press, 1997) pp 170–184.Google Scholar

106 Weyers, H ‘Legal recognition of the right to die’ in Garwood-Gowers, A et al (eds) Contemporary Issues in Healthcare Law and Ethics (Edinburgh: Elsevier Butterworth-Heinemann, 2005) p 253 at p 264.Google Scholar