Informal legal change on assisted suicide: The policy for prosecutors

Legal Studies

Volumn 31, Issue 1, 2011, Pages 119-134

  Lewis, Penney ^a  

^a KING'S COLLEGE LONDON   (United Kingdom)

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[No Author keywords available]

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EID: 84859992088     PISSN: 02613875     EISSN: 1748121X     Source Type: Journal    
DOI: 10.1111/j.1748-121X.2010.00184.x     Document Type: Article

References (114)

1. R (Purdy) Director of Public Prosecutions[2009] UKHL 45, [2010] AC 345 56
2. Suicide Act 1961, s requiring the DPP's consent to prosecution.2(4)
3. DPP, Decision on Prosecution - The Death By Suicide of Daniel James (9 December 2008), available at .2008
4. Purdy, above n 1, at [65] per Baroness Hale.
5. DPP, Interim Policy for Prosecutors in respect of Cases of Assisted Suicide (September ), available at2009
6. DPP, Code for Crown Prosecutors (February ) paras 4.5-4.9, available at 2010
7. Interim Policy, above n 7, paras 20 and 22.
8. DPP, Policy for Prosecutors in respect of Cases of Assisted Suicide (February 2010) (Final Policy) para 4.7, available at2010
9. Interim Policy, above n 7, para 5.
10. Purdy, above n 1, at [54].
11. An earlier version was factor 7 against prosecution in the interim policy.
12. DPP, Statement regarding the deaths of Sir Edward and Lady Downes (19 March 2010), available at2010
13. See Medical Protection Society Clinicians Need Clarification on Assisted Suicide says Leading Doctors' Body (12 August 2009), available2009
14. 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 at2010
15. Medical Defence Union MDU's Concerns over CPS's New Assisted Suicide Policy (25 February, available at2010
16. 'Lawyers seek clarification on role of UK doctors in assisted suicide' (2009) 339 BMJ 3275
17. C Dyer 'Doctors face greater risk of prosecution than the public for assisting suicide' (2010) 340 BMJ 1167.
18. 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
19. HM Government Code of Practice on Consultation (London: BRE, ) para 3, available at, reproduced on the Interim Policy consultation website, above n 7.2008
20. 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.
21. 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).
22. Code of Practice on Consultation, above n 20, para 3.
23. 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 ) paras 2.3-2.5, available at 2010
24. Code of Practice on Consultation, above n 20, para 6.1 (emphasis added).
25. Summary of Responses, above n 24, para 7.6.
26. Death With Dignity Act, ss 1.01(11) and 3.10.
27. Death with Dignity Act, RCW 70.245.010(11), 70.245.130.
28. M Adams and H Nys 'Euthanasia in the low countries: comparative reflections on the Belgian and Dutch Euthanasia Act'in P Schotsmans and T Meulenbergs (eds) Euthanasia and Palliative Care in the Low Countries (Leuven: Peeters, 2005)pp 11-12
29. H Weyers and M Adams Euthanasia and Law in Europe (Oxford: Hart, 2008) pp 312-313.
30. 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: J Legemaate De zorgverlening rond het levenseinde: een literatuurstudie naar begripsomschrijvingen en zorgvuldigheidseisen (Utrecht: KNMG, 2005) p 49
31. Including me. See Lewis, above n 19, para 9.4.
32. P Kurzer Markets and Moral Regulation: Cultural Change in the European Union (Cambridge: Cambridge University Press, 2001) pp 175-180.
33. S Fischer et al 'Suicide assisted by two Swiss right-to-die organisations' (2008) 34 Journal of Medical Ethics 810, Table 1.
34. L De Uriarte 'La opción mexicana' Reforma (Mexico) (19 May 2008) 1-4
35. Tijuana: parada al paraíso' Reforma (Mexico) (19 May 2008 4
36. Lecciones para "bien morir"' Reforma (Mexico) (20 May 2008) 4
37. 'Sólo les queda México' Reforma (Mexico) (21 May ) 4. All at .2008
38. 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' 154:9 Solicitors Journal 10.2010
39. Oregon Death With Dignity Act, s 1.01(12); Washington Death with Dignity Act, RCW 70.245.010(13).
40. 'Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2001, s 2(1)(b)' (2001) 8 European Journal of Health Law 183.
41. '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 .2003
42. Purdy, above n 1, at [68].
43. Summary of Responses, above n 24, paras 2.10 and 6.14-6.17.
44. I examine this issue in P Lewis Assisted Dying and Legal Change (Oxford: Oxford University Press, 2007) pp 37-40.
45. T Grisso and PS Appelbaum 'The MacArthur Treatment Competence Study, abilities of patients to consent to psychiatric and medical treatments' (1995) 19 Law and Human Behavior 149
46. J Vollmann et al 'Competence of mentally ill patients: a comparative empirical study' (2003) 33 Psychological Medicine 1463.
47. 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.
48. In, though, there were no such cases reported to the Regional Review Committees. Regionale toetsingscommissies euthanasie Jaarverslag 2009 (June 2010) p 6, available at2009
49. Lewis, above n 42, 99-101 and 124-127.78-81
50. Federal Department of Justice and Police Organised Assisted Suicide to be Regulated: Federal Council Presents Two Options for Consultation (28 October 2009), available at2009
51. This factor would have gone some way to providing a palliative filter. See P Lewis 'Euthanasia in Belgium five years after legalisation' (2009) 16 European Journal of Health Law 125 at 134-1362009.
52. House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill Report, HL Paper 86-I (2005), available at2005[269(1006
53. J Massion 'L'Exception euthanasique en droit Belge' (2005) 124 Louvain Médical 238-243.
54. Griffiths et al, above n 31 91-93.
55. Lewis, above n 48, n 24.
56. Lewis, above n 42, p 127.
57. Swiss Penal Code, art 115.
58. O Guillod and A Schmidt 'Assisted suicide under Swiss law' (2005) 12 European Journal of Health Law 25-29.
59. G Bosshard 'Switzerland' in Griffiths et al, above n 31, ch 16.
60. Fischer et al, above n 34.
61. 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
62. Also available in German: Organisierte Suizidhilfe: Vertiefte Abklärungen zu Handlungsoptionen und -bedarf des Bundesgesetzgebers, available at; and Italian: Assistenza organizzata al suicidio: analisi approfondita delle possibilità e della necessità di intervenire sul piano legislativo, available at
63. SA Hurst and A Mauron 'Assisted suicide and euthanasia in Switzerland: allowing a role for non-physicians' (2003) 326 BMJ 271
64. Fischer et al, above n 34; Bosshard, above n 56.
65. Factor 10 in favour of prosecution could also be grouped with these factors. See above, text accompanying n 44
66. Summary of Responses, above n 24, para 3.3.
67. J Horder Excusing Crime (Oxford: Oxford University Press, 2007) p 228.
68. Interim Policy, above n 7, factor 6 against prosecution, factor 10 in favour of prosecution.
69. Summary of Responses, above n 24, paras 6.18-6.20.
70. DPP, The Suicide of Mr Raymond Cutkelvin - Decision on Prosecution (25 June 2010), available at2010
71. DPP, No Charges following Death of Caroline Loder (16 August ), available at .2010
72. Lewis, above n 42, pp 76-81.
73. RS Magnusson Angels of Death - Exploring the Euthanasia Underground (New Haven, CT: Yale University Press, 2002) pp 202-10.
74. BBC Panorama, I Helped My Daughter Die (1 February, available at2010
75. See Oregon Death With Dignity Act, s 3.03; Washington Death with Dignity Act, RCW 70.245.060.
76. S Jamison 'When drugs fail: assisted deaths and not-so-lethal drugs' in MP Battin and AG Lipman (eds) Drug Use in Assisted Suicide and Euthanasia (Binghamton, NY: Pharmaceutical Products Press, 1996) p 223
77. S Jamison Final Acts of Love: Families, Friends, and Assisted Dying (New York: GP Putnam, 1995).
78. HV McLachlan '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
79. The Netherlands (Termination of Life on Request and Assisted Suicide (Review Procedures) Act 2001, 20
80. Belgium (Act on Euthanasia of May 28 ss 3§1 and 4§2)2002
81. Luxembourg (Loi du 16 mars sur l'euthanasie et l'assistance au suicide, art 12002
82. Oregon (Death With Dignity Act, s 3.01) and Washington (Death with Dignity Act, RCW 70.245.040).
83. K Faber-Langendoen and JHT Karlawish 'Should assisted suicide be only physician assisted?' (2000) 132 Annals of Internal Medicine 482-486.
84. Switzerland (Penal Code, art 115).
85. IG Finlay, VJ Wheatley and C Izdebski 'The House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill: implications for specialist palliative care' (2005) 19 Palliative Medicine 444-450.
86. Final Policy, above n 11, factors 11 and 12 in favour of prosecution.
87. See above, text accompanying nn 66-68.
88. Magnusson, above n 70 203.
89. Final Policy, above n 11, factor 6 in favour of prosecution, factor 2 against prosecution.
90. See Summary of Responses, above n 24, para 6.6.
91. Horder, above n 64, p 225
92. See above, text accompanying nn 64-69.
93. Lewis, above n 42.
94. Rodriguez v British Columbia (Attorney-General) 3 SCR 519.1993
95. Vacco v Quill 521 US 7931997
96. Washington v Glucksberg (1997) 521 US 702. More recently, see Baxter v State 354 Mont 234, 224 P3d 1211.2009
97. R (Pretty) v Director of Public Prosecutions[2002] 1 AC 800
98. Pretty v UK 35 EHRR 1.2002
99. Comité Consultatif National d'Ethique Fin de vie, arrêt de vie, euthanasie no 63 (27 January ), available at2000
100. English: End of Life, Ending Life, Euthanasia, available at
101. See above, text accompanying nn 12-14.
102. Lewis, above n 42, 83-97.
103. Final Policy, above n 11, factor 6 in favour of prosecution, factor 2 against prosecution.
104. Lewis, above n 42,137-146.
105. 'Compassion' in AO Rorty (ed) Explaining Emotions (Berkeley, CA: University of California Press, 1980) p 507-509
106. L van Zyl Death and Compassion: A Virtue-Based Approach to Euthanasia (Aldershot: Ashgate,2000) p 165.
107. '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.
108. Lewis, above n 42, pp 138-149.
109. Final Policy, above n 11, para 5. See also Summary of Responses, above n 24, paras 10.9-10.17.
110. JM Cuperus-Bosma et al 'Physician-assisted death: policy-making by the Assembly of Prosecutors General in the Netherlands' (1997) 4 European Journal of Health Law 225
111. JM Cuperus-Bosma et al 'Assessment of physician-assisted death by members of the public prosecution in the Netherlands' (1999) Journal of Medical Ethics 8.
112. Lewis, above n 42, pp 76-83
113. M Otlowski Voluntary Euthanasia and the Common Law (Oxford: Oxford University Press, 1997) pp 170-184.
114. H Weyers 'Legal recognition of the right to die' in A Garwood-Gowers et al (eds) Contemporary Issues in Healthcare Law and Ethics (Edinburgh: Elsevier Butterworth-Heinemann, 2005) p 253-264