For many of its long and illustrious years, the Orient Express travelled across Europe from Calais via Zurich to exotic Eastern destinations. Were it still running today, it might well have found itself doing a brisk trade in one-way tickets to Switzerland, following the DPPs final guidance on prosecuting cases of assisted suicide issued today.
The final guidance has shifted its position significantly from that found in the interim guidance issued last year. The focus has moved away from factors associated with the suicidee (the best term Dr No can come up with to describe the ‘victim’) towards the motivation of the assister. If the assister can show that he or she was acting wholly out of compassion – that they acted with ‘love in their heart’ – then he or she is unlikely to be prosecuted.
On the face of it, this final guidance appears clear enough – little more, in fact, than an explicit codification of that which is already implicit. The moment we look a little deeper, however, the cracks start to appear.
First – and most fatally to the DPP’s ‘refreshed’ guidelines – we have no way of assessing compassion. There is no such instrument as a compassionometer, capable of objectively measuring compassion. In practice, we will only have the assister’s word for it. And – as we have seen in recent cases (albeit ones that have involved killing rather that assisting suicide) – ‘perps’ invariably claim that they were acting for the best of motives, with ‘love in their heart’. But – they would say that, wouldn’t they…but how do we know?
The second substantial flaw is that whole process is constitutionally unsound. However much the DPP may protest that the law remains unchanged, the issuance of formal guidelines that detail circumstances in which – despite the fact that a crime has been committed – prosecution is unlikely to follow is a direct subversion of the rule of law – and the will of parliament, which has debated the question many times, and remains resolutely opposed to assisted suicide. The Law Lords and the DPP have no business undermining that will.
The third flaw – which might one day affect any one of us when we are at our most vulnerable – is the scope for creep. The practical difficulties of establishing genuine ‘love in the heart’ mean that there will be many with something rather less compassionate on their minds who will hide behind effusions of devotion, and will get away with it, because – all said and done – we can never know what was said in that quiet back room to a frightened and vulnerable person. “How awful you look, dear granny! Shall I perhaps help you – you know – help you to do the decent thing?”
We cannot – and should not – stop those of settled intent and sound mind taking the one way ticket to Zurich. But that is an entirely different matter to issuing guidelines that amount to nothing less than a thinly disguised domestic ‘Snuffer’s Charter’.
Isn’t it ironic that just as we get the revalidation tick box inquisition to prevent another Dr Shipman we are encouraged to all be Shipman Lite.
I did once make a rather innapropriate joke about a patient to a colleague “refer to Dr Shipman for further management” Now it seems that we are supposed to encourage that approach. Dr Shipman was a man ahead of his time.
I would add another point to the above list. “the suicide must have written a clear will and testament, with no financial benefit acruing to the assistant” that would sort out whether it was genuine compassion. Follow the money.
Oh Dear Me! From personal experience, I can relate to the desire of wishing a loved to exist in ‘a better place’ to free them from whatever I perceive to be an ?uncomfortable existance.
After reading the last three of the six public interest factors; I can bump my loved one off at will. Cannot be proven otherwise after death!
Switzerland, here we come! Or perhaps, just in my front room. Hang onto your hats every family member that irritates me ever so slightly, for I have the power of life and death in my hands when you are vulnerable!
It is worth reviewing the ‘against prosecution’ factors for provability:
The six public interest factors against prosecution are:
• The victim had reached a voluntary, clear, settled and informed decision to commit suicide.
• The suspect was wholly motivated by compassion.
• The actions of the suspect, although sufficient to come within the definition of the crime, were of only minor encouragement or assistance.
• The suspect had sought to dissuade the victim from taking the course of action which resulted in his or her suicide.
• The actions of the suspect may be characterised as reluctant encouragement or assistance in the face of a determined wish on the part of the victim to commit suicide.
• The suspect reported the victim’s suicide to the police and fully assisted them in their enquiries into the circumstances of the suicide or the attempt and his or her part in providing encouragement or assistance.
The first could be ‘proved’ eg by a written statement or other witnesses. The second to fifth can all be claimed by the ‘perp’ – and who can say otherwise? And the last is a joke – ‘help’ the Bill and they’ll treat you lightly.
As Nikita says, hold on to your hats!
Dr No fully appreciates the dilemma faced in watching a relative/friend suffer. But the answer is better palliative care, not Gosling’s ‘pillah’. The Dutch experience is salutary.