As the author of the updated do it yourself advice and director of the Scottish society, Exit—both mentioned by Brewer1—I would like to clarify a few points.
Many people are worried about the ready availability of information about suicide. Exit takes both patient empowerment (of the kind mentioned by Brewer) and suicide intervention seriously. Those with a persistent rational wish to die (as exemplified by Tony Nicklinson2), and those who need to be protected from their own temporary suicidal urges, deserve honest recognition and support.
We make information on self deliverance available to UK members of Exit in strict accordance with the law, after a basic age check and three months’ wait. These precautions prevent young people or those in the first stages of acute depression from obtaining the information. Newer evidence on impulsivity challenges the accepted view that people can be suddenly “pushed over the edge” to suicide,3 but we still enforce the three months’ wait.
Suicide information is available online—from newsgroups recommending bleach and toilet bowl cleaner (hydrogen sulphide suicides) or less painful methods and from organisations similar to ours. We are a very small player.
The print version of our updated advice is also available to anyone.4 Until legislation allows a full range of assisted dying options, and better safeguards exist for the current “back street or Switzerland” approach, this seems the “least worst” course of action.
Cite this as: BMJ 2012;345:e7073
Competing interests: CD is the author of Five Last Acts and director of Exit.