Prohibition on assisting a suicide is interference with rights of severely disabled people, UK Supreme Court is toldBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7589 (Published 18 December 2013) Cite this as: BMJ 2013;347:f7589
A builder who was left quadriplegic after a car crash 23 years ago and the widow of a man with locked-in syndrome who died last year after losing his case in the Court of Appeal took their right to die case to the United Kingdom’s highest court this week.
Paul Lamb and Jane Nicklinson, widow of Tony Nicklinson, argued that UK law that prevents doctors helping disabled people who are suffering unbearably to end their lives breaches the European Convention on Human Rights.
A total of nine judges heard the case in the Supreme Court, a measure of the difficulty and sensitivity of the issues confronting the court. Most cases are heard by a panel of only five judges, and more important cases usually by seven.
The issue is whether the right to end one’s own life can include assistance by a doctor in the case of those, such as Lamb and Nicklinson, who are too severely disabled to act alone. The courts must balance the right to autonomy of severely disabled people against the right to life of vulnerable people who, disability groups suggest, might be put under pressure to end their lives, in the belief that they were a burden to others.
Paul Bowen QC, for Lamb and Nicklinson, told the justices they had more than one course of action if they decided that the prohibition on assisting a suicide in section 2 of the Suicide Act 1961 was a disproportionate interference with the rights of such severely disabled people.
They could “read in” a defence of necessity, applicable because a doctor acted under a duty to relieve the patient’s suffering. The alternative was to declare that section 2 was incompatible with article 8 of the European Convention on Human Rights, the right to respect for private and family life.
That would leave it to parliament to legislate to make the law compatible. Bowen said that parliament was reluctant to legislate on issues relating to human mortality, and courts had had to grapple in previous cases with issues that they might consider were more appropriate for parliament.
The Supreme Court was founded in October 2009, but shortly before, its predecessor, the appellate committee of the House of Lords, heard the landmark case brought by Debbie Purdy. She wanted her husband’s help in going to Switzerland for an assisted suicide but sought assurances that he would not face prosecution.
The House of Lords ruled that the director of public prosecutions for England and Wales would have to issue new guidance making it clear in what circumstances people who assisted a suicide would or would not be prosecuted.1 The guidance issued in 2010 indicated that loved ones who acted from compassionate motives would be unlikely to face prosecution, but doctors and other medical staff would be at greater risk.2
Bowen said that people who were extremely disabled, such as Lamb and Nicklinson, would require major assistance from a doctor to end their lives. To provide that kind of assistance doctors would need absolute assurance in advance that they would not be prosecuted.
David Perry QC, for the Ministry of Justice, told the justices that the correct conclusion would be to dismiss the appeals, for two essential reasons. One was that section 2 sought to protect life, and human life was inviolate. Secondly, only parliament could change the law in this area. There was no proper constitutional basis for the courts to intervene.
Lady Hale, one of the nine judges, asked, “So these individuals are being required to continue suffering unbearably in order to protect other people’s right to life?”
Perry said, “It is important that the state should not send a message that life is to be undervalued.”
The hearing continues. Later in the week the court will hear argument on behalf of “Martin,” another man with locked-in syndrome, who wants the help of medical staff to go to Switzerland for an assisted suicide.
Cite this as: BMJ 2013;347:f7589