Intended for healthcare professionals


New interim guidance on assisted suicide

BMJ 2009; 339 doi: (Published 26 November 2009) Cite this as: BMJ 2009;339:b4900
  1. Richard Huxtable, senior lecturer and deputy director1,
  2. Karen Forbes, consultant and Macmillan professorial teaching fellow in palliative medicine2
  1. 1Centre for Ethics in Medicine, Department of Community Based Medicine, University of Bristol, Bristol BS6 6AU
  2. 2Department of Palliative Medicine, Bristol Haematology and Oncology Centre, Bristol BS2 8ED
  1. r.huxtable{at}

    Doctors need more help on how to keep within the law

    At the insistence of the House of Lords, in its final judgment before reconvening as the Supreme Court,1 the director of public prosecutions has issued interim guidance on prosecution policy in cases of assisted suicide that seem to fall foul of English law.2 Clarity is undoubtedly important here,3 yet the policy prompts serious questions, not least for medical professionals looking to navigate a course within the boundaries of responsible (and demonstrably lawful) practice.

    The problems begin with the purpose (and audience) of the policy. Strictly speaking, it is a tool for retrospective use by prosecutors—it is not meant to provide tips for the potential assistant in suicide. The policy therefore differs from proposals for legalising assisted suicide, and this is not the only difference. Such proposals typically clarify the types of activity that would (not) be permitted.4 But the circumstances in which the prosecution policy might apply are less clear. The policy is certainly capable of encompassing a wide range of behaviours and actors, from the cell mate who encourages suicide, to the loved one or doctor who “provides the pills,” knowing how they might be used.5 Yet uncertainty surrounds some of the other activities in which medical personnel might be involved or implicated.

    “Assisted suicide tourism” is particularly problematic.6 …

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