Q&A: Assisted suicide

By Nick Triggle
BBC News health reporter

Assisted suicide is still illegal in England and Wales

The director of public prosecutions has set out new guidelines on assisted suicide.

Keir Starmer QC said he hoped his intervention would bring greater clarity over the thorny issue of prosecution.

Why did he act?

Law Lords ruled over the summer that there was a need for greater clarity after hearing an appeal from a multiple sclerosis suffer.

Debbie Purdy, from Bradford, had gone to the House of Lords after losing her court case to get clarification over whether her husband would be prosecuted if he helped her go abroad to die.

Her legal team argued that the DPP had acted illegally by not providing guidance on how decisions over prosecutions are made.

They agreed, saying she deserved to have some information about what is taken into account in such cases.

However, Mr Starmer was not asked to change the law - indeed he does not even have the power to do that.

What does the current law say?

The 1961 Suicide Act makes it an offence to aid, abet, counsel or procure a suicide or a suicide attempt in England and Wales.

Anyone doing so could potentially face 14 years in prison

The law is almost identical in Northern Ireland.

There is no specific law on assisted suicide in Scotland, creating some uncertainty although in theory someone could be prosecuted under homicide legislation.

To date more than 100 UK citizens have travelled to Dignitas to end their life.

Although some cases have been considered by the DPP, no relative has yet been prosecuted.

What has the DPP published then?

He has basically set out a range of factors that influence whether a person would face prosecution or not.

The idea is that it will allow people who are asking their loved ones to help them die an indication of whether they would then face charges.

However, Mr Starmer has stopped short of saying he would offer guarantees as the individual circumstances of each case would still need to be investigated.

He has set out 16 factors that could influence the authorities in favour of a prosecution.

These include issues such as financial motive, pressuring the individual into suicide and whether the person wanting to die was under 18 or suffering from a mental illness.

There are also another 13 factors which would influence prosecutors against action.

These include the individual wanting to die asking personally on his or her own initiative help to commit suicide and whether the suspect was motivated wholly by compassion and was a spouse, partners, close relative or personal friend.

Does this change anything?

Not the law. The legislation on assisted suicide remains the same.

And Mr Starmer was also quick to point out that this does not effect the legality of euthanasia - whereby someone kills an individual who wants to die but is not able to commit suicide themselves.

Such actions are considered to be acts of murder or manslaughter.

However, the DPP said he hoped it would bring greater clarity for people in situations such as those Britons who have travelled to Dignitas.

Campaigners believe the intervention will, but, at the end of the day, prosecutors will still be exercising discretion.

All individuals who help someone die would face a police investigation during which the factors spelt out by Mr Starmer would be taken into account.

Will this lead to a Dignitas-style clinic being set up here?

It seems inconceivable that it would.

The factors set out by the DPP put a large emphasis on a suspect having to know the person and for it to be a one-off occurrence to avoid a prosecution.

This would seem to exclude an organisation or business offering a suicide service like Dignitas does.

The organisation is only allowed to operate because of Switzerland's liberal laws on assisted suicide, which suggest that a person can only be prosecuted if they are acting out of self-interest.

Interestingly, however, Mr Starmer accepted having such clear factors written down "may in time" lead to people helping their loved-ones commit suicide in this country.

To do this, a lethal drug would be needed to induce death - a barbiturate solution is used in Switzerland - and this is far from easy to obtain.

Nonetheless, it seems highly likely this already happens to some extent, although even groups like Dignity in Dying have struggled to put any kind of figure on the numbers.

Is it possible there could be a change in the law?

There have already been several attempts to legalise assisted suicide, but these have been rejected.

The most recent, in 2006, was defeated in the House of Lords by 148 votes to 100.

It is likely the issue will come before parliament again in the future.

While surveys of public opinion on the issue can show mixed results depending on who is asking the question and how it is asked, there is certainly an appetite for more debate.

Indeed, in Scotland a bill is expected to come before its parliament in the next year in a bid to make assisted suicide legal.