February 2010 articles archive:

The assisted suicide question: what happens in other countries?

Are we the only country grappling with this issue? Why do we always think of Switzerland when discussing assisted suicide?

For those of you who may be asked to research and write about the debate surrounding assisted suicide, some information about what the law is elsewhere may help put things into some kind of context. 

Maybe it is because of the Dignitas clinic near Zurich that we have begun to associate assisted suicide with Switzerland.  Are we right to do so?  No, in reality, it was pioneered elsewhere, namely, the Netherlands.  Each year around 2,300 people opt to die by assisted suicide in the Netherlands.  This is out of a population of almost 17 million.

In the Netherlands, assisted suicide was legalised in 2002. Like the experiences of the Swiss, a doctor is involved but there are processes to go through and these take longer than is the case in Switzerland.

As Keir Starmer is quick to assert, the law has not changed in this country and it is still an offence to take another's life or to help them to die.  We do not seem able to accept change at the present, other countries have experienced increased instances of assisted suicide and this includes Holland.  The law in the Netherlands was not always as helpful and at one time there was no regulation despite the increased numbers resorting to such means.

In Holland if a doctor is approached by someone wishing to die, there are stringent safeguards.  A second doctor, who must be sufficiently experienced, has to be consulted.

The patient must be suffering unbearably and the condition must be incurable with no chance of recovery. It is clear, therefore, that there is an assessment stage.  All very well in clear-cut cases but as one can imagine there would be times when things were less certain.  For example, even in the Netherlands, it may not be enough to satisfy the doctors involved that the patient or a family member believes that life is not worth living.

It is not expected that there will be a change in the law in the Netherlands either.  Apparently, the Royal Dutch Medical Association, the equivalent of the British Medical Council, is convinced that its members are strongly in favour of the present system.

In the US, in the absence of a national approach, a limited number of states have adopted legislation effectively permitting assisted suicide.  The first such state being Oregon back in 1998 and this has been followed more recently by Washington.  Oregon and Washington are neighbouring states so perhaps it is not that strange that Washington's residents should follow the lead taken in Oregon.  What is more noticeable is that both these initiatives followed a state wide ballot on the issue which is something lacking closer to home.  We only seem to be able to respond as a result of pressure applied through the courts by individuals such as multiple sclerosis sufferer Debbie Purdy.

In other European countries the debate continues and in many countries where there is a strong Roman Catholic influence communities can be divided.  France, Italy, Spain, Sweden, Belgium, Luxembourg, Germany and Poland all have their own family stories and tragedies much like Britain. 

You will recall for example that the Director of Public Prosecutions, Mr Keir Starmer, decided not to prosecute the parents of Daniel James, a rugby player who had been paralysed from the shoulders down when a scrum collapsed.

Daniel James had tried to commit suicide three times before he was able to persuade his parents to help him travel to Switzerland to die at the Dignitas clinic.

There was never going to be a problem about there being sufficient evidence, but Mr Starmer, as head of the Crown Prosecution Service decided that to prosecute Daniel's parents would not be in the public interest.

In the meantime, in the absence of a change of the law, prosecutors now have new guidelines to help them decide who will be prosecuted and who will not.  The guidelines are as follows:


  • The victim had reached a voluntary, clear, settled and informed decision of dying;
  • The suspect was wholly motivated by compassion;
  • 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 seen as reluctant encouragement or assistance in the face of a determined wish on the part of the victim;
  • The suspect reported the victim's suicide to the police and fully cooperated with the police in their enquiries;
  • The victim was under 18;
  • The victim lacked the mental capacity to reach an informed decision;
  • The evidence points to the victim not having reached a voluntary, clear, settled and informed decision;
  • The suspect was not wholly motivated by compassion, for example they stood to gain in some way;
  • The suspect pressured the victim or had a history of abuse against them;
  • The suspect was unknown to the victim;
  • The suspect was paid by the victim or was working for an organisation which provides facilities for a person to commit suicide;
  • The suspect was acting in his or her capacity as a doctor or other caring role;




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