Suicide and the Law

In most western countries, suicide is legal, yet assisted suicide is a crime that can attract harsh legal penalties. While a person who takes their own life commits no crime, a person found guilty of assisting another can potentially face a long jail term. Think about it. The law makes it a crime for a person to assist another person to do something that is lawful. How strange that it can be considered a crime to assist a person who is acting lawfully: there is no other example of this type of incongruity in modern western legal systems. Yet, any person who chooses to be involved in the death of another - however tangentially and for whatever reasons - needs to be very careful indeed. This is especially true when friends and family are involved and emotions may cloud one's judgement.

Assisted suicide is usually defined as 'advising,' 'counselling' or 'assisting' a person to end their life. Sometimes the words 'aid and abet' are also used. In most countries assisting a suicide carries severe legal penalties. In Australia, the penalty ranges from 5 years to life imprisonment, depending upon the jurisdiction. In Britain and Canada the penalty extends to 14 years.

In the USA, assisting a suicide is illegal in slightly more than half of all states, with the remainder treating it the same as the crime of murder or manslaughter. Again the penalties for assisted a suicide vary from state to state. Only in the state of Oregon is there an exception where Physician Assisted Suicide (PAS) is legal in some circumstances. In Michigan, Dr Jack Kevorkian remains in prison for the assisted suicide of his terminally ill patient, Thomas Youk. In assisting Youk to die, Kevorkian was convicted of second degree murder in March 1999 and sentenced to 10 to 25 years jail. With certain caveats, assisted suicide has been legal in Switzerland since the 1950s.

Defining Assisted Suicide

Yet what is assisted suicide? At the current time, argument about what actually constitutes 'assisted suicide' shows no sign of easing. A significant grey area continues to exist at the boundaries, with lawyers unable to give clear and concise answers to many questions about this issue. The dearth of case law leaves it unclear about whether, for example, giving a person the information they need, or even sitting with a person while they take their own life, is assisting with their suicide. On the one hand there is the argument that the mere act of sitting with someone about to suicide provides psychological encouragement? Or does it? Perhaps those present have a duty of care to prevent that person from harming themselves? Perhaps you should leap from your chair and grab the glass of lethal drugs from the person's lips? But wouldn't that be an assault? The law regarding assisted suicide is often ill defined and murky.

VE Legislation - What Type of Law is Needed?

Voluntary Euthanasia laws have attempted to bring clarity and order to the assisted suicide debate. By defining the class of person who could be helped to die and by stipulating the manner in which this help could be provided, the Rights of the Terminally Ill Act (Northern Territory) went a long way towards establishing uniformity and equity. To make use of the law you had to be 'terminally ill,' and this was defined in the Act. You also had to satisfy a number of other strict criteria. If you qualified, however, you obtained the right to request lawful assistance from a doctor to die. Other laws (Oregon, Holland etc) have also set out to define exactly which group of people can have help to die. In all cases, eligibility is tightly controlled.

Yet even where VE laws work well, there is one significant drawback. The very strict set of conditions means that the process of establishing eligibility is demanding and often humiliating. And many people, for example those who are well, elderly, and tired of life, will simply never qualify. In the Northern Territory, the terminally ill person had to obtain two medical opinions, a palliative care review and a psychiatric consultation before they could qualify to use the law (qualify to die!). In practice, this meant that some very sick people had to beg the medical profession in order to get permission to die.

In the course of my involvement with this law, it soon became clear that none of my four patients who used the ROTI Act would have bothered with the exhaustive assessment if they had access to a Peaceful Pill in the cupboard. Why would a person subject themselves to a compulsory psychiatric examination, if they already had control over the means of their death?

They would simply have waited till the time was right and then taken the Pill. The very laws that were supposed to empower these sick and frail people seemed to do the exact opposite. The law denied these individuals' control, placing it instead in the hands of those doctors tasked with establishing eligibility.

While some people may wish to involve a team of doctors in their deaths, others do not. Our point is that death need not be a medical event. It is also arguable whether the medical profession should be given the role of arbiter, of who gets the right to die with dignity, and who does not. (An extensive discussion of Exit's philosophy of death and dying can be found in Killing Me Softly: VE and the Road to the Peaceful Pill, 2005). This powerful medical model of death and dying hangs over us and needs to be challenged. This is, in part, the reason this book has been written.

While the past decade has seen several countries legalise assisted suicide or voluntary euthanasia, in Australia, the situation has worsened. Following the overturning of the ROTI Act, the Australian Federal Government amended the Customs Act in 2001 to outlaw the importation or exportation of ' suicide related material,' which even includes the transfer of printed material on suicide technique and methods. Then, in early 2006, the government went one step further and passed the Suicide Related Material Offences Act (2006). This law prohibits the use of a 'carriage service' such as a telephone, fax, email or the internet to discuss the practicalities of end of life issues and extends legal definitions of assisted suicide to include 'incitement' and 'discussion'.

These legislative initiatives have broadened the crime of assisted suicide, increased the legal uncertainty associated with the practice and made everyday discussion of voluntary euthanasia extremely difficult.

Conclusion

There are many understandable reasons why a seriously ill person (or an elderly person) might plan for their own death. Exit does not accept the proposition that seriously ill people who reflect upon, or plan for, the end of their life are necessarily depressed or mentally ill.

Rather, a person's right to end-of-life information needs to be seen as central, enabling that person to make their own considered decisions and choices, just as they have done all their life. By implementing laws that restrict and withhold this information, the State is behaving in a way that is not only cruel, but fundamentally inequitable and unjust.

Those with money and connections will always be better resourced, better able to bend the rules, better able to get the necessary information and better able to access the restricted drugs, than those who are less well off. In the current climate of restriction, inaccurate and misleading information proliferates.

Bad information is dangerous and serves no one's interest. In the absence of a law that allows voluntary euthanasia, we seek in this book to make reliable and accurate information available to those who want to know they are in control, not only of their lives, but also of their deaths.

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