While I’ve been migrating, the Director of Public Prosecutions  has published his guidelines on how he is going to decide whether to prosecute people if they assist suicides. He was forced to do this by the Debbie Purdy case earlier in the year. You can find the consultation at his website:

CPS Consultation : Assisted Suicide.

It sets out a number of factors in favour of prosecution for assisting a suicide and then against a prosecution. These are not totted up: there are major and minor ones and also the CPS should look at the whole situation. It is important to know what the factors are, because people will increasingly ask about it, and practitioners should not rely on press reports.

To avoid prosecution basically someone over 18 has to make a spontaneous and consistently maintained decision that they want to commit suicide, and the assister has to be clearly motivated by compassion, have a close relationship with them and not have an interest. It is better if assisters tried to dissaude them and clearly did it unwillingly in the face of a determined person. This helps, because I have come across people who have been determined to commit suicide, and have pushed their relatives into helping even though they have been against it. Assisters can’t do it for them: that would be murder.

They have to have a terminal condition, a severe disability or a severe degenerative condition from wehich they have no possibility of recovery. They have to do the act in private (no committing suicide for a public cause – you may remember demonstrators setting fire to themselves in a political cause).

The palliative care lobby will note that assisters are less likely to be prosecuted if the victim has investigated and rejected suitable care options.

One of the interesting things for social workers or palliative care professionals is that the definition of assisting is ‘aids, abets, cousels or procures’, so giving advice is relevant as well as practical assistance. A specific factor is that if assisters are paid to care for the victim in a care setting, they’re more likely to be prosecuted. Also, the CPS is likely to be less sympathetic if they are not a close relative or friend or if they gave advice not really knowing them (eg through a website). This makes it very clear that assisting suicide is only to be done in close relationships. therefore, in giving advice, social workers should probably take the line that anyone who inherits obviously should not be an assister, but in reality the requirement that assisters should be close is likely to be in tension. What do you say to assisters whose ‘victim’ (the preferred CPS term) is likely to have to pay carehome costs? They certainly have a financial interest, because they will inherit more if the victim goes ahead with the suicide. As time goes on because this is likely to be a big issue for families of frail older people, and the CPS view is not clear to me.

The DPP is Keir Starmer; one of our nurses saw a photo and said: ‘he’s a bit of a hunk isn’t he?’ This is for me a new view of a Director of Public Prosecutions. See the pic on the Guardian website and tell me if you agree.

Keir Starmer: ‘I wouldn’t characterise myself as a bleeding heart liberal . . .’ | The Guardian