Disability campaigners, MPs and pro-life groups said that new guidance published by the Director of Public Prosecutions would put pressure on vulnerable people to end their lives.
The revised policy follows a court case in which the DPP, Keir Starmer QC, was ordered to make clear who would and would not be prosecuted for helping someone commit suicide. If Mr Starmer had hoped that his attempt to clarify the law would settle the issue once and for all, he will have been greatly disappointed.
And although he said the new rules did not change the law or open the back door to euthanasia, critics leapt on factors for and against prosecution which they claimed supported their point of view. Jayne Spink, director of policy and research at the MS Society, said: "While we welcome the guidance and the clarity it provides, we remain concerned that the law on assisted suicide continues to place a burden on individuals to seek end of life care and support themselves, rather than on society to provide it."
Richard Hawkes, chief executive of disability charity Scope, warned: "We do not support any weakening of the protection offered under the law on assisted suicide, which is exactly what these new guidelines do.
"Many disabled people are frightened by the consequences of these new guidelines and with good reason. There is a real danger these changes will result in disabled people being pressured to end their lives."
But groups in favour of assisted dying suggested the guidance did not go far enough because what was needed was a clear change in the law. Sarah Wootton, chief executive of Dignity in Dying, welcomed the guidelines as a "victory for common sense and compassion" but also committed the charity to press for a change in the law.
Yesterday MPs demanded a full debate so that Parliament, rather than the DPP, shaped policy. Labour's David Winnick stressed the importance of debating the policy "in view of the controversy", and Conservative MP Mark Pritchard said it was up to Parliament to set the law and the courts to interpret it. He said: "There is real concern out in the community that this House is not having a say. People are very concerned that this is a new back-door to euthanasia in the UK."
Mr Starmer insisted that each case would be judged on its merits and denied he had legalised assisted suicide. Under the revised policy, the emphasis is firmly placed on the motives and actions of the suspect rather than the health of the victim.
It also makes clear that anyone assisting suicide who benefits from the death is unlikely to be prosecuted, as long as compassion was the "driving force" behind their actions.
Mr Starmer said: "The policy is now more focused on the motivation of the suspect rather than the characteristics of the victim. The policy does not change the law on assisted suicide. It does not open the door for euthanasia. It does not override the will of Parliament. What it does do is to provide a clear framework for prosecutors to decide which cases should proceed to court and which should not."
Mr Starmer acted after a long running legal fight by Debbie Purdy, from Bradford, who has multiple sclerosis. In July, the House of Lords ruled she had the right to know under what circumstances her husband, Omar Puente, would be prosecuted if he helped her travel abroad to die.
She had argued that, without clarification, she would have had to travel earlier than she wanted while she was still fit enough to go alone. Yesterday, Ms Purdy said she was "overwhelmed and delighted" by the victory and that she and Mr Puente could now "get on with our lives".
She said she now knows that if her husband, a Cuban jazz violinist, is judged to have acted with compassion then a prosecution will not be pursued. "The important thing about the guidelines is they've been able to really clarify the difference between malicious encouragement and compassionate support for somebody's decision," she said. "The current guidelines are enough to give me my life back and to know that I can carry on living and don't have to worry about making a decision now."
The author Sir Terry Pratchett also welcomed the news as "the best we can get without a change in the law". The 61-year-old, who suffers from Alzheimer's disease, believes people should have the right to choose when they die.
He used a lecture this month to call for tribunals to consider cases where people were seeking to end their lives. Sir Terry said: "They [the new rules] don't conform to my distant goal of what I want, but I think it represents probably the best that we can get without a change in the law. It doesn't look like such a tick box exercise as it used to."
Do the new guidelines mean it is no longer an offence to help someone commit suicide?
Q. Why has the Director of Public Prosecutions (DPP) published new guidance?
A. The House of Lords ruled last July that the Crown Prosecution Service must specify the factors its lawyers should consider when deciding whether to charge someone for helping a person take their own life.
Q. What prompted the legal challenge?
A. Debbie Purdy, from Bradford, had gone to the House of Lords after losing her court case seeking clarification on whether her husband would be prosecuted if he helped her go abroad to die. Her lawyers argued that the DPP had acted illegally by not providing guidance on how decisions over prosecutions were made. They agreed.
Q. Do the new guidelines mean that it is no longer an offence to help someone commit suicide?
A. The DPP, Keir Starmer, says most definitely not. It will remain an offence to encourage or assist in the suicide of another until the law is changed.
Q. So why the controversy?
A. Nothing was written to say how the law should be followed, but under the existing prosecutors code the DPP could use a wide discretion in deciding whether to charge, based on sufficiency of evidence and the public interest. From today, both anti- and pro-euthanasia campaigners can point to 22 fixed prosecution factors supporting their own understanding of the law.
Q. Who is more likely to escape prosecution?
A. Under the guidance a suspect who can show that he or she acted wholly out of compassion, where the victim had a clear and settled determination to die, is unlikely to face charges.
Q. Does it make a difference if the person committing suicide is suffering from a severe disability or terminal illness?
A. The new guidance does not take account of the physical health of the person wishing to die: provided the person is of sound mind and over 18 years old, prosecutors will not consider the individual's illness as a relevant factor.
Q. Surely most people who want to benefit from the guidance will be assisting someone suffering from a severe disability or advanced terminal illness?
A. Yes, but the public response to the interim guidelines published last year made clear that the inclusion of this factor discriminated against this group of people. Disability groups said such a factor allowed families of very ill people to assist in their deaths and might pressurise such individuals to acquiesce to their own deaths. The DPP appears to have agreed.
Q. Disability and anti-euthanasia groups must be delighted that this is no longer part of the criteria to be considered by prosecutors?
A. Not really. Campaigners argue that the only group of people targeted in this policy are the severely disabled or terminally ill. Any written guidelines would help those wishing to avoid prosecution by assisting in another's death.
Q. What happens next?
A. The controversy has led to concern that the DPP is being asked to do something that is the remit of Parliament. MPs have called for a full debate on the policy so that any changes can be legislated.
Q. Will this lead to the legalisation of mercy killing or a new law for assisted dying?
A. Probably not. Recent attempts to get an assisted dying law through Parliament have all failed.
Q. So British people will continue to travel to Switzerland to end their lives?
A. Yes. Despite Mr Starmer's attempt to clarify the law many will feel that the Dignitas model offers the best protection. More than 100 Britons have been assisted in their suicide in Swiss clinics. Not one has been successfully prosecuted.
Robert Verkaik
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