The change in guidance on the law on assisted suicide is a momentous breakthrough in the campaign for patient choice and dignity at the end of life.
For the first time, there is formal recognition that, in certain circumstances, people should not be prosecuted for helping someone to die. This is something that society wants, that common sense demands – and that those patients, families and loved ones facing tough choices deserve. It is a sensible, compassionate policy that balances the need to prevent fears of a duty to die and the reality of the current law, which forces a duty to suffer.
But what does it actually mean for patients and their families facing this desperate dilemma? Most importantly, it means that an area of the law, previously grey and confused, is now clear and transparent. Those who assist a suicide must be "wholly motivated by compassion" and the patient must have made an independent and informed decision to commit suicide. These are essential safeguards. It is also crucial to give patients access to a range of options at the end of life – including assisted suicide – allowing them to exercise true patient choice.
It also means that patients at their most vulnerable are protected. The guidance makes a clear distinction between those who compassionately assist and those who maliciously encourage. If it means prosecution for those who coerce or act with dubious motives, that can only be good for the protection of vulnerable people.
And it also reflects public opinion, while underlining the huge shift in society's view on end-of-life choice since the 1961 Suicide Act. The public do not want to see the prosecution of those who assist loved ones to die out of compassionate motives. Even those who oppose assisted suicide agree that people who act out of compassion shouldn't be hauled through the courts.
Even before yesterday's guidance was published, the Director of Public Prosecutions, Keir Starmer QC, chose not to prosecute the families who had accompanied loved ones abroad to die – because it was not "in the public interest". Yet the threat of prosecution still hung over these families. And people like Debbie Purdy were unwilling to take the risk of their families assisting them abroad to die if they could face up to 14 years imprisonment. They sought clarity in the face of the law. Under what circumstances could people be prosecuted? Why were some people investigated and others not?
Crucially though, these guidelines do not change the law. That is a job for Parliament. They do not provide a safeguarded means for people to end their life if their suffering becomes unbearable. To that extent, people will still take and make decisions behind closed doors, and we will continue to export a moral problem abroad.
We need a change in the UK law to reflect the policy steer that this new guidance gives – because this interim policy still represents retrospective prosecution rather than up front safeguards. A change in British law would address that anomaly; protecting the vulnerable and promoting patient choice within a legal framework. It would cement the commonsensical, compassionate approach that Keir Starmer has clearly exercised.
The author is Chief Executive of Dignity in Dying