Tidying things up can make them worse. That is the worry about Keir Starmer's valiant attempt yesterday to clarify the law on assisted suicide. The Director of Public Prosecutions had no choice, of course. His hand was forced by the House of Lords, following Debbie Purdy's historic legal victory in winning the right to determine the timing and manner of her own death.
Ms Purdy, who has multiple sclerosis, wanted to know what would happen to her husband if he helped her to end her life. In particular she wanted to know if he would face prosecution if he accompanied her to the Dignitas clinic in Switzerland. When she won her appeal before the Law Lords last July, she expressed her relief with the striking phrase "We have got our lives back". But what works in her favour may not work in favour of others.
The huge public interest in – and concern over – assisted suicide is reflected in the 5,000 submissions Mr Starmer received in response to his interim guidelines, published in September. On the one hand, many are worried at the prospect of their relatives, or themselves, facing the end of their lives in increasing pain or disability with no prospect of release. On the other, many fear that elderly, sick or disabled people may come under subtle pressure from relatives or friends who stand to gain financially or in other ways to take the quick way out.
Mr Starmer's final guidelines have been modified, to put more focus on the motivation of the suspect – whether they sought to dissuade the victim, whether they acted wholly out of compassion and whether, in the final instance, they offered "reluctant" encouragement in face of the patient's determined wish. On the patient's side, they now need not be terminally ill or disabled (to avoid charges that this would make people with a progressive or disabling condition more vulnerable) but must require assistance to commit suicide.
These are helpful amendments but they do not address the central concern that a clarified law may do more harm than good. When Ms Purdy won her case last summer we questioned her description of the ruling as a "huge step towards a more compassionate law". In principle, clarity in the law is highly desirable, essential even. But there are instances – and difficult ethical issues are among them – where exactitude can be more of a hindrance than a help.
In recent weeks, a series of cases has come to light highlighting the difficulty of framing a law that will liberate people in Ms Purdy's position without bringing inappropriate pressure on others or giving rise to perverse judgments that match the spirit but not the letter of the law.
In one case a permanently disabled woman pleaded for help to end her life before a change in her circumstances – the development of a new friendship – altered her view and convinced her of the value of remaining alive. In another case, a man who helped his disabled wife to die admitted that he could not be certain whether she had asked for assistance out of concern for herself, or for him.
Even campaigners who have backed Ms Purdy privately fear that the clarified law could backfire by making it more likely that prosecutions will be brought. Equally, there are dangers in reversing the presumption that aiding someone to end a life prematurely is a bad thing.
The law is a blunt instrument for deciding such delicate issues. Whatever it says, the wise exercise of discretion will be critical.
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