Assisted suicide: addressing legal dilemmas

drugs_pillsQuestions have been raised today about a man who received assisted suicide in Switzerland following a misdiagnosis. The court hearings of Final Exit Network (FEN) in the USA, although securing a victory for the FEN volunteer guides, relied in part on controversial legal acrobatics.

Should this make us put tighter restrictions on assisted suicide? Or should we be working to improve implementation by making cases more open, less restrictive – and in some ways – more permissive?

When assisted suicide is conducted against a backdrop of disapproval and distanced from the medical profession, mistakes are more likely to happen. The answer is not further to limit access to assisted suicide but to push forward with more comprehensive legislation.

The type of bill favoured by Exit is one crafted not by proponents or politicians but by legal experts after study and research. It separates responsibility for the patient’s ongoing health care from the responsibility for considering assisted suicide. (This is quite close to the way patients are protected when organ donation is being considered.) Next, it recognizes the limits of medical science. It requires the opinion of two registered medical practitioners, that the person is either a) terminally ill; or (b) in extreme physical or mental suffering. Doctors make mistakes, and end of life diagnosis is frequently uncertain. But there are standard ways in law to minimize uncertainty.

Pushing the practice underground (as it is in the American States where FEN operate), or to the province of fringe organizations (as in Switzerland) limits society’s ability both to serve the patient well and also instil the best possible safeguards.

Exit’s bill, a template produced by two of Scotland’s leading experts, Joseph Thomson and Sheila McLean,* can be found at Its generic format is adaptable for any legal system.

It might be a good idea if politicians, when drafting their bills to advance the cause of assisted suicide, would just occasionally listen to the best advice . . .   .


Note to readers: articles by Joseph Thomson and Sheila McLean can be found in EXIT Newsletter archives. See our main website.

*Joseph Thomson: Regius Professor of Law, member of the Scottish Law Commission, fellow of the Royal Society of Edinburgh, President of the Society of Public Teachers of Law, Editor of the Juridical Review (Scotland’s oldest law journal), and Author of many of the principal books upon which Scottish Law rests. *Sheila A.M. McLean, Emeritus Professor of Law and Ethics in Medicine, International Bar Association Chair of Law and Ethics in Medicine, Consultant to the World Health Organization and the Council of Europe, Member, BMA Ethics Committee, Audit Committee of the World Association for Medical Law, American Society for Bioethics and Humanities, Scottish Criminal Cases Review Commission, Multi-Centre Research Ethics Committee.


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