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GPs given right to assist patient suicide

By Gareth Iacobucci

GPs will be permitted to help patients commit suicide in mitigating circumstances under controversial new guidelines.

The guidance from director of public prosecutions Keir Starmer is intended to clarify the legal position for families and friends of terminally ill patients, but also applies to doctors and nurses, who will be able to choose if they are free to help patients die.

But medical defence experts warned the guidance, which has not changed the law, may not protect GPs from prosecution.

The guidelines outline 13 mitigating factors that should mean no charges being brought, including if the victim expressed a clear wish to commit suicide, asked for assistance in killing themselves, had a terminal illness or a severe and incurable physical disability; or a severe degenerative physical condition.

Other factors weighing against legal action are if those assisting were wholly motivated by compassion, the victim was physically unable to undertake the act that constituted assistance, and if the act of assistance or influence was judged to be relatively minor.

However, the guidance said prosecution would be more likely if the suicide victim was under 18 years old, the victim's capacity to make an informed decision on suicide was affected by illness or learning difficulties, or if the victim did not have a terminal illness, nor a severe and incurable physical disability nor a severe degenerative physical condition.

Cases would also be more likely if the victim had not unequivocally indicated a wish to kill themselves, or had not personally asked for assistance.

But the Medical Defence Union (MDU) warned GPs that the guidance does not change GPs' position.

MDU solicitor, Ian Baker, said: ‘It is important to recognise that nothing in the DPP's guidance changes the law in any way, neither does it give a guarantee that prosecution will not take place. The guidelines have no application to the GMC which may decide to investigate a doctor's fitness to practise whether or not a prosecution is brought.'

The issue caused huge controversy earlier this year, when the BMA passed a motion opposing the legalisation of assisted suicide at its annual representatives meeting. The RCGP is also known to be opposed to any change to the law, but the Royal College of Nursing recently switched its stance to adopt a neutral position on the issue.

The BMA welcomed the clarification, but said it had not altered its opposition to any change to the current law.

A BMA spokesperson said: ‘The BMA supports clarity in the law and we hope today's guidance will be of benefit to patients and families who are facing very difficult decisions about how to deal with end of life issues.

‘However, the guidance does not impact on the BMA's policy on assisted suicide in that we remain firmly opposed and are not seeking any change in UK legislation on this issue.'


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