Medico-legal risk in assisted suicide

The risks faced by doctors who assist in a suicide have been set out for the first time in a new policy from the Director of Public Prosecutions.

The final Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide makes it clear that doctors risk prosecution if they help a patient end their life. It marks a change from the previous draft policy because it specifically states that a prosecution is more likely if a suspect was “acting in their capacity as a medical doctor, nurse, other healthcare professional.”

In light of the new guidelines, MDDUS is advising members to act with extreme caution when providing information or advice to patients who may be considering suicide. This includes the provision of factual medical reports and even medical records.

The policy clearly states that it applies to the encouragement or assistance, in England and Wales, of “any suicide or attempted suicide anywhere in the world”. It lists a number of factors in favour of prosecution. Doctors are specifically singled out in this section unlike in the interim policy which only referred to a suspect “acting as a paid carer in a nursing home” as a factor in favour of prosecution.

It is worth noting that one of the factors listed against prosecution is that the suspect had sought to dissuade the victim from taking the course of action which resulted in his or her suicide. MDDUS believes doctors would therefore be expected to actively try to dissuade a patient they considered was planning suicide.

MDDUS senior medico-legal adviser Dr Gail Gilmartin said: “In view of the very clear terms of this policy, we would advise members not to provide a factual medical report requested by patients to be used in the process of arranging a suicide. We would also advise caution in circumstances where a doctor knows of a patient’s suicidal intentions and they request copies of their medical records under the Data Protection Act. We advise members to get in contact with us for specific advice on the case.

“The policy clearly singles doctors out and because of that we would advise doctors to act more cautiously. If a patient explicitly mentions they are planning a trip to a clinic such as Dignitas in Switzerland, and they request a medical report or copies of their medical records, we would advise members not to comply and to seek advice from MDDUS. In cases where the doctor only suspects a patient is considering suicide and receives a request for a report they should again seek advice from MDDUS.”

ACTION: Act with extreme caution and seek advice from MDDUS before providing medical reports or medical records if you have concerns that a patient is planning or considering ending their life.

Dr Susan Gibson-Smith, medical adviser, MDDUS