China
Africa
Explore chapters and articles related to this topic
Patient autonomy and criminal law
Published in Paweł Daniluk, Patient Autonomy and Criminal Law, 2023
However, the so-called indirect active euthanasia, defined as the use of means to relieve suffering (palliative care), e.g., morphine, which may have the effect of shortening the patient's life, is generally regarded as permissible.48 Also, passive euthanasia in the sense of withholding life-sustaining medical treatment (either by not initiating treatment or by terminating it at some point) is not treated as a criminal offence, provided certain conditions are met.49 This kind of euthanasia is generally justified by the patient's will not to be kept alive. Assisting or inciting suicide is legally prohibited only in cases of selfish motives (Art. 115 CC). The law therefore generally allows assisted suicide, for example enabling a person to obtain the necessary lethal pharmaceuticals, which the person wishing to commit suicide then takes without any external assistance. This contrast in legislation between Switzerland and other countries, e.g., the United Kingdom, and the existence of several right-to-die organisations in Switzerland that provide help with any medical, administrative and social procedures related to the assisted suicide,50 has led to a phenomenon described by some as ‘suicide tourism'.51
Medically Assisted Death
Published in Gary Seay, Susana Nuccetelli, Engaging Bioethics, 2017
Beneficence provides another argument for PAS: namely, preventing harm to patients who travel abroad to obtain it because it is unlawful where they live. Patients from, among other jurisdictions, Britain, Australia, the USA, and until recently, Canada, engage in suicide tourism. Let’s look closely at the UK phenomenon. The ban on suicide in Britain was lifted by the 1961 Suicide Act, which also made aiding and abetting a suicide unlawful. This provision, however, is not without rationale, for the state also has a duty to protect vulnerable individuals from being persuaded or coerced into committing suicide. Such crimes, though rare, do sometimes occur. For example, in 2011 detection work by a crime-aficionado and retired teacher landed William Melchert-Dinkel, a Minnesota nurse, in prison, convicted of assistance in two suicides. He apparently used the Internet for pro-suicide ‘counseling’ of vulnerable individuals, effectively persuading at least two to commit suicide.
Introduction
Published in Jennifer Hardes, Law, Immunization and the Right to Die, 2016
In England, which also forms the focus of this book, the law has not been so lenient. The courts have thus far consistently decided that voluntary active euthanasia and physician-assisted suicide is to remain unlawful: there can be no “right to die.” While suicide was decriminalized in 1961 and in the 1990s a precedent was set in Bland that legalized “passive” euthanasia, the law still denies what it regards as “active” forms of assistance. This matter was most recently concluded in 2014 in a Supreme Court ruling on the case of R (Nicklinson & Lamb) v Ministry of Justice, R (AM) v Director of Public Prosecutions [2014] UKSC 38 25 June 2014. The court, led by Lord Neuberger, heard an appeal from Nicklinson, whose previous appeals had been denied, in association with Paul Lamb, another right to die appellant, alongside “Martin,” who sought clarity as to whether a care worker could assist with travel to Dignitas without fear of prosecution. The decision followed precedent set in a swell of earlier debates concerning the right to die that emerged in the early 2000s: Dianne Pretty’s appeal to physician-assisted death was denied in the early 2000s by both the English courts and on appeal to the European Court of Human Rights (see R (Pretty) v Director of Public Prosecutions [2001] UKHL 61; Pretty v The United Kingdom [2002] ECHR 427). However, there were also “grey areas” regarding assisted death that were explored and, when appealed, clarified and permitted. Such was the case of R (Purdy) v Director of Public Prosecutions [2009] EWCA Civ 92; R (Purdy) v Director of Public Prosecutions [2010] 1 AC 345 that led to the issuing of a 2010 policy document in which the Director of Public Prosecutions (DPP) outlined terms associated with likelihood of prosecution regarding those who would assist loved ones to travel to a destination where assisted death is legal without fear of prosecution in one’s home country. Some continue to regard this 2010 policy as unclear on certain matters; for example, Martin’s appeal in 2014 asked for clarity from the DPP regarding the likelihood that “strangers” such as care workers would be able to assist in travel to Dignitas. This appeal was, however, denied and it was noted that there was no reason to order the DPP to conduct a review based on Martin’s appeal. Rather it was noted in the case that “she [the DPP] will no doubt be considering this position in light of the decisions made in this Court and in the Court of Appeal” (R (Nicklinson & Lamb) v Ministry of Justice, R (AM) v Director of Public Prosecutions [2014] UKSC 38 25 June 2014, paragraph 323). As Lord Neuberger noted in this case, even without absolute clarity in the law regarding the likelihood of prosecution, before the case of Purdy from which the 2010 policy emerged, between 1998 and 2011, 215 British people travelled to Dignitas and none of those assisting this travel were prosecuted. Indeed, it is said that as many as a quarter of suicide cases at Dignitas, a well-known assistedsuicide clinic in Switzerland, are British: some are calling this “suicide tourism” (Gauthier et al., 2014).
Assisted Dying: More Attention Should Be Paid to the Epistemic Asset of Personal Experience
Published in The American Journal of Bioethics, 2023
Hui Zhang, Lihan Miao, Feifei Gao, Yongguang Yang, Yuming Wang
Approximately 100 million people (about 1.25% of the world’s population) have access to some form of assisted dying legislation (Sallnow et al. 2022). People travel to other countries to receive assisted suicide because their national laws do not permit such a procedure, which has given rise to the phenomenon of “suicide tourism.” According to the websites of six Swiss official right-to-die organizations, they assist in about 600 cases of suicide per year, of which “suicide tourists” account for 150–200 cases. A pilot study on assisted suicide showed that 611 suicide tourists from 31 countries around the world visited Switzerland for assisted suicide from 2008 to 2012. The majority of such tourists were from developed countries in Europe and North America, such as Germany, the UK, Italy, and the U.S., while very few came from Asia, Africa, and South America (Gauthier et al. 2015). As the whole process that begins with applying for assisted suicide lasts for months and the cost during the overall period is an enormous figure for these tourists, dying in a foreign country is not an accessible pathway for the majority of ordinary individuals. Indeed, in countries where assisted dying is illegal, the legalization of euthanasia and physician-assisted suicide is widely debated. There have been high levels of public support in some countries. For example, in recent cross-sectional studies, the majority of public participants in the UK (70%) and South Korea (76.4%) expressed positive attitudes toward the legalization of euthanasia and/or assisted suicide (Pentaris and Jacobs 2022; Yun et al. 2022).
Trends and characteristics in barbiturate deaths Australia 2000–2019: a national retrospective study
Published in Clinical Toxicology, 2021
G. Campbell, S. Darke, E. Zahra, J. Duflou, F. Shand, J. Lappin
Pentobarbitone was overwhelmingly the most common barbiturate. This is notable, as the drug is not commonly prescribed for human use in Australia. The current case series demonstrates that access to pentobarbitone appears to have facilitated increased prevalence of barbiturate-related deaths, with an approximate doubling of such deaths following 2010. There was a marked increase in internet-sourced barbiturates after 2010, supporting previous research of such practices occurring [26], with a minority of cases indicating international travel to obtain pentobarbitone, referred to as ‘suicide tourism’ [27]. For context, the total number of scripts for barbiturates in Australia, specifically phenobarbitone and primidone, reduced by half over the approximate same time period (from 49,997 prescriptions in 2001 to 26,553 in 2015 [28]. The high levels of substances other than barbiturates, and of respiratory depressants in particular, is worthy of note. Such a profile is typical of poisoning deaths more broadly [29]. In such cases, it is likely to be the cumulative effects of multiple drugs that cause death, with the relative contribution of individual drugs not able to be determined.
Human exposures to veterinary pharmaceutical products reported to Australia’s largest poison information centre
Published in Clinical Toxicology, 2019
Claire E. Wylie, Rose Cairns, Jared A. Brown, Nicholas A. Buckley
Despite previous attention to PIC exposures regarding tilmicosin and xylazine, only three and one exposures were reported, respectively. With the increasing trend of “suicide tourism”, defined as “the practice of travelling to a foreign destination to commit suicide”, pertaining to pentobarbitone (a companion animal euthanasia agent also referred to as pentobarbital) [25,39], it is prudent to highlight the 13 reported cases, of which 3 were intentional self-harm and 10 were veterinary practice unintentional exposures (1 to vapours, 4 needlesticks and 5 dermal/ocular exposures during injection).