First appeared in The Times Saturday 19th October
A new bill for the terminally ill has been proposed by the Labour MP Kim Leadbeater. Three former directors of public prosecutions explain why they back it
Three of the country’s top prosecutors have united to back a change in the law to allow someone who is terminally ill to end their life.
Sir Max Hill, Dame Alison Saunders and Lord Ken Macdonald of River Glaven, who have all served as director of public prosecutions (DPP), have revealed their support for a landmark bill to legalise assisted dying for terminally ill adults.
The lawyers, who all considered potential charges in assisted suicide cases during their tenures, said the experience led them to conclude that the existing law was not fit for purpose.
LUCY NORTH/PA
Kim Leadbeater introduced her bill, Choice at the End of Life for Terminally Ill Adults, last week
Hill, who led the prosecution service between 2018 and 2023, said there had been no “groupthink”, and that all three former DPPs had arrived at their decision independently. He added: “I think there’s the real force, the fact that we’ve all reached the same conclusion, because that is genuinely borne by our experience across almost three decades now.”
It comes days after Kim Leadbeater, the Labour MP for Spen Valley, introduced her bill, titled Choice at the End of Life for Terminally Ill Adults. A debate and vote, which could usher in one of the greatest social changes in the UK since the Abortion Act 1967, will take place on November 29. MPs will be given a free vote.
Assisted suicide — intentionally helping another person to end their life — is currently illegal, and carries a maximum prison sentence of 14 years. This includes helping someone to die both in the UK and overseas.
Sir Keir Starmer, when he served as DPP between the tenures of Macdonald and Saunders, issued guidance indicating that anyone acting with compassion to help end the life of someone who had decided they could not go on would be unlikely to face criminal charges.
The advice lists a range of factors that will be taken into account when deciding if a prosecution is appropriate or not, including whether the victim reached a “voluntary, clear, settled and informed” decision. There is particular emphasis on the motivation of the suspect: they would be expected to have acted “wholly compassionately” and not for financial reasons.
That has not stopped people from being investigated by the police. From April 1, 2009 to March 31, 2024, 187 cases were referred to the Crown Prosecution Service by the police that have been recorded as assisted suicide, according to records held by the Dignity in Dying campaign group. Of these, 127 were not proceeded with by the CPS and 36 cases were withdrawn by the police.
There are currently six active cases. Four cases of encouraging or assisting suicide have been successfully prosecuted; one case of assisted suicide was charged and acquitted after trial in May 2015; and eight cases were referred onwards for prosecution for murder or another serious crime.
Between 2009 until the end of 2023 there have been 464 assisted deaths of Britons at Dignitas, the Swiss suicide clinic. In addition, it is estimated that up to 650 terminally ill people a year take their lives in the UK — some with assistance — as well as many more that go under the radar.
The text of the bill has not been published, but its long title states that it would “allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life”. It is expected to propose that assisted dying be restricted to mentally competent adults with six months or less to live, although a 12-month prognosis is also a possibility.
The prime minister, who cared for his seriously disabled mother Josephine as she suffered from Still’s disease, has previously backed a change in the law. Speaking in March, when leader of the opposition, he said: “I personally think the law should be changed. There will be people equally passionate, with powerful points to make about why it shouldn’t be.”
• Read more: How soon could assisted dying become legal in the UK?
Tom Baldwin’s biography claims Starmer was motivated to act by the case of a young rugby player, Daniel James, who turned out for England as a teenager and looked set for a professional career until a scrum collapsed on him while training for Nuneaton.
Paralysed from the chest down, he travelled to Dignitas with his parents to end his life.
‘I was in floods of tears’
Alison Saunders took over as director of prosecutions after Sir Keir Starmer’s tenure in 2013. She served until 2018
TIMES PHOTOGRAPHER BEN GURR
Alison Saunders remembers bursting into tears when the first assisted suicide case she had been asked to review crossed her desk.
“It was so emotional,” she said. “I ended up sitting there in floods of tears, thinking, oh my God, this is so awful to have to advise on. I remember quite vividly reading the first one and thinking I need to shut my door, because I had to compose myself.”
The barrister, 63, said the case was “not untypical”, adding: “It was somebody who knew that they were very ill. They were pretty much bedridden and had been suffering for a long time.”
Subsequent cases tended to follow a similar pattern. “They had been pleading with their loved ones to help because they couldn’t do it all themselves. There had been this ongoing debate. Nobody in the family wanted to do it — but, equally, nobody wanted the suffering to continue. And eventually the family members sort of succumbed and assisted. It’s a horrible situation to be in.”
Saunders said there was often a “very clear and very definite wish to end a life”, with notes and even videos left to try and ensure loved ones were not prosecuted. But the story never ended there.
“[The family] has gone through this whole trauma of should they or shouldn’t they be helping and then the police come round, and the next thing they know they’re being interviewed at the station and the case is referred to the Crown Prosecution Service. With the best will in the world, all of that takes time. I think it’s just pretty ghastly, the whole thing.”
The barrister said assisted dying was not an issue she had ever been called to deal with, or “thought deeply” about, prior to becoming DPP. “I was lucky, nobody in my family’s been in that position at all. Nor have I known people who were in that position — or if they were, they didn’t share.”
But after reading several cases Saunders felt increasingly uncomfortable about the position she was being put in. In October 2014, she amended her department’s prosecution policy under the 1961 Suicide Act, making it less likely that healthcare professionals would be charged.
“I remember being quite uncomfortable that we were having to deal with this rather than it being a parliamentary thing, where elected officials could debate it,” she said. “The DPP isn’t an elected official with the resources of parliament to consult in that way and debate it.”
It was only after leaving the role that she realised how many people the issue affected.
‘The application of the law is discriminatory’
Lord Macdonald of River Glaven, DPP from 2003 to 2008, said his personal experiences with the issue had had a “profound impact” on him
TIMES PHOTOGRAPHER TOM PILSTON
Lord Macdonald of River Glaven believes the existing law surrounding assisted suicide is a “real mess”.
He said the “discretion” exercised by prosecutors only helped a “small subset of people” and was “discriminatory” to those who cannot afford to spend thousands of pounds travelling to Switzerland. Although it is still illegal to help someone end their lives overseas, the guidance means that prosecution is less likely than in cases of assisted suicide in Britain. There is also a perception that terminally ill people who cannot afford that will be less able to end their lives in the UK.
The barrister, 71, said the Supreme Court tried to alleviate this by asking us to publish guidelines, but this obliges prosecutors to tell people how to break the law. “In other words, if you break the law this way, we won’t prosecute you. If you break it that way, we will.”
He added: “We’ve got ourselves into this real mess where the application of the law is discriminatory and prosecutors are making law by deciding there’s a category of case they won’t prosecute. In the meantime, a lot of people are suffering very ugly deaths. So I think that the whole situation is just grim at the moment.”
He has had “one or two personal experiences” that had “quite a profound impact” on him. “Thinking back over the cases I looked at, not only wasn’t it in the public interest to prosecute these people but fundamentally, deep down, I just couldn’t believe they’d done anything wrong,” he said. “And I don’t think the criminal law should be penalising people who haven’t done anything wrong. And by wrong, I mean morally wrong. I didn’t think they made a bad moral choice.”
The peer said one of the primary reasons for not prosecuting people was that it was felt juries would believe they “had no real choice” and would not convict.
He added: “We’ve read the statements about the medical conditions these people were suffering — and I underline the word ‘suffering’. We’ve read of cases where death was going to occur anyway in a few weeks and people were in an unbearable situation. And we’ve read the statements of the people who took them to Switzerland and I think it’s no surprise that the foremost senior officials on the prosecution side, who have considered these cases at the highest level, have all come to the same conclusion.”
He said the law needed to keep pace with social change. “It was only in the early Nineties that it was finally decided [in law] that a man could rape his wife. We used to hang children for stealing. The law has to catch up, otherwise it can’t retain public confidence.”
‘Compassionate acts of love’
Sir Max Hill was DPP from 2018 to 2023. He prosecuted just one person in the 27 assisted dying cases he oversaw
TIMES PHOTOGRAPHER JACK HILL
Sir Max Hill pressed charges against one individual involved in an alleged assisted dying case.
“Of the 27 that I personally, anxiously and carefully considered, there was only one in which a charge was appropriate,” he said. “It involved young people aged under 20. In that case, the teenager who was charged pleaded guilty and was sentenced to a term of imprisonment. But in the other 26 cases, I would say that half represented families who had supported a terminally ill close relative in their decision to have their life ended at the Dignitas clinic, and half represented those who, whether for lack of money or any other reason, have seen the life of a terminal relative draw to a close in this country.
“In all of those cases, when I looked at the details, they involved a settled, clear and evidenced decision to bring a terminally ill life to a close.”
The assistance given ranged from booking a plane ticket to leaving a capsule of tablets within reach of someone who could not remove a tamper-proof lid. “In none of those cases did they represent improper hastening of the end of life. Still less did these represent murder. They were entirely compassionate, reluctant acts out of love, often for a lifelong partner. And one of the questions I ask now is whether it’s right that in those cases the compassionate, loving, lifelong partner should have to remain under threat of prosecution for many months, if not years.
“The answer seemed clear to me and clear to my predecessors that these were not truly criminal cases.”
Hill says he was not a campaigner for legal change as DPP but, since leaving, and looking at draft legislation in Scotland, the Isle of Man and Guernsey, as well as statements from the prime minister and Esther Rantzen, who has terminal lung cancer, he wanted to intervene.
“It seemed to me that who better than the former directors of public prosecutions to at least come forward to assist the debate, and, more importantly, to help parliament, which is in a unique position here,” he said.
The barrister added that presently the DPP alone is trying to “steer the right course between those cases that are murder or manslaughter, those that do represent the criminal offence of assisted suicide, and those where there should be no criminal charge at all. That, it strikes me, is one way of placing a heavy burden on a single public official.”
