Tomlinson-Online - Suicide and the Law

This book investigates the law’s approach to suicide in England and Wales. It explores the seismic shift in perceptions of the law’s role in respect of suicide from imprisonment as a punishment for attempting suicide, to courts hearing arguments about whether there is not only a right to suicide but also a right to assistance in suicide. This development stands alongside a global recognition of suicide prevention as a public health priority. In this book, the dual priorities of respect for autonomy and the protection of human life are recognised as equally important and the legal issues surrounding suicide in a range of different contemporary contexts, including suicide in prison and juvenile suicide, are considered. The book also investigates what the relationship between mental health and suicide means for its legal regulation, and evaluates the enduring legal offence of assisted suicide, particularly in the context of the terminally ill. It is argued that a more refined approach to the topic of voluntary death should be recognised in the law; one that distinguishes more clearly between autonomous decision-making about the end of life, and incapacitated self-caused risks to life that require effective preventative interventions.

1. Suicide: Definitions and Conceptual Approaches I. Defining Suicide A. Why Define? B. Self-caused Death C. An Intention to Die II. Different Conceptions of Suicide A. The Moralistic View B. The Sociological View C. The Medical Model D. The Rights View E. The Consequentialist View III. Conclusion 2. The History of the Law against Suicide I. Historical Background II. Punishment of Suicide in English Law III. The Insanity Exception A. The Pivotal Role of Coroner’s Juries B. Life Insurance Suicide Exclusion Clauses IV. The Nineteenth-century Removal of the Penalties for Suicide V. The Development of the Offence of Attempted Suicide VI. A Medical or Social Problem: Treatment not Punishment VII. Conclusion 3. The Legalisation of Suicide I. Impetus for Legalisation A. The Treatment Concern – The Mental Health Act 1959 B. The Religious Objection – The Church of England’s ‘Ought Suicide to be a Crime?’ Report C. The Political Perspective – Parliamentary Interest in the Issue D. The Legal Issue – The Criminal Law Revision Committee’s Report 1960 E. Conclusion II. Parliamentary Passage of the Suicide Bill A. House of Lords B. House of Commons III. Suicide in the Courts aft er 1961 A. Suicide Pacts B. The New Statutory Offence of Assisted Suicide IV. Changing the Wording of the Offence V. Legal Duties to Prevent Suicide VI. Conclusion 4. Suicide and Mental Health I. Suicide and Rationality A. Can a Suicidal Person have Capacity? B. Can Suicide Ever be a Rational Choice? C. Implications for Suicide Prevention and the Law II. Current Legal Framework: The Use of Mental Capacity and Mental Health Laws to Prevent Suicide A. Overview of Mental Health Laws for Preventing Risk of Suicide B. Application of Mental Capacity Laws for Preventing Risk of Suicide C. Problems with Both Mental Capacity and Mental Health Laws in the Suicide Context D. A Refined Legal Approach with Capacity at its Core III. Conclusion 5. Suicide in Detention and the Human Rights Obligations to Prevent it I. Suicide in Detention II. Suicide in Detention and the Right to Life A. Assessment of Suicide Risk B. Preventative Steps and Reasonableness III. Suicide in Detention and Degrading Treatment IV. Suicide and Autonomy in Detention V. Suicide, Detention and Vulnerability VI. Conclusion 6. Suicide of Children and Young Persons I. Suicide and the Young II. Young People, Autonomy and Choices about Dying A. Judicial Approaches to Children who Choose to Die B. The Meaning of Autonomy and Capacity in Relation to Young Persons’ Choices to Die C. Seeking a Principled Basis for Overriding a Young Person’s Choice to Die III. Responding to Suicide Risks in Young People IV. Conclusion 7. Suicide and Refusal of Treatment at the End of Life I. Refusing Life-sustaining Medical Treatment and Suicide II. Is Respecting a Choice to Die Assisting a Suicide? III. Is there a Duty to Prevent Suicide at the End of Life? IV. Conclusion 8. Assisting and/or Encouraging Suicide I. The Current Offence of Assisting Suicide A. The Assisted ‘Dying’ Challenge B. Prosecutorial Tolerance of Assisting Suicide C. The Ongoing Judicial Struggles with Assisted Dying D. Conclusions on the Current Offence II. Encouraging Suicide – Using the Criminal Law to Protect Human Life III. Legalising Assistance with a Capacitated Voluntary Death IV. Conclusion 9. Conclusion and Recommendations I. ‘Suicide’ and the Law – Changing the Label, Recognising the History II. Capacity to Choose to Die – The Key to the Law’s Proper Ambit III. Suicide Prevention in Context IV. A Call for Reform of the Criminal Offence V. Applying the Current Law and Preventing Suicide