ABSTRACT
The previous chapter has shown that, although some terminally ill patients who forgo life-sustaining treatment clearly do intend to die, the courts have simply decided that this has nothing to do with suicide. However, if it is accepted, as has been argued, that some treatment refusals are suicidal, must it also be the case that doctors who withdraw life-sustaining treatments are helping some patients to commit suicide? This conclusion is problematic because, ideally, one would not want it to be said – bearing in mind the essence of a doctor’s role – that medical professionals are aiding and abetting/assisting their patients’ suicides. Unfortunately, however, there would appear to be no real means by which this conclusion can be avoided or remedied. One could argue perhaps that a patient’s consent negates any duty of care, but a patient cannot consent to his own death (or at least he cannot consent to his death by positive means). Similarly, saying that withdrawing treatment is an omission does not help because (a) withdrawing treatment can equally be described as an act and (b) even if it is an omission, suicide and, some would argue,1 aiding, abetting and assisting suicide can be carried out by virtue of an omission. As such, treatment withdrawal by the doctor can be a cause or at least the part cause2 of the patient’s death. Similarly, claiming
the absence of intention cannot avoid the conclusion either because often, both the patient and the doctor’s clear intent can be that the patient dies. In fact, the intention required for accessorial liability, as will be explained below, is both complex and confusing in so far as the intention required by the principal and the accessory are different. This chapter again therefore examines the role of intention and causation, but in the context of the accessorial role a doctor would play in aiding and abetting/assisting suicide.
