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Guidelines and Policies

End of Life Care and Decision Making Guidelines [PDF]    NSW
NSW Health
Guidelines set out a process of decision making in regards to end-of-life.


Crimes Act 1901 (NSW) ss18, 31C NSW
Legislation prohibiting intentional or negligent killing, manslaughter and assisted suicide.

Euthanasia Laws Act 1997 (Cth) Cth
Act to repeal the Northern Territory legislation that had legalised assisted suicide. Revoked the Legislative Assembly’s power to enact laws permitting assisted suicide.

The Rights of the Terminally Ill Act 1995 (NT) [PDF]   NT
NT introduced legislation legalising assisted suicide. It was repealed by the Cth Euthanasia Laws Act 1997 (Cth)

Toolkits and Protocols

Euthanasia and End-of-life Issues

Euthanasia and Physician Assisted Suicide – Do the Moral Arguments Differ
British Medical Association

Human Rights and Euthanasia
Australian Human Rights Commission

Physician-Assisted Suicide
University of Illinois College of Medicine

Position Statement on Voluntary Euthanasia [PDF]    NSW
NSW Nurses Association

Responding to patient requests relating to assisted suicide: guidance for doctors in England, Wales and Northern Ireland
British Medical Association

Voluntary Euthanasia and Physician Assisted Suicide: Position Statement of Palliative Care Australia [PDF]
Palliative Care Australia
Position of Palliative Care Australia on euthanasia and physician assisted suicide.


Airedale National Health Service Trust v Bland [1993] AC 789 UK
Withdrawal of treatment is not assisted suicide.

R v Adams (Bodkin) [1957] Crim Law Rev 365  UK
not on bailii
Outlines the principles of the doctrine of double effect.

R v Maxwell [2003] VSC 278 Vic
Accused was found guilty of assisting his wife to commit suicide. Was given a suspended sentence of 18 months imprisonment.

R (on the application of Nicklinson) v Ministry of Justice [2012] EWHC 2381 (Admin) UK
The case involved two claims for judicial review brought by disabled patients for a declaration that necessity was a defence to homicide if the homicide was an act of voluntary euthanasia. Toulson LJ (Royce and Macur JJ concurring) felt that necessity could not be expanded to include voluntary active euthanasia. Such a decision could only be made by parliaments, not courts.

R v Nicol [2005] NSWSC 547 NSW
The accused received a suspended sentence after pleading guilty to the manslaughter of his wife. The accused killed her with a metal bar after she had asked to be ‘put out of her misery’. The wife had recently had her legs amputated and was in constant pain.

DPP v Karaca [2007] VSC 190 VIC
A suspended sentence for attempted murder was imposed where friends were asked by the victim to kill him with an iron bar should his attempt at overdosing himself fail. The friends tried and failed to kill him with the metal bar and then gave themselves up to the police.

DPP v Nestorowycz [2008] VSC 385 VIC
The defendant pleaded guilty to attempted murder after stabbing her husband (and then herself). The husband had been placed in a nursing home after becoming immobilised with diabetes. Nestorowycz was sentenced to two years and nine months’ imprisonment but the sentence was wholly suspended.

DPP v Riordan (unreported, VSC, Cummins J, 20 November 1998) VIC
Cummins J sentenced a man to a three-year good behaviour bond after he unsuccessfully attempted to kill his wife and himself. The wife lived in a nursing home and had advanced dementia. The husband had been a totally devoted carer.

Martin v R [2005] NZSC 33 NZ
The Supreme Court of New Zealand upheld a conviction for attempted murder against a woman who had killed her mother, for allegedly compassionate reasons.

R v Nielsen [2012] QSC 29 QLD
A man received effectively six months’ imprisonment for travelling to Mexico for the purpose of acquiring Nembutal and then providing it to his friend to enable the friend commit suicide. The friend died soon after. The friend was ill but was not terminally so. The accused had been made the beneficiary of the deceased’s will. The deceased thought himself to have suffered a stroke, but the evidence suggested that this was not the case. The judge was critical of the haste to which the accused went about supplying the drug and the fact that the accused had a financial interest in the suicide.

R v Jemielita (1995) 81 A Crim R 409 UK
The deceased died pursuant to a suicide pact whereby the accused gave an injection of a substance to the victim, which could only cause death when taken with another drug. The accused injected the first drug but the victim ingested the second and subsequently died. The accused’s actions were still considered as the cause of death because the accused had foresight that the final step was going to be taken by the victim.

Attorney-General v Able [1984] QB 795  UK
The supply of drugs can be considered to constitute homicide. The Attorney-General brought a civil action against the members of a voluntary euthanasia society. A declaration was sought that the conduct of the defendants in publishing a booklet which outlined how to commit suicide effectively was unlawful. The book’s aim was to reduce people’s fear of dying and to reduce the incidence of unsuccessful suicide. Evidence was presented which suggested that 15 cases of suicide were associated with the booklet. The declaration was refused on the grounds that it could hinder future conduct which may not have been criminal. Woolf J outlined the elements of the offence of aiding and abetting suicide.

R v Hood [2002] VSC 123 VIC
Where the accused had assisted his ex-lover to commit suicide by buying a large packet of panadeine, which was then consumed by the deceased, along with other drugs and alcohol. The evidence suggested that this had had no effect on the cause of death, which was from combined drug toxicity, namely, codeine, morphine paracetamol, diazepam and temazepam. The judge took this into account when sentencing Hood to an 18 months’ suspended sentence for assisting a suicide.

Carter v Attorney-General (Qld) [2012] QSC 234 QLD
The applicant had been convicted of murdering one drug addict and of assisting the suicide of another. The addicts had requested help to die from the applicant. The applicant mixed heroin and directly injected the heroin into one of the victims, who then died. For this the applicant was convicted of murder. The other victim inserted the needle into his own arm and got the applicant to push down the plunger. This resulted in a conviction for assisted suicide. The applicant had sought a pardon from the Governor, and a review of the case by the Attorney General, but both requests had been denied. The applicant then sought judicial review of these decisions. Wilson J dismissed the application and found specifically that there was no error in the conviction for murder, as the applicant had directly contributed to the death of the victim.

R v Justins [2008] NSWSC 1194 NSW
The accused was the de facto partner of Graeme Wylie, a retired airline pilot who had been diagnosed with Alzheimer’s disease. Justins, and her friend Jennings, made arrangements for Jennings to go to Mexico to procure nembutal (also known as pentobarbitone) for the purpose of killing Wylie. Justins also took Wylie to his solicitor to have his will changed so as to substantially increase her beneficial interest. Issues arose about Wylie’s capacity. Howie J gave written instructions to the jury about the elements for when a person has the legal capacity to commit suicide. A jury found both Justins and Jenning guilty of manslaughter after the prosecution refused to accept their offer to plead guilty to the crime of assisting suicide. Before being sentenced, Jenning killed herself. Justins was sentenced to 30 months’ periodic detention (with a 22-month non-parole period).

Justins v R [2010] NSWCCA 242 NSW
Justins successfully appealed the conviction. Both Spigelman CJ and Simpson J (with Johnson J agreeing) found that, while it was necessary to frame the issue of the cause of death around competence, the trial judge’s directions regarding capacity had gone too far. The issue of Mr Wylie’s capacity was an issue of fact and Howie J’s directions elevated the factual issue into a legal issue which usurped the proper role of the jury. Justins’ conviction was quashed and a new trial ordered.

R v Justins [2011] NSWSC 568 NSW
Latham J found Justins guilty of aiding and abetting a suicide. Latham J took into account the time she had already served in prison and sentenced her to the rising of the court (meaning that she was free to leave after the judge left the room).

Stuart v Kirkland-Veenstra (2009) 237 CLR 215 Cth
The High Court found that, while there was a power to prevent self-harm, there was no common law duty to prevent others from self-harming. The power conveyed to police to use force to prevent suicide did not also convey a duty to prevent a person from self-harming.

Pretty v Director of Public Prosecutions and Secretary of State for the Home Department [2001] UKHL 61 UK
The House of Lords reaffirmed that medical treatment may be administered to a terminally ill person to alleviate pain although it may hasten death, as long as the outcome was foreseen but not intended.

Re Baby D (No 2) [2011] FamCA 176 Cth
Double effect reasoning was recognised in this case concerning a premature twin who have been given ventilatory support using an endotracheal tube. The parents sought an order that the tube be removed and that no further life-saving treatment be provided. They also wished the court to order that B could be sedated to relieve her pain and distress during the procedure, even though this would increase the chances of death. The judge agreed that parents could authorise the removal of the tube and the sedation of Baby D on best interests grounds and that such a decision could be made by parents without judicial review. The judge found that terminal palliation was permissible under the ‘double effect’ principle.

R (on the application of Nicklinson) v Ministry of Justice [2012] EWHC 2381(Admin) UK
The case involved two claims for judicial review brought by disabled patients for a declaration that necessity was a defence to homicide if the homicide was an act of voluntary euthanasia. The court refused to grant the application because Toulson LJ (Royce and Macur JJ concurring) felt that necessity could not be expanded to include voluntary active euthanasia.

Local Authority v Z [2004] EWHC 2817 (Fam) UK
The case concerned Mr and Mrs Z. Mrs Z had cerebella ataxia, a condition which attacks the body’s motor functions. The condition is terminal, incurable and irreversible. Mrs Z had unsuccessfully attempted suicide through paracetemol poisoning and later expressed her desire to go to Switzerland to be euthanised. Her family initially were opposed but later came to support her decision. The local authority came to know of Mrs Z’s decision and investigated whether she was a vulnerable person in need of protection. A social worker for the authority believed that she was competent but also expressed concern that for her decision to be carried out she would need the help of her husband and this might be a criminal act. Hedley J found that that Mrs Z was competent and that the Suicide Act 1961 (UK) did not prohibit her committing suicide.

R (Purdy) v Director of Public Prosecutions [2009] UKHL 45 UK
Debbie Purdy, a woman with multiple sclerosis, was contemplating suicide overseas but wanted to know more about whether her husband, Omar Puente, would be prosecuted for helping her travel. Purdy argued that the DPP breached her human rights by failing to provide a list of criteria that would be considered in the determining of who would be prosecuted for assisting a suicide. The DPP responded with a policy that was subjected to a consultation process. The policy lists a number of factors which will make a decision to prosecute more likely, including that ‘the victim did not have the capacity (as defined by the Mental Capacity Act 2005 (UK)) to reach an informed decision to commit suicide’ (Director of Public Prosecutions 2010).

Papers, Reports and Books

A modern myth: that letting die is not the intentional causation of death: some reflections on the trial and acquittal of Dr Leonard Arthur
(1984) Journal of Applied Philosophy 1(1) 21-38
Author: Helga Kuhse
Argues that, in the situation of a doctor treating a patient, the moral and legal difference between letting die and intentionally causing death is a myth, that in some cases intentionally causing death may be the morally preferable option.

Accompaniments to suicide per year and residence [PDF]
Dignitas (2011)

Angels of Death, Exploring the Euthanasia Underground
Melbourne University Publishing 2002
Author: Magnusson, Roger
Provides an account of assisted suicide in Australia.

Euthanasia, Ethics and Public Policy: The value of human life
Cambridge University Press 2002
Author: Keown
Introduction to the issues surrounding the legalising of euthanasia and, in particular, the slippery slope argument.  It surveys the literature on the topic, provides case studies and considers relevant guidelines.

Life’s dominion : an argument about abortion, euthanasia, and individual freedom
Author: Ronald Dworkin
This book provides an insight into why abortion and euthanasia spark such controversies within our society. Looks at moral viewpoints behind the issues and the legal status of human life.

Legal and ethical aspects of refusing medical treatment after a suicide attempt: the Wooltorton case in the Australian context
Ryan, CJ and S Callaghan (2010) 193(4) Med J Aust 239-42.

Managing intentions: the end-of-life administration of analgesics and sedatives, and the possibility of slow euthanasia
Douglas, C, I Kerridge, et al (2008) 22(7) Bioethics 388-96.

Policy for Prosecutors in Respect of Cases of Assisted Suicide 2010 UK
Director of Public Prosecutions.

Presidential Address: Is the Sanctity of Life Ethic Terminally Ill?
(1995) Bioethics 9(3) 327-343
Author: Peter Singer
Investigates the issues arising from our ability to keep human beings alive and its effect on the sanctity of life ethic. Argues that there is a shift towards an ethic that is more about preserving the life that is worth living rather than just human life in general. Also looks at when doctors may intentionally end the life of a human being.

Survey results – attitudes to voluntary euthanasia 2011
The Australia Institute (2011)

The intention to hasten death: a survey of attitudes and practices of surgeons in Australia
Douglas, CD, IH Kerridge, et al (2001) Med J Aust 175(10) 511-15.

The legislation of active voluntary euthanasia in Australia: will the slippery slope prove fatal?
J Med Ethics. 1996 Oct;22(5):273-8

The Principle of Double Effect and Terminal Sedation [PDF]
(2001) Med Law Rev 9(1) at 41
Author: Glenys Williams
Article assesses the usefulness of the principle of double effect in the context of terminal sedation.

Voluntary Euthanasia and the Common Law
Clarendon Press 1997
Margaret Otlowski
Summary of the legal position on euthanasia in several common law countries and an exploration of the possibility of reform.

WHO Definition of Palliative Care
World Health Organization (2012)

News Reports

Euthanasia: Australia’s missing human right
Independent Australia

Time Capsule: Euthanasia pioneer
The Australian

Timeline: Terri Schiavo case
BBC News

Italian man sparks euthanasia row
BBC News


Assisted Sucide in Oregon

Assisted suicide on TV for first time

Case Ramón Sampedro – assisted suicide of a quadriplegic person  
Video 1
Video 2

Death debate: Should euthanasia be legalised?

Dying Man Opposes Assisted Suicide

Euthanasia – our right to choose the time to die Australian democrats

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