This commentary explores the background to, and implications of, the recently published Director of Public Prosecutions guidelines for prosecutors in respect of cases of encouraging or assisting suicide. It considers the extent of the provisions and questions the legitimacy of their focus on the compassionate motivation of the assistant, and the apparent prohibition on healthcare professionals providing such help. It concludes by suggesting that a permissive change in the law would provide better safeguards for those who seek assisted dying.

Neither the English courts nor the National Health Service (NHS) have been immune to the modern mantra of patient choice. This article examines whether beneath the rhetoric any form of real choice is endorsed either in law or in NHS policy. I explore the case law on ‘consent’, look at choice within the NHS and highlight the dilemmas that a mismatch of language and practice poses for clinicians. Given the variance in interpretation and lack of consistency for the individual patient (...) I argue for a semantic change that obviates the use of ‘choice’, focussing instead on the options for treatment that are available and accessible, with due acknowledgement of individual patient preferences, without raising unfettered and false expectations. (shrink)