Introduction

Two widely publicised medicolegal cases in the United Kingdom1 2 have prompted renewed debate about the moral and legal validity of providing assistance to die (box 1).3 The debate has been fuelled by publication of the report of a House of Lords select committee set up to consider the Assisted Dying for the Terminally Ill Bill4 and final determination by the US courts that hydration and nutrition could lawfully be withdrawn from a patient in a persistent vegetative state.5 6

Proposed legislation

The UK bill provides for a competent adult who has resided in Great Britain for at least one year and is suffering unbearably as a result of a terminal illness to receive medical assistance to die at his or her considered and persistent request (box 2). The bill also incorporates various qualifying conditions and safe-guards to protect the interests of patients and clinicians.

The proposed change should be supported as a matter of both principle and practicality. As a matter of principle, it reinforces current trends towards greater respect for personal autonomy.7 It also provides a logical extension to the well established principle in English law that competent adults are entitled to withhold or withdraw consent to life sustaining treatment.8 Some people would argue that because assisted dying introduces new intervention—the drug used with specific intent to procure death—it is different from allowing death by withholding or withdrawing …