Intended for healthcare professionals

Education And Debate Taking the final step: changing the law on euthanasia and physician assisted suicide

Moral dimensions

BMJ 2005; 331 doi: (Published 22 September 2005) Cite this as: BMJ 2005;331:689
  1. Torbjörn Tännsjö, Kristian Claëson professor of practical philosophy (
  1. 1Department of Philosophy, Stockholm University, Stockholm, 106 91 Sweden
  • Accepted 6 July 2005

Doctors in the United Kingdom can accompany their patients every step of the way, up until the last. The law stops them helping their patients take the final step, even if that is the patient's fervent wish. Next month's debate in the House of Lords could begin the process of changing the law. To help doctors decide where they stand we publish a range of opinions


Western medicine is increasingly interested in the problem of euthanasia. There are two main reasons for this. One is related to the fact that modern medicine has prolonged not only our lives but also our period of dying. Modern medicine supports hastening death through withholding life supporting treatment or giving high doses of pain relief to those who are dying. Is this morally different from euthanasia? The second reason is the increased emphasis on respect for the patient's autonomy. Doctors have to abide by all sorts of requests from their patients. It is only natural, therefore, to wonder whether we have good reasons to decline a patient's request for euthanasia.

Public support for a system of euthanasia is high in Western countries. In surveys I conducted, as many as 63% of Norwegians, 79% of Swedes, and 68% of Germans thought that if a patient has an incurable disease and doesn't want to go on living, he or she should be allowed to receive a lethal injection (unpublished data). And yet, most doctors and politicians in most Western countries are strongly opposed to legalised euthanasia. Is there any plausible moral rationale behind their opposition?

Three principles

To consider this question I will examine euthanasia using three basic moral outlooks: deontology, basic moral (negative) rights, and utilitarianism (box). I have used sharply distinguished ideal types of these ideas. Of course, all sorts of compromise positions are possible between …

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