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Euthanasia and free speech in Ireland

BMJ 2009; 338 doi: (Published 27 May 2009) Cite this as: BMJ 2009;338:b2109
  1. Len Doyal, emeritus professor of medical ethics, Queen Mary, University of London
  1. l.doyal{at}

    I have long argued that both non-voluntary and voluntary euthanasia should be legalised under conditions that are strictly regulated.1 2 3 Indeed it can be said that doctors already practise a form of euthanasia when they withdraw or decide not to initiate life sustaining treatment for severely brain damaged patients. In so doing they are taking positive steps to end lives that they (and others) deem to be of no further benefit to the patients concerned. The moral good inherent in such actions needs to be recognised and embraced. However, because non-voluntary euthanasia is illegal in the United Kingdom, the death that is then clinically managed may be slow and distressing. It is this reality that lies at the heart of the case for the legalisation of active non-voluntary euthanasia.

    Competent and terminally ill patients can already make decisions about the burden of continued life when they refuse life sustaining treatment. But again they may still face a needlessly slow death without dignity. Hence I and many others argue that the law should be changed so that these patients are legally permitted to request and obtain a quick ending of life, from caring doctors who are willing to provide this help. The consequences …

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