Euthanasia and assisted suicide Euthanasia and assisted suicide are hugely controversial subjects. Dr Trisha Macnair looks at the arguments for and against, and explains the current medical and legal positions in this country and abroad.

In this article

Definitions Arguments for and against

Voluntary euthanasia Assisted suicide

The legal position

In the hundred years since Victorian times, attitudes to sex and death have completely reversed. In those days death was much discussed and celebrated as a normal part of daily life while sex was virtually unmentionable. Now the reverse is true - sex is open for wide discussion while death has become the great taboo.

Perhaps this is one of the reasons why the way in which we leave this world is a subject that brings out intense emotion and often anger. And nothing seems to raise the debate to more fevered levels than the idea that each of us may choose the time and place of our death. Not many people sit on the fence on the issue of euthanasia or assisted suicide - most have fairly strong beliefs that they're either morally right or morally wrong.

A variety of terms are used to describe the intentional termination of life. Euthanasia itself is said to be derived from the Greek, euthanatos, which means a gentle and easy death, but this hardly sums up what euthanasia is about. Killing in the name of compassion, or mercy killing, are other terms given to euthanasia.

In the Netherlands, euthanasia is understood to mean termination of life by a doctor at the request of a patient. The Dutch government doesn't turn a blind eye to it. There, the question of whether and how criminal liability for euthanasia should be restricted has been the subject of broad political and public debate for the past 30 years.

There are plenty of arguments against sanctioning euthanasia

There are plenty of arguments against sanctioning euthanasia. For instance, how can we be sure a person really wants to die and isn't being taken advantage of, for financial reasons, for example?

On the other hand, shouldn't people enduring unbearable suffering as part of terminal disease be allowed to relieve their agony and bring forward their inevitable death?

You can hear both sides of the argument from organisations with opposing views. Those in support include the Dignity in Dying, Exit, and the World Federation of Right to Die Societies. Those who believe euthanasia to be dangerous or wrong include the International Anti-Euthanasia Task Force, Care Not Killing and Euthanasia.com.

You can see more of the arguments for and against, at: http://www.bbc.co.ukreligion/ethics/euthanasia/.

Voluntary euthanasia simply emphasises that the choice to die has been made voluntarily by the person in question, rather than imposed on them by legal or social rules. However, opponents of euthanasia often argue that it can be very difficult to be sure that someone's request is truly voluntarily made. For example, an elderly person requiring expensive healthcare may feel that they're such a burden to relatives that they should request euthanasia. There's also a risk that people being treated with powerful painkillers or cancer drugs may not be in a sufficiently clear state of mind or competent enough to make an informed and balanced judgement.

In assisted suicide, it's the person who dies who takes the final action to end his or her life, but this action relies on the help or assistance of another (for example, to provide the means of death), compared with euthanasia where the other person actually performs the killing.

Many don't like the word 'suicide' because it brings to mind impulsive and often dramatic acts. The term self-deliverance is being increasingly used instead by those who feel suicide is an inappropriate term to describe the action taken, for example, by someone whose suffering cannot be relieved. But to others, including the law, it's the same as suicide.

A survey found that more than 50 per cent of doctors were in favour of a change in the law to allow physician-assisted suicide in some circumstances, such as extremes of suffering. Opinion polls consistently show that more than 80 per cent of the British public also support it.

The law is clear about euthanasia in this country: it's illegal and has never been sanctioned.

However, according to a report in the British Medical Journal, a considerable number of doctors are already acceding to requests for active voluntary euthanasia. They're breaking the law, albeit in the belief that they are acting in their patient's best interests.

In the Netherlands, euthanasia is now covered by the Termination of Life on Request and Assisted Suicide Act (January 2002) which amends the criminal code - so that while euthanasia is still a criminal offence, doctors are exempted from liability if they report their actions and show they've satisfied certain criteria. Find out more about the Act at the website of the Netherlands Ministry of Foreign Affairs.