J R Soc Med. 2018 Nov;111(11):407-413. doi: 10.1177/0141076818803452.

Euthanasia and assisted dying: what is the current position and what are the key arguments informing the debate?

Fontalis A1, Prousali E2, Kulkarni K3.

Author information

1

1 St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK.

2

2 Aristotle University of Thessaloniki, 54124 Thessaloniki Greece.

3

3 University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.

Abstract

Assisted dying is a highly controversial moral issue incorporating both physician-assisted dying (PAD) and voluntary active euthanasia. End-of-life practices are debated in many countries, with assisted dying receiving different consideration across various jurisdictions. In this paper, we provide an analytic framework of the current position and the main arguments related to the rights and moral principles concerning assisted dying. Assisted dying proponents focus on the respect of autonomy, self-determination and forestalling suffering. On the other hand, concerns are raised regarding the interpretation of the constitutional right to life and balancing this with the premise of assisted dying, alongside the impacts of assisted dying on the doctor-patient relationship, which is fundamentally based on trust, mutual respect and the premise of 'first do no harm'. Our review is underpinning the interpretation of constitutional rights and the Hippocratic Oath with the premise of assisted dying, alongside the impacts of assisted dying on the doctor-patient relationship. Most clinicians remain untrained in such decision making, with fears against crossing key ethical divides. Due to the increasing number of cases of assisted dying and lack of consensus, our review enables the integration of ethical and legal aspects and facilitates decision making.