ABSTRACT
We have seen in the previous chapter that in some cases people are allowed to choose to die – in part by characterising the act bringing about that death as an omission. However, the requests of other competent people to have their choice for an assisted death will not be respected as long as assisted dying is unlawful. I have proposed that there is in reality no difference between requests for the termination of life-sustaining treatment and those for an actively assisted death: neither in terms of intention nor in causation. Therefore, the rationale for the legal distinction between these cases must be highly dubious and the justifi cation for differential treatment is absent. Of course, it might be said, the real difference rests on respect for the sanctity of all life; that by removing treatment we are simply ‘letting nature take its course’. However, this argument, as I have suggested, fails to convince. In any case, a mere glance at the reality of end-of-life decisions is suffi cient to demonstrate that we do not in fact always respect the sanctity of all life, and this is true not only in situations where the person refuses treatment but also where the person cannot express an opinion about life and death either because of their clinical condition or because of their age.
