ABSTRACT
This chapter examines the legitimacy of the distinction between specialist palliative care practices and euthanasia. It argues that a distinction can be made but the basis for this distinction is often precarious and influenced by subjective interpretation. The chapter also examines the application of the acts and omissions distinction in the context of specialist palliative care. It investigates legal and ethical justifications for specialist palliative care practices including proportionality, patient autonomy, double effect, and the acts and omissions distinction. The chapter provides greater insight into the practice of voluntary active euthanasia and physician assisted suicide than can be achieved from merely setting out the definition for these practices in a vacuum. It highlights the points of similarity that the legal and ethical justifications can be applied in a way which accurately addresses criticism. The chapter illustrates the complexity of palliative sedation without artificial nutrition and hydration.
