Literally meaning the procuring of an easy and painless death, euthanasia (or ‘mercy killing’) has come to be understood as a deliberate act or omission whose primary intention is to end another person’s life. The qualiﬁers ‘voluntary’, ‘involuntary’ and ‘non-voluntary’ are used to indicate the degree of patient involvement in the decision. Much debate has centred on whether individuals should be entitled to manage their own death or appoint others to do so for them (voluntary euthanasia). UK public-opinion surveys appear to indicate substantial support for such a proposal but this partly reﬂects the way in which the issue is broached. Predictably, if the choice is portrayed as one between euthanasia and an inevitably drawn-out, painful or distressing death, many agree that competent, terminally ill patients who ask for euthanasia should be helped to die. Diﬃcult issues arise, however, when attempts are made to set limits and safeguards. This has generally been seen as a major stumbling block to any proposal to change the law prohibiting euthanasia in the UK. Such pragmatic rather than ethical or legal arguments were a key feature of the conclusions of the House of Lords Select Committee on Medical Ethics in 1994. There has also been much debate about whether euthanasia should attract a lesser penalty than other forms of murder which carry a mandatory life sentence. Nevertheless, in the UK, killing a person intentionally is still classiﬁed as murder, even if that person consents to the killing.
Most of the detailed information available about the practice of euthanasia comes from the Netherlands, where court rulings in the 1970s and 1980s began to permit voluntary euthanasia under certain circumstances (although both euthanasia and assisted suicide remain technically illegal). The diﬃculty of maintaining limits was highlighted in 1994–5 when it became clear that a small percentage of Dutch patients undergoing euthanasia had previously expressed an interest but not speciﬁcally requested it (involuntary euthanasia) or had no known desire for it and may have been opposed to it (non-voluntary euthanasia). The relevance of terminal illness and physical suﬀering was tested in Holland in 1994 when a patient received euthanasia who was not physically ill and subject to mental rather than physical suffering. Nevertheless, Dutch doctors risk prosecution if they fail to follow rules of careful conduct when carrying out euthanasia or assisted suicide. (See also ETHICS; SUICIDE.)