Letter: Euthanasia: definitions, the Dutch example, dignity, and a judge's words

Sir: Your leading article on voluntary euthanasia and the Nigel Cox case (21 September) expresses a viewpoint that, although common, is not universal. You support what is technically known as passive euthanasia, when life-sustaining treatment is ended or withheld and the patient is allowed to die. But you conclude that active voluntary euthanasia - when the doctor actively ends a patient's life - should remain unlawful.

What is the real moral difference between these practices? The Institute for Medical Ethics Working Party on the Ethics of Prolonging Life and Assisting Death stated that:

When the intention and outcome of killing and letting die are equivalent (in each case a good intention and a fatal outcome), then the circumstances become a crucial factor in the moral evaluation of killing and letting die.

Indeed, there is a strong case for arguing that actively ending life is more ethical, since death is guaranteed to be quick, easy and dignified - exactly what everyone wants. On the other hand, when treatment is withheld and a patient is simply allowed to die, that death is not necessarily quick or easy. Nor, under current practice of passive euthanasia, does the patient always consent.

The most important point is whether the individual involved asks for help to die. And, despite your fears to the contrary, people do know their own minds on the matter. It is patronising and paternalistic to assume that anyone else does not know what is really best for them.

Yours sincerely,

JOHN OLIVER

General Secretary

The Voluntary Euthanasia

Society: Exit

London, W8

23 September