Cover -- Half-title -- Title -- Copyright -- Dedication -- CONTENTS -- PREFACE -- FOREWORD -- ACKNOWLEDGMENTS -- TABLE OF CASES -- ABBREVIATIONS -- Introduction -- PART I Definitions -- 1 'Voluntary euthanasia' -- 'Voluntary' -- 'Euthanasia' -- 'Euthanasia' as the active, intentional termination of life -- 'Euthanasia' as the intentional termination of life by act or by omission -- 'Euthanasia' as intentional or foreseen life-shortening -- Conclusions -- 2 Intended v. foreseen life-shortening -- Distinguishing intention from foresight -- Moral difference -- The principle of 'double effect' -- Double effect in traditional medical ethics -- Double effect in criminal law -- Annie Lindsell -- Dr David Moor -- Woollin -- Intended ends and intended means -- 'Catch-22' -- Conclusion -- 3 'Physician-assisted suicide' -- Conclusions -- PART II The ethical debate: human life, autonomy, legal hypocrisy, and the slippery slope -- 4 The value of human life -- 'Vitalism' v. 'sanctity/inviolability of life' v. 'Quality of life' -- Vitalism -- Sanctity/inviolability of life -- The prohibition of intentional killing -- Intention and foresight -- Acts and omissions -- The worthwhileness of treatment: its benefits and burdens -- Quality of life -- Distinguishing 'Quality of life' from 'quality of life' -- Illustrating the distinctions -- Mary's case -- Dr V(italism) -- Dr Q(uality of life) -- Dr I(nviolability of life) -- Angela -- Dr V -- Dr Q -- Dr I -- Conclusion -- 5 The value of autonomy -- The 'right to choose' -- Choosing what is right -- The purpose and value of autonomy -- The right to refuse futile or excessively burdensome treatments -- How autonomous? -- Conclusion -- 6 Legal hypocrisy? -- The current law -- VAE as murder -- Autonomy and the law -- Five criticisms of the current law -- Ineffective? -- Palliative care and euthanasia.

A right to commit suicide? -- A right to commit suicide by refusing treatment? -- Active and passive euthanasia -- Conclusion -- 7 The slippery slope arguments -- VAE in principle and in practice -- The nature of the slippery slope argument -- Empirical and logical slopes -- The empirical argument -- The logical argument -- Voluntariness -- 'Unbearable suffering' -- Conclusion -- PART III The Dutch experience: controlling VAE? condoning NVAE? -- 8 The guidelines -- The Dutch law -- 'Strict safeguards'? -- The guidelines -- 'Precisely defined' and 'strict'? -- The government bill -- Conclusion -- 9 The first Survey: the incidence of 'euthanasia' -- The Remmelink Report and the Van der Maas Survey -- The findings of the Survey -- Methodology -- The retrospective study -- The death certificate study -- The prospective study -- How much 'euthanasia'? -- VAE -- Other cases of 'euthanasia' -- 2,700 or 9,050? -- 'Dances with data'? -- Conclusion -- 10 Breach of the guidelines -- An explicit request -- An 'entirely free and voluntary' request which was 'well considered, durable and persistent'? -- 'Life-terminating acts without the patient's explicit request' -- Other cases lacking an explicit request -- Unbearable suffering and last resort -- Unbearable suffering? -- Last resort? -- Consultation and reporting -- Consultation -- Reporting -- Conclusion -- 11 The slide towards NVAE -- The Remmelink Report -- The KNMG -- Prosecutors -- Courts -- The speed of the slide -- Conclusion -- 12 The second Survey -- The data -- VAE and PAS -- Active termination of life without explicit request -- Intensification of pain and symptom treatment -- Withholding/withdrawing treatment -- Neonates -- Assisted suicide of psychiatric patients -- Consultation -- Reporting -- Analysing the data -- Incidence of VAE and NVAE -- VAE as an alternative to palliative care.

Widespread failure to report -- Conclusion -- 13 The Dutch in denial? -- Van der Maas and Remmelink -- Dutch diplomacy -- Death on Request -- The Dutch Ambassador -- Dr Van Delden -- Conclusion -- PART IV Australia and the United States -- 14 The Northern Territory: ROTTI -- ROTTI -- The patient's request -- The first doctor's opinion -- The second and third doctors' opinions -- Other conditions -- Palliative care -- Withdrawal of request -- Records and reporting -- Miscellaneous -- A vague and lax Act -- Precise? -- 'Terminal illness' -- Treatment 'reasonably available' -- 'In the course of a terminal illness' -- 'Treatable clinical depression in respect of the illness' -- 'Reasonably available' palliative care -- Strict? -- Summary -- The Act in practice: seven deaths in Darwin -- Conclusion -- 15 Oregon: the Death with Dignity Act -- The requirements of the Act -- Patients -- Age -- Residency -- Terminally ill -- Capable -- Request -- Physicians -- The attending physician -- The consulting physician -- Counselling -- Documentation and reporting -- Immunity -- Liability -- The least strict and precise? -- Precise? -- Strict? -- The Act in practice -- The first reported case -- The OHD reports -- The first report: practice in 1998 -- The second report - practice in 1999 -- The third report - practice in 2000 -- Conclusion -- PART V Expert opinion -- 16 Expert committees -- The House of Lords Select Committee -- The Special Committee of the Canadian Senate -- The New York State Task Force -- Conclusion -- 17 Supreme Courts -- The Law Lords -- The Canadian Supreme Court -- The US Supreme Court -- The Supreme Court opinion -- Glucksberg -- Quill -- State interests -- Justice Souter -- Souter's sources -- Professor Epstein -- Judge Posner -- Van der Wal -- Conclusion -- 18 Medical associations -- The British Medical Association.

The Canadian Medical Association -- The American Medical Association -- Conclusion -- PART VI Passive euthanasia: withholding/withdrawing treatment and tube-feeding with intent to kill -- 19 The Tony Bland case -- The facts -- The courts' reasoning -- From inviolability to Quality -- Tube-feeding: futile treatment or basic care? -- Misunderstanding the inviolability of life -- Responsible medical opinion: the 'Bolam test' -- A slippery slope? -- Misunderstanding autonomy -- From Quality to inviolability -- Explaining the shift from inviolability -- Applying inviolability -- Conclusions -- 20 Beyond Bland: the BMA guidance on withholding/withdrawing medical treatment -- Tube-feeding as medical treatment not basic care -- From inviolability to Quality -- The ethical alternatives -- Worthless treatments or worthless lives? -- Equal dignity and rights? -- Going beyond Bland ? -- From 'no awareness' to 'limited mental capacity' -- Imposition of the new ethic? -- Assisting suicidal refusals of treatment -- Law-led ethics? -- Conclusion -- 21 The Winterton Bill -- The bill -- Criticisms by the BMA and the government -- The BMA's criticisms -- The competent patient's right to refuse treatment -- The incompetent patient's best interests -- Complexity -- Two scenarios -- The government's criticisms -- The competent patient's right to refuse treatment -- The incompetent patient's best interests -- Purpose and intention -- Conclusions -- Conclusions -- AFTERWORD: THE DIANE PRETTY CASE -- BIBLIOGRAPHY -- INDEX.