The Reality of Assisted Dying: Understanding the Issues

PART 1 Context 
1 Introduction
Ilora Finlay and Julian C. Hughes 
2 Polling on assisted suicide: the misuse of public opinion 
Andrew Hawkins 
3 Voluntary euthanasia and physician-assisted suicide: seven prominent but weak arguments for legalization
John Keown 


PART 2 Global perspectives 
4 Assisted dying: the evidence from abroad
Conall Preston 
5 Making euthanasia legal in the Netherlands: implications for the doctor-patient relationship 
Cees Hertogh 
6 The Dutch experience: from the perspective of lifelong disability 
Irene Tuffrey-Wijne and Leopold Curfs 
7 The rapid expansion of euthanasia and assisted suicide: the view from Canada 
Ramona Coelho and Leonie Herx 
8 Assisted dying in Aotearoa New Zealand: a victory of politics over informed debate?
Sinead Donnelly, Peter Thirkell, John Kleinsman and Wendi Wicks 
9 The Australian perspective 
Frank Brennan, Adrian Dabscheck and Leeroy William 


PART 3 Law 
10 Read the question!
Robert Preston 
11 Safeguards - what safeguards? 
Robert Preston 
12 Reviewing prosecution policy on assisted suicide and 'mercy killing' in England and Wales 
Alexandra Mullock 
13 Assisted dying - the capacity complexities
Alex Ruck Keene 
14 A journey through the contested territory of assisted dying: how law can go wrong - and right
Richard Huxtable 


PART 4 Medical and palliative care issues 
15 Physician-assisted suicide for psychiatric disorders: pros and cons(equences) John Maher 
16 Challenges in diagnosis and prognosis
Fiona MacCormick 
17 Palliative care: need, provision and evidence
Katherine E. Sleeman and Lesley E. Williamson 
18 Sedation at the end of Life 
Katherine Frew and Paul Paes 
19 Should assisted dying be part of mainstream health care?
Suzanne Ost and Nancy Preston 
20 De-medicalization: why we should completely separate assisted dying from health care and what this would achieve 
H. Lucy Thomas 
21 The enigma of lethal drugs 
Claud Regnard 


PART 5 Safety and vulnerable groups 
22 Disability - a duty to die? 
Tanni Grey-Thompson and Flora Klintworth 
23 People with intellectual disabilities and autistic people
Sheila Hollins and Alice Firth 
24 Vulnerable lives - euthanasia in the newborn and paediatric populations 
John Wyatt
25 Older people and those living with dementia 
Julian C. Hughes 
26 The euthanasia paradox - free choice or coercion? 
John Maher 


PART 6 Philosophical and ethical concepts 
27 Autonomy and assisted suicide 
Onora O'Neill 
28 Dignity, quality of life and the care of the dying
Daniel P. Sulmasy 
29 The imperative to prevent suicide and not to encourage or assist it
David Albert Jones 
30 Instability of eligibility criteria for assisted death and its implications Scott 
Y.H. Kim 


PART 7 Faith and no faith 
31 The place of religion in the public debate about assisted suicide
Nigel Biggar 
32 Assisted suicide: an Islamic perspective
Abdul-Azim Ahmed 
33 Assisted dying: a Jewish perspective
Alexandra Wright 
34 The Humanist case against assisted suicide and euthanasia 
Kevin Yuill

“This is a book to be read by all involved in either side of this heated debate.”
Dr C Fourcade, President of the French Association for Palliative Care, France

"This powerful collection of essays brilliantly unpacks the legal, ethical and practical issues around the assisted dying debate.”
Jonathan Herring, Professor of Law, University of Oxford, UK

“This is an essential exploration of the complexities behind the sound bites.”
Baroness Campbell of Surbiton DBE, UK

“A much needed, timely compendium covering the main issues underlying and surrounding Assisted Dying.”
Robert Twycross, Past Head, WHO Collaborative Centre for Palliative Care, Oxford, UK

"Wherever your views lie on … assisted dying, you should read this book.”
Dr Matt Morgan, Professor of Intensive Care, Cardiff University, UK, and Curtin University, Australia

At a critical moment in the UK debate, this book provides up-to-date reflections from a broad variety of international experts on the profoundly important issues that surround changes in the law in any jurisdiction in connection with assisted dying and considers the realities that surround such changes.

The Reality of Assisted Dying covers all the important issues in the debates about assisted suicide and euthanasia. This includes thoughts on the role of the law, discussion of important philosophical and ethical concepts, investigating the various issues that arise in the practice of medicine and palliative care, and scrutinizing concerns about definitions, coercion, consequences and safety.

This book:

• Provides up-to-date data, evidence and reflections from professionals from countries where assisted dying has been legalized;
• Takes a fresh look at the arguments around legalization of assisted dying;
• Shows how a change in the law must take account of all those who will be affected, including families and those who will feel compelled to participate by assisting suicides or performing euthanasia;
• Shows the problems and dangers of embedding assisted dying within healthcare, and explores how alternative socio-legal procedures would improve legitimacy and monitoring for patients and their families.

The book is relevant to a variety of intellectual disciplines and to political and social debates both in the UK and internationally, as well as being of interest to general readers and students studying the many relevant subjects, from medicine, to law, sociology, politics, philosophy and ethics.

Julian C. Hughes has studied and been a professor of both philosophy and of old age psychiatry. He was an NHS consultant in old age psychiatry and served as deputy chair of the Nuffield Council on Bioethics, UK. His most recent book was Dementia and Ethics Reconsidered, published by Open University Press.

Ilora G. Finlay is a Crossbench Peer in the House of Lords, an honorary professor of palliative medicine at Cardiff University, UK, past President of the BMA and the Royal Society of Medicine. A founder director of Living and Dying Well, she co-authored Death by Appointment and led on legislation to encourage the availability of palliative care for all.