The right to life does not just mean the right to exist, but implies the right to a minimum level of life, says Professor of Philosophy Anthony Grayling. That minimum includes the right to be "as free as reasonably possible from distress and pain."

If an individual feels that their life is being lived below that minimum quality, they also have the right to end their life - and by extension to have medical assistance to achieve this painlessly, he argues.

In most countries people attempting suicide are not prosecuted if they fail an acknowledgement of an individual's freedom to end their lives. Capable patients refusing medical treatment or those who draw up living wills - advance directives for doctors should a patient become incapacitated - are also exercising a right to die, says Professor Grayling.

The same right becomes more difficult to apply when the decision to withdraw life prolonging treatment falls to a third party - for instance when the patient is incapacitated and there is no living will. If there is disagreement among third parties, the decision must be made by the courts as dispassionate adjudicators, says the author, since "political and religious sentiments may obscure the interests of the patients in such cases."

More problematic is an individual seeking medical help to end their lives. Doctors and lawyers distinguish between withholding treatment, which results in death, and giving treatment to cause death. But both involve the decision to end life, and so are effectively the same, argues Professor Grayling. Any distinction between the two is fictitious, he concludes.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
7-Apr-2005