helenjoyce

This is the really tricky question, isn't it? Some disabled groups are totally set against any notion of doctor-assisted dying. They feel very, very strongly that writing in law anything that suggests someone might respond to their very difficult physical circumstances by wanting to die is a huge insult to everyone else with similar conditions. Like saying their lives are less worthwhile. Others - including the wonderful Steven Fletcher, a Canadian MP I interviewed who's quadriplegic and authored a bill on assisted dying - feel that this is again about agency. His life, his choice. You can read his op-ed on our website: http://www.economist.com/node/21656111 Highly recommended. On the mental health problems - this is also very hard, we agree. But there are already very hard decisions on mental capacity - for example when someone is 'sectioned' as we say in Britain - judged too mentally ill to be competent, and therefore in need of protection and medical help - or with Alzheimer's. Quite simply, if someone isn't competent to consent, they can't have doctor-assisted dying. Because killing them without their consent is - well it's murder. On the people who are depressed - we need cooling-off periods. Mandatory counselling. Lots of support. Most depressed people become well again and are glad they are alive again. We all want that. But if someone's will is settled, they are judged mentally competent, they've waited, they've tried everything else - with a heavy heart, this may be what they want. I feel really, really sad writing this. Like many of you here who are thinking about this topic, I've been touched by this personally.

Hey there. The Hippocratic Oath is obviously central to the medical profession - but in its original wording it's not taken any more. And it has been reshaped before. For example it originally precluded abortion. And strictly, if you're not going to administer poison, you can't administer morphine for pain relief in high enough doses to ease end-of-life pain - it also shortens life. But a more meaningful answer is this: as medical technology has developed, it's enabled us to extend life but sometimes at a quality that the person living it doesn't want to endure. Doctors are trained to 'fight disease' and 'fight death' - but death, always, always wins in the end. The wisdom to know when to lay down weapons can shade into the wisdom to beat a tactical retreat. Does that make sense? I should say that as the editor responsible for this story - and our leader - I've been living this topic now for months. So many colleagues came and told me moving stories. And several told me of their parents' or spouses' deaths, and those terrible final days. When there was no hope whatsoever left of healing. But still the doctor is there, and still the doctor has a role.

Hey Duxal, great question for our first one! Doctor-assisted suicide is legal in some places - notably a few American states and Switzerland - this is giving someone a lethal prescription to take themselves. Voluntary euthanasia - actually administering the lethal drug - legal in others, Belgium and the Netherlands. (Involuntary euthanasia, ie killing someone against their will, is something very, very different...) Some people make a big distinction - perhaps they feel voluntary euthanasia is easier to slip into involuntary euthanasia, or they feel troubled by the idea of the doctor actually killing someone... We at The Economist feel that the central moral point is about agency, consent and capacity to consent. And of course if you insist someone takes a lethal draught themselves, you make it impossible for very severely incapacitated people. That includes some of the most vociferous campaigners, like those with motor neurone disease. If they have to take the drug themselves they may die earlier than they would otherwise wish - which for me is the bigger moral issue.

I think this is one of those topics where people feel that the answer is obvious - whether they're for or against. So I feel so strongly 'for' that it's hard for me to see the logic in against! But I listened really, really carefully and did my level best. Ilora Finlay, the president of the BMA, wrote us an op-ed explaining why she's against: http://www.economist.com/node/21654933 which you might find interesting. The argument that worried me most was that by making it legal you 'suggest' to people that they might want to do it. You 'suggest' that they might ask their doctor about it. In many countries doctors have such huge authority. That was certainly what Baroness Finlay felt. On the other hand, the doctor's role is changing - more of us feel that we're in the driving seat and we turn to the doctor for help and advice, but in the end we decide. So in the end, though troubled by that thought, we decided the harm of leaving doctors trying to drag out people's last, sad, painful days, fighting against death when the battleground - ie the individual patient - would prefer the battle was abandoned, outweighs this risk. Hope that makes sense...

Hi m0q, could you expand? Thanks so much!