Quality of life and the right to die: an ethical dilemma.

In an increasingly 'patient-centred' health service individuals are demanding to make independent judgements about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide. The issues in the euthanasia debate usually revolve around patients who are terminally ill and/or suffering intractable pain. However, pain is not the only determinant of an intolerable existence and the problems become more complex when existential quality of life issues are the focus. This can lead to difficult decision making for the health workers involved in care. The paper uses a case study approach to examine the ethical and legal issues surrounding euthanasia. The dilemma under discussion involves a quadriplegic patient who wished to commit suicide by refusing nutrition. The discussion offered centres around the principles of beneficence, non-maleficence and autonomy in relation to whether it was morally or legally appropriate to intervene with this patient's wishes by artificial feeding. Conclusions and recommendations are offered.