As was acknowledged from the outset, active voluntary euthanasia is a notoriously complex and controversial issue. This work is by no means the last word on the subject, but simply a contribution in a vast debate which is developing at an accelerating pace and becoming increasingly prominent.
On the basis of the analysis in the foregoing chapters, certain conclusions can be drawn. It is clear from the analysis of the criminal law in Chapter 1 that there is a sharp distinction in the law's approach to passive and active euthanasia. Whilst the law recognizes the patient's right to refuse treatment and permits passive euthanasia in certain circumstances, active voluntary euthanasia is unequivocally prohibited in most jurisdictions as murder regardless of the special mitigating circumstances usually existing in such cases.1 Further, as was explained in Chapter 2, a doctor who actively assists a patient to commit suicide will be criminally liable for the offence of assisting suicide irrespective of the special circumstances.2 However, a doctor may lawfully comply with a patient's request for the withholding or withdrawing of life-saving treatment which will result in death: although the patient's conduct may in fact constitute a form of suicide by omission, the courts have rejected this characterization, albeit on spurious grounds, and have thus been able to hold that the issue of assisted suicide is not implicated in these circumstances.
Notwithstanding the present legal prohibition on active voluntary euthanasia and doctor-assisted suicide, substantial evidence has been put forward in Chapter 3 from all common law jurisdictions under consideration which indicates that doctors are already involved in these practices. However, this conduct is largely hidden and doctors are very rarely prosecuted for performing active voluntary euthanasia or assisting the suicide of their patients. From the experience to date, there is every possibility that if a prosecution does arise in a genuine case, the doctor would escape the full rigours of the criminal law. However, as the prosecution of Dr Cox in the____________________