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A right to die?
Did Tony Bland, and the infants C and J have a right to die? No such right is articulated in the US Constitution, or the United Nations Declaration on Human Rights, or the European Convention on Human Rights. Before returning to such cases of non-voluntary euthanasia, the so-called 'easy' case of voluntary euthanasia should be explored. If the willing patient may not be killed at his express request, clearly no other category of patient can be said to have a right to be killed. But, if a competent patient freely and fully understanding the consequences of her choice wishes her life to end, what business is it of the law's to interfere with her autonomous choice?
As later chapters will illustrate, in practical terms a right to die may well depend on the accident of exactly what kind of condition precipitates a patient's wish to die. A competent patient generally enjoys an absolute right to refuse further treatment. A person with terminal cancer can decide when enough is enough and prohibit further surgery or chemotherapy. Any imposition of unwanted treatment will constitute assault, however genuinely his doctors believe that the patient might benefit from continuing treatment. In England at least, no patient has to justify rejecting even life-saving treatment. 'It matters not whether the reasons for refusal were rational, or irrational, unknown or even non existent9 .' Moreover patients can ensure that they control the stage at which treatment should cease even when that point arrives at a time when they are no longer able to communicate their wishes. Advance directives already have legal force in common law jurisdictions, even where no specific legislation yet exists. Providing there is unequivocal evidence that a certain mode of treatment was prohibited by the patient, it is as much assault to impose that treatment on the now unconscious or incompetent patient as to force similar treatment on an actively protesting individual
In circumstances where refusing further treatment effects a person's wish to die, he enjoys a right to die. However injury or disease may result in disability or suffering the patient finds intolerable, yet life looks set to continue. The terminally ill patient may regard the likely 'natural' termination of her life as too long delayed. Her desire to die encompasses a wish for immediate death, a demand to be killed. If a competent patient freely seeks to exercise such a choice that cannot be violation of his right to life? And what of other fundamental human rights?
The European Convention, albeit it nowhere touches on a right to die, establishes other rights pertinent to the patient who desires to die. No one may be subjected to torture or to inhuman or degrading treatment or punishment11 . Does there come a point when continued existence equates to degrading treatment? Is 'life' sustained via tubes feeding you and tubes evacuating bowels and bladder equivalent to torture when imposed on an unwilling patient? Such may well be the case, but the right not to be subjected to degrading treatment does no more than reinforce the right to refuse further or continuing treatment. What of the right to privacy12?

Might it be contended that so long as a competent patient who freely makes a choice to die can find a willing accomplice to effect an act that were he capable of carrying out himself would not be criminal, it is an invasion of privacy to interfere with that choice. If suicide is permitted society has accepted the individual's right to choose to end her life. It may seem unjust to deny that right to those so ill or disabled as to be incapable of doing so independently
In those jurisdictions who as yet refuse to lift the prohibition on active killing, the justification for the consequent denial of choice to the patient is often thought to rest on what has been judicially described as 'society's interest... in upholding the concept that all human life is sacred'13 . Does a doctrine of sanctity of life still command support today? And are there perhaps other, more pragmatic, grounds for the law's unease about active euthanasia?