If Mrs Pretty was permanently and severely incompetent, and if her doctors believed that medical treatment could provide no benefit because of her inability ever to engage in self directed activity, then legally they could withdraw life sustaining treatments. Yet, she cannot invite them actively to end her life and to advise them about how this should be done.
This decision becomes all the more morally questionable when we realise that Mrs Pretty can refuse life sustaining treatment at any time, and her doctors are legally obliged to respect her choice, say the authors. If it can be morally right to allow some competent patients to die at their own request, then it must be morally justified to give them the medical wherewithal to kill themselves, they reason.
It is open to debate whether what Mrs Pretty requires can best be described as voluntary euthanasia or physician assisted suicide, say the authors. To provide either of these to appropriate patients who make a competent request represents respect for their autonomy and their desire to die with what they perceive to be dignity, they conclude.
Editorial: Why active euthanasia and physician assisted suicide should be legalised BMJ Volume 323, pp 1079-80