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Despite the major advances in medicine and palliative care witnessed by the last century, many patients, even in affluent Western nations, still die in pain and distress. Some entreat their doctors to put an end to their suffering either by killing them or by helping them to kill themselves. In almost every country in the world, a doctor who complies with such a request commits the offence of murder or assisted suicide and faces a lengthy term of imprisonment and professional disgrace. Yet many people think it should be lawful for a doctor to end a suffering patient's life on request, either by administering a lethal injection or by assisting the patient to commit suicide. Organisations campaigning for legal reform, such as the Hemlock Society in the USA or the Voluntary Euthanasia Society (VES) in the UK, are not proposing that a doctor should be allowed to kill patients whenever he feels like it. Mindful of the obvious and gross abuses which might follow were doctors given a completely free hand, such organisations typically propose that doctors should be allowed to end life only if the patient is competent to make a decision, has been informed about alternatives such as palliative care, and has voluntarily asked for life to be ended or to be given the means to commit suicide. Nor do such organisations typically propose that the law should allow doctors to kill patients whenever the patient feels like it. The patient should not only have thought seriously about the options but must also be terminally ill or at least experiencing serious suffering. Further, reformers generally put forward some form of procedural safeguards in an attempt to ensure that VAE would only be available to patients whose request was truly voluntary and who were genuinely terminally ill or suffering gravely. Such proposals often include a requirement that the doctor consult an independent doctor beforehand, such as an expert in the illness from which the patient is suffering and/or an expert in palliative care, and they also provide for at least the possibility of official review, as by requiring the doctor, having performed VAE, to report the details of the case to some public authority such as a coroner. . .
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