**Commentary** The British House of Lords select committee on medical ethics defines [euthanasia](https://militaryhealth.bmj.com/content/147/3/367) as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering". There are two key ways in which a doctor could help a patient to end their life: active and passive euthanasia. Often people feel strongly about allowing one type but not the other, so it is important to understand their differences. **Passive euthanasia**: -Passive euthanasia occurs when doctors (or other individuals) help people end their lives by allowing them to pass by stopping an action that was keeping them alive, such as: - switching off life-support machines - disconnecting feeding tubes - not carrying out a life-extending operation - not administering life-extending drugs. -Passive euthanasia is currently legal under specific circumstances in many countries including the UK whereas active euthanasia is not. -This is because there is considered to be a moral difference between _letting_ someone die by withholding treatment and actively 'killing' them. - There are also voluntary and non-voluntary forms of passive euthanasia, with voluntary meaning the patient has given consent, and non-voluntary referring to times where the patient is not in a position to consent such as in a coma. **Active euthanasia:** - Active euthanasia is only legal in a small handful of countries such as the Netherlands, Belgium and Canada. - Examples of active euthanasia can include administering lethal substances with the intention of ending a patients life. - Assisted suicide comes under the umbrella of active euthanasia. - In the UK and others, it is considered a criminal offence even with consent. Pros of allowing both: - Dying with dignity, in the company of loved ones and without further suffering. - Allowing control over one's life and decisions - individuals should be given freedom and a right to die how they wish. - Patients may have to travel to countries where it is legal in order to die on their own terms, spending thousands. - Healthcare costs can be reduced. Cons: - Laws like this without good-quality universal healthcare can lead to less wealthy people resorting to euthanasia because they cannot afford comfortable end of life care. - Permanent, non-reversible decision. - Individuals are desperate and suicidal intent may be transient. - Mental illnesses, particularly those unrecognised, may affect decisions. - Risk of corruption and coercion where healthcare costs can be saved - family or staff could influence decision-making. - Feelings of guilt and not wanting to burden family with prolonged care may persuade decisions. - The conditions under which patients are eligible can be difficult to determine.