Glossary

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Defining frequently used terms in the end-of-life debate

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Assisted Dying

A term which has no meaning in English law.  It is a euphemism used by campaigners for legal change in England and Wales to refer to physician-assisted suicide for terminally ill people.  It is sometimes used, however, to include also physician-administered euthanasia.

Assisted Suicide

Assistance provided by one person to another to enable the latter to end his or her life.  It is illegal in England and Wales under Section 2(1) of the Suicide Act 1961.

Physician-Assisted Suicide (PAS)

Assistance with suicide provided by a doctor prescribing or otherwise supplying lethal drugs to a patient at that patient's request in order to enable the patient to end his or her life.  It is illegal in England and Wales under Section 2(1) of the Suicide Act 1961.  It is legal in certain circumstances in the US States of Oregon and Washington and in The Netherlands.

Physician-Administered Euthanasia (PAE)

Administration of lethal drugs to a patient by a doctor in order to end that patient's life. PAE may be with or without the patient's request or consent.  In Britain it is regarded as murder and is illegal under the Homicide Act 1957.  PAE at a patient's request is legal under certain circumstances in The Netherlands, Belgium and Luxembourg.

Palliative Care

The multi-disciplinary branch of health care which specialises in alleviating the pain or other suffering arising from incurable illness.  It comprises specialist medicine, nursing, physiotherapy and psychological and spiritual care.  In Britain, unlike in many other countries, palliative medicine is a recognised clinical speciality, with lengthy and rigorous training required to achieve consultant status.

Terminal Illness

Incurable illness which is expected to result in death.  Though many chronic illnesses may fall within this definition, within the 'assisted dying' debate the term 'terminal illness' is generally used to denote an incurable illness with a relatively short prognosis of life remaining - ie one expressed in terms of weeks or months.

Mental Capacity

The ability to understand information and to make decisions free from mental disorder.  Under the terms of the Mental Capacity Act 2005, "a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain".

Diagnosis

The process of identifying, via tests and other clinical means, an illness or malady.

Prognosis

The estimation of the course of an illness. In the 'assisted dying' debate the term is generally used to refer to estimation of the length of life remaining for a patient who has been diagnosed as having a terminal illness.

Decriminalisation

If an offence has been decriminalised, charges are not brought against the person committing that offence. For example, committing, or attempting to commit, suicide was decriminalised by Section 1 of the 1961 Suicide Act and, in consequence, a person who commits or attempts to commit suicide is not subject to prosecution. Encouraging or assisting another person's suicide, on the other hand, remains a criminal offence - ie an offence for which charges may be brought.

Director of Public Prosecutions (DPP)

The DPP is the Head of the Crown Prosecution Service (CPS) for England and Wales. The CPS reviews cases where a criminal offence is believed to have been committed, examines the evidence available and decides on the basis of the evidence whether or not a prosecution should be brought and, where charges are brought, undertakes prosecution.

Liverpool Care Pathway (LCP)

The LCP is a clinical framework designed to provide guidance to doctors, nurses and other health care professionals caring for patients who are in the last hours or days of their lives.

End of Life Decisions

Decisions relating to treatment towards or at the end of life. They include decisions by patients to refuse life-sustaining treatment and by doctors to refuse or withdraw such treatment where it is considered to be futile or excessively burdensome to the patient. End-of-Life Decisions do not involve decisions to end the life of a patient and are both legal and clinically ethical. They are distinct from ending-life decisions, such as PAS or PAE, which are illegal and clinically unethical in Britain and where the intention of the decision is to bring the patient's life to an end.

Advance Directives

Sometimes referred to as 'living wills', these are statements recording a person's wishes concerning future medical treatment in the event that that person should lack capacity as defined by the Mental capacity Act 2005. Advance Directives may include refusal of specified treatments (for example, resuscitation) but they cannot include requests for life to be ended, which is illegal in Britain.

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