INTRODUCTION

Issues of death and dying have become the focus of intense debate in recent times among theologians, ethicists, lawyers and the public at large. This has to a significant extent been due to a number of controversial decisions of superior courts on these matters such as Cruzan v. Director, Department of Health in the United States, Airedale National Health Service Trust v. Bland in the United Kingdom, Rodriguez v. British Columbia (Attorney General) in Canada and the Wittig and Hackethal cases in Germany. There are two other reasons for this debate. First, the dramatic advances in medical technology and pharmacology which have been made in the course of this century have made it possible to sustain the lives of terminally or otherwise hopelessly ill patients for extended and often indefinite periods of time. Ever greater power has been concentrated upon specialist medical practitioners, whose decisions to use, not to use or to discontinue life–sustaining treatment, have truly given them control over life and death. Secondly, as was stated by Mr Justice Stevens, of the United States Supreme Court, due to these ‘advances, and the reorganization of medical care accompanying the new science and social conditions of death people are less likely to die at home, and are more likely to die in relatively public places, such as hospitals or nursing homes. Ultimately questions that might have been dealt with in intimacy by a family and its physician have now become the concern of institutions’.