Ramon Casha pleads the case for the legalisation of assisted dying eloquently. However, he focuses on what is essentially one side of the argument: the case for.

Although there are times when physicians long to help to end patients’ distress, there are also occasions when we have to act to protect patients against requests made under duress.

However, my main concern in legalising euthanasia, or assisted dying, is how to ensure robust monitoring and policing of the ‘conditions’ linked to meeting such a request as well as the ethics and reliability of staff involved in the selection of patients and the administration of the medicine.

The British Abortion Act, a law which was deemed necessary to protect about 11,000 desperate women from back-street abortionists, provides (on paper, at least) pretty strict criteria for screening out those who do not meet the required conditions. In effect, we now have abortion on demand in UK, with upwards of 200,000 procedures carried out annually, no counselling beyond standard pre-operative warnings about complications and, worst of all, the fact that most clinics have pre-signed consent forms stacked up in cupboards.

Quite honestly, I cannot remember the last time a patient of my GP practice had an abortion request denied. Familiarity breeds contempt; people wishing to work in clinics or settings such as Dignitas must find it very hard to turn anyone down.

Much as we all sympathise hugely with the immensely sad cases of unfortunate folk faced with deteriorating health and a possibly uncomfortable end to their lives (though I happen to believe that good palliative care helps the vast majority to meet their end in peace), the proponents of assisted dying and euthanasia will have to come up with some extraordinarily robust and sustainable regulation of any such scheme to make it workable. Even a single mistake would mean an unnecessary death too many.

All this, of course, ignores the additional argument about the sanctity of life.