Control over our own lives is one of the most important goods we enjoy. In health, we exercise control daily over how we shall live, making decisions that shape our lives and affect their quality. We take the making of these decisions for granted: it is our life, and how we live it and what we make of it is up to us. We take for granted as well our ability to see that our decisions in these regards are put into practice: in health, we act in ways that reflect our decisions about how we want to live. When serious illness overtakes us, however, it becomes harder to control the course of our lives; other people become involved in our care, and we can lose the ability to see that the decisions we make with respect to our lives are implemented.

Today, the media are filled with stories of terminally ill patients who seek a dignified release from the lives they are presently living and who turn to their doctors for assistance in dying. In a perfectly straightforward sense, such patients seek to continue to exercise control over their lives, now in the form of bringing about their deaths. They no longer want to live the life to which illness has condemned them. They seek an exit, a dignified exit. Quite naturally, they turn to their doctor for help.