Euthanasia trials in Japan: implications for legal and medical practice.

A variety of recent developments in medical technology enable physicians to prolong life, a goal long sought by the medical profession. Artificial life support, in particular, has changed the medical environment, and physicians now seem to pay more attention to prolonging life than to pain relief and other important aspects of quality of life as it relates to medical care. The perception of quality of life differs from one individual to another. Some patients may desire to live regardless of their physical condition, whereas others may desire to be ‘‘killed’’ before pain becomes intolerable. For the latter, the issue of euthanasia arises. Euthanasia has generally been conceived and debated, in Western countries, as the deliberate ending, on request, of the life of a patient suffering severe physical pain. Modern medicine has, however, made substantial progress in the area of palliative care in recent years. Although not all physical pain can be alleviated, palliative care has changed the frames of reference for euthanasia. Euthanasia has become not only an issue of freedom from pain but also an issue of the patient’s right to self-determination. Medical technology frequently offers a variety of clinical options in relation to which the patient has the possibility of personal choice. Euthanasia may be viewed in this context as one among several choices of how to die when prematurely faced with the final stages of life. In Western countries, there has been much discussion of the legal, ethical, sociological, psychological, and political ramifications of euthanasia. In the Netherlands, euthanasia has