Parliament's health select committee has been hearing submissions on voluntary euthanasia for more than a year and it begins to seem inevitable that change to the law will result. The weight of public opinion appears to support a right to die with deliberate medical assistance even though the weight of medical opinion remains decidedly against it.
The disagreement exists more in principle than in practice. Doctors who do not want the legal power to deliberately kill a patient can, and do, make decisions for the relief of pain that they know are likely to advance a dying patient's death. Likewise, people who want the right to die with a doctor's assistance already have the right to decline to be kept alive.
Last month journalist David Barber told the select committee that having cared for his late wife, who suffered from Alzheimer's disease, he has signed a directive that if ever he becomes mentally incompetent to accept or decline life-sustaining treatment, "I should not be resuscitated, placed on life support or fed by conventional or artificial means."
That is a clear and effective instruction legally available to anybody whose greatest fear is to spend the final days, months or years in the condition they have seen a loved one. But Barber hopes a law change will enable his present instructions to be superseded by "a request for a physician to end my life so that I could die peacefully in the company of friends and family."
It is quite likely that a dying person who has signed a directive not to be fed, resuscitated or given life support will be able to die in the company of friends and family, if not quite the gathering that could be invited to a scheduled euthanasia. Will it really come to that?
The issues of principle are very important but the practical difficulties are more telling. If the law is to be changed in accordance with submissions such as Barber's, at what point in a mentally incompetent patient's deteriorating condition is a doctor supposed to act on the directive? Frances Barber was diagnosed with early onset Alzheimer's at 48, needed secure care from age 52 and died at 55. Could the decision be made for one so young?
Advocates of euthanasia are confident they know the mind of sufferers and the wishes their loved ones cannot express. They often refer to "unbearable pain and suffering" though modern palliative care relieves this. The greater suffering may be felt by those who see a parent or partner in end-of-life care.
Though the select committee is still hearing submissions, its members probably feel after a year they have heard all the arguments for and against euthanasia in principle and they need to hear much more practical suggestions as to precisely how, when and by whom death could be chosen, and how the right could be confined to those diagnosed with a terminal condition.
It is vital the law does not provide a right to die for everybody who feels their life unbearable, and equally vital old people who have become a burden to their families do not feel it is an option they should take. The committee has an unenviable task.