Although many countries prohibit physician assisted dying, an increasing number of jurisdictions are making moves to allow the practice. Opinion remains sharply divided over the rights and wrongs of making such a move—disagreement continues about which practice(s) should be accommodated, how such practices such be labelled, and the strength of the ethical and professional arguments on either side.

Building on my previous research, I will first address some preliminary matters, specifically introducing the (contested and confusing) range of terms used in these debates, as well as providing a snapshot of some of the different legal responses around the world.

Against this backdrop, I move to consider important moral matters by focusing on the main ethical arguments for and against allowing (physician) assisted dying. Arguments in favour of the practice essentially claim that choice matters and suffering matters. Arguments against the practice, meanwhile, claim that life matters, medicine matters, and consequences matter. I will therefore engage with key claims about respect for autonomy, quality of life, the intrinsic value of life, the integrity of medicine, and the prospect of embarking on ‘slippery slopes’.

These are well-worn arguments, and understandably so, given the strength of feeling and the apparent strength of the claims on each side. Moving to end matters, I consider the merits of a different way forward. In a departure from many contributions to this longstanding debate, I suggest that a case can be made for striking a balance between the opposing camps, such that each side can make gains, whilst also incurring losses. On such a contested landscape, there may be worst places to be than the ‘middle ground’. I will sketch some of the options which can occupy this middle ground, in the hope this offers a fresh perspective and a different way forward.