A critical study of principles, laws and documents around the world on decision making at the end of life and guidelines development

Our critical study of laws and guidelines on End-of-Life decision making revealed that: (1) No slippery slope effect occurs if there is trust in the doctor-patient relationship and transparency is secured throughout the procedure; (2) Palliative care and euthanasia are not mutually exclusive but are deemed integral part of good end-of-life care; (3) Nevertheless, the slippery slope hypothesis cannot be totally dispelled because doctors do not necessarily gain their patients' consents before they withdraw or withhold treatment, or practice life-shortening palliative care, even though they are normal medical practices. Thus, it is concluded that the best way to secure 'a high quality of death' is to establish systems to ensure transparency in all medical end-of-life care, including these normal medical practices.