Rachel argues that “[T]he distinction between passive and active euthanasia is considered crucial to medical ethics. The idea is that it is permissible, at least in some cases, to withhold treatment and allow a patient to die. The law made a clear distinction between the withdrawal of life-sustaining treatment that resulted in death and a request for assistance in ending life. Passive euthanasia is considered legal while active euthanasia is illegal according to the suicide law. In Bland, a distinction was made between killing by act and letting die by omission. It was argued in this case that the withdrawal of artificial nutrition and hydration (“ANH”) was considered an omission and that the patient would die due to his underlying conditions. Coming to this conclusion is illogical, Bland would have continued to live without ANH removal, so his death was the result of kidney failure due to dehydration and starvation. In reaching this conclusion, the court considered that ANH was a medical treatment and could be withdrawn if it was of no use. This argument was based on allegations of medical futility. Bland can be compared to the R case (on the application of Pretty v DPP. Pretty failed in her attempt to obtain advanced immunity for her husband if he assisted her in ending her life. The court upheld the assertion that assisted suicide would continue In doing so, it continued to place greater emphasis on the distinction between acts and omissions in terms of assisted dying and withdrawal of life-sustaining treatment. Advocating such a position is illogical, because the withdrawal of medical assistance in dying is illogical the treatment will most likely involve an action on the part of the doctor....... middle of article..... .ge Cavendish 2007)Major TJ, “Life: Sanctity or Quality? (1988) 3 Journal of Biblical Ethics in Medicine 19Otlowski M, Voluntary Euthanasia and the Common Law (Oxford, Clarendon Press 1997Rachel J, 'Active and Passive Euthanasia' (1975) 2 New England Journal of Medicine 78Rietjens JA et al, 'Two Decades research on euthanasia in the Netherlands: what have we learned and what questions remain (2009) 6 Journal of Bioethical Inquiry 271Shaw AB, “Two Challenges to the Double Effect Doctrine: Euthanasia and Abortion” (2002) 28 Journal of Medical Ethics 102Smith M, “Patients and doctors: rights and responsibilities in the NHS (2)” (2005) 5 Clinical medicine 501 Steinbock B, “The case for assisted suicide: not (yet) proven” (2005) 31 Journal of Medical Ethics 235 Wacks R, Understanding Jurisprudence: An Introduction to Legal Theory (3rd edition Oxford: OUP 2012 )