The House of Lords recently set up a Select Committee on Medical Ethics to consider euthanasia and related medical decisions at the end of life. This followed widespread publicity surrounding recent cases, particular the trial and conviction of a doctor for the attempted murder of a consenting terminally ill patient, and the House of Lords' ruling that it is not unlawful to withdraw life-sustaining treatment from a patient in a “persistent vegetative state”. This paper suggests a perspective on some of the moral issues and conflicts which the House of Lords will no doubt consider. A legal structure in which medical euthanasia could be both permitted and controlled is then proposed involving two complementary mechanisms, a formal Euthanasia Notification procedure and a system of Euthanasia Tribunals.