In order to legalise euthanasia or assisted suicide one must first conclude that existing methods to foreshorten the life of the terminally ill are not adequate. Currently the practices of suicide, treatment refusal, stopping life-sustaining treatment and the “double effect” or aggressively treating pain symptoms even if life expectancy is compromised (of which terminal sedation is an example) are all legal in Canada. We contend that if other practices are legalized, assisted suicide should be considered rather than euthanasia, since this practice respects better the rights of patients to change their minds. Experiences in the Netherlands and in Oregon indicate that 40 % or more of people who request euthanasia change their minds after obtaining the means or ending their lives or after being offered better treatment of their symptoms. Euthanasia and assisted suicide should not substitute for good palliative care.