Hull and McKeown O"Donovan offer a philosophical examination of the case of Marie Fleming, confined to a wheelchair and in the final stages of multiple sclerosis. The High Court in the Republic of Ireland ruled that she did not have the right to be assisted in taking her own life and made a strong moral distinction between letting nature take its course and bringing about death. Through an examination of the work of Jonathan Glover, Shelly Kagan, Warren Quinn, and James Rachels, the authors argue that the most compelling philosophical basis for a moral emphasis on the distinction between acts and omissions lies in the structural difference, where acts interfere with a victim in a way that omissions do not. It is also argued that assisted suicide can be morally justified in the advanced stages of terminal illness in a limited way that can resist any inevitable descent down a slippery slope.