R (Nicklinson) v Ministry of Justice [2012] EWHC 2381 was a tragic case that considered a perennial question: whether voluntary active euthanasia is murder. The traditional position was affirmed, that is, it is indeed murder. The law's treatment of decisions to refuse treatment resulting in death is a stark contrast to the position in respect of voluntary, active euthanasia. In cases of refusing treatment, principles of individual autonomy are paramount. This article presents an overview of the legal distinction between refusing medical treatment and voluntary, active euthanasia. It questions the purported differences between what are described as acts of "active" or "passive" euthanasia. It also highlights the inconsistency of the law's treatment of different ways that people decide to die.