There is something very moving about the accounts of the deaths, together in a private Swiss clinic, of conductor Sir Edward Downes and his wife Joan, a former ballet dancer.

Though he was older by eleven years, and frail, it was she who was terminally ill, and their mutual assisted death clearly seen by them and their family as a last great act of love in a long and loving marriage spanning 54 years.

It is fitting also that the story emerged as Health Secretary Andy Burnham was setting out new proposals on long-term care, designed to meet the fact that more and more people are living longer and longer lives.

The proposals seem to make sense of that changing reality, and the new demographics which mean Brtitain now has more pensioners than children. It is another necessary reform of welfare state principles, and even though people might like to be able to get all the help they need, ‘from cradle to grave’, there is already a widespread understanding of the need to share the load between individuals, families, local communities and the State as a whole.

Just as we have reluctantly got used to the need for a mix of funding streams in further and higher education, including from the individual, so the same is happening in long-term care.

So the government proposals are out there, the Opposition will presumably develop their own, pressure groups and other interested parties will raise doubts and fresh ideas, and eventually changes in the law will come.

The euthanasia debate is rather different, but at some point is going to require government to take a fresh look, and MPs to take take a lead. It is already a fairly polarised debate, as is clear from some of the reactions yesterday, like Dominica Roberts, chairwoman of the Pro-Life Alliance, who said ‘I’m sure they could have lived out the rest of their lives happily.’ How could she know?

The non-prosecution of people who help the terminally ill to end their lives prematurely is itself an indication that the terms of this debate are changing. But there is something almost random about the way that debate is unfolding, around what happens at the Swiss clinic run by Dignitas, and occasional activity in the British courts.

Some of the greatest Parliamentary debates I ever saw were ‘free vote’ debates on issues of conscience, notably on the subject of abortion. I can see why there might be some reluctance to enter into a debate on this subject right now, because of the many difficult moral questions it poses. But, a bit like death, it is going to have to come some day, and maybe sooner than we think.