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« Absence of Cognitive Function | Main | "If it were up to me, I'd kill the Americans and drink their blood." »

March 22, 2005

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The ethical distinction here is not about the dying. Certainly someone is just as dead whether they are suffocated or denied supplemental oxygen. The distinction is in the "killing". Watching someone die and doing nothing to stop it is not the same as murder. That is what the withdrawl of treatment is - it is resuming a course of doing nothing. That may entail an active step, but ethically it is no different than not initiating care to begin with. Euthanasia is ethically a different question entirely. That isn't to say it is always wrong, but it falls under the category of "acceptable" murder, like war or capital punishment (not acceptable to me, but to many others). There is no consensus in our society or in the medical community about if or how euthansia would be acceptable.

That may entail an active step, but ethically it is no different than not initiating care to begin with.

Right, but in the terminal patient case, you've almost certainly done a great deal of care already. The way I see it, in both the withdrawal/lethal injection scenarios there are three steps:
1. Doctor to patient: "When I become terminal and unconscious, I want you to do X, so that I don't linger unnecessarily."
2. Doctor to patient: "I agree to carry out your wishes."
3. Patient becomes terminal and unconscious, and doctor does X.
Whether X is withdrawing a hydration tube or injecting potassium chloride is really just a detail.

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