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It is widely accepted in clinical ethics that removing a patient from a ventilator at the patient’s request is ethically permissible. This constitutes voluntary passive euthanasia. However, voluntary active euthanasia, such as giving a patient a lethal overdose with the intention of ending that patient’s life, is ethically proscribed, as is assisted suicide, such as providing a patient with lethal pills or a lethal infusion. Proponents of voluntary active euthanasia and assisted suicide have argued that the distinction between killing and letting die is flawed and that there is no real difference between actively ending someone’s life and “merely” allowing them to die. This paper shows that, although this view is correct, there is even less of a distinction than is commonly acknowledged in the literature. It does so by suggesting a new perspective that more accurately reflects the moral features of end-of-life situations: if a patient is mentally competent and wants to die, his body itself constitutes unwarranted life support unfairly prolonging his or her mental life.
It is widely accepted in clinical ethics that removing a patient from a ventilator at the patient’s request is ethically permissible. This is often termed voluntary passive euthanasia (VPE), although there is controversy over this terminology and in particular over the idea that ending a patient’s life in this way is any less direct than other means.1 Conversely, voluntary active euthanasia (VAE), such as giving a patient a lethal overdose with the intention of ending that patient’s life, is ethically proscribed, as is assisted suicide (AS), such as providing a patient with lethal pills or a lethal infusion. Proponents of VAE and AS have argued that the distinction between killing and letting die is flawed, and that there is no real distinction between actively ending someone’s life and “merely” allowing them …
Work on this paper was supported by a grant from the Philosophical Quarterly.
Competing interests: None declared.
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