Bioethics Blogs

Withdrawing life-prolonging treatment not the same as killing

Lawfully allowing a patient to die should be kept distinct from euthanasia. Shutterstock

There is a clear legal distinction in Australia, the United Kingdom, and the United States between withdrawing life-prolonging treatment – such as ventilation for a person who can’t breathe unaided, or artificial nutrition and hydration for those who can’t eat and drink – and euthanasia, a lethal injection or potion.

But philosophers and legal academics disagree. The almost unanimous view is that when doctors withdraw life-prolonging treatment from a patient they are killing her rather than allowing her to die from her underlying condition.

On this basis, they argue the law is incoherent because it prohibits killing by lethal injection or lethal potion, while permitting killing by withdrawing life-prolonging treatment from those dependent on it.

I disagree; withdrawing life-prolonging treatment is not the same as killing.

Bad reasoning? I don’t think so

Australian philosopher and professor of practical ethics at Oxford University Julian Savulescu describes the law’s view that withdrawing a feeding tube is an omission of treatment as “a spectacular example of bad reasoning”.

Similarly, American bioethicists Franklin Miller and Robert Truog have claimed that such a view “flies in the face of a candid look at the facts”.

These claims are used to suggest that the law cannot coherently continue to prohibit euthanasia because it is effectively allowing it to be practised already. On their view, the act of withdrawing a tube is no different from the act of giving a lethal injection.

Miller and Truog claim that it is also incoherent to worry that retrieving organs from willing donors at the end of their lives might cause their deaths, because the law allows doctors to cause their deaths anyway by withdrawing life-prolonging treatment in specified circumstances.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.