passive euthanasia vs. disconnecting life support?

[babybop112]

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Hi.....Does anyone know the difference between passive euthanasia (illegal) and disconnecting someone from life support (legal)? Why is one legal and the other one not? Aren't they they same thing?

 

[sacrament]

Hi.....Does anyone know the difference between passive euthanasia (illegal) and disconnecting someone from life support (legal)? Why is one legal and the other one not? Aren't they they same thing?

Euthanasia is a human input into a natural situation which "unnaturally" hastens death. Discontinuing life support is simply allowing nature to take its course, and is morally equivalent to allowing a patient to chose a DNR status in the first place.

 

[47534]

Discontinuing life support is simply allowing nature to take its course, and is morally equivalent to allowing a patient to chose a DNR status in the first place.

This, I think, is an outdated view on withdrawing treatment. It is not simply allowing nature to take its course. As stated in Practical Decision Making in Health Care Ethics by Devettere, if life support is removed form a person who needs it, then both the disease/injuries and the withdrawal are causes of death, but neither alone is sufficient. The physician does have a causal impact on the patient's death--the hard part would be to determine whether or not the withdrawal was morally justified.

 

[sacrament]

This, I think, is an outdated view on withdrawing treatment. It is not simply allowing nature to take its course. As stated in Practical Decision Making in Health Care Ethics by Devettere, if life support is removed form a person who needs it, then both the disease/injuries and the withdrawal are causes of death, but neither alone is sufficient.

How so? If you remove life support from somebody who "needs" it and they die, then I would posit that the injury itself was sufficient to end life. The withdrawal of life support did not "cause" death, as it was only holding back the natural course of events in the first place. Rather the withdrawal of life support allows death.

The physician does have a causal impact on the patient's death--the hard part would be to determine whether or not the withdrawal was morally justified.

The competent patient has every right to demand withdrawal of life-saving measures, just as they have every right to deny such measures in the first place. In my opinion--and the law's--the physician's viewpoint has no bearing.

 

[47534]

If you remove life support from somebody who "needs" it and they die, then I would posit that the injury itself was sufficient to end life. The withdrawal of life support did not "cause" death, as it was only holding back the natural course of events in the first place. Rather the withdrawal of life support allows death.

I think a physician withholding treatment (i.e., like when a doctor chooses not to perform CPR on someone in cardiac arrest) is the only clear-cut case of "letting die." The whole notion that the physician plays no causal role in the death of a patient when s/he withdraws life support was probably because the AMA clearly states that doctors should not intentionally cause death, so doctors are forced to reason that their actions are not the only cause of death.

What I meant when I said that neither the illness nor the withdrawal of life-support alone was sufficient causes of death, was that for death to occur when a person has been put on life support already, the illness/injury must make it impossible for the ptient to live without life support and someone (i.e. the doctor) must remove the lifesupport--an action that directly impacts the patient.

The competent patient has every right to demand withdrawal of life-saving measures, just as they have every right to deny such measures in the first place. In my opinion--and the law's--the physician's viewpoint has no bearing.

I agree that the competent patient has the right to make decisions regarding his/her treatment, including life-sustaining treatments. I didn't mean that it was up to the physician to decide whether or not it was morally justified. I meant, with all circumstances considered, whether the decision to withdraw life-sustatining treatment was morally sound. It would be justifiable for the physician to stop treatment if the competent patient is aware of all consequences and agrees or if the treatment no longer serves any benefit to the patient. It would not be morally justifiable for the doctor to withdraw life support for cost reasons alone.

 

[babybop112]

I still am having a hard time understanding the difference between the two concepts because

Passive euthanasia is defined as "the putting to death, by painless method, of a terminally-ill or severely debilitated person through the omission (intentionally withholding a life-saving medical procedure) of an act"

Why is that illegal if disconnecting life support is legal? Isnt disconnecting life support also omission of a life saving medical procedure?

Note: active euthanasia is different from passive euthanasia and is also illegal

 

[45408]

I think a physician withholding treatment (i.e., like when a doctor chooses not to perform CPR on someone in cardiac arrest) is the only clear-cut case of "letting die." The whole notion that the physician plays no causal role in the death of a patient when s/he withdraws life support was probably because the AMA clearly states that doctors should not intentionally cause death, so doctors are forced to reason that their actions are not the only cause of death.

I disagree. That's like saying that if you were able to catch someone while they were falling but weren't able to hold onto them tightly enough to pull them to safety that you caused their death.

 

[Iwy Em Hotep]

I still am having a hard time understanding the difference between the two concepts because

Passive euthanasia is defined as "the putting to death, by painless method, of a terminally-ill or severely debilitated person through the omission (intentionally withholding a life-saving medical procedure) of an act"

Why is that illegal if disconnecting life support is legal? Isnt disconnecting life support also omission of a life saving medical procedure?

Note: active euthanasia is different from passive euthanasia and is also illegal

My ethics professor put it this way:

With passive euthanasia, the goal is for the patient to die. If the patient does not die, something went wrong.

With withholding treatment, the goal is *not* for the patient to die, and if the patient somehow continues to live, everyone will rejoice.

The only difference is the intent, even if the result ends up being the same.

 

[47534]

I'm sorry, babybop, I completely forgot to answer your question. From what I understand, you got it right--passive euthaniasia consists of either withholding or withdrawing treatment, which means disconnecting life support fits into that category. I'm not sure where you got that it was illegal? 😕

I disagree. That's like saying that if you were able to catch someone while they were falling but weren't able to hold onto them tightly enough to pull them to safety that you caused their death.

I think your example is more akin to a doctor who tries to save a patient, but is unable to do so. In that case, no one would blame the doctor. It's not like you dropped the unfortunate soul to his or her death on purpose in that scenario, whereas a doctor who disconnects life support actively does something. Also, the intents are completely different. In your case, you don't intend for the person to fall to his death, whereas a physician who withdraws life support does so because he intends for the patient to die (whether it is to respect the patient's autonomy, end suffering, etc.)


EDIT: Looks like Iwy beat me to it...

 

[Mumpu]

You can keep a brain-dead person "alive" for years with mechanical ventilation. Just because you can do something, does not mean you should.

So is it that not intubating someone who is full COR is passive euthanasia, and not intubating someone who is DNR is withdrawal of treatment?

 

[Tiki]

Withdrawing life support if a form of passive euthanasia and it is legal. However not all forms of passive euthanasia are legal. For example, if a physician were to provide drugs to a patient (i.e. Dr. Timothy Quill) knowing that the patient's intent is to commit suicide--that is an illegal form of passive euthanasia--although done all the time.

At least that is how we learned it in Ethics.