Death is Not Always the Greatest Evil: Killing and Letting Die in Bioethics

Dissertation, Queen's University at Kingston (Canada) (2002)

One cannot venture far into the euthanasia/assisted suicide debate without becoming involved in the controversy over the killing/letting die distinction. Frequently that distinction is interpreted as corresponding to the difference between active and passive euthanasia, or roughly to the difference between physicians doing something to cause death and doing nothing to prevent death. The moral argument then engages the question of whether a moral distinction need be drawn between a physician killing a patient or letting a patient die. ;However, in this thesis I join with those who view the issue from a somewhat different perspective. I question the presumption that a physician who withholds or withdraws life-support or aggressively treats pain and symptoms is doing nothing to cause but only failing to prevent death. In terms of causal agency, a physician who engages in those practices appears to be just as much doing something to cause death as those engaged in euthanasia and physician-assisted suicide are. My thesis is that deaths consequent to the withdrawal of life-support treatment that are currently assumed to be deaths from letting die are, instead, deaths from either euthanasia or physician-assisted suicide
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