Thomas Fuchs, MD, PhD and Associate Professor of Psychiatry at the University of Heidelberg, stated in his 1998 article "The Notion of Killing: Causality, Intention, and Motivation in Active and Passive Euthanasia," published in the journal Medicine, Health Care, and Philosophy:
"Passive
euthanasia or letting die may be realized by active doing (withdrawing
life-sustaining treament) as well as omission (i.e. withholding
treament)...
'Letting
die' ... means to give way to an ongoing inner-organismic process of
disintegration, without supporting or substituting vital functions.
Therefore the extubation [removal from a ventilator] of an incurably
ill patient, though a physical action with subsequent death, is not
killing in its proper meaning... The extubation does not produce the
effect of death; it only influences the time of its ocurrence. Calahan
(1992) has aptly illustrated this difference of causality: The lethal
injection kills both the ill as well as the healthy person; the
discontinuation of life-sustaining treatment, however, only causes the
death of the mortally ill, whereas on the healthy it would have no
effect at all."
Jonathan Moreno, PhD and Emily Davie and Joseph S. Kornfeld Professor of Biomedical Ethics in the introduction to his 1995 book Arguing Euthanasia, stated:
"Strictly
speaking, the term 'euthanasia' refers to actions or omissions that
result in the death of a person who is already gravely ill ... passive
euthanasia can be achieved by failing to treat a pneumonia or by
withholding or withdrawing ventilatory support. The current medical
ethics consensus has thus implicitly legitimized voluntary passive
euthanasia. This consensus relies on the moral legitimacy of letting
the underlying disease process take its natural course, if that is what
the patient would have wanted. Although many do not find passive
euthanasia to satisfy the idea of a 'good death' (eu-thanasia), most
prefer it to lengthening the dying process due to human intervention."
Frances M. Kamm, PhD, Professor of Philosophy and Public Policy, wrote in her essay "Physician-Assisted Suicide, Euthanasia, and Intending Death" that appeared in the 1998 book Physician-Assisted Suicide: Expanding the Debate:
"Euthanasia
involves a death that is intended (not merely forseen) in order to
benefit the person who dies...it involves a final act or omission by
someone other than the patient (e.g., the doctor) in order to end the
patient's life. I speak of act or omission because there can be passive
as well as active euthanasia, and at least some passive euthanasia
occurs by omission. In a clear case of the latter, the doctor does not
provide lifesaving treatment, intending the patient's death for the
patient's good...
If
a patient is already receiving life-saving treatment and a doctor must
actively terminate it by, for example, pulling out tubes, an act rather
than an omission is required to terminate aid, yet ... I consider this
passive euthanasia. Furthermore, if the doctor is terminating aid that
she (or the organization of which she is a part) is providing or that
is provided by means that belong to them, then I think she lets die
rather than kills.
Consider
the following analogy: I am saving someone from drowning and I decide
to stop. Even if I must actively push a button on my side to make
myself stop, I still let the person die rather than kill him."
The BBC website's columns entitled "Coping With Grief - Terminal Illness," and "Active and Passive Euthanasia" stated :
"Passive euthanasia is an alternative name for withdrawal of treatment - the doctor withholds life-sustaining treatment...
Passive
euthanasia occurs when the patient dies because the medical
professionals either don't do something necessary to keep the patient
alive, or when they stop doing something that is keeping the patient
alive.
