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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 treatment)...
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.