, PLEASE USE THIS DOCUMENT AS A GUIDE ONLY
TABLE OF CONTENT
Biomedical Ethics Page 3
Business Ethics Page 10
Environmental Ethics Page 18
, 1. Do you think that euthanasia in the form of physician assistance in dying is ethically different
from letting a patient die by withdrawing treatment or life-support? Write an essay in which you
answer this question. Provide reasons for your argument.
Introduction
The ethics of end-of-life care presents some of the most contested terrain in contemporary
biomedical ethics. Among the most pressing questions is whether euthanasia in the form of physician
assistance in dying (PAD) — where a physician provides a lethal dose of medication that the patient
self-administers — is ethically different from letting a patient die by withdrawing treatment or
life-support (e.g., turning off a ventilator or stopping artificial nutrition and hydration). Many legal
and professional guidelines treat these two practices as morally distinct: passive euthanasia
(withdrawing treatment) is widely accepted, while active euthanasia or physician-assisted dying
remains illegal in most jurisdictions. However, philosophers such as James Rachels have argued that
there is no morally significant difference between killing and letting die. This essay will argue that
physician assistance in dying is not ethically different from withdrawing treatment or life-support,
provided certain safeguards are met. The supposed ethical distinction rests on several untenable
premises: the act-omission distinction, the intention doctrine, and the causal role of the physician.
Through a critical examination of these premises, and by appeal to principles of patient autonomy,
beneficence, and equality of suffering, this essay demonstrates that the two practices are ethically
equivalent. Nevertheless, the essay will also acknowledge that practical and psychological
differences exist, but these do not amount to ethical differences.
1. Defining Key Terms
Before comparing ethical frameworks, it is essential to define the practices under consideration.
Physician Assistance in Dying (PAD) refers to a physician providing a competent, terminally ill
patient with a lethal prescription (e.g., barbiturates) that the patient voluntarily self-administers to
end their life. This excludes active voluntary euthanasia where the physician administers the lethal
injection, though many arguments apply similarly.
Withdrawing treatment or life-support involves discontinuing medical interventions — such as
mechanical ventilation, dialysis, antibiotics, or artificial nutrition and hydration — that are keeping a
patient alive, with the foreseeable result that the patient will die from their underlying disease.
Letting die is often contrasted with killing. The former is typically described as an omission (failing
to act), while the latter is an act (doing something directly to cause death). In biomedical ethics,
withdrawing treatment is generally classified as “passive euthanasia” and is legally and
professionally permissible in most countries (Garrard & Wilkinson, 2005).
2. The Act-Omission Distinction and Its Problems
The most common ethical argument for differentiating PAD from withdrawing treatment is the
act-omission distinction: killing (an act) is morally worse than letting die (an omission).
Withdrawing treatment is framed as merely ceasing to intervene, allowing the disease to take its
natural course, whereas PAD involves a positive act of supplying lethal drugs.
TABLE OF CONTENT
Biomedical Ethics Page 3
Business Ethics Page 10
Environmental Ethics Page 18
, 1. Do you think that euthanasia in the form of physician assistance in dying is ethically different
from letting a patient die by withdrawing treatment or life-support? Write an essay in which you
answer this question. Provide reasons for your argument.
Introduction
The ethics of end-of-life care presents some of the most contested terrain in contemporary
biomedical ethics. Among the most pressing questions is whether euthanasia in the form of physician
assistance in dying (PAD) — where a physician provides a lethal dose of medication that the patient
self-administers — is ethically different from letting a patient die by withdrawing treatment or
life-support (e.g., turning off a ventilator or stopping artificial nutrition and hydration). Many legal
and professional guidelines treat these two practices as morally distinct: passive euthanasia
(withdrawing treatment) is widely accepted, while active euthanasia or physician-assisted dying
remains illegal in most jurisdictions. However, philosophers such as James Rachels have argued that
there is no morally significant difference between killing and letting die. This essay will argue that
physician assistance in dying is not ethically different from withdrawing treatment or life-support,
provided certain safeguards are met. The supposed ethical distinction rests on several untenable
premises: the act-omission distinction, the intention doctrine, and the causal role of the physician.
Through a critical examination of these premises, and by appeal to principles of patient autonomy,
beneficence, and equality of suffering, this essay demonstrates that the two practices are ethically
equivalent. Nevertheless, the essay will also acknowledge that practical and psychological
differences exist, but these do not amount to ethical differences.
1. Defining Key Terms
Before comparing ethical frameworks, it is essential to define the practices under consideration.
Physician Assistance in Dying (PAD) refers to a physician providing a competent, terminally ill
patient with a lethal prescription (e.g., barbiturates) that the patient voluntarily self-administers to
end their life. This excludes active voluntary euthanasia where the physician administers the lethal
injection, though many arguments apply similarly.
Withdrawing treatment or life-support involves discontinuing medical interventions — such as
mechanical ventilation, dialysis, antibiotics, or artificial nutrition and hydration — that are keeping a
patient alive, with the foreseeable result that the patient will die from their underlying disease.
Letting die is often contrasted with killing. The former is typically described as an omission (failing
to act), while the latter is an act (doing something directly to cause death). In biomedical ethics,
withdrawing treatment is generally classified as “passive euthanasia” and is legally and
professionally permissible in most countries (Garrard & Wilkinson, 2005).
2. The Act-Omission Distinction and Its Problems
The most common ethical argument for differentiating PAD from withdrawing treatment is the
act-omission distinction: killing (an act) is morally worse than letting die (an omission).
Withdrawing treatment is framed as merely ceasing to intervene, allowing the disease to take its
natural course, whereas PAD involves a positive act of supplying lethal drugs.
