Re: Australian who won 'right to die' case has died Originally Posted by nascentRN
I'm not sure I understand why I should feel any better letting someone die instead by refusing treatment when there could be a more humane way available should the patient choose it.
Hi nascent

This topic occupies a subsection of ethicists - it's often referred to as Killing vs Letting Die, and explores why we feel differently about taking action rather than withholding intervention, even when the intended outcome is the same. In health care examples include why it feels more wrong or conflicted to withdraw a lifesaving intervention (like dialysis or ventilation) rather than deciding not to initiate it in the first place, even though the outcome (death) is known and the same regardless.
A philosophical thought experiement brings this idea to a wider audience, asking whether you should flip a switch and divert a runaway train from a main line (where it will kill all aboard) to a sideline (where it will kill one or five men). For some interesting variations on this, check
this.
A last thing to think about - euthanasia is a multi-stranded issue, that ranges from "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, also known as "passive euthanasia") or commission of an act ("active euthanasia'). See also living will" (
source) to "Nazi euphemism for the deliberate killings of institutionalized physically, mentally, and emotionally handicapped people. The euthanasia program began in 1939, with German non-Jews as the first victims. The program was later extended to Jews" (
source). Some definitions even include providing the means for death to a patient (like Dr Kevorkian's suicide machine).
if I have an unconscious patient in apparent distress, whose death within minutes to hours is inevitable, I feel comfortable giving them prescribed PRN narcotics in generous quantities and with frequency. Although my intent is partly symptom relief, it's also significantly to shorten the patient's life and suffering. Yet somehow, giving morphine feels morally appropriate, but giving potassium would feel morally wrong, even though the method (IV push), intent (bring about a faster death than no intervention) and outcome (death) are the same. Why does the mechanism (morphine vs potassium) feel different?
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