Withdrawing Life-Sustaining Treatment
Allowing to Die or Causing Death?
A traditional norm of medical ethics is that doctors must not intentionally cause the death of their patients. However, withdrawing life-sustaining treatment has become a common practice in hospital intensive care units. This practice has been made consistent with the traditional norm by means of the conventional view in medical ethics that withdrawing life support allows the patient to die but does not cause death. In this chapter we challenge this conventional view. Adopting a common-sense conception of causation, we argue systematically that withdrawing life-sustaining treatment, such as mechanical ventilators, causes death. In addition, we argue that causing death by stopping life support is typically an intentional act. Nevertheless, causing death by withdrawing life-sustaining treatment is justified because it respects the self-determination and promotes the well-being of patients. The argument in Chapter 1 sets the stage for discussing the ethics of medical acts that cause death in subsequent chapters.
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