Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—In his article, Mr Gostin1 makes a mistake common to many, especially in our
court system (eg, Quill v Vacco2).
Patients from whom artificial hydration and nutrition are removed because
it is ineffective do not die of starvation. Rather, they die of the existing
pathology that had been circumvented by artificial hydration and nutrition.
Moreover, ethical actions are not judged solely by physical results. Rather,
they are evaluated by the proximate intention that brings about the physical
results. Thus, although the results of assisted suicide and withdrawing ineffective
life support are similar from a physical perspective, from an ethical point
of view, they are diametrically opposed.
O'Rourke K. Deciding Life and Death in the Courtroom: Debate and Clarification. JAMA. 1998;279(16):1259-1261. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-16-jac80007