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June 26, 1995

The Distinction Between Active and Passive Euthanasia-Reply

Author Affiliations

Boston, Mass

Arch Intern Med. 1995;155(12):1329. doi:10.1001/archinte.1995.00430120123016

In reply  Gert is correct that there is a distinction between refusals and requests that is relevant to the ethical debate about euthanasia. I may correctly be criticized for not having highlighted it in my discussion of definitions and for having overly stressed the importance of the physician's intention.1 However, my point in stating the definitions was not to settle ethical arguments by clever definitions but to make sure we all use these terms in the same manner.In considering the ethical arguments against euthanasia, I clearly acknowledge the ethical importance of the refusal-request distinction. In my article,1 I state:Prohibiting euthanasia and physician-assisted suicide does not prevent individuals... from committing suicide by any number of other mechanisms.... In this sense, the autonomy to kill oneself does not extend "to have someone else's assistance."... The philosopher Francis Kamm put it this way: "[T]he person who requests it does