{"id":2051,"date":"2012-10-05T15:09:54","date_gmt":"2012-10-05T14:09:54","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=2051"},"modified":"2012-10-05T19:57:40","modified_gmt":"2012-10-05T18:57:40","slug":"passive-euthanasia-a-cri-de","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/","title":{"rendered":"Passive Euthanasia: A Cri de C\u0153ur"},"content":{"rendered":"

Don’t worry: this isn’t another instance of me yammering on about the right to die or the right to induce death.<\/p>\n

I’ve recently received a parcel; it contained a copy of this book<\/a> by Leanne Bell,\u00a0which happened to fall open at\u00a0p 204.\u00a0 On that page, you’ll find this passage:<\/p>\n

Active euthanasia involves a deliberate act intended to kill […].\u00a0 This is illegal in England and Wales because it satisfies the definition of ‘unlawful killing’ and will therefore either be murder or manslaughter depending on the mens rea (that is, the state of mind) of the doctor at the time.\u00a0 He is likely to face criminal prosecution, regardless of whether the patient and\/or the family requested or consented to it.\u00a0 By contrast, passive euthanasia involves the withholding or withdrawing of treatment from the patient, i.e. an omission rather than an act, and, in certain circumstances, can be legal.<\/strong> [emphasis mine – IB]<\/p><\/blockquote>\n

No.\u00a0 Wrong.\u00a0 Wrong on two fronts.\u00a0 Withholding treatment may be an omission, but withdrawing it isn’t.\u00a0 More importantly, while the active\/ passive distinction boils down to one between administration and non-administration, it is simply not true that non-administration is the same as passive euthanasia<\/em>.<\/p>\n

Euthanasia requires the intention to end life based on a motive of beneficence directed at the person who will die.\u00a0 Neither withdrawing nor withholding treatment indicates the intention to end life.\u00a0 Only if you’re withdrawing or withholding treatment with the intention that this should end life<\/em> have you committed passive euthanasia.<\/p>\n

There’s a simple test you can run here: When withdrawing or withholding treatment, would it be coherent to hope for the patient’s survival – however miraculous\u00a0–\u00a0without further intervention?\u00a0 It would not be coherent in cases of euthanasia, because you can’t intend that life should end and yet hope that it doesn’t.\u00a0 It could be coherent otherwise.<\/p>\n

Or another version of the same test: If you are considering withholding or withdrawing treatment and the patient does not die, would you see this as contrary to your intention?\u00a0 If yes, you’re considering passive euthanasia; if no, you aren’t.<\/p>\n

Bell is by no means alone in getting PE wrong.\u00a0 The mistake is all over the place – both in the clinical ethics literature, and in the wider public domain<\/a>.\u00a0 I’m not wholly sure where it’s come from, but I suspect it may derive from Rachels having made it in”Active and Passive Euthanasia<\/a>“, and then a little\u00a0more\u00a0explicitly in\u00a0“Killing and Letting Die<\/a>“:<\/p>\n

\n

Many people believe that “passive euthanasia” – allowing terminal patients to die, rather than pointlessly prolonging their lives – is sometimes permissible; but they also believe that killing patients is always wrong. <\/span><\/p>\n<\/blockquote>\n

I’ve got a lot of time for Rachels, and much of what he says on killing and letting die in these essays is good.\u00a0 But this is wrong. \u00a0Even good essays can have wrinkles in them; and this is a big one.\u00a0 And if it’s the source of the same mistake being made elsewhere, that’s quite serious.<\/p>\n

ADDENDUM:<\/em><\/strong> Oh, hell – it gets worse.\u00a0 From p 203:<\/p>\n

Voluntary euthanasia involves a mentally competent patient asking the doctor to end their life, whereas involuntary euthanasia refers to a situation where the patient either lacks mental capacity or lacks the physical ability to communicate his wishes due to severe disability or lack of consciousness.<\/p><\/blockquote>\n

So I looked through the rest of the book.\u00a0 It’s embarrassingly bad, at least in respect of the ethics.\u00a0 Another random sample: Futility is, apparently, a school of ethical thought alongside consquentialism and deontology (p 22).\u00a0 That’s not only philosophically incompetent: believing it requires that one has only the vaguest grasp of English.<\/p>\n

How did this get past peer-review?<\/p>\n

If you’re considering recommending this book to your students: don’t.\u00a0 You’ll be doing them a serious disservice.<\/p>\n","protected":false},"excerpt":{"rendered":"

Don’t worry: this isn’t another instance of me yammering on about the right to die or the right to induce death. I’ve recently received a parcel; it contained a copy of this book by Leanne Bell,\u00a0which happened to fall open at\u00a0p 204.\u00a0 On that page, you’ll find this passage: Active euthanasia involves a deliberate act […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[371,563,591,394,328,403,577,472],"tags":[],"class_list":["post-2051","post","type-post","status-publish","format-standard","hentry","category-book-review","category-language","category-life-and-death","category-methodology","category-philosophy","category-rant","category-resource","category-thinking-aloud"],"yoast_head":"\nPassive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Passive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"Don’t worry: this isn’t another instance of me yammering on about the right to die or the right to induce death. I’ve recently received a parcel; it contained a copy of this book by Leanne Bell,\u00a0which happened to fall open at\u00a0p 204.\u00a0 On that page, you’ll find this passage: Active euthanasia involves a deliberate act [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2012-10-05T14:09:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2012-10-05T18:57:40+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Passive Euthanasia: A Cri de C\u0153ur\",\"datePublished\":\"2012-10-05T14:09:54+00:00\",\"dateModified\":\"2012-10-05T18:57:40+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/\"},\"wordCount\":658,\"commentCount\":11,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"Book review\",\"language\",\"Life and Death\",\"Methodology\",\"Philosophy\",\"Rant\",\"Resource\",\"Thinking Aloud\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/\",\"name\":\"Passive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\"},\"datePublished\":\"2012-10-05T14:09:54+00:00\",\"dateModified\":\"2012-10-05T18:57:40+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/10\\\/05\\\/passive-euthanasia-a-cri-de\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Passive Euthanasia: A Cri de C\u0153ur\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"name\":\"Journal of Medical Ethics blog\",\"description\":\"A blog to discuss the ethics of medicine in its many guises and formats.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\",\"name\":\"Journal of Medical Ethics blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"width\":200,\"height\":50,\"caption\":\"Journal of Medical Ethics blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Passive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/","og_locale":"en_US","og_type":"article","og_title":"Passive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog","og_description":"Don’t worry: this isn’t another instance of me yammering on about the right to die or the right to induce death. I’ve recently received a parcel; it contained a copy of this book by Leanne Bell,\u00a0which happened to fall open at\u00a0p 204.\u00a0 On that page, you’ll find this passage: Active euthanasia involves a deliberate act [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/","og_site_name":"Journal of Medical Ethics blog","article_published_time":"2012-10-05T14:09:54+00:00","article_modified_time":"2012-10-05T18:57:40+00:00","author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Passive Euthanasia: A Cri de C\u0153ur","datePublished":"2012-10-05T14:09:54+00:00","dateModified":"2012-10-05T18:57:40+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/"},"wordCount":658,"commentCount":11,"publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"articleSection":["Book review","language","Life and Death","Methodology","Philosophy","Rant","Resource","Thinking Aloud"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/","name":"Passive Euthanasia: A Cri de C\u0153ur - Journal of Medical Ethics blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website"},"datePublished":"2012-10-05T14:09:54+00:00","dateModified":"2012-10-05T18:57:40+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/10\/05\/passive-euthanasia-a-cri-de\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/medical-ethics\/"},{"@type":"ListItem","position":2,"name":"Passive Euthanasia: A Cri de C\u0153ur"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","name":"Journal of Medical Ethics blog","description":"A blog to discuss the ethics of medicine in its many guises and formats.","publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/medical-ethics\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization","name":"Journal of Medical Ethics blog","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","contentUrl":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","width":200,"height":50,"caption":"Journal of Medical Ethics blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/medical-ethics\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/2051","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/comments?post=2051"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/2051\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/media?parent=2051"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/categories?post=2051"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/tags?post=2051"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}