Comment on “End-of-life care: is euthanasia the answer?”by Truog

Excerpt

In an recent editorial published in Intensive Care Medicine Truog [1] commented upon the article by Provoost and colleagues [2] concerning the use of drugs with a life-shortening effect in end-of-life pediatric care, and he concluded that following the “doctrine of double effect” (DDE) is a preferable alternative to euthanasia. Although the DDE is morally acceptable in order to relieve the patient's suffering and not directly to cause death when no alternatives are not available, we disagree with Truog's use of the term euthanasia. The author uses euthanasia to describe unilateral decisions to avoid unnecessary suffering, decisions made without taking the patient's opinion into account, on the basis of quality-of-life criteria as judged by physicians or parents. However, the patient's explicit request for euthanasia as an option for end-of-life care is an essential condition in Dutch law for the use of this term. Obviously the term cannot be applied to infants who are not competent to make decisions of this kind. Therefore we believe that it is highly relevant to use the proper word, for the moral consequences involved in the concept are very important: euthanasia consists of putting an end to life when the patient is experiencing terminal suffering only if this is the expressed will of the patient. …