Withholding and Withdrawing Life-Sustaining Treatment and the Relevance of the Killing Versus Letting Die Distinction

In this paper, we argue that a defence of the moral equivalence of withholding and withdrawing life-sustaining treatment (LST) would be more difficult if withdrawing life-sustaining treatment is considered to be a form of killing rather than letting die. Dominic Wilkinson and Julian Savulescu have defended the equivalence thesis (the moral equivalence of withholding and withdrawing LST) in a number of papers. But Savulescu has also claimed that withdrawing life-sustaining treatment is killing. We argue that if Savulescu is right about this, then he and his co-authors face a very significant hurdle in defending the equivalence thesis, because they would need to argue for the very controversial view that killing and letting die are morally equivalent. After decades of debate, however, there is no consensus on this issue. Fortunately, there is a different option. We should simply reject the claim that withdrawing LST is a form of killing. If we reject this claim, it is far easier to defend the claim that withholding and withdrawing LST are morally equivalent, because we would then only need to claim that different forms of letting die are morally equivalent, rather than claim that killing and letting die are morally equivalent. Savulescu and colleagues should therefore drop the claim that withdrawing LST is a form of killing.