죽임(Toten)과 죽게 내버려둠(Sterbenlassen): 인과성의 관점에서 바라본 부작위(Unterlassen)

Whereas active and direct euthanasia is ethically and legally prohibited, passive or indirect euthanasia is, except for special cases, acceptable and even recommendable. The actual difference between an intentional act of killing and an act of withholding or withdrawing life-sustaining treatment can be described most clearly in terms of the causal role of the physician. Active euthanasia represents a new cause of death: the patient’s death results from the physician’s medical intervention (iatrogenic). In the case of passive euthanasia, the cause of death is the patient’s underlying disease. But a physician’s omission’ which allows the patient to die may be a cause of the patient’s death in the sense of an inus-condition, that is, an insufficient but non-redundant part of an unnecessary but sufficient Condition. The inus-condition is responsible for the causation of the occurrence. Both killing and letting die are inus-conditions of minimally sufficient conditions of the patient’s death. The abandonment of withholding or withdrawing of persistence-treatment is thus causally responsible for the fatal outcome.