A distinction may
be drawn between „help in dying“ - HID - and „helping the dying“ - HTD. The
first notion includes euthanasia (E) and physician-assisted suicide (PAS), acts
which must be regarded as „death promoting“. By contrast, HTD is about helping
terminally ill people to an optimal quality of life. This might include
submission to a palliative medicine unit, symptomatic treatment, social
support, etc. Thus, behind HTD lies a „life promoting“ intention. Normally,
acts of abstention of treatment in the terminally ill („letting die“) are
categorized as HTD actions - they are not grouped together with HID actions
such as E and PAS. But perhaps some instances of abstention are more
appropriately labeled HID than HTD actions? Consider the following case: If you
do not offer antibiotics to a patient with symptoms (pneumonia) and the patient
dies soon with symptoms, you violate your duty of offering optimal symtom
control. You may also cause an earlier death to the patient - i.e., earlier as
compared with what would have happened if the patient received antibiotics. It
might be said that in not treating the patient, you are „letting nature take
its course“ and so the patient dies „a natural death“ due to his underlying
disease. But if you refrain from offering treatment for the infection because
you think that it is better for the patient to die, then arguably you are
performing a HID action. Similar cases will be discussed and analyzed in the
light of the concepts HID and HTD