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Discontinuation of Dialysis Is Not Euthanasia-Reply

Richard W. Carlson, MD, PhD; Syed K. Shahryar, MD
Arch Intern Med. 1995;155(15):1681-1682. doi:10.1001/archinte.1995.00430150177020.
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In reply  The debate on euthanasia dates to ancient times.1 The definition of the terms surrounding this topic has also been controversial.2 Although Karlawish and Siegler are associated with a renowned center for clinical medical ethics, we submit that the withdrawal of life support is a form of euthanasia, although we may have added the adjective passive.3 We used the word unique to describe the discontinuation of dialysis. Interestingly, the term euthanasia is borrowed from the Greek,4 meaning a good death, which is the subtitle (albeit in the form of a question) of an article by Cohen et al.5 We therefore were referring to the general topic of easing the dying process.Karlawish and Siegler also discuss the issue of intent, to distinguish between killing and letting die. We believe that it is not as simple and straightforward as they state: "When a physician withdraws


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