- Withdrawing medical treatment may lead to death, but that isn't the intent. Indeed, the point is to stop an unwanted bodily intrusion, not to kill. As Paul Ramsey put it, that is treating the "patient as a person."
- With the exception of a feeding tube, such deaths are uncertain. Sometimes -- if unexpectedly -- people live. For example, Karen Ann Quinlan lived about ten years after her respirator was removed.
- Death is certain in euthanasia and assisted suicide.
- When medical treatment is withdrawn or withheld on request, if it comes, the death is natural.
- In euthanasia and assisted suicide, death is unnatural, e.g., a result of homicide or suicide.
- In contrast to removing unwanted treatment, the intent of assisted suicide and euthanasia is to kill.
Not Dead Yet sees clearly that assisted suicide and euthanasia discriminate invidiously against people with disabilities because they treat them as a disposable caste whose lives are not worth saving if they become suicidal.
The vital distinction between "allowing to die" and "making dead" through homicidal or suicidal means was recognized 9-0 by the United States Supreme Court in the 1997 decision Vacco v. Quill :
[A] physician who withdraws, or honors a patient's refusal to begin, life sustaining medical treatment purposefully intends, or may so intend, only to respect his patient's wishes to cease doing useless and futile or degrading things to the patient when the patient no longer stands to benefit from them. ...
A doctor who assists a suicide, however, "must necessarily and indubitably, intend primarily that the patient be made dead." Similarly, a patient who commits suicide with a doctor's aid has the specific intent to end his or her own life, while a patient who refuses or discontinues treatment might not ...[and, indeed] may instead "fervently wish to live, but to do so free of unwanted medical technology, surgery, or drugs." [Citations omitted.]