In 1986 the American Medical Association ruled it was ethical for

doctors to remove life-support, including food and water, from terminally

ill patients about to die and from those who could linger in a

coma. Four years later a Gallup poll showed that 84 percent of Americans

would prefer to have treatment withheld if they were on lifesupport

and had no hope of recovering. 3

The decision to limit or withhold life-sustaining treatments is

often called "passive euthanasia." Death is allowed to happen naturally,

by refraining from medical intervention or heroic measures that

can only lengthen a person's life by days or hours, and where their

condition is not amenable to treatment. It would include terminating

aggressive treatments or therapies aimed at curing the dying person,

refusing or discontinuing life-support machinery and intravenous feeding,

and dispensing with cardiac resuscitation. This passive form of

euthanasia also takes place when the family and doctor choose not to

treat a secondary condition that will result in death. For example, a

person dying in the final stages of bone cancer may develop pneumonia,

which if not treated may lead to a death that is more peaceful,

and less painful and prolonged.

What about people who are terminally ill and decide to take

themselves off life-support? By ending their lives, are they committing

a negative action? Kalu Rinpoche has answered this question

very precisely:

The person who decides that they have had enough suffering and wish

to be allowed to die is in a situation that we cannot call virtuous or nonvirtuous.

We certainly cannot blame someone for making that decision. It

is not a karmically negative act. It is simply the wish to avoid suffering,

which is the fundamental wish of all living beings. On the other hand, it

is not a particularly virtuous act, either,,,, Rather than being a wish to

end one's life, it's a wish to end suffering. Therefore it is a karmically

neutral act.

What if we are caring for a dying person who asks us to remove

life-support? Kalu Rinpoche said:

We may not be able to save the patient's life. We may not be able to

relieve the person's suffering. But we are trying our best, motivated in the

purest way possible. Whatever we do, even if it is not ultimately successful,

can never be thought of as karmically damaging or karmically negative..

When a healer is instructed by a patient to remove life-support systems,

that puts the healer in a difficult position, because the instincts of the

healer may be telling them, "If this person stayed on the life-support system

they would remain alive. If I take them off, they will die," The karmic

consequences depend upon the healer's intent because the healer will be

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