The Ninth Circuit court of Appeals feels that there is no distinction between withholding medication and prescribing lethal medication. They feel this way for many reasons. One is the fact that it is common to prescribe medication to a terminally ill patient knowing it is going to relieve pain and hasten death. They also feel that a doctor who "pulls the plug" on a respirator is in fact taking an action. He is taking actions that will undoubtedly result in the death of his patient.
They also feel that the statement that a patient should die of an underlying disease is an invalid statement since a patient that gets taken off of feeding tubes does not die of an underlying disease, they die of starvation. They feel that this is the doctor helping the patient to die and not allowing the disease to kill them. .
The author if this article Richard McCormick feels that these are unfair assumptions. He feels that they are using terms that really should not be used in the context in which they were used. They rely to heavily on "Starve" and "Hasten death." They have identified with one characteristic of each and feel that they are somehow linked by this one characteristic. .
He tries to show his point by quoting George Annas who states that it is ridicules to believe that Nancy Cruzan dies of starvation and not the vegetative state that made her need artificial feeding tubes in the first place. He goes on to say that if you believe in this then you must also believe that when a doctor stops cardiopulmonary resuscitation it is not the cardiac arrest but the doctor who intentionally stops compressing the heart that is the reason for the death.
James Rachel tries to state points that show there is no distinction between commission-omission. He starts off by saying that letting someone die may take longer then if you just gave him or her lethal drugs, which would defeat the purpose of deciding to die in the first place.