So, I just had a close relative pass away with hospice care so I have a little insight into this.
Once you get to hospice, you are in the last paragraph of the last chapter of the book. There is no more treatment for the underlying disease; the focus is on improving quality of life and making the passing as painless and dignified as it possibly can be.
This happens in stages. For a while, the person can be lucid and “active” but at some point they transition to the “actively dying” stage where the body is starting to shut down. They often become unresponsive and no longer want to eat or drink – the body is in the final stages of giving up for good. The last sentance of the last paragraph of the last chapter of the book, if you will.
At that point, it is about letting the body do what it is naturally going to do. Forcing anything that would prolong life – like intravenous fluids or nutrition – is no longer in the patent’s best interests. If they want something you give it to them, but otherwise you just let the body die. They only things you give are things that minimize discomfort. It is a passive process – you simply don’t intervene in what is naturally happening.
This is very different from assisted suicide, where you give them something that hastens death. A massive dose of sedative that would stop their breathing for example. This is an active process – you are stepping in and _doing something_ to specifically make death happen.
In most countries, withholding some aspects of care is not seen as assisting in death and is thus permissible for healthcare workers in certain situations.
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