If I remove life support, am I responsible for the death?
There is no meaningful medical, legal, or ethical difference between withholding life-sustaining technology and withdrawing it, and none of the advance-directive laws delineate between the two. People have a constitutional right to request the withdrawal or withholding of medical treatment, even if doing so will result in death. As a legal matter, the courts are presently distinguishing between physician-assisted suicide, which is illegal virtually everywhere, and withdrawing or withholding life support, which is legal.
Morally, people are not responsible for the death of another if they don’t cause it or intend it. When life support is removed, the illness or injury—not the withdrawal—is the medical cause of death. Nevertheless, withdrawal can be done with the primary intent of bringing on death sooner—i.e., the same problematic intent involved in assisted suicide and euthanasia (see question 15). Or, withdrawal can be done with the praiseworthy intent of allowing a loved one to die without the added burden of a medically prolonged dying process (i.e., when the condition is irreversible and death is imminent; see question 3).
Some people feel guilty after making a decision to withdraw life support because something between the patient and the decision maker was left unresolved or because they had not discussed the patient’s treatment desires prior to an injury that left the patient suddenly unconscious. The quality of our relationships and our ability to communicate have much to do with the difficulty that we have in making and executing end-of-life decisions. How we love one another throughout our lives will determine the way in which we emotionally handle the decisions during the dying and death experience. However, the fact of the matter remains: A decision to terminate end-of-life technology need not be a decision to kill, but rather may be a decision to accept the inappropriateness of continued medical intervention.
Such removal of life support is not playing God. Remember, medical intervention is a human invention, not a divine mandate. Using medical intervention should always benefit the patient; when it is of no use, it should be removed. God has given each of us a certain amount of time on this earth. Because we cannot know the exact time of death, we are responsible to make decisions that honor life and please God. Honoring life and pleasing God includes knowing when efforts to continue life are futile. The Scripture often reminds us of the brevity or fragility of life and the frustration that accompanies it (Ps. 90:10). James tells us that each of our lives is as a “vapor that appears for a little time and then vanishes away” (James 4:14), and Isaiah compares our flesh to grass—though it has a moment of beauty, eventually it withers and fades away (Isa. 40:6–10). As death draws near, we are under no obligation to fight unceasingly as if we could conquer it. We will never overcome death until Christ returns. So until that time, we must use the gift of medical intervention as a tool that sustains life, improves health, and provides comfort.
Stewart, G. P., Cutrer, W. R., Demy, T. J., O’Mathúna, D. P., Cunningham, P. C., Kilner, J. F., & Bevington, L. K. (1998; 2004). Basic Questions on End of Life Decisions (59–61). Kregel Publications.