Views & Reviews Personal View

Withholding versus withdrawal of life support: is there an ethical difference?

BMJ 2011; 342 doi: (Published 09 February 2011) Cite this as: BMJ 2011;342:d728
  1. Shimon Glick, Lord Rabbi Immanuel Jakobovits Center for Jewish Medical Ethics, Joyce and Irving Goldman School of Medicine, Ben-Gurion University, Beer-Sheva, Israel
  1. gshimon{at}

We ignore healthcare workers’ intuitions at our peril. In particular I refer to one area that Western philosophers and ethicists seem to have settled on, ignoring the feelings of many physicians and nurses. This is the area of the ethical comparison of withdrawal versus withholding of life sustaining therapy. But my reasoning applies to other areas as well, such as whether active and passive euthanasia are ethically similar or not.

In a journal article experts in bioethics stated categorically that “law and medical ethics treat the withholding and the cessation of life-sustaining treatment the same” and that the view that they were different was a “myth” that had been recognised as such a decade earlier.1 But just a few pages earlier in that very same issue a survey of neonatologists from 10 European countries showed that more than two thirds did not equate withholding and withdrawing life support …

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