Conventional medical ethics and the law draw a clear line that distinguishes the permitted practice of withdrawing life-sustaining treatment from the prohibited practice of active euthanasia by lethal injection. When clinicians legitimately withdraw life-sustaining treatment, they allow patients to die, but are not morally responsible for the patient's death. In contrast, clinicians wrongly kill patients when they deliberately administer a lethal dose of a drug. The article argues that the differing moral evaluation of these two practices is based on a series of moral fictions - motivated false beliefs that mischaracterise the withdrawal of life-sustaining treatment in order to align accepted end-of-life practices with the dominant moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes clear that conventional medical ethics relating to decisions at the end of life are radically flawed
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