# How can someone turn off someone's life support machine in hospital not be guilty of murder then? **URL:** \ **Category:** Factual Questions\ **Created:** [June 5, 2018, 10:27pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495 "2018-06-05T22:27:02Z")\ **Posts on this page:** 16\ **Page:** 1
**Author:** ![Dunmurry](https://avatars.discourse-cdn.com/v4/letter/d/d2c977/32.png) [@Dunmurry](https://boards.straightdope.com/u/Dunmurry)\ **Post date:** [June 5, 2018, 10:27pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/1 "2018-06-05T22:27:02Z")
Well I was just wondering how someone could turn off someone’s life support machine and yet not be guilty of murder. They are doing something that will end the life of a human being within a few hours probably and yet they’re not guilty of murder. It’s not vastly different to forcing a cushion over their face and suffocating them. So if a doctor turns off someone’s life support machine which will cause their death within a few hours how does lit work from a legal perspective that they are not guilty of murder or something similar to that? ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 5, 2018, 10:30pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/2 "2018-06-05T22:30:22Z")
Disclaimer: IANAL I’m guessing either 1) they have the backing of laws that specifically \*\*state \*\*that this is not murder and grant doctors permission as such, and/or 2) there is a difference between actively killing someone and passively denying them what they need to live (although I can’t imagine a parent who starves kids to death winning such an argument in court.) ---
**Author:** ![Bijou\_Drains](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bijou_drains/32/2814_2.png) [@Bijou\_Drains](https://boards.straightdope.com/u/Bijou_Drains)\ **Post date:** [June 5, 2018, 10:36pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/3 "2018-06-05T22:36:05Z")
some people have a living will which spells out what can be done or not done in certain medical situations. The Drs. follow that in most cases. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 5, 2018, 10:40pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/4 "2018-06-05T22:40:21Z")
I thought it was because they simply lack the required legal intent for murder, because there’s no malice (as defined by the law, not the everyday meaning). ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [June 5, 2018, 10:46pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/5 "2018-06-05T22:46:20Z")
> [@Ravenman](#): > > I thought it was because they simply lack the required legal intent for murder, because there’s no malice (as defined by the law, not the everyday meaning). Well, there are all kinds of deaths that have no malice but are illegal (i.e., manslaughter or negligence.) Surely, in doctors’ cases, it is simply because they have “authority” to pull the plug? ---
**Author:** ![naita](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/naita/32/5862_2.png) [@naita](https://boards.straightdope.com/u/naita)\ **Post date:** [June 5, 2018, 10:46pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/6 "2018-06-05T22:46:45Z")
> [@Dunmurry](#): > > Well I was just wondering how someone could turn off someone’s life support machine and yet not be guilty of murder. They are doing something that will end the life of a human being within a few hours probably and yet they’re not guilty of murder. It’s not vastly different to forcing a cushion over their face and suffocating them. So if a doctor turns off someone’s life support machine which will cause their death within a few hours how does lit work from a legal perspective that they are not guilty of murder or something similar to that? It is vastly different from forcing a cushion over someones face. For one thing the cushion trick is a lot less certain than movies will have you think. As to the legal aspect, here is one article. I’m sure you can find one for your own jurisdiction if this one does not apply: [Legal Aspects of Withholding and Withdrawing Life Support from Critically Ill Patients in the United States and Providing Palliative Care to Them](https://www.atsjournals.org/doi/full/10.1164/ajrccm.162.6.1-00) ---
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [June 5, 2018, 10:47pm UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/7 "2018-06-05T22:47:56Z")
> [@Dunmurry](#): > > Well I was just wondering how someone could turn off someone’s life support machine and yet not be guilty of murder. They are doing something that will end the life of a human being within a few hours probably and yet they’re not guilty of murder. It’s not vastly different to forcing a cushion over their face and suffocating them. So if a doctor turns off someone’s life support machine which will cause their death within a few hours how does lit work from a legal perspective that they are not guilty of murder or something similar to that? In most cases, it is because the patient is already dead according to the legal definition of [brain death.](https://en.wikipedia.org/wiki/Legal_death) > [@](#): > > Brain death determinations are made in cases where heartbeat and breathing are supported by machines. Brain death is determined by there being no signs of brain function during neurological examination of a person with a beating heart.[2] Confirmatory tests document either no blood flow to the brain, or no brain electrical activity in absence of factors[3] known to produce reversible loss of brain function.[4] Unlike cardiopulmonary death which sometimes involves a decision not to resuscitate the heart, brain death is a determination that the brain biologically cannot be resuscitated. You can’t murder someone who is already legally dead, even if their heart is being kept beating artificially. It can get stickier when there is some ambiguity about whether brain death has occurred or that it is impossible to resuscitate someone. ---
**Author:** ![Lucas\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lucas_jackson/32/303_2.png) [@Lucas\_Jackson](https://boards.straightdope.com/u/Lucas_Jackson)\ **Post date:** [June 6, 2018, 2:31am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/8 "2018-06-06T02:31:35Z")
> [@Dunmurry](#): > > It’s not vastly different to forcing a cushion over their face and suffocating them. Yes, it is. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 6, 2018, 3:16am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/9 "2018-06-06T03:16:17Z")
I saw plenty of orders to discontinue life support for people who were not brain dead, and in some cases were fully conscious and able to consent. These were usually people who needed assistance in breathing (not full mechanical ventilation) whose prognosis was hopeless, and they were ready to go and usually died naturally within a matter of hours. Sometimes they were sedated, and sometimes they weren’t. ---
**Author:** ![cochrane](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cochrane/32/10441_2.png) [@cochrane](https://boards.straightdope.com/u/cochrane)\ **Post date:** [June 6, 2018, 3:44am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/10 "2018-06-06T03:44:59Z")
> [@Bijou\_Drains](#): > > some people have a living will which spells out what can be done or not done in certain medical situations. The Drs. follow that in most cases. My father had a brain aneurysm and went into a coma. He had a living will which requested that if he were ever on life support and was non-responsive, doctors had his permission to take him off life support after seven days if there was no hope of him ever regaining consciousness. After seven days, his wishes were carried out and he passed away within a few hours. This is not the same as taking positive action to end someone’s life. It is permitting the natural course of death to occur. tl;dr: Turning off life support doesn’t cause death if death would have occurred naturally without it. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [June 6, 2018, 4:07am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/11 "2018-06-06T04:07:52Z")
> [@Ravenman](#): > > I thought it was because they simply lack the required legal intent for murder, because there’s no malice (as defined by the law, not the everyday meaning). In fact, there’s locations where someone who turns off the life support machines without appropriate permissions can be prosecuted for murder. Doing it with appropriate permissions is an appropriate medical act, doing it without is an “angel of death” murder. ---
**Author:** ![Tim\_T-Bonham.net](https://avatars.discourse-cdn.com/v4/letter/t/46a35a/32.png) [@Tim\_T-Bonham.net](https://boards.straightdope.com/u/Tim_T-Bonham.net)\ **Post date:** [June 6, 2018, 6:50am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/12 "2018-06-06T06:50:23Z")
> [@Dunmurry](#): > > It’s not vastly different to forcing a cushion over their face and suffocating them. Certainly it id. If I take a knife and stab it into your belly, it’s vastly different than if a surgeon takes a scalpel and cuts into your belly. Intent & purpose, authority & expertise all enter into this. And in the worst case, it will come down to the common sense of a jury of your peers. ---
**Author:** ![Isilder](https://avatars.discourse-cdn.com/v4/letter/i/cc9497/32.png) [@Isilder](https://boards.straightdope.com/u/Isilder)\ **Post date:** [June 6, 2018, 7:05am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/13 "2018-06-06T07:05:03Z")
The test is that the patient is of sane mind if they chose to not receive treatments. So an insane patient may not be able to say so, but a sane patient can. The family, the next of kin, is able to make the same decision for someone not able to communicate - or even make the decision… but only if sane reasonable person could decide to end their own life in the same situation. In the emergency, such as a sudden onset of illness, it is assumed that the patient would NOT chose to foregoe treatment when with a sane mind. (Sometimes a distressed patient is saying, “no I just want to die”, when its not even clear that they understand what their diagnosis AND prognosis is.) It also means that failure to treat someone who can easily be treated is murder or manslaughter, neglect , if the person would not want to be mistreated like that. So treat their bed sores and change their diaper today, even if they are dying tommorrow. Because if they die today, it could be said due to neglect rather than what a sane person would want. Here’s the legal discussion which shows you won’t find written law on the topic. In the United States, the withholding and withdrawal of life support is legally justified primarily by the principles of informed consent and informed refusal, both of which have strong roots in the common law. The principles hold that treatment may not be initiated without the approval of patients or their surrogates excepting in emergency situations, and that patients or surrogates may refuse any or all therapies. The application of these principles to the care of the critically ill began in the Quinlan case (6), in which the New Jersey Supreme Court held that a patient had the right to refuse mechanical ventilation, and that, because she was vegetative and could not exercise that right directly, her parents could act as surrogates for her. The California Court of Appeals took a similar approach in the Barber case (7), in which it held that physicians charged with murder had not committed an unlawful act when, with permission from a patient’s family, they removed nutrition and hydration from a comatose patient. ---
**Author:** ![rowrrbazzle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rowrrbazzle/32/414_2.png) [@rowrrbazzle](https://boards.straightdope.com/u/rowrrbazzle)\ **Post date:** [June 7, 2018, 3:21am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/14 "2018-06-07T03:21:43Z")
Rare related case: CPR works so well that the patient remains conscious, but the heart does not restart. [A rare but extremely distressing phenomenon: Patients being conscious during CPR | ScienceDaily](https://www.sciencedaily.com/releases/2018/06/180604182509.htm) > [@](#): > > During admission the patient experienced a short period of tachycardia (rapid heart rate) followed by a cardiac arrest, causing medical staff to immediately begin CPR in the form of chest compressions and the provision of ventilation with 100% oxygen via a mask. By the time the cardio-resuscitation-team arrived, the patient had a blood oxygen level of 100% and a high level of awareness with open eyes and movement of the head and limbs. Regular checks were made to see if the patient’s heart had begun to beat but these showed no rhythm, and no noticeable movement of the heart was observed during the multiple ultrasound echocardiograms that were conducted during the 90 minutes of CPR… > > Despite the best efforts of the medical staff, the patient did not survive and an autopsy later confirmed that he had suffered a complete aortic dissection… > > They note that that even though the patient had a poor prognosis, the termination of CPR after 90 minutes raised ethical questions in the team as the individual was still conscious at the time. ---
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [June 7, 2018, 3:55am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/15 "2018-06-07T03:55:50Z")
> [@rowrrbazzle](#): > > Rare related case: CPR works so well that the patient remains conscious, but the heart does not restart. [A rare but extremely distressing phenomenon: Patients being conscious during CPR | ScienceDaily](https://www.sciencedaily.com/releases/2018/06/180604182509.htm) Very rare. I’ve done CPR hundreds of times and I’ve never seen anything like that. If the patient wakes up, his heart is working at least temporarily. The article was posted to an ER discussion group with the headline “Patient Remains Awake During 90 Minutes of CPR”. I assumed it was satire from Gomerblog or The Onion. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [June 7, 2018, 4:04am UTC](https://boards.straightdope.com/t/how-can-someone-turn-off-someones-life-support-machine-in-hospital-not-be-guilty-of-murder-then/815495/16 "2018-06-07T04:04:26Z")
Bottom line the answer is “murder” as a crime is whatever the law defines it as. If the law allows for unplugging life support then it is, by definition, not murder. Presumably the people doing the unplugging are scrupulously following the applicable laws. Unless the OP wants to talk about murder in the colloquial sense and not legal sense.