The Difference Between "Pulling the Plug" and Euthanasia

A summary by Margaret Somerville. There are many good points, but this is the bottom line:

This brings us to the issue of legal causation, which also differentiates refusals-of-treatment-that-result-in-death from euthanasia. In the former, the person dies from their underlying disease — a natural death. The withdrawal of treatment is the occasion on which death occurs, but not its cause. If the person had no fatal illness, they would not die. We can see that when patients who refuse treatment and are expected to die, do not die. In contrast, in euthanasia death is certain and the cause of death is the lethal injection. Without that, the person would not die at that time from that cause.

The fact that the patient dies both in refusing treatment and in euthanasia is one of the sources of the confusion between the two. If we focus just on the fact that in both cases the outcome is death, we miss the real point of distinction between death resulting from refusing treatment and from euthanasia