In both cases, the patient knowingly chooses a course of action that will lead to her or his death, rather than an alternative course of action that would have led to a longer but burdensome life. By focusing on the narrower intention to refuse burdensome treatment, rather than the broader implications of the choice, the Roman Catholic Church is able to avoid the inhumane implication that patients must always accept life-prolonging treatment, no matter how painful or costly such treatment may be.
这种区分的界限非常模糊。在两种情况下，病人都是在知道的情况下选择一种可以导致他们死亡的行为，而没有选择去延长他们已成负担的生命。强调了狭义的拒绝带来负担的治疗手段，而没有强调这一选择更广阔的涵义，罗马天主教会确实避免了不人道的涵义，亦即病人必须接受维持生命的治疗，不管这有多痛苦有多高的代价。但这一做法与教会做极力反对的辅助自杀以及自愿安乐死确实有出入的。