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.