Cochrane’s excellent target article (2009) is based on a few ethical and legal assumptions that are currently accepted as “bedrock” principles inWestern medicine and bioethics, such as patient autonomy and the right to refuse medical interventions. From this point of departure, he tries to push the envelope further by arguing in support of a practice that is currently “not widely recognized” (47), that of withdrawing ‘natural’ feeding, even from incompetent patients. His main concern is the pressure created by what he considers to be a misconception regarding the need to use a “window of opportunity" (47) to die and the life-and-death decisions made under this pressure. In order to assuage the fear of patients or their surrogates regarding the possibility of “being stuck with life” (47) he argues elaborately that there is no ethical distinction between stopping tube feeding and stopping feeding by hand.
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