. 2014 Aug 16;11:507–529. doi: 10.1007/s11673-014-9554-z

Table 1.

Foundations of palliative care and of legal euthanasia: Many similarities and a few differences

	Palliative Care	Legal Euthanasia
Fundamental paradigm Attributes of caregivers	Centrality of the patient Competence and compassion^a	Centrality of the patient Competence and compassion^a
Clinical objectives	1. Relief of suffering 2. Prevention of medical futility	1 Relief of suffering 2. Prevention of palliative futility
Perception of most prominent ethical values	1. Beneficence 2. Patient autonomy^b	1. Patient autonomy 2. Beneficence ^b
Life stance of activists	Often religious	Often agnostic or atheistic
Potential for abuse^c	1 Palliative futility 2. Under the pretence of observing the PC tenet of not prolonging life (WHO), denying life-prolonging treatment to a patient who is doing well in PC.	1. Slippery slope phenomena 2. Substitute for palliative care 3. Erosion of public confidence in the health care system
Public support	Well-nigh universal Distrust by some professionals and politicians^d	Large and growing majority in the advanced countries. Distrust by some professionals and politicians^e

^a See, e.g., de Zulueta 2013

^bIn this order, though the common virtue overarching both beneficence and respect for autonomy is compassion, i.e. the capacity and propensity to put oneself in another person’s place)

^cit should be emphasised here that the reality of medical futility (Bernheim, Vansweevelt, and Annemans 2014) probably dwarfs any abuses of palliative care, that, as detailed below, abuses of euthanasia did not materialise, and that any imperfections in the application of the euthanasia law only minimally detract from the major improvements in the carefulness of end-of-life practices relative to the situation before the law (Deliens et al 2000; Chambaere et al. 2011b)

^dSome still discern many opponents of euthanasia in the PC movement and suspect them to only pay lip service to the Flemish PC’s official doctrine of comprehensive PC

^eThe advocacy of further liberalisation of euthanasia elicits new oppositions