I have read the authors’ point of view1 in relation to Aid in Dying (AD) and the repercussion in our Units. The “social and professional debate” has not occurred since no consultations were made. Medical professionalism,2 detailed reports from organisms in the field of ethics,3 and communications from the Spanish Society of Palliative Medicine, exposing the generated risks,4 were lacking.

As you rightly point out, diversity and moral values differ among people and cultures, though the mechanism for listening to all the implicated parties has not been used. The authors correctly adopted a position from the perspective of professional ethics, though here things are also debatable.

In answering the issues raised, references have been made to emotivism, compassion and autonomism, which seem unquestionable in today’s society, and which have replaced rationalism with desire, opinion and emotion, which occupy the entire philosophical debate.

Intensivists with ethical training fundamented good medical practice and the limitation of therapeutic effort, contributing conceptual and ethical development to it. We help patients to fulfill their will to not prolong their refractory terminal condition, without resorting to euthanasia practices.

On the other hand, euthanasia is hard to regard as a medical act if we take medical deontology into account, as updated with a new code in 2022,5 and which does not contemplate such practices. Likewise, it is not consistent with the definitions of the Hastings Center on the purposes of Medicine. These ethical codes are considered to evolve according to the interests and obligations that we as professionals assign to ourselves, though this has not been the case to date. Controversy is generated in view of the higher ranking of laws concerning the professional codes — a fact that also generates ethical conflicts.

Our involvement in the organ donation process after euthanasia extends beyond the possibilities of the article of the authors and also of my own observations. Such delicate and important issues should not be addressed in a summarized way. A deep, paused and constructive analysis is needed in order to improve upon what is being proposed.