What I am speaking of is of a person plainly expressing their own intent, perhaps to the contrary opinions of medical professionals, family, legal professionals, et c.
Obviously if that expression of intent was coerced, there is a question of legitimacy of the expression of intent itself. But that is not really what we are discussing.
There is of course room for legal opinion on whether or not the documentation of the intent is valid or not. But the intent itself cannot morally be questioned by any second party for any reason, on any grounds. Our bodies are our own.
If they lack the ability to do so for some reason should they be assisted?
Is that should a moral imperative?
Obviously the best thing to do is to minimize the numbers of people who end up in such situations by addressing root causes. But that is something society has proven unwilling to deal with at scale. There will always be some people who have intractable suffering, with no tolerable outcome possible, and they deserve a peaceful way out.
Assistance is a whole ‘nother ballpark. I don’t think it’s a moral imperative for anyone to do anything for a second party that the first does not fully consent to.
If someone is not able to sign a DNR it must be because they have no autonomy over their medical care at all at that point. Which of course happens regularly but needs precise controls and protocols, and of course is rife for abuse.
Generally the presence of an intervention versus choosing not to intervene provides a clear dividing line. In this case, the choice not to force feed someone who is refusing food is why this is not euthanasia.
I think for example if someone has a previously executed DNR, I would say a valid medical proxy would not be able to override it. I’m trying to recall an instance when I filled out such a form for my wife before a procedure, I seem to recall there even being a section on resuscitation and whether the appointee could make that call?