You seriously don't see a moral difference between taking active action to end someone's life vs. failing to take an action that will keep someone alive? That's your basic trolley problem

No, it’s petty minded high-school philosophy to pretend that starving a paraplegic is morally speaking better than euthanising them with morphine.

There are endless things that distance this from the trolley problem, but mainly starving someone to death isn’t inaction, it’s a conscious clinical choice.

It’s utterly bizarre in my mind that is what the USA settled on as a grotesque compromise. Particularly so because outside the medical setting this would still be homicide by starvation.

Exactly. Having a duty of care for someone and deliberately not providing that care with the intention of killing them is making you just as complicit in their death as euthanasia.

Furthermore it's not inaction, in order to starve someone to death you have to get a lawyer and a judge to sign the death warrant. Pretending this is ethical is palming off the moral responsibility to some medical-tech who refills the feeding tube.

There's a moral difference if one alternative would result in a slower more painful death . Which is likely to be the "neglect to provide sustenance" option - ie. it's likely to be morally preferable to actively end someone's life quickly/ humanely than it is to just let them die slowly (from dehydration or whatever).

I dunno it seems like basic decency to kill someone painlessly once that is the what's going to happen. It is crazy cruel to just watch someone die of thirst over a period of days, we wouldn't do that to animals.