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I would like to understand this passage in Makkot 7a:

https://www.sefaria.org/Makkot.7b.4?lang=bi&with=Commentary&lang2=bi

[The mishna teaches that] Rabbi Tarfon and Rabbi Akiva say: If we had been [members of the Sanhedrin, we would have conducted the trials in a manner where no person would have ever been executed. The Gemara asks:] How would they have acted [to spare the accused from execution if witnesses testified that he intentionally committed murder?] Rabbi Yoḥanan and Rabbi Elazar both say [that they would have asked the witnesses]: Did you see [whether the accused] killed a tereifa, [i.e., a person with a condition that would lead to his death within twelve months,] or if [he killed someone who was] intact? [The halakhic status of a tereifa is like that of one who is dead, in the sense that one who kills him is not executed. Since no witness can be certain with regard to the victim’s physical condition, they would invalidate any testimony to a murder.]

Surely it does not mean it is acceptable to kill a terminally ill person, does it?

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No, it does not mean that. It is definitely prohibited to hasten the death even of one who is about to die (ShA YD 339:1). One who murders a terminally ill individual doesn't receive statutory punishment by a human court though (Rambam, Laws of Murder 2:8) which is the relevant technicality for your citation.

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    There are a few different kinds of "terminally ill individuals" for purposes of halachah, and that should be clarified in this answer. Someone who kills a גוסס בידי שמים can in fact be executed by the court for doing so; a טריפה, not; and a גוסס בידי אדם is a doubtful case (paskened by Rambam as like a טריפה). – Meir Feb 5 at 20:56

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