According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the first of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the analysis of the distinction between doing and allowing harm. I explore some of the most prominent attempts to analyse this distinction:. Philippa Foot’s sequence account, Warren (...) Quinn’s action/ inaction account, and counterfactual test accounts put forward by Shelly Kagan and Jonathan Bennett. I also discuss Jeff McMahan’s account of the removal of barriers to harm. I argue that analysis of the distinction has often been made more difficult by two mistaken assumption: (1) the assumption that when an agent does or allows harm his behaviour makes the difference to whether or not the harm occurs (2) the assumption that the distinction between doing and allowing and the distinction between action and inaction are interchangeable. I suggest that Foot’s account is the most promising account of the doing/allowing distinction, but that it requires further development. (shrink)

Most deontologists claim that it is more objectionable to do harm than it is to allow harm of comparable magnitude. I argue that this view faces a largely neglected puzzle regarding the moral relevance of an agent's past behavior. Consider an agent who chooses to save five people rather than one, where the one person's life is in jeopardy because of something the agent did earlier. How are the agent's obligations affected by the fact that his now letting the one (...) die would retroactively make it the case that he has killed? I argue that the most promising deontological responses to this question are difficult to defend. Further, it is unclear how the deontologist can resolve a further set of cases, in which commonsense intuition indicates that an agent is required to terminate a threat she initiated more recently in preference to a threat she initiated less recently. (shrink)

Most deontologists claim that it is more objectionable to do harm than it is to allow harm of comparable magnitude. I argue that this view faces a largely neglected puzzle regarding the moral relevance of an agent's past behavior. Consider an agent who chooses to save five people rather than one, where the one person's life is in jeopardy because of something the agent did earlier. How are the agent's obligations affected by the fact that his now letting the one (...) die would retroactively make it the case that he has killed? I argue that the most promising deontological responses to this question are difficult to defend. Further, it is unclear how the deontologist can resolve a further set of cases, in which commonsense intuition indicates that an agent is required to terminate a threat she initiated more recently in preference to a threat she initiated less recently. (shrink)

The moral significance of the distinction between killing and allowing to die has played a key role in debates about euthanasia and physician assisted suicide. Since the withdrawal of life-sustaining treatment is held as morally permissible in the medical community, it follows that if there is no morally significant difference between killing and allowing to die, then there is no morally significant difference between withdrawing life-sustaining treatment or administering a lethal injection to end a patient’s life. Consistency then requires that (...) voluntary active euthanasia is also morally permissible. The debates over whether the distinction is morally significant have carried on for decades with little hope of consensus. We begin by surveying the literature to identify common argumentative strategies used in defending or rejecting the distinction’s significance. We observe, based on our review, that many of these strategies operate in ways that are conceptually removed from the concrete clinical situation of physicians involved in practices that lead to patient death. We conclude by arguing for a novel way of moving the debate forward indicated by our reading of the literature, namely, by paying careful attention to the moral experience of physicians involved in end-of-life interventions to understand how they experience these practices. Exploring physician experience can reveal how the distinction may or may not be useful for moral deliberation and can provide the needed context to theorize about the distinction in a more empirically informed and practically useful way. (shrink)