Abstract

In this dissertation, I defend the view that the distinction between killing and allowing to die is coherent and morally important. ;I first review the history of the distinction from Hippocrates to the early 20th century. I next show that contemporary accounts of the distinction do not reflect the intuitions of those who employ it. I dismiss accounts based on acts and omissions, causing and allowing, harming and benefitting, double effect, the movements of agents, social expectations, and causal responsibility. ;Because of the confusing ways in which the words 'killing' and 'allowing to die' are used, I introduce neologisms. Gribbing is an act in which an agent creates a new, non-therapeutic, lethal pathophysiological state intending that a human being should die by way of that act. Alting is an act in which an agent removes or refrains from initiating an intervention that stops or delays the natural history of an underlying lethal state, either intending that a human being should die by way of that act, or not so intending. The form of the distinction I defend is that all Gribbing is wrong, except in cases of self-defense or rescue. Some Alting is wrong, and some is not. ;I then present a theory of intention to support the thesis that what all Gribbing has in common with the bad cases of Alting is the agent's intention that a human being should die by way of the agent's act. This gives the distinction practical moral importance, since the burden of proof is upon the Gribber to show that death was not the intention. ;Finally, I apply this formulation in a variety of cases, showing that it leads to judgments that generally coincide with those of people who employ the unexamined distinction. If what one means by 'the distinction between killing and allowing to die' is a distinction between Gribbing and Alting, then the distinction is coherent and morally meaningful. The remaining task is to justify the premise that acting with the intention that a human being should die by way of one's act is always morally wrong