In this article Judith Jarvis Thomson's Good Samaritan Argument in defense of abortion in the case of rape is defended from two objections: the Kill vs. Let Die Objection, and the Intend to Kill vs. Merely Foresee Death Objection. The article concludes that these defenses do not defend Thomson from further objections from Peter Singer and David Oderberg.

Is it worse to kill someone than to let someone die? It seems obvious to common sense that it is worse. We allow people to die, for example, when we fail to contribute money to famine-relief efforts; but even if we feel somewhat guilty, we do not consider ourselves murderers. Nor do we feel like accessories to murder when we fail to give blood, sign an organ-donor card, or do any of the other things that could save lives. Common (...) sense tells us that, while we may not kill people, our duty to give them aid is much more limited. Some philosophers, however, have argued that common sense is wrong about this. They have defended the Equivalence Thesis, which says that killing and letting die are equally bad. This is a more specific version of the idea that there is no moral difference between making something happen and allowing it to happen. The Equivalence Thesis is a radical conception that would require changes in our ordinary moral beliefs. If it is true, then obviously our duty to give aid is much stronger than we commonly assume. But our views about other matters, such as euthanasia, will also be affected. Many people believe that “passive euthanasia”--allowing terminal patients to die, rather than pointlessly prolonging their lives--is sometimes permissible; but they also believe that killing patients is always wrong. If the Equivalence Thesis is true, this combination of beliefs is inconsistent. The idea behind the Equivalence Thesis is not that every individual case of letting die is equally as bad as every individual case of killing. Obviously, if we compare an ordinary murder--say, a man killing his wife out of jealousy--with the actions of a physician who humanely permits a suffering patient to die, the murder is much worse. Rather, the idea is that the difference between killing and letting die does not itself make a difference to the moral assessment of the actions. Other factors may still be important. (shrink)

abstract Applied ethics engages with concrete moral issues. This engagement involves the application of philosophical tools. When the philosophical tools used in applied ethics are problematic, conclusions about applied problems can become skewed. In this paper, I focus on problems with the idea that comparison cases must be exactly alike, except for the moral issue at hand. I argue that this idea has skewed the debate regarding the moral distinction between killing and letting die. I begin with problems that can (...) arise from attempts to produce comparison cases that are exactly alike, except for the moral issue at hand. I then argue that attempts to produce such examples are doomed to failure. Finally, I argue that abandoning concerns about similarity advances the debate regarding the moral distinction between killing and letting die. (shrink)

Considers the moral relevance of a distinction between killing and letting die, which distinction is sometimes morally critical, as shown in the difference between killing one to save five and leaving one to die while rescuing them A more basic distinction is, she thinks, between initiating a harmful sequence of events and not interfering to prevent it. The latter is sometimes permissible where the former would not be, because in general we have a stronger right not to be interfered with (...) than positively to be helped. (shrink)

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)

There is as yet no widely agreed-upon solution to the standard textbook problem whether actively shutting off a life-sustaining medical device, e.g. a respirator, and thus bringing about a patient9s death amounts to active killing or just to an omission of further treatment. Apart from a range of astutely contrived case examples and respective particular solutions proposed in the literature, there seems to be no consensus on the normative principles such solutions should be grounded in, not even on the need (...) for such principles beyond sheer intuition. The present paper attempts to develop a normative approach based on fundamental principles of law. From this perspective, what is decisive for the question of ‘killing or letting die’ in such cases is not that death ensues from a behaviour that is active and relevantly causative, but rather, whether or not the agent in performing the deadly act transgresses the boundaries of the domain of his or her sole normative authority, and thereby intervenes in the protected sphere of another. Unless he or she does so, their behaviour cannot be classified as active commission regardless of the amount of causal activity it may display and regardless of its potentially harmful consequences. This conception is spelled out in detail and tested in a range of case examples, as are several of its corollaries that deviate from standard type solutions. (shrink)

Many people hold that there is an important moral distinction between passive euthanasia and active euthanasia. Thus, while the AMA maintains that people have a right quote to die with dignity, quote so that it is morally permissible for a doctor to allow someone to die if that person wants to and is suffering from an incurable illness causing pain that cannot be sufficiently alleviated, the MA is unwilling to countenance active euthanasia for a person who is in similar straits, (...) but who has the misfortune not to be suffering from an illness that will result in a speedy death. -/- A similar distinction with respect to infanticide has become a commonplace of medical thinking and practice. If an infant is a mongoloid or a microcephalic, and happens also to have some other defect requiring corrective surgery if the infant is to live, many doctors and hospitals believe that the parents have the right to decide whether the surgery will be performed, and thus whether the infant will survive. But if the child does not have any other defect, it is believed that the parents do not have the right to terminate its life. -/- The rationale underlying these distinctions between active and passive euthanasia, and between active and passive infanticide, is the same: the idea that there is a crucial moral difference between intentionally killing and intentionally letting die. This idea is admittedly very common. But I believe that it can be shown to reflect either confused thinking or a moral point of view unrelated to the interests of individuals. (shrink)

Many people hold that there is an important moral distinction between passive euthanasia and active euthanasia. Thus, while the AMA maintains that people have a right quote to die with dignity, quote so that it is morally permissible for a doctor to allow someone to die if that person wants to and is suffering from an incurable illness causing pain that cannot be sufficiently alleviated, the MA is unwilling to countenance active euthanasia for a person who is in similar straits, (...) but who has the misfortune not to be suffering from an illness that will result in a speedy death. -/- A similar distinction with respect to infanticide has become a commonplace of medical thinking and practice. If an infant is a mongoloid or a microcephalic, and happens also to have some other defect requiring corrective surgery if the infant is to live, many doctors and hospitals believe that the parents have the right to decide whether the surgery will be performed, and thus whether the infant will survive. But if the child does not have any other defect, it is believed that the parents do not have the right to terminate its life. -/- The rationale underlying these distinctions between active and passive euthanasia, and between active and passive infanticide, is the same: the idea that there is a crucial moral difference between intentionally killing and intentionally letting die. This idea is admittedly very common. But I believe that it can be shown to reflect either confused thinking or a moral point of view unrelated to the interests of individuals. (shrink)

Some philosopher argue that the distinction between killing and letting die lacks moral significance, since the prima facie objections to both arise from a feature which killing and letting die share: Either way, an agent chooses a course of action resulting in someone's dying, when he could have chosen a course of action having the opposite result. I find this claim ambiguous. Does it mean that in either case, if the agent had chosen the alternative course of action, the victim (...) would not have died at all, at least not for some time yet? Or does it mean that if the agent had acted differently, the victim would have died a death numerically distinct from his actual death? ;I argue that killing is prima facie objectionable owing to the causal relation connecting the agent's action to the victim's token death. If an agent kills someone, his action is prima facie objectionable even if another agent would have killed the person moments later anyway. But failing to prevent a token death event is not in itself prima facie objectionable. On the whole, such a failure is prima facie objectionable only if preventing that token death event would have benefited the victim. And on the whole, preventing a token death event benefits the victim only if it prevents there from occurring any event of the type death of that person, at least for some time yet. ;I do not provide a positive rationale for attributing moral significance to the distinction between killing and letting die. Rather, I try to undermine skepticism about the possibility of providing such a rationale by demonstrating that the prima facie objections to killing and letting die cannot be accounted for in the same way. I also discuss the nature of killing and letting die, how both differ from enabling someone's death to occur, and the relationship between the concepts of harm and benefit. (shrink)

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try to prevent each and everyone from (...) dying. In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations. (shrink)

I consider four recently suggested difference between killing and letting die as they apply to active and passive euthanasia : taking vs. taking no action; intending vs. not intending the death of the person; the certainty of the result vs. leaving the situation open to other possible alternative events; and dying from unnatural vs. natural causes. The first three fail to constitute clear differences between killing and letting die, and "ex posteriori" cannot constitute morally significant differences. The last constitutes a (...) difference but is not morally significant. (shrink)

In a recent Article Carla Kary attempts to show that there should be a significant moral difference between instances of killing and letting die. I shall maintain in Section I that Kary's argument is somewhat weakened by the failure to note an important ambiguity in the notion of killing a person. I shall also argue in Section II that a similar ambiguity affects the notion of letting someone die, and that the failure to note this latter ambiguity also weakens the (...) position developed by Robert Coburn with regard to defective newborns. CiteULike Connotea Del.icio.us What's this? (shrink)

Christian pro-lifers often respond to Thomson’s defense of abortion that the violinist is allowed to die while the embryo is killed. Boonin and McMahan counter that this distinction does not provide an objection to extraction abortions that disconnect embryos and allow them to die. I disagree. I first argue that letting die and killing are not to be distinguished by differences between acts and omissions, moral and immoral motives, intentional or unintentional deaths, and causing or not causing a pathology. I (...) offer a taxonomy in which hysterotomies turn out to be killings. I then argue that if either the placenta is considered an organ of the embryo or the embryo is construed as a part of the pregnant woman, then abortion pills kill rather than allow death. So, assuming that killing people is morally worse than letting them die, extraction abortions can be condemned to the same degree as other abortions. (shrink)

Reviews the legal position on the distinction drawn between killing and letting die in medically assisted dying.

This article has two main sections. In Section I, I argue against the skeptic's position. I examine an attempt to see both prima facie objections as arising from features that killing and letting die have in common, and then argue that all such attempts are doomed to failure. In Section II, I explain how even defenders of the distinction's significance have misconstrued the difference between the two objections. In so doing I attempt to develop a better account of why killing (...) and letting die are prima facie objectionable. I also briefly explore some related matters. (shrink)

Judith Jarvis Thomson; Killing, Letting Die, and The Trolley Problem, The Monist, Volume 59, Issue 2, 1 April 1976, Pages 204–217, https://doi.org/10.5840/monis.

In some medical cases there is a moral distinction between killing and letting die, but in others there is not. In this paper I present an original and principled account of the moral distinction between killing and letting die. The account provides both an explanation of the moral distinction and an explanation for why the distinction does not always hold. If these explanations are correct, the moral distinction between killing and letting die must be taken seriously in medical contexts. Defeasibly, (...) when an agent kills she takes responsibility, but when an agent lets die she does not take responsibility. Therein lies the moral distinction between killing and letting die. The distinction, however, is defeated when an agent is already responsible for the surrounding situation. In such cases, killing does not involve taking any further responsibility and letting die does not avoid taking any responsibility. Medical examples are frequently complicated because patients' autonomous choices impact upon medical practitioners' surrounding responsibility. (shrink)

Routinely, in Arriving at decisions on what treatments to recommend in intensive care wards, the moral presumption is that there is an intrinsic difference between the positive duty to save lives and the negative duty not to take lives. The discontinuation of treatment – say stopping chemotherapy or removing a ventilator – is thought of as a “negative” action, an allowing to die, not “positively”, say as an act of suicide by the patient, or a killing by the hospital staff. (...) But the distinction between “positive” and “negative” here, despite its grave ethical import, is elusive and difficult to grasp firmly. St. Anselm of Canterbury was fond of citing the trickiness of the distinction between “to do” and “not to do”. In answer to the question “What's he doing?” we say “He's just sitting there.”, really meaning something negative: “He's not doing anything at all.” Sometimes the “negative” action is described in “positive” terms, or vice versa, and that makes one wonder if the distinction might be somehow trivial, a bit of jesuitry too insubstantial to bear much serious ethical weight. (shrink)

The distinction between killing and letting die is too simple. A third category must also be recognized. Like killing, preventing a person from being saved is a species of doing harm; like killing, it infringes one of the victim's negative rights. Yet preventing a person from being saved is morally on a par with letting die, which infringes one of the victim's positive rights. It follows that we cannot explain the moral inequivalence of killing and letting die by saying, as (...) so many have, that negative rights are more stringent than positive rights. A more promising strategy is suggested at the end of the article. (shrink)

Many political libertarians argue, or assume, that negative moral duties (duties not to harm others) prevail over positive moral duties (duties to aid others), and that the legal system ought to reflect such pre-eminence. I call into question this strategy for defending a libertarian order. I start by arguing that a successful account of the well-known case of a runaway trolley that is about to kill five innocents unless a passer-by diverts it onto one innocent, killing him, should point (...) to (i) the ex ante advantage to all six of being subject to a policy of redirection of runaway trolleys, and (ii) the causal structure of killing vs. letting-die choices. I then argue that this account of the trolley case entails that legal systems reflecting the relative stringency of negative and positive moral duties should uphold redistributive measures at odds with libertarianism. The assumption that the legal system ought to reflect, through non-causal routes, moral principles and their relative weights leads to either an ideal-theory (in Rawls's sense) assessment of libertarianism or a symbolic account of the relationships between morality and law. Libertarians should undermine this assumption if they hope to offer an all-things-considered case for free markets. (shrink)

ABSTRACTI believe that there is no intrinsic moral difference between killing and letting die. That is, there is no difference that depends solely on the distinction between an act and an omission. I also believe that we can reasonably establish this thesis by appeal to the Bare Difference Argument. The form of this argument involves considering two imaginary cases in which there are no morally relevant differences present, save the bare difference that one is a case of killing and one (...) a case of letting die. But in the pair of cases under consideration this bare difference makes no moral difference. Hence it cannot be that the bare difference between killing and letting die is in itself a morally important difference.Winston Nesbitt has recently argued that the Bare Difference Argument fails because “the examples produced typically possess a feature which makes their use in this context illegitimate, and that when modified to remove this feature, they provide support for the view which they were designed to undermine”. I argue that Nesbitt misunderstands the logic of the Bare Difference Argument and that accordingly his objections are mistaken. (shrink)

ABSTRACT There are a number of arguments that purport to show, in general terms, that there is no difference between killing and letting die. These are used to justify active euthanasia on the basis of the reasons given for allowing patients to die. I argue that the general and abstract arguments fail to take account of the complex and particular situations which are found in the care of those with terminal illness. When in such situations, there are perceptions and intuitions (...) available that do not easily find propositional form but lead most of those whose practice is in the care of the dying to resist active euthanasia. I make a plea for their intuitions to be heeded above the sterile voice of abstract premises and arguments by examining the completeness of the outline form of the pro‐euthanasia argument. In doing so, I make use of Nussbaum's discussion of moral perception and general claims to be found in the literature of moral particularism. (shrink)

ABSTRACTThere are a number of arguments that purport to show, in general terms, that there is no difference between killing and letting die. These are used to justify active euthanasia on the basis of the reasons given for allowing patients to die. I argue that the general and abstract arguments fail to take account of the complex and particular situations which are found in the care of those with terminal illness. When in such situations, there are perceptions and intuitions available (...) that do not easily find propositional form but lead most of those whose practice is in the care of the dying to resist active euthanasia. I make a plea for their intuitions to be heeded above the sterile voice of abstract premises and arguments by examining the completeness of the outline form of the pro‐euthanasia argument. In doing so, I make use of Nussbaum's discussion of moral perception and general claims to be found in the literature of moral particularism. (shrink)

This essay analyzes the principle of double effect and, to a lesser extent, the distinction between killing and letting die in the context of the Pittsburgh protocol for managing patients who may become non-heart-beating donors or sources of organs for transplantation. It notes several ambiguities and unresolved issues in the Pittsburgh protocol but concludes that neither the principle of double effect nor the distinction between killing and letting die (with the prohibition of the former and the allowance of the latter (...) under some circumstances) erects insurmountable obstacles to the implementation of the protocol. Nevertheless, the requirement of the principle of double effect that the intended good effects outweigh the unintended side effects necessitates careful attention to the probable overall impact of the proposed policy on organ procurement, particularly because public mistrust plays such a significant role in limiting the number of organ donations. (shrink)

Introduction This paper defends the moral significance of the distinction between killing and letting die. In the first part of the paper, I consider and reject Michael Tooley’s argument that initiating a causal process is morally equivalent to refraining from interfering in that process. The second part disputes Tooley’s suggestion it is merely external factors that make killing appear to be worse than letting die, when in reality the distinction is morally neutral. Tooley is mistaken to claim that we are (...) permitted to kill bystanders who had no fair chance to avoid being at risk of harm. We can support the significance of the killing / letting die distinction by considering the difference between what we are permitted to do in self-defence against those who are going to kill us, and what we can do against those who are going to let us die. I also suggest that we are less responsible for the deaths we allow than for the deaths that we cause, since we do not make people worse off for our presence in cases where we fail to save them. (shrink)

Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it (...) trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible. (shrink)

Ever since the debate concerning euthanasia was ignited, the distinction between active and passive euthanasia – or, letting die and killing – has been marked as one of its key issues. In this paper I will argue that a) the borderline between act and omission is an altogether blurry one, and it gets even vaguer when it comes to euthanasia, b) there is no morally significant difference between active and passive euthanasia, and c) if there is any, it seems to (...) favor active instead of passive euthanasia. Therefore, while the distinction between active and passive euthanasia might be meaningful in terms of description, if it is considered to be endowed with moral weight and used on purpose of justifying one type of euthanasia instead of the other, it becomes morally problematic and misleading. (shrink)

Disconnecting a patient from artificial life support, on their request, is often if not always a matter of letting them die, not killing them—and sometimes, permissibly doing so. Stopping a patient’s heart on request, by contrast, is a kind of killing, and rarely if ever a permissible one. The difference seems to be that procedures of the first kind remove an unwanted external support for bodily functioning, rather than intervening in the body itself. What should we say, however, about cases (...) at the boundary—procedures involving items that seem bodily in some respects, but not others? When, for instance, does deactivating an implanted device like a pacemaker count as killing, and when as letting die? Contra existing proposals, I argue that the boundaries of the body for this purpose are not drawn at the boundaries of the self, or (if this is different) the human organism. Nor should we determine when we are killing and when we are letting die by deferring to existing practices for distinguishing ongoing from completed treatment. Rather, I argue that whether something (organic or inorganic) counts as body part for purposes of this distinction depends on the results of a normative analysis of the particular character of our rights in it—particularly, whether and in what way these rights ought to be alienable. I conclude by arguing that there are likely good reasons to recognize distinctively “bodily” rights and restrictions in at least some implantable devices. (shrink)