Killing and Letting Die
Introduction
Is it morally worse to kill someone than to let someone die?At first it seems that killing is worse. Pushing someone off a cliff is worse than failing to save someone hanging over the edge of a cliff. In general it does seem that actively killing someone is morally worse than failing to render assistance even when this failure results in death. It looks, then, as if the original question has a clear answer. However, I want to present you with some hypothetical cases which may incline us to think again. The principle which states that killing is worse than letting die is called the “Acts and Omissions” principle (A/O for short). The question is whether A/O is a sound moral principle.
First of all here are some reasons in support of A/O:
- Killing is worse than letting die because the motives for killing are usually worse. Failing to save someone may be due to moral laziness or even callousness, but killing is usually the result of malice or brutality.
- Killing is worse than letting die because when you kill someone you are the cause of the person's death, whereas in a situation where you fail to save you are not the direct cause of death (The person was already dangling over the edge).
- Killing is worse because there is a stronger duty to refrain from killing than there is a duty to save someone. Your (positive) obligation to render assistance is weaker than your (negative) obligation not to kill.
The Transplant Surgeon
The first case actually supports A/O.Helen is a great transplant surgeon. Five of her patients, in order to survive, need new organs - one needs a new heart, the others need respectively liver, kidney, lung and spleen. All are of the same rare blood type and by chance Helen has a relatively healthy patient with that rare blood type. Helen can kill the healthy patient and use the organs for the five who need them. Or she can refrain from killing the healthy patients, allowing the five to die. Obviously it would be wrong for Helen to kill the healthy patient so killing is worse than letting die even when it is a case of killing one rather than allowing five to die. A/O still seems the right principle. But now consider this case.
The Trolley
Edward is a passenger on a trolley whose driver has just shouted that the brakes have failed, and who then died of a heart attack. On the track ahead of Edward are five people; the banks are so steep that they will not be able to get off the track in time. The track has a spur leading off to the right, and Edward can turn the trolley onto it. Unfortunately there is one person on this right hand track. Edward can turn the trolley, killing the one; or refrain from turning the trolley, killing the five. The Trolley is interesting because it seems that the right thing for Edward to do is to turn the trolley and kill the one. If he doesn't turn the trolley then he's not actually killing the five - he's letting them die. But if he turns the trolley he is killing the one, so if turning the trolley is indeed the right thing to do, then we appear to have a case of killing not being worse than letting die. Perhaps A/O is not as sound as first thought. Here's another case.The Health Pebble
Suppose there are six men who are dying. Five are standing in one group on a beach and one is standing further along. Floating on the tide is a marvellous pebble, the Health Pebble; it cures what ails you. The one needs for a cure the whole Health Pebble; each of the five needs only a fifth of it. Now in fact the Pebble is drifting towards the one, so if nothing is done to alter its course, the one will get it. You happen to be swimming nearby, and are in a position to deflect it towards the five. Is it permissible for you to do this? Notice that the Health Pebble is similar to the Trolley except that the Pebble is something good which all six want, whereas the trolley is something bad which all six want to avoid. Yet both raise similar problems for the A/O principle. For in both cases we are inclined to say that it is morally preferable to actively kill (the one) rather than let (the five) die.The Company Directors
Case 1 (Killing): John is a company director and desperately wants to be managing director. John sneaks into the managing director's office, poisons his coffee and the managing director dies of what looks like a heart attack. John becomes managing director.Case 2. (Letting die): Betty is a company director (in a different company) and desperately wants to be managing director. Betty sneaks into the managing director's office intending to poison his coffee but instead finds him dying of a heart attack and calling for an out-of-reach bottle of pills (which will save him). Betty doesn't hand over the pills, the managing director dies and Betty becomes managing director.
The Assassins
- The active assassin: Jill wants to kill the PM and the Cabinet and, knowing that they are travelling by plane, plants a bomb on board, the plane crashes and all are killed.
- The passive assassin: Jack wants to kill the PM and the Cabinet and, knowing that they are travelling by plane, is about to plant a bomb on board when he notices an engine fault (he is the last technician to inspect the plane before takeoff, suppose). If the fault is not rectified it will cause the plane to crash, Jack does nothing and all are killed.
Do these cases show that A/O is false? Or to ask again the original question: Is killing worse than letting die? The hypothetical cases at least point to the possibility of situations where killing and letting die are morally equivalent. Whether or not there are any actual situations where killing and letting die are morally the same will depend on the motives and the causal responsibility in those situations. Killing and letting die may sometimes be morally equivalent.
One consequence
In discussions of (voluntary) euthanasia it is often claimed, especially by those opposed to euthanasia, that the active killing of a person is always wrong, even when the person wants to die and requests it. These opponents of euthanasia go on to argue that it may, however, be morally permissible to withhold treatment from, say, terminally ill patients who want to die. That is to say that killing is always wrong, but letting die is sometimes permissible. Active euthanasia is wrong but passive euthanasia may be morally OK. A consequence of the above discussion of killing and letting die is that killing may in some instances be no worse than letting die. So if cases arise in medical ethics where it is agreed that letting die is morally permissible, then it may be that in those cases killing is also morally permissible. The philosophical argument can establish a possibility. What is right or wrong in actual cases will depend on the facts of the situation.Some questions
- Is the duty to save life as strong as the duty not to take life? Why?
- Should people be punished for failing to save someone when this can be done easily? (Most European countries have laws requiring easy rescue).
- Given that a doctor has a very strong duty of care, can there be a significant moral distinction between withholding treatment and active killing (eg lethal injection)?