The moral distinction between killing and letting die in medical cases

Bioethics

Volumn 22, Issue 5, 2008, Pages 278-285

  Asscher, Joachim ^a  

^a MONASH UNIVERSITY   (Australia)

Author keywords

End of life; Killing; Letting die; Responsibility

Indexed keywords

ARTICLE; DECISION MAKING; ETHICS; HOMICIDE; HUMAN; MEDICAL ETHICS; MORALITY; PASSIVE EUTHANASIA; PERSONAL AUTONOMY;

DECISION MAKING; ETHICAL ANALYSIS; ETHICS, MEDICAL; EUTHANASIA, PASSIVE; HOMICIDE; HUMANS; MORALS; PERSONAL AUTONOMY;

EID: 43049107188     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2008.00616.x     Document Type: Article

References (15)

1. J. Asscher. Killing and Letting Die: the Similarity Criterion. J Appl Philos 2007 23, No 3 : 271 282.
2. There are important caveats to this claim; in order to introduce the basic thesis of this paper these caveats are being set aside.
3. Richard Trammell appeals to the notion of responsibility in a slightly different context (negative versus positive duties). His account, however, is inadequate because it fails to distinguish between surrounding responsibility and taking responsibility. See R. Trammell. 1975. Saving Life and Taking Life. In Killing and Letting Die, Second Edition. B. Steinbock & A. Norcross, eds. New York: Fordham University Press: 290-297.
4. It cannot be argued that Frank's wish to die should be ignored on the grounds that it demonstrates mental incompetence. Given the presupposition that Frank is able to make autonomous choices, Frank is mentally competent.
5. J. Rachels. 1986. The End of Life. Oxford: Oxford University Press: 107.
6. It is presumed throughout this paper that proper procedures are followed in obtaining consent.
7. Similar points are made by T.L. Beauchamp & J.F. Childress. 2001. Principles of Biomedical Ethics, Fifth Edition. Oxford: Oxford University Press: 141-142.
8. The claim is defeasible because it depends upon others not having responsibility in a way that precludes your taking responsibility. For instance, when Frank does not want to be treated in Throat Cancer Begins, he prevents medical staff from taking responsibility for doing something good.
9. Such an attack is implicit in, for instance, G. Grisez & J.M. Boyle. 2006. The Morality of Killing: A Traditional View. In Bioethics An Anthology, Second Edition. H. Kuhse & P. Singer, eds. Malden, MA: Blackwell Publishing: 283-287.
10. M. Philips. Are 'Killing' and 'Letting Die' Adequately Specified Moral Categories. Philos Stud 1985 47 : 151 158
11. For the sake of brevity, cases where the patient is unable to make autonomous choices but the patient's previous autonomous choices are known have been ignored.
12. See, e.g. J. Rachels. 1986. op. cit. note 5, p. 115.
13. The killing is not justified by Sally's condition alone. Suppose that the medical staff relinquish responsibility for Sally by ending life support - in other words, by letting her die. In this case, they cannot then kill her even though her condition remains the same. For if they kill Sally, they retake responsibility for Sally, and medical staff should not take responsibility for killing a patient when it is unclear whether the patient has a life worth living.
14. In this vein, G. Gillet has suggested 'trial of treatment' rather than treatment. In trial of treatment, treatment is discontinued if it is producing 'unacceptably bad survival'. See G. Gillet. 2004. Bioethics in the Clinic Hippocratic Reflections. Baltimore MD and London: The Johns Hopkins University Press: 184-185.
15. P.D. Hopkins. Why Does Removing Machines Count as 'Passive' Euthanasia? Hastings Center Rep 1997 27 : 29 37.