To Kill or Not to Kill.... But to Stand Idly By While One Dies

The moral distinction between killing and allowing to die, as pertains to the arguments of passive and active euthanasia. [Ethical theory paper which is worth 1/3 of my grade and so I really, really, need it to make sense. Ideally, my argument should be clear enough that anyone can understand it, even with no philosophical/ethical background and can be read at a 3rd grade level. FEEDBACK IS MAJORLY APPRECIATED, I WILL PAY YOU IN GRATITUDE AND CC]

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    The distinction between the two subsets of euthanasia, passive and active, relies on the difference between killing and letting die. It is this division which is essential to positions concerning the permissibility of active euthanasia, or even physician assisted suicide. There are several approaches to this issue; it has been proposed that allowing a person to die is no different than killing  them, or, alternately, that killing is vastly more wrong than allowing someone to die. Here, I shall combine Peter Singer’s case in support of charity for the poor with the Doctrine of Acts and Omissions to argue for the permissibility of active euthanasia. I will argue that letting a person die is morally equivalent to killing them only if a person has the power to help, without sacrificing anything of equal moral significance, and refrains. If this claim can be well supported by existing philosophical arguments and thought experiments, it can then be applied to overcome moral dilemmas experienced in Judith Jarvis Thomson’s Trolley and Transplant experiments and in the debate over the permissibility of active euthanasia.

    To begin, I will first explain the basis of my argument and its origins in the work of Peter Singer. In his famous article “Famine, Affluence, and Morality,” Singer uses what he considers an incontrovertible principle to encourage individuals to give aid to charity. He says, “If it is within our power to prevent something very bad from happening without thereby sacrificing anything morally significant, we ought, morally, to do it.” I believe that this principle can be adapted for use in other ethical dilemmas - in this case, the moral significance of allowing someone to die. His maxim can be reworked into this: If it is in our power to prevent someone from dying without thereby sacrificing anything morally significant, we ought, morally to do it. Dying is widely considered to be “very bad,” and so it seems like an acceptable substitution to make, and not one which will cause much dissent. 

    The second premise on which my argument rests is that of the Doctrine of Acts and Omissions. This doctrine states that there is no inherent difference between acts and omissions, for the intentions are the same, and the outcome is the same. Therefore, if it follows that there is no intrinsic difference between killing and letting die, then it should only be extrinsic differences that we must concern ourselves with. Foremost among those differences, in the context of dying, is the ability of a bystander to provide aid. For example, if a child were drowning in a river, and the only person in the immediate vicinity is partially paralyzed and wheelchair-bound, I doubt that many - if anyone at all - would place blame on the handicapped for failing to save the child and allowing them to drown. Conversely, if the bystander happened to be an olympic swimmer, it seems clear that their inaction is in violation of some moral code. It is through a combination of this doctrine and Singer’s premise that I have developed the following principle: Letting die is morally equivalent to killing only if it is in our power to help, without sacrificing anything of comparable moral relevance, and we do not.

    The first thought experiment in support of this claim is James Rachels’s Jones and Smith experiment. The original experiment as Rachels provides it goes like this: Jones is put in charge of a young child. If this child dies while in Jones’s care, he will receive a large sum of money from the child’s insurance policy. One day, while the child is in the bath, he decides to kill the child, stage it as an accidental drowning, and inherit the money. On the way to do this, he hears the child fall and hit his head. Thrilled with his luck, Jones watches the child drown, ready to take action if he begins to surface. He does not have to, and the child dies. In an alternate, but almost exact same arrangement, Smith also has a child in his care, and makes the same decision to kill him. The difference is Smith’s child doesn’t fall of his own accord, and Smith is forced to stage the accident and kill the child himself. The question here is: Whose actions were more wrong? 

    Rachels argues that the actions of Jones and Smith are equally wrong, and rightly so. Given that Jones was fully capable of saving the child (without a morally relevant sacrifice) and chose not to, his inaction is, by my premise, equal to killing. In order to illustrate a situation in which Smith’s actions would be worse than Jones’s, I propose a variation to this thought experiment. Suppose Jones intends to kill the child, heads to the bathroom, and finds the door locked. Then, he hears the child fall, but even if he had wanted to help save the child, the locked door would have prevented him. In this situation, I would argue that Jones is not as responsible for the death of the child as Smith, who actively killed him. While the guilt of his intentions might mar his conscience, Jones was physically unable to save the child. By standing idly by, Jones might be more guilty than if he had attempted to break down the door to save the child, but his actions are not as morally wrong as in the original situation. Therefore, in this scenario, letting die is not as bad as killing. 

    Furthermore, I will propose a second variation in support of the claim that killing is not equivalent to letting die when a comparable morally relevant sacrifice is involved. Consider a scenario where Jones is put in charge of twins with equal life insurance policies. One day, while one of the twins is bathing, he slips, hits his head, and begins to drown. He is discovered in time, but has suffered damage such that without some vital transplant or transfusion, he will die. The need is immediate, and the only present and compatible donor is his twin brother, who would die in the procedure. It seems clear that killing the brother should not be allowed, even to save the life of the dying child. If their lives are of equal value, there is nothing which gives the dying child preference over the healthy child. In this situation, note that the doctor is physically incapable of saving the dying child without sacrificing the brother. This is undoubtably a sacrifice of equal moral relevance, and, therefore, is not permissible. As such, it follows from my argument that letting die is not equivalent to killing in this case. By allowing the injured child to die, the doctor is not committing the same moral crime that he would be by killing the second child to save the first. The benefit of this second alternate scenario is that it removes Jones’s intentions from the equation. In fact, it removes him entirely. Instead, it illuminates the kind of moral sacrifice which would make killing worse than simply allowing to die, and it does so while falling in line with our moral intuitions.

If the proposed principle has so far been well established, it can then be applied to overcome traditional moral dilemmas and reconcile our moral intuitions with what seems to be strict logic. In a thought experiment that Judith Jarvis Thomson helped popularize, many people find it difficult to justify their instinctual moral intuitions with logic. Thomson’s scenario is this: Suppose there are five workers on the tracks with a trolley heading straight towards them. For whatever reason, they cannot clear the tracks in time to escape death, but you, as a bystander, happen to be standing by a switch that will divert the trolley to an alternate track. However, on this alternate track is one worker who will surely die if you were to pull the switch. Are you permitted to pull the switch? 

    This Trolley debate has become one of the most famous in casual ethical discourse, but the real dilemma comes when it is paired with the second experiment which Thomson introduces, dubbed the Transplant experiment. In this experiment, you are an excellent transplant surgeon with five patients dying of organ failure. There are no donors in the vicinity, and without these organs, all five people will soon die. However, you notice that a person with healthy, compatible organs to all five patients has just entered the hospital. Assuming that you are such a good surgeon that there is no chance of failure, are you permitted to operate on one to save the five? 

    Thomson’s experiments prompt difficult questions to answer. It is widely agreed that, from the standpoint of moral intuitions alone, most people presented with the Trolley experiment find it permissible to pull the switch. Why, then, do they answer that it is not permissible for the doctor to operate in the Transplant experiment? Thomson’s answer to this dilemma has to do with an issue of rights and threats, but I would argue that the difference is in ability. Take, first, the Trolley experiment. If the bystander is standing by the switch, they have the power to save the lives of the five in question. This ability is not predicated on the fact that one person is on the alternate track. Whether that track is empty or holds that one person, their ability to save the five isn’t affected. Therefore, by my premise, failure of the bystander to act would make allowing those five to die equivalent to killing them. It is also clear that, by diverting the trolley to the alternate track, you are killing that one person. As such, no matter what you do, you are killing someone, and killing one is clearly better than killing five. This conclusion falls in line with our moral intuitions that a bystander is not only allowed to pull the switch, but quite possibly required to.

    It is the Transplant experiment, however, which causes more dissent. It seems that the doctor shouldn’t be allowed to operate on the patient, and that doing so would be clearly wrong, and this is, indeed, the case. Since the doctor doesn’t have legitimate transplantable organs on hand, he does not have the ability to save the five dying patients. If the person with a wealth of healthy organs had never entered the hospital, the doctor would have been forced to let the five patients die, and he would not have been guilty of killing them if he had done so. Letting die is not the same as killing here, for the saving of the five is not only predicated on the killing, but also the very existence, of the one. Killing the one healthy person in question would constitute a sacrifice of comparable moral relevance, and so cannot be permitted even to stop something very bad like the death of five people. Therefore, the doctor is not permitted to operate, and is still not guilty of killing anyone, as most people’s moral intuitions seem to agree with.

    A possible objection to this argument worth considering comes when defining what is implied by a sacrifice of comparable moral relevance to the life or lives in question. Through the second variation to the Jones and Smith  thought experiment, I believe I have shown that the unjust taking of one life is enough of a moral sacrifice to prohibit killing one to save one. However, it could be argued that the unjust killing of one is not clearly more morally wrong than, say, allowing two people to die. I would argue that this is not the case. Even though, from a mathematical standpoint, it would seem as though two lives should trump one, there are other considerations which need to be taken into account. Foremost among these are those that Thomson uses to justify the inaction of the doctor in her examination of the Transplant experiment. Thomson argues that the rights of the healthy patient trump the utilities that he might provide, and the same would be the case here. Even though two lives are in question rather than the mere one of the person being killed, that one person has a right to life. He is not faced with whatever danger the two are being faced with, and so, by killing him, you would be creating a new danger for him as well as violating his rights. Therefore, I would say that even two dying lives cannot overcome the moral relevance of the one who would be killed. Any further number of people being allowed to die - three, four, five, and on - that would overwhelm the right of the one would have to be chosen arbitrarily. After all, what would make four lives not enough to trump one, but five enough? Or seven lives inadequate, but eight over the moral threshold? The only number of significance is two against one, for that exceeds the one life for one life consideration. If letting two people die cannot be held to be more morally significant than unjustly killing one, then no higher number can be chosen without being arbitrary.

    If the premise that letting die is equivalent to killing only when you have the ability to prevent it and choose not to is convincing, then it would follow that passive euthanasia is equivalent to active euthanasia when the doctors are able to prevent or postpone death and do not. With modern technology, it is very often the case that doctors are able to keep the patient alive through the use of life support systems without any major moral sacrifices. When they do not act on this ability and allow the patient to die in passive euthanasia, this is essentially killing by the premise stated above. If this is the case, then it would be, morally, no different from active euthanasia in which the doctors administer some sort of lethal injection to achieve the same ends. However, it doesn’t necessarily follow from this argument that either killing or letting die is impermissible. It has been well argued by philosophers such as Rachels and Singer that, in most euthanasia cases, dying is preferable to continued suffering. Even in the sense of modern legislation, passive euthanasia is an accepted and applied practice. If passive euthanasia is acceptable, and if passive euthanasia and active euthanasia are morally equivalent, then it should logically follow that active euthanasia be accepted as well. 

    In conclusion, if the premise offered here is valid and supported by Singer and Rachels’s the Jones and Smith thought experiment, then it can be used to bridge the disparity of moral intuitions in Thomson’s Trolley and Transplant scenarios. Furthermore, it can be applied to show that, if passive euthanasia is permissible, then it is only logical that active euthanasia be considered permissible as well.

 

 

 

 

 

--- Any feedback at all would be super super helpful. Even if (especially if) you're really confused. Knowing where/what confuses people would be incredibly helpful for me to make this paper more clear. My grade is counting on this, please help me, I will love you forever. Thank you, friends ---

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