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Letting and making death happen, withholding and withdrawing life-support: Morally irrelevant distinctions

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Abstract

The author argues that there is no morally relevant distinction between letting and making death happen, and between withholding and withdrawing life-support. There is a discussion of possible adverse consequences in believing that there are moral distinctions. And then he shows that acknowledging the absence of such a distinction does not necessarily imply any endorsement of active euthanasia.

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Reference notes

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    The Toronto Star, April 27, 1989.

  2. 2.

    The Toronto Star, May 19, 1989.

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    There have been other argumentsagainst the belief that there is a moral difference between letting and making death happen. For example, J. Bennett, “Whatever the Consequences,”Analysis, 26: 83–102, 1965–66. This paper is criticized by D. Dinello, “On Killing and Letting Die,”Analysis, 31: 83–86, 1971. Objections to Dinello's position are found in D. Husak's “Killing, Letting Die and Euthanasia,”Journal of Medical Ethics, 5: 200–202, 1979. The most popular paper against the distinction is J. Rachels's “Active and Passive Euthenasia,” inEthical Issues in Death and Dying, T. L. Beauchamp and S. Perlin (eds.) (Englewood Cliffs, New Jersey: Prentice Hall, 1978), pp. 240–246. This paper was first published in theNew England Journal of Medicine, 292: 78–80, 1975. For a criticism of this paper see T. L. Beauchamp, “A Reply to Rachels on Active and Passive Euthansia” inEthical Issues in Death and Dying, pp. 246–259. Rachels' excellent response to Beauchamp and other critics is in “Reasoning about Killing and Letting Die.”The Southern Journal of Philosophy, 19: 465–473, 1981. The issue is also taken up in Rachels'The End of Life (Oxford: Oxford University Press, 1986). My approach is different from all previous arguments against the belief that there is a moral difference between these concepts.

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    For a discussion of other subtleties: Abelson, R., “To Do or Let Happen,”American Philosophical Quarterly, 19: 219–228, 1982; Brand, M., “The Language of Not Doing,”American Philosophical Quarterly, 8: 45–53, 1971; Green, O. H., “Killing and Letting Die,”American Philosophical Quarterly, 17: 195–204, 1980; Husak, D. N., “Omissions, Causation and Liability,”The Philosophical Quarterly, 30: 318–326, 1980; Lee, S., “Omissions,”The Southern Journal of Philosophy, 16: 339–354, 1978; Mack, E., “Causing and Failing to Prevent,”The Southwestern Journal of Philosophy, 7: 83–90, 1976; P. G. Milanich, “Allowing, Refraining, and Failing: The Structure of Omissions,”Philosophical Studies, 45: 57–67, 1984; C. R. Pincher, “Moral Relevance in the Killing/Letting Die Debate,”The Southern Journal of Philosophy, 25: 193–205, 1987; Reichenbach, B. R., Euthanasia and Active-Passive Distinction,”Bioethics, 1: 51–73, 1987; Smith, P. G., “Ethics and Action Theory on Refraining: a Familiar Refrain in Two Parts,”Journal of Value Inquiry, 20: 3–17, 1986; “The Concept of Allowing,”The Southern Journal of Philosophy, 22: 223–240, 1984; Talja, J., “On the Logic of Omissions,”Synthese, 65: 235–248, 1985; Thomson, J. J., “Killing, Letting Die, and the Trolley Problem,”The Monist, 59: 204–217, 1976; Walton, D., “Omitting, Refraining and Letting Happen,”American Philosophical Quarterly, 17: 319–326, 1980; “Splitting the Difference: Killing and Letting Die,”Dialogue, 20: 68–77, 1981; Weinryb, E., “Omissions and Responsibility,”The Philosophical Quarterly, 30: 1–18, 1980. Zimmerman, M. J., “Taking Some of the Mystery Out of Omissions,”The Southern Journal of Philosophy, 19: 541–554, 1981.

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Correspondence to Claude Gratton.

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Gratton, C. Letting and making death happen, withholding and withdrawing life-support: Morally irrelevant distinctions. J Med Hum 11, 75–80 (1990). https://doi.org/10.1007/BF01650687

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Keywords

  • Adverse Consequence
  • Active Euthanasia
  • Relevant Distinction
  • Moral Distinction
  • Irrelevant Distinction