Lecture Notes on Rachels, "Active and Passive Euthanasia"

1. Categories:

• Active euthanasia
• Passive euthanasia
• 'letting nature take its course' (i.e. non-intervention cases)
• 'making nature take its course' (i.e. discontinuing-aid cases)
• Physician Assisted Suicide

Be sure you understand the definitions of each of these categories, as elaborated upon in lecture. Our focus will be on the distinction between active and passive euthanasia.

2. Rachels' Three Claims:

(i) Active euthanasia is in many cases ____________________ than passive euthanasia.

(ii) The conventional doctrine of the AMA leads to life-or-death decisions based on irrelevant grounds, and is therefore unacceptable. (E.g., two babies case.)

(iii) The conventional doctrine of the AMA relies on the assumption that the general distinction between ____________________is morally significant. Rachels argues, however, that the ______________________ distinction is not morally significant.

We'll focus today on Rachels' third claim.

See if you can correctly fill this in before class:

3. How does Rachels argue that __________________________ is morally insignificant?

• First, he assumes (without argument) that if the ___________________ distinction were morally significant, then _____________ must always be worse than _______________, all else being equal. In other words, it would have to be the case that in every pair of otherwise similar cases X and Y, which differ only in that X is a ____________ while Y is a _____________, X is worse than Y.
• Then he argues that it's NOT true that _____________ is always worse than _____________, all else being equal. There are some pairs of otherwise similar cases X and Y, which differ only in that X is a killing while Y is a letting-die, where Y is every bit as bad as X!

What pair of cases does he offer to support this claim?

• So he concludes that the ___________________ distinction is not in itself a morally significant one. It never makes a moral difference in itself. Only other factors are morally relevant.

4. But Rachels' first assumption above is faulty: it is possible for the killing/letting die distinction to be morally significant without any implication that killing is always worse than letting die. The moral relevance of the distinction may be context-sensitive: it may make a moral difference in some contexts, i.e. in some pairs of otherwise similar cases, but not in others. We need to explore this possibility.

5. How can we make sense of this claim of context-dependent moral relevance?

Foot's (now very familiar) theory of the precedence of ______________ over _________________ (i.e. _______________ are stronger and less easily overridden) can explain how the killing/letting die distinction can make a difference in some cases, though it needn't always make a difference.

Recall her examples of Rescue I and Rescue II to illustrate this. Here, the killing/letting die distinction seems to be making a moral difference, though everything else is held equal: We may let die in RI, but we may not kill in RII; RI was okay, but RII was wrong, and Foot's theory explains this. Be sure you understand how her above thesis about rights explains why RI is okay but RII is not.

• This explains how the killing/letting die distinction can make a differences in at least some contexts.

• But then Rachels is wrong in claiming that the killing/letting die distinction itself never makes a moral difference. All he's shown, at most, is that killing is not always worse (or not always much worse) than letting die. It did not succeed in showing that the killing/letting die distinction never makes a moral difference.

6. Can Foot's theory explain why the killing/letting die distinction makes a moral difference in her rescue cases but not in the Smith and Jones cases? Can you see how? (Think about the situation regarding the relevant rights in the various cases, and what's happening with respect to them.)

• Lesson: Foot never denied that a wrongful letting die may be as heinous as a wrongful killing. Her claim was just that in some contexts, a letting die may actually be permissible (not wrong at all) while killing would be wrong.

• Interesting point: Is Rachels even correct in claiming that the Smith and Jones cases are morally equivalent? I'll describe one way of arguing that even in those cases there is an interesting moral inequivalence between the killing and the letting die.

7. What is the upshot for the euthanasia debate?

If Foot is right, and the killing/letting die distinction is sometimes morally relevant, then it MAY turn out to be morally relevant in at least SOME euthanasia cases. So we need to look carefully at those particular contexts, and the rights situations involved, to see whether the difference between active and passive euthanasia is morally significant or not. In other words, if Foot is right, then things are at least more complicated than Rachels thought!