Brandeis University, Philosophy Department
Fall 2009
Brandeis University Web Stite

Philosophy 1A


Professor Andreas Teuber
Prof. Teuber


The Survival Lottery:

John Harris' "The Survival Lottery"

Imagine the following: "[Suppose] that everyone be given a sort of lottery number.
Whenever doctors have two or more dying patients who could be saved by transplants,
and no suitable organs have come to hand through 'natural' deaths, they can ask
a central computer to supply a suitable donor. The computer will then pick the number
of a suitable donor at random and he will be killed so that the lives of two or more
others may be saved." - John Harris, Philosophy, Vol. 50, 1975, pp. 81-7

Consider the following true story:

Matthew Donnelly was a physicist who had worked with X-rays for thirty years. Perhaps as a result of too much exposure, he contracted cancer and lost part of his jaw, his upper lip, his nose, and his left hand, as well as two fingers from his right hand. He was also left blind. Mr. Donnelly's physicians told him that he had about a year left to live, but he decided that he did not want to go on living in such a state. He was in constant pain - one writer said that "at its worst, he could be seen lying in bed with teeth clinched and beads of perspiration standing out on his forehead." Knowing that he was going to die eventually anyway, and wanting to escape his misery, Mr. Donnelly begged his three brothers to kill him. Two refused, but one did not. The youngest brother, 36-year-old Harold Donnelly, carried a .30 caliber pistol into the hospital and shot Matthew to death.

Many believe that what Harold did was wrong. What do you think? Do you agree?

If so, on what moral grounds? If not, why not? What's the moral argument?

In the situation described above Harold could have let his brother die. As the doctors said his brother Matthew had about a year to live. Harold, however, chose not to wait. He shot and killed his brother. Was his decision justified?

On the basis of what fundamental moral principle might Harold's decision be justified or not?

Some would argue that the principle which states that "each and every human life is precious, valuable and uniquely sacred" shows that Harold's decision was not justified: The intentional, deliberate killing of an innocent human being is always wrong.

What do you think? Do you agree?

Some believe there is an important distinction to be made between killing and letting die and that Harold, in acting as he did, failed to honor this distinction.

And yet, as James Rachels writes in an article published in the New England Journal of Medicine in 1975, "one reason why so many people think that there is an important moral difference between active and passive euthanasia is that they think killing someone is morally worse than letting someone die. But is it? Is killing, in itself, worse than letting die?"

To investigate this issue, two cases may be considered that are exactly alike except that one involves killing whereas the other involves letting someone die. Then, it can be asked whether this difference makes any difference to the moral assessments. It is important that the cases be exactly alike, except for this one difference, since otherwise one cannot be confident that it is this difference and not some other that accounts for any variation in the assessments of the two cases. So, let us consider this pair of cases:

In the first, Smith stands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.

In the second, Jones also stands to gain if anything should happen to his six-year-old cousin. Like Smith. Jones sneaks in planning to drown the child in Ills bath. However, just as fie enters the bathroom Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he stands by, ready to push the child's head back under if it is necessary, but it is not necessary. With only a little thrashing about, the child drowns all by himself, "accidentally," as Jones watches and does nothing.

Now Smith killed the child, whereas Jones "merely" let the child die. That is the only difference between them. Did either man behave better, from a moral point of view?

If the difference between killing and letting die were in itself a morally important matter, one should say that Jones's behavior was less reprehensible than Smith's. But does one really want to say that? I think not. In the first place, both men acted from the same motive, personal gain, and both had exactly the same end in view when they acted. I t may be inferred from Smith's conduct that he is a bad man, although that judgment may be withdrawn or modified if certain further facts are learned about him - for example, that he is mentally deranged.

But would not the very same thing be inferred about Jones from his conduct? And would not the same further considerations also be relevant to any, modification of this judgment? Moreover, suppose Jones pleaded, in his own defense, "After all, I didn't do anything except just stand there and watch the child drown. I didn't kill him; I only let him die." Again, if letting die were in itself less bad than killing, this defense should have at least some weight. But it does not. Such a "defense" can only be regarded as a grotesque perversion of moral reasoning. Morally speaking, it is no defense at all.

The Solicitor General of the United States would have none of this, He argued before the United States Supreme Court in the Nancy Cruzan case in 1984 "though government may not prevent a doctor from discontinuing life support if the patient insists, it may absolutely prevent him, in any and all circumstances, from prescribing lethal pills the patient requests, because in the former situation the doctor only omits to take action that could save life while in the latter he positively contributes to causing death."

And the American Medical Association has gone on record, stating that "the intentional termination of the life of one human being by another" is "contrary" to the policy of the AMA.

But is there a difference, a moral difference, between killing and letting die? Rachels seems to think there is none. See what he says in full. Here is his article attached as a PDF File: Active and Passive Euthanasia.

What do you think? Is there a moral difference between causing and allowing, between causing and allowing someone to die. Never? Sometimes? in some cases? But if this is so, what is it about those cases that makes them candidates for the applicability of the killing/letting die distinction? Or perhaps you think there is no distinction to be made, that is, that there is no moral distinction, between killing and letting die, that people like the Solicitor General of the United States are just confused when they think there is.

This, of course, is exactly what Harold did. He intentionally terminated the life of his brother by shooting him.

There seems to be a similar predicament in John Harris' description of Survival Lottery since there in that scenario someone is killed so that two persons in need of an organ transplant may survive:

[Suppose] that everyone be given a sort of lottery number. Whenever doctors have two or more dying patients who could be saved by transplants, and no suitable organs have come to hand through 'natural' deaths, they can ask a central computer to supply a suitable donor. The computer will then pick the number of a suitable donor at random and he will be killed so that the lives of two or more others may be saved.


And John Harris claims in his essay on Survival Lottery, published in the journal Philosophy in 1971, one cannot object to it "on the ground that it involves killing the innocent" because any alternative, all the alternatives also "involve killing the innocent" and, Harris goes on to say, if one does wish to object one "must point to some morally relevant difference between positive and negative 'killing'."

John Harris essay is also attached and you may wish to take a closer look at John Harris's essay by clicking HERE.

Drawing on the reading and your own sound reasoning and good judgment, is the scheme proposed in Harris' essay morally wrong? If so , on what moral grounds and which moral theory and or principle or principles best support and explain your reasoning? Or is it perhaps not morally objectionable or what moral objections there are may be overcome or overridden by other moral considerations. Perhaps as far as you are concerned the scheme is "for the best" from a moral point of view. If so, what makes it justified? Again: what moral theory or principle or principles best support and explain your position?

What, if anything, is morally wrong with Harris' survival lottery? What's your defense of your answer and what objections might be raised to your defense and how might you best respond to them?

In the course of giving your answer how does it square with, help to explain your judgment of Harold Donnelly's decision described above? Does the theory and principle or principles you propose that best support and explain your position on the survival lottery also support and explain your position on that case? Recall, too, some of the cases we have already discussed - at least to some extent - in class. Here I am thinking about the handouts on "Baby Theresa" , "John on a Botany Expedition in the Amazon", Queen v. Dudley , and Peter Singer's "The Shallow Pond and Envelope Cases" as well as "The Trolley Problem Case"and "John: The Mad Transplant Doctor" .

What is your view of John in the Amazon, John as Transplant Doctor, John as Trolley Driver, Levin's Case for Torture, The Baby Theresa Case?

Does your moral theory, principle or principles best capture your intuitive judgment of how these cases ought to be decided. And if you think your theory and principle or principles apply to all these cases, think of several objections to your appeal to this theory or that principle or principles, and respond to them.

You may want to take a look again at the moral theories laid out in the reading in the Perry, Bratman, Fischer text, in the Oxford edition of the Introduction to Philosophy in the section with the title: "Ethics and Society" at utilitarianism, Kantianism, virtue theory, and the social contract theory of John Rawls.

You may also find the different positions taken by Onora O'Neill in her "Kantian Approaches to Some Famine Problems" and by Peter Singer in his Singer's "Famine, Affluence and Morality" provide some insight into how philosophers argue for and against contemporary moral issues as well as some insight into how philosophers apply different moral theories to moral problems.

So, too, you may find Thomas Nagel's essay on "War and Massacre," also in the reading for the course , to be useful since it provides a Kantian approach to the treatment of civilians and non-combatants in time of war and so offers insight into how moral theory can be given practical application.

Free Will



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