Brandeis University, Philosophy Department
Fall 2006
Brandeis University Web Stite

Philosophy 1A

Introduction to Philosophy

Professor Andreas Teuber
Prof. Teuber

Active v. Passive Euthanasia

Active vs. Passive Euthanasia:
Is There a Moral Difference?

James Rachels' Argument
in The New England Journal of Medicine

"Killing is not in itself any worse than letting die;
if my contention is right, it follows that active
euthanasia is not any worse than passive euthanasia."

- James Rachels, New England Journal of Medicine

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.

The Solicitor General of the United States, for an example, 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.

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

James Rachels, however, in his article in the reading for the course, pp. 650-53 on "Active and Passive Euthanasia," originally published in The New England Journal of Medicine (1975), is of the opinion that "killing is not in itself any worse than letting die" and he goes on to argue that "if [his] contention is right, it follows that active euthanasia is not any worse than passive euthanasia."

No worse? Really?

Drawing on the reading and your own sound reasoning and good judgment, make a case for or against James Rachels' argument in his NEJM article reprinted in REASON AND RESPONSIBILITY, pp. 650-53 and in a PDF FILE online that there is no morally relevant difference between killing and letting die, hence no morally relevant difference between active and passive euthanasia.

In giving your answer recall 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" and Michael Levin's "The Case for Torture", and Peter Singer's "The Shallow Pond and Envelope Cases" as well as "The Trolley Problem Case" and "John: The Mad Transplant Doctor" and "John and Alice in Sumatra" to choose seven examples that we discussed in class.

What is your view of some or any of these cases and Harold Donnelly's Decision. Do any of the cases help you to understand Harold's decision or serve as model for the sorts of moral considerations that might be relevant in Harold's case?

What principle best captures your judgment of how these cases should be decided, think of several strong objections to your arguments and your defense of principle, and respond to them.

Judith Thomson's "A Defense of Abortion" [Brandeis Access Only] and Don Marquis' "Why Abortion Is Immoral" [Brandeis Access Only] may help provide some insight into how philosophers argue for and against contemporary moral issues. Or you may 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" [Brandeis Access Only] provides some insight into how philosophers apply diffferent moral theories to moral problems.

You may wish to take a peek, too, at John Harris' Survival Lottery in the main text for the course, pp. 645-49 since the Survival Lottery appears to raise some of the same concerns raised by Harold's decision to kill his brother.

In defending your position, offer what you believe are the most principled arguments you can make. In thinking of objections to your opinion, think of the best possible objections that someone on the other side might be able to come up with, i.e., give yourself a hard time.

If you can respond to the other side at its strongest rather than at its weakest point, that can only help to strengthen your own opinion and make it that much more persuasive.











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