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Terms in this set (16)

I the first, Kyle 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, Kyle sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident. In the second, Letty also stands to gain if anything should happen to her six-year-old cousin. Like Kyle, Letty sneaks in planning to drown the child in his bath. However, just as she enters the bathroom Letty sees the child slip and hit his head, and fall face down in the water. Letty is delighted; she 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 Letty watches and does nothing. Now Kyle killed the child, whereas Letty "merely" let the child die. That is the only difference between them. Did either person 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 Letty's behavior was less reprehensible than Kyle's. But does one really want to say that? I think not.

No Inherent Moral Distinction Between Killing & Letting Die (Rachels)
1. If there is an inherent moral distinction between killing and letting die, then our moral evaluation of any two cases that differ only insofar as one is a case of killing and the other a case of letting die should always be different.
2. Our moral evaluation of any two such cases is not always different [e.g., the Smith (Kyle) and Jones (Letty) cases].
3. Therefore, there is no inherent moral distinction between killing and letting die.
4. Therefore, whenever two cases differ only insofar as one is a case of killing and the other is a case of letting die, the case of killing is permissible if the case of letting die is permissible.
Withdrawing Life-Sustaining Treatment Is a Kind of Killing (Rachels)
1. If (a) we believe the law is morally correct to allow withdrawing life-sustaining treatment and (b) withdrawing life-sustaining treatment is a kind of killing, then we already think a kind of VAE is morally and legally permissible.
2. If we already think a kind of VAE is morally and legally permissible, then it seems we should have no objection to legalizing other forms of VAE, such as lethal injection (which in certain circumstances would seem to be preferable because it ends pain and suffering sooner than withdrawing life-sustaining treatment).
3. (a) We do believe the law is morally correct to allow withdrawing life-sustaining treatment, and (b) withdrawing life-sustaining treatment is a kind of killing. ("What is the cessation of treatment, in these circumstances, if it is not 'the intentional termination of the life of one human being by another'? Of course it is exactly that, and if it were not, there would be no point to it" [p. 704].)
4. Therefore, it seems we should have no objection to legalizing other forms of VAE, such as lethal injection.

Beneficence and Autonomy (Brock)
1. If physicians' duties to (a) promote their patients' well-being (principle of beneficence) and (b) respect their patients' right to self-determination (principle of autonomy) make it right in some situations for physicians to comply with their patients' refusal of life-sustaining treatment, then these same two duties equally make it right, in similar situations, for physicians to comply with their patients' request for VAE.
2. These duties do make it right, in some situations, for physicians to comply with their patients' refusal of life-sustaining treatment.
3. Therefore, these duties equally make it right, in similar circumstances, for physicians to comply with their patients' request for VAE.
- "If people are offered the option of euthanasia, their continued existence is now a choice for which they can be held responsible and which they can be asked by others to justify. We care, and are right to care, about being able to justify ourselves to others. To the extent that our society is unsympathetic to justifying a severely dependent or impaired existence, a heavy psychological burden of proof may be placed on patients who think their terminal illness or chronic infirmity is not a sufficient reason for dying. Even if they otherwise view their life as worth living, the opinion of others around them that it is not can threaten their reason for living and make euthanasia a rational choice. Thus the existence of the option becomes a subtle pressure to request it." (677R)
- Brock: If there were anything to this worry, then it would have manifested itself already with the legalization of voluntary passive euthanasia. But there's no evidence of subtle pressure associated with this legal practice. Also, procedural safeguards can protect against such abuse, as they've evidently done regarding voluntary passive euthanasia.

- If voluntary active euthanasia were legalized, the right to relief from suffering (principle of beneficence), which is such a big part of our culture's moral reasoning, would mandate nonvoluntary active euthanasia.
- In time, judges will relent, and this immoral form of euthanasia will be legal. To prevent that from happening, we shouldn't legalize voluntary active euthanasia.
- Brock's response (679R-680R): If the legalization of nonvoluntary passive euthanasia (i.e., forgoing life-sustaining treatment for a mentally incompetent patient) hasn't caused significant abuse, why think the legalization of nonvoluntary active euthanasia would? Admittedly, legalizing nonvoluntary active euthanasia "would greatly enlarge the number of patients on whom it [nonvoluntary euthanasia] might be performed and substantially enlarge the potential for misuse and abuse." But the underlying problem is nonvoluntary euthanasia, not active euthanasia. The solution, then, is to double down on procedural safeguards for both forms of nonvoluntary euthanasia, not keep one form legal and the other illeg