There is No Moral Difference Between Active and Passive Euthanasia

In ”Active and Passive Euthanasia, “ James Rachels argues that there is no moral difference between actively terminating an individual’s life and terminating it by “allowing” him to die as a result of a disease or other circumstance in all cases. His focus is on cases of euthanasia in which the goal is to end an individual’s suffering brought on by a painful disease. Rachels regrets that the contemporary consensus in the medical community on the morals of active versus passive euthanasia; i.e. that actively terminating a patient‘s life by administering a fatal drug is morally worse than allowing a patient to die by withholding treatment. Rachels first contends that active euthanasia is often more humane than passive in that it results in less pain. If the passive euthanasia route is selected, the patient will suffer in agony for days before dying.

Rachels employs an example of children born with Down’s syndrome and an occasionally accompanying congenital defect in the intestinal tract, which needs to be operated on so that the child may live Allowing them to die means that they will suffer of dehydration and infection. The alternative of active euthanasia will terminate their lives quickly and (presumably) relatively painlessly. It is then asserted that the moral distinction between active and passive euthanasia ”leads to decisions concerning life and death made on irrelevant grounds”. Using the above example of Down’s syndrome children with the intestinal tract defect, Rachels argues that, if the decision were to be made to allow the baby to die by not operating on the intestines, then the purpose would be to minimize suffering due to the Down’s syndrome, not the intestinal blockage.

Therefore, life and death would be differentiated on irrelevant grounds. He then posits that there is no moral difference between killing and allowing someone to die. He cites an example of a man who kills a child in order to gain a large inheritance and another man who allows a child to die, in a situation wherein he can intervene and save the child, in order to gain a large inheritance In either case, both individuals’ actions are morally indefensible. Allowing someone to die is an action (unjust or otherwise) just the same as actively and directly killing someone is.

Finally, Rachels addresses a number of arguments that contradict his position. One major argument in favor of a moral distinction between active and passive euthanasia is that, in a medical situation, if a patient is allowed to die, it would be the disease that is doing the killing, whereas if the doctor actively terminates the patient’s life, it is his responsibility. Going back to his third contention, Rachels argues that allowing a patient to die is an action made by the doctorjust the same. He concedes that this distinction may be useful within the contemporary legal paradigm, but there is no moral difference regardless.

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