Concerning our moral obligations to other people, what is the distinction between killing and letting die? For example, if I'm at the beach and there's a child playing in the water, I think I can safely say that everyone would agree that it would be wrong for me to go in to the water and drown the child. But say I see the child drowning, and there's no one else around, and I could easily jump in and save him without risking my own life, would it be wrong for me to stand there and do nothing as he drowns? I'm not so sure what one's moral obligation is in this case. Personally, I would feel awful about letting the child drown and would certainly try to save him, but maybe not everyone would, and I'm hesitant so say they've done something wrong by doing nothing. In other words I don't know if I would support a law punishing such behavior.

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How far does our responsibility go to others is an interesting issue. Would we have more of an obligation to the child if he was our child, or someone we know, or someone who is from our country, and so on? And what counts as being culpable in not paying attention? For example, if we see a child in difficulties we ought to help him, but suppose we see a child by himself in the water and go to sleep. Would we be at fault then? It is not our job to search the water for potential dangers to others, but if we are responsible for harm we could prevent perhaps we should never relax at the beach but spend all our time combing the area for potential dangers to others. This brings out what is problematic in the idea of preventing harm to others. If we are so responsible then it is difficult to know where to draw the line. Should we prevent children from eating hamburgers on the beach, because we may think they are unhealthy, or drinking soft drinks that are bad for teeth? Should we stop them reading trashy magazines and insist they stick to the Philosophical Review?

If we can fairly easily save someone from harm by intervening we should consider if the intervention would be welcomed, as in saving someone from drowning (provided they did not want to drown, perhaps). If it would then presumably we ought to do it. To punish people for not intervening seems rather harsh, though. In my view saving people in those circumstances counts as acting beyond the demands of duty and so does not merit punishment if not pursued. What makes it not a duty is precisely the difficulty of knowing how far it is reasonable to intervene in someone else's life and the objectionability of going too far in this direction.

I would like to distinguish two questions: (1) In any given case, is the mere difference between killing and letting die morally significant? and (2) From the point of view of public policy, should we draw a distinction between killing and letting die?

I am convinced by the arguments that James Rachels provides in "Active and Passive Euthanasia," New England Journal of Medicine 292 (1975) against the moral significance of the distinction between killing and letting die per se. Through an examination of different cases, Rachels argues persuasively that when you hold all other factors equal (consequences, motive of the agent, consent of the person whose life is at stake), the mere difference between killing and letting die is morally insignificant. We tend to believe that there is a significant difference between this act (killing) and omission (letting die), because in most cases, these other factors are not equal. Usually people who kill have malicious intent and create significant harm; and usually people who fail to prevent deaths that they could have prevented have no malicious intent. Especially in a medical setting, those who fail to prevent death usually do so, because their patients judge that the benefits of prolonging their lives are not worth the costs. But, as Rachels argues, when considering the actions of a malevolent uncle and his young nephew whose death promises a big inheritance to the uncle, it makes no moral difference whether the uncle drowns his young nephew or merely fails to prevent him from drowning in the bathtub.

However, because instances of killing and instances of letting die tend to be correlated with other morally relevant factors, from the point of view of public policy, it may well be morally justified to draw a distinction between killing and letting die, especially when we are considering whether to punish individuals who do one or the other. Overall, the policy that draws this distinction (and holds killers morally responsible for their acts but does not hold the morally indifferent responsible for their omissions) may have better consequences than a policy that does not draw such a distinction.

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