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be undesirable but are not comparable with actual malice or |
similar motives. |
Second, it is not difficult for most of us to act in accordance |
with a rule against killing people: it is, on the other hand, very |
difficult to obey a rule that commands us to save all the lives |
we can. To live a comfortable, or even luxurious life it is not |
necessary to kill anyone; but it is necessary to allow some to |
die whom we might have saved, for the money that we need |
to live comfortably could have been given away. Thus the duty |
to avoid killing is much easier to discharge completely than the |
duty to save. Saving every life we could would mean cutting |
our standard of living down to the bare essentials needed to |
keep us alive. l To discharge this duty completely would require |
a degree of moral heroism utterly different from that required |
by mere avoidance of killing. |
Strictly, we would need to cut down to the minimum level compatible with |
earning the income which, after providing for our needs, left us most to give |
away. Thus if my present position earns me, say, $40,000 a year, but requires |
me to spend $5,000 a year on dressing respectably and maintaining a car, I |
cannot save more people by giving away the car and clothes if that will mean |
taking a job that, although it does not involve me in these expenses, earns |
me only $20,000. |
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Practical Ethics |
A third difference is the greater certainty of the outcome of |
shooting when compared with not giving aid. If I point a loaded |
gun at someone at close range and pull the trigger, it is virtually |
certain that the person will be killed; whereas the money that |
I could give might be spent on a project that turns out to be |
unsuccessful and helps no one. |
Fourth, when people are shot there are identifiable individuals |
who have been harmed. We can point to them and to their |
grieving families. When I buy my stereo system, I cannot know |
who my money would have saved if I had given it away. In a |
time of famine I may see dead bodies and grieving families on |
television reports, and I might not doubt that my money would |
have saved some of them; even then it is impossible to point |
to a body and say that had I not bought the stereo, that person |
would have survived. |
Fifth, it might be said that the plight of the hungry is not my |
doing, and so I cannot be held responsible for it. The starving |
would have been starving if I had never existed. If I kill, however, |
I am responsible for my victims' deaths, for those people |
would not have died if I had not killed them. |
These differences need not shake our previous conclusion that |
there is no intrinsic difference between killing and allowing to |
die. They are extrinsic differences, that is, differences normally |
but not necessarily associated with the distinction between killing |
and allowing to die. We can imagine cases in which someone |
allows another to die for malicious or sadistic reasons; we can |
imagine a world in which there are so few people needing |
assistance, and they are so easy to assist, that our duty not to |
allow people to die is as easily discharged as our duty not to |
kill; we can imagine situations in which the outcome of not |
helping is as sure as shooting; we can imagine cases in which |
we can identify the person we allow to die. We can even imagine |
a case of allowing to die in which, if I had not existed, the |
person would not have died - for instance, a case in which if |
I had not been in a position to help (though I don't help) |
224 |
Rich and Poor |
someone else would have been in my position and would have |
helped. |
Our previous discussion of euthanasia illustrates the extrinsic |
nature of these differences, for they do not provide a basis for |
distinguishing active from passive euthanasia. If a doctor decides, |
in consultation with the parents, not to operate on - and |
thus to allow to die - a Down's syndrome infant with an intestinal |
blockage, her motivation will be similar to that of a |
doctor who gives a lethal injection rather than allow the infant |
to die. No extraordinary sacrifice or moral heroism will be required |
in either case. Not operating will just as certainly end in |
death as administering the injection. Allowing to die does have |
an identifiable victim. Finally, it may well be that the doctor is |
personally responsible for the death of the infant she decides |
not to operate upon, since she may know that if she had not |
taken this case, other doctors in the hospital would have |
operated. |
Nevertheless, euthanasia is a special case, and very different |
from allowing people to starve to death. (The major difference |
being that when euthanasia is justifiable, death is a good thing.) |
The extrinsic differences that normally mark off killing and allowing |
to die do explain why we normally regard killing as much |
worse than allowing to die. |
To explain our conventional ethical attitudes is not to justify |
them. Do the five differences not only explain, but also justify, |
our attitudes? Let us consider them one by one: |
1. Take the lack of an identifiable victim first. Suppose that |
I am a travelling salesperson, selling tinned food, and I learn |
that a batch of tins contains a contaminant, the known effect |
of which, when consumed, is to double the risk that the consumer |
will die from stomach cancer. Suppose I continue to sell |
the tins. My decision may have no identifiable victims. Some |
of those who eat the food will die from cancer. The proportion |
of consumers dying in this way will be twice that of the community |
at large, but who among the consumers died because |
225 |
Practical Ethics |
they ate what I sold, and who would have contracted the disease |
anyway? It is impossible to tell; but surely this impossibility |
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