According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the second of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the moral status of the distinction between doing and allowing harm. I look at objections to the doctrine such as James’ Rachels’ Wicked Uncle Case and Jonathan (...) Bennett’s argument that any acceptable analysis of the distinction leaves it implausible that the distinction is morally relevant. I consider putative defences of the Doctrine from Philippa Foot and Warren Quinn. I argue that neither Foot not Quinn provides a satisfactory justification of the Doctrine of Doing and Allowing, but that the idea of self-ownership discussed by Quinn can be developed to provide a justification of the doctrine. (shrink)

According to the Doctrine of Doing and Allowing, the distinction between doing and allowing harm is morally significant. Doing harm is harder to justify than merely allowing harm. This paper is the first of a two paper critical overview of the literature on the Doctrine of Doing and Allowing. In this paper, I consider the analysis of the distinction between doing and allowing harm. I explore some of the most prominent attempts to analyse this distinction:. Philippa Foot’s sequence account, Warren (...) Quinn’s action/ inaction account, and counterfactual test accounts put forward by Shelly Kagan and Jonathan Bennett. I also discuss Jeff McMahan’s account of the removal of barriers to harm. I argue that analysis of the distinction has often been made more difficult by two mistaken assumption: (1) the assumption that when an agent does or allows harm his behaviour makes the difference to whether or not the harm occurs (2) the assumption that the distinction between doing and allowing and the distinction between action and inaction are interchangeable. I suggest that Foot’s account is the most promising account of the doing/allowing distinction, but that it requires further development. (shrink)

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)

In January 2012, the Journal of Medical Ethics published online Giubilini and Minerva's paper, ‘After-birth abortion. Why should the baby live?’.1 The Journal publishes articles based on the quality of their argument, their contribution to the existing literature, and relevance to current medicine. This article met those criteria. It created unprecedented global outrage for a paper published in an academic medical ethics journal. In this special issue of the Journal, Giubilini and Minerva's paper comes to print along with 31 articles (...) from some of the best scholars in the world, from the broadest range of perspectives on abortion and infanticide, including those strongly critical of Giubilini and Minerva.The killing of a baby is among the most shocking of human practices. I am strongly opposed to the legalisation of infanticide along the lines discussed by Giubilini and Minerva. But I would like to explain why a journal of medical ethics published an article examining infanticide and now devotes a special issue to bringing a wide range of perspectives for further examination of these issues.Infanticide has been practised throughout human history for various reasons and continues to be practised today throughout the world. In rare cases, infanticide can be practised openly and legally—for example, as specified under the ‘Groningen Protocol’, in the Netherlands. The Groningen Protocol allows doctors to end the life of neonates at the request of their parents if the infant is experiencing hopeless and unbearable suffering.2But medical infanticide arguably occurs elsewhere other than in the Netherlands today.In neonatal intensive care, it is not uncommon for a doctor to withdraw artificial ventilation with the consequence that a baby dies.3 If anyone else performed that act, including the parents of the child, it would be viewed as an act of homicide, in some cases …. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Accepted medical practice already violates the dead donor rule. Explicitly jettisoning the rule—allowing vital organs to be extracted, under certain conditions, from living patients—is a radical change only at the conceptual level. But it would expand the pools of eligible organ donors.

Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices (...) is based on a series of moral fictions – motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken. (shrink)

Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at http://www.jstor.org/about/terms.html. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use.

This paper examines the recent prominent view in medical ethics that withdrawing life-sustaining treatment is an act of killing. I trace this view to the rejection of the traditional claim that withdrawing LST is an omission rather than an act. Although that traditional claim is not as problematic as this recent prominent view suggests, my main claim is that even if we accepted that withdrawing LST should be classified as an act rather than as an omission, it could still be (...) classified as letting die rather than killing. Even though omissions are contrasted with acts, letting die need not be, for one can let die by means of acts. The remainder of the paper is devoted to establishing this claim and addresses certain objections to it. (shrink)

Most people believe that there are limits to the sacrifices that morality can demand. Although it would often be meritorious, we are not, in fact, morally required to do all that we can to promote overall good. What's more, most people also believe that certain types of acts are simply forbidden, morally off limits, even when necessary for promoting the overall good. In this provocative analysis Kagan maintains that despite the intuitive appeal of these views, they cannot be adequately defended. (...) In criticizing arguments for limited moral requirements as well as those for unconditionally prohibited acts, Kagan offers a sustained attack on two of the most basic features of ordinary common sense morality. (shrink)

An updated and extended second edition supporting the findings of its well-known predecessor which claimed that courts employ common-sense notions of causation in determining legal responsibility.

An updated and extended second edition supporting the findings of its well-known predecessor which claimed that courts employ common-sense notions of causation in determining legal responsibility.

This article references the following linked citations. If you are trying to access articles from an off-campus location, you may be required to first logon via your library web site to access JSTOR. Please visit your library's website or contact a librarian to learn about options for remote access to JSTOR.

It is widely believed to be permissible for a physician to discontinue any treatment upon the request of a competent patient. Many also believe it is never permissible for a physician to intentionally kill a patient. I argue that the prospect of deactivating a patient’s artificial heart presents us with a dilemma: either the first belief just mentioned is false or the second one is. Whichever horn of the dilemma we choose has significant implications for contemporary medical ethics.

This volume continues the examination of issues of life and death which F.M. Kamm began in Morality, Mortality, Volume I. Kamm continues her development of a non-consequentialist ethical theory and its application to practical ethical problems. She looks at the distinction between killing and letting die, and between intending and foreseeing, and also at the concepts of rights, prerogatives, and supererogation. She shows that a sophisticated non-consequentialist theory can be modelled which copes convincingly with practical ethical issues, and throws considerable (...) light on some of the key distinctions and concepts of ethical discourse. (shrink)

According to the "sanctity-of-life" view, all human lives are equally valuable and inviolable, and it would be wrong to base life-and-death medical decisions on the quality of the patient's life. Examining the ideas and assumptions behind the sanctity-of-life view, Kuhse argues against the traditional view that allowing someone to die is morally different from killing, and shows that quality-of-life judgments are ubiquitous. Refuting the sanctity-of-life view, she provides a sketch of a quality-of-life ethics based on the belief that there is (...) a profound difference between merely being alive and life being in the patient's interest. (shrink)

One of the reasons why most of us feel puzzled about the problem of abortion is that we want, and do not want, to allow to the unborn child the rights that belong to adults and children. When we think of a baby about to be born it seems absurd to think that the next few minutes or even hours could make so radical a difference to its status; yet as we go back in the life of the fetus we (...) are more and more reluctant to say that this is a human being and must be treated as such. No doubt this is the deepest source of our dilemma, but it is not the only one. For we are also confused about the general question of what we may and may not do where the interests of human beings conflict. We have strong intuitions about certain cases; saying, for instance, that it is all right to raise the level of education in our country, though statistics allow us to predict that a rise in the suicide rate will follow, while it is not all right to kill the feeble-minded to aid cancer research. It is not easy, however, to see the principles involved, and one way of throwing light on the abortion issue will be by setting up parallels involving adults or children once born. So we will be able to isolate the “equal rights” issue and should be able to make some advance... (shrink)