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)

As the twentieth century begins to draw to a close, Europe is undergoing a process of political transformation whose outcome cannot be predicted with confidence, in part because the process is being driven by two powerful but conflicting tendencies. The first is the movement toward greater economic and political union among the countries of Western Europe. The second is the pressure, in the aftermath of the collapse of the Soviet Union, for the countries of Eastern Europe to fragment along ethnic (...) and communal lines. (shrink)

According to the Doctrine of Doing and Allowing, it is more difficult to justify doing harm than it is to justify allowing harm. Enabling harm consists in withdrawing an obstacle that would, if left in place, prevent a pre-existing causal sequence from leading to foreseen harm. There has been a lively debate concerning the moral status of enabling harm. According to some (e.g. McMahan, Vihvelin and Tomkow), many cases of enabling harm are morally indistinguishable from doing harm. Others (e.g. Foot, (...) Hanser) support the Equivalence Hypothesis, according to which enabling harm is morally equivalent to allowing harm. Here I argue that there is every reason to embrace, and no reason to reject, the Equivalence Hypothesis. (shrink)

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1. Introduction This essay deals with the hard topic of the permissible killing of the innocent. The relevance of this topic to the morality of war is obvious. For even the most defensive and just wars, i.e., the most defensive and just responses to existing or imminent large-scale aggression, will inflict harm upon – in particular, cause the deaths of – innocent bystanders. 1 The most obvious and relevant example is that of innocent Soviet noncombatants who would be killed by (...) even the most precise defensive strike against Soviet strategic weapons or troop formations that is now possible. Should there be no vindication or, at least, no excuse for some killings of such innocent bystanders, morality would dictate that even defensive counterforce measures against largescale attacks should be renounced. (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)

The series of 'trolley' examples issue a challenge to moral principles based on intentions, since it seems that these give the wrong answers in two important cases: 'Fat Man', where they seem to say that it is permissible to push someone in front of a trolley to save others, and 'Loop', where they seem to say that it is wrong to divert a trolley towards a single person whose body will stop it and save others. I reply, first, that there (...) is a parallel between the wrongful intention to mutilate in 'Transplant', where one person's vital organs are removed to save others' lives, and the intention to assault in Fat Man. Secondly, I defend Frances Kamm's view that in Loop one can divert the trolley towards the one without an intention to kill or assault, since good potential side-effects can be taken into account in deciding what to do, without their becoming intentions. (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.

In Intricate Ethics, Kamm questions the moral importance of some non-consequentialist distinctions and then introduces and argues for the moral importance of ...

The concept of causation is fundamental to ascribing moral and legal responsibility for events. Yet the precise relationship between causation and responsibility remains unclear. This book clarifies that relationship through an analysis of the best accounts of causation in metaphysics, and a critique of the confusion in legal doctrine.

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)