In James Rachels’ famous article, “Active and Passive Euthanasia,” he argues that, if the only relevant difference between active and passive euthanasia is that the former involves killing and the latter involves letting die, then that difference is not a morally relevant difference if there’s no morally relevant difference between killing and letting die. And indeed, he argues, there is no morally relevant difference between killing and letting die, a conclusion drawn from the Bathtub Case (which, along with Judith Thomson’s Violinist Analogy, is one of the most famous thought experiments in moral philosophy). Now there’s indeed a lesson to be learned here, but I don’t believe it’s the one Rachels had in mind. Instead, I think there’s a really interesting lesson about the asymmetry of our patterns of blame and praise to be had.
The Bathtub Case goes as follows: Smith and Jones both stand to inherit quite a bit of money upon the death of their young nephew, so both want that kid dead. Smith sneaks into the bathroom one night when his nephew is taking a bath and drowns him, then arranges things to make it look like an accident. In the second case, Jones sneaks into the bathroom one night when his nephew is taking a bath, prepared to drown him, but then the boy slips, hits his head, and drowns all on his own. Jones is ready to push the kid’s head back down under the water, but he doesn’t have to. Rachels’ conclusion: the only difference between the two cases is that one involves killing and the other involves letting die, but what Jones did is just as morally bad as what Smith did, so there’s no moral difference between them, and so there’s no moral difference between killing and letting die (there’s a more precise way to put the argument, but I’m sure you get the drift). And if the only relevant difference between active and passive euthanasia is the killing/letting die distinction, then there’s no moral difference between active and passive euthanasia.
In teaching this article over the years, I’ve tried to raise possible counterexamples, pairs of cases of killing/letting die where the killing case is morally worse than the letting die case. I’m sure many of you take the same tack. What I had done for a while was present the following pair: in case (a1), you’re the only one who knows about a family of four in Africa Africa
Now what’s interesting is that, the more one eliminates the disanalogies between various pairs of cases and the Bathtub Case, the more it becomes difficult to see them as counterexamples to Rachels. So, for instance, suppose we move the family of four to the apartment next door to you: in (a2), you know they’ll starve to death if you don’t bring them any food, so you don’t bring them any food; in (b2), you hear them through the wall watching TV one night and aim your shotgun at where their heads would be and pull the trigger, killing them all. (In both cases, you want them dead because their laughter at night reminds you of your own pitiful loneliness.) The effort, motives, and so forth are now roughly on a par in both cases. But now it also seems as if the cases are on a moral par: what you do in letting them die seems just as bad as what you do in killing them.
Portmore suggested to me a very different pair of counterexample cases. In (a3), I drive my boat to the lake one Saturday, and I see one person clinging to a rock on one side of the lake, and five people clinging to a rock on the other side of the lake. I want to save some folks from death, and everyone will drown if I don’t do something, but I can only save either the one or the five. I motor over to the five and save them, letting the one die. In (b3), I’m driving my boat to the lake one Saturday, and I see five people offshore, clinging to a rock, clearly about to drown. I can – and want to – save them, but only by driving over one person who’s unconscious on the loading dock. I nevertheless drive over him, killing him, but I manage to save the five in so doing. Now it seems there’s a moral difference between a killing and letting die case, and that (b3) – the killing case – is morally worse than (a3) – the letting die case.
But now there’s a disanalogy with Rachels’ original case, for in (a3) and (b3), the agent’s motive is good, i.e., in either case I intended to save as many people as I could. In Rachels’ case, however, the motive was bad, for the agents in question intended to bring about the death of someone solely for financial gain. What I want to suggest, then, is a series of speculations, based on the previous remarks.
First, I don’t believe one can come up with counterexample pair-cases to Rachels where the motive in question is bad. This is purely speculative, of course, perhaps based on my own lack of imagination, but I hereby present it as a challenge to our sharp readers. As I think is illustrated by the family-of-four case above, the more structurally analogous it’s made to the original Rachels case, the less we’ll be inclined to judge there’s any morally relevant difference between them.
Second, I take it that the Portmore examples are indeed counterexamples to the claim that there is never a morally relevant different between killing and letting die. If I’m wrong about this, though, speak up.
Third, what explains the fact that we can’t find counterexamples to Rachels when the motives of the agents are bad, but we can find counterexamples to Rachels when the motives of the agents are good? One obvious explanation is that there’s an asymmetry in our attributions of moral responsibility and it turns on our assessment of motives: there must be some kind of “moral motive threshold,” such that once we determine certain identical outcomes are either directly or indirectly dependent on the motives of some agent(s) that fall below that threshold in terms of moral acceptability, our blame knows no gradations, i.e., we judge that any agents “producing” those outcomes dependent on that bad motive (either by omission or commission) are equally blameworthy – it’s all bad, to introduce a variation on a common contemporary locution. However, when the motive is above that threshold, we do maintain gradations, either in praise or in general assessments of moral worth. So given that Smith’s and Jones’ motives are below the threshold (theirs are morally impermissible motives), they’re both equally blameworthy, as are the people in my family-next-door case. But in the Portmore case, the motives are good, and so here we’re willing to assess the cases differently (in moral terms). And this different assessment may at that point rest entirely on the difference between killing and letting die.
(All of this may simply be another way of reaffirming the work that our own Joshua Knobe (and others) have done, showing (via more straightforwardly experimental methodology) that our antecedent moral judgments determine (at least in part) the moral relevance of certain distinctions, such as killing/letting die.)
Fourth, if this is right, then it has a real payoff for the euthanasia case. For while we may agree with Rachels that there’s no morally relevant difference between killing and letting die in the Bathtub Case, because Smith’s and Jones’ motives were below the moral motive threshold, we may insist there is (or could be) a morally relevant difference in cases where the motive is above the threshold. And insofar as cases of euthanasia are precisely cases in which the motive is good (to stop the terrible pain of a terminally ill patient), there may still be a morally relevant difference between active and passive euthanasia.