Beauchamp and Childress outline the difference between killing and letting die. Both require moral discussion because they bring up moral dilemmas of nonmalefence, and in some cases, autonomy. Killing involves one imposing some sort of intervention on the patient that ends his life, such as providing euthanasia. Letting die means that a medical intervention is not used and the patient therefore will die, such as disconnecting a patient from a breathing machine when he does not have functioning lungs. There are some cases when killing or letting die are always wrong, and other cases where the moral lines are less clear. Beauchamp and Childress describe how the action alone is not the moral dilemma, “rightness and wrongness depend on the merit of the justification underlying the action, not on whether it is an instance of killing or of letting die”(p. 176). Killing and letting die are instead unique acts that are incredibly dependent on a specific situation when trying to morally justify them.
Many laws surrounding killing and letting die are very restrictive because of this. Laws do not govern specifics situations, but all situations. Because killing and letting die could occur in situations that would make the acts morally wrong, laws are overly cautious and restrictive of this. One of the most controversially debated issues today is the state-by-state legality of late-term abortions after twenty weeks of pregnancy. This relates to the issues of killing and letting die because many of the women who seek late-term abortions are pregnant with fetuses with severe medical issues.
Fetuses always are complicated to discuss because there is disagreement about whether or not they should be morally considered in the same way as living humans. Conversations surrounding abortion, however, consider the fetus much more after twenty weeks of pregnancy because the fetus is viable outside the womb and therefor could become a person. Many states have outlawed abortion after twenty weeks because of this, thinking it is comparable to infanticide. One of the biggest arguments against this, though, is that it can be very harmful to both women and fetuses with health complications to not allow abortion.
With advanced obstetric technology today, health complications in utero can be detected most of the time. Some of these complications like severe spina bifida, heart problems, and brain tissue damage are known by doctors to cause a baby to die shortly after birth. Nonmaleficence is used to justify abortion in this case because it eliminates the pain the newborn baby will face shortly before death. It also eliminates the emotional pain and trauma parents go through by carrying a fatal fetus to term and then watching it die shortly after birth.
In these cases, abortion proponents argue that killing the fetus by aborting the pregnancy causes the least amount of harm for both the parents and the fetus. Often times the fetus can feel pain in utero and in almost every single case will feel pain after it is born. Opponents of abortion argue that killing a fetus is always wrong and that the fetus dying naturally in utero or after birth is the best approach. Letting die could also apply to babies born with health complications. Many parents who find out about the health complications before the child’s birth choose not to intervene when the child is born. They often feel that surgeries and medical interventions will only cause the child pain for a small chance of recovery. Opponents of abortion often support this approach because it avoids killing the fetus, but also minimizes additional pain the baby could feel.

Citation: Beauchamp, Tom L., and James F. Childress. “Nonmaleficence.” Principles of Biomedical Ethics. 7th ed. New York, NY: Oxford UP, 2013. 174-78. Print.