I find Beauchamps and Childress’s explanation of killing vs. letting die inadequate. I believe that they overlook a foundational question and that they contradict themselves. The authors argue that “in ordinary language, killing is a causal action that brings about death, whereas letting die is an intentional avoidance of causal intervention so that disease, system failure, or injury causes death” (175). Death is the obvious result of both of these explanations, but Beauchamps and Childress barely address death in the explanations they give. I would define killing as the taking life and letting die as the allowance of death. While my definition is very simple, I believe it focuses on the foundation of the distinguishment: death.
I believe the core question is “when is death acceptable in a medical setting”? One flaw that the authors have is the lack of specification. They justify their explanations with non-medical examples that apply conceptually, but not in practice. For example, they support the claim that killing “does not entail a wrongful act or crime, or even an intentional action” with the case of one driver killing another in an automobile accident (175). Conceptually, this example could apply in a medical setting because a doctor and a driver could kill a person. I believe it does not apply in practice to a medical setting because a doctor has more responsibility to a patient than a driver has to a fellow driver or pedestrian. A doctor has an obligation to try and improve the life of his/her patient, while a driver has an obligation not to interfere with others drivers. I do not believe that the responsibility that a driver has can be compared to that of a doctor because a doctor has an obligation to improve the other but a driver has an obligation not to interfere. Therefore, I believe that the driving example is inadequate to support the claim that killing “does not entail a wrongful act or crime, or even an intentional action” (175).
Furthermore, Beauchamps and Childress go on to contradict the claim that killing “does not entail a wrongful act or crime, or even an intentional action” (175) by stating that “killing has traditionally been conceptually and morally connected to unacceptable acts (176). By definition an act that is unacceptable is wrong; therefore, killing has to be wrong if it is unacceptable. Now, it is possible for something to be wrong, but acceptable. For example, some doctors over treat patients and that is wrong, but it is acceptable. The authors try to justify their contradictory claim by giving examples of cases that do not apply to the foundation of the issue. They list a series of circumstances in which killing is justified. I believe that this does not apply when making the distinguishment between killing and letting die because you cannot use exceptions to create the rule. At the foundation, killing will always be wrong because it is unacceptable. There is a difference between justification and acceptability. Things that are accepted are the norm and apply in majority of circumstances; but there are some circumstances in which things can be justified in order to be accepted, but they are not the norm. I believe that the authors support their arguments in this section based upon the exceptions and not the norms. You cannot build a strong argument based off of exceptions. Thus, I find their distinguishment between letting die and killing to be inadequate.
Jasmine,
I think that you raised an interesting argument concerning the distinction between “killing” and “letting die”. I agree that Beauchamp and Childress are not clear in their discussion of the morality surrounding death. You make the correct assumption that a strong argument cannot be based on exceptions alone. I view “killing” as being active while “letting die” is a passive notion. I think your definitions of “killing” and “letting die” are very well said and make a clear distinction. I struggled with Beauchamp and Childress’s attempt to parallel the driver in an automobile accident with a physician in a medical setting. I argue that killing has a negative connotation and is often “a wrongful act or crime” that is intentional. I also agree that a doctor’s obligation is to improve the life of a patient whereas a driver has an obligation not to put another driver’s life in danger. It is important to acknowledge, as you noted, that some circumstances are justified in order to be accepted. Killing, in the case of self-defense, is justified and has been accepted as a norm in society. This is an instance where killing is intentional but not necessarily wrong.