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There are significant moral differences between killing and letting die. 1 There are corresponding differences between active and passive euthanasia. For example, the relevant moral duties differ. Even when acts and omissions have the same outcomes, they are not thereby necessarily morally identical: how and why what is done matters. It can matter too who does it. Some of the arguments presented by Garrard and Wilkinson 2 in their discussion of passive euthanasia might tend to obscure these points. 3
KILLING AND LETTING DIE
Killing is not in all significant respects the same as letting die. For example, the absence of a ventilator kills no one. The presence of a ventilator might, in some instances, serve to counteract a cause of death. The switching off of a ventilator might, in a sense, be an indirect cause of death but it will not kill directly as, say, a heavy dose of some drugs will. 4 - 6 Suppose that someone is restraining a violent thug and then ceases to do so. If the thug then murders a passer-by, it might be said that the cessation of the constraint was an indirect cause of the killing, but it was clearly not the direct cause of the death no matter how predictable the subsequent events were and whether or not they were wished for. The cessation of the constraint was not murder.
In some particular circumstances, particular people might have a moral duty to restrain particular thugs. For example, if a policeman wantonly released from his grasp an aggressive thug who was comfortably under his control, or a jailor, without authorisation, released one of his prisoners, he would be at fault and would bear some responsibility for any consequent carnage. In general, however, our moral obligations with regard to refraining from killing people are different from our obligations concerning the restraining of thugs. For one thing, we are morally obliged to refrain from wantonly killing anyone. We can hardly be morally obliged to restrain or even to try to restrain all thugs. It would be impossible to accomplish and futile to attempt such an undertaking. Similarly, our moral obligations with regard to killing people are different from our obligations with regard to letting them die. We are obliged...