Abrams on active and passive euthanasia.

Abstract

In her article 'Active and Passive Euthanasia' (Philosophy 53, No. 204, April I978) Natalie Abrams argues that active euthanasia is preferable to passive euthanasia on the basis of a moral difference between acting and refraining in 'positive' cases where the outcome is desirable for the victim. She contends that in positive cases we intuitively feel an individual who merely allows a good thing to occur is not as praiseworthy as one who actually does something to bring it about, assuming identical motives and outcomes. Thus if Dick rescues his wife from a flaming building, we find him praiseworthy. But if Ernest's wife staggers out of a flaming building by herself before Ernest is able to find a way to go into the building to take her out, we do not believe him praiseworthy. Abrams then claims that euthanasia should be classified as a positive case, since it is performed only where the outcome is believed to be the more desirable outcome for the patient. Therefore a doctor who acts to bring about the death of a patient is more praiseworthy than one who merely allows the death to occur. There are a number of questionable points in Abrams's argument. For example, we may disagree that euthanasia should be classified as a positive case. Are there not cases in which death is mistakenly judged to be desirable for the patient? Also, one could argue that Ernest is just as praiseworthy as Dick, not for his inaction in allowing another to live but for his actions in attempting a rescue. After all, Ernest did not merely allow another to live. He took certain steps with the intention of bringing about the positive outcome. However, I will grant Abrams these points. Still, I believe her argument fails, because it is not true that given identical motives allowing a positive outcome to occur is never as praiseworthy as acting to bring about that outcome. Consider the following pairs of cases: