Here are some basic ethical distinctions by way of background. I won't cover all the bases in the active/passive debate (active--taking lives, passive--letting die).
by J.P. Moreland
We talked about withholding and withdrawing treatment. I said that there wasn't any significant ethical distinction between those two, arguably. We talked about ordinary treatments and extraordinary. The gist of those is ordinary are those treatments that don't seem to offer a reasonable benefit and place an undue burden on someone. It's hard to pin that down, but the gist of it is we all recognize that certain treatments are not morally obligatory because they seem to be pointless. They're not accomplishing much and the burdens outweigh what the benefits are.
The most important thing is the Law of Double Effect. The Law of Double Effect is not arbitrary, it's testable. The Law of Double Effect, if you'll recall, is an attempt to state in principles what would then be true from basic ethical actions. Most of the time we know that a person's intention makes all the difference in the world, at least basically. What a person intends really defines what their action is. We also know that generally speaking we ought not use a bad means to accomplish a good end. So the Law of Double Effect tries to say that when an action has good and bad consequences, it can be permissible if the [certain] things obtain.
We took a look at Rachels' view, not necessarily so you'd know who he was, but primarily he is the clearest most articulate expositor of active euthanasia. [His] idea behind active euthanasia is, one, there's no difference between active and passive euthanasia. They're the same thing. The reason they're the same thing is because an intention isn't part of an action. As in Smith and Jones' case where Smith drowns the boy and Jones waits while he drowns. One was active and the other passive, but they're equivalent. That means, by the way, that if passive euthanasia is justifiable then active would be too because there's no difference between them. In cases where passive would be justifiable, so would active such as in assisted suicide or directly intentionally taking a person's life would be morally permissible.
When does that happen? That requires an analysis of the biographical/biological distinction. He says that being a human being is just having biological life and that's not what matters morally speaking. Instead it's having biographical life. I have a biographical life. That means that I have goals and ambitions and activities that are worthwhile to me from my point of view that I can pursue in a meaningful way. If I lose biographical life like Donald C., the Texas burn case victim who was in an accident. He was in rodeo and chased women, basically. He could lead a normal life, but he had no biographical life because he couldn't pursue the goals important to him. So Rachels would say that he was within his rights to want to commit suicide. There was nothing immoral at all about it. A physician who assisted him would be justified. A person who wanted to save their family financial trauma, that's okay as long as they've chosen. That's basically the gist of it.
The other argument was that it is merciful in some cases to take a person's life rather than to let them suffer longer. My point on that was that even in those cases, which are very small relatively speaking, but still intend to merely ease the pain of that patient even though you foresaw that it might shorten life somewhat without directly intending to take the person's life. So the intent would still be different and you wouldn't accomplish a good by means of killing a patient. The treatment would directly have that product although that was not its intent and although it did treat pain.
I tried to say that placing all your money on biographical life and saying that's really what matters does not allow anybody to make a distinction between an appropriate and inappropriate biographical life. As long as you've got a biographical life that's appropriate to you. But it does seem, Rachels not withstanding, that some biographical lives are better than others, more intrinsically valuable. In fact, some biographical lives are flat wrong if you want to be the best male prostitute you can be. So if that's true you could argue that the difference between appropriate and inappropriate biographical lives is based upon what it is that humans are supposed to be like and how they're supposed to live versus how they're not supposed to live. That depends on being a human, not a sea gull or anything else.
The next thing I tried to say was that the intention of the act makes all the difference in the world. Rachels tries to make the intention of the active separate from the actions. So the difference between active and passive is not whether I move my hands or don't move my hands. The difference between active and passive is intentionally taking a patient's life versus permitting a patient to die although not intending that patient to die. So the Smith and Jones case was not an example of active and passive. It was, instead, two people committing active [killing], one by means of moving, the other by refraining from moving. That was where we left it.
In active euthanasia you directly and intentionally cause a person's death. In passive euthanasia you do not directly take their life but you permit them to die. You don't intend this, although you may foresee it.
The third thing is that you're withholding extraordinary treatment, not ordinary. According to the traditional view it is never appropriate to withhold ordinary treatment. Extraordinary treatment can be withheld.
Finally, the death of the patient cannot be directly intended or caused, but only permitted.
About the Author
J. P. Moreland, Ph.D. is Professor of Philosophy at Biola Unviersity. He has authored or co-authored many books including Christianity and the Nature of Science, Scaling the Secular City, Does God Exist?, Immortality: The Other Side of Death and The Life and Death Debate: Moral Issues of Our Times. He is also co-editor of Christian Perspectives on Being Human. His work has appeared in a wide variety of journals, including Christianity Today, Journal of the Evangelical Theological Society, Philosophy and Phenomenological Research and The American Philosophical Quarterly. Dr. Moreland served with Campus Crusade for 10 years, planted two churches, and has spoken on over 100 college campuses.