ACTS AND OMISSIONS


15th July 1997


The next issue, Number 15 , will appear on 15th August 1997.





Is an omission to act exactly equivalent, ethically speaking, to the commission of an act having similar consequences - given that the motive for omitting to act and the motive for acting are the same?

This question is at the centre of ethical and legal judgments in 'the right to die' cases. The view, often taken, is expressed neatly in a couplet by the humanist poet, Arthur Hugh Clough (1819-1861):

"Thou shalt not kill but needst not strive, officiously, to keep alive."

The soundness or otherwise of this distinction was of little practical interest in 'the right to die' cases when, practically speaking, we could do very little to "keep alive" however "officiously" we might have striven to do so.

But times move on and technology develops. We can now "keep alive" far more effectually than we could, even a generation ago, let alone in Clough's time. We can now sustain the persistent vegetative state for many years. Would Clough perhaps have written, had he known what was to come, - "shouldst not strive, officiously, keep alive"?

May we not say with confidence that - given the same intent and the same result - that 'killing' and 'letting die' are ethically indistinguishable? Perhaps we can say this in many instances - but only after fuller consideration, after more thorough unpacking of each case.

For a start, the phrase 'let die' can be interpreted differently according to one's beliefs. On an atheist basis, this phrase means ceasing, clinically speaking, to make further efforts to sustain the life in question. On a theist basis, this same phrase might mean giving up on such clinical efforts and then giving faith a free hand or (to quote, from memory, Barbara Smoker in The FREETHINKER) -"believers may say you must always give the Almighty a sporting chance to effect a miraculous cure."

Perhaps giving up on clinical knowhow is effectively the same as giving up on the timely miracle. 'Giving up' is agonising in anyone's book. Rather than concerning ourselves with alternative ways of agonising, perhaps it would be better to examine concretely the idea that - given the same intent and the same result, 'killing' and 'letting die' are ethically indistinguishable.



Further Considerations


Let us take two very different cases.

Case A: I am persuaded that by giving one hundred pounds to OXFAM I can save the life of a starving African child for long enough to enable that child to go on to live a flourishing life. I do not know (and neither does anyone else) which particular child would be saved by my donation. IF I omit to donate the sum required THEN an unidentified child, who might otherwise have lived, will surely die. My omission to act would have precisely the same result as if I had gone to Africa and strangled the first starving child I met.

My omission to act to save a life, and my commission of an act to destroy a similar life, have precisely the same consequences - the death of an unidentified starving child.

What is more, IF both my hypothetically failing to donate, and my hypothetically strangling a child, were because of my wish to prevent the survival of starving children (perhaps as a rather radical way of limiting future growth of population) THEN my omission and my act would satisfy Barbara Smoker's criterion of "same intent and same motive" as well as having the same consequences.

Can we truly say that the omission and the act ethically equivalent?

Intuitively, we have to say NO. Can it really be said that my not signing a> cheque in the comfort of my home is ethically equivalent to murder with my bare hands? Intuitively the two are seen to be by no means equivalent.

And there is more to it than intuition; rationally unpacking the problem, my donating to OXFAM has prevented my donating the same money to SAVE THE CHILDREN who might have used the it to save a life in, say, Asia. Clearly it is absurd to say that saving an African child entails murdering a similarly placed Asian child.

Case B: I wish to murder, but in no great hurry, a certain Mr X against whom I have a serious grudge. We are both, let us suppose, keen mountaineers. I invite Mr X to climb with me a mountain that I know very well but with which he is quite unfamiliar and, let us further suppose, he suspects nothing of the grudge I bear and the murder I contemplate.

We reach the summit and - no great surprise to me for I know the mountain very well - a dense mist comes down very quickly. I advise that we should stay where we are for safety's sake; Mr X wishes to descend rather than risk perhaps long exposure to cold and damp. He makes to move in a direction that I know, and he does not know, leads to a precipice.

He disregards my advice and over he goes - killed instantly.

Is my omission, firmly to warn him, ethically the same as if I had actively misdirected him or even pushed him over the edge?

Clearly my omission and my act would be quite equivalent. Indeed one might say that my simply letting him fall to his death was a more satisfactory way, from my point of view, of murdering him than my actively pushing him - because, had I pushed him, there might have been a struggle and I might have been the one to die. In a sense, the deliberate omission might be thought to be even worse than the deliberate act having similar consequences and similar motivation.

My conclusion is that, in general. acts and omissions - given the same motives and the same results - are ethically equivalent but 'in general' should not NOT be taken to mean 'always'.

Perhaps we can say that the onus of justification is upon those who claim that there is a significant general ethical distinction between an act and an omission arising from similar motives and having similar consequences.





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