Difference Thesis and Moral Actions

Winston Nesbitt: Is Killing No Worse than Letting Die?

• Nesbitt addresses the question of whether killing someone is morally worse than letting someone die, exploring the validity of the Difference Thesis.
• The Difference Thesis (DT) asserts that deliberately causing death is morally worse than deliberately failing to prevent it.
• Nesbitt supports the Difference Thesis.
• To properly assess the moral difference, one must consider the motives, because indifference is not as bad as malice.
• Overlooking details may lead to incorrect conclusions about the moral status of killing versus letting die.
• James Rachels and Michael Tooley argue against the Difference Thesis, attempting to create unbiased cases.
• Nesbitt contests their arguments and upholds the Difference Thesis.

Rachels' Argument

• Rachels presents a scenario involving Smith, who drowns his nephew for inheritance, and Jones, who lets his nephew die.
• Rachels argues there is no moral difference between killing and letting die, considering both Smith and Jones equally reprehensible.
• Nesbitt claims Rachels overlooks that Jones was also prepared to kill his nephew.
• Nesbitt endorses the principle that someone fully prepared to commit a reprehensible act is as reprehensible as someone who carries it out.
• Nesbitt argues that to see that being prepared to act is the morally significant factor, imagine that Jones slips, hits his head, and never gets to kill or let die, still being as reprehensible as Smith.

Tooley's Argument

• Tooley illustrates a case of two sons planning to poison their wealthy father.
• One son puts poison in the father's whiskey but is discovered by the other, who then lets the father drink the whiskey.
• Tooley argues the sons are equally reprehensible.
• Nesbitt counters that both brothers being prepared to kill their father explains their equal reprehensibility, not that killing and letting die are equally reprehensible.

Nesbitt's Positive Account

• Failures in Rachel and Tooley's arguments stem from the perpetrators being prepared to kill.
• While preparedness to kill results in moral equivalence along the dimension of what they are prepared to do, this does not equate to equivalence along dimensions of killing and letting die.
• To test the Difference Thesis effectively, cases must involve one person prepared to kill and another who would let die for moral reasons.
• Smith is willing to kill for inheritance, whereas Jones would let his nephew die but morally refuses to kill.
• Nesbitt claims Jones is morally superior to Smith.
• The fact that Jones is better than Smith is supposed to show that killing is worse than letting die.
• Those like Smith are threats, while people like Jones are not.
• Those like Jones will not help, but won't kill, while those like Smith are prepared to kill if it benefits them.
• Nesbitt considers a rational preference for Jones-like people evidence that killing is worse than letting die.

Helga Kuhse's Response to Nesbitt

• Kuhse contends that Nesbitt's defense of the Difference Thesis fails.
• Kuhse asserts Nesbitt overlooks the distinction between reprehensible actions and reprehensible persons.
• A person willing to kill for personal gain may be worse than someone willing only to let die for personal gain. And someone motivated by self-interest alone is a worse person than someone motivated by the common good.
• Kuhse states that none of this demonstrates that killing is a worse action than letting die.
• Jones drawing a line at letting his nephew die may make him a less reprehensible person than Smith.
• This does not imply Jones' inaction was less reprehensible.

Are Killing and Letting Die Always Evil?

• Nesbitt considers people like Smith a threat, while people like Jones are not.
• Kuhse suggests that Nesbitt focuses on cases where both killing and letting die are evil.
• Kuhse points out many consider dying, in some cases, preferable to living.
• Terminally ill patients and doctors may view death as the best outcome.
• Patients might decline treatment, and doctors might stop treatment, given consent, to end living.
• Killing could be more helpful if it reduces suffering.
• In such instances, killing may be morally superior to letting die.
• Kuhse argues people unwilling to kill would be more threatening than those willing to kill out of compassion.

Paul T. Menzel: Rescuing Lives: Can't We Count?

• Menzel presents a case about Laura, a five-year-old needing multiple organ transplants
• Laura needed a small intestine, large intestine, stomach, pancreas, and liver
• Her parents raised money through private donations via newspaper publicity.
• The chance of success for Laura's transplant was 50/50.
• Menzel questions if transplant is morally objectionable, believing it sacrifices several lives.
• The text identifies four justifications for the procedure.

Justifications for the Procedure

• Scarce organ transplants advance medical experimentation.
• Menzel responds by saying the argument works only if multiple organ transplants will not sacrifice more than one person to save another.
• There is more urgency in multiple scarce organ transplant cases.
• Menzel replies that needing one organ puts one in an urgent situation.
• There should be heightened urgency due to the difficulty of the recue, but Menzel believes this is a mistake.
• The amount of organs required should not impact urgency.
• The fact that organs could save more than one is morally irrelevant.
• Menzel counters with a continual striving to expand the organ pool to save more lives.
• With an expanded organ pool, multiple transplants could save the same amount of lives as without multiple transplants.
• There may be implicit consent by sincerely participating in a luck-infused system to having one life saved when several could have.
• Menzel responds potential recipients do not get policy makers off the hook.
• Policy makers should empathize equally with potential recipients, helping save the most lives.
• Scarce healthcare resources are like organ donation, so similar considerations apply.

A.B. Shaw: In Defense of Ageism

• Shaw presents objections to rationing healthcare by age, offering replies to each concern.
• Chronological and biological age correlate imperfectly, making ageist policies unfair for medical resource allocation.
• Biological age references physical condition, like arteries or joint health.
• Chronological age is viewed as an arbitrary basis for medical decisions.
• Shaw replies that correlation exceptions are too infrequent to oppose ageist policies.
• There is more likely to be a 50 year-old with a 70 year-old body than one in good condition.
• Age takes its toll, so policies should be based on general cases.
• Shaw suggests seniors might need special protections similar to children and the disabled.
• Healthcare should not be diverted to seniors.
• It is more beneficial for children to have resource access, thus being right, not more than right.
• Ageism would not be discrimination.
• Allocation should be determined by years lived and left to live, not contribution to society.
• All lives are of equal value, so age should not impact sentencing upon death.
• Shaw replies the statement is a bad analogy.
• Moral statuses of doctor actions assess the fairness system for resource distribution.
• Fairness dictates who attains the most benefit.
• Wisdom and love may be seen as more valuable than economic value.
• Shaw replies that benefit, based on understating years, is more essential than value.
• Seniors are ends that should not be means to a just society.
• Seniors have intrinsic value, not just instrumental value.
• Shaw replies that limited resource chooses between ends and should be distributed to inflict least injustice.
• Rationing should not ignore quality of life considerations.
• Shaw replies medical and personal value decisions should stay separate.

Methods of Rationing

• Rationing mechanisms exist that discriminate senior care due, to:
• Chance: facility proximity affects old
• Queuing: conditions push patients down list, worsening senior's chance of survival.
• Wealth: those with care options prosper competitively, leaving seniors at loss.
• Shaw argues for explicit age policy over implicit rationing.

PHL 2120: The Trolley Problem

• The trolley problem explores ethical decision-making in scenarios where harm is inevitable.

The Trolley Problem

• As a trolley driver, you face a choice due to brake failure: continue straight, killing five workers, or divert onto a side track, killing one.
• Almost everyone agrees it is morally permissible to turn the trolley.
• As a surgeon, five patients need organ transplants to survive.
• A healthy young man visits for a check-up; he's a perfect match. Could you sacrifice him to save the others?
• Almost everyone agrees it is morally impermissible to take his life.
• The trolley problem, per Philippa Foot, is not about what to do, but why it's permissible to divert the trolley (killing one) yet impermissible to sacrifice the man (killing one).

Foot's Solution

• Killing is worse than letting die; killing one is worse than letting five die.
• A surgeon must not kill the one to save five and trolley driver must choose between killing one worker and killing five workers.
• Killing five is worse than killing one, so driver should divert trolley into the one worker.

Judith Jarvis Thomson's Solution

• Bystander Scenario: You can divert a trolley, killing one to save five.

The Dilemma

• You are not driving the trolley. You are strolling down the tracks and notice trolley charging toward five people. If you pull the switch, you can divert trolley in direction of one man.
• It is permissible to throw switch. But it is also permissible to do nothing, letting five die. Is Foot's Solution wrong?
• Thompson believes trolley problem lies in bystander case for explination. So, problem is:
• Why is it permissible to throw the switch and kill one individual?
• We need a more refined approach than killing and letting die.

Making the Switch

• The bystander is making something that threatens the five people.
• The bystander is not engaging in any stringent personal rights.
• Rights have say on permissibility in this case such as infringing on someone's rights and acting toward maximum utility.
• The threat to five was organ failure. Surgeon does not redirect threat.

Outweighing Utility

• If there were no other people on track, it would be violating the stringent personal rights.
• Rights are weighed against utility, thus there is something the bystander does to outweigh man's right that they not kill him.
• Saving five does not make something that threatens to kill people.
• The five against others that they not kill him is violated.

The Stringency of a given right is key

Consider this example:

• Walking across the man’s property to get to it, but it's a permissible wrongdoing.
• Right has the has the right against others than they do not violently handle him.
• Means that a threat diverted with connection to the act. The means which the threat was diverting the man off the bridge, but that infringes one’s rights.
• Killing violates a right. It entails that it is impermissible for the bystander to push the man onto the tracks to save one.

Explore the core arguments of the Difference Thesis (DT) and Nesbitt's perspective. Nesbitt critiques arguments against DT, particularly those from Rachels and Tooley. The discussion covers moral implications of killing versus letting die.