Doing vs. Allowing Harm
Stanford Encyclopedia of Philosophy First published Tue May 14, 2002; substantive revision Fri Sep 21, 2007
Is doing harm worse than allowing harm? If not, there should be no moral objection to active euthanasia in circumstances where passive euthanasia is permissible; and there should be no objection to bombing innocent civilians where doing so will minimize the overall number of deaths in war. There should, however, be an objection—indeed, an outcry—at our failure to prevent the deaths of millions of children in the third world from malnutrition, dehydration, and measles.[1] Moreover, it seems that the question is pertinent to the question of whether consequentialism is true, as consequentialists believe that doing harm is no worse than allowing harm while anti-consequentialists, almost universally, disagree. But is doing harm worse than allowing harm? We might divide approaches to this question into two broad kinds: those that attempt to answer it using examples without saying anything about the nature of the distinction. (Following Shelly Kagan, I'll call this approach ‘the contrast strategy.’) And those that analyze the distinction in depth and try to show that its underlying nature dictates an answer to the moral question.
1. The Contrast Strategy
James Rachels provides a classic example of the first approach.[2] He offers us a pair of cases—in one, Smith drowns his young cousin in the bathtub; in the other, Jones plans to drown his young cousin, but finds the boy already unconscious under water and refrains from saving him. The two cases are exactly alike except that the first is a killing and the second a letting die. Rachels invites us to agree that Smith's behavior is no worse than Jones's. He then concludes that killing per se is no worse than letting die per se, and that if typical killings are worse than typical lettings die that must be because of other factors.
Although Rachels seems correct about Smith and Jones, the inference from these cases to the moral equivalence of killing and letting die in general (where other things are equal) has been challenged. Shelly Kagan argues that it assumes that “if a factor has genuine moral relevance, then for any pair of cases, where the given factor varies while others are held constant, the cases in that pair will differ in moral status.”[3] He claims, moreover, that this assumes the Additive Assumption, the view that “the status of the act is the net balance or sum which is the result of adding up the separate positive and negative effects of the individual factors.”[4] He raises several objections to the Additive Assumption. Firstly, one might describe a pair of cases that are exactly alike except that one is a killing and the other a letting die, where the first intuitively seems far worse than the second. If this pair of cases is as good as Rachels' pair, then either the inference is valid in both cases—to prove the contradiction that killing is both worse and not worse than letting die—or it is invalid in both cases. Secondly, one might raise the rhetorical question: why addition—rather than, say, multiplication or some other function?
Instead of using the contrast strategy, let's try to figure out the nature of the distinction between killing and letting die and, more generally, between doing and allowing harm. In both doing and allowing, an agent is responsible for or relevant to a bad upshot—such as a death or injury—in the sense that she could have prevented it. The contrast is most naturally picked out by the terms ‘doing’ and ‘allowing’, or ‘making’ and ‘allowing’, but since these have vagaries and awkwardnesses in practice, I shall use the terms “positively relevant to an upshot” and “negatively relevant to an upshot” for cases of “doing” and “allowing”, respectively.[5]
2. Distinguishing Distinctions
Suppose some upshot occurs and would not have occurred if the agent had behaved in some different way. The question of whether the agent is positively or negatively relevant to the upshot is often conflated with or distorted by questions that should be kept distinct from it, like the questions of (i) whether the agent intended the upshot, (ii) whether she could easily have prevented the upshot, (iii) whether she guaranteed the upshot or merely made it probable, and even (iv) whether the agent's behavior was morally objectionable. It can easily be seen that these do not coincide with the distinction between doing and allowing.
(i) Consider the distinction between cases where an agent intends the upshot and cases where she does not. If you drive your car into someone's body and she dies as a result, you undoubtedly killed her, even if you did not intend her death. Conversely, someone may intentionally allow a child to drown in order to inherit his fortune.
(ii) It tends to be easier to avoid killing than to avoid letting die, but this is only a tendency. Sometimes saving is easier than not killing. It is easy to throw a life preserver, and it may be difficult to refrain from killing someone who is threatening one or who has treated one appallingly. There are even cases where it is physically difficult to avoid killing; as for example, where one has to hold tight to a tree to prevent one's (light) vehicle whose brakes have failed from running into a pedestrian.
(iii) Sometimes the terms ‘making’ and ‘allowing’ are used to suggest the difference between making certain and making possible or probable. For example, in discussions of the problem of evil, people sometimes say, “Well, God didn't actually make the murder occur. He just allowed it to occur.” This is best understood, I believe, as a distinction between raising the probability of murder to 1 from something less than 1, on the one hand, and raising the probability of murder from 0 to something higher but still less than 1. This is a morally significant distinction but it is not the distinction between doing and allowing. An agent can kill without guaranteeing death. For example, by adding small quantities of poison to her victim's meals she may bring about the death, even though there was a 20% chance that the poison would not kill her. On the other hand, an agent might guarantee the demise of a plant by failing to water it in a situation where she is the only one who can do so.
(iv) Finally, the distinction between doing and allowing harm is sometimes thought to have, as part of its conceptual content, a moral element. This thought is rarely made explicit, but the way people are inclined to classify cases suggests that they are guided by it. There are two main difficulties with this way of drawing the line. Firstly, if it is true by definition that killing is worse than letting die, then the question of whether killing is worse than letting die is settled in a trivial, circular, uninteresting way. Secondly, there are obvious counterexamples to this crude account—morally appalling cases of letting die—failing to feed one's children—and morally acceptable cases of killing. We have no hesitation talking of killing in self-defense. Let's turn to some more plausible candidates. In what follows I discuss a series of accounts of the distinction, and where appropriate, the moral significance or insignificance of each account.
3. Causing and Not Causing Not to Occur
One natural suggestion is that the agent who is positively relevant to the upshot causes it to occur; whereas the agent who is negatively relevant to the upshot doesn't cause it, but simply fails to prevent it where she could have done so.[6] This suggestion has immediate moral implications. It seems true by definition (almost) that you can be causally responsible only for upshots that you cause. And it is arguably true that you can be morally responsible only for what you are causally responsible for. So, if you cause a bad state of affairs, you've probably done wrong; whereas if you don't cause a bad state of affairs, you haven't. In choosing between killing and letting die, you are choosing between doing wrong and not doing wrong. (Of course, this doesn't apply to non-harmful cases of killing, such as, arguably, some cases of active euthanasia.) The question of what you ought to do is then tautologously easy.
This argument begins to get into trouble when we reflect on the fact that we are often responsible for upshots we allow: the death of the houseplants or the child's illiteracy. When we notice that, in these cases, the plants die or the child remains uneducated because of some failure on the agent's part, it becomes clear that the agent does, in some sense, cause the upshots. Moreover, most widely accepted contemporary accounts of causation imply that some event or fact involving these agents causes the deaths or illiteracy. For example, the counterfactual account of causation—according to which (very roughly) event E causes F if and only if had E not occurred F would not have occurred either—implies that it was the agent's failure to water the plants that caused the deaths.[7] John Mackie's INUS condition—according to which E causes F if and only if E is a(n insufficient but) necessary part of a(n unnecessary but)sufficient condition for F—implies that the fact that the agent failed to water the plants causes the plants to die.[8]
4. Counterfactual Accounts
We are concerned then with a contrast between two ways the behavior of agents causes upshots. One suggestion is to say that when the agent is positively relevant to the upshot, the upshot would not have occurred if she had been absent from the scene.[9] Suppose, for example, the victim dies because I push his head under water. He wouldn't have died if I had been absent. On the other hand, suppose he is in deep water and cannot swim and I don't save him. He would have drowned anyway if I had been absent. In these two cases, the counterfactual account draws the line in the intuitively correct way.
This account is sometimes used to support the claim that doing harm is worse than allowing harm, on the grounds that, on this account, allowing harm is simply a matter of letting nature take its course, which, other things being equal, is good, or at least permissible. There are two or three quick objections to this argument. Firstly, it assumes that acting (such as killing or saving lives) is a matter of interfering with the course of nature—in other words, that human action is somehow outside of the course of nature. This is extremely controversial. Secondly, even if human action is outside the course of nature, if the agent is faced with a choice between killing one and allowing two to die at the hand of some other agent, this argument would favor neither option since neither involves letting nature take its course. But, as traditionally understood and used, the Doctrine of Doing and Allowing is supposed to favor letting die in this case just as much as in others. Thirdly, interfering in the course of nature is sometimes obviously the better course of action—to stop the bleeding, restart the heart, and so on.
A different way the counterfactual account can be used to support the claim that doing harm is worse than allowing harm is this: if something bad happens when you are not present (or, especially, if you had never existed) then you aren't responsible for it. If we turn our attention to another world where you are present, but which is otherwise exactly like the first, it seems that your presence makes no difference empirically and, hence, should make no difference morally. This superficially compelling argument seems to prove too much—politicians' careers have hung on the question of whether they were in the room at the time the conspiracy was being hatched. Moreover, suppose an SS officer, Franz, tortures someone to death. But this is standard practice in the Gestapo. If Franz had stayed home with a sore throat, or if Franz had never existed, his pal Hans would have done the torturing, in the same way, at the same time Franz did. If the counterfactual account is correct, then Franz is negatively relevant to the victim's death by torture. That is, Franz merely allowed the death to occur. This case also creates problems for the idea that killing is worse than letting die, since the fact that Hans was waiting in the wings in no way diminishes Franz's wrongdoing in this case.[10] So, this way of drawing the distinction is problematic, and this argument for the moral significance of the distinction is flawed.
Alan Donagan suggests a similar account of the distinction.[11] To determine whether the agent is positively or negatively relevant to an upshot, we should consider what would have happened if the agent had not acted at the relevant moment, or what would have happened if the agent had ‘abstained from intervening in the course of nature’. It isn't entirely clear what we are supposed to imagine when we imagine this but perhaps it's that the agent is asleep or in a trance or in some other way not exercising her agency. Now—with respect to some behavior that led to some upshot, we might ask: would that upshot have occurred if the agent had abstained from intervening in the course of nature? If it would have, the agent allowed the upshot. If it would not have, then she did it (her relevance to the upshot is positive).
The Hans/Franz example can be revised to work against Donagan's version, but here's an additional counterexample. Suppose a man is lying asleep on the ground. He is awoken by a crash and notices a large rock rolling down the hill towards him. He can easily move out of its way, but realizes that if he does so the rock will gain momentum and kill a group of small deaf children further down the hill. He tenses his muscles, fights his desire to run away and stands his ground. The rock hits and seriously injures him. But he stops it. And he saves the children. Donagan's account, however, seems to imply that he merely allows the rock to stop, since, had he remained asleep, the rock would have struck and been stopped by his body.[12]
5. Action, Inaction and Positive and Negative Rights
Warren Quinn offers an account of the distinction—guided he admits by the conviction that doing harm is worse than allowing harm[13] —according to which an agent is positively relevant to a harmful upshot when his most direct contribution to the harm is an action, whether his own or that of some object.[14] His relevance is negative when his most direct contribution is an inaction, a failure to prevent the harm. An agent's most direct contribution to a harmful upshot of his agency is the contribution that most directly explains the harm. And one contribution explains harm more directly than another if the explanatory value of the second is exhausted in the way it explains the first.
The key difference here is between cases where the agent produces the result by an action and cases where she produces it by an inaction—pushing the head under water or refraining from throwing a life preserver. There's an extra complication here, however. Sometimes, Quinn says, your relevance to a death can be positive, you can kill, in other words, even though you don't act. This happens, for example, when you are on a train headed towards some drowning victims you wish to save when you notice someone tied to the tracks ahead of you. You can stop the train but you choose not to in order to reach your destination. Quinn believes that you kill in this case, because the train acts as your agent, taking you where you want to go, and crushing the person tied to the tracks in the process. On the other hand, if you had chosen not to stop the train for some other reason but you would have not minded had someone else stopped the train, then your failure to stop the train would not have constituted a killing.
What are the moral implications of this way of drawing the line? Following Philippa Foot, Quinn believes that the key here is the distinction between negative and positive rights.[15] Positive relevance to harm involves the violation of negative rights; negative relevance to harm involves the violation of positive rights. Since negative rights are more stringent than positive rights, it is worse to be positively relevant to harm than to be negatively relevant to harm (ceteris paribus). But why should we think negative rights more stringent. Here's Quinn:
[i]n such a morality [neutral vis á vis killing and letting die] the person trapped on the road has a moral say about whether his body may be destroyed only if what he stands to lose is greater than what others stand to gain. But then surely he has no real say at all. For, in cases where his loss would be greater than the gain to others, the fact that he could not be killed would be sufficiently explained not by his authority in the matter but simply by the balance of overall costs. And if this is how it is in general—if we may rightly injure or kill him whenever others stand to gain more than he stands to lose—then surely his body (one might say his person) is not in any interesting moral sense his. It seems rather to belong to the human community, to be dealt with according to its best overall interest…. Whether we are speaking of ownership or more fundamental forms of possession, something is, morally speaking, his only if his say over what may be done to it (and thereby to him) can override the greater needs of others.[16]