A special timer will be fitted to a patient's respirator which will sound an alarm 12 hours before turning it off.
Normally, carers would override the alarm and keep the respirator turned on but, if various stringent conditions are met, including the giving of consent by the patient or legal guardian, the alarm would not be overridden.
At first, the distinction seems ridiculous, regardless of whether you support or oppose euthanasia. Whether a carer turns off a respirator directly or doesn't stop the timer which will turn it off automatically is irrelevant to the result: the patient will die either way.
Yet we make this sort of moral distinction between activity and passivity every day.
Philosopher and ethicist Peter Singer, in his excellent article The Singer Solution to World Poverty, quotes NYU Philosopher Peter Unger's book Living High and Letting Die:
Bob is close to retirement. He has invested most of his savings in a very rare and valuable old car, a Bugatti, which he has not been able to insure. The Bugatti is his pride and joy. In addition to the pleasure he gets from driving and caring for his car, Bob knows that its rising market value means that he will always be able to sell it and live comfortably after retirement. One day when Bob is out for a drive, he parks the Bugatti near the end of a railway siding and goes for a walk up the track. As he does so, he sees that a runaway train, with no one aboard, is running down the railway track. Looking farther down the track, he sees the small figure of a child very likely to be killed by the runaway train. He can't stop the train and the child is too far away to warn of the danger, but he can throw a switch that will divert the train down the siding where his Bugatti is parked. Then nobody will be killed —but the train will destroy his Bugatti. Thinking of his joy in owning the car and the financial security it represents, Bob decides not to throw the switch. The child is killed. For many years to come, Bob enjoys owning his Bugatti and the financial security it represents.
Bob's conduct, most of us will immediately respond, was gravely wrong. Unger agrees. But then he reminds us that we, too, have opportunities to save the lives of children. We can give to organizations like UNICEF or Oxfam America. How much would we have to give one of these organizations to have a high probability of saving the life of a child threatened by easily preventable diseases? ... Unger called up some experts and used the information they provided to offer some plausible estimates that include the cost of raising money, administrative expenses and the cost of delivering aid where it is most needed. By his calculation, $200 in donations would help a sickly 2-year-old transform into a healthy 6-year-old —offering safe passage through childhood's most dangerous years. To show how practical philosophical argument can be, Unger even tells his readers that they can easily donate funds by using their credit card and calling one of these toll-free numbers: (800) 367-5437 for Unicef; (800) 693-2687 for Oxfam America. [http://supportunicef.org/forms/whichcountry2.html for Unicef and http://www.oxfam.org/eng/donate.htm for Oxfam --Singer]
How far does our responsibility go?
Now that you have distinguished yourself morally from people who put their vintage cars ahead of a child's life, how about treating yourself and your partner to dinner at your favorite restaurant? But wait. The money you will spend at the restaurant could also help save the lives of children overseas! True, you weren't planning to blow $200 tonight, but if you were to give up dining out just for one month, you would easily save that amount. And what is one month's dining out, compared to a child's life? There's the rub. Since there are a lot of desperately needy children in the world, there will always be another child whose life you could save for another $200. Are you therefore obliged to keep giving until you have nothing left? At what point can you stop?
Hypothetical examples can easily become farcical. Consider Bob. How far past losing the Bugatti should he go? Imagine that Bob had got his foot stuck in the track of the siding, and if he diverted the train, then before it rammed the car it would also amputate his big toe. Should he still throw the switch? What if it would amputate his foot? His entire leg?
As absurd as the Bugatti scenario gets when pushed to extremes, the point it raises is a serious one: only when the sacrifices become very significant indeed would most people be prepared to say that Bob does nothing wrong when he decides not to throw the switch. Of course, most people could be wrong; we can't decide moral issues by taking opinion polls. But consider for yourself the level of sacrifice that you would demand of Bob, and then think about how much money you would have to give away in order to make a sacrifice that is roughly equal to that. It's almost certainly much, much more than $200. For most middle-class Americans, it could easily be more like $200,000.
So by what basis do we allow ourselves to buy televisions, ipods, or even the newspaper? How can we justify going out to lunch when we could eat at home and donate $5-10 to the homeless? How can we own houses or rent apartments when much of the world lives on a dollar a day?
The moral question of passivity isn't only about money, either. How can we sit back and do nothing about Darfur? How did we Jews and Americans inaugurate the Holocaust Museum in Washington DC, saying "Never Again," while "an average of 10,000 people were being butchered each and every day" (source) in Rwanda? For those who opposed the Iraq war, can you say you did everything you possibly could to prevent it?
I think most of us -- and I'm definitely including myself -- prefer to live in denial. Starvation and atrocities are other people's responsibilities. We tell ourselves that the dictators of Africa are corrupt, that it was Clinton's fault we didn't do anything about Rwanda, that Bush isn't doing enough for Darfur, that it's Bush's fault we've killed tens of thousands of civilians in Iraq while losing thousands of American lives.
There is of course some truth to the claim that others bear responsibility, maybe even the lion's share of the responsibility, but it doesn't absolve us of our responsibilities. Maybe we can't single-handedly stop the Darfur genocide, but we might be able to save a couple of lives. How can we not try?
If we can't get ourselves to drop everything and devote ourselves 100% to our fellow human beings, perhaps we can get ourselves to do just a little bit better. After all, "$200 in donations would help a sickly 2-year-old transform into a healthy 6-year-old —offering safe passage through childhood's most dangerous years."