I recently happened upon a website run by the family of Terri Schindler-Schiavo, who are trying to prevent her husband from having her feeding tube removed. (She’s been in a quasi-vegetative state for over a decade.) I have no particular opinion on the specific case, partly because I haven’t taken the time to read all the matter on the site, and partly because the information there only represents one side of the case.
Rather, I’m just going to note how appalling the method of death is: slow starvation over the course of up to two weeks. Insofar as the woman’s not totally unconscious, however damaged she may otherwise be, this sounds like an awful way to go. The problem is that the law has no problem with letting a patient die, that is, with removing a feeding tube and letting her starve, but it does object to euthanasia by way of, say, a relatively quick and painless lethal injection.
Now, I’m not among those who repudiate the killing/letting die distinction. Under normal circumstances, pushing someone who can’t swim into a pond is far worse than failure to throw a line to someone who’s fallen in (though I won’t be handing out medals for either), even though the end result is the same. But here, the distinction seems pointless. The rule here is that it is permissible to withdraw life support with the consequence, both intended and foreseen, that the patient in question die. What kind of logic says that, although this is permissible, once the feeding tube is removed, it’s wrong to hasten the foregone conclusion, avoiding weeks of unnecessary suffering?
After all, even in the case where you allow a death without bringing it about, we think moral criticism is in order. But that’s not the case in situations like this: We wouldn’t think it were OK to withdraw the feeding tube if the patient were due to recover inside of a few weeks. So even if the killing/letting die distinction is a valid one, can’t we conclude that the same factors which remove the moral opprobrium from letting die in such cases would, a fortiori, remove it from a killing that differs primarily in that it entails less pain? The usual force of the distinction turns on the fact that I have a special responsibility for pushing you into a pond that doesn’t obtain between two strangers, one of whom is in trouble. But in cases like these, the decision is being made by a legal guardian who’s voluntarily taken on responsibility for the other person’s wellbeing. If I fail to feed a random stranger who’s starving, I’ve allowed them to die. If I purposefully fail to show up with food for someone with whom I’ve made an agreement to do so while they’re unable to get their own, there’s a pretty strong case that I’ve effectively killed them. In which case, the killing/letting die distinction really does seem to evaporate: How can one be justified, and not the other?