Both the American Medical Association and the American judicial system recognize a sharp distinction between "active euthanasia- and "passive euthanasia."" The first of these terms, "active euthanasia,"" refers to any action that directly contributes to the death of someone who is terminally ill or in great pain. "Passive euthanasia,"" on the other hand, refers to a decision not to treat a life threatening condition on the grounds that no extraordinary measures should be taken to save the life of someone who is either terminally ill or in great pain. Legally, the difference between active and passive euthanasia is the difference between "killing- and "allowing to die-; the first is punishable by the strictest penalties to be found in our legal system, while the second is not even a misdemeanor. Despite this tremendous legal distinction between active and passive euthanasia, however, doctors and philosophers such as James Rachels and Daniel Callahan regularly disagree on whether or not it is possible to make a meaningful distinction between the two terms at all.
In "Killing and Allowing to Die,"" Daniel Callahan, a professor at the Harvard Medical School and the founder of The Hastings Center for Bioethical Research, argues that, while there are certain ambiguities that can make it difficult to see the differences between active and passive euthanasia, there is a basic distinction between killing and allowing to die that has metaphysical, moral, and medical implications. .
The most important distinction that Callahan draws between killing and letting die is metaphysical "and therefore intensely philosophical "in nature. Human beings, he argues, become accustomed as children to see the world primarily as an extension of themselves and to perceive themselves as fundamentally in control of every aspect of their existence. This philosophical perception, however, is flawed.