Humans are not in control of the universe, and our actions do not always determine our fate. But, in trying to blur the distinction between killing and letting die, Callahan insists, we suggest that there is no difference between things that are outside of our control (such as disease and suffering) and things that are within our control (such as the power to take a human life) "thus overemphasizing the place of human beings in the universe.
In addition to this complex philosophical issue, Callahan sees both a moral and a medical justification for separating the concepts of "killing- and "letting die."" Morally, he acknowledges that there are some cases where it is just as wrong to let some die as it is to kill them, but he insists that these occasional convergences do not make the two concepts morally equivalent, since, in the majority of cases, allowing someone to die from a disease that cannot be cured is substantially different than becoming the direct agent of that person's death. Medically, he suggests that the social role of doctors requires that they never use their special knowledge of the human body to cause its death. If society were to allow physicians to take life directly, serious abuses of this power would likely follow. .
In "Active and Passive Euthanasia,"" James Rachels rejects two of the three arguments that Callahan makes. Rachels does not speak to the metaphysical implications of mercy killing; however, he does argue that there is no moral difference at all between killing and letting die, and he insists that, medically, the obligation that doctors have to terminally ill and suffering patients requires them to treat active and passive euthanasia as the same thing.
To illustrate the basic difference between killing and letting die, Rachels constructs an analogy of two hypothetical men, Smith and Jones, who both desire the death of their young cousins in order to receive an inheritance.
