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 85IS THERE A MORAL DIFFERENCE BETWEEN ACTIVE 
AND PASSIVE EUTHANASIA? 
TOM TOMLINSON, PH.D. 
Medical Humanities Program 
Michigan State University 
East Lansing, Michigan 
 The purpose of this paper is to answer the question whether there is a moral
difference between active and passive euthanasia. So bong as a competent,
informed, adult patient has requested it, does it matter whether what he
has requested is active euthanasia instead of passive euthanasia? 
 Certainly institutionalized, traditional medical ethics holds that there
is a difference between active and passive euthanasia. For example, the American
Medical Association's House of Delegates has issued the ruling that "The
intentional termination of the life of one human being by another—mercy
killing—is contrary to that for which the medical profession stands
and is contrary to the policy of the AMA (House of Delegates, 1973). The
opposition to active euthanasia in medical ethics goes back much further
than the AMA. When the physician pledges the Hippocratic oath he promises
that "I will neither give a deadly drug to anybody if asked for it nor
will
I make a suggestion to this effect." 
 It is interesting to note that these uncompromising stands against active
euthanasia may be lagging somewhat behind important shifts in public opinion.
A series of Gallup organization surveys between 1950 and 1973 asked the question
"When a person has a disease that cannot be cured, do you think doctors
should
be allowed by law to end the patient's life by some painless means if the
patient and his family request it?" In 1950 60% of respondents thought
that
the doctor should not be allowed to fulfill the patient's request whereas
40% thought that he should. Twenty-three years later the distribution of
opinion had flip-flopped, so that 
in 1973 only 43 07~ believed that physcians should not have that discretion,
while 57% thought that the physician should be allowed to end the patient's
life by painless means (Public Opinion, 1983). Within society as a whole
there is clearly a sharp division of opinion about the relative acceptability
of voluntary active euthanasia. 
 So is there "a moral difference" between active and passive euthanasia?
First of all we have to be clear about what question we are asking. One way
of getting clearer about that is to be clear about what kind of answer we
may be looking for. There are two kinds of "NO" answers that might
be given.
The first kind of "NO" answer would say that active euthanasia
and passive
euthanasia are "morally equivalent." That is, in any situation
in which passive
euthanasia would be justified active euthanasia would be justified also,
and vice-versa. 
 The other kind of "NO" answer that might be given to the question
is to
say that there is no moral difference between active euthanasia and passive
euthanasia that can justify permitting the use of passive euthanasia, but
absolutely prohibit the use of active euthanasia. In this second sense of
the question we are asking a question about policy: whether the current policy
absolutely prohibiting active euthanasia can be morally justified. 
 When I ask the question whether there is a moral difference between active
euthanasia and passive euthanasia I will be asking it in the second of these
two senses. I will be focusing on this second sense for two reasons. First
of all the claim of moral equivalence of active and passive euthanasia is