The classic trolley problem takes this form—a trolley is heading towards 5 people bound to the track; you can either:
Do nothing, letting 5 people die.
Pull a lever to make the trolley go towards 1 person bound to the track, saving the 5 people.
Whether or not you accept that there’s a distinction between acting and omitting will usually determine your course of action in the trolley problem. In order for something to be considered an omission, you have to actively decide against acting when weighing the consequences of action and inaction; anything outside of this wouldn’t be considered an omission since you aren’t rationally aware of it.
Most people who believe that you’re obligated not to pull the lever ground their belief in the fact that pulling the lever means you intentionally kill 1 person, while doing nothing simply means you’re omitting—simply choosing not to act. Most people (me included) who believe that you’re obligated to pull the lever believe that there is no distinction between intentionally killing people and being in a position where you can save people but actively refuse to do so.
Now, some implications come with both affirming and negating the moral significance of the act-omission distinction. Consider the following scenario that affirms the act-omission distinction:
As a surgeon, your job is to prevent the death of a patient in critical condition as a result of a car crash. You decide to intentionally delay life-saving care, allowing the patient to die. In this case, you can’t be held culpable for murder—you never killed the patient yourself; it’s simply an omission.
I think that is an undeniably bad conclusion. Even if you rejected the conclusion that you can’t be held liable in any aspect, you’d still have to embrace the weaker conclusion that what the surgeon did in the scenario is morally superior to murder. If the surgeon had simply injected the patient with cyanide as a form of active euthanasia under the pretense that the patient would die anyway, this would also be morally equivalent to allowing the patient to die off!
People who accept the distinction normally tell you that the surgeon simply has a special obligation to care for every patient—after all, their job is literally to save the lives of patients.
Such a refutation proves too much. The profession of a “surgeon” only exists because people in positions of causal power over another person’s life have a moral responsibility for that person’s life, regardless of whether they act or omit. That objection only presupposes that the act-omission distinction bears no moral weight. We simply give patients to surgeons and medical professionals since they are by far the best equipped to perform life-saving operations; in fact, we all have an obligation to take people whose lives are in jeopardy to these medical professionals, as that step is necessary for the outcome of the person’s life.
If you can prevent something bad from happening without sacrificing something of comparable moral importance, you have an obligation to do it; whether or not you pushed a baby into a bathtub is irrelevant to your obligation to pull the baby out before it drowns. Any rational person would agree that refusing to pull the baby out should leave you culpable for the death of the baby!
Proponents of the distinction also make the claim that killing is worse because it creates a new chain of events leading up to death, while omitting allows that chain to continue as is. Consider two people walking around a lake as a baby drowns in it:
A bystander who doesn’t know how to swim at all lets the baby drown in the lake; the bystander is not going to be held morally responsible for the baby’s death.
An olympic swimmer who can easily reach the baby lets the baby drown in the lake; the swimmer is going to be held morally responsible for the baby’s death.
The factor that changes the moral weight placed upon each person is the ability to alter the chain of events, something that applies equally to actions and omissions.
The same absurdity does not stem from rejecting the distinction.
Here’s a scenario that reads like most of the objections against denying the distinction:
You spend $20 on ice cream. If you had instead donated that $20 to the Against Malaria Foundation, one of those 10 nets you’ve funded would’ve saved the life of a child in Africa. Because you could’ve diverted that $20 to saving a life while incurring minimal cost, you should be held culpable for the death of that child.
It sounds absurd because most people doing something perfectly acceptable would be indicted with murder, but a much better hypothetical can be created from the ice cream scenario:
You’re in line waiting to spend $20 of ice cream. It’s then confirmed that if you had spent that $20 on malaria nets, those nets would have saved the life of an innocent child in Africa, giving him a life worth living. Would you rather press a button to pay for ice cream or pay for malaria nets?
Practically everyone in line for ice cream that day, if presented with such an offer, would choose to divert that $20 towards saving a life. In this case, you’re actively presented with a choice between acting and omitting, as well as the epistemic access to being able to save a life with your existing $20. Not only are we usually unaware and detached from suffering occurring half the globe away, but saving lives half the globe away requires cohesive management and logistics that add intermediaries between your aid and the life being saved—increasing the chance that your action does not produce desired results.
If a baby were drowning in the middle of your town’s lake, the baby drowning is not attributed to your failure to act; most people don’t know how to swim, and, out of the people who can, very few of them can be expected to plunge into a lake, swim to the center, retrieve the baby, and swim back to shore with it. Almost everyone would incur a significant risk of death from drowning themselves, causing 2 people to die instead of 1 or 0 (if you saved the baby).
In the trolley problem, it seems intuitive that saving those 5 people is better than letting them die to save 1 person. Accepting that you’re just letting a casual chain continue in the latter option while intentionally murdering someone in the former forces you to accept absurd conclusions; if you could redo the trolley problem but 1 billion people were tied to the track, and you had the option to divert it to kill 1 person instead, there is simply no reason to allow 1 billion deaths because you’re just “omitting”.
The act-omission distinction holds absolutely zero moral weight. Variables like epistemic access, proximity to harm, and causal ability determine moral weight—arguments that misattribute the work done by these variables to the act-omission distinction normally collapse under basic scrutiny.
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