{"id":4786,"date":"2026-06-26T03:02:26","date_gmt":"2026-06-26T02:02:26","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4786"},"modified":"2026-06-26T03:02:26","modified_gmt":"2026-06-26T02:02:26","slug":"still-relying-on-thomson-and-rachels-read-this-first","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/06\/26\/still-relying-on-thomson-and-rachels-read-this-first\/","title":{"rendered":"Still relying on Thomson and Rachels? Read this first"},"content":{"rendered":"

By Matti H\u00e4yry<\/p>\n

Judith Jarvis Thomson\u2019s \u201cA Defense of Abortion\u201d (1971<\/a>) and James Rachels\u2019s \u201cActive and Passive Euthanasia\u201d (1975<\/a>) are still the gold standard for philosophical argument in medical ethics, five decades after they were published. This is horrible.<\/p>\n

Academic folklore has it that they both advocate reasonably moderate, even permissive views on abortion and euthanasia. While this may have been the authors\u2019 intention, neither article does anything of the kind. Let me tell you what they actually say.<\/p>\n

Thomson tells a story and asks a question. You have been kidnapped during the night. You are now in a hospital, physically connected to a seriously ill person, who dies unless your circulatory systems stay connected for nine months. Are you allowed to disconnect?<\/p>\n

Rachels tells two stories and asks a question. Smith drowns a young relative in a bathtub to gain an inheritance. Jones lets a young relative drown in a bathtub, intentionally failing to help, to gain an inheritance. Is there a moral difference between Smith and Jones?<\/p>\n

Received wisdom has it that the implications are far-reaching. Since you are allowed to disconnect, women are usually allowed to terminate their pregnancies. And since there is no moral difference between the drownings, if we may let a patient die, we may also kill a patient.<\/p>\n

Reading Thomson\u2019s analogy carefully, its message is more constrained. If you may disconnect, then women are allowed to terminate forced pregnancies as non-destructively as possible. This is as far as the hospital scenario carries, if fetuses are granted a right to life.<\/p>\n

Rachel\u2019s stories fare even worse. If medical personnel are permitted, intentionally and for self-interest, to let a healthy patient die, then they are also permitted, intentionally and for self-interest, to kill a healthy patient. There is no discernible link to voluntary euthanasia here.<\/p>\n

Convinced? Ditch these relics. Not convinced? Read all about it in \u201cA Defense of Terminating a Forced Pregnancy as Non-Destructively as Possible<\/a>\u201d and \u201cFifty Years of Killing and Letting Die<\/a>\u201d \u2013 and weep.<\/p>\n

Article<\/strong>: A Defense of Terminating a Forced Pregnancy as Non-Destructively as Possible<\/a>
\nAuthors<\/strong>: Matti H\u00e4yry [1] and Amanda Sukenick [2]
\nAffiliation<\/strong>: [1] Aalto University, Aalto, Finland; [2] The University of Chicago, USA
\nConflicts of Interest<\/strong>: None declared<\/p>\n","protected":false},"excerpt":{"rendered":"

By Matti H\u00e4yry Judith Jarvis Thomson\u2019s \u201cA Defense of Abortion\u201d (1971) and James Rachels\u2019s \u201cActive and Passive Euthanasia\u201d (1975) are still the gold standard for philosophical argument in medical ethics, five decades after they were published. This is horrible. Academic folklore has it that they both advocate reasonably moderate, even permissive views on abortion and […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":503,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8059,8060],"tags":[],"class_list":["post-4786","post","type-post","status-publish","format-standard","hentry","category-abortion","category-euthanasia"],"yoast_head":"\nStill relying on Thomson and Rachels? Read this first - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/06\/26\/still-relying-on-thomson-and-rachels-read-this-first\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Still relying on Thomson and Rachels? 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