In "Active and Passive Euthanasia," James Rachels addresses the moral issues surrounding active verses passive euthanasia and the American Medical Association's (AMA) position regarding its conventional doctrine. He suggests that in these cases the distinction between killing someone and letting someone die have no moral difference. He also believes that AMA's conventional doctrine addressing medical ethics surrounding euthanasia forces people to make life and death decisions on morally irrelevant grounds.
             Rachels argues that active euthanasia may actually be more humane than passive euthanasia. He uses Downs Syndrome to discuss this point: two children are both born with Downs Syndrome, while one also has intestinal blockage. Now, the child with Downs Syndrome and intestinal blockage is allowed to die, even though a simple operation could cure this. It is rationalized by people based on the acceptance of the conventional doctrine that the child is better off dead because they have Downs Syndrome, and therefore no operation is performed and the child dies. But the child with only Downs Syndrome is allowed to live, so now the basis on whether a child is allowed to live depend on the condition of their intestines. The fact that that child has Downs Syndrome is irrelevant in this case but is what has been rationalized by many to be the reason the child is better off dead even though a child with just Downs Syndrome lives.
             Another example that Rachels uses is the Smith/Jones scenario: Smith and Jones are two men that are in identical situations where one is active in the killing of his younger cousin and the other is passive in letting his cousin die while he does nothing. Rachels argues that there is no moral difference between the two, that letting someone die has as much weight as murdering the person.
             Rachels believes that by letting someone die, its just as bad as killing that person. This is the basis for...