The Doctrine of Doing and Allowing (DDA), generally from Philippa Foot’s early explanation, is a significant moral difference between doing harm and merely allowing harm to happen. The Doctrine of Doing and Allowing seen by her is not about action and inaction but the two different relations between an agent and the agent’s involvement in the sequence of events that lead to harm.  To initiate a harmful sequence or to sustain an existing one, is a violation of negative rights, the negative duty to not harm others. On the other hand, to allow a harmful sequence to complete itself is a violation of positive rights, and the positive duty to act on behalf of others. In comparison, according to Foot, negative rights are more significant than positive rights. In consequence, morally speaking, doing harm is harder to justify than allowing harm.

The Doctrine of Doing and Allowing is seen slightly different by Warren Quinn , whom puts DDA in another way as demonstrated in the article. Instead of saying harming is generally worse than failing to save someone from harm, the focus shall be on how these two different kinds of choices come up against different rights. There are existing differences in Quinn’s definition of these rights compared to that of Philippa Foot’s. Before talking about the different rights, the difference between the positive agency and negative agency, in which they are associated with different kinds of agency in relation to the violation of different rights, shall first be defined. Intentions are significant in categorizing if an agency is upholding positive or negative right. Hence, both foreseeably harmful actions and inactions are positive agency because the intrinsic intention is to harm. While on the other hand, foreseeably harmful actions or inactions that could not or need not be avoided is negative agency because the intrinsic intention is not to harm. Accordingly, claimed rights against harmful intervention from harmful positive agency are negative rights, while the claimed rights violated from harmful negative agency are positive rights. Since the voluntariness in harmful positive agency is higher than harmful negative agency, harmful positive agency can hardly be justified, and thus negative rights are more significant than positive rights. On this ground, the Doctrine of Doing and Allowing is that intending to harm (which is a harmful positive agency violating negative right) is less justifiable than not able to save others from harm or benefit others (which is a harmful negative agency violating positive rights) here. 

2. Why does Quinn think that it is morally IMPERMISSIBLE to harm someone even when the action can cause a greater good in society?

Quinn thinks that the act of harming (to kill or torture) someone in order to achieve greater good to society is morally impermissible:

“A very strong thesis of precedence, on the other hand, would rule out any infringement of certain very important negative rights (for example the right not to be killed or the right not to be tortured) no matter what positive rights protecting more important goods-would permit us,to knock one person down to save another from injury. But it would not permit us, for example to kill or torture one to save any number of others even from death and torture. (p.307)

This is because he believes that negative right are a lot more significant than positive rights, as he mentioned, ‘if there is going to be precedence, it is clearly has to be precedence of negative rights’ (p.308). 

He thinks that the idea consequentialists’ idea of a person as belong to human community but not to oneself,therefore one shall be sacrificed for the good of a larger population under the reason that that one person’s loss is fewer than the gain of others, is morally incorrect. 

Firstly, he believes that the value of a  person shall not be altered by his gain or loss to others because other part of aspects of a person is neglected. Firstly, the humanity side of a person, which is constituted by his body and mind is ignored. The person has have primary say over what may done to them by other beings, not because this is the best way to promote human welfare, but because any harm done to him without his consent violate his dignity as a person and his authority to be ends of his own. And this would picture the person not as a being but as merely a unit from a collective whole. 

Secondly, he thinks that life is important in a way that there are individuality in different persons, and it shall be protected by negative right, in which to decide for how their life should be lived but not controlled by other beings.

To Quinn, a society that ignore the dignity of mankind and their negative rights, so as to allow killing or harm will less likely able to maximize the overall good because people are treated as objects other than “Citizen” (human member), being eliminated of value or respect. 

3. Does the DDA provide a good explanation about the Trolley Problem? (The Trolley Problem: it is permissible to proceed in Trolley, but not in Transplant, though the costs and benefits are the same in both cases.)

Taking Philippa Foot’s definition of Doctrine of Doing and Allowing to trolley problem where bystander has to alter the switch so as to save the five people who are trapped on the track, while it kills the one on the other track, to kill one is the violation of negative right and the action is a harmful positive agency. As for killing five, it is the violation of positive right (the right to be saved), thus it is a harmful negative agency. Therefore it is seen to be more morally permissible to let the five die as to save one. 

However, we think that there is a counter example presented in the trolley problem, that if we do not switch the track, it is foreseeable that the five people must be killed, therefore it is a harmful positive agency.

In view of this perspective, we are more in favor of Quinn’s definition of Doctrine of Doing and Allowing, that letting the five people die and killing the one are both harmful positive agency, so both decisions are violating the negative rights.

Theoretically, when weighing five negative rights and one negative right, it seems to be more permissible to harm one negative right. Thus, in this sense it is more permissible for the bystander to alter the switch. 

However, when valuing the transplant problem with the trolley problem, to kill the one man on the sidetrack seems to be permissible, but not in the case of killing one healthy man and use his organs to save the five patients. Plainly from the perspective of gain and loss, the costs and benefits are the same in both cases, which shows that DDA has loopholes in adapting to all circumstances. What is lacked from this discussion may be the respect for humanity and the rights and responsibility given to different individuals who act different roles. 

In our view, the internal elements (value standard to a medical professional and a normal citizen) among the two cases are not completely identical. In the following, differences between the two cases will be discussed.

The main difference is the responsibilities of different individuals. In the transplant case, the doctor is seen as the harmful positive agent. The fundamentally and ultimate mission of a doctor is to save lives, in which the roles of doctors are mainly determined by social standard, which saving lives is the intrinsic value that a doctor should uphold. Thus, in the transplant case, the doctor has to ‘murder’ a person, that is to kill someone on purpose, which indeed violates the responsibilities of a doctor which are accepted and emphasized by the society.

At the same time, although the bystander undertakes the similar action by killing one to save five people, the bystander carries less responsibilities in saving life. When we put the two (doctor and bystander) on the same ground, the doctor is less permissible to kill one in the case of transplant in order to save five.