Is killing people different from letting them die?

Is killing people different from letting them die? A photo of an African-American woman wearing casual clothes and glasses appearing depressed and worrying.

“Is killing people different from just letting them die? One is abuse, and the other is neglect - those are separate charges. I know that.” | Photo Caption: © / Adobe Stock

Is killing people different from letting them die?

An oblique argument for saving the Affordable Care Act

I fell yesterday. I’ve had multiple sclerosis for about twenty years, so I fall every day, but yesterday was particularly bad: I fell with my hand caught between a door and the wall, between the upper and lower set of door hinges. I landed flat on my back, knocking the wind out of me. I couldn’t move my hand at all. It hurt awfully, and my first thought, unbidden, was “Oh God, no. Please, no. We can’t afford this. Please.”

Not “Christ, this hurts” (it did). Not “How am I going to be able to get help?” (I was alone, and my phone was in the other room).  Not “I can’t stand up. I can’t even crawl.” (although both those statements were true at the moment).

“We can’t afford this. Please.”

And that filled me up with a rage so thick and heavy I can barely breathe. I can’t get rid of it. I can’t work, I can’t think.

What’s happening in Chechnya is a genocide.

What’s happening in Syria is a genocide.

What’s happening to Black Americans is a genocide.

What’s happening to sick Americans feels like an attempted genocide, but maybe that’s just melodramatic.

Killing people is different from just letting them die, right? One is abuse and the other is neglect – those are separate charges. I know that.

I have a lot of gaps in my memories from childhood – my therapist says that’s not unusual for people like me. I remember CPS coming to the house. I remember what they were wearing, that it was a young man and an older woman, both kind. I remember the first few questions they asked, then the memory fades out like a song. I can’t recover it.

I remember the group home, its dormitories, and playground, and that it was downtown, near the jail. I remember eating spinach for the first time and being made to brush my teeth and hair every night. I remember the beginnings of subsequent interviews: sitting on a bunk bed; in the cafeteria; on the edge of the playground. But each fades out one after the other, and I don’t think I’ll ever get them back, not ever.

I remember when my mom came to take me back after the judge said she could. I can’t remember what she said to me or what I was thinking, exactly, but I can see it like a movie: We were outside. I was screaming. All the other kids scattered. The adults stood by the building with their arms crossed. She was dragging me by one arm, and there was a little sapling and I grabbed it with my opposite hand and tried to dig my nails in. Screaming.

She pulled until I let go. Two of my fingernails broke deep my skin. I vomited and began to choke. A woman covered her mouth and went inside. I’ll never forget that.

My mother picked me up and threw me over her shoulder, and this made me vomit again, strings of bile. My mother marched us towards the parking lot, and I started screaming again, reaching as hard as I could toward the people standing by the building. What was I screaming? I think it was “please.”

Afterward, she took me to the downtown Sonic and got me a cherry limeade, my favorite treat. I didn’t speak. I don’t remember what she said, but I do remember how calm and nice she seemed, as if she had no idea why I was so upset. And here I actually can remember what I was thinking. I thought this exact sentence: “She’s going to kill me, and nobody can stop her.” I was four years old.


Whether my mother had been charged with abuse or neglect, I don’t know. I do know that this was the moment I realized that nobody could save me, and that I would die if I couldn’t figure a way out. I’ve never forgotten that. It’s who I am.

And I didn’t forget it on the floor last night. I didn’t forget it while I drag myself into the living room with one arm and then laid on the floor, panting, until I was strong enough to grab my iPad and send a message that I would be a little late for our conference call, forgive me. Then I panted some more until I was strong enough to get on the sofa – it took six tries. Then I rested until I was strong enough to reach my phone and turn it on and call into our bi-weekly workshop, because this is my life, because the alternative is to die on the floor like a sick dog, and I won’t. I can’t. I’ve fought too hard. I have too much pride.

I regained movement in my hand while we talked – it’s badly bruised, nothing more. I apologized for being late and was instantly forgiven. This is just one day – I got through it, got a good night’s sleep, and came roaring back today because I have to, because there’s no other way. Figure it out, or die.

What is my point? Christ, I don’t know. I gotta go – I’m already late for another meeting, of course. Why am I rambling? What’s the point of all this?

Maybe this: Nobody saved me then and nobody can save me now, but some people tried and that meant everything. It meant that they saw what was happening to me and they cared enough to try, whether it worked or not. I knew my life had value because they tried to save it, and so then I could try to save it. Because they saw. Because it mattered.

Thank you, everyone reading this essay on “Is killing people different from letting them die.” Thank you for seeing, thank you for trying to save lives. Whether it works or not, trying shows people their lives have value. Because you see them. Because they matter.

Is there a moral difference between killing and letting die in healthcare?


The doctor that allows the patient to die without providing life-saving measures, and the doctor that administers a lethal injection both have the same outcome. The patient dies in either case.”


Dr. Mohammed Ratoubi Alanazi and Dr. Mansour Moklif Alanzi


Article by
Martha Stallman

Martha Stallman, the author of "Is killing people different from letting them die," 'lives and writes in Austin, Texas. Her work has appeared in The James Joyce Quarterly, The Joyce Studies Annual, The Offing, Electric Literature, and Playboy.