Avoidance of killing is a moral consideration that arises in health care controversies involving the notions that human life is sacred or that killing is morally wrong. Pharmacists may find themselves in positions where they must reconcile the idea that generally killing is a harm to be avoided based on the principle of nonmaleficence with the idea that death might be perceived by a particular patient as a beneficial outcome. This chapter explores the principle of avoidance of killing, highlights differences between active, merciful killing and decisions to forgo treatment, and discusses the concept of proportionality. The cases presented involve topics such as withholding treatment and withdrawing treatment and direct versus indirect killing.
