  A modified example still seems problematic. Just suppose that the five patients need a kidney, a lung, a heart, and so forth because they were all victims of murder attempts. Then the world will contain the five killings of them if they die, but not if they do not die. Thus, even if killings are worse than deaths that are not killings, the world will still be better overall (because it will contain fewer killings as well as fewer deaths) if the doctor cuts up the “donor” to save the five other patients. But most people still think it would be morally wrong for the doctor to kill the one to prevent the five killings. The reason is that it is not the doctor who kills the five, and the doctor’s duty seems to be to reduce the amount of killing that she herself does. In this view, the doctor is not required to promote life or decrease death or even decrease killing by other people. The doctor is, instead, required to honor the value of life by not causing loss of life (cf. Pettit 1997).