There are cases where the active step is the one that bypasses an immense amount of suffering, right? That's right. And because it requires actually a different psychology to do one versus the other, they are different. But if we abstract away from those differences and talk about public policies and what governments should do, then the act and omission difference shouldn't be morally salient to us anymore. It would take a very different sort of person to go to Africa with the intention of killing someone then merely decline to buy a bed net when told on good information that this would save a human life.

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