This paper will explore the moral distinction many ethicists make between “killing” and “letting die”. My claim is that while the notions are conceptually distinct there may not necessarily exist a moral distinction in every situation. I suggest that whether or not there is a moral distinction depends upon the empirical data and details of the specific case where moral assessment is being considered. At a more fundamental level, how one understands the wrongness of killing when it is wrong affects our evaluation of the moral legitimacy of the distinction. Some bioethicists think that if the distinction is not maintained in and of itself and by itself that it opens the door for the moral permissibility physician assisted suicide and euthanasia. I want to argue that this is not necessarily the case. Further, I maintain that there is and ought to remain a strong prima facie prohibition against killing, and that these claims are consistent with an evangelical approach to Christian theology.