The Ghost of Christmas Present says these words to Scrooge after he has shown Scrooge this Christmas at the Cratchit family's home. Scrooge has begun to soften, especially having seen Tiny Tim and becoming aware of the young boy's illness. Earlier in the story, however, Scrooge had told some men collecting money to help the poor that if the poor would rather die than go to the poorhouse or the workhouse, then they should just go ahead and die.
Now, the spirit throws these words back in Scrooge's face to admonish him for his callousness and selfishness, and he utters the line you've cited in your question. It's a rhetorical question that the spirit asks Scrooge; of course it is not up to Scrooge who lives and who dies. He has no right to decide who's life is worth living or who's life is of greater or lesser value than another's. The spirit attempts to put Scrooge in his place by reminding him that he isn't God.
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