That’s the question that “bioethicists” are trying to answer. (Whenever I see the word “bioethicist,” by the way, I get a little queasy.) From a non-religious point of view, and certainly from a non-Judaeo-Christian point of view, I can understand why philosophers and bioethicists would argue this way. After all, pragmatism and utilitarianism rule every other facet of our lives: does it work or not? and, will the end(s) justify the means? Those are obviously simplistic ways of putting the question, but that is how those philosophical ideas trickle down into the thoughts and lives of an ordinary person. So for killing: does it work for saving money, or beds, or human organs, or time, etc.? Will it justify the ends of making life better for other people, or, since we cannot imagine any sense in which lying in a hospital bed might be better than our judgments of what make life worth living, will death make life better for the person who is killed? (Yeah, I don’t get it, either.)
I have a difficult time wading through the shoddy and laughable logic employed by Sinnot-Armstrong and Miller in this piece. It is full of unsubstantiated assumptions and appeals to “intuition.” Why these assumptions and these intuitions should be reliable bases from which to draw conclusions is left unexplained and, apparently, unexamined.
Our intuitions about this case seem clear. We see nothing to make Betty’s death worse than her total disability. This intuition seems to be widely shared, since many people dread death no more than and for the same reasons that they would dread total disability. There is nothing to be dreaded about death that wouldn’t also be dreaded about total disability. Indeed, one of us even finds it plausible to see total disability as worse than death, because there is disvalue in a disordered state of consciousness with no control over experiences. In any case, Betty is not worse off dead. In our view, then, what explains the wrongness of Abe’s act of killing Betty is not that he caused her death but only that he caused her total disability.
“Our intuitions”? “We see nothing”? From this to killing the seemingly permanently disabled? They assume they know what is going on inside someone’s (“Betty”) mind, and from that they are willing to make life-and-death decisions. Not only that, but since “many people” share this intuition, the feelings of the majority easily trump any rational consideration of what makes life worth living.
I am not arguing that people should be kept artificially alive, if that means a machine pumping blood, and a machine inflating and deflating lungs. But that is, by its nature, a very gray line, and it is a fearful thing to make such flimsy assumptions–including the claim that we know what is happening inside the brains of those in, for example, a “persistent vegetative state” (a degrading term, if I’ve ever heard one)–the basis for deciding whether one’s life is worthy of life, or not.
Moreover, it is not clear whether the traditions that say ‘Life is sacred’ or ‘Killing is wrong’ really believe what they say. The point is not (just) that these traditions also justify killing in self-defence or war as well as capital punishment. That might be explained by the qualification ‘… without an adequate reason’. Instead, the point here is about whether the tradition really means ‘life’ and ‘killing’. If life were really what is sacred, then all life would be sacred. But nobody believes that—not even Jains. After all, weeds are alive. Hence, if killing were wrong just because it is causing death or the loss of life, then the same principle would apply with the same strength to pulling weeds out of a garden. If it is not immoral to weed a garden, then life as such cannot really be sacred, and killing as such cannot be morally wrong. Of course, what people mean when they say ‘Don’t kill’ is ‘Don’t kill humans’ (or maybe ‘Don’t kill sentient animals’). But why then are humans (or sentient animals) singled out for moral protection? The natural answer is that humans (and sentient animals) have greater abilities than plants, and those abilities give human lives more value. Humans can think and make decisions as well as feel (an ability that they share with sentient animals). But if these abilities are what make it immoral to kill humans (but not weeds), then what really matters is the loss of ability when humans (but not weeds) are killed. And then the view that human life is sacred does not conflict with—and might even depend on—the view that what makes life sacred (if it is) is ability, so the basic moral rule is not ‘Don’t kill’ but is instead ‘Don’t disable’.
Huh? Have these people ever encountered any of these “traditions”? Or are they making these straw men up just to knock them down and argue that it’s okay to take human life if we think they’d be better off dead? It is not “killing…without an adequate reason,” it is “You shall not murder,” at least for Israelites and Christians. That tradition is clear that the government has the authority to take life as punishment or to protect its citizens (though, of course, this does not mean that the government must exercise capital punishment). That is not murder, though it is killing. The whole section is based on the assumption that what, especially, religious traditions object to is killing qua killing, when that is clearly not the case. Nor is it simply “without an adequate reason.” And it is not only that human life is intrinsically sacred, but that only God may decide when a person dies. (Something Christians seem to have forgotten is that life is sacred only in relation to the Holy One who created it and who sent His Son to die for it.) According to the Judaeo-Christian tradition, He gives the authority to take life to government in a limited way, but it is still His authority. He does not give it to individuals, not even to bioethicists. When individuals or groups arrogate that authority to themselves, they infringe on an authority not their own, and they will, sooner or later, face the consequences for violating the divine order inherent in creation.
But if that’s unconvincing, because belief in divine authority is lacking (though, naturally, if a God exists, unbelief has no bearing on that fact), why is it not apparent that the position advocated by Sinnot-Armstrong and Miller has a long history and not a good one? (Yes, I realize that’s a moral judgment, but also one that “many people share,” as long as we’re appealing to the majority.) It has never failed that when anyone, regardless of his pedigree or title, presumes to decide who may be killed “morally,” the circle of those who should be thus eliminated widens ever further. There is no limit to the boundaries of human imagination when it comes to genocide. And this sort of reasoning, even to the amazing comparison between certain humans and weeds, is always at the root of genocide. Of course they’re not advocating genocide, or eugenics, or forced sterilization (at least, here), or any of the other four-letter words of the 20th Century. But neither will they have control over who appropriates their ideas. Ideas have consequences, and the consequences of these ideas are very bad indeed.
Traditional medical ethics embraces the norm that doctors (and other healthcare professionals) must not kill their patients. This norm is often seen as absolute and universal. In contrast, we have argued that killing by itself is not morally wrong, although it is still morally wrong to cause total disability.
In what moral universe does that stand? You can draw a line in the sand, but if the tide is still coming in, it will only last as long as the line is deep. This seems like a very shallow line. They go on to apply their definition of “total disability” to organ donation and, again, their logic depends on a number of unsubstantiated assumptions (as well as strange phrases such as “Consequently, no harm or wrong is done to them by vital organ procurement, after which they will become dead.” Become dead?) That their argument moves in this direction ought to, at least, make us reconsider organ donation–something which Gilbert Meilaender has done, in a different context, here.
I have probably spent too much time dissecting an argument (if it even rises to that level) which could probably be dispelled immediately with a sharper wit than mine. Nevertheless, this is the sort of utilitarian argument we will hear more and more often in such a technologically and scientifically expert culture such as ours. After all, these are bioethicists. They have “ethics” in their name. Surely they have insight we do not have. And, as they point out, most people believe that there are some forms of life to which death is preferable.
That is perhaps the most dangerous assumption, held all too often by Christians, which gives this sort of plea its moral force. Who wants to live life stuck in a hospital bed, we say. Who wants to be helpless and hooked up to all sorts of machines? Who would want to have to eat through a tube? Those questions, and their rhetorical siblings, are the bedrock on which these philosophers and bioethicists stand. If we don’t like their conclusions, maybe we shouldn’t grant their premises.