Euthanasia 3.3 - 234 Chapter 6 no view has been expressed...

Info iconThis preview shows pages 1–2. Sign up to view the full content.

View Full Document Right Arrow Icon
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Background image of page 2
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: 234 Chapter 6 no view has been expressed about the nature of goods other than life itself. The point is that on any view of the goods and evils that life can contain, it seems that a life with more evil than good could still itself be a good. It may be useful to review the judgments with which our theory must square. Do we think that life can be a good to one who suffers a lot of pain? Clearly we do. What about severely handicapped people; can life be a good to them? Clearly it can be, for even if someone is almost completely pars alyzed, perhaps living in an iron lung, perhaps able to move things only by means of a tube held between his lips, we do not rule him out of order if he says that some benefactor saved his life. Nor is it differ ent with mental handicap. There are many fairly severely handicapped people—such as those with Down's Syndrome (Mongolism)——for whom a sim- ple affectionate life is possible. What about senility? Does this break the normal connection between life and good? Here we must surely distinguish between forms of senility. Some forms leave a life which we count someone as better off having than not hav— ing, so that a doctor who prolonged it would ben- efit the person concerned. With some kinds of sen« ility this is, however, no longer true. There are some in geriatric wards who are barely conscious, though they can move a little and swallow food put into their mouths. To prolong such a state, whether in the old or in the very severely mentally handi- capped, is not to do them a service or confer a benefit. But of course it need not be the reverse: only if there is suffering would one wish for the sake of the patient that he should die. It seems, therefore, that merely being alive even without suffering is not a good, and that we must make a distinction similar to that which we made when animals were our topic. But how is the line to be drawn in the case of men? What is to count as ordinary human life in the relevant sense? If it were only the very senile or very ill who were to be said not to have this life, it might seem right to describe it in terms of operation. But it will be hard to find the sense in which the men described by Panin were not operating, given that they dragged themselves out to the forest to work. What is it about the life that the prisoners were living that makes us put it on the other side of the dividing line from that of some severely ill or suffering patients, and from most of the physically or men- tally handicapped? lt is not that they were in cap- tivity, for life in captivity can certaide be a good_ Nor is it merely the unusual nature of their life. in some ways the prisoners were living more as other men do than the patient in an iron lung. The suggested solution to the problem is, then that there is a certain conceptual connection betweerl life and good in the case of human beings as in that of animals and even plants. Here, as there, how- ever, it is not the mere state of being alive that can determine, or itself count as, a good, but rather life coming up to some standard of normality. it was argued that it is as part of ordinary life that the elements of good that a man may have are relevant to the question of whether saving his life counts as benefiting him. Ordinary human lives, even very hard lives, contain a minimum of basic goods, but when these are absent the idea of life is no longer linked to that of good. And since it is in this way that the elements of good contained in a man's life are relevant to the question of whether he is berr— efited if his life is preserved, there is no reason why it should be the balance of good and evil that counts. it should be added that evils are relevant in one way when, as in the examples discussed above, they destroy the possibility of ordinary goods, but in a different way when they invade a life from which the goods are already absent for a different reason. So, for instance, the connection between life and good may be broken because consciousness has sunk to a very low level, as in extreme senility or severe brain damage. In itself this kind of life seems to be neither good nor evil, but if suffering sets in, one Would hope for a speedy end. The idea We need seems to be that of life which is ordinary human life in the following respect— that it contains a minimum of basic human goods. What is ordinary in human life—even in very hard lives—is that a man is not driven to work far beyond his capacity; that he has the support of a family or community: that he can more or less satisfy his hunger; that he has hopes for the future; that he can lie down to rest at night. Such things were denied to the men in the Vyatlag camps described by Panin; not even rest at night was allowed them when they were tormented by bed—bugs, by noise and stench, and by routines such as body—searches and bath-paradesfiarranged for the night time so that work norms would not be reduced. Disease too can so take over a man’s life that the nor— 1 l l mal human goods disappear. When a patient is so overwhelmed by pain or nausea that he cannot eat with pleasure, if he can eat at all, and is out of the reach of even the most loving voice, he no longer has ordinary human life in the sense in which the words are used here. And we may now pick up a thread from an earlier part of the discus- sion by remarking that crippling depression can destroy the enjoyment of ordinary goods as effectively as external circumstances can remove them. This, admittedly inadequate, discussion of the sense in Which life is normally a good, and of the reasons why it may not be so in some particular case, completes the account of what euthanasia is here taken to be. An act of euthanasia, whether literally act or rather omission, is attributed to an agent who opts for the death of another because in his case life seems to be an evil rather than a good. The question now to be asked is whether acts of euthanasia are ever justifiable. But there are two topics here rather than one. For it is one thing to say that some acts of euthanasia considered only in themselves and their results are morally unob- jectionable, and another to say that it would be all right to legalize them. Perhaps the practice of euthanasia would allow too many ab uses, and per— haps there would be too many mistakes. Moreover, the practice might have very important and highly undesirable side effects, because it is unlikely that we could change our principles about the treatment of the old and the ill without changing fundamen- tal emotional attitudes and social relations. The topics must, therefore, be treated separately. In the next part of the discussion, nothing will be said about the social consequences and possible abuses of the practice of euthanasia, but only about acts of euthanasia considered in themselves. What we want to know is whether acts of euthanasia, defined as we have defined them, are ever morally permissible. To be more accurate, we want to know whether it is ever sufficient justifi- cation of the choice of death for another that death can be counted a benefit rather than harm, and that this is why the choice is made. It will be impossible to get a clear view of the area to which this topic belongs without first mark— ing the distinct grounds on which objection may lie when one man opts for the death of another. There are two different virtues whose require‘ Euthanasia 235 ments are, in general, contrary to such actions. An unjustified act of killing, or allowing to die, is con— trary to justice or to charity, or to both virtues, and the moral failings are distinct. Justice has to do with what men owe each other in the way of noninter— ference and positive service. When used in this wide sense, which has its history in the doctrine of the cardinal virtues, justice is not especially con— nected with, for instance, law courts but with the whole area of rights, and duties corresponding to rights. Thus murder is one form of injustice, dis- honesty another, and wrongful failure to keep con— tracts a third; chicanery in a law c0urt or defraud— ing someone of his inheritance are simply other cases of injustice. Justice as such is not directly linked to the good of another, and may require that some- thing be rendered to him even where it will do him harm, as Home pointed out when he remarked that a debt must be paid even to a profligate debau— chee who “would rather receive harm than benefit from large possessions."7Charity, on theother hand, is the virtue which attaches us to the good of othem. An act of charity is in question only where some- thing is not demanded by justice, but a lack of char- ity and of justice can be shown where a man is denied something which he both needs and has a right to; both charity and justice demand that wid— ows and orphans are not defrauded, and the man who cheats them is neither charitable nor just. It is easy to see that the two grounds of objec- tion to inducing death are distinct. A murder is an act of injustice. A culpable failure to come to the aid of someone whose life is threatened is normally contrary, not to justice, but to charity. But where one man is under contract, explicit or implicit, to come to the aid of another, injustice too will be shown. Thus injustice may be involved either in an act or an omission, and the same is true of a lack of charity; charity may demand that someone be aided, but also that an unkind word not be spoken. The distinction between charity and justice will turn out to be of the first importance when vol, untary and nonvoluntary euthanasia are distin- guished later on. This is because of the connection between justice and rights, and something should now be said about this. I believe it is true to say that wherever it man acls unjustly he has infringed a right, since justice has to do with whatever a man is owed, and whatever he is owed is his as a matter 236 Chapter 6 of right. Something should therefore be said about the different kinds of rights, The distinction com- monly made is between having a right in the sense of having a liberty, and having a "claim-right" or "right of recipience."8 The best way to understand such a distinction seems to be as follows. To say that a man has a right in the sense of a liberty is to say that no one can demand that he do not do the thing which he has a right to do. The fact that he has a right to do it consists in the fact that a certain kind of objection does not lie against his doing it. Thus a man has a right in this sense to walk down a public street or park his car in a public parking space. it does not follow that no one else may pre- vent him from doing so. If for some reason I want a certain man not to park in a certain place I may lawfully park there myself or get my friends to do so, thus preventing him from doing what he has a right (in the sense ofa liberty) to do. It is different, however, with a claim-right. This is the kind of .right which I have in addition to a liberty when, for example, [ have a private parking space; now others have duties in the way of noninterference, as in this case, or of service, as in the case where my claim-right is to goods or services promised to me. Sometimes one of these rights gives other people the duty of securing to me that to which I have a right, but at other times their duty is merely to refrain from interference. If a fall of snow blocks my private parking space, there is normally no obligation for anyone else to clear it away. Claim- rights generate duties; sometimes these duties are duties of non interference; sometimes they are duties of service. If your right gives me the duty not to interfere with you, I have "no right" to do it; sim— ilarly, if your right gives me the duty to provide something for you, 1 have "no right” to refuse to do it. Whatl lack is the right which is a liberty; I am not "at liberty" to interfere with you or to refuse the service. Where in this picture does the right to life belong? No doubt people have the right to live in the sense of a liberty, but what is important is the cluster of claim—rights brought together under the title of the right to life. The chief of these is, of course, the right to be free from interferences that threaten life. If other people aim their guns at us or try to pour poison into our drink we can, to put it mildly, demand that they desist, And then there are the services we can claim from doctors, health officers, bodyguards, and firemen; the rights that depend on contract or public arrangement, Per. haps there is no particular point in saying that the duties these people owe us belong to the right to life, we might as well say that all the services owed to anyone by tailors, dressmakers, and couturiers belong to a right called the right to be elegant. But contracts such as those understood in the patient. doctor relations hip come in an important way when we are discussing the rights and wrongs ofeuthan— asia, and are therefore mentioned here. Do people have the right to what they need in order to survive, apart from the right conferred by special contracts into which other people have entered for the supplying of these necessities? Do people in the underdeveloped countries in which starvation is rife have the right to the food they so evidently lack? Joel Feinberg, discussing this ques— tion, suggests that they should be said to have "a claim," distinguishing this from a "valid claim," which gives a claimeright. The manifesto writers on the other side who seem to identify needs, or at least basic needs, with what they call "human rights,” are more properly described, I think, as urg— ing upon the world community the moral principle that all basic human needs ought to be recognized as claims (in the customary prima facie sense) worthy of sympathy and serious consideration right now, even though, in many cases, they cannot yet plausibly be treated as valid claims, that is, as grounds of any other people’s duties. This way of talking avoids the anomaly of ascribing to all human beings now, even those in pre-industrial socie eties, such "economic and social rights" as “periodic holidays with pay.”0 This seems reasonable, though we notiCe that there are some actual rights to service which are not based on anything like a contract, as for instance the right that children have to support from their pa rents and parents to support from their children in old age, though both sets of rights are to some extent dependent on existing social arrangements. Let us now ask how the right to life affects the morality of acts of euthanasia. Are such acts some— times or always ruled out by the right to life? This is certainly a possibility; for although an act of euthanasia is, by our definition, a matter of opting for death for the good of the one who is to die, there is, as we noted earlier, no direct connection between that to which a man has a right and that which is for his good. It is true that men have the right only to the kind of thing that is, in general, a good: we do not think that people have the right to garbage or polluted air. Nevertheless, a man may have the right to something which he himself would be better off without; where rights exist, it is a man's will that counts, not his or anyOne else’s estimate of benefit or harm. So the duties complementary to the right to life—the general duty of noninter— ference and the duty of service incurred by certain Persons—a re not affected by the quality of a man’s life or by his prospects. Even if it is true that he would be, as we say, "better off dead," so long as he wants to live this does not justify us in killing him and may not justify us in deliberately allowing him to die. All of us have the duty of noninterfer~ ence, and some of us may have the duty to sustain his life. Suppose, for example, that a retreating army has to leave behind wounded or exhausted soldiers in the wastes of an arid or snowbound land where the only prospect is death by starvation or at the hands of an enemy notoriously cruel. It has often been the practice to accord a merciful bullet to men in such desperate straits. But suppose that one of them demands that he should be left alive? It seems clear that his comrades have no right to kill him, though it is a quite different question as to whether they should give him a life-prolonging drug. The right to life can sometimes give a duty of positive service, but does not do so here, What it does give is the right to be left alone, Interestingly enough, we have arrived by way of a consideration of the right to life at the distinc— tion normally labeled "active" versus "passive" euthanasia, and often thought to be irrelevant to the moral issue."J Once it is seen that the right to life is a distinct ground of objection to certain acts of euthanasia, and that this right creates a duty of noninterference more widespread than the duties of care, there can be no doubt about the relevance of the distinction between passive and active euthanasia. Where everyone may have the duty to leave someone alone, it may be that no one has the duty to maintain his life, or that only some people do. Where then do the boundaries of the "active" and "passive" lie? In some ways the words are themselves misleading, because they suggest the Euthanasia 23? difference between act and omission which is not quite what we want. Certainly the act of shooting someone is the kind of thing we were talking about under the heading of "interference," and omitting to give him a drug a case of refusing care. But the act of turning off a respirator should surely be thought of as no different from the decision not to start it; if doctors had decided thata patient should be allowed to die, either course of action might follow, and both should be counted as passive rather than active euthanasia if euthanasia were in ques~ tion. The point seems to be that interference in a course of treatment is not the same as other inter- ference in a man's life, and particularly if the same body of people are responsible for the treatment and for its discontinuance. In such a case we could speak of the disconnecting of the apparatus as kill- ing the man, or of the hospital as allowing him to die. By and large, it is the actof killing that is ruled out under the heading of nonintorference, but not in every case, Doctors commonly recognize this distinction, and the grounds on which some philosophers have denied it seem untenable. Iames Rachels, for instance, believes that if the difference between active and passive is relevant anywhere, it should be relevant everywhere, and he has pointed to an example in which it seems to make no difference which is done. if someone saw a child drowning in a bath it would seem just as bad to let it drown as to push its head under water.” If “it makes no difference" means that one act would be as iniq- uitous as the other, this is true. It is not that killing is mrse than allerwing to die, but that the two are contrary to distinct virtues, which gives the pos~ sibility that in some circumstances one is imper- missible and the other permissible, In the circum- stances invented by Rachels, both are wicked: it is contrary to justice to push the child’s head under the water something one has no right to do. To leave it to drown is not contrary to justice, but it is a parlicularly glaring example of lack of charity. Here it makes no practical difference because the requirements of justice and charity coincide; but in the case of the retreating army they did not: charity would have required that the wounded soldier be killed had notjustice required that he be left alive.12 in such a case it makes all the difference whether a man opts for the death of another in a positive action, or whether he allows him to die. An anal~ ...
View Full Document

This note was uploaded on 05/18/2010 for the course GENERAL ED UGD 2901 taught by Professor 謝建泉、陶國璋 during the Spring '10 term at CUHK.

Page1 / 2

Euthanasia 3.3 - 234 Chapter 6 no view has been expressed...

This preview shows document pages 1 - 2. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online