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Debate

Euthanasia Debate (I)

Tim Chappell explains “Why Euthanasia is in Nobody’s Interest”.

In Harry Potter and the Chamber of Secrets, Chapter 12, Harry is alone in Professor Dumbledore’s office, where he finds “a decrepit-looking bird which resemble[s] a half-plucked turkey”. Suddenly, to Harry’s astonished dismay, the bird bursts into flames and dies. Harry expects Professor Dumbledore, who arrives at this point, to blame him for the spontaneous combustion and demise of his exotic pet. But Dumbledore’s response is this: “About time, too… Fawkes is a phoenix, Harry. Phoenixes burst into flame when it is time for them to die and are reborn from the ashes. Watch him…”

Why is Harry dismayed when Fawkes bursts into flame? Because Harry doesn’t understand the natural history of the (mythical) species the phoenix. Not understanding that, Harry fails to understand what is in the interests of a phoenix. It is a surprising fact about Fawkes that, at the time when Harry sees him, it is in his interest to burst into flame and die. The reason why is because Fawkes is a phoenix, and because periodic combustion and resurrection is part of what well-being is for phoenixes.

Moral: if you want to know what is in a given creature’s interest, you need to understand what kind of creature it is, and what well-being is for that kind of creature. This is at least partly a matter of natural history.

Philippa Foot, in her book Natural Goodness expresses an idea very much like this, saying: “We invoke the [idea of what is necessary as a means to some crucial good] when we say that it is necessary for plants to have water, for birds to build nests, for wolves to hunt in packs, and for lionesses to teach their cubs to kill. These… necessities depend on what the particular species of plants and animals need, on their natural habitat, and the ways of making out that are in their repertoire. These things together determine what it is for members of a particular species to be as they should be, and to do that which they should do.”

So what is in a person’s interest? By the argument just given, the answer to that depends on what kind of creature a person is. All the persons we know about are human beings; a person, then, is a living human body. You might reply, “But there might be persons of other species – intelligent aliens. These persons would not be living human bodies.” Correct. The right response is to widen the definition of persons “persons are living human (or intelligent alien) bodies”.

“But,” you say, “how do we recognise persons? The case of intelligent aliens shows that persons are not recognised by their being living bodies, but by their displaying a particular type of psychology. So a person can’t be simply a living human (or intelligent alien) body. A person must be at least a living body of some kind that possesses a particular psychology.”

This doesn’t follow. The criteria whereby we first diagnose a natural kind – water, say – may include for example wetness. It doesn’t follow that water is essentially wet, still less that water is wetness. Similarly, the criteria whereby we first diagnose personhood need not be even part of the essence of persons. Still less need personhood be identified with the sum of those criteria. (See Saul Kripke’s Naming and Necessity, pp.116 ff.) An unconscious person, a brain-damaged person, a person in a deep coma, might still be a person despite lacking a particular psychology. So the question becomes: What is in a human being’s interest?

The answer is, of course, that human well-being is complex and multifarious. Human beings have such a wide range of different capacities and abilities that they might develop, in ways that would contribute to their well-being, that we hardly know where to start to draw up a list of human interests. But this much I think we can say. Promoting human wellbeing means developing human nature; and developing human nature means developing and exercising human capacities and abilities.

So should we say that what is in a human being’s interest is “whatever develops and exercises human capacities and abilities”? Not quite, because some activities develop one human capacity while wantonly destroying or endangering some other (or others). Becoming a gladiator is very good for your hand/eye co-ordination, but only so long as you still have hands and eyes. So: what is in a human being’s interest is whatever develops or exercises some human capacity (/capacities) or ability (/abilities) while not wantonly destroying or endangering any others. (I have defended this pattern of argument elsewhere – see ‘further reading’.)

Now there are plenty of other risky activities besides being a gladiator – mountaineering, scuba diving, extreme skiing, whatever. Moreover, life is short. Whichever capacities or abilities I choose to develop, there are bound to be others that I don’t choose to develop. As a result of this neglect, those capacities may well actually perish altogether. (When I was eleven I had quite a nifty cover-drive, but now…) To my proposal that “What is in a human being’s interest is whatever develops or exercises some human capacity (/capacities) or ability (/abilities) while not wantonly destroying or endangering any others”, you might retort that I’ve begged the question of what counts as the wanton destruction, endangering, or neglect of any human capacity.

I certainly have begged that question. For present purposes, it doesn’t matter. We don’t need an account of wantonness to understand why death is not in any human’s interests. I’ve said: “What is in a human being’s interest is whatever develops or exercises some human capacity or ability while not wantonly destroying or endangering any others”. This immediately implies that whatever does not develop or exercise any capacity or ability of a given human being, while destroying (wantonly or not) all of that human’s capacities and abilities, can’t possibly be in that human’s interest.

But that’s just how it is with death. Death neither exercises nor develops any human capacity or ability. Humans, like other physical objects, are not exempt from the law of entropy. That doesn’t mean that humans have a capacity to die, or an ability that they exercise by dying. (Humans can go blind too, or suffer from collapsed lungs; but humans don’t have a capacity for blindness, or an ability to get collapsed lungs.) What death does is destroy the human person. In the process, death destroys all the human person’s capacities and abilities. Since a person’s interests are all to do with developing and exercising these capacities and abilities, it follows that it is never in anyone’s interest to die. In fact, dying is the most extreme possible negation of anyone’s interests.

Now the commonest arguments in favour of euthanasia are these two:

(1) “Euthanasia should sometimes be administered, because it is sometimes in a patient’s interest to die.”

(2) “Euthanasia should sometimes be administered, because some patients choose to die, and we have no business interfering with their choice.”

Let’s look at these two arguments in turn.

Argument (1) fails simply because it is a mistake to think that it is ever in a patient’s interest to die. Obviously, it might be in a patient’s interest to be freed from pain, or from suffering or indignity. Also obviously, the only way to free the patient from pain (or whatever) might be to do something that causes or hastens her death. But what does that show? It shows that the palliative-care approach to those who are terminally ill and in great pain gets things exactly right, whereas the euthanasiac approach gets things crucially wrong. The palliative carer believes that he has reason to free the patient from pain, and in certain circumstances is prepared to accept the patient’s death as a side-effect – possibly an inevitable sideeffect – of pain relief. What the palliative carer does not think he has reason to do, unlike the euthanasiac, is aim at the patient’s death, either as a means to releasing her from pain, or as an end in itself. The thesis that there is a crucial moral distinction between aiming at a consequence and accepting it (the principle of double effect) is often attacked, but it has not been refuted. My own defence of that principle is in ‘Two Distinctions that do make a Difference’, Philosophy 2002.

If death is never in anyone’s interest, indeed is the negation of all interests, we can see why the palliative carer is right to see his reasons this way. There is no reason to do what is not in anyone’s interest; and there is positive reason not to do what negates people’s interests. So there is no reason to perform any act of euthanasia, and every reason not to perform it.

Meanwhile argument (2) says that “we have no business interfering with the choice” of patients who choose to die. This robust assertion that autonomy is paramount has a grand ring to it. But the grand ring has a hollow echo. We don’t generally think that autonomy is paramount. We don’t think that we are bound to respect people’s freedom of choice anywhere and everywhere. If someone’s autonomous choice is to rob banks, we think they should be stopped, not allowed to get on with it.

In short, we think that autonomy is paramount only where people are making choices that we already think are not seriously wrong. But I have just argued that the choice to kill a human being – yourself, or someone else – is seriously wrong. Ethics – at least, as it concerns humans – is all about promoting and respecting human interests, and avoiding doing what negates human interests; and killing is the ultimate negation of human interests. So if anything is wrong, killing humans is wrong. The idea that euthanasia can be justified by appealing to autonomy is no more plausible than the idea that bank-robbery can be justified by appealing to autonomy.

At the moment in the English speaking world, there is a vigorous and extensive publicity campaign “in favour of euthanasia and its legalization”. To put it more plainly, there is a campaign in favour of the proposition that doctors should sometimes murder their patients, that wives should sometimes murder their husbands, that fathers should sometimes murder their children, and that no one should be prosecuted for any of these murders. At present most of the discussions of euthanasia that happen under the supposedly neutral aegis of ‘analytic philosophy’ merely reflect and repeat the slogans of this publicity campaign. Looking through much of the recent literature, or at some of the undergraduate courses in applied ethics that have been made available on the Internet, it would be easy to think that there simply aren’t any serious philosophical arguments against euthanasia. Or that if there are arguments against euthanasia, they are only ‘indirect’ ones (thin end of the wedge, too easy to abuse the policy, etc., etc.), and not arguments that show directly that euthanasia is a bad thing. Or that, to be opposed to euthanasia, you have to be –in the usual vague uncomprehending phrase – “religious or something”.

On the contrary, there is at least one serious philosophical argument directly against euthanasia which has nothing whatever necessarily to do with religion, and everything to do with a question that enthusiasts for euthanasia usually skimp. This is the question I’ve pursued here: “What is in a person’s interests?” Part of the right answer to that question, I’ve argued, is that euthanasia is literally in nobody’s interest; indeed, it is the deliberate negation of all a person’s interests. This makes euthanasia, in itself, seriously immoral. Since it is bad for our characters to spend much time entertaining seriously immoral proposals, please, let’s spend no more time considering the very bad idea of legalising euthanasia.

Tim Chappell teaches philosophy at the University of Dundee, Scotland.

Other writings by Tim Chappell on this topic:
Understanding Human Goods (Edinburgh UP, 1998), Ch.3; ‘The Implications of Incommensurability’, Philosophy 2001; ‘Practical Rationality for Pluralists about the Good’, Ethical Theory and Moral Practice 2003.