The Right to Die
Hey all (by which I mean the 3-4 people who may read this), sorry for the long delay. Last week work was really strenuous, so I never got around to posting. Shame, too because last week’s topic was so juicy. Oh well. I was going to post on Saturday night but I had to spend two hours convincing Sarthak that people have a right to life (but actually…..).
Anyway, physician-assisted suicide is the question before us, and tonight I want to briefly deal with the question of morality in this scenario. As per usual, I’ll be offering an insultingly cursory analysis of a nuanced issue.
We all acknowledge (including Sarthak) that there is a right to life; this right is fundamental in rights-based theories of ethics, because without a right to life, we have no other rights (we cannot have rights if we are not alive). But do we have a right to death? This is by no means the only relevant moral question on this issue (other questions pertaining to the rights and obligations of physicians are also important), but it’s the most fundamental. No doctor ever has an obligation to perform a procedure that he or she feels is unethical (if this is a reasonable belief), so of course a doctor cannot be compelled to participate, but empirically we see that some doctors find this acceptable. Thus, we must evaluate whether the patient has the right to request such a procedure, in order to even be able to move on to the next step of evaluating the doctor’s standpoint.
I think we generally accept that people have the right to do things that are personal. In other words, I am sitting in my room right now, and if I wanted to do something that wouldn’t affect anybody except me, I have a right to do that without being prevented, whether or not that action is objectively good for me (ie, I could raid the fridge and eat all of the surplus food that my family doesn’t need). Of course, this situation does not parallel exactly that of a potential physician-assisted suicide: obviously, other individuals have a stake in that as well. But even though family members and loved ones may have emotional connections to the patient, nobody would claim that they (the family) have a right to the patient’s continued existence. Thus, the emotional connection is not inviolable. I submit that with consent, which is to say, a sincere and rational agreement between the patient and all relevant friends and loved ones, the emotional connections are, for ethical purposes, dissolved. This is not to say that they are nonexistent, simply to say that they are not ethically relevant. For example, if I wanted to smoke (which I don’t do) in a group of friends, it would be nice of me (though arguably not ethically required) to ask my friends for permission. Some may say that it is immoral to smoke in the company of others without that permission, since their permission indicates their consenting to the potential ramifications that my smoking may have on them. Having received permission, though, surely nobody would argue that it is immoral for me to smoke around my friends. Of course, assisted suicide is several orders of magnitude more serious than a cigarette, but I believe that the ethical principle holds: with consent, given with no mental reservation, from relevant (an ambiguous term) individuals, the obligations a suffering patient may have to others are dissolved from that consent, thereby allowing the patient to take an action that may be objectively ill-advised.
This is a simplistic view of the issue, but it feels right to me. Obviously, though, there are lots of different ways to view the morality of physician-assisted suicide, as with any major moral dilemma. Paternalism has many justifications, some better than others in one situation or another: those justifications may or may not apply here. Additionally, there may be pragmatic issues embedded in a legal codification of the above principles; issues of consent, rational analysis and prognosis are serious and need to be (and likely have been) considered by legislatures discussing this issue. My treatment of PAS above is not the final word on the issue, but I think it’s a good start. I’ll do my best not to get lost in work again but there are no guarantees. Curing cancer is hard work 😛 (because of course, that’s what I’m doing….)
Cheers,
Evan Goldstein ’12
Evan's CollectKnowledge Blog 
I feel that this question invariably raises another: do people own themselves? I think that if people own themselves, they can make whatever choice they want about their lives.You analyzed one aspect of this question–whether or not people are owned by their family and friends–to which you argued that emotional connections do not equate to some sort of part-ownership. I can buy this argument, but I think you can look at the question of whether people own themselves from more viewpoints. For example, (this diverges from the vegetable state life or death question) what about a person upon whom, as a result of that person’s deliberate actions, the well-being or lives of others depend on. Say, does a pilot on a plane have the right to die if his death will mean the death of all his passengers? In other words, do his passengers own a part of the pilot’s life? That, I think depends on how you view distribution of responsibility. If responsibility is heavily weighted on the pilot (i.e. he is responsible for the lives of others that he certainly does not own), he must ensure the continuity of the lives of others and thereby forfeit complete ownership of his life. If the passengers are responsible for getting on the plane and risked such a suicidal pilot through that choice, the pilot does not owe them and so owns his own life. I hope that makes sense–I know it doesn’t really address PAS. However, I think you can apply it to PAS. If a person’s family’s continued well-being depends on that person’s survival as a result of that person’s conscious actions, he is more or less in the same position as the pilot.
Hmm I’ll respond more thoroughly to this once I’m more awake, but I think you can apply my above analysis to the pilot example: in the same way that PAS (or smoking) is unjustified without consent, as would be the pilot’s action in that case, stemming from his obligations to others, rather than from any issue of ownership. The scenarios are slightly different because if all the passengers on the flight told the pilot they were willing to accept his suicide, we would assume that they were not making a rational choice, but if you look at things like Flight 93, that’s not terribly far from what happened, and surely that was a moral act.
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So I would say I generally agree with what you said. I’d argue that self-ownership is simply the right to determine your own actions (ownership being defined as the ability to control the use of a certain asset), and I think we generally feel that people have a right to act as they wish. The one major exception is as you’ve described: when a person’s self-ownership conflicts with other rights that people enjoy.
I think in general, I’d agree with you Evan; but I don’t think that someone wanting to die requires any type of consent from loved ones or people that may have an interest in their continued existence. I think in part, this comes from our different approaches to rights. I’ll send you my position paper soon, but I think the primary right, the most significant right we have as human beings, is the right to self-ownership. From that perspective, I think people always have the option of ending their lives, regardless of what others may think.
Evan, your last sentence – “The one major exception is as you’ve described: when a person’s self-ownership conflicts with other rights that people enjoy.”
I disagree completely. One person’s self-ownership is paramount. Also, the only rights of people that one person’s suicide can affect are positive rights, which a) I don’t believe exist (without contract, in which case they’re no longer ‘rights’ per se), and b) No one has the responsibility to recognize (again, absent a contract).
Well actually, I do agree with the statement in principle, just not given your interpretation of rights.
I think there are practical issues with the view you’ve advanced: how do you determine what constitutes sufficient emotional interest or entanglement to necessitate seeking consent? It seems to be a slippery slope to me; there are potentially thousands of people (for example, if you’re a perfectly healthy CEO) who could be affected by your choice to die; do you need to seek permission from all of them? Half? None at all? Is it just wrong for you to end your life?
In the case of the airplane pilot, I would agree that the pilot should seek permission, but I think its very different from seeking consent from friends. The pilot has entered into a contractual agreement with these individuals to transport them safely from location X to Y – and it would be highly immoral for the pilot to violate this contract in midair, most likely killing his passengers. (And, if you deny the existence of a contract, given the complexity of flying a commercial airliner, it might, depending on the skill/existence of the other pilots, constitute an act of murder for a pilot to just kill himself mid-air.)
So bottom line: as long as individuals have no legitimate contractual obligations, they can morally commit suicide. If they have contracted themselves, then I think basic ethics demands that they either a) attempt to negotiate a release from the contract, or b) complete the obligations set forth by the contract. (Barring some type of awful catastrophe/trauma… which, yes, is an intentionally vague loophole to prevent some unlikely but barbaric outcome.)
And either way, it would be nice (but not a moral mandate) to alert friends and family.
I agree that there are practical issues with the view I’ve advanced,
and those would be dealt with by a legislature. All I was trying to
say is that legislation permitting this sort of thing is a moral
endeavor. I also agree that consent of loved ones is less morally
relevant than other things, namely the ability of the patient to make
a rational choice.
I actually agree with a lot of what you said, except for one thing
(which I suspect is really just a misinterpretation of the argument I
made). Obviously self-ownership can’t be paramount in a moral context:
I could not use my self-ownership to kill you. Thus, as I said above,
we can restrict self-ownership, or declare it immoral, in those
circumstances where the absolute exercise of self-ownership infringes
upon the rights of others (like if I kill you or steal your Kindle or
something). What those rights are is, of course, the source of
dispute, but that’s a separate issue. I think on the former point, of
the potential restrictions of self-ownership, we generally agree.
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Right, I’m just saying that instead of a legislature, there’s a very simple litmus test to determine if you have a moral obligation to alert someone/request consent for you to kill yourself – the existence of a contractual obligation. If there is no contract, you can kill yourself, if there is one, you must request permission. I think that’s a clear and simple way to solve any of those practical issues.
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I think its just a disagreement of what self-ownership is. I would argue that self-ownership is absolute ownership of your body/mind and control of what enters it, interacts with it, etc.
I think your definition of ownership – the right to determine the use of something – is a bit off. The mark of ownership isn’t the ability to determine use of an asset, but rather absolute possession of that object. Your claim that ownership is the right to determine use does logically follow, but it is a feature of your possession rather than the source of your ownership. For example – labor can be contracted out. When you contract to an employer to perform X, Y, and Z tasks for 10 hours every week, your employer has the ability to determine how he uses you (the asset). Does this now mean that your employer owns you for these 10 hours every week? I’d argue no, his limited use of you does not constitute ownership, because a) there are 158 hours in the week where he cannot determine your action, b) he cannot force you to do anything in these 10 hours, but only X, Y, and Z tasks, and c) whatever contract has been created, the employer can only attempt to (legitimately) coerce you into performing his tasks. He cannot actually cause you to blink, or cross your legs, or do anything for that matter. He has no control over your body except for what you afford him.
So the employer has determined his use of you, and continue to determine his use of you, for 10 hours every week. But this can hardly be called ownership, in any sense. Even were we to go the extreme – you contract yourself to an employer for 168 hours every week for a month, or a year – where the employer has absolute control to do whatever he wants with you, still this is not ownership. The situation is akin to slavery in the past, but the last point – c) – still stands. The employer no more has control of your labor than he does over any other part of your body, and he must exact your voluntary effort.
Do people that own assets have a right to determine their use? Yes, but that must be derived from the possession of the object itself. An important technicality.
So going to your example – “I could not use my self-ownership to kill you.” The statement is, of course, false – but because it misunderstands the right of self-ownership itself.
If we proceed from my premise, that self-ownership is paramount in morality. You couldn’t kill me, because all humans have the right to self-ownership, and thus we both have absolute possession of our bodies. That means I have the right not to be killed by you.
So an absolute principle of self ownership in a moral context is incapable of violating another’s negative rights. It may result in a violation of positive ‘rights’.
But as you said yourself, its a technicality. I think you’ll agree with the conclusions I’ve drawn as well, if not the definitions.
You write too much. Write less. I actually think that my definition of ownership is the same as yours; our differences are semantic. Complete possession entails complete determination of usage and vice versa (of course, I could have complete possession of an object and not be allowed to use it, say if I’m holding it for you until I can give it back). In your example, your boss would not own you, because he lacks complete determination of your action. He has limited ownership of you because you’ve contracted to him limited control. I don’t think we actually have substantive differences on this issue. Any concept of self-ownership implies free will, which is limited only when the exercise of that free will, without which self-ownership is meaningless, would infringe upon the free will (yes, the negative rights) of others. I think we agree on that.
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Absolute determination of usage would require absolute possession.
But absolute possession does not entail absolute determination of usage. From the right to possess property, you have a right to change that property. You may change it then, and involve other property you own (or have the rights to use). Unowned resources can be acquired through the homesteading principle – by mixing your labor with them.
You have the right to ‘determination of usage’ given that this usage affects only that which you a) own b) have a right to use or c) find unowned. A right to absolute possession does not bestow the right to initiate interactions with property you do not own/have rights to. The reason is that you derive your right to determine usage from your right to possession. Which would lead to the logical conclusion that another’s absolute possession over their property has a stronger moral claim than your right to determine the usage of your property. In practice, this leads to the non-aggression axiom. NB: The axiom is not a restriction of the right to self-ownership or right to property, but its logical consequence.
(Btw – in your example, you have only temporary possession with limited rights.)
I also don’t agree that my boss has partial ownership of me. You can grant another individual a contract to your labor or waive some of your exclusive rights to your body in respect to another. You cannot sell your mind or control of your body (which is what self-ownership entails). In this example, the individual contracts his labor, not a ‘partial’ right of ownership.
There can be no property in people other then yourself.
I still think that we generally agree on most of these issues, you’re just trying to define them more fancifully than I am. We’ll sort out the real issues via essay rather than blog comments haha. I’ll also ignore for now the fact that you have no warrants for anything you’ve said so far.
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Mhm, okay. I’ll send you my essay (just need to cut it down. Its pretty bloated atm.)
And yeah, the first draft was 600 words. I cut a lot out (as per your request :p) leaving my basic position.
600? BDR told me 2000+ lol I really think we only have one major point of difference though
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No, my comment (lacking warrants) was originally 600 words.
The essay is about 2.5k xD