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Jefferson Marshall
Jason Gooch
Philosophy 215
May 2, 2016
In Which I Ramble About Killing People
By most reasonable accounts, we hold it true that killing another living being (in particular, human beings), is wrong, in that it robs the individual of all future existence and pleasure. According to Kantian ethics, this is non-debatable; it is our moral duty to preserve life to the best of our ability, no questions asked. But what about cases where preserving life leads to no possible future pleasure, and instead leads to increasing amounts of pain with no hope for improvement? What about individuals who, for all intents and purposes, have already lost all conscious existence, but continue to live in such a way that costs absurd amounts of money and resources so as to cause suffering in the conscious beings that also rely on those resources? In these cases, a utilitarian approach leads to a much more reasonable conclusion: that euthanasia can often be the best option for avoiding the suffering caused in and of a dying individual.
First, let us establish that it is not impossible to kill someone, be it oneself or another, in a way that is morally sound. Given that we as humans are naturally inclined to want to survive and avoid death from both an individual and group standpoint, euthanasia and suicide are usually not very morally responsible things to do. But suppose that there exists a race of creatures for whom existence is intrinsically painful. (Let’s call these creatures “painlings.”) This pain is so extreme, and so excruciating, that humans cannot even begin to imagine it, and the only way to escape this pain is through death. Any sort of technological advancement for this species would be of little value, as the intense pain would eclipse any need or want for entertainment or even sustenance; sustaining oneself would be counter-intuitive. Would it be considered a morally sound action to knowingly create such a race of creatures? Obviously not; there’s not much need for discussion there. To create a painling is not much different from grabbing any innocent critter and torturing it. Now, let us consider instead that we came across a planet of painlings, yelling at us in agony and begging for the sweet release of death. Would it be morally permissible to launch a world-bursting torpedo at the planet, bathing it in hellfire and putting the painlings out of their misery once and for all? Or should we fly away in our spaceship, leaving them to suffer on their own? The Utilitarian would easily argue that launching the nuke is the best option, as it ends what may be centuries of suffering, and even throws in a bit of fireworks to boot. What is more interesting is that even a Kantian approach would find trouble leaving the planet to its own devices. Leaving the planet alone in order to remain comfortable would breach an imperfect duty to kill the painlings, who are clearly motivated to have themselves killed for the purposes of ending their suffering.
This thought experiment concerning painlings lends itself very well to some real world examples. Let’s start with a single person, a man by the name of Hisashi Ouchi, whose story is documented in the NHK-TV crew’s book, A Slow Death: 83 Days of Radiation Sickness. The fittingly named Mr. Ouchi was a worker at a nuclear power plant in Tokaimura, Japan, where, on September 30th, 1999, he was exposed to 17 Sieverts (Sv) of radiation during a criticality accident, well over twice the amount of radiation that is considered fatal, 7 Sv. In a matter of days after he and his coworkers were admitted to the hospital, Ouchi was already begging for death, as his DNA-damaged skin and muscle began to rot and melt off of his very limbs and body. Suffering from cancerous tumors, cardiac arrests, organ failures, and a destroyed immune system, Ouchi had undergone several blood transfusions and skin grafts before eventually passing out. The family desperately wanted Ouchi to survive, having the hospital do everything in its power to make sure that he lived - while the nurses tending to him frequently had to question whether his life was worth the effort and resources. It wasn’t until December 20th that his doctor convinced Ouchi’s family to allow a do not resuscitate order to be placed, and Ouchi finally died on December 22nd, 83 days later. By all accounts, Ouchi was a doomed man the moment the uranium he was handling went critical, and the efforts that went toward piecing back together his rapidly crumbling body only prolonged the suffering of both himself, and his family, who could have been through mourning if he had died on day one. The moral conclusions made here are consistent with that of the plight of the painlings; to prolong a creature’s suffering is immoral when concerned with the well-being of conscious creatures, especially so when there is no hope for recovery. As such, Ouchi should have been euthanized from the very beginning, via lethal injection or some other instantaneous means, to save both himself and his family from the struggle that would come over the next several months.
If this logic works for just one individual with radiation poisoning, why shouldn’t it be applicable to other, similar situations? Say a man, who we’ll call Mr. Wiggins, has been diagnosed with pancreatic cancer, a disease with a survivability rate as high as 25% in the most generous of cases, according to the Hirshberg Foundation. His cancer has already spread far enough into his body that any operation will be exceedingly difficult, and furthermore, his family lacks the income to pay for chemotherapy, which is often a very messy and painful process of treatment. With few viable avenues for treatment, Wiggins’s doctor tells him that he would have less than 8 months to live, over the course of which, his symptoms would grow worse and worse. Wiggins, being of sound mind, is now faced with a choice: choose to go through with treatment, putting unnecessary stress on himself and his family for a slim chance of survival, or pin a date on the calendar, and prepare for death at a time when he will still have his dignity. The latter of these is initially the more appealing option, removing the struggle that comes with treatment, and allotting time for preemptive mourning and maybe a bucket list to explore. As such, the Utilitarian argument is clear: Wiggins should pursue assisted suicide.
But this is also where the Kantian argument starts to swing the other direction, noting that even the lowest chance of survival is a chance large enough to take, as human life is to be treated with the highest respect and value. Both Mr. Wiggins and Mr. Ouchi are similar to the painlings in that their pain could be escaped through death, but Wiggins also differs from the painlings in that his suffering has alternate, albeit slim methods of alleviation. As there is not much pleasure to be gained in this decision, and only pain to evade, a cost benefit analysis of the situation would do us well. Choosing to go through with assisted suicide would result in a 100% chance of death, but with dignity. On the other hand, choosing to undergo treatment gives us a roughly 8-20% chance of survival and a life beyond, but an 80-92% chance of death despite these efforts, with all the added suffering of chemotherapy, and so on. The suffering seen in the more likely case of pursuing treatment significantly exceeds that of choosing to get it over with, and so it follows that this is also the least desirable choice, just as pouring money into the lottery will bankrupt a man far more often than it would award him his billions.
The case of Mr. Wiggins, one may argue, only works in that his decision has a voluntary component. What about cases where the person in question can’t communicate their desires? Then let us consider such a case: the case of Ms. Ficklepickle, a lady in her 30s who suffered a head injury in a car crash, sending her into a coma. Weeks later, she awoke, but in a persistent vegetative state (PVS), where her cerebral cortex has started to die and atrophy, rendering her unable to speak or even think, and possibly without consciousness. But, her brain isn’t entirely dead; her spinal cord at the very least continues to function, monitoring her heart beat and breathing cycles, though still without the ability to swallow or move her limbs beyond involuntary reactions. In order to keep Ficklepickle alive, a series or machines are attached to her body, including a heartrate monitor, a catheter, and a feeding tube down her throat. The argument for keeping her alive is, again, largely Kantian, that her life has intrinsic worth. It could further be argued that her PVS is only incurable due to the current state of technology and that keeping her body alive long enough to see adequate technology develop would save her life in the long run. Unfortunately, this argument is a bit far-fetched. Curing a PVS and restoring Ficklepickle’s brain to its previous functional state is on the same scale of structuring the entire brain itself on a cellular level, a subject whose surface that scientists today are only just beginning to scratch. It would take an extraordinary amount of time for this technology to develop, and the money sank into keeping this living corpse alive could be better used elsewhere, such as saving the life of a conscious person in need of heart surgery. Imagine if all patients sustaining a PVS were kept alive like this: we would have on our hands a pile of barely living bodies acting as a drain to our hospitals’ valuable resources while providing themselves nothing more than their own existence. Admittedly, if Ficklepickle’s body is killed through whatever means today, and if the technology needed to save her life is developed tomorrow (and that is a big “if”), then this line of reasoning would ultimately be in vain. But such a circumstance is incredibly unlikely, and Utilitarian cost-benefit analysis again leads us to the conclusion that FicklePickle is better off being killed than kept alive.
This line of reasoning isn’t without opposition, however. Some claim that it comes with some pretty dangerous implications. If we are to determine the threshold for who lives and who dies by the amount of suffering they’re sustaining, or how much they contribute to society as a whole, then where is the dividing line going to end up? Should we allow euthanasia for handicapped individuals for their inability to work? And if we should euthanize these people, wouldn’t it also be okay to euthanize people with poor genetic makeup, thereby making the gene pool of society less susceptible to certain disease, or the average population happier, or the average population more intelligent? Would it then be permissible to commit genocide on an entire race of humans on the basis that the color of their skin is unattractive, or that they, like painlings, are on an endless feedback spiral of pain and suffering and that all parties would be better off with them dead, rather than alive? Though this argument raises some serious concerns, it takes the form of a slippery slope. The utilitarian arguments above all take into consideration the will of the individual. The painlings and Mr. Ouchi clearly have or had a will to die, and if Mr. Wiggins decided to push forward with treatment, then that decision should be respected; after all, the fate of his life should be in his own hands, as no other being has the right to enforce their views of the morality of his situation onto him. Ms. Ficklepickle is a bit of an odd duck, given that her will to live is unknowable. However, it can also be said that the poor lady, in all likelihood, doesn’t have a will to do anything at all, nor will she at any point in the future, and so the burden of choice for whether she will live or die can then pass to others that do have a will and consciousness.
Existing laws that allow for physician assisted suicide also follow these restraints. The first such law in the United States was passed in 1994 in the state of Oregon, by the name of the Death with Dignity Act. This act allows a terminally ill patient to receive and take a lethal prescription provided that they can request it both in written and oral form, have received permission and recommendation from their physician. Opponents of this act commonly showed concern that people would flock to its use to the tune of several hundreds, and if not from Oregon alone, than from other states as well. There was concern that people would find more and more mundane reasons to commit suicide, and that the law would eventually lead to the idea that suicide is okay, so long as you have an excuse. But again, this is a slippery slope! To be fair, according to US Library of National Medicine, in the years since 1994, there has indeed been a steady increase of individuals seeking physician assisted suicide each year, but the increase has been relatively small, reaching 65 prescriptions and 38 deaths in 2005. But this number isn’t reaching anywhere near the supposed hundreds and hundreds of deaths. Furthermore, this increase in deaths and prescriptions is just as easily attributed to the fact that prior to the law being passed, there was simply no way to legally commit suicide. With these numbers, it is reasonably sufficient to say that the legalization of physician assisted suicide is not going to lead to a mass suicide apocalypse.
All things considered, these laws are still somewhat in their infancy, and there is no way of telling how things will develop in the future. However, with our current knowledge and our current technology, there are still limits to how well we can treat and repair our bodies. While we may not be able to electronically upload our brains to a supercomputer, we should still be able to rest easy knowing that we don’t have to suffer a grisly or painful death at the raw hands of nature, like our ancestors had. And why shouldn’t we have the option to avoid such a death? After all, when faced with the narrow choice of a short and quick death versus a long and painful one, most people would agree that the first option is the most welcome.
Works Cited
Battin, Margaret P et al. “Legal Physician‐assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in ‘vulnerable’ Groups.” Journal of Medical Ethics 33.10 (2007): 591–597. PMC. Web. 30 Apr. 2016.
Cholbi, Michael. "Suicide." Stanford Encyclopedia of Philosophy. Stanford University, 8 Oct. 2015. Web. 29 Apr. 2016. <https://plato.stanford.edu/archives/win2015/entries/suicide/>.
MacKinnon, Barbara, and Andrew Fiala. Ethics: Theory and Contemporary Issues. 8th ed. Stamford, CT: Cengage Learning, 2015. PDF.
NHK-TV “Tokaimura Criticality Accident” Crew. A Slow Death: 83 Days of Radiation Sickness. New York: Vertical, 2008. Print.
"Pancreatic.org." Prognosis of Pancreatic Cancer. Hirshberg Foundation for Pancreatic Cancer Research, 2010. Web. 30 Apr. 2016.
Young, Robert. "Voluntary Euthanasia." Stanford Encyclopedia of Philosophy. Stanford University, 06 July 2015. Web. 30 Apr. 2016. <https://plato.stanford.edu/archives/fall2015/entries/euthanasia-voluntary/>.
Jefferson Marshall
Jason Gooch
Philosophy 215
May 2, 2016
In Which I Ramble About Killing People
By most reasonable accounts, we hold it true that killing another living being (in particular, human beings), is wrong, in that it robs the individual of all future existence and pleasure. According to Kantian ethics, this is non-debatable; it is our moral duty to preserve life to the best of our ability, no questions asked. But what about cases where preserving life leads to no possible future pleasure, and instead leads to increasing amounts of pain with no hope for improvement? What about individuals who, for all intents and purposes, have already lost all conscious existence, but continue to live in such a way that costs absurd amounts of money and resources so as to cause suffering in the conscious beings that also rely on those resources? In these cases, a utilitarian approach leads to a much more reasonable conclusion: that euthanasia can often be the best option for avoiding the suffering caused in and of a dying individual.
First, let us establish that it is not impossible to kill someone, be it oneself or another, in a way that is morally sound. Given that we as humans are naturally inclined to want to survive and avoid death from both an individual and group standpoint, euthanasia and suicide are usually not very morally responsible things to do. But suppose that there exists a race of creatures for whom existence is intrinsically painful. (Let’s call these creatures “painlings.”) This pain is so extreme, and so excruciating, that humans cannot even begin to imagine it, and the only way to escape this pain is through death. Any sort of technological advancement for this species would be of little value, as the intense pain would eclipse any need or want for entertainment or even sustenance; sustaining oneself would be counter-intuitive. Would it be considered a morally sound action to knowingly create such a race of creatures? Obviously not; there’s not much need for discussion there. To create a painling is not much different from grabbing any innocent critter and torturing it. Now, let us consider instead that we came across a planet of painlings, yelling at us in agony and begging for the sweet release of death. Would it be morally permissible to launch a world-bursting torpedo at the planet, bathing it in hellfire and putting the painlings out of their misery once and for all? Or should we fly away in our spaceship, leaving them to suffer on their own? The Utilitarian would easily argue that launching the nuke is the best option, as it ends what may be centuries of suffering, and even throws in a bit of fireworks to boot. What is more interesting is that even a Kantian approach would find trouble leaving the planet to its own devices. Leaving the planet alone in order to remain comfortable would breach an imperfect duty to kill the painlings, who are clearly motivated to have themselves killed for the purposes of ending their suffering.
This thought experiment concerning painlings lends itself very well to some real world examples. Let’s start with a single person, a man by the name of Hisashi Ouchi, whose story is documented in the NHK-TV crew’s book, A Slow Death: 83 Days of Radiation Sickness. The fittingly named Mr. Ouchi was a worker at a nuclear power plant in Tokaimura, Japan, where, on September 30th, 1999, he was exposed to 17 Sieverts (Sv) of radiation during a criticality accident, well over twice the amount of radiation that is considered fatal, 7 Sv. In a matter of days after he and his coworkers were admitted to the hospital, Ouchi was already begging for death, as his DNA-damaged skin and muscle began to rot and melt off of his very limbs and body. Suffering from cancerous tumors, cardiac arrests, organ failures, and a destroyed immune system, Ouchi had undergone several blood transfusions and skin grafts before eventually passing out. The family desperately wanted Ouchi to survive, having the hospital do everything in its power to make sure that he lived - while the nurses tending to him frequently had to question whether his life was worth the effort and resources. It wasn’t until December 20th that his doctor convinced Ouchi’s family to allow a do not resuscitate order to be placed, and Ouchi finally died on December 22nd, 83 days later. By all accounts, Ouchi was a doomed man the moment the uranium he was handling went critical, and the efforts that went toward piecing back together his rapidly crumbling body only prolonged the suffering of both himself, and his family, who could have been through mourning if he had died on day one. The moral conclusions made here are consistent with that of the plight of the painlings; to prolong a creature’s suffering is immoral when concerned with the well-being of conscious creatures, especially so when there is no hope for recovery. As such, Ouchi should have been euthanized from the very beginning, via lethal injection or some other instantaneous means, to save both himself and his family from the struggle that would come over the next several months.
If this logic works for just one individual with radiation poisoning, why shouldn’t it be applicable to other, similar situations? Say a man, who we’ll call Mr. Wiggins, has been diagnosed with pancreatic cancer, a disease with a survivability rate as high as 25% in the most generous of cases, according to the Hirshberg Foundation. His cancer has already spread far enough into his body that any operation will be exceedingly difficult, and furthermore, his family lacks the income to pay for chemotherapy, which is often a very messy and painful process of treatment. With few viable avenues for treatment, Wiggins’s doctor tells him that he would have less than 8 months to live, over the course of which, his symptoms would grow worse and worse. Wiggins, being of sound mind, is now faced with a choice: choose to go through with treatment, putting unnecessary stress on himself and his family for a slim chance of survival, or pin a date on the calendar, and prepare for death at a time when he will still have his dignity. The latter of these is initially the more appealing option, removing the struggle that comes with treatment, and allotting time for preemptive mourning and maybe a bucket list to explore. As such, the Utilitarian argument is clear: Wiggins should pursue assisted suicide.
But this is also where the Kantian argument starts to swing the other direction, noting that even the lowest chance of survival is a chance large enough to take, as human life is to be treated with the highest respect and value. Both Mr. Wiggins and Mr. Ouchi are similar to the painlings in that their pain could be escaped through death, but Wiggins also differs from the painlings in that his suffering has alternate, albeit slim methods of alleviation. As there is not much pleasure to be gained in this decision, and only pain to evade, a cost benefit analysis of the situation would do us well. Choosing to go through with assisted suicide would result in a 100% chance of death, but with dignity. On the other hand, choosing to undergo treatment gives us a roughly 8-20% chance of survival and a life beyond, but an 80-92% chance of death despite these efforts, with all the added suffering of chemotherapy, and so on. The suffering seen in the more likely case of pursuing treatment significantly exceeds that of choosing to get it over with, and so it follows that this is also the least desirable choice, just as pouring money into the lottery will bankrupt a man far more often than it would award him his billions.
The case of Mr. Wiggins, one may argue, only works in that his decision has a voluntary component. What about cases where the person in question can’t communicate their desires? Then let us consider such a case: the case of Ms. Ficklepickle, a lady in her 30s who suffered a head injury in a car crash, sending her into a coma. Weeks later, she awoke, but in a persistent vegetative state (PVS), where her cerebral cortex has started to die and atrophy, rendering her unable to speak or even think, and possibly without consciousness. But, her brain isn’t entirely dead; her spinal cord at the very least continues to function, monitoring her heart beat and breathing cycles, though still without the ability to swallow or move her limbs beyond involuntary reactions. In order to keep Ficklepickle alive, a series or machines are attached to her body, including a heartrate monitor, a catheter, and a feeding tube down her throat. The argument for keeping her alive is, again, largely Kantian, that her life has intrinsic worth. It could further be argued that her PVS is only incurable due to the current state of technology and that keeping her body alive long enough to see adequate technology develop would save her life in the long run. Unfortunately, this argument is a bit far-fetched. Curing a PVS and restoring Ficklepickle’s brain to its previous functional state is on the same scale of structuring the entire brain itself on a cellular level, a subject whose surface that scientists today are only just beginning to scratch. It would take an extraordinary amount of time for this technology to develop, and the money sank into keeping this living corpse alive could be better used elsewhere, such as saving the life of a conscious person in need of heart surgery. Imagine if all patients sustaining a PVS were kept alive like this: we would have on our hands a pile of barely living bodies acting as a drain to our hospitals’ valuable resources while providing themselves nothing more than their own existence. Admittedly, if Ficklepickle’s body is killed through whatever means today, and if the technology needed to save her life is developed tomorrow (and that is a big “if”), then this line of reasoning would ultimately be in vain. But such a circumstance is incredibly unlikely, and Utilitarian cost-benefit analysis again leads us to the conclusion that FicklePickle is better off being killed than kept alive.
This line of reasoning isn’t without opposition, however. Some claim that it comes with some pretty dangerous implications. If we are to determine the threshold for who lives and who dies by the amount of suffering they’re sustaining, or how much they contribute to society as a whole, then where is the dividing line going to end up? Should we allow euthanasia for handicapped individuals for their inability to work? And if we should euthanize these people, wouldn’t it also be okay to euthanize people with poor genetic makeup, thereby making the gene pool of society less susceptible to certain disease, or the average population happier, or the average population more intelligent? Would it then be permissible to commit genocide on an entire race of humans on the basis that the color of their skin is unattractive, or that they, like painlings, are on an endless feedback spiral of pain and suffering and that all parties would be better off with them dead, rather than alive? Though this argument raises some serious concerns, it takes the form of a slippery slope. The utilitarian arguments above all take into consideration the will of the individual. The painlings and Mr. Ouchi clearly have or had a will to die, and if Mr. Wiggins decided to push forward with treatment, then that decision should be respected; after all, the fate of his life should be in his own hands, as no other being has the right to enforce their views of the morality of his situation onto him. Ms. Ficklepickle is a bit of an odd duck, given that her will to live is unknowable. However, it can also be said that the poor lady, in all likelihood, doesn’t have a will to do anything at all, nor will she at any point in the future, and so the burden of choice for whether she will live or die can then pass to others that do have a will and consciousness.
Existing laws that allow for physician assisted suicide also follow these restraints. The first such law in the United States was passed in 1994 in the state of Oregon, by the name of the Death with Dignity Act. This act allows a terminally ill patient to receive and take a lethal prescription provided that they can request it both in written and oral form, have received permission and recommendation from their physician. Opponents of this act commonly showed concern that people would flock to its use to the tune of several hundreds, and if not from Oregon alone, than from other states as well. There was concern that people would find more and more mundane reasons to commit suicide, and that the law would eventually lead to the idea that suicide is okay, so long as you have an excuse. But again, this is a slippery slope! To be fair, according to US Library of National Medicine, in the years since 1994, there has indeed been a steady increase of individuals seeking physician assisted suicide each year, but the increase has been relatively small, reaching 65 prescriptions and 38 deaths in 2005. But this number isn’t reaching anywhere near the supposed hundreds and hundreds of deaths. Furthermore, this increase in deaths and prescriptions is just as easily attributed to the fact that prior to the law being passed, there was simply no way to legally commit suicide. With these numbers, it is reasonably sufficient to say that the legalization of physician assisted suicide is not going to lead to a mass suicide apocalypse.
All things considered, these laws are still somewhat in their infancy, and there is no way of telling how things will develop in the future. However, with our current knowledge and our current technology, there are still limits to how well we can treat and repair our bodies. While we may not be able to electronically upload our brains to a supercomputer, we should still be able to rest easy knowing that we don’t have to suffer a grisly or painful death at the raw hands of nature, like our ancestors had. And why shouldn’t we have the option to avoid such a death? After all, when faced with the narrow choice of a short and quick death versus a long and painful one, most people would agree that the first option is the most welcome.
Works Cited
Battin, Margaret P et al. “Legal Physician‐assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in ‘vulnerable’ Groups.” Journal of Medical Ethics 33.10 (2007): 591–597. PMC. Web. 30 Apr. 2016.
Cholbi, Michael. "Suicide." Stanford Encyclopedia of Philosophy. Stanford University, 8 Oct. 2015. Web. 29 Apr. 2016. <https://plato.stanford.edu/archives/win2015/entries/suicide/>.
MacKinnon, Barbara, and Andrew Fiala. Ethics: Theory and Contemporary Issues. 8th ed. Stamford, CT: Cengage Learning, 2015. PDF.
NHK-TV “Tokaimura Criticality Accident” Crew. A Slow Death: 83 Days of Radiation Sickness. New York: Vertical, 2008. Print.
"Pancreatic.org." Prognosis of Pancreatic Cancer. Hirshberg Foundation for Pancreatic Cancer Research, 2010. Web. 30 Apr. 2016.
Young, Robert. "Voluntary Euthanasia." Stanford Encyclopedia of Philosophy. Stanford University, 06 July 2015. Web. 30 Apr. 2016. <https://plato.stanford.edu/archives/fall2015/entries/euthanasia-voluntary/>.
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