Reflections from the Front: Bad Ideas
Drs. W. Sinott-Armstrong and F.G. Miller (Sinnott-Armstrong W, Miller FG. J Med Ethics (2012). doi:10.1136/medethics-2011-100351) in a Featured Article in the Journal of Medical Ethics, entitled “What Makes Killing Wrong” write that :
“What makes an act of killing morally wrong is not that the act causes loss of life or consciousness but rather that the act causes loss of all remaining abilities. This account implies that it is not even pro tanto [only to that extent] morally wrong to kill patients who are universally and irreversibly disabled, because they have no abilities to lose. Applied to vital organ transplantation, this account undermines the dead donor rule and shows how current practices are compatible with morality.”
While I usually write on issues from the front, I make an exception for this reflection on an article from the literature, because of its profound implications for those of us on the front.
This article is firmly entrenched in a view that makes no distinction between human life and other life. It employs circular logic–since we know that human life is of no greater value than other forms of life, we should treat it essentially as any other form of life–so we will.
They predict the future–no meaningful life–for severely injured patients. Time and again, such prediction has been shown to be fraught with error. This is one of the major weaknesses of utilitarianism. It pretends to be able to predict outcomes of actions. One of the deep truths in politics and society is the law of unintended outcomes. Well-meaning people make principled decisions that turn out very poorly because things don’t turn out as predicted. (Take Welfare laws, for instance.)
They state “If [human] life were [sic] sacred then all life would be sacred,” but they don’t define sacred, or show good reason why this statement should be accepted. It is based on an atheistic evolutionary position (theistic evolution might still maintain that humans are distinct from animals in their moral worth) that says that since we all evolved from the slime, no human is of greater moral worth than any other living thing. Hard core environmentalists have a saying “A rat is a pig is a dog is a boy”, which allows them to ignore people affected by environmental decisions, in favor of trees, or darter fish, or whatever. While trees are very important, people are inherently of more worth.
They declare, but don’t effectively defend, that human worth is based solely on abilities. They never prove this point, but assume it. Most Protestants, Catholics and Jews, among others, maintain that human worth is based on our being created in God’s image, not in what we can or cannot do.
It is hard at times to enter the public arena and be respectful of others from all positions. A typical flawed position is to state that since we can’t prove a religious position to be materially true it cannot be posited in a public debate. This is in itself, however, a faith statement, namely that God doesn’t count in these deliberations. A good book on this written a few years ago by Audi and Wolterstorff titled “Religion in the Public Square” provides an enlightening discussion of this complex issue.
Ad hominem arguments come in various forms. These authors lump “traditionalists” (whoever they are) into one group and then paint them as backward. It is a subtle, but recurring ploy they use to preemptively denigrate the opinions of those likely to disagree with them.
They assume that Donation after Cardiac Death (DCD) is a proven, morally acceptable position. This is still an open question and is widely debated. In 2009, Verheijde, Rady, and McGregor wrote an excellent review article (Philosophy, Ethics, and Humanities in Medicine 2009, 4:15) on the flaws of this position and called for a moratorium on DCD. When bad ideas are initially discussed people are revolted. Later, they are intrigued, then engaged, then supportive. Finally they act as if the idea is so clearly self-evident that it need not be defended. I’m not sure if DCD is a terrible idea or not, but it is not the clear best solution to our organ shortage.