In his book chapter, Singer examines the euthanasia issue, and breaks it down into three types: Voluntary Euthanasia (VE) (the person is cognizant and aware at the time and chooses this option), Involuntary Euthanasia (IE) (the person is not cognizant and aware, but has at some time indicated that they wish to die and this action is carried out only in order to cease suffering), and Non-Voluntary Euthanasia (NVE) (this is the ethically controversial situation in which the person is no longer cognizant nor aware in order to make a choice).
The gripping issues in NVE are that the intentions of the subject are not evident, which raises issues such as for whom is the death a benefit or harm, and under what circumstances does that benefit or harm take place (e.g., morphine in order to lessen the discomfort). Besides playing into the current Schiavo debate, this is also relevant when considering the Groningen Protocol I posted about earlier. Especially as in all these cases the subject is not capable of self-determination, does not have self-awareness, and does not possess any significant power of rationality. He utilizes spina bifida in a great way to shed light on the ethical issues that arise in NVE from a utilitarian perspective. And ultimately that is one of the best tools that one can use to begin an analysis of an ethically controversial dilemma; that is, what will bring the greatest amount of good to each member involved –there are, of course, limits to the utilitarian scope, as this is not a naïve theory (and a brief explanation on the nuanced aspects of utilitarianism can be found at the Wikipedia).
He makes a great distinction between being biographically alive (i.e., cognizant and autonomous) and being alive solely on a biological level (i.e., all systems go except no awareness, in much the same way as a dreamless/experienceless night of sleep). This is best described in his own words:
If they have no experiences at all, and can never have any again, their lives have no intrinsic value. Their life's journey has come to an end. They are biologically alive, but not biographically. (If this verdict seems harsh, ask yourself whether there is anything to choose between the following options: (a) instant death or (b) instant coma, followed by death, without recovery, in ten years' time. I can see no advantage in survival in a comatose state, if death without recovery is certain.) The lives of those who are not in a coma and are conscious but not self-conscious have value if such beings experience more pleasure than pain, or have preferences that can be satisfied; but it is difficult to see the point of keeping such human beings alive if their life is, on the whole, miserable.
Note that while these words may prima fascia sound harsh (e.g., no value), this is for the sake of philosophical accuracy and those readers not familiar with this language should not be turned off by it –instead, feel free to comment and I will do my best to explain!
He then goes on to make a distinction between killing and an omissive act (i.e., euthanasia by noted inaction). This distinction makes use of the double effect very well in a way to tease-apart the above, as this is highly controversial between the Edict Driven Approach folks and the Mechanistic Approach folks. What he points out very well is something that I struggled with while learning about the double effect: if I know the consequences of my actions, why am I not responsible for both outcomes? This, of course, is a difference between two schools of ethics: consequentialist and virtue ethics. Noting that the double effect is useless to the consequentialist school (and likely, to the utilitarian school therefore…). He offers that the best way to deal with the issue is to face it head on: admit that the goal is to cause a death as a way of minimizing suffering.
As an aside, the Dude’s evening class resumed and so I’m unlikely to post on Tuesdays and Thursday…