Life and Death
- The End of Life by James Rachels
Oxford, 196 pp, £12.95, January 1986, ISBN 0 19 217746 X
- Voluntary Euthanasia edited by A.B. Downing and Barbara Smoker
Peter Owen, 303 pp, £14.95, February 1986, ISBN 0 7206 0651 9
- Moral Dilemmas in Modern Medicine edited by Michael Lockwood
Oxford, 250 pp, £12.95, January 1986, ISBN 0 19 217743 5
Most professional philosophers think of themselves primarily as scholars, as hunters and gatherers in the field of understanding with no particular commitment to serve society in any other role. Yet some philosophers have lately found to their delight that they can be useful: indeed that their advice is actually sought by those who have to take decisions of policy or practice. So now in England we have the Warnock Report, while in America philosophers advising hospital ethics committees have been known to carry bleepers to summon them to conferences on matters of life and death. Medical ethics – a subject unheard of only a few decades ago – is lately the main growth area in philosophical publishing, with books, anthologies and journals on subjects such as abortion, euthanasia and medical experimentation tumbling out at a prodigious rate.
The full text of this book review is only available to subscribers of the London Review of Books.
Vol. 8 No. 17 · 9 October 1986
SIR: If Philippa Foote’s incredulous astonishment at the suggestion that severely retarded children be killed is genuine (LRB, 7 August), and not merely the hysteria that often accompanies moral outrage in women (itself unsuitable in a serious critic), she seems too naive to be reviewing serious books at all. Or perhaps it is a means of discrediting by ridicule the serious and quite sane people who recommend it. A reader waits vainly for some mention of the viable alternative that her vehemence suggests she has in mind. We do not expect her to provide a solution to the problem, but we do expect her to acknowledge that it is one. In discussing voluntary euthanasia, about which her views seem rational and calm, she writes: ‘to most of us … it seems that if a dying person has got to the stage at which we hope for his sake for a speedy end, then we would want to be able to listen to his demand that we help him to die soon.’ A severely brain-damaged child is a dying person (when he is a person) all his life, but Professor Foote would seemingly be willing to force the ‘right to live’ upon him without finding it at all necessary to ‘hope for his sake for a speedy end’, an end that, owing to the frightful efficiency of medical science, is likely to be far from speedy. It seldom occurs to champions of the ‘right’ to live that this implies the ‘right’ to die: if it does not, living is not a right but a tyranny. A severely retarded infant, who will with average ill-luck grow up to be a severely retarded adult, has rights only in a metaphorical sense, since his real rights are usurped for ever by his next of kin. Only a human being with a functioning brain, capable, according to expectation, of eventually taking over his life from the adults who are his regents, can have rights if the word is to have any meaning at all. A human being without it is a person only by courtesy of the unhappy adults who must somehow reconcile themselves to living with him.
Rhinebeck, New York
SIR: Philippa Foot is amazed by the likes of Michael Tooley and James Rachels, and she has amazed me in turn. The moral conclusions drawn by these gentlemen do not suit her, but instead of looking to their arguments to see where they went wrong, or entertaining the notion that they might be correct, she responds like a vigorous pathologist who has spotted disease. Soon enough she unearths the microbe of utility at work and prescribes a stiff dose of rights as cure.
Utilitarianism is a troublesome doctrine, but so is the theory of rights, as demonstrated by tough-minded philosophers a generation ago, who were preceded by an earlier generation of critics at work before the Second World War. The issues of medical ethnics, as Foot acknowledges, remain extremely troublesome, too troublesome to be met by quick gestures and comfortable presumptions.
Vol. 8 No. 18 · 23 October 1986
SIR: Two correspondents in the last number of your paper take issue with me. We should ask the first, Vera Liebert, if we are to kill severely retarded children for their sakes, or for ours? And is it all right to kill the senile as well, provided they are senile enough?
Gerard Elfstrom seems to have missed the long central paragraph of my review in which I single out for reasoned criticism the mistake that James Rachels and others have made in denying moral relevance to the distinction between allowing something to happen and bringing it about. It is a grave charge against utilitarianism that it cannot accommodate this part of our everyday morality.
University of California, Los Angeles