- The Ethics of Killing: Problems at the Margins of Life by Jeff McMahan
Oxford, 554 pp, £35.00, February 2002, ISBN 0 19 507998 1
Two-thirds of the way through this dense, involved and exhausting book, its author acknowledges that his views about the nature of persons have the following implication. Suppose that a woman, without family or friends, dies giving birth to a healthy infant. At the same hospital there are three five-year-old children who will die if they do not receive organ transplants, and the newborn has exactly the right tissue type. If Jeff McMahan’s theory is right, it is morally permissible to ‘sacrifice’ the orphaned infant in order to save the other three children.
We can hold off for a moment on the question of why his theory has this implication. The simple fact that it does, as he points out, appears to be a reductio ad absurdum of his position. And McMahan has the grace to confess that he ‘cannot embrace’ this implication ‘without significant misgivings and considerable unease’. But he embraces it nevertheless, since he continues his examination of abortion and euthanasia for a further 150 pages, still drawing on the same account of the nature of persons that led to the apparent reductio in the first place – as if simply acknowledging its existence constituted a sufficient settling of accounts with it.
Reduction to absurdity is, of course, a fate that any philosophical theory might meet – although it is relatively rare for a theorist simultaneously to underline and ignore this flaw in his progeny. But such split-mindedness is peculiarly disturbing when the theory concerns itself with morality, since in such a context a reductio argument confronts us with moral absurdity – or, to put it more bluntly, with the morally intolerable, the morally unthinkable. Elizabeth Anscombe once said that anyone who thought in advance that it was open to question whether an action such as procuring the judicial execution of an innocent person should be entirely excluded from consideration showed a corrupt mind. She thereby expressed a (highly controversial but hardly unintelligible) fear not only of evil actions, but of thinking evil thoughts – a fear of the dulling and degrading of moral sensibility that such acts of contemplation can encourage and express. The analogy with McMahan’s moral absurdity is not exact. A morally innocent victim is certainly central to his cautionary tale; but while (to his credit) he cannot bear explicitly to accept this evil consequence of his theory, he also cannot bear to reject the theory on its account. On the contrary, he acts as if his claim to be a serious moral thinker would be more severely damaged if he took such evil consequences as sufficient reason to abandon his theoretical endeavour. Being a fearless thinker matters more, it seems, than avoiding morally fearful thoughts.
In this respect, his work is representative of the mainstream of contemporary practical ethics in the Anglo-American philosophical world. Take the fact that the moral intolerability of his theory is revealed by invoking an imaginary case. The Ethics of Killing is full to bursting with such thought-experiments, or ‘cases’ as McMahan calls them. Their deployment is a central technique in the modern moral philosopher’s tool-kit; it is even the way some philosophers achieve a kind of immortality – as with Judith Jarvis Thomson and her ‘case’ of the woman to whom a violinist is hooked up for life support, a case designed to illustrate a certain argument for abortion (McMahan’s critical discussion of it is the best I have seen).
The Ethics of Killing puts this technique to more systematic and imaginative use than any other book I know of. McMahan’s cases even get a separate, and very useful, index – although its enigmatic entries (‘The Pipe Sealer’, ‘The Accidental Nudge’, ‘The Whole-Body Transplant’) irresistibly reminded me of the ‘Concordance of Nicola Six’s Kisses’ in Martin Amis’s London Fields (‘The Rosebud’, ‘Clash of the Incisors’, ‘The Turning Diesel’). However, inventing, varying and examining such cases requires and encourages the exercise of a certain kind of imagination – the kind evoked by the label ‘thought-experiments’. These cases are devised rather than created, modified rather than rewritten, analysed rather than entered into; they invite precisely the epithets with which McMahan’s book has been greeted – ‘novel and ingenious’, Peter Singer tells us on the dust-jacket, rather than, say, ‘wise and insightful’.
McMahan’s ‘Sacrificial Newborn’, with which we began (my title, not his; strangely, it doesn’t appear in his index), is a case in point. Its sole rationale is to present us with a lightly clothed calculation. Eliminate anyone with whom the newborn might have a human relationship (since their distress might complicate the sums), and whistle up enough older children to outnumber our orphan (thereby forcing us to acknowledge that three is at least three times greater than one). It’s an arithmetical tale, morality by numbers – and the simpler the texture, the clearer the point.
But what if our concern were not clarity but understanding, or an engagement of our moral imagination with something resembling the texture and complexity of human reality? Not only is medical unlikelihood bypassed for McMahan’s purposes (no tissue-typing problems); we hear nothing of the family and friends of the three five-year-olds. This is presumably because their obvious joy at the redemption of their children would simply shift the balance of calculation even further in the same direction. But what if the mother of one of these children discovers the source of her daughter’s new organs? Would her joy be untainted by this knowledge? Is it obvious that she, or any of the parents involved, would regard it as legitimate for a healthy orphan to be thus abused? Is it obvious that any of them, or indeed any of the hospital staff, would not feel an obligation to the memory of the newborn’s dead mother that might make them hesitate over its ‘sacrifice’?
The full text of this book review is only available to subscribers of the London Review of Books.
Vol. 24 No. 17 · 5 September 2002
In June 1944 the chance of war has made a young British officer part of an Italian resistance formation. When an Allied arms drop is signalled he is in charge of its reception. Arriving at the dropping zone he meets a group of Italians led by his second in command, an Italian officer, who takes him aside and says that there is a man too many in the group – a man unknown to anyone. The British officer interrogates the man – he is in his late teens – who is unable to explain his presence. It would be impossible to keep a prisoner secure. The drop is imminent. The British officer consults with his Italian colleague who says: You are in command here. The British officer says the man has to be got rid of. He is duly shot.
Having been that officer, I am still worried by the ‘case’, which seems to me more difficult to deal with than an imaginary one concerning the ‘sacrifice’ of an orphaned infant, discussed by Stephen Mulhall (LRB, 22 August).
Vol. 26 No. 16 · 19 August 2004
What makes David Wootton think that the ‘mysterious mathematics’ of conjoined twins raises questions which ‘have been ignored by philosophers’ (LRB, 22 July)? The moral dilemmas presented by such cases have been extensively debated in the field of applied ethics, usually as part of broader discussions about organ transplants, euthanasia, abortion and the treatment of severely disabled people. The implications of these cases for our understanding of personal identity have been at the heart of contemporary debates in the philosophy of mind, usually in conjunction with a variety of real and imagined cases of brain-division, brain transplantation, bodily fusion and so on. Whether any of these discussions have advanced our moral or metaphysical understanding may, of course, be doubted; but that is a rather different charge.
As is often the case, ignorance of the relevant philosophical debates here nourishes fantasy. Take Wootton’s critique of the legal judgments made in the case of the conjoined twins Gracie and Rosie Attard. He rightly rejects the suggestion that Rosie ‘sucks the life-blood out of Gracie’, but then claims that a better image for their position in a shared body is that of passengers in an overcrowded lifeboat: ‘The lifeboat belongs equally to each one of them.’ The modern source of debates about the relation between human identity and embodiment is Descartes, who is often accused of advocating a simple (even simple-minded) dualism, characterising persons as mind conjoined with bodies. In his Meditations, he explicitly considers the suggestion that a person’s mind is lodged in her body as a pilot is in the ship whose course he is guiding, but rejects it on the grounds that it underestimates the intimacy of the union. Wootton’s image is more Cartesian than Descartes’s own. Even if it permits Rosie to be as much a ghost in this physiological machine as Gracie, both appear as lodged in their body, as if it is their (common) possession; so their body appears as possessed or haunted by their minds or psyches or souls – in any case, by them. Is this really the right way to acknowledge that humans are embodied, flesh and blood creatures?
David Wootton’s statement that obstetricians face more difficult choices in cases of conjoined twins than they do in cases involving the priority as between a foetus and its mother may be simplistic. English law does favour the survival of a mother over an unborn foetus, but Shyam Kothan, in a recent piece in the British Medical Journal, records a case in which a fully competent and informed pregnant woman chose the life of her unborn child over her own: ‘Just as a runner passes on the baton to the next one in a relay race, so she gave birth to her daughter and died.’ Wootton suggests that had Rosie and Gracie been able to speak, if Gracie had protested, ‘Stop it [Rosie], you’re killing me,’ Rosie might well have responded: ‘It isn’t your life-blood, Gracie, it’s ours.’ However, Kothan’s example raises the possibility that either sister may have willingly sacrificed herself for the other.
Wootton’s claim that for ‘two centuries no one has felt the need to ask whether Byrne ought to be on display’ is incorrect: Hilary Mantel did just that in The Giant, O’Brien in 1998.
Vol. 26 No. 17 · 2 September 2004
I was surprised by the tone of Stephen Mulhall’s letter in response to my essay on conjoined twins, and to be told that I had demonstrated ignorance of the philosophical debates on applied ethics, personal identity and the mind-body problem (Letters, 19 August). Fourteen lawyers were in court for the Gracie and Rosie Attard case in September 2000; all recognised they were engaged in a philosophical as well as a legal debate. Lord Justice Walker’s judgment included a list of academic authorities on the ethics of euthanasia. A section of Lord Justice Brooke’s judgment was headed ‘Necessity: modern academic writers’. But these authors were of limited help because the choice the court faced was different in character from the situations they had discussed. I gather, however, that the philosophical literature has moved on since 2000, particularly with the publication of Jeff McMahan’s The Ethics of Killing, reviewed by Mulhall in the LRB (LRB, 22 August 2002).
As for personal identity, there are plenty of philosophical discussions of ‘brain-division, brain transplantation, bodily fusion and so on’, but none, I think, of conjoined twins. Finally, I said nothing about the mind-body problem. I did say that the position of Gracie and Rosie was comparable to that of passengers in an overcrowded lifeboat, in that one could survive only at the expense of the other, yet both had a right to be in the boat. Arguments about this sort of situation go back to Cicero. Mulhall moves from my word ‘belongs’ to his word ‘possession’, and, via a pun, to ‘possessed or haunted’, conjuring up a Cartesian ‘ghost in this physiological machine’. So he convicts me of holding a sub-Cartesian position on the mind-body problem when I said nothing at all about the relationship between minds and bodies: what I discussed was the situation of two people who were completely dependent on a resource (oxygenated blood) of which the supply was insufficient, and what I argued was that the blood couldn’t properly be said to ‘belong’ to just one of them. Mulhall claims that my ignorance ‘nourishes fantasy’, but here at least he is arguing with a fantasy figure, not with me.
University of York