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Archive for July 2008

The Sense of the Asymmetry

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In my most recent piece, “The Austrian Basement and Beyond: Consequences of Rejecting the Antinatalist Asymmetry,” I introduced a couple of examples – the Austrian Basement and Slum World – in order to make a point about the intuitive soundness of the asymmetry that philanthropic antinatalism rests upon, and the consequences of rejecting the asymmetry.

In the Austrian Basement case, I introduced a scenario that, I think, is difficult to analyze in good faith while rejecting the asymmetry. If absent pain were not good, why should we feel a sense of relief should E. F. decide to use the birth control? If absent pleasure were not a much lesser moral consideration – were it not in fact merely neutral or not good, but not bad either – why should we feel horror at the prospect of babies being born into the dungeon?

This is especially important for those who still cling to the “non-identity problem” as a genuine problem. “How can a baby be harmed by being born into the dungeon? Before the baby is born, there’s no one to be harmed! And if no one is harmed, it is not a wrong. So procreate away!” But, of course, it is wrong. We have a duty to avoid creating babies in dungeons. To demand that there be someone to be harmed before we recognize a wrong strikes me as a bit silly. I am with Professor Benatar that it is enough that an outcome be bad for a person, in the sense of worse than the alternative (nonexistence), to qualify the bringing about of that outcome as a wrong.

In the case of Slum World, I attempted to put a concrete face on the so-called “repugnant conclusion” of aggregate well-being measures, and to demonstrate that the claim that nonexistent people have for happiness/existence is weak (that absent pleasure, if someone is not thereby deprived, is merely neutral). The prospective inhabitants of Slum World do not have a strong claim to come into existence. The nonexistence of their pleasures is merely neutral, and the nonexistence of their pain is just good. This is true even though, once born, the inhabitants of Slum World would presumably choose to keep living (lead lives worth continuing). Low Population Splendor World is good, Slum World is awful, and rejecting the asymmetry seems to require one to claim otherwise.

Coming into existence is sui generis, and it is difficult to construct clear examples to use in testing intuition that aren’t just different situations of bringing people into existence. My last example, below, attempts to illustrate something like the asymmetry without being about bringing people into existence.

3. Commercial Children’s Television

An advertisement for a new children’s toy runs several times per hour on a commercial children’s television program. The advertisement creates a desire for the toy in the children who see the commercial. Of these children, many of them will eventually receive the toy from their parents, but others will not. Still other children, cruelly brought to life in the households of liberal academics, do not have televisions and therefore do not see the advertisement, and never desire the toy at all.

a. Which group out of the three is best off?

b. Do television advertisers actually do children good by creating desires that might later be fulfilled?

Written by Sister Y

July 31, 2008 at 1:46 am

The Austrian Basement and Beyond: Consequences of Rejecting the Antinatalist Asymmetry

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David Benatar’s philanthropic antinatalism, explored in his book Better Never To Have Been: The Harm of Coming Into Existence, rests on an asymmetry between pain and pleasure: that, while absent pain is always good, absent pleasure is merely neutral, not bad, given that there is no one who was deprived of this pleasure. A related asymmetry is that, while there is a moral duty to avoid having a child who will be miserable (lead a life not worth continuing), there is no moral duty to create a child who would lead a life very much worth continuing.

Benatar explains the pain/pleasure asymmetry in depth in Chapter 2 of the book, and those who feel they have a slam-dunk logical objection to the asymmetry might be advised to read the detailed treatment of the asymmetry in the chapter before assuming Professor Benatar just missed the objection. Ultimately, though, there remain real, non-trivial objections to the asymmetry, because the asymmetry is built using the common ethical philosophy tool of explaining and analyzing commonly held intuition. Since the asymmetry is ultimately based on intuition, it may be disputed by those who, in good faith, do not share the intuitions upon which it is built.

Many, however, deny the asymmetry without fully grasping the consequences of the asymmetry. I wish to map out some ethical problems that those who deny the asymmetry must explain in a manner consistent with rejecting the asymmetry.

1. The Austrian Basement

E. F. has been kidnapped by her father and imprisoned in an Austrian cellar since her early adolescence. Her father repeatedly rapes her over the course of several years. E. F. gives birth to several children sired by her father. She reasonably believes that all these children have severe health problems, and that at least the female children will likely be abused by her father as they grow up.

In Year 10 of her imprisonment, with four children born and removed from her by her father, she discovers a box (unknown to her father) hidden under a floorboard in her cell, containing everything she needs in order to practice undetectable birth control.

a. Does she have a duty to practice birth control and avoid having more babies? Does she have a duty not to practice birth control, because she would be depriving her unborn babies of life (which, while it would have certain problems, would nevertheless presumably be worth living)? (Assume she would like the company of more babies, but fears the pain of more unassisted childbirth, and the “interests of the unborn children” is the concern that will break the tie, given her personal ambivalence.)

b. Why?

c. (Only for those who think that antinatalism requires suicide.) If you answered that the daughter has a duty to practice birth control, is that the same as saying that the real-life E. F.’s seven children have worthless lives and should be put to death?

Of course, I’m making up the part about the birth control choice, but here’s an excerpt from the real life story:

The dungeon in which they lived was so small that the older ones had to watch as his father delivered his daughter’s subsequent children. Presumably they also had to watch as he had intercourse with his daughter to beget them – she claims that he repeatedly raped her – and regularly beat her. The dungeon contained one padded room, its walls and floor covered in rubber, the purpose of which is still unclear.

2. Slum World

The Supreme World Leaders meet in Tokyo in 2100 and decide that the world has a choice. Either the 2100 world population of 3 billion can be maintained in relative splendor, with fresh kumquats and sensory implants for everyone, or the world population can be increased to 100 billion, with everyone living in conditions similar to the conditions of a 20th century slum, apparently endured by upwards of 900 million people circa the year 2000.

a. Which condition should the Supreme World Leaders choose?

b. Why?

c. If you answered that Low Population Splendor World is preferable to Slum World, what about the interests of the unborn people who would have come into existence had Slum World been selected? Aren’t they being harmed by not being brought into existence? What right to the inhabitants of Low Population Splendor World have to deny the extra 97 billion people a right to exist, just for the sake of the happiness of 3 billion?

Written by Sister Y

July 29, 2008 at 9:01 pm

The Moral Effect of "Being Glad It Happened"

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In my post “When It’s Permissible To Force Someone To Stay Alive For His Own Good” and elsewhere, I have addressed the fact that many people who are forcibly prevented from committing suicide later report being glad they were forced to stay alive. This fact is often used to justify coercive suicide prevention practices.

Similarly, the vast majority of people appear to report that they are glad to have been born. This is occasionally used as a justification for procreation (against antinatalist arguments).

While I am not attempting, in this piece, to address the question of whether suicide or procreation is right or wrong, I wish to question the validity of the argument that goes something like this:

  1. Action
  2. Object of the action is later glad the action occurred
  3. Therefore, Action was morally correct.

I will jump right in with an illustrative counterexample: genital mutilation of children. In many countries, female children are subject to genital mutilation, usually for the purpose of maintaining their chastity by making sex painful or less pleasant, though sometimes for other purposes. Those of us who find the genital mutilation of children horrifying are confronted with the fact that, in many cases, women who were genitally mutilated as children grow up to participate in, and actively perpetrate in many cases, the genital mutilation of their own daughters. The fact that they practice genital mutilation on their own children is strong evidence that these woman are glad to have been genitally mutilated. But does this make forcible genital mutilation of children morally right? Clearly not.

In many cases, we may suffer wrongs that begin a chain of causation that leads to a subjectively good result. It should not take much introspection to come up with cases in our own lives when someone committed a wrong against us for which we were ultimately grateful, because the eventual consequences of the wrong were subjectively pleasant or otherwise beneficial. My claim is that this after-the-fact feeling of gladness does not render the initial act any less wrong.

More on the parallels between birth and female genital mutilation in my piece, “Birth and Consent: An Alternate Philanthropic Route to Antinatalism.”

The “glad it happened” justification seems to be a species of the Golden Rule Argument – if you’re glad you’re alive, have more babies (who will presumably be glad to be alive). If you’re glad you were prevented from committing suicide, prevent others from committing suicide. And so on. The problem with this line of thinking is people like me – people who are not happy to be alive, and who sincerely wish to die. What effect would a Golden Rule have when applied to me – should I go around killing people because I want to die? Hardly. It is moral for me to respect the lives and desires of others, just as I feel it is moral for others to respect my wish to die. I think “do unto others as you would like to have done unto you” has a serious flaw, and the variety of human experience is that flaw.

Obviously, the majority of people are happy to be alive. Perhaps the majority of “rescued” attempted suicides are even happy to have been rescued. But this line of thinking turns action into a consequentialist game of playing the odds. Respecting the values of individuals – even those with unusual desires – and placing a high value on consent, is a more coherent and appealing strategy. “Do unto others as they would have done unto them.”

Thanks to Sister Wolf for crystallizing the argument at her site!

Written by Sister Y

July 26, 2008 at 12:03 am

States Coerce Their Citizens By Prosecuting Their Doctors

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In the UK, Dr. Iain Kerr, a family physician, was suspended from his practice for six months for prescribing 30 tablets of the sleeping pill sodium amytal to an elderly, ill adult patient at her request.

The patient did not use the pills to die, but disposed of them when she found out Dr. Kerr was being investigated for acceding to her request. She later committed suicide using a much less reliable drug cocktail consisting of Temazepam, antihistamines and painkillers.

Dr. Kerr told the General Medical Counsel:

I think when dealing with someone holding a rational view of the circumstances in which they want to end their life, it was my duty to at least consider whether he or she had a reasonable opinion and that it was my duty to assist if I thought I agreed with that patient’s assessment.

Prosecuting physicians who risk sanctions to respect the choices of their patients and treat them as rational adults is yet another way in which governments act coercively to prevent suicides, without addressing the suffering that causes suicides in any way.

It is unfortunate that the General Medical Counsel felt the need to sanction Dr. Kerr for his act. But he may stand before any man or god, confident that his action was the morally correct one and the one most respectful of humanity.

Written by Sister Y

July 25, 2008 at 1:19 am

The "Unwanted Life" Diagnosis

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When providing a medical treatment of any sort, physicians are generally expected to produce a diagnosis of a medical problem that the treatment is intended to correct. In most cases, the medical problem is one that anyone would recognize as a medical problem, such as diabetes or a broken leg. However, one of the most widely prescribed medical treatments is contraception. But what “medical problem” do you diagnose in order to prescribe contraception?

People in institutional settings (locked hospitals, homes for the developmentally disabled, etc.) are, of course, sexually active. The doctors that care for them must provide contraception to prevent pregnancy – usually injected hormone contraception. The surprising (to me) diagnosis you most commonly see on the chart of an institutionalized patient, when a doctor is prescribing contraception to her, is “unwanted fertility.” Fertility is something we think of as healthy – but doctors may diagnose “unwanted fertility” as a medical problem for which contraception is the preferred treatment.

I think this is an interesting solution, although the diagnosis is often, strictly speaking, a fiction, as many female residents of group homes and such will tell you they definitely want to get pregnant – what is really meant is that the patient’s fertility is unwanted by her guardian.

A similar diagnostic possibility is necessary in the case of the rational suicide. A diagnosis of “unwanted life” could form the basis for the provision of lethal means of suicide that require a prescription, without requiring general legalization of the lethal drugs. The diagnostic criteria might even include more than just a wish to die – requirements might include that the wish be persistent (repeated requests over a period of time), that it not be accompanied by (or motivated by) delusions, and that the wish to die be clear and unambiguous.

Although I do not think there is a moral right to procreate (for anyone), I am concerned with the use of the “unwanted fertility” diagnosis against the expressed wishes of patients, even though these patients would likely not be able to care for any children borne by them. It is a convenient solution, but it stretches the truth a bit. This worry is even more important in the analogous “unwanted life” case. The “unwanted life” diagnosis would never be appropriate in cases where the life of the subject is unwanted by someone other than himself (his guardian, say) rather than unwanted by the subject of the diagnosis. Likewise, if a person met the criteria for the “unwanted life” diagnosis, despite having some sort of mental illness as defined by the DSM-IV, it would be inappropriate for his wish to be denied because others disagreed with his wish to die.

Written by Sister Y

July 17, 2008 at 7:25 am

A List of My Responses to J. David Velleman Articles

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This is a list of various responses I have made to arguments that J. David Velleman advances against a right to suicide.

Life Rights and Death Rights – in which I briefly introduce, and more briefly consider, Velleman’s argument that giving (terminally ill or disabled) people a right to die harms them even if they are fully rational and can be trusted to make choices that maximize their various interests.

Velleman’s Sorrow of Options – in which I review Velleman’s pro-forced-life argument in more detail, attempt to identify problems with the argument, and apply the argument given different starting conditions to get shocking conclusions.

Respecting and Erasing, in which I respond to J. David Velleman’s pro-forced-life paper “A Right of Self-Termination?” In his article, Velleman proposes that suicide is nearly always morally wrong, because by taking one’s own life, one acts in such a way that denies the inherent value of a person in general. I argue that killing oneself (and destroying something in general) does not at all require denying a person’s (or a thing’s) value, and that a person or a thing that is absent often paradoxically has a high value.

Altruism and the Value of Life: Another Response to Velleman – in which I challenge the ideas set forth in “A Right of Self-Termination?” in a different way, this time by contrasting Velleman’s position (that suicide to end suffering is wrong because it involves trading “mere” agent-relative benefits for a human life) with the commonly-held intuition of the moral worthiness of altruistic suicides.

Written by Sister Y

July 17, 2008 at 6:25 am

The Kind of Suicide Prevention I Can Get Behind

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I’m still on a break, but wanted to briefly mention a study that exemplifies the kind of suicide prevention I fully support. The study, published in the Archives of Opthalmology (July 2008), links suicide with low vision – but only when health is poor in general. Risk of suicide is elevated (though not statistically significantly) for individuals with low vision only, but is significantly elevated for individuals who are in poor health and have visual impairment – well above the increased risk for individuals with poor health alone.

The intervention proposed by the authors of the study is not to lock up everyone with low vision, or to have their doctors ask them humiliating questions to check for depression, but, shockingly, “better treatments for the underlying conditions that cause visual impairment.” (The authors also encourage eye doctors to be aware of the increased risk and provide appropriate referrals, but the primary recommendation of the study seems to be better treatment of visual problems.)

This is the kind of suicide prevention that even one who believes strongly in a right to suicide can support. This sort of study identifies specific types of suffering that lead to suicide, and recommends actually relieving the specific types of suffering. If this type of intervention were implemented – if old, sick people got better vision care – suicides would likely be prevented, but they wouldn’t be the suicides of people determined to die, people whose true end is death. The suicides averted by this type of intervention would be bad suicides – suicides by people who value their lives but suffer so greatly from a specific problem (or problems) that they choose to end their lives. There is nothing humiliating or coercive about better vision care. I would love to see more studies like this, and more interventions of this type.

Written by Sister Y

July 14, 2008 at 10:37 pm