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If you have a loved one in the hospital with a terminal illness and this person

If you have a loved one in the hospital with a terminal illness and this person no longer has a capacity to communicate, sustain thought, or make critical decisions, can it be considered ethical to pull the plug on them without their consent given their circumstances?

What can be considered ethical will, of course, depend on what conception of ethics (and also, perhaps, what metaphysical assumptions) one brings to bear on the question. So, for example, if one believes in the absolute sanctity of (human) life, then the fact that the loved one continues to be (biologically) human and alive will provide the answer. On the other hand, if you think that what makes something human (in the ethical sense) is the ability to make decisions (I think it can be argued that Aristotle, for example, believed this), then it would seem that it is ethically open to end the biological life of the loved one, since their human life had already ended, in your scenario. However, it would also follow from the Aristotelian view that there is nothing wrong with terminating the life of a fetus (or even infant!) until the time it is able to engage in decision-making.

In other words, a proper answer to your question must flow from having, first, an adequate conception of what sort of being we are dealing with here. The fact that something is biologically human and alive does not seem to be enough to make a confident ethical judgment--we wouldn't, for example, afford a "right to life" for living tissue samples, for example. Once we get a grip on that question, then we also need to make some basic ddecisions about how things of that kind are to be recognized within our ethical theories.

Speaking just for myself, I am inclined to be very suspicious of "all or nothing" answers to these sorts of questions, as if there is some clear conceptual breaking point between what deserves to be afforded a right to life and what does not. But certainly ethical theories that recognize a central role for "rights" not only exist, they continue to flourish within the philosophical community.

In the ethical approach I favor (virtue theory), questions about when and what circumstances merit which sorts of actions are understood, instead, in terms of desirable characteristics of agents. In this way of looking at things, your sort of question would turn into something like this: What would an excellent human being decide to do about a loved one in such a circumstance? I expect that the questioner might find this version of the question not much help, because it is difficult to try to get a grip on all that an excellent human being might bring to bear on such a decision. So, virtue theorists, I think, have to concede that there may be no such thing as fixed and fully general answers to such questions--nothing that might be regarded as an "algorithm" or decision principle for making ethical judgments of the sort you seek here. That may be simply a failing of virtues theories, and some critics have held it to be such. But some of us, anyway, think that it is actually a virtue of virtue theory--it recognizes the necessity of the exercise of human judgment, because the morally relevant circumstances of any given situation may be such as to merit different answers in different cases.

In other words, your question seems to want to force a "yes" or "no" answer, and I am suggesting that either answer is likely to be artificial and forced. Does the loved one have medical insurance that will indemnify his or her heirs against the likely heavy medical costs of continuing his or her life? Are there other loved one's whose opinions and feelings about this very question matter, and if so, how do they feel about it? Would the limited resources that are going to be used in maintaining the life of this person be such as to be better assigned to something (or someone) else? Did this person leave a living will, or some other document that proposed an answer to this very question, if such a situation arose? And so on... I suspect that if we tell the rest of the story in such a way as to capture all of the morally relevant details, we might find we are prepared to offer different answers to different cases, precisely because of the effects (potentially incommensurable, but still significant to the agent practicing judgment) of these morally relevant details.

In brief, then, I think you should be wary of the very idea that questions like this one can be given clear, definitive, and ethically defensible answers! Not so fast!

What can be considered ethical will, of course, depend on what conception of ethics (and also, perhaps, what metaphysical assumptions) one brings to bear on the question. So, for example, if one believes in the absolute sanctity of (human) life, then the fact that the loved one continues to be (biologically) human and alive will provide the answer. On the other hand, if you think that what makes something human (in the ethical sense) is the ability to make decisions (I think it can be argued that Aristotle, for example, believed this), then it would seem that it is ethically open to end the biological life of the loved one, since their human life had already ended, in your scenario. However, it would also follow from the Aristotelian view that there is nothing wrong with terminating the life of a fetus (or even infant!) until the time it is able to engage in decision-making. In other words, a proper answer to your question must flow from having, first, an adequate conception of what sort of...

Over the past few years, my wife has become a staunch antivaccinationist. (We

Over the past few years, my wife has become a staunch antivaccinationist. (We have a son on the autism spectrum; she has bought into the discredited vaccine causation theory of autism.) She is unreachable on this topic; no facts or reason will move her from her position. Unfortunately, she has decided that our children are to have no further vaccinations. She will not compromise on this. I, of course, want our children to be protected from dangerous diseases and thus want them to be vaccinated. My question: What are my ethical obligations in this situation--to my wife, to my children, and to society? Going behind my wife's back and having the children vaccinated without her knowledge does not seem ethical. Agreeing to her demand that the children receive no further shots also seems unethical--this would put my kids at risk of disease, as well as other people. Telling my wife up front that I'm taking the children to get their shots, despite her objections, also seems problematic--they are her children...

I agree with Professor Smith. The only thing I would add may be obvious and may be something you've already tried. It sometimes helps to have third parties intervene to provide all the facts and arguments you would use to try to persuade your wife to change her mind. Here, your knowledge of who might influence her is useful. Would she trust your family's pediatrician or react harshly against him/her as a member of the 'vaccine conspiracy'? Her parents or yours? Mutual friends? While an 'intervention' would be extreme, making friends and family aware of a serious issue that affects the health of your children (and others) and enlisting their help might make it easier for your wife to back down without feeling pressured to do so solely by you. But should these methods fail, then Prof. Smith's suggestion seems appropriate.

Oh boy, I really feel for you. I also have a son with autism spectrum, and as we both know, it is difficult enough dealing with that, even without the additional problem of an unreasonable spouse. My advice is that you do a little homework and find some support in your area (and not among the nutbags who have bought into the antivaccinationist nonsense, because it has been medically proven that nonsense is absolutely what it is). Because your wife needs help , to put it rather bluntly. She is feeling victimized by something that is just terrible luck and that has nothing whatsoever to do with where she is pointing the finger of blame here. But the other thing is that you really, really have a serious ethical problem here, which your questions shows you are aware of. Because your wife's adamant views now affet your otheer children, which puts not only them at risk--it also puts at risk any other children who might be exposed to your own children's (preventable) diseases. This...

Should people who engage in health damaging choices like smoking, drinking, drug

Should people who engage in health damaging choices like smoking, drinking, drug abuse, overeating be denied organ transplants if their organs where to fail as a result of their actions?

I don't see why. If there is reason to think that these bad choices would continue in such a way as to make the transplant likely to fail, then I can see having them be a factor. But if a patient needs a transplant, then it does not seem to me to be up to the medical profession to deny that transplant on some moralistic ground.

Consider two cases, where both need a kidney transplant. In one case (A), we have good reason to believe that the patient needs the transplant because of drug abuse earlier in their lives. (Let's not complicate the issue further by going into how likely we think it is that the person might return to drug abuse if the transplant is done successfully.) In the other case (B), we see no such evidence, but we also do know that B has been guilty several times in his life of physically or sexually abusing members of his family in numerous ways. Imagine finally that only A and B could be plausible candidates for this transplant--the kidney will spoil and be useless to anyone if the transplant is not made in the next day. Should it be a medical decision to withhold the transplant from A or B because of what we know about them?

The reason I give this case is because I think that there may be any number of factors that might incline us to favor one over another candidate for a transplant. Maybe A is also a really funny person who is charming to be with and B is a total grouch liked by very few people. Should that matter? I can sympathize with those who feel the pull of such considerations, but I really think it would be a very bad idea to have doctors or medical staff making medical decisions based on such factors.

Medical teams do have criteria they apply to these decisions, and perhaps the sself-inflicted nature of some medical conditions should count as a kind of "tie-breaker" in otherwise similar cases. But bringing in more such considerations seems to me to be an extremely risky business, and judgments about these are not appropriately made by medical professionals.

I don't see why. If there is reason to think that these bad choices would continue in such a way as to make the transplant likely to fail, then I can see having them be a factor. But if a patient needs a transplant, then it does not seem to me to be up to the medical profession to deny that transplant on some moralistic ground. Consider two cases, where both need a kidney transplant. In one case (A), we have good reason to believe that the patient needs the transplant because of drug abuse earlier in their lives. (Let's not complicate the issue further by going into how likely we think it is that the person might return to drug abuse if the transplant is done successfully.) In the other case (B), we see no such evidence, but we also do know that B has been guilty several times in his life of physically or sexually abusing members of his family in numerous ways. Imagine finally that only A and B could be plausible candidates for this transplant--the kidney will spoil and be useless to anyone...

A friend of mine has an adult daughter who is mentally disabled. Roughly

A friend of mine has an adult daughter who is mentally disabled. Roughly speaking, her daughter thinks and talks like a seven-year old child, and cannot take care of herself. The disabled daughter is sexually interested in men, but as far as I know she never had sex with anyone. When she was 20-something, the mother had the daughter medically sterilized. This brought her no suffering, and she behaves as she did before. The mother's fear was that she would get pregnant. For a few weeks every year, the daughter is away from her mother in a clinic for mentally disabled people. I wonder if it was morally acceptable for the mother to have her daughter sterilized.

This is the kind of case that makes reasonable people feel very squeamish, and over which reasonable people can disagree. But though I won't be surprised if others respond and reject what I am about to say, I'm inclined to side with the mother.

Ethical theorists generally approach questions like these from one of three basic approaches. One of these is called the deontological approach, which tends to focus on our moral notions of basic obligations and responsibilities. If we think that everyone, no matter what their mental defects, has a fundamental right to autonomy, then the mother's actions obviously interfered with the daughter's autonomy with respect to having (her own biological) children. On the other hand, we may doubt that such a fundamental extends in an absolute or complete way to someone who is incapable of exercising that autonomy, which appears to be the fact about this case. The daughter could biologically have a child, but could not actually be responsible for the child she might have. So my own reaction is to think that this particular "right" (the right to have biological children) is not a basic right at all. If so, there seems to be no reason to think the mother violated her daughter's rights.

Another way to approach such questions is "consequentialism," which estimates the value of actions in terms of foreseeable and morally relevant consequences. A rough and ready way of thinking of this case in such a way is to ask, "What if the daughted did get pregnant?" The obvious answers are: (a) She could have an abortion, or (b) she could give birth and then give the child up for adoption, or (c) some family member(s) could raise the child for/with her. It is not clear to me that forcing the daughted into situation (a) isn't pretty much comparable to what the mother did: one way or the other this is to force the daughter into an invasive medical procedure for which the daughter has not the competence to give genuine assent. But in this case, it might actually be much worse than what the mother did, because not only could there be other medical risks here, but also possibly emotional risks--even seven-years-olds can feel emotions and have these be significant in their lives. Moreover, situation (a) is one that might have to be repeated, maybe even many times! I think you can see how this works, by just thinking about how (b) and (c) could play out. There looks to be lots of realistic and likely outcomes that are very negative in each case. The mother's action prevented any and all of these bad consequences.

Finaally, there is a virtue theoretic approach, according to which we assess actions as indications of, and motivated by, morally significant character traits. The mother had her daughter sterilized for what are likely to be many different reasons (including, as I have suggested, concerns about likely bad consequences). Are we prepared to say that in doing this, the mother's motives were (mainly) selfish ones? If so, we would condemn the selfishness--but this seems quite wrong to me, since the mother seems to continue to take care of the daughter in what sounds like a very unselfish way. Instead, I am inclined to think the mother did it out of concern for the daughter, and for those the daughter's actions might impact. That concern, and the mother's sense of responsibility in this matter, seem to me to indicate something more like virtue than vice.

By each measure, accordingly, I am inclined to think the mother did the right thing.

This is the kind of case that makes reasonable people feel very squeamish, and over which reasonable people can disagree. But though I won't be surprised if others respond and reject what I am about to say, I'm inclined to side with the mother. Ethical theorists generally approach questions like these from one of three basic approaches. One of these is called the deontological approach, which tends to focus on our moral notions of basic obligations and responsibilities. If we think that everyone, no matter what their mental defects, has a fundamental right to autonomy, then the mother's actions obviously interfered with the daughter's autonomy with respect to having (her own biological) children. On the other hand, we may doubt that such a fundamental extends in an absolute or complete way to someone who is incapable of exercising that autonomy, which appears to be the fact about this case. The daughter could biologically have a child, but could not actually be responsible for the child she...

Why shouldn't we test drugs and cosmetics on mentally challenged or severely

Why shouldn't we test drugs and cosmetics on mentally challenged or severely disabled human beings, rather than animals?

Other things being equal, perhaps we might. But of course they're not equal. Our social morality -- the morality we live by -- is 'speciesist' in the sense that human beings -- whatever their mental or physical capacities -- are considered to be due special protection. If we were to seek to remove that protection, chances are that it would probably degrade our ethical sensitivities to the point that things went overall worse for non-human animals than they do at present. What we should be asking, rather than your question, is: Why should we continue testing drugs and cosmetics on non-humans to the extent we do, when we wouldn't dream of carrying out such testing on human beings with similar capacities?

I just answered another question related to this one. Please see my answer to that one. In gist, (1) which animals did you have in mind--"animals" is too generic for me to get much traction on an ethical issue. And (2) why do you think it is more appropriate to run experiments on mentally challenged or disabled human beings? Are (some species of) animals somhow more deserving of our moral respect? Why? Are (some species of) animals more ethically important than (some) human beings? What makes you think that? I can think of a great variety of what seem to me to be ethically significant issues that need to be visited here. One is the question of consent, which I discussed in my answer to the other question. Others include: ability to experience pain, cognitive capacities (such as memory, self-awareness), normal life-expectancy of the creature, normal "quality of life" expectancy of the creature (and how much experimentation would lead to deviation from such expectancies). I tend...

Isn't it more morally acceptable that we use consenting, informed adults in

Isn't it more morally acceptable that we use consenting, informed adults in scientific tests rather than animals? The adults would at least know what they were being tested for and the possible benefits. Added to which the tests are likely to be safer as scientists would be more likely to value a human life rather than that of an animal. Plus this way would fulfil the moral criterion for both utilitarianism as it decreases suffering for the reasons aforementioned and Kantianism but using no one as a mere means, human or animal (although Kant himself argued that an animal cannot be used as a mere means I will ignore this as it is arguable and that if we can avoid using them as a mere means then we should). Could it also be argued that testing on animals is even worse when no consenting, informed adult volunteered? And that such tests shouldn't be done under any circumstances? Many thanks :)

I think the PETA people will think I have a very blind moral eye, but I am inclined to think that your question makes the issue far more simple than it is. For one thing, I think there are morally significant differences between different species of non-human animals. I wouldn't think of causing gratuitous suffering or death to a wild primate, for example, but gladly crush mosquitoes to death whenever given the chance. For another (and related to the first, in fact) I think the very idea of whether animals do or do not consent and how this notion may apply to them is hardly obvious, and perhaps simply otiose. If animals (or some species) do not and cannot give consent or refuse it, then it seems to me this is not a useful more indicator for them.

I think the PETA people will think I have a very blind moral eye, but I am inclined to think that your question makes the issue far more simple than it is. For one thing, I think there are morally significant differences between different species of non-human animals. I wouldn't think of causing gratuitous suffering or death to a wild primate, for example, but gladly crush mosquitoes to death whenever given the chance. For another (and related to the first, in fact) I think the very idea of whether animals do or do not consent and how this notion may apply to them is hardly obvious, and perhaps simply otiose. If animals (or some species) do not and cannot give consent or refuse it, then it seems to me this is not a useful more indicator for them.