This stuff is of great interest to me not only because I have a daughter with physical and cognitive diabilites but also because I am a christian and believe what the bible says about all humans being made in the image of God. It's quite tragic that Singer is held up as one of the leading thinkers in the "bioethics" camp.
[The quotes below are from Peter Singer's book Rethinking Life and Death, which he will be teaching this fall at Princeton. Additional material can be found in his book Practical Ethics and in Should the Baby Live?, which he co-authored with Helga Kuh se.]Peter Singer attempts to make the case that certain members of society should not be granted the same civil rights and protection of the law. Because he is speaking of a devalued segment of society, it is especially crucial that his arguments be subje cted to careful scrutiny. In the United States we have learned from history that those who argue that people seen as "less worthy" may be treated as second-class citizens - or worse - are all too often capable of disguising flawed arguments so as to make them appealing to members of privileged classes. And in fact, Singer's work is entirely inadequate to support the withdrawal of equal protection of the law from a devalued segment of society. Moreover, like the eugenicists at the start of the century who claimed that "we" could not bear the genetic burden of people with cognitive disabilities and like those in the middle of the century who claimed that "we" could not bear the social burden of the "menace of the feeble-minded", Singer joins the ranks of those who claim that "we" cannot bear the economic burden of treating people with significant cognitive disabilities as full members of society. The erosion or outright denial of civil rights to members of society who are seen as less valuable than those in power has a long and sad history. It has always been wrong in the past and it is wrong now.
Unequal Treatment Under the LawAccording to Singer, to be ethical, we must treat all "persons" according to moral guidelines. But not all humans are "persons." Singer claims that in order to be "persons" and to deserve moral consideration, beings must be self-aware, and capable of perceiving themselves as individuals through time.
Singer claims that some people with life-long cognitive disabilities never become "persons" at any time throughout their lives. He claims that some people who acquire cognitive disabilities cease to be "persons."
"We often use 'person' as if it meant the same as 'human being'. In recent discussions in bioethics, however, 'person' is now often used to mean a being with certain characteristics such as rationality and self-awareness." [page 180]
Singer then extends his reach from ethics to bioethics. Bioethics is a field which aspires to shape public policy.
"[T]he term 'person' is no mere descriptive label. It carries with it a certain moral standing. Just as, in law, the fact that a corporation can be a person means that a corporation can sue and be sued, so too, once we recognise a nonhuman animal as a person, we will soon begin to attribute basic rights to that animal." [page 182]
The corollary of this statement is that once we begin to see a human being as a non-person, we will soon begin to see - and then treat - him or her as undeserving of basic rights. We can see that when Singer says:
"The right to life is not a right of members of the species Homo sapiens; it is … a right that properly belongs to persons. Not all members of the species Homo sapiens are persons, and not all persons are members of the species Homo sapiens." [page 2 06]
Abandonment of Human Rights"Like cosmology before Copernicus, the traditional doctrine of the sanctity of human life is today in deep trouble. ….
"It is time for another Copernican revolution. It will be, once again, a revolution against a set of ideas we have inherited from the period in which the intellectual world was dominated by a religious outlook. Because it will change our tendency to see human beings as the centre of the ethical universe, it will meet with fierce resistance from those who do not want to accept such a blow to our human pride. At first, it will have its own problems, and will need to tread carefully over new ground . For many the ideas will be too shocking to take seriously. Yet eventually the change will come. The traditional view that all human life is sacrosanct is simply not able to cope with the array of issues that we face. The new view will offer a fresh and more promising approach." [page 189]
Since Singer is discussing policy change, he is speaking of more than "the traditional view that all human life is sacrosanct" - he is speaking of "the traditional view that all human beings should be accorded basic civil rights, including the right no t to be killed at society's convenience.
"We need to find another way of responding to human beings who can never be conscious. While the Royal Children's Hospital panel was unable to reach consensus on taking organs from infants with no prospect of ever gaining consciousness, this highly di verse group of people did agree that we need not keep such babies alive. … If it is not possible to find a tenable basis for declaring people to be dead who have irreversibly lost - or never had - consciousness, we may still be able to find a justificati on for ending their lives." [page 55]
It appears that the reason "[w]e need to find another way" is, simply, that the burden of treating all human beings as worthy of civil rights is more than Singer thinks "persons" should be forced to bear.
In other words, like the eugenicists at the start of the century who claimed that "we" could not bear the genetic burden of people with cognitive disabilities and like those in the middle of the century who claimed that "we" could not bear the social b urden of the "menace of the feeble-minded", Singer claims that "we" cannot bear the economic burden of "non-persons" with cognitive disabilities. The erosion or outright denial of civil rights to members of society who are seen as less valuable than thos e in power has a long and sad history. It has always been wrong in the past and it is wrong now.
Less Valued LivesSinger says that killing a "non-person," even if he or she is human, does not carry the same moral weight as killing a "person." It should not, therefore, he claims, carry the same legal weight either.
"Only a person can want to go on living, or have plans for the future, because only a person can even understand the possibility of a future existence for herself or himself. This means that to end the lives of people, against their will, is different from ending the lives of beings who are not people. Indeed, strictly speaking, in the case of those who are not people, we cannot talk of ending their lives against or in accordance with their will, because they are not capable of having a will on such a matter. …. [K]illing a person against her or his will is a much more serious wrong than killing a being that is not a person. If we want to put this in the language of rights, then it is reasonable to say that only a person has a right to life." [pag es 197-198]
In California, the case of Robert Wendland, who sustained brain damage in an automobile accident, is in litigation. Mr. Wendland's wife and conservator is arguing that she should be able to withhold food and water from him. Neurologist Ronald Cranfor d, who testifies frequently in such cases, has urged that Robert Wendland should be killed because all indications are that he is not "sapient". Nonetheless, Cranford admits that there are physical disabilities which might prevent Wendland from demonstra ting his "sapience" - it is possible that Wendland might understand everything that is going on and merely be unable to convey that fact. This is an example of the murkiness that surrounds the issue of judgments about cognition in the real world.
It is telling that Singer's philosophical theories and even his proposed policies do not deal with this murkiness. He chooses instead to find a few extreme examples and then proposes to allow his conclusions in those cases to dictate policy for the mo re common and confusing situations:
"We all like the notion of the intrinsic worth of human life. We accept such a noble idea without much critical scrutiny, as long as it does not restrict us from doing what we really think is important. Then one day we find it is making us do things that are manifestly pointless, or likely to lead to disaster. So we take a better look at the fine phrases we so readily accepted. And start to wonder why we ever believed them in the first place. Then we drop them." [page 57]
In 1998 the Down Syndrome Association of Great Britain produced a report indicating that 28% of families with a member who had Down Syndrome had experienced severe medical discrimination. A disturbing number of families reported that children with Dow n Syndrome were denied - or the families were never informed about - life-saving surgery, in part because such surgery was seen as pointless. Sustaining the lives of people with Alzheimer's Disease may also be seen as pointless; Singer suggests as much when he says:
"In 1989, Janet Adkins, a fifty-four-year-old Oregon woman, was in the early stages of Alzheimer's disease. …. She knew that she might live another ten years or more, but that in the final phase, which can last for several years, she would be unable to recognise or communicate with anyone, and would lie huddled in bed, her mind completely gone." [page 133]
Who Judges?"First New Commandment: Recognise that the worth of human life varies. …
"Consistent with the first new commandment, we should treat human beings in accordance with their ethically relevant characteristics. Some of these are inherent in the nature of the being. They include consciousness, the capacity for physical, so cial, and mental interactions with other beings, having conscious preferences for continued life, and having enjoyable experiences. Other relevant aspects depend on the relationship of the being to others, having relatives for example who will grieve ove r your death, or being so situated in a group that if you are killed, others will fear for their own lives. All of these things make a difference to the regard and respect we should have for a being." [pages 190-191]
Not only is Singer claiming that these are the ethically relevant characteristics, but further that they are politically relevant characteristics. And he leaves the judgment of who has these politically relevant characteristics to doctors, with no inv estigation into the known problems of making such judgments.
The euthanasia of people whose minds are judged inadequate would be a way to benefit others. Hospitals and insurance companies could save money. Families could "move on." And a source of organs for transplantation to people whose minds have been jud ged acceptable could be developed. According to Singer, very often people with cognitive disabilities should be killed.
"At the time of the controversy over the Reagan administration's 'Baby Doe' rules, I wrote a commentary on the issue for Pediatrics, the journal of the American Academy of Pediatrics. My commentary contained this sentence:
If we compare a severely defective human infant with a nonhuman animal, a dog or a pig, for example, we will often find the nonhuman to have superior capacities, both actual and potential, for rationality, self-consciousness communication, and anyt hing else that can plausibly be considered morally significant.
"The editor received more than fifty letters protesting against my views in this commentary, several condemned the editor for allowing it to be published. Many of the correspondents protested particularly against the comparison of the intellectual abilities of a human being and a dog or a pig. Yet the sentence that so disturbed them is not only true, but obviously true." [page 201, emphasis in the original]
Whether or not the sentence is true, it is far from obvious. These judgments cannot be made reliably even by those who understand the complexities, much less by those who gloss over them. Chris Borthwick has reported that in one study, 58% of people judged to be permanently unconscious (a judgment Singer believes is reliably made throughout the world) were conscious within three years. But, as is mentioned above, Singer makes no investigation into the reliability of the judgments, for he regards the m as obvious.
It is on the basis of such "obviousness" that Singer argues for policy change. And clearly, such "obviousness" is entirely inadequate to support the withdrawal of equal protection of the law from a devalued segment of society.
Technorati Tags: ethics, special needs