The following article was submitted to the IGS editorial group by Heidi Stevenson and was originally published on her own website Gaia Health. Heidi speculates about the possible implications of a radical change in medical ethics proposed by the authors of a report in the Journal of medical ethics
In an incredible display of sophistry masquerading as moral generosity, a pair of medical ethicists have set about redefining the meaning of death. Chillingly, the title of their article proposing the change is ”What makes killing wrong?”
Immediately, the authors slide the subject from death to killing. It’s difficult, if not impossible, to interpret that as anything but an introduction into the concept of killing people for some greater purpose: Perhaps freeing up their organs for transplant? Using their bodies for research? Or maybe simply to free society of undesirables?
In fact, the authors state:
“[I]t is not even pro tanto morally wrong to kill patients who are universally and irreversibly disabled, because they have no abilities to lose. Applied to vital organ transplantation, this account undermines the dead donor rule and shows how current practices are compatible with morality”.
Editorial comment: The use of the term “pro tanto” seems to be an obfuscation, an attempt to obscure, as it doesn’t appear to have any real meaning in context. Pro tanto means “only to that extent”, but what it adds to the sentence is only confusion.
The authors are Walter Sinnott-Armstrong, the Chauncey Stillman Professor of Practical Ethics at Duke University, and Franklin G. Miller, Senior Faculty in the Department of Bioethics, National Institutes of Health (NIH). They published the piece in the Journal of Medical Ethics, a sub-publication of the British Medical Journal (doi:10.1136/medethics-2011-100351).
That impressive combination of Ivy League university and the public agency primarily responsible for medical procedures in the US—coupled with publication in the UK’s equivalent of the Journal of the American Medical Association—is terrifying. It’s indicative of a coordinated plan to redefine how death is determined, who makes the determination, and an intention to move beyond definition of when death occurs towards actively ending life.
New Undefined Definition for Acceptable Killing
The authors propose to apply a new definition for death, though they clarify that what’s really meant is the point at which it’s acceptable to kill someone. Instead of attempting to tie it to a physical basis, such as heart stoppage or loss of brain activity, they propose applying a standard that is vague and cannot possibly be determined objectively. They propose to define a degree of disability, which they call “irreversible”, as the point at which killing is acceptable.
How does one determine when someone is “irreversibly disabled”? Who gets to make that decision? Interestingly, the article, tortuously moving from one specious argument to another, never tackles this most significant issue. Here is how they evade it:
“We also admit that our talk of disability needs to be sharpened. What exactly is disability? How do disabilities differ from inabilities? Is it ability, capacity, capability, power or control, or something else that really matters morally? How do future abilities weigh against present abilities? Again, we will not address these problems here, except to say that a theory with both the disability and killing rules will have just as much trouble with these difficult issues”.
In other words, the central point of their argument hasn’t been defined.
They’re claiming that they have a better definition of death, one so good that it can justify killing—yet they are entirely incapable of stating what that definition actually entails!
We know that the doctors are not going to be terribly interested in what the next-of-kin think. They already discount that, generally keeping relatives in the dark. They even go to court to wrench from a patient’s loved ones the right to decide whether or when to pull the plug. We know that the medical system is tied at the hip to the plutocrats running the governments. That leads to only one conclusion: The authors are opening the door to the unthinkable.
Who will be the first to go? The focus of the still-nonexistent—and sure to be forever vague—definition is on disability. There can be little doubt that people whose lives hold no value for having no abilities—according to the powers-that-be—would be first to go. That’s exactly what happened in Nazi Germany. It was the first step in the slippery slope to genocide. First dull the people’s sensibilities by disposing of those whom many already believe have little value—the disabled and mentally ill.
Once people are inured to that, it’s just a small step to killing people with healthy organs, but whose lives are not as valuable—according to those who make the decisions—for use in other, more valuable, people. Who makes those determinations? The ethicists, of course—guided by the ethos of the plutocracy. And that means anyone considered a problem could be defined as leading a life of no further abilities. It’s just small steps from killing the disabled to killing the inconvenient.
Ginger Ross Breggin wrote on this with the same disgust, but from her own unique and interesting point of view. You might be interested in reading her take on it in “The ‘Thou Shalt Nots’ Matter“.