Replies to Smith and Klinghoffer

Wesley Smith and David Klinghoffer have now replied to yesterday's post, here and here respectively.

Smith's reply simply ignores all of the main points that I made. He's mostly sore that I did not discuss two specific cases from his original essay, of people who faced great physical suffering but overcame it to live long and meaningful lives. I did not discuss those cases because they were entirely irrelevant to the points I was making.

I had two main points. One was that everyone has the right to personal autonomy and dignity. The other was that it is possible to reach a state of such physical debilitation that everything that gave your life meaning has been permanently taken from you. When a mentally competent person decides he has reached that point, it is immoral to deny him the right to die.

How are specific cases of people who overcame suffering relevant to either of those points?

If you would care to read Smith's piece, you will find that the two people he discusses were both in far better condition than was John Rehm, the subject of the profile to which Smith was responding. But let's imagine two people facing precisely what Rehm was facing. Further imagine that one decides to live until he dies naturally, while the other decides he cannot take it anymore and requests the means to end his life peacefully. My point is that the law has no business interfering in either one of those decisions. Moreover, I would not find either one of those decisions to be inherently worthy either of praise or of criticism. People have to make these decisions for themselves, in conjunction with whoever's opinion they value, and with respect to the specific circumstances they face.

Klinghoffer's reply is far more interesting. Dispensing with trivial points first, we need to clear up something about the genetic fallacy. You see, in his first post Klinghoffer wrote this:

Whether the context is biology or cosmology, the ultimate issue at stake in the controversy over origins is the picture we carry around in our mind of what a human being is, what a human life is worth. There are two paradigms. They are mutually exclusive and separated by a vast gulf.

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

Or human life is not special, hardly more valuable — or indeed not one bit more valuable — than animal or plant life. Why? Because all life is equally the product of blind, uncaring forces, tossed up from the mixing of materials at random, to be “selected” by dumb, callous nature for survival and propagation, nothing more.

I described this as a clear-cut illustration of the genetic fallacy, and it is. One of my commenters, however, demurred. He wrote: “Jason, ”the genetic fallacy” is judging an argument based on who first made it.” Klinghoffer, unsurprisingly, endorses this comment in his new post.

But as I pointed out to my commenter, and apparently must now point out to Klinghoffer, the genetic fallacy is not simply judging an argument based on who first made it. That's a specific, very common, manifestation of the genetic fallacy, but it is not the whole thing. Courtesy of the ever useful Wikipedia:

The genetic fallacy, also known as fallacy of origins, fallacy of virtue, is a fallacy of irrelevance where a conclusion is suggested based solely on something or someone's origin rather than its current meaning or context.

That's precisely what Klinghoffer did. If life arose from blind, uncaring forces then it has no special value. That's the genetic fallacy.

As I said, that's the trivial point. Here's the important point. In my post, I wrote this:

Answers about our origins have no implications at all for questions of meaning and value. Arising through blind, uncaring forces in no way implies that life is not awesomely precious, and being made in the image of a transcendent designer in no way implies that it is.

Klinghoffer replies:

Now this I find very strange. Jason Rosenhouse wrote a book called Among the Creationists which I didn't read but that is evidently an account of his experiences meeting and talking with people who doubt Darwinian theory, sloppily classed together as “creationists.” I wonder, has he not noticed even the sociological reality that very different values, on the exceptional preciousness of a human life, are widely upheld among Darwin skeptics as compared to among Darwin defenders?

Oh, for heaven's sake. If Klinghoffer had at least read as far as the table of contents, he would have discovered an entire chapter devoted to distinguishing between young-Earth creationism and intelligent design. (That chapter bears the subtle title “Intelligent Design Vs. Young-Earth Creationism.”) In that chapter I go on for several pages about the distinctions, both scientifically and culturally, between the two schools of thought. Sloppy classification indeed. Granted, the conclusion of that chapter is that the similarities between the two schools are more important than the differences, but still.

Klinghoffer continues:

If you polled his colleagues in the Darwin-defending community, you don't think you would find broad agreement with his stance in favor of assisted suicide, and probably significant disagreement if you talked to folks inclined to sympathize with intelligent design?

Obviously, that doesn't tell you anything about whether either view, upholding the sacredness of life or not, is valid.

That last sentence is doing a lot of work! Klinghoffer was getting perilously close to adding argumentum ad populum to his list of fallacies. He is, however, guilty of providing a non sequitur.

Klinghoffer's reply here is based on a grotesque bait and switch. He simply equates support for assisted suicide with a low opinion of the value of human life. But it was the latter, not the former, that was at issue in the quotes under discussion. As I made clear in my post, it is precisely because I do value human life so highly that I support assisted suicide. It is Smith and Klinghoffer who cheapen it, by forcing people to persist in lives of suffering and humiliation simply because their heart continues to beat.

So let's review the discussion so far:

KLINGHOFFER: If we arose from blind, uncaring forces, then human life has no special value.
ROSENHOUSE: That's absurd! Human origins have no implications for the value of human life.
KLINGHOFFER: But most Darwinists support assisted suicide and most religious people oppose it.

Do you see the problem? If Klinghoffer really wants to decide this by polls, perhaps he should try asking the “Darwin-defending community” about their opinion of the value of human life. When one hundred percent reply that it is very valuable indeed, he can then try to explain to them how they managed to miss the implications of accepting evolution.

More like this

Klinghoffer:

There are two paradigms. They are mutually exclusive and separated by a vast gulf.

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

Or human life is not special, hardly more valuable — or indeed not one bit more valuable — than animal or plant life.

Fallacy of the excluded middle. Pretty obvious example, actually.

About the only positive spin I could put on his position is this: public policy is most fair and transparent when it makes clear-cut distinctions. The more fuzziness and gray areas there are, the greater the possibility that human bias can creep in. So it behooves all of us - pro-life or pro-choice - to try and make the rules and regulations as clear as possible.

Having said that, there is at best a loose and biased relationship between Klinghoffer's view on human value and public policy. The fundie right endorses the death penalty, for example. How is that consistent with a view that all humans are "possessing a unique dignity?" If your position is that we can morally kill someone possessing unique dignity, then I don't see necessarily how you necessarily arrive at a pro-life position.

What we have going on here is a dispute between people arguing about two distinct but related kinds of things-- one is an abstraction referred to as "Human Life" and treated (by Klinghoffer ans Smith) as an absolute. On the other hand, Rosenhouse is taking a humanitarian's approach to something different from the absolutiist's abstraction. Mr. Rosenhouse's concerns are all about humans' lives --as individuals not as somehow components of an absolutist's abstraction.

Smith and Klinghoffer are worried: unless we protect the abstraction, "Human Life" in an absolutist way, we invite the endangerment of various and sundry individual human lives--since, by all sane measures and views, the actual merit of individuals and their lot in life as they find it--- that is, the desirability of their particular life's escapable or inescapable conditions-- can and does vary tremendously.

So, rather desperately, Klinghoffer's and Smith's (like so many people's through history) solution to this practical ethical dilemma is to apply a one-size-fits-all rule and declare that all lives, whatever their particular circumstances may be, either are sacrosanct or must be treated as though they are in order to prevent the dangers of applying varying ideas of what constitutes a worthwhile life.

Indeed, too narrow and utilitarian a view of lives' values is a real danger in an age which is already far advanced in placing everything under the withering scrutiny of profit-driven notions of efficiency experts.

The trouble is that another of scourges of our times is the penchant for the imposition of an all-consuming authority over every aspect of our lives leaving us denied even the final dignity of each competent person being permitted to determine for himself when his life is worth prolonging and when it is not.

In order to vouchsafe an absolute sanctity of "Human Life", Klinghoffer and Smith would have the power of law require that many individual human lives are left to linger in final weeks, months or years of misery while Jason Rosenhouse would counter that the humane thing to do is to allow the difficult task of deciding which lives are so miserable that it is better to allow those living them to escape in what happens to remain (under circumstances which change with the "advances" of medical technology) the only manner available.

By proximity1 (not verified) on 30 Jul 2014 #permalink

There are two fallacies in K's statement. The first, which you call out, is the insulting statement that people who defend Darwin don't care about life. The second is that people who believe in a particular creation myth are uniquely moved by the sanctity of life. If you poll religious Christians in the US, you might find popular support for the death penalty. In the run-up to the Iraq invasion, the religious right strongly supported the war. Looking further back in history we find the Catholic Church providing blessings to fascists, invaders, crusaders, and inquisition murderers. Various Protestant churches have their own bloody histories. Religious people support the sanctity of life, when it suits them to do so. They are as bloodthirsty as any other humans can be, when that suits them.

Jason,

I think Smith might have a case for claiming that you didn't really read either of his responses. Here you ask:

I had two main points. One was that everyone has the right to personal autonomy and dignity. The other was that it is possible to reach a state of such physical debilitation that everything that gave your life meaning has been permanently taken from you. When a mentally competent person decides he has reached that point, it is immoral to deny him the right to die.

How are specific cases of people who overcame suffering relevant to either of those points?

The thing is, Smith answered it:

* Both wanted suicide.
* Both -- and I could have given many other examples -- couldn't get it because it was illegal.
* Both were later very happy to still be alive.
* Both were alive to be happy precisely because they had not been able to access doctor-prescribed death.

Which leads to his explicitly commenting on what I thought was an implication of your first post and one that you had to and yet didn't deal with:

If that is true, it means that assisted suicide must be available to anyone who wants to die for any reason they think sufficient. Who is Rosenhouse to say no to anyone who wants to die for any reason? That is the argument we should be having, because it illustrates the true stakes in the euthanasia controversy.

On your stance, repeated here, you would have to conclude that in those two examples those people who wanted assisted suicide ought to have been granted it. Except that because they weren't allowed, both of them concluded, at the end of the day, that that was the WRONG decision, and that their disabilities didn't, in fact, mean that they couldn't have a meaningful life after all. Except if it had been allowed based on their mental state at the time, they would have been dead and never discovered that.

So, either you allow people to decide based on their own judgement completely -- and thus support the mistakes that would have been made in those two cases -- or you start putting in "objective" standards where external bodies decide which conditions merit at least consideration of that option, which is not what you want AND risks implying that people in those situations OUGHT to think that their life isn't worth living, which is bad for the disabled in general.

It seems clear that there are cases where a medical professional, when faced with someone who thinks their life is over and has no meaning, ought to try to convince them that the problem is not their disability, but with what they think would give their life meaning. But under your view any attempt to do that would potentially violate their own judgement. And you can't use the "mentally competent" angle for those cases because it becomes circular: they aren't qualified to decide on ending their life because they aren't mentally competent, but the only evidence of that mental incompetence is the fact that they want to end their life in a situation where people think they shouldn't want that. There are potentially ways around that, but all of them end up with an external body imposing a set of standards for when an individual can "reasonably" make this decision.

Or, you can not allow it at all, which risks some people staying alive when they really have no reason to live, but ensures that everyone gets the chance to adjust their view of what makes life worth living when faced with these sorts of dramatic decisions. Or only allow it for terminal cases where all they are doing is choosing when they die, and not that they will.

By Verbose Stoic (not verified) on 30 Jul 2014 #permalink

VS (quoting Smith): If that is true, it means that assisted suicide must be available to anyone who wants to die for any reason they think sufficient. Who is Rosenhouse to say no to anyone who wants to die for any reason?

This is the slippery slope argument and the answer is pretty obvious: the state, acting as the representative of the people, is the one "to say" i.e. put limits on when people can and cannot kill themselves. The state already makes these decisions every day: the state decides whether you killed in self-defense or whether its murder. Who is to say whether you really felt threatened? The state is to say. The state decides whether some accident was criminal negligence or not - who is to say whether you should have known better? The state is to say. We recognize that the state has such authority every day of our lives (well, all of us non "sovereign citizens" do, at least).

Specifically on assisted suicide, Oregon has been operating with the state deciding when suicide is allowed for 17 years, and they haven't slipped down the slope to 'anything goes' or 'who is to say' land.

Personally I think we should maintain strict oversight over the process for exactly the slippery slope reason. But we already have a case of that oversight working for almost two decades, so I feel pretty comfortable dismissing Smith's slippery slope argument as inconsistent with the evidence. Yes, its possible to do this wrong. But that is not inevitable, and since we have a case of a state doing it right for 17 years without any slippage, the mere possibility that we might do it wrong is not a good enough reason to stop it (IMO).

eric,

This is the slippery slope argument and the answer is pretty obvious: the state, acting as the representative of the people, is the one “to say” i.e. put limits on when people can and cannot kill themselves.

Except that it isn't the slippery slope argument, but is in fact the consequence of Jason's stated main principle:

The other was that it is possible to reach a state of such physical debilitation that everything that gave your life meaning has been permanently taken from you. When a mentally competent person decides he has reached that point, it is immoral to deny him the right to die.

Thus, your answer to issues raised by Jason saying that it is immoral to deny someone the right to die when they have reached the point where they feel their life has no meaning ... is to say that, of course, it's TOTALLY okay to do that as long as the state is doing it and look, here's a state that's been doing it for 17 years!

Once you accept that the state can indeed say that people who do, in fact, genuinely feel that their life no longer has meaning are wrong and cannot have assisted suicide, you are on the side of Smith, not the side of Jason. All you are debating over is where that line should be drawn.

And that's putting aside the other concerns that I've raised that wouldn't be convered in your source studies ...

By Verbose Stoic (not verified) on 30 Jul 2014 #permalink

Jason, the idea that the origins of anything never have relevance would be a fallacy. So a case by case analysis is called for. In the case of humanity, origins are relevant because they signify what the nature of humanity is. For the strict Darwinian, the origin of humanity shows we are different only in degree from plant life. Therefore the value of human life can only be different by degree from plant life. For example, a very rare plant might have more value than a dreary human life.

Those who find that human life differs in kind rather than merely degree from plant life cannot accept this. Their understanding of human origins is necessarily different.

Making mistakes is the price of thinking and making decisions. I believe that brains work using the evolutionary algorithm (random variations, selection criteria, memory) so mistakes are inevitable, but whether this hypothesis is correct or a mistake, empirically it is a fact that all people make mistakes. The only way to prevent people from making mistakes is to take decisions out of their hands, such as lobotomies which prevent them from thinking and making decisions; then others will act in their behalf, still making mistakes. I suppose we could try appointing philosopher-kings to make all our decisions for us, but even Plato made mistakes (such as philosopher-kings).

Meanwhile, the lesson of life (evolution) is to try things, and if they make things a little better keep trying them; otherwise try something else. Of course thanks to evolution we can use our brains to do some of this process on a meta-level by simulating them in our heads or with mathematical/computer analysis and seeing if they pass the selection criteria there. My brain tells me I would like to have the option when I am old and blind from optical macular degeneration and too weak to do anything for myself and in pain to speed up the process of dying which I saw my father go through.

VS:

Once you accept that the state can indeed say that people who do, in fact, genuinely feel that their life no longer has meaning are wrong and cannot have assisted suicide, you are on the side of Smith, not the side of Jason.

Did you completely miss the part where Smith says this leads to "assisted suicide must be available to anyone who wants to die for any reason they think sufficient?" That's slippery slope. It doesn't necessarily lead there because we have a real life example of it not leading there.

Oregon does not make it available to anyone who wants to die for any reason they (the individual) thinks sufficient. Smith is claiming we're all going to slip down the slope to that end state, and empirically it hasn't happened. He's just wrong on that.

And while this may be a matter of tomato tomahto, I think the position "state regulated and limited assisted suicide" to be closer to Jason's position than Smith's rejection of any form of it. Jason says he thinks mentally competent people should be allowed to end their life when in a state of extreme physical debilitation. State regulation plays the role of trying to put some reasonably objective limits on what counts as "extreme physical debilitation" and "mentally competent," but it ultimately supports the power of the individual to make that decision, it does not seek to block or prevent it.

Its just silly to claim that my support of regulation means I'm on the 'opposed' side. That's like saying the I'm opposed to driving because I think State-required drivers licenses are a good thing.

eric,

Did you completely miss the part where Smith says this leads to “assisted suicide must be available to anyone who wants to die for any reason they think sufficient?”

Obviously not, since I quoted it. What you are missing is that this is a conclusion based on Jason's reasoning, not a slippery slope argument that this is what will happen. Smith quoted Jason's statement:

And here's the point: Everyone has to decide for themselves when that point [when life is too painful to go on] is reached. People like Smith and Klinghoffer have no business holding forth on the meaning of anyone's life but their own.

Presumably Jason includes "The State of Oregon" in the lsit of people who have no business holding forth on the meaning of anyone's life but their own, or else his argument is a meaningless platitude. Thus, Oregon's approach is NOT the approach Jason would prefer, as it would indeed in some cases mean that someone who is mentally competent and who really does genuinely believe that their life would have no meaning would not be allowed assisted suicide, which is precisely what Jason desperately wants to avoid. He can make an argument that he'll sacrifice principle for practicality in some cases, but then he'd need a principled way of determining that.

A slippery slope argument is a fallacy because it argues that once you allow X, then there is no way that you can avoid also allowing Y. But there may indeed be a principled way of distinguishing X from Y. The argument here -- that I agree with and argued for -- is that under Jason's stated main principle, there IS no principled way to avoid allowing them assisted suicide as long as THEY think it's problematic enough. Anything else violates that principle.

Oregon does not make it available to anyone who wants to die for any reason they (the individual) thinks sufficient.

Yes, and Jason's stated principle is that they must or be immoral.

Jason says he thinks mentally competent people should be allowed to end their life when in a state of extreme physical debilitation. State regulation plays the role of trying to put some reasonably objective limits on what counts as “extreme physical debilitation” and “mentally competent,” but it ultimately supports the power of the individual to make that decision, it does not seek to block or prevent it.

I take Jason's position as being compatible with the state determining what counts as "mentally competent" -- as long as they don't use the fact that they are requesting assisted suicide in a particular case as evidence that they aren't mentally competent -- but NOT compatible with the state determining what counts as "extreme physical debilitation", as he repeatedly says that we don't get to decide for others when their life would have meaning or under what conditions it wouldn't. The "mentally competent" angle comes in because we have to ensure that they are indeed able to make such a momentous decision, but if they are indeed competent to make that decision it seems to me -- unless the argument is just meaningless rhetoric -- that any body stepping in to not allow the assistance would be something that Jason would find troubling and problematic AT BEST. Not perfectly acceptable, because it would be taking that decision away from them, and Jason's main objection is that no one -- or no body -- can take that decision away from someone mentally competent enough to make it.

Its just silly to claim that my support of regulation means I’m on the ‘opposed’ side. That’s like saying the I’m opposed to driving because I think State-required drivers licenses are a good thing.

Well, if someone's argument is that it is wrong to, say, limit getting a driver's licence by testing, and someone else says that we absolutely have to case it on testing, you are not supporting the former's argument by saying "Maybe we can take parallel parking off the test, but it's still reasonable to have one." You agree with the latter that testing is still required, but are disagreeing over what needs to be on it. The same thing applies here: you agree that the state has the ability and even the need to deny some people assisted suicide, you're just arguing over where that kicks in. Smith might be arguing for "It must be all cases". Others -- and Smith might take this line as well -- would say "Terminal cases only". But you're arguing over where the line is, not over whether there should be a line beyond "Not mentally competent to make the choice", and for Jason's argument to be more than rhetoric he has to be arguing that that line should be the only one.

By Verbose Stoic (not verified) on 30 Jul 2014 #permalink

Presumably Jason includes “The State of Oregon” in the lsit of people who have no business holding forth on the meaning of anyone’s life but their own, or else his argument is a meaningless platitude. Thus, Oregon’s approach is NOT the approach Jason would prefer, as it would indeed in some cases mean that someone who is mentally competent and who really does genuinely believe that their life would have no meaning would not be allowed assisted suicide, which is precisely what Jason desperately wants to avoid. He can make an argument that he’ll sacrifice principle for practicality in some cases, but then he’d need a principled way of determining that.

Perhaps Jason will weigh in on whether he thinks Oregon's mechanism is fine or doesn't go far enough. That is as much as I will say on the substantive position, because it's his position we're discussing not mine.

But I do think you are trying to exclude the middle and interpret his words in the most extreme manner possible when you say that his position is a 'meaningless platitude' if it means anything other than completely uregulated choice (once one is determined mentally competent). What, there are no retorical flourishes allowed on the internet? Nobody's allowed to use intentionally provocative speech? A simple description of a nuanced position is verboten, and if you give one, you're giving a meaningless platitude?

Smith might be arguing for “It must be all cases”. Others — and Smith might take this line as well — would say “Terminal cases only”.

It's pretty clear it's the forrmer. I thought you had read his piece. How do you interpret Smith's comment: "Of course I didn't think that self-starvation was the morally correct outcome. But neither would it have been right to have the law allow a doctor have given him a lethal injection or a poison prescription."

That's a pretty clear indication of his position. And, as I said before, the law saying when a doctor can administer a lethal injection is (IMO) a lot closer to Jason's position than Smith's position that the law cannot or should not allow it at all.

Is it ok to commit a genetic fallacy by dismissing Smith's and Klinghoffer's arguments simply because they work at the Discovery Institute?

How is hastening one's death in Rehm's case any different than those hastening one's death by smoking, or driving without seat belts, or eating fast food? Shouldn't we be regulating these things by forbidding them? We know the odds are they will shorten your life. That someone can only be arsed enough to care that all pregnancies are carried to term and no one commits suicide hardly makes qualifies as "pro-life." There is a hell of a lot in-between that matters - quality and not just quantity needs to be taken into account.

Has the DI or its minions advocated for anything that would improve the quality of life for everyone - universal health care access? universal education? universal food and housing? A living wage? And on and on.

By Michael Fugate (not verified) on 30 Jul 2014 #permalink

It's worth noting that Jason did seem to imply in his argument, taken as a whole, that it was primarily about terminal illness. Here for instance is a quote from the first post:

"His abstract musings about hope and meaning amount to nothing in the face of actual terminal illnesses like the one faced by John Rehm."

If you've ever read Eric MacDonald at Choice In Dying, he'll tell you why limiting assisted dying to terminal cases only can be cruel for people whose condition is not terminal but who are still suffering, e.g. Tony Nicklinson.

The biggest cruelty is in cases like Nicklinson or Rehm where they are at the point that they will refuse food and drink in order to die. In those cases they have to suffer for days to accomplish what could be over in a few painless minutes. What is the point of that besides cynically upholding abstract principles about Human Life and the Spiritual Value Of Suffering?

By Another Matt (not verified) on 30 Jul 2014 #permalink

Another Matt,

It’s worth noting that Jason did seem to imply in his argument, taken as a whole, that it was primarily about terminal illness. Here for instance is a quote from the first post:

But then his main point about not allowing someone else to decide when your life has meaning doesn't work, as Smith points out, because it DOESN'T allow a differentiation between terminal and non-terminal cases.

Which allows me to answer eric's question about rhetoric: either Jason means what he has said twice now and is relying on a general principle that leads to an extreme but still at least potentially credible argument, or he doesn't mean that and is only talking about terminal cases, which are better supported by other arguments. Rhetorical flourish doesn't work when it obscures your point, especially when that "flourish" actually is identical to an actual argument in the debate, and especially when people point out the consequences of the argument you're stating and you don't say "That's not what I meant", but instead repeat the flourish.

The biggest cruelty is in cases like Nicklinson or Rehm where they are at the point that they will refuse food and drink in order to die. In those cases they have to suffer for days to accomplish what could be over in a few painless minutes. What is the point of that besides cynically upholding abstract principles about Human Life and the Spiritual Value Of Suffering?

Since they're asking for other people to get involved, if it would be immoral then they'd be asking someone else to do something immoral or they'll hurt themselves. I guess it's the Stoic in me, but I find that that kind of moral blackmail should be resisted, not given into.

Note that Smith does have an answer for that: we should be working to convince those people that their life can indeed still have meaning and so convincing them to stop refusing food and drink, not simple give in and let them die.

Note also that I do, personally, find it hard to argue against assistance in terminal cases, but that's mostly on the argument that there all they're doing is deciding WHEN to die, not IF they're going to die. About the only reasonable counter-argument I can think of is "What if they lived long enough to be cured?", but we probably shouldn't hold out based on long odd hopes, and there are going to be lots of cases where that almost certainly won't be an issue. Non-terminal cases are another matter, and as you've pointed out are indeed part of the debate as well, linking back to the fact that if someone wants to allow terminal but not non-terminal cases they really need to make that clear.

By Verbose Stoic (not verified) on 30 Jul 2014 #permalink

Verbose Stoic--

Eric is right.

Two separate issues are being conflated. The first is the question of personal autonomy. Do we have a right to die? The second is what our public policy should be. My posts, as I think was obvious, were entirely about the first question. Answering yes to that question in no way implies that I think our public policy should be that anyone has the right to be granted assisted suicide for any reason at any time.

I’m sure you believe people have a right to free speech, and I’m equally sure you don’t think that implies our public policy should be that anyone has the right to say anything at any time for any reason.

Had Smith and Klinghoffer only been discussing the second question I would not have responded as harshly as I did. Had they acknowledged that people have a right to autonomy, but then argued that this is one of those cases where personal liberty must yield to the greater good, then I would still disagree with them, but I would have been more open to their argument.

But Klinghoffer wasn’t discussing public policy at all. He went off on how support for assisted suicide implies you think human life has no special value, and then argued that this follows logically from accepting evolution. Do you agree with that? Smith, for his part, responded to a heartbreaking profile of Diane and John Rehm by acting like it was journalistic malpractice to tell their story without giving equal time to some imagined other side, and then tossed off two irrelevant stories of people in very different circumstances.

I gave a strong indication of what I think about public policy in referring to mental competence and severe physical debilitation. The very fact that we’re talking about assisted suicide implies that we’re talking about people too physically debilitated to do it themselves. John Rehm plainly clears both hurdles. He had lived with his condition for years, had reached a state of complete physical helplessness, and made a calm, reasonable decision in conjunction with his family. By contrast, to judge from Smith’s description, neither of his two cases cleared either hurdle. At the time they wanted suicide both were in decent physical condition and both were making heat-of-the-moment decisions in the throes of depression.

I think what Oregon does is very reasonable. They strike a reasonable balance between the right of people to autonomy with the need to protect people from rash decisions made from depression.

Now, if you can distract yourself for a moment from the project of desperately trying to find the most extreme interpretation of what I said, you need to answer some questions yourself. Do you think what happened to John Rehm was morally acceptable? Do you think our public policy should be that no one ever has the right to suicide for any reason? That’s the consequence of what Smith and Klinghoffer want.

I think the assisted part comes in through having access to the most humane means to commit suicide - John Rehm could kill himself and did - but if he had access to certain drugs he could have done it much more humanely. These drugs are controlled substances and one would need a prescription to acquire them legally.

I am still interested to know why Smith and Klinghoffer are so interested in preventing John Rehm's death, but seem so uninterested in the millions of other preventable deaths of people who actually don't want to die. Are they in favor of increased regulations in the workplace, on the highways, in the food industry, gun control? I think we know the answers by looking at the DI's recommended reading on their Center for Wealth and Poverty site.

By Michael Fugate (not verified) on 30 Jul 2014 #permalink

It is also interesting that the DI has a "human exceptionalism" unit. Why? because Man is created in God's image. For this reason they oppose abortion and assisted dying and animal rights. If God created you personally with his very hands then he and only he gets to kill you off - well at least during pregnancy and if you are old - otherwise it is a bit iffy. It is also why animals can't have the same rights as humans - evolution didn't happen - we aren't even vaguely related to apes and the other riff raff.

It is also of note that Bill Gates dumped a bunch of money on them....

By Michael Fugate (not verified) on 30 Jul 2014 #permalink

Since they’re asking for other people to get involved, if it would be immoral then they’d be asking someone else to do something immoral or they’ll hurt themselves. I guess it’s the Stoic in me, but I find that that kind of moral blackmail should be resisted, not given into.

But nobody's being blackmailed. We're talking about whether or not assistance in dying should be legal. We've more or less presupposed that the involved party is willing and does not find assisting to be immoral. I think it's a stretch to suggest that the state itself could be so blackmailed into allowing a willing party to assist. Maybe I'm being naive.

By Another Matt (not verified) on 30 Jul 2014 #permalink

@15

Two separate issues are being conflated. The first is the question of personal autonomy. Do we have a right to die? The second is what our public policy should be. My posts, as I think was obvious, were entirely about the first question. Answering yes to that question in no way implies that I think our public policy should be that anyone has the right to be granted assisted suicide for any reason at any time.

I’m sure you believe people have a right to free speech, and I’m equally sure you don’t think that implies our public policy should be that anyone has the right to say anything at any time for any reason.

Had Smith and Klinghoffer only been discussing the second question I would not have responded as harshly as I did. Had they acknowledged that people have a right to autonomy, but then argued that this is one of those cases where personal liberty must yield to the greater good, then I would still disagree with them, but I would have been more open to their argument.

But Klinghoffer wasn’t discussing public policy at all.

Of course he is discussing public policy. There's no need to pronounce emphatically, "This stuff, by the way, is also all about public policy."

As soon as you are concerned with legal rights you are--whether you recognise it or not, whether you acknowledge it or not--indeed discussing a matter of public policy.

Whatever is or isn't being conflated, it isn't the matter of whether and how an assertable right to die (under certain recognised circcumstances) concerns public policy.

For Klinghoffer, the getting to expressly taking up the public policy aspect is precluded by his position that (in his view) there is (or, rather, ought to be) no right to die. That is a position on a public policy matter. Kli9nghoffer simply doesn't intend to get involved with discussing what you describe above as "The second (question) (...) what our public policy should be."

By proximity1 (not verified) on 31 Jul 2014 #permalink

Other confusions--

the "genetic fallacy" and terrestrial life's origins, for example.

Genetic, schmenetic. Klinghoffer's mistake is in being sloppy, imprecise about the implication of his argument which he puts (and Rosenhouse cites) this way:

Whether the context is biology or cosmology, the ultimate issue at stake in the controversy over origins is the picture we carry around in our mind of what a human being is, what a human life is worth. There are two paradigms. They are mutually exclusive and separated by a vast gulf.

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

Or human life is not special, hardly more valuable — or indeed not one bit more valuable — than animal or plant life. Why? Because all life is equally the product of blind, uncaring forces, tossed up from the mixing of materials at random, to be “selected” by dumb, callous nature for survival and propagation, nothing more.

In the "either / or" Klinghoffer presents, we have, in the first part, "your life" being qualified with the phrase " is of ultimate value" (emphasis added), "possessing unique value," while, in the second part--- the "or"--- that qualifying phrase is absent, when it ought to be included for fair consistency.

Corrected, then, his assertion should read,

Whether the context is biology or cosmology, the ultimate issue at stake in the controversy over origins is the picture we carry around in our mind of what a human being is, what a human life is worth. There are two paradigms. They are mutually exclusive and separated by a vast gulf.

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

Or human life is not ultimatelyspecial, hardly more <b. uniquely valuable — or indeed not one bit more uniquely valuable — than [other] animal or plant life. Why? Because all life is equally the product of blind, uncaring forces, tossed up from the mixing of materials at random, to be 'selected' by dumb, callous nature for survival and propagation, nothing more. "

The problem--as Eric's objection pointed out--is that there is no need for either "Human Life" or for humans' lives to possess unique or ultimate value in order that these possess some very significant value as a commonly accepted premise.

Kinghoffer and Smith make sophomoric errors in their cartoonish reasoning. They really oughtn't be allowed to get away with such stuff.

By proximity1 (not verified) on 31 Jul 2014 #permalink

Michael @17:

It is also of note that Bill Gates dumped a bunch of money on them…

Huh? Bill Gates is funding DI? That's the first I've heard of this. Do you have a reference or news article about it? I thought their primary funder was Howard Ahmanson (Jr., I believe).

Proximity1:

The problem–as Eric’s objection pointed out–is that there is no need for either “Human Life” or for humans’ lives to possess unique or ultimate value in order that these possess some very significant value as a commonly accepted premise.

Just to give credit where it's due, you are referring to Eric MacDonald, not me, right? I mostly agree with EM's position, but he's the one who's done the heavy lifting on this issue, not me.

@ 21 : ..."you are referring to Eric MacDonald, not me, right?"

No, I meant by that reference post # 1, above, where (you?) observed:

eric
July 30, 2014

Klinghoffer:
There are two paradigms. They are mutually exclusive and separated by a vast gulf.

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

Or human life is not special, hardly more valuable — or indeed not one bit more valuable — than animal or plant life.

Fallacy of the excluded middle. Pretty obvious example, actually.

By proximity1 (not verified) on 31 Jul 2014 #permalink

Jason,

You know, reading your comment last night I was pretty hopeful, until I got to this point:

Now, if you can distract yourself for a moment from the project of desperately trying to find the most extreme interpretation of what I said, you need to answer some questions yourself. Do you think what happened to John Rehm was morally acceptable? Do you think our public policy should be that no one ever has the right to suicide for any reason? That’s the consequence of what Smith and Klinghoffer want.

Because at least up until then you weren't misrepresenting MY arguments or ignoring what I'd already said. But after sleeping on it I think I can reply in a more productive manner than I would have last night, so let me give that a shot.

So, first, the reason, I think, for your accusation of my trying to find the most extreme interpretation possible is that you think the argument I made is an attempt to use a slippery slope strawman to drive you towards an extreme and obviously unacceptable argument so as to dismiss your claim entirely. But from my side, I had already pointed out in my reply to Another Matt that that extreme argument was extreme, but wasn't incredible. To put that clearer, the "extreme" argument I was holding you to was a) one that people like Eric MacDonald ACTUALLY hold and b) might actually be the right position. That you react strongly to that suggestion is pretty standard, but that doesn't make it wrong, and I did argue that it FOLLOWS from your rights statement.

Which leads to a second point, that I had already conceded you the practical argument, in my reply to eric,

He can make an argument that he’ll sacrifice principle for practicality in some cases, but then he’d need a principled way of determining that.

When we restrict free speech rights, we have a principle to appeal to to do that, or else it seems fairly dodgy. In the classic "Shouting 'Fire!' in a crowded lobby" case, we have public safety to appeal to. Usually, we suspend individual rights on the basis that it violates the rights of others or that it's just impossible to practically implement. Which leads to Oregon ...

You like Oregon's policy, but a quick skimming leads me to believe that they limit it to terminally ill patients only. Taking your stated principle -- and you want to argue on the basis of the principle -- there seems to be no principled way to draw that distinction, and I don't see any overwhelming practical impediment. I NEVER argued against the "mental competence" angle, nor did I ever suggest that you wouldn't put that restriction in place, so that's not relevant. I DID warn you that you can't use "They want to die in a case where we think their life still has meaning" as an argument for that, and note that the "It's too early and they're too depressed to make a considered decision right now" has been argued against on the basis that it essentially does that; of COURSE someone facing that sort of decision is depressed, but that doesn't mean that they can't make that decision. But we can agree -- and Smith won't -- that we ought to be able to find reasonable ways to determine mental competence. So it's all about degree of suffering and how that will impact the meaning of their lives, as judged by them. And it was THAT stance that I claimed you held, that no one else had the right to decide that their condition wasn't serious enough and so they were wrong to think that their life wouldn't have meaning if they lived on, and so we should at least not grant them assistance in those cases where we think they were just plain wrong. I think that's still a safe conclusion, but you can correct me if I'm wrong ... but holding that doing that is immoral does not allow for a distinction between terminal and non-terminal illness, at least on that criteria alone.

Which leads to the next gripe, where you demand that I answer questions that I had already answered in my comment to Another Matt:

Note also that I do, personally, find it hard to argue against assistance in terminal cases, but that’s mostly on the argument that there all they’re doing is deciding WHEN to die, not IF they’re going to die. About the only reasonable counter-argument I can think of is “What if they lived long enough to be cured?”, but we probably shouldn’t hold out based on long odd hopes, and there are going to be lots of cases where that almost certainly won’t be an issue. Non-terminal cases are another matter, and as you’ve pointed out are indeed part of the debate as well, linking back to the fact that if someone wants to allow terminal but not non-terminal cases they really need to make that clear.

So, I can't argue against allowing it in terminal cases, but note that that isn't based on "Personal autonomy" but instead "This is not a matter of choosing to die, but of simply choosing WHEN to die as the condition will kill them anyway". The reason for this is that I don't think that the personal autonomy argument can indeed draw a distinction between terminal and non-terminal cases in any principled way. You can appeal to things like public opinion, but it will feel a bit like a betrayal of an important principle if you don't. Under Stoicism, suicide is considered a lot more respectable, but only because things like these sorts of situations are things that good Stoics aren't supposed to let change them, so I'd be torn on that even IF my main view of that didn't place autonomy in a central position in morality. But even then they can indeed still decide to do it, as happened in the Rehm case, but only with more suffering. But my comment to Another Matt was entirely meant to argue that if someone will choose a means to do something that will cause them more suffering than if I do it for them, that doesn't make it morally right for me to do it for them if otherwise it would be morally wrong (unless your moral code determines morality by amount of suffering, which mine absolutely doesn't). So even in that end I actually don't infringe on autonomy, and the argument from people like Smith is that assisting in these things is morally wrong ... so we aren't going to settle anything with that.

Which leads to, finally, why I claimed that if you didn't hold the stronger position -- and note that for me, being more philosophical as opposed to political, I always WAS talking about the moral implications and not the policy ones -- your statement would be nothing but a useless platitude: Your position, taken from your words, must imply at least that the meaning of someone's life is determined internally by them and not externally or objectively. By that, if someone genuinely decides (which includes mental competence, which I ALWAYS granted you) that their life has no meaning, they can't be WRONG about that. Smith and Klinghoffer deny that, and think that a person's life has value even if they genuinely decide that it doesn't. And this is an interesting philosophical clash over the value of human life. But if you are willing to say that, say, the people in Smith's example are WRONG about their life with their conditions having no value and so shouldn't be allowed assisted suicide -- and note that I'm not saying that this IS your position, because in failing to address them in that way I can't tell what your view is -- then you are REJECTING that view, and saying that there really is an objective view of human value, and that people can be wrong in their assessment of human value EVEN IF they are making a genuine personal decision. At that point, your view of the value fo human life is just as externalist as theirs is, and philosophically as willing to impose the "right" view of value on others; you're just disagreeing with them on where that line is, and for them the answer is a not utterly incredible argument "human life always has value". Again, I don't know if you ARE willing to say that a competent person can be wrong about their assessment of the value of their life, but if you aren't then I think that you are taking my interpretation of your claim and not eric's.

This is a bit long for a comment, I guess. I thought about making a blog post out of it but thought this might fit better, so sorry about the length anyway,

By Verbose Stoic (not verified) on 31 Jul 2014 #permalink

@21 Wikipedia is the source for the Bill Gates funding.

By Michael Fugate (not verified) on 31 Jul 2014 #permalink

VS:

I don’t think that the personal autonomy argument can indeed draw a distinction between terminal and non-terminal cases in any principled way.

Okay, but neither Jason nor I think it has to do that lift. Empiricism can do that.
Jason says "I had two main points," the first of which is the autonomy argument and the second of which is about empirical support that someone is actually terminal. So I am not sure what sent you down the path of thinking anyone here was trying to use the aunotomy argument on its own.

@24: Ah, I see they are a funder of the DI's Cascadia project for local (regional) transportation development. Yeah sure, that money might be fungible and some of it might make it's way to creationist use. But I honestly don't take much offense over the Gates' efforts to support public transportation in the state. This doesn't give them a black mark in my book.

$50,000 goes to pay the salary of Bruce Chapman. Given their idiocy on other issues, I wouldn't trust them to study kindergarten math.

By Michael Fugate (not verified) on 31 Jul 2014 #permalink

eric,

Okay, but neither Jason nor I think it has to do that lift. Empiricism can do that.
Jason says “I had two main points,” the first of which is the autonomy argument and the second of which is about empirical support that someone is actually terminal. So I am not sure what sent you down the path of thinking anyone here was trying to use the aunotomy argument on its own.

Because from my reading of the post, the empirical point is NOT "Empirical science can tell us when someone's life is, in fact, not worth living" but is in fact an offshoot/consequence of the autonomy argument stating that that determination must be made by the person in that condition and not by anyone else. From this post:

The other was that it is possible to reach a state of such physical debilitation that everything that gave your life meaning has been permanently taken from you. When a mentally competent person decides he has reached that point, it is immoral to deny him the right to die.

The issue here is over internal/external or objective/subjective, so talking about empirical isn't going to resolve that issue.

By Verbose Stoic (not verified) on 31 Jul 2014 #permalink

Let me clarify a little before I get into trouble again:

I do think that it is indeed the case can you can have physical debilitation to the extent that everything that gave your life meaning is permanently lost. However, as Smith would point out that was indeed the case for the two examples he gave, and I can agree that it probably was. Now the question is if in those cases we have to reteach those people to find meaning in other things, or if we have to accept their assessment of it. Jason does hint that he thinks that in at least some cases people can make mistakes about what really gives life meaning, and so we should convince people of that. But that contradicts the autonomy point, or at least the point that people have to decide for themselves what gives their life meaning. If he's going to advocate for an objective criteria for life having meaning -- like relationships with people -- then it isn't personally determined and so he would seem to have to AGREE that we can indeed tell people what ought to give their life meaning even if they are competent to decide that for themselves, which puts him closer to Smith's camp than I think he should probably like, and reduces this to a debate over what the "real" meaning of life is and when or if that can be lost.

At that point, standing on comments about people having to decide that point for themselves seem hollow or rhetorical, and cause issues with moderates in the middle who may be accused of not respecting autonomy only because we draw that line too far in one direction, as opposed to actually opposing autonomy completely.

By Verbose Stoic (not verified) on 31 Jul 2014 #permalink

VS:

the question is if in those cases we have to reteach those people to find meaning in other things, or if we have to accept their assessment of it. Jason does hint that he thinks that in at least some cases people can make mistakes about what really gives life meaning, and so we should convince people of that. But that contradicts the autonomy point

I don't see how it's contradictory. You are again trying to exclude the middle. We can encourage terminal and in-pain people to find meaning or happiness in the condition that they have - and we can see that effort as a social good - AND at the same time allow them the decision to end their life. One effort doesn't preclude the other, and thinking the latter is a moral or social good does not preclude thinking the former is a social good too.

I also think you're getting wrapped around the axle on the issue of who determines meaning of life and whether it can be objectively determined. The individual seeks to find that, and society seeks to prevent them from making a damaging or costly mistake. There is give and take between the two, and there probably always should be. You might see that as a hollow or rhetorical support to individual autonomy, very close to Smith's position that nobody should ever be legally allowed to end their own life, but I don't. I made this point with the drivers's licence example: my personal autonomy to drive is restricted in part by the State, but that's not equivalent to a condition of having no driving autonomy. Its not hollow by any means - at least to me it isn't. Maybe to you it is.

eric,

I think you're talking policy and not principle here, which is what I was chided for. The point I'm making here is around this question: How do we determine -- or who gets to decide -- whether a person's life still has meaning or not? The strong statements that Jason is making based on personal autonomy, if taken literally and seriously, say that it's only the person themselves that decides that, and no one else. Thus, if a fully-informed and mentally competent person decides that their life no longer has meaning, then it no longer has meaning. End of discussion. No one can say that they're wrong.

This doesn't mean that you can't try to convince them otherwise, or point out things that they're missing, or point out flaws in their reasoning or etc, etc. It simply means that if they make that decision fully-informed and mentally competent, they are right, and no one can say that they're wrong even if YOU would still have a meaningful life in their condition This is what I take Jason as advocating, and it is contradictory to an idea that you can find cases where they are, in fact, wrong about that even if fully-informed and mentally competent. The closest you can come to a middle ground here is a claim that even though it IS their decision, all fully-informed and mentally competent people WILL come to the conclusion that their life would still have meaning in certain circumstances, and while it seems to be true for at least some circumstances, it doesn't work for some of the cases we're talking about, nor would it allow for one person to think their life has meaning in a case like Rehm's and for another to not think that, which I am pretty sure that Jason wants to allow.

By Verbose Stoic (not verified) on 31 Jul 2014 #permalink

Either your life is of ultimate value, possessing unique dignity, potentially cast in the image of a transcendent designer and thus awesomely precious.

So a person who believes in a "designer" couldn't possibly value anything more than their own life. Therefore religious martyrs do not exist. QED.

What a maroon.

By Reginald Selkirk (not verified) on 31 Jul 2014 #permalink

@30:

The strong statements that Jason is making based on personal autonomy, if taken literally and seriously, say that it’s only the person themselves that decides that, and no one else. Thus, if a fully-informed and mentally competent person decides that their life no longer has meaning, then it no longer has meaning. End of discussion. No one can say that they’re wrong.

As a strictly practical matter of fact, life's given circumstances make this true whether the God-fearing like it or not. Suicide is open to any nomally sane and physically able person. Even many others, intentionally or unintentionally, prove themselves capable of ending their own lives.

The issue here really only concerns how and why this prerogative ought to be denied to many others who, though mentally competent adults, otherwise recognised as competent to decide all of life's other important matters for themselves, because they are incapacitated through illness, cannot do for themselves what is open to the rest--end one's own life by deliberate choice. Since the suffering in such cases depend on the help of others to end their lives, it's up to those with sufficient humanitarian consciousness to recognise the need and the importance of giving such help --since religious zealots, convinced of the all-important sanctity of Life in the abstract, cannot countenance, even if they can conceive of, the act of mercy by which one person helps another end his own intolerable (as the principal concerned sees it) life.

By proximity1 (not verified) on 31 Jul 2014 #permalink

proximity1,

As a strictly practical matter of fact, life’s given circumstances make this true whether the God-fearing like it or not. Suicide is open to any nomally sane and physically able person. Even many others, intentionally or unintentionally, prove themselves capable of ending their own lives.

Actually, no, it doesn't. You're replying to a statement about whether their assessment of the meaning of their life can be considered wrong with a comment that they can always kill themselves if they want to anyway. Sure, but that has no bearing on whether we can say that they were right or wrong in their judgement of the meeaning of their life that led them to commit suicide. In short, whether or not they do kill themselves doesn't mean that we have to say that because they did kill themselves they were right to do so.

And this has policy implications. If we can say that someone is fully-informed, mentally competent and yet still judging the meaning of their life incorrectly, then we can ask whether we should intervene to TAKE AWAY their ability to kill themselves, as if they are wrong that their life has no meaning and their reason is that their life has no meaning, then we would be preventing a tragedy.

Note: This does depend on being able to say that they're wrong and can be wrong about the meaning of their life if they are fully-informed and mentally competent, which Jason at least seems to be arguing against.

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

@33: "Actually, no, it doesn’t. You’re replying to a statement about whether their assessment of the meaning of their life can be considered wrong with a comment that they can always kill themselves if they want to anyway. Sure, but that has no bearing on whether we can say that they were right or wrong in their judgement of the meeaning of their life that led them to commit suicide."

LOL!

Hmmm. I see your rather trivial point. In my cut-and-paste haste, I included the unfortunate .."End of discussion. No one can say that they’re wrong," when, obviously, these last are not strictly the case. It's isn't the "end of discussion" and certainly not true that "no one can say they're wrong."

My actual point was that most normal, healthy, mentally competent people have a naturally-given capacity to end their own lives if, in their sole opinions, their lives are not worth enduring any longer. Of course, it was hasty to have included in the cut-and-paste the last two remarks, but I did that, didn't I?

So, here, allow me to amend that and state that---

as a matter of simple fact, though others can debate it, can pass whatever judgment they may please on it, Nature endows most healthy people with the capacity to choose suicide and to act on that choice.

Period. End of my declarative statement. But, here, of course, not the end of "the debate."

I invite you to demonstrate that the above (which was really the point I intended to make) is somehow not true if you can.

The debate here, then, turns on how and why those who are sick and suffering and who are not physically capable of suicide ought to be denied by custom's taboos or by formal legal prohibition from seeking and getting the aid of others to help in their desired suicide.

By the way, regarding this:

... "And this has policy implications. If we can say that someone is fully-informed, mentally competent and yet still judging the meaning of their life incorrectly, then we can ask whether we should intervene to TAKE AWAY their ability to kill themselves..." (emphasis added)

True, no doubt we can ask whether we should (i.e. ought to) intervene to TAKE AWAY their ability"... etc. and, similarly, we can also ask by what compelling reason we ought to consider ourselves justified in determining that the answer to the question of whether "we should (i.e. ought to) TAKE AWAY their ability" should be the affirmative, "yes."

What's your rationale for such a "Yes"? (Or, just point me to the post above where you've already set this out for us. Thanks.)

By proximity1 (not verified) on 01 Aug 2014 #permalink

VS:

How do we determine — or who gets to decide — whether a person’s life still has meaning or not?

I think I have answered this three times already. The individual does, but in collaboration with and oversight from our representative government. This type of limited/collaborative autonomy is extremely common, in fact we can probably call it the norm. You also have a limited/collaborative autonomy to speech. To religious practices (though not belief; that's not limited). To bearing arms. To driving. To biking. To home remodeling. To medical decisions not involving end of life issues. To what you wear. And so on, and so on, and so on...

The strong statements that Jason is making based on personal autonomy, if taken literally and seriously, say that it’s only the person themselves that decides that, and no one else.

That is half of what Jason is saying. You are focusing on one of two points he makes up front, and arguing about where it leads as if the second point doesn't exist.

Now, knowing you're a philosopher, I can see how you might be intellectually curious to discuss that as an interesting sidebar. But if you want to discuss the logical consequences of the position Jason laid out in the original post, you cannot take his two main points, analyse the first in the absence of the second, and then claim you've come up with a problem in his position. That's, IMO, strawmanning.

P.S. @ 33

VS: Here's an real-life case-example.

At a blog I long frequented, I came to "know" and like many of the other regulars. As happens in real life, many of us were troubled people and one of the regulars was one of the more troubled among us (*). His lot in life was very much up and down, and when it was down it was deeply, deeply down.

At one point, he posted a comment at the blog which could only be interpreted as a "good-bye, cruel world" farewell. Alarmed, the site's regulars who knew him best immediately raised the alarm and he was found comatose at home or at the home of a friend witih whom he was staying temporarily. (Details are now hazy.) After he was rushed to the hospital and saved and once out of the coma, he was furious with friends and family who'd intervened to save him. So, naturally, several of us were concerned that (as I said above) he'd again exercise nature's right to try and end his life--and next time probably not leave a farewell note at the blog.

I posted an appeal trying to convince him not to do that. I tried to tell him that, while I couldn't site any ultimate grand purpose or meaning to carrying on in this veil of tears, that he, if he only tried, could likely come up with some contingent reason to stick it out here with the rest of we his fellow suffering fools. Some applauded me for it. But, after reflection, I came to think that, if this guy couldn't muster a good reason why he ought to go living (and by the way, though he suffered from depression, he was not terminally ill or even suffering a chronic illness --other than depression, that is.) it was presuming a hell of a lot in trying to provide the second-hand confidence to keep looking for one. In the end, he did try again and succeed. He lept off the Golden Gate bridge. Afterward, I wrote in the blog asking, generally, of the other regulars, whether any of us were really up to the task and responsibility of assuming for someone else the role of finding an enduring meaning and purpose for another's life when the principal himself could not succeed at that. It finally struck me as a very presumptious thing to do and I still think so today. Unless a person is clearly insane--as in he or she believes he's a lampost, or otherwise not a competent adult, I don't think it's our place as individuals or as a society to decide for others (let alone enforce such a decision on them) when their lives are or are not worth carrying on.
-------

(*) though, while we oftened agreed, this fellow didn't actually participate that much in discussions, he did have a certain voting authority among the stie's rulers and he acutally intervened on my behalf at times when otherwise I'd have faced a vote of banishment (Go figure!) for so insistently and controversially speaking my mind) )

By proximity1 (not verified) on 01 Aug 2014 #permalink

I think that behind a great deal of the religious fevor for the doctrine which holds that life is God's supremely sacred gift which, therefore, should never, under any circumstances, no matter how unbearable, be willingly relinquished (except in the effort to save another's life) is a deeply frightening fear that, in fact, suicides speak very powerfully against such a doctrine and are therefore dangerous affronts to doctrinal authority. The priest and rabbi and imam have long recognised the importance of the power to determine for others whether, when and how they may marry, procreate and die. That each one may take upon himself the responsibilities for such questions is nothing short of an open challenge to religion's power. And that's just tough, isn't it?

By proximity1 (not verified) on 01 Aug 2014 #permalink

@ 29: Good points RE @28 : "Now the question is if in those cases we have to reteach those people to find meaning in other things, or if we have to accept their assessment of it. "

to which I add, by a certain Darwinian view, it's true that, ultimately, a human society which leaves many of its members in such a deplorable state of misery that they find the idea of early and prompt suicide a welcome alternative to living is a society the longterm prospects of which are in serious trouble. So, in that sense, extraordinary levels of suicide are, as they ought to be, cause for concern but most of all in one particular respect: they ought to serve as a prompt to seriously question and examine and correct the set of miserable living conditions which could prompt so many to prefer not to live at all.

And this, by the way, is something that present-day industrial society has, I believe, some very good reasons to be taking into consideration.

Please look to yourselves and your society's conditions, those who'd ask of others, "How dare you throw your life away?" since the reply may come, "Here's how."

By proximity1 (not verified) on 01 Aug 2014 #permalink

eric,

That is half of what Jason is saying. You are focusing on one of two points he makes up front, and arguing about where it leads as if the second point doesn’t exist.

Read the two points again. The first point is expicitly talking about having autonomy. The second says what I said Jason was saying. Precisely which of his two major points are you claiming I'm ignoring?

proximity1,

Your LOL and your comments about triviality would be more credible if those two sentences you claim you should have left off WEREN'T my actual point. Thus, your comment 34 is pretty much irrelevant to the discussion, which was my point in 33 (that your comment about people being able to kill themselves anyway is irrelevant to determinations of whether their view, if fully informed and mentally competent, could ever be wrong). Your example and discussion actually DOES get to the point, but there's no argument there; you capture the problem, but you don't reason out a solution other than to assert it. If someone is wrong about their life having meaning and we might be able to teach them otherwise, can we prevent their suicide until they do see that? It's a tough question, but is based around an idea of whether there can be an objective answer to the question of what gives life meaning, which Smith et al think is absolutely the case and I think Jason will tend to deny (note that his comments about it not being arbitrary don't quite get to objective, nor does he seem to be trying to get there).

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

Read the two points again. The first point is expicitly talking about having autonomy. The second says what I said Jason was saying. Precisely which of his two major points are you claiming I’m ignoring?

When you say that "only the person themselves that decides that [when they kill themselves], and no one else," you are ignoring the "such a state of physical debilitation" point. Jason is not supporting suicide without limit. He made that very clear to you in @15, and yet you're still arguing against this autonomy-without-limits position that he has said explicitly he doesn't hold. That's straw manning.

There's another case to be made here -- there is anecdotal evidence that for many people with degenerative diseases, knowing that they will still have the agency to control their destiny when they are eventually incapacitated may in fact prolong their lives, as they might decide to end their lives "prematurely", while they were still able to make the decision and physically follow through with it. Eric MacDonald's wife comes to mind immediately, but there are other similar stories.

By Another Matt (not verified) on 01 Aug 2014 #permalink

eric,

I'm not ignoring it. My point -- which Jason seems to have confirmed in his latest post -- is that the details of that state -- ie how debilitated that has to be -- is determined by the person, not by the state. Assuming that they are mentally competent and fully informed, of course. To do otherwise would contradict the first point. But instead of quibbling over what Jason means, let's try to see what it would mean.

Let's imagine someone who loves music, and playing it and listening to it is their absolute greatest joy. And then they go deaf. They live that new life for a reasonable amount of time to determine what it will be like for them, they are mentally competent, and they know about all appropriate options and so are fully informed. And they decide that without the ability to experience music, their life has no meaning. They know about friends, family, love and all of those things, have experienced them, and STILL decide that their life no longer has meaning and decide to die. Does the state or anyone else get to reasonably call them wrong, or is the fact that they, fully informed and mentally competent, made that decision sufficient to claim that they are right and justified in their decision?

THIS is where the state issue comes in. The person above likely wouldn't need assisted suicide, but if the state wouldn't allow them to get it based on THIS DETERMINATION as opposed to them not needing it, that would indeed be something that we should see as contradicting the personal autonomy point ... and, therefore, both of Jason's points.

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

@ 39:

In fact, I understand that you really don't want to dwell on the fact that, as a practical matter, suicide is, for most people, (at least those in average health) an option open to them if and when they should determine "correctly or incorrectly" (as you'd have it) that their lives are not worth continuing.

Instead, given that, your focus is on matter of who determines and how it's determined that a suicidal person's judgment of his life's continued worth is correct or incorrect, true or mistaken.

You're ready to take the question as proper one for society's concern and debate it. You're not bothered by the fact that bridges, tall buildings and railroad tracks and their passing trains make ready venues for those contemplating suicide to carry out their urges whether or not their judgment on their life's worth is valid or faulty. For you, the practical reality does not trump the importance or usefulness of a formal social ruling on this issue. Society should declare itself pro or con assisted-suicide.

And if for no other reason, perhaps it ought to-- merely so that those who think far enough ahead can avoid finding themseleves in need of help to die when the time comes that they are convinced that that is what is best for them in their circumstances.

As I see things, personal freedom implies the freedom to make mistakes, to misjudge--including even fatally-- the value of continuing one's own life or not continuing it. Certain mistakes of course have to be liable to criminal prosecution and penalties of imprisonment because they do foreseeable harm to others.

I don't see the issues as so terribly thorny. I think that suicide prevention, like assisted-suicide for the terminally ill and incapacitated, should remain open courses for those who are inclined to take these up as causes for the improvement or relief of other's living circumstances. The matter should, I think, be elective. It's not wrong to counsel a suicidal person against that act. Whether or not such an impulse is mistaken or rightly arrived at is after all a subjective matter. What I do regard as morally wrong is to substitute one's own percepts of what should or must constitute the grounds for determining that life is or is not worth continuing for those of another--the principal whose life it is that is in question.

... "If someone is wrong about their life having meaning and we might be able to teach them otherwise, can we prevent their suicide until they do see that? It’s a tough question, but is based around an idea of whether there can be an objective answer to the question of what gives life meaning, ....

I doubt that there can be such an objective answer to such a question and I certainly hope that there cannot be. If we could be convinced in large numbers that there is an objective answer to this question, the certain next step would be to classfy that answer and enforce it in law upon any and all who happen to disagree.

That, in fact, is what I argued in the case of the fellow chat-room participant. My point was that we ought to be grateful that there is apparently probably no such objective answer and for the fact that, for lack of one, we are left free to find or invent one which suits us and, if we cannot, then we are equally free to decide that we needn't be constrained to carry on a life in which we can neither find nor create some compelling purpose to pursue.

For me, the issues are practical ones, not theoretical ones. Yes, they are philosophical issues but, as such, they should relate to practical living realities, not abstractions which spring from an attachment to dogma. I don't want the responsibility for providing another individual with his or her decisive reason to carry on living. I'm satisfied if I can simply help contribute to making social conditions such that, if left free to use their own creative faculties, people can, by their manner and for their own reasons, find in social conditions all the reasons they require to decide that their lives are worth carrying on. If they cannot, if they fail--even by mistaken judgment--to discover any good reason to live, I don't want to stand in the way of their choice about the matter and I certainly don't intend to do so either in my capacity as individual or as one member of the larger society.

By proximity1 (not verified) on 01 Aug 2014 #permalink

VS:

My point — which Jason seems to have confirmed in his latest post — is that the details of that state — ie how debilitated that has to be — is determined by the person, not by the state.

I'm not sure he's confirmed it as much as you think he has. My position is that the details of how debilitated one has to be is not determined solely by the individual, the state sets limits, and I also think that supporters of even very liberal suicide polcies are going to admit that the state has a role to step in and stop some bad decisions. IOW I think pretty much everyone is going to agree on some state-determined limits and regulation, the question is how much. Nobody wants teenagers killing themselves because oh my God Suzie stole my boyfriend and I just can't live without him. Nobody is suggesting that an individual solely decide when they are debilitated enough, because that is the practical equivalent of 'no debilitation at all' suicide, suicide on whim. And I'm not arguing for that. Jason isn't arguing for that. AFAIK Eric MacDonald isn't arguing for that. So who are you arguing against when you argue against that 'full autonomy' position?

eric,

Why don't you give me your answer for the case I outlined instead of ramping up to the extreme case? Then we can see what the clash is or if you're trying to dodge the hard questions.

Note, again, that I repeatedly talked about needing a principled reason to break the absolute autonomy that Jason talks about, and I don't think there is one. You have not provided any principle, and so so far are only saying "No one is saying THAT" about cases that you, it seems, personally and intuitvely have problems with. That's not enough to trump any right, even as we all agree that rights have limits. Even in your example, what right would the state have to decide that the teenager is wrong about that, beyond an argument that they aren't folly informed or aren't mentally competent at the time?

As for the debate, again remember my comment from before: don't fire off rhetoric about how this is all about autonomy and how no one can tell someone else when their life has meaning when you are, in fact, perfectly willing to do so. This is not a criticism of Jason's postion, as I take it, but of your continual attempt to defend it by insisting that the determination of the meaning of their life is not theirs alone, but also includes state determination and possibly even IMPOSITION, which is what Smith et al are also claiming, but they just draw the line on where someone gets to decide that further down the road than you are.

If you have a principled way of drawing that line, present it, otherwise it simply looks as arbitrary a distinction and thus as much of an infringement of autonomy as what Smith et al want. And since pragmatic concerns have already been conceded, that's not the argument you can stand on; you would be arguing, there, for the strong position as I accuse you of but that the real world sometimes does not allow for the ideal.

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

eric,

Caught this as I was posting, and so this might get it down to brass tacks.

My position is that the details of how debilitated one has to be is not determined solely by the individual, the state sets limits, and I also think that supporters of even very liberal suicide polcies are going to admit that the state has a role to step in and stop some bad decisions.

And the question is this: Given personal autonomy and that argument against people like Smith, and given that an individual is both mentally competent to make this decision and is also fully informed about all of the consequences, what right does the state have to claim that this would be a "bad decision"? What criteria can they use to decide this for someone who is mentally competent and fully informed? And what principle can you rest that on that doesn't make Smith et al just as respecting of personal autonomy as you are, it's just that they think that some cases are bad decisions when you don't?

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

Messed up the blockquote; first paragraph is yours, second is mine.

By Verbose Stoic (not verified) on 01 Aug 2014 #permalink

VS:

Why don’t you give me your answer for the case I outlined instead of ramping up to the extreme case? Then we can see what the clash is or if you’re trying to dodge the hard questions.

Sure. In my opinion, your deaf musician should not have legal assisted suicide as an option, because his/her condition is not terminal.

The 'principled reason' is that mentally competent people can sometimes make mistakes in judgement, and the one method that humans have to help minimize mistakes is to evaluate such a request against community standards of distress. Its certainly not perfect, but its better (IMO) than no 'check and balance' at all. We have a lot of history of humans getting over things, we have a general idea of what distress they will get over and what distress they won't, but someone in distress might not see it that way. So we do our best to use that history to ensure that we do not allow suicide for the types of distress that 99% or 99.9% of people get over, and go on to live happy lives with. Like deafness.

Now, can you do me the favor of answering my question? You've spend a lot of time arguing against the "pure autonomy" position. Who do you think holds that position? Who are you arguing against?

eric,

Let me outline the POSITION that I'm talking about, to make sure you get it, and then you should be able to see how it seems to be the position of Jason and likely Eric MacDonald. Note that I am leaving the policy discussions out of it for a bit, so it will look extreme, but I'll adjust that afterwards.

1) Personal autonomy means that only the individual gets to decide when their life has meaning.
2) If someone decides that their life has no meaning, it is cruel and immoral to force them to continue living.

This has at least a couple of implications. One is that assisted suicide should be allowed in all of these cases if necessary. The second is that you shouldn't intervene to prevent a suicide of someone who has made such a decision.

Now, there are a few other considerations, and the biggest one is about when someone can be said to have actually made that decision. One can argue that in some cases the person is either permanently or temporarily unable to make such a decision due to a mental issue, and so in that case they cannot be said to have really made that decision. This is what results in the "mentally competent" exception. Additionally, someone may be mentally competent but not be fully informed as to all of the consequences and what the future would actually be like. Thus, the "fully informed" exception.

However, what Eric clearly holds and what Jason has just clearly stated is that from that starting point drawing a distinction between terminal and non-terminal cases cannot be done, and moreover is contradictory. If you start from a "meaning of life" argument -- not so much personal autonomy, actually -- then it is clear that there are people with non-terminal conditions whose quality of life would be precisely as bad if not worse than people with terminal conditions. There's no reason to say that just because they aren't going to die in a short amount of time that their condition is more meaningful or allows for more meaning. In fact, it can be said to be worse: after all, not allowing assisted suicide in those cases only leaves them in that state LONGER, as there is no reason to think that the condition will kill them anytime soon.

So if you are going to criticize people for trying to tell others what should give their life meaning in these cases, you can't draw a distinction between terminal and non-terminal cases. Otherwise, you look like you run afoul of Jason's first post title: you think that because in the non-terminal cases their heart will keep beating that, therefore, they either will have lives that have meaning or that someone life itself is worth preserving regardless of whether that life will have meaning. Both of these contradict the whole principle outlined above, in ways that mentally competent and fully informed don't.

In fact, your whole "we need to stop them from making a mistake" line is, in fact, a big part of Smith's argument, and the reason he gave the examples he did, as they are examples of people who at least in theory were mentally competent and fully informed and decided that they wanted to die, who later decided that that decision would have been a mistake. To deny assisted suicide in some cases because you think they would be making a mistake is to take Smith's position, not Jason's. To put it better, it is inconsistent with Jason's position to say that if we think that it might be the case that a mentally competent and fully informed person is making the wrong decision then we should make the decision for them. From that position, the "tie" as it were goes to the individual, not the state or the society or the social context or whatever. It is, under that view, their decision to make. You can intervene if you think that they are missing some critical information or critical capacity -- within reason -- but otherwise you are taking that decision away from them, which you cannot do.

To be consistent, people like Jason and Eric should, in my view, have to believe that it is better for people to choose to end their own life even when if they hadn't they would have found new meaning in it than it is to force someone who really has no meaning in life and will never have any meaning in life to keep on living. People like Smith argue the opposite: that it is better to force someone to live when they legitimately feel that their life isn't worth living than to allow someone to die when they would indeed regain a reason to live. Sure, everyone would probably rather neither case happen, but the fight over, at least, the meaning argument comes down to where the tie goes.

By Verbose Stoic (not verified) on 04 Aug 2014 #permalink

VS, the problem with your dichotomy is that we can't ever know the answer. People find the means to commit suicide without a doctor's help every day. If the individuals Smith highlighted had really wanted to die, the illegality of assisted death would not necessarily stop them. Where there's a will, there's a way. Perhaps it is more likely that they really didn't want to die in the first place.

Why isn't it possible to put enough safeguards into place to allow people autonomy? Why do we allow "do not resuscitate orders"? Why are people allowed to disconnect life support? Do you not think that people making this choice haven't thought about it long and hard - that their friends and relatives haven't try to talk them out if it - even for purely selfish reasons? These are not snap judgements of depressed people.

The argument from sanctity of life is mindless - it is a cliché. We know very well that both states and religions encourage individuals to sacrifice their lives for a supposed greater good. They routinely kill those presumed guilty of offending god or country and innocents as "collateral damage."

Smith is attempting to apply a personal religious belief to everyone. He believes a God has authority over everyone's life and this God gets to decide who lives and dies - abortion and euthanasia violate this God's will. The idea that this God has some plan for our lives and will only kill us off when that plan is fulfilled. The idea that life is more important than anything else is vacuous - especially when those making that claim don't really believe it themselves. When Smith can tell me when, where, how and why this God told us that there should be no assisted suicide, perhaps then I will consider his empty rhetoric has some substance.

By Michael Fugate (not verified) on 04 Aug 2014 #permalink

VS, I don't know whether arguing with you further on this point will do any good, so I will just reiterate two of my points.

First, I think you're (still) strawmanning JR and EM's positions, and that neither of them are advocating for suicide on a purely-individually decided basis. Perhaps terminal/non-terminal is not the appropriate place to draw the line, but I think both support the notion of the government (acting as representatives for we the poeple) placing oversight and regulations on that decision.

Second, I think you are utterly incorrect to say my position is more like Smith's than Rosenhouse's. Smith advocates for none. Rosenhouse advocates for some, under a hazy rules set. I advocate for some, under a community-defined rules set. Which of these things is not like the other?

It may also be worth remembering that law -- in general terms -- tends to be reactive and inductive rather than prescriptive and deductive. What this means for policy is that it need not always be based on principle that always runs through to logical conclusions; slides down slippery slopes can be halted simply by legislative fiat. Legalizing marijuana need not entail legalizing meth, for one example -- messy lines have to be drawn as new cases and new evidence arises.

Autonomy!!
*except in cases A, B, C, D, and E, for these reasons...

By Another Matt (not verified) on 04 Aug 2014 #permalink

eric,

First, I think you’re (still) strawmanning JR and EM’s positions, and that neither of them are advocating for suicide on a purely-individually decided basis. Perhaps terminal/non-terminal is not the appropriate place to draw the line, but I think both support the notion of the government (acting as representatives for we the poeple) placing oversight and regulations on that decision.

You're strawmanning MY position ... or, at least, the position I'm claiming they have. Remember, I'm continually, continually saying that we can have restrictions on this on the basis of legal pragmatic concerns, and specifically on the basis of mental competence and fully informed. That the state can place some restrictions on it is not under debate. Whether restrictions can be placed on it on the basis of MEANING OF LIFE is what's under debate here, which is something that you have continuously failed to grasp no matter how often I talk about it. Jason and Eric's position, as far as I can tell, is that you can't say to someone who genuinely believes that their life has no meaning that it really does, that they are wrong to think so, and that therefore we will not allow them the options that we would allow to someone who is correct about that determination, because there is, in fact, no right answer to the question of whether a life has meaning beyond what that person decides.

Second, I think you are utterly incorrect to say my position is more like Smith’s than Rosenhouse’s. Smith advocates for none. Rosenhouse advocates for some, under a hazy rules set. I advocate for some, under a community-defined rules set. Which of these things is not like the other?

Smith is willing to tell people that they are wrong to think that their life has no meaning. Jason's rhetoric and comments about Oregon's position suggests that he is hesitant to do that, and perhaps is utterly unwilling to do that. You, by your own admission, are indeed willing to tell people who are mentally competent and fully informed that they are or may be wrong about their decision, and prevent them from getting assisted suicide on that basis. That Smith is willing to say that they are wrong if they EVER think that their life has no meaning and that you are only willing to say it in cases where a very high percentage of people -- who may not be them -- WOULD still have meaning in their lives indicates what I've argued from the beginning: the difference is not in terms of principle, but simply where you'll draw the line. Which you admitted here.

Another Matt,

It may also be worth remembering that law — in general terms — tends to be reactive and inductive rather than prescriptive and deductive. What this means for policy is that it need not always be based on principle that always runs through to logical conclusions; slides down slippery slopes can be halted simply by legislative fiat. Legalizing marijuana need not entail legalizing meth, for one example — messy lines have to be drawn as new cases and new evidence arises.

Remember Jason's comments about conflating the question of personal autonomy and the question of public policy? That's what you're doing here. Also note that this doesn't seem to help your position, considering that I've conceded practical considerations already. You just can't do it in such a way that says, essentially, that we think you're using personal autonomy in a way we don't agree with, so you can't have it. Harkening back to the free speech example, the same thing applies: you can restrict harmful speech, but not speech that people just don't like or agree with.

By Verbose Stoic (not verified) on 04 Aug 2014 #permalink

Whether restrictions can be placed on it on the basis of MEANING OF LIFE is what’s under debate here, which is something that you have continuously failed to grasp no matter how often I talk about it.

I grasp it perfectly, always have, and have been responding to it. The 'meaning of life' position is the 'full autonomy' position, the position that once someone is found mentally competent, if they decide their life has no meaning, no other person or government can countermand or contradict that finding.

You keep saying Jason and Eric hold that position, but it is very clear that Jason, at least, does not. He's told you that explicitly. Here's a reminder:

Answering yes to that question in no way implies that I think our public policy should be that anyone has the right to be granted assisted suicide for any reason at any time.

I’m sure you believe people have a right to free speech, and I’m equally sure you don’t think that implies our public policy should be that anyone has the right to say anything at any time for any reason.

Seems pretty clear; Jason is arguing for autonomy but not the absolute autonomy you keep attributing to him. He's not arguing that a mentally competent individual's determination of (lack of) meaning of life gives them the legal right to suicide no matter what; the state can place limits on it the same way the state places limits on your speech.

Jason and Eric’s position, as far as I can tell, is that you can’t say to someone who genuinely believes that their life has no meaning that it really does, that they are wrong to think so, and that therefore we will not allow them the options that we would allow to someone who is correct about that determination, because there is, in fact, no right answer to the question of whether a life has meaning beyond what that person decides.

That's a very complex sentence, but it seems pretty clear to me that Jason is saying you can say to someone who thinks their life has no meaning that they aren't legally allowed assisted suicide.

eric,

Yes, it seems absolutely clear to me that Jason and Eric are saying that if a person genuinely determines that their life has no meaning, that no person or government can countermand or contradict that determination ... the determiniation, specifically, that their life has no meaning. If you add this -- as they seem to do -- to an argument that if someone's life has no meaning that therefore to force them to go on living is cruel and immoral, then you get to the case that the state ought to allow them assisted suicide when THEY make the determination that their condition is such that their life has no meaning. Note that this doesn't follow if you don't try to use personal autonomy to justify allowing assisted suicide, but they clearly do.

So, then, does that imply that I'm also saying that this isn't the case?

...t seems pretty clear to me that Jason is saying you can say to someone who thinks their life has no meaning that they aren’t legally allowed assisted suicide.

Not at all. As I've said a ton of times over the last few comments, you can indeed not legally allow assisted suicide under a number of conditions. You have to be able to tell that they are mentally competent. You have to be able to determine that they are fully informed. And there may be practical considerations (ie we can't tell what your decision actually IS clearly enough). Whatever. So there being some restrictions is again not under debate.

The key here -- and if you respond to nothing else in this comment, this is what you have to respond to -- is that I hold their position as needing to be this to be consistent: the government cannot say that someone is not legally allowed assisted suicide because despite the fact that we know that they made the decision that their life has no meaning, that they were mentally competent to make that decision, and that they were fully informed about all aspects OF that decision, because that decision -- again, just that their life no longer has meaning -- is not the one that the government or even the majority of people think that person should make. In short, the government can't say "We know you decided that your life has no meaning genuinely, but we think you're wrong, so we're not granting you legally assisted suicide". If you allow that case, then you are contradicting the personal autonomy argument completely, not merely carving out reasonable exceptions. Because you are indeed challenging the basis of the argument: that the only person who can decide if their life has meaning is the person themselves.

Now, if you note my answer to terminal/non-terminal, this does go away if you don't use "meaning of life" as your basis for saying that not allowing legally assisted suicide would be wrong. That's not what Jason does here, and Eric aims at the same sort of argument, and without that you have no cause to criticize anyone for not respecting personal autonomy.

To summarize, if you start from saying that the only person who can determine whether their life still has meaning is the person themselves, and use that to get to "Therefore, we should allow assisted suicide", then at that point you cannot restrict that allowance on the basis that others get to decide for them whether their life has meaning or not when they are indeed able to make that determination themselves. Again, you can't say "No assisted suicide for you because you're making a different choice than we would/think you should make". And that, to me, is the absolute autonomy argument, or at least the implication of it.

So, given that, do you STILL think I'm strawmanning them? What case of the government deciding "Your decision is wrong" WOULD be consistent with that principle, that only the person themselves can decide if their life still has meaning? Or, if you think they don't actually hold that, what quote can you provide other than "We can restrict it sometimes" that contradicts the flat-out statement of that point, noting that I can easily show lots of restrictions that DON'T run afoul of this because they DON'T say that the decision is wrong?

By Verbose Stoic (not verified) on 05 Aug 2014 #permalink

I always get to the end of these discussions and never learn anything about what opinions VS actually holds. I can't figure out if he is arguing for or against a position because he has a position or if he is just playing devils's advocate. Does he think individuals should have access to assisted dying and if so under what circumstances or for what reasons should they have access?

I do know Smith thinks that all human life has meaning (animal and plant life doesn't) because a God creates humans in its image and therefore humans are unique and special (in other words exceptional). The state, given it authority from this God, should ban all abortions and assisted suicides and under some circumstances should hold women responsible for their miscarriages.

It is an authoritarian and a religious view even though he uses secular language. Without a God, the argument falls apart. This is all tied into their anti-evolution stance.

By Michael Fugate (not verified) on 05 Aug 2014 #permalink

VS:

I hold their position as needing to be this to be consistent: the government cannot say that someone is not legally allowed assisted suicide because despite the fact that we know that they made the decision that their life has no meaning, that they were mentally competent to make that decision, and that they were fully informed about all aspects OF that decision, because that decision — again, just that their life no longer has meaning — is not the one that the government or even the majority of people think that person should make. In short, the government can’t say “We know you decided that your life has no meaning genuinely, but we think you’re wrong, so we’re not granting you legally assisted suicide”. If you allow that case, then you are contradicting the personal autonomy argument completely, not merely carving out reasonable exceptions.

I disagree: I think carving out reasonable exceptions to personal autonomy is not only a possible position, it is a reasonably justified possible position. Limited autonomy bounded by social policy is the norm. We do it for speech. We do it for religious practice. We do it for the right to assemble and freedom of the press. We do it for gun ownership. We even do it for far more trivial things such as what you can wear in public. And in fact we do it for assisted suicide in Oregon. So I find your assertion that we cannot do it for assisted suicide - that such a position would be inconsistent with the notion of personal autonomy - to be a bald assertion with zero empirical support and tons of empirical counter-evidence.

And whether it's inconsistent or not, it's the position Jason and I both hold. IMO you should argue against the wisdom of the position we actually hold, rather than using it as a jumping-off point to argue against the 'full autonomy' position that nobody on this board actually holds. What's bad about it? What's going to happen if we hold it? I think that would be a much more fruitful discussion than you telling us why a position nobody on the board actually holds is a bad position.

In short, the government can’t say “We know you decided that your life has no meaning genuinely, but we think you’re wrong, so we’re not granting you legally assisted suicide”. If you allow that case, then you are contradicting the personal autonomy argument completely, not merely carving out reasonable exceptions. Because you are indeed challenging the basis of the argument: that the only person who can decide if their life has meaning is the person themselves.

How are you going from "My life no longer has meaning, I wish to end it now" to "Oh, yeah, personal autonomy, here's your death pill!" as the only possible answer?

Is this your version of "no objective morality = nihilism?"

eric,

I disagree: I think carving out reasonable exceptions to personal autonomy is not only a possible position, it is a reasonably justified possible position. Limited autonomy bounded by social policy is the norm.

This also isn't what we're arguing over. I'm trying to figure out how in the world you keep insisting that I'm arguing that the position must be completely unrestricted when I've listed more valid restrictions -- mentally competent, fully informed, potential practical considerations -- with more arguments than YOU have. I can only surmise that you're still holding Smith's "for any reason" literal quote against my position, despite my not having done that for ages and ages.

So, we agree that there can be some reasonable restrictions on assisted suicide. I'll assume that you aren't going to argue that there can't be any UNREASONABLE restrictions on assisted suicide, because I can't believe that you'd hold such an obviously insane argument AND the argument against Smith is that his restrictions ARE unreasonable. So, since we're at that point, please understand that my comments are about one set of restrictions that I think that Jason and Eric MacDonald would find unreasonable:

Restrictions based on the state deciding that even though the person genuinely believes that their life has no meaning, their life ACTUALLY DOES HAVE MEANING, or at least ought to.

And here are the consequences of that:

Take my deaf person example. The state would be placing an unreasonable restriction if it said: "Being deaf and not being able to experience music doesn't mean your life has no meaning. After all, you have family and friends and can live a productive life. So, for no other reason than that we think you're wrong even though we think you mentally competent to make this decision and fully informed about it and we have no practical reasons to deny this, we are denying you assisted suicide". As I have said umpteen million times, that would be the state IMPOSING an idea of what gives life meaning on a person, and insisting that they remain alive even though that person's life HAS no meaning. The only way to argue against that is to drop the idea that the only person who gets to decide if their life still has meaning is the person themselves. You tried to dodge this by distinguishing between terminal and non-terminal cases, except Jason doesn't, Eric MacDonald doesn't, and even you yourself conceded that maybe you couldn't justify that distinction, so you have given no reason to think that it would be an unreasonable restriction to deny it in this case.

Smith's examples also fit this case, that even though later they came to realize that they made a mistake, if at the time they really believed this then using the PHILOSPHICAL underpinning as opposed to the policy underpinning -- and remember that Jason chided me for conflating the two, while you continually do so especially in your insistence on empirical data -- we would have to respect their decision. Even wrong, it's their decision to make, not ours. Jason avoided this by essentially using the "initial shock" argument, which is not a bad one, but he'd have to concede that once we determined that they were past that if they still believed that then it would still be their mistake to make. Which, BTW, is actually a far more respectable position to take given Jason's comments than trying to wrangle it so that you can stop them from making what you think is a mistake even if they are legitimately convinced that they are making the right decision. From Jason's starting point, it's their decision to make, and intervening in those sorts of cases is indeed making that decision for them (as opposed to the mentally competent and fully informed and initial shock cases, which simply question whether at this time they are indeed capable of making such a momentous decision).

Even your teenager case, that you denied, follows from "it's their decision, not ours". In the teenager case, we easily run afoul of both mentally competent and fully informed, but imagine that someone like Rehm found meaning in their spouse, but their spouse passes away, and they decide that at this point their life has no meaning, the state couldn't say "No" to him on the basis that he still has children and grandchildren and so should find meaning in them. To do anything else is to have the state decide what should give their life meaning, which is the contradiction.

So, now, what's REALLY at stake here? The thing is, the strong "meaning of life" argument (PLEASE stop referring it as the personal autonomy argument because when you try to apply it to other rights things get really confused) is actually a pretty good argument because it avoids one of the potential pitfalls of assisted suicide: classifying certain physical CONDITIONS as being ones where a person would be better off dead, and thus impacting those people who have those conditions and yet want to and can live a meaningful life. The "meaning of life" argument sidesteps all of this by rather pointedly not talking about physical conditions at all, but only on the person's perception of them. If those conditions are such that a) they require assistance (even if that's just to make it painless) and b) they feel that they are better off dead than still living in them, they get assistance. For those who can indeed still find meaning in their lives even with those conditions, more power to them. That's great. That some people can find meaning even under those conditions doesn't imply anything about those who can't, and more importantly the fact that some people CAN'T find meaning under those conditions implies nothing abou those who can. It's the ultimate way to sidestep the "respect for the disabled" argument.

Of course, it also has the implications that I've just outlined, which some people don't want to accept. But any attempt to look at physical condition beyond "Needs assistance" philosophically, at least, runs into the issue of essentially saying that in some conditions it is reasonable and perhaps even MORE reasonable to decide that your life isn't worth living than that it is. But that has implications for those who think that their life has meaning in those conditions: are they just afraid to die? Are they being a burden on others, and selfish? Are they simply misguided? Getting an external body to say, in any way, that in certain physical conditions it's reasonable to consider whether you want to go on living as a general rule or policy decision will always imply that those conditions DO greatly impact the meaning of one's life, and that's an attitude that we don't want to foster, at all.

That's why I argue that you pretty much have to go one way or the other. You either have to allow people to decide what gives their life meaning or insist that there's an objective -- not just non-arbitrary -- definition for what gives life meaning, so tha you can draw the line based on that objective meaning. Note, BTW, that that objective meaning doesn't have to be strict; it can be fuzzy around the edges. But there have to be clear, justifiable cases where it won't and where it will, or else you might as well retreat to "They decide for themselves".

And to answer Michael's comment, while a lot of my position has been outlined -- it's complicated, but should be allowed in terminal cases -- the main thrust of a lot of my comments is not to say that one position is clearly right or clearly wrong, but to point out what the positions are, ensure that the positions are consistent, oppose dismissals of arguments that have some merit, and ultimately to ensure that people are clear on their arguments and what they entail, to allow for much better arguments and discussions. It's an occupational hazard; all good philosophers ought to be able to present as good if not better arguments for opposing positions than those who support those positions, and in general only when people understand what the real arguments are can people decide what side they're on and, more importantly, why. This is what it means to reason and use critical thinking.

By Verbose Stoic (not verified) on 06 Aug 2014 #permalink

Sigh.
I am arguing that the government CAN say “We know you decided that your life has no meaning genuinely, and we accept that you are mentally competent and fully informed, but we’re not granting you legally assisted suicide” without contradicting the personal autonomy argument completely. That's a direct address of your @58 post, so stop telling me I'm talking about a different issue.

This is possible, and the state's position is reasonable, because personal autonomy is not a binary thing. One can have none, some, a lot, or absolute. When the government allows personal autonomy within boundary conditions, it is recognizing that personal autonomy has value and is a social good, they just aren't supporting the notion that it must be absolute in nature for us to have it.

And in fact we don't require absolute autonomy in any other decision in life, so what is your basis for requiring it here? You seem to be arguing that assisted suicide with boundary conditions would be worse that assisted suicide without them. If so, in what way is it worse?

the strong “meaning of life” argument (PLEASE stop referring it as the personal autonomy argument because when you try to apply it to other rights things get really confused) is actually a pretty good argument because it avoids one of the potential pitfalls of assisted suicide: classifying certain physical CONDITIONS as being ones where a person would be better off dead, and thus impacting those people who have those conditions and yet want to and can live a meaningful life.

Baloney. The government allowing suicide in case X is not equivalent to the government saying people in X would be better off dead. I have no idea how you even got from point A to point B; this statement of yours seems like a complete nonsequitur to me.

And I hate to burst your bubble, but assisted suicide laws aren't the thing that's going to make (physically or emotionally) debilitated people question whether they are a burden on their families. That happens without such laws.

Getting an external body to say, in any way, that in certain physical conditions it’s reasonable to consider whether you want to go on living as a general rule or policy decision will always imply that those conditions DO greatly impact the meaning of one’s life, and that’s an attitude that we don’t want to foster, at all.

Of course a debilitating physical conditions may impact the meaning of ones' life. This is just a fact we must recognize and grapple with. People get cancer, they reevaluate the meaning of their life. Happens every day. Are you saying they ought not do that? That it's really bad for someone to reevaluate the meaning of their life when they get afflicted by some terrible condition?

I think you are trying to say that when the government permits suicide in circumstance X, they are saying a person in circumstance X has no (or little) value. But you'll have to explain that logic to me, I don't see how giving this freedom is the equivalent of the government saying that person has little or no value.

Thank you VS for an answer. I agree that one needs to be generous with others' arguments and I obviously was not with Smith's.

Here is Dennett from "Intuition Pumps" on arguing well.

1. You should attempt to re-express your target’s position so clearly, vividly, and fairly that your target says, “Thanks, I wish I’d thought of putting it that way."
2. You should list any points of agreement (especially if they are not matters of general or widespread agreement).
3. You should mention anything you have learned from your target.
4. Only then are you permitted to say so much as a word of rebuttal or criticism.

I also think that John Wilkins wrote a very good commentary on rights in response to the 10th anniversary of 9/11. http://evolvingthoughts.net/2011/09/goodbye-freedom/

He lists four essentials:
1. Learn to live with risks. (Sometimes people will choose to die, even given time and the best advice, when living might have been a better choice. Also those left behind may be unable to see the situation through the eyes of the person choosing to die.)
2. Use the law, don’t circumvent it. (Convict people if they try to use coercion or if drugs are provided without exhausting all options. Don't hound people who are following the law.)
3. Don’t prohibit something because there’s a chance someone might use it badly.
4. Presume always that people have an established right, not that they do not or must demonstrate they do.

I am sure it is clear, but let me add that I am convinced that DI fellows are arguing from faulty premises. Everything they believe emerges from the first three chapters of Genesis. Humans were made in God's image (the only one of God's creation) and humans have dominion over all other living things. This entails that God is like humans and studying how humans think and create tells us how God thinks and creates.

Steve Fuller, for instance, believes that it was the arrogance that we could understand and control the world as God does – epitomized by Newton – which led to modern science. We had to believe we were apart from rather than a part of nature. Evolution, on the other hand, puts us back in nature – as animals functioning within ecosystems – subject to the whims of the environment. Evolution makes us objects acted upon by nature rather than subjects acting on nature. Evolution is a science killer.

By Michael Fugate (not verified) on 06 Aug 2014 #permalink

Michael Fugate,

I am sure it is clear, but let me add that I am convinced that DI fellows are arguing from faulty premises. Everything they believe emerges from the first three chapters of Genesis. Humans were made in God’s image (the only one of God’s creation) and humans have dominion over all other living things. This entails that God is like humans and studying how humans think and create tells us how God thinks and creates.

I agree with this, which is why everyone should notice that I don't make God arguments for any of this, because even if they were right -- and a lot of them are suspect -- you're not going to convince non-religious people using that. That's why I boil down the argument to "Life always has meaning", and focus on the push from Smith about proven mistakes. The key to his examples, in my opinion, is that they are cases where someone made a determination about the meaning of their life and would have taken the option if it was given, but later -- and this may be much later -- realized that doing so would have been a mistake. It's not unreasonable to suggest that we should prevent people from doing things that we know are mistakes, and the more serious the consequences the more likely we are to feel obligated to do so. That's why the key here, I think, is to push the line that they have no reason to say that what they did is actually a mistake ... but the examples are hard to argue if you don't accept that there's an objective standard that they were wrong about. And thus we have a potentially interesting debate about what people's positions are.

But that doesn't mean that they're right about there being an objective value of life or that it's "Always" as they assert.

By Verbose Stoic (not verified) on 07 Aug 2014 #permalink

eric,

I am arguing that the government CAN say “We know you decided that your life has no meaning genuinely, and we accept that you are mentally competent and fully informed, but we’re not granting you legally assisted suicide” without contradicting the personal autonomy argument completely. That’s a direct address of your @58 post, so stop telling me I’m talking about a different issue.

The problem is that you always leave off the fact that I'm talking about one specific case or scenario, and that your big defense is always "Yes, the government can introduce restrictions". which led me to think that your objection to me was that I was saying that things couldn't be restricted at all, which was frustrating since that clearly wasn't the case. And since the only example you've ever given of restricting a specific case was the deafness case where you originally said "It's not terminal" and then backtracked it -- and that clearly wasn't a restriction that Eric and Jason support -- I really don't know what level of restriction or, more importantly, what REASONS for restriction you'd allow. The only thing I have is this:

Smith advocates for none. Rosenhouse advocates for some, under a hazy rules set. I advocate for some, under a community-defined rules set.

I'm not sure that "under a community-defined rules set" is LESS hazy than Jason's, nor do I think that Jason's is all that hazy (it boils down to "under conditions where they can makea genuine choice"). But the issue with using "community-defined rules set" is that rights, in general, are built so that people AREN'T held to standards that the community, or the majority, hold but that they don't. Restrictions on free speech, for example, aren't held to be reasonable because it's speech that most people wouldn't say or wouldn't think should be said, but are because that speech is harmful in some way, or that facilitating it requires demanding things from people that you have no right to demand. Nothing about the community at all.

Taking that and your constant talk about justifying all rights using personal autonomy -- ie personal choice, which isn't the case for speech and other rights as far as I know -- I'm going to take a stab at an argument here. It might be wrong, but if you can read it and at least deny it we might be able to make progress:

As a broad statement, "personal autonomy" talks about choices or decisions that we make, to take or not take actions or say and not say things. And so from simply a shallow statement, we can see that the government restricts "personal autonomy" all the time, from speed limits to what colour you can paint your house to what you can buy. From that angle, it's easy to justify saying that the state could put restrictions on autonomy any time they like, and constantly do.

But that's not what we mean when we justify something based on the RIGHT to autonomy. A free society will allow people to choose what they want as much as they can, but given even a token reason they can restrict those things, even based on what the community -- ie the majority -- want to see. None of that is objectionable. But when we say that someone has a RIGHT to do something based on autonomy, we aren't talking about everyday decisions that the government can restrict any time they like. We're talking about the decisions that must be as unrestricted as possible or else you are unacceptably violating their autonomy, and making decisions for someone that you really, really can't make for them. These are, therefore, not everyday decisions, but special ones, ones that government interference with is far more problematic and needs far better reasons to do.

So, for example, a workplace can make it mandatory that an employee take a client to a hockey game, or out for entertainment. They CAN'T make it mandatory that the employee have sex with the client in order to entertain them. This is because choosing to have sex is one of those special choices, and no one can decide for someone else if they are going to have sex or not. Their right to autonomy means this sort of requirement is illegal.

Abortion is a similar case. While advocates talk about it being about the "right to choose", it's not about simple everyday choices. It's about the right to decide for oneself what to do and what gets to use one's body, which is a special choice, and one that the government can't reasonably restrict (note that a major complaint about things like WAITING PERIODS is that it unduly infringes on this special choice).

Assisted suicide always starts from this being a special choice, because the state never has any obligation to provide the means for someone to implement and everyday choice. If I want to buy a Ford instead of a Toyota, the government is not required to fund the difference between them so that I can, but it might be required to fund special choices if that overly infringes on my ability to make them (in Canada, funding for abortions is considered at least potentially part of the right, because if you don't have access you can't make that choice). So when you ask the state to allow physicians to prescribe pills for a non-medical purpose -- ie to not make you better, but to literally make you WORSE -- that's asking the government to ensure access, in at least some way, and that automatically implies that it's a special instance of autonomy, one that follows from the right to autonomy and not merely from what a free society should provide.

If you argue that the government cannot or ought not make something illegal because it violates autonomy, you are always treating it as a special choice that needs special privileges/protections. Thus, acceptng that starting point for assisted suicide implies that the state needs strong reasons to place restrictions on that choice, and not merely "Because we restrict things all the time."

And I hate to burst your bubble, but assisted suicide laws aren’t the thing that’s going to make (physically or emotionally) debilitated people question whether they are a burden on their families. That happens without such laws.

There's no reason to make that worse by codifying those impressions into law ...

I think you are trying to say that when the government permits suicide in circumstance X, they are saying a person in circumstance X has no (or little) value. But you’ll have to explain that logic to me, I don’t see how giving this freedom is the equivalent of the government saying that person has little or no value.

No, what I'm trying to say is that if the government permits suicide in circumstance X and denies it in circumstance Y using the reasoning that those in circumstance Y clearly still have lives that have value -- recall that that's the specific reasoning I'm opposing -- then that implies that people in circumstance X don't clearly still have lives that have value, and that's not an implication that works well for those in circumstance X who DO think that their lives clearly do still have value. Starting from autonomy avoids all such implications by not trying to classify cases where it is clear that someone should think their life has value from those where they can at least debate it, at the cost of being unable to retroactively introduce those distinctions without becoming contradictory.

By Verbose Stoic (not verified) on 07 Aug 2014 #permalink

As an aside -- and an example of how semantics can be really, really important -- note that in my above example I deliberately said "don't clearly" instead of "clearly don't", which have entirely different implications.

By Verbose Stoic (not verified) on 07 Aug 2014 #permalink

VS:

I really don’t know what level of restriction or, more importantly, what REASONS for restriction you’d allow.

I covered that in @49. Mentally competent people make errors in judgement. We can empirically look at data to help us assess whether someone's decision is likely to be temporary or something they're going to stick with. That's the basis on which you make the restriction(s).

But the issue with using “community-defined rules set” is that rights, in general, are built so that people AREN’T held to standards that the community, or the majority, hold but that they don’t.

I agree, and I was very sloppy in my use of language here. When I say community-based, I mean the state has an interest in regulating the conduct using solid reasoning. I don't mean majority rule goes. I don't want to get into whether they should have to meet a strict scrutiny, intermediate scrutiny, or rational basis test in order to place a restriction on it (let's leave that for another day), but I would agree with you that the restrictions need to have more behind them than just 'the majority said no to this form of assisted suicide.'

Assisted suicide always starts from this being a special choice, because the state never has any obligation to provide the means for someone to implement and everyday choice...
...So when you ask the state to allow physicians to prescribe pills for a non-medical purpose...that’s asking the government to ensure access, in at least some way, and that automatically implies that it’s a special instance of autonomy, one that follows from the right to autonomy and not merely from what a free society should provide.

I'm not insisting that the person be allowed to get their suicide medicine free or illegally. Yes it would have to be a legal prescription, yes the state would have to recognize the use as a legimitate medical use (and not an "off-brand" use), and yes they would have to pay for it as with any other medical expense. No exceptional treatment is required or asked.

[eric] And I hate to burst your bubble, but assisted suicide laws aren’t the thing that’s going to make (physically or emotionally) debilitated people question whether they are a burden on their families. That happens without such laws.

[VS] There’s no reason to make that worse by codifying those impressions into law …

Here we run into the empiricism and slippery slope issue I mentioned above. I am sympathetic to the intutive notion that allowing suicide makes the problem worse. But we have almost 20 years of data on how it works in practice, and that data shows it doesn't make it worse. It was a valid concern at the outset; it is not a valid concern now. Unless you have data to back up the notion that assisted suicide makes the problem worse?

the sort of decision they're going to stick with. You use that empirical data to set limits on when you allow it and when you don't. If the vast, vast majority of mentally competent newly deaf people (a) get depressed, and then (b) get over it and go on to enjoy their lives, then it is reasonable to say that a newly deaf person who contemplates suicide is likely making a temporary error in their own judgement.

ack, ignore my last paragraph. It was a draft/expanded version of my first paragraph which accidentally got left on the editing floor (the bottom of my message). Jason, you really need a preview pane.

Why shouldn't this be a right with proper safeguards in place?

We do this for all rights - judges and legislators decide how those rights should be limited - speech, religion, press, guns, searches, etc.

Currently, the suicide rate in the US is 12.4 per 100,000 - among those older than 75 it is 16.3 per 100,000. The most common methods are guns, poison and suffocation - with guns being the most common over 75.

Would suicides be more common if drugs were available by prescription? It could well be that if individuals openly talked it over with health professionals and their families, the numbers would be reduced. Some figures available indicate that about a third of suicides have alcohol in their systems, a quarter antidepressants and a fifth opiates. This indicates that many are likely impaired when making the decision.

http://www.cdc.gov/violenceprevention/pdf/suicide_datasheet_2012-a.pdf

By Michael Fugate (not verified) on 07 Aug 2014 #permalink

eric,

I think the theme of this comment will be "Empirical data doesn't prove as much as you think it does".

So, the first point:

I covered that in @49. Mentally competent people make errors in judgement. We can empirically look at data to help us assess whether someone’s decision is likely to be temporary or something they’re going to stick with. That’s the basis on which you make the restriction(s).

The problem is the problem of induction that you always run into, which means that you can't apply that induction to cases that depend greatly on facts about the specific individual, even if some similarities can be drawn. Take my deafness example. I was careful to craft that example in a way that sound was far more important to that person's life than it would be for most other people. So in that case using others as an example doesn't work so well, because they aren't the same cases at all. Putting in some kind of legal restriction based on that would definitely violate the autonomy argument.

That's the overall issue here. I'm not arguing that you can't use the empirical data of other similar cases to guide how you approach a specific case. But if someone is fully-informed about what their life will be like, and fully mentally-competent to decide if that life would be worth living for them, then there are two key points here. First, they are unlikely to be making a mistake, and are less likely to be making a mistake than anyone else would be, even given the empirical data. Second, even if they are making a mistake, what right does the state or anyone have for preventing them from making that mistake? It's their mistake to make. So claiming that people make mistakes and so we are allowed to restrict assisted suicide ON THAT BASIS.

So, once a psychological assessment and treatment is made so that they are fully-informed and mentally-competent, then the state, under the autonomy justification for assisted suicide, has no cause to interfere on the basis that they might be making a mistake. The empirical data you cite is very useful for determining what sorts of information they need, what examples to show them, if a waiting period is required and how long that would be, etc, etc but you can't stand up and say "No, you don't get it even if you need it because you might be making a mistake".

To make this clearer, I presume that in my deafness case you'd advocate for them being given psychological help and exposed to things that would make their life worth living so that they can see that they made a mistake. Note two things about Smith's argument, though: his examples are aimed at pointing out exactly these sorts of mistaken cases and using them to argue for restrictions, and he advocated for psychological help to teach people -- even those in Rehm's situation -- that their lives really do have meaning. The only difference, then, between you and Smith seems to be where you draw the line, and possibly the evidence you use to determine that (and finally maybe a tolerance for error). The difference between Jason and Eric MacDonald and Smith is far deeper and is over a deeper principle.

Here we run into the empiricism and slippery slope issue I mentioned above. I am sympathetic to the intutive notion that allowing suicide makes the problem worse. But we have almost 20 years of data on how it works in practice, and that data shows it doesn’t make it worse. It was a valid concern at the outset; it is not a valid concern now. Unless you have data to back up the notion that assisted suicide makes the problem worse?

Your data works against a "If you allow any assisted suicide, the sky will fall!" argument -- which is why I think such arguments bad -- but DOESN'T work against the argument I outlined here. First of all, you can't use Oregon -- your specific example -- as a counter because it distinguishes between terminal and non-terminal cases, and as I pointed out that can be justified without saying that people in that situation have lives that aren't worth living; they're deciding when to die and how much they should suffer dying, not that their current physical condition means that they should die. For other jurisdictions, if they take the stronger autonomy stance that I talked about -- and given the case of Eric MacDonald's wife, they might -- then they again don't have that problem. And the number of cases is still reasonably small; a lot of jurisdictions don't have it, at least not using the attitude towards restrictions that you advocate. So not seeing these cases might just reflect something specific about those places, and not something that works generally. Additionally, we don't know that it hasn't had an impact, because all we'd see empirically is that more people in these physical conditions will opt for assisted suicide, which could be used as evidence that people will use them even when they would have good lives otherwise (due to pressure or impression) or could be just a "Well, duh! If you let them do it some people will do it!". You also have the issue that attitudes may not seem to change, but if people in those conditions are advocating for an IMPROVED impression of people in those conditions who don't opt for ending their lives then a lack of progress might indeed indicate an impact on attitudes. And, finally, since you admit that the attitudes already exist in society you'll have a really hard time demonstrating that encoding it into law doesn't just solidify them, in line with the above point; the lack of improvement might reflect that encoding this into law has simply made these attitudes that much harder to overcome, even if they don't or wont get any worse.

So there are so many confounds that your empirical data is essentially meaningless, in both cases, and start to look less like good empirical data and more like a use of data to justify a specific position. Empirical data minus a good theoretical and philosophical framework usually isn't all that great ... hence, the importance of the philosophical argument of what the distinction you propose actually implies, even if people don't necessarily realize that.

By Verbose Stoic (not verified) on 11 Aug 2014 #permalink