What's it got to do with assisted dying?
Posted by Eric MacDonald
People may sometimes wonder what some of my posts have to do with assisted dying, the central reason for a choice in dying website in the first place. (The clue, of course, is in the first word of the blog title. And, while I do not consider this in what follows, I do sometimes discuss things that interest me which have nothing at all to do with assisted dying.) For example, what has the discussion of scientism to do with assisted dying? Why don’t I concentrate more on the issues involved in the assisted dying debate, issues like the sanctity of life, slippery slopes, human dignity, and so on? Well, to put it briefly, as I say in the blog’s banner, I argue for the right-to-die, and against the religious obstruction of that right, so anything which impinges on the issue, even indirectly, is of importance to me. That’s why disputing scientism seems to me to be important, because it implicitly defines away all other forms of inquiry which do not satisfy the canonical rules of scientific inquiry and decision. And that includes morality. In one of his responses to my posts on scientism, Jerry Coyne suggested that we should do away with talk of morality altogether. Here are his words:
I am starting to think that we should dispense with the idea of “moral” and “immoral” acts for two reasons. The first is because morality is implicitly connected with free choice, that is, with “free will.” If one can’t choose one’s acts freely, [then] one can’t decide to be “moral” or “immoral.” Rather, as a consequentionalist, I’d replace “morality” with what it really means for most people, “the effects of an act on an individual or society.” Thus an “immoral act” might better be seen as “an act that reduces societal well being.”
(I need to interject here, lest it be thought that I am picking a fight with Jerry, that what I say here is said with the greatest affection. I have no trouble in arguing with people I admire.) First of all, I cannot, in a short compass, provide satisfactory arguments for retaining the ideas of moral and immoral acts, moral obligation or the notion of freedom of choice. The question of free will is perhaps one of the most complex issues in philosophy, theology, and science, about which more is written than about any other single issue. This is partly due to the fact that it tends to overlap a number of disciplines (or quasi-disciplines, since I have deep reservations about theology as a respectable domain of knowledge). Also of importance in this connexion is the fact that whether or not we use the language of moral right and wrong, of duty and rights, this is a ”choice” which may have significant practical effects. If people were convinced, as Jerry Coyne and other naturalists seem to be convinced, that we are in no sense at all reasonably thought to be the originators of our actions, and thus responsible for them, then it seems that we will have to develop an entirely new language to deal with society, human relationships and self-conception or self-understanding. (And what would it mean “to develop” this or anything else?) For, of course, on this premise, the self is as much an illusion as is ”its” sense of authorship of “its” “actions.” (All these words become misleading under the proposed revisions.) Very few people seem to be aware of the enormous revision of common sense intuitions and expressions that would be necessary to accommodate a thoroughgoing determinism in respect of human “actions.” Indeed, according to the deterministic understanding of the human, we are but puppets on strings of causal sequences, incapable of choice or responsibility.
Jerry Coyne (and many others, of course) would replace the language of morality with the language of consequences and well-being, which, he suggests, is what most people mean anyway. While I doubt that this is what people mean anyway, from a position of a thoroughgoing determinism, there are no acts and no consequences. There are only events in causal sequence. And the term ‘well-being’, which seems to smuggle value language in through the back door, can mean no more than to refer to states of organic systems in causal relationship. It would be, in these terms, simply a mode d’expression to speak in terms of “preferred” states of such systems, for such “preference” would be entirely inscrutable (to use Harris’s language), and not a “preference,” as such, at all. “Preference” would merely identify a behavioural inclination towards the state said to be ”preferred,” much as we may be said to indicate a behavioural inclination towards being healthy rather than towards being sick, these states being simply occurrences and not something to which the language of preference and choice seems obviously to imply (except insofar as — as it seems we can – we can “choose” to undergo treatment, which may lead to the “preferred” outcome). Indeed, it does not seem to me that we have the slightest idea of the effect on self and social order that would result from the proposal that choice is not open to us, and that we are comprehensively determined from moment to moment by forces outside of our control. Large swathes of language would simply become meaningless. Speak in terms of consequences all you like, if ”our” supposed “acts” are simply downstream effects of causation, it no longer makes sense to chastise someone for a broken promise (which would be an act and not simply an event), or for acts of brutality, and it seems peculiar to think in such terms, but the truth is the truth, after all, so we “should” — what? — make an “effort”? But then, what about truth? If we are comprehensively deterministic systems, then so-called “reasons for belief” are also things over which we have no control. We cannot choose to base belief on the evidence. Belief would be simply an occurrent phenomenon, with no intentional content at all, just like “actions” we used to think of as moral or immoral, however much it might seem to be held for “reasons.” As I say, this could become very confusing.
In this situation I can scarcely do better than to quote from Ronald Dworkin:
Determinism and epiphenomenalism may both be true: I am not competent to judge either of them as scientific theories. Neither has been demonstrated to be true. Everything is possible. Every Tuesday brings fresh surprises about brain geography, physics, and chemistry, about potent alleles on neglected chromosomes, and about the interrelations among all these and our mental life. Every dinner party brings fresh speculation about the sexual reasoning of baboons, the religious lives of chimpanzees, the reptilian brain beneath your cerebrum, and the neo-Darwinian explanation of the trolley problem I discuss in Chapter 13. Our grandchildren had better be ready for anything. [Justice for Hedgehogs, 220]
At the moment, however, it seems best to retain the language of morality and moral responsibility. That is the only way, at any rate, that I can make sense of the question of assisted dying. Assisted dying is assistance offered to those who are dying in great pain and misery which they find intolerable, or who are living with chronic conditions which make continuing to live a contradiction of all that it seemed reasonable to hope for in life, at their choice and request. This is the only way I can understand Elizabeth’s life and her decision – considered deeply for several years before she opted for it, and then only after she had tried and failed to end life on her own, without assistance – to ask for assistance in dying. The act, when it came, was one of great dignity and courage, and it seems absurd to me to suggest that it was simply an occurrent phenomenon, to which praise (or blame), or the language of reasons for action, cannot be ascribed.
It is perhaps apropos to make a short digression here to express my regret at the recent death of Ronald Dworkin, whose arguments in defence of assisted suicide are remarkable by their scope and clarity. Perhaps the most significant legal mind of his generation, Dworkin’s writings extend from boldly original work on the principles of jurisprudence to interpretations of American constitutional law, especially as these impinged on human rights, which he took as the basis for the claim that law is grounded in morality — which is why this recent Jesus and Mo cartoon (linked here), while certainly reflecting Walter Kaufmann’s view of the parallels between law and theology, is simply wrong. Certainly, law does take the legal tradition seriously, sometimes too much so, and the exposition of the law as traditionally understood is an important element in legal judgements. But the legal tradition plays a very different role in law than sacred texts play in theology. In theology, the moral law is read from texts held to be unrevisable. The common law tradition is always in the process of evolution, based upon the changing moral template of the society in which interpretation of the legal tradition takes place. And Dworkin was a central figure in making clear how this is based on the principle of human rights. His death is a great loss. He died at 81, of leukemia, and published not long before his death a genuine tour de force, Justice for Hedgehogs, not only an important analysis of the nature of morality, but unusually, in the present climate, where the idea of the good life, or of a life lived well, is seldom addressed by contemporary philosophy, seeks to answer the question of the ethical meaning of life, “the only kind of meaning in life,” as Dworkin says, “that can stand up to the fact and fear of death.” (198) The book itself is a remarkable achievement for a man of any age, but for someone in or nearing his eighth decade of life, written in failing health, it is outstanding. (For Dworkin obituaries, if you are interested, check Arts and Letters Daily, in the first column, under Articles of Note.)
We may argue, if we like, and as Onora O’Neill does (see her Autonomy and Trust in Bioethics), about the complexity of the notion of informed consent, but one aspect of that argument will not be that consent itself is merely an illusion. Attempts at understanding morality simply in terms of consequences and well-being, besides being implicitly self-contradictory, do not take account of the decisions that individuals are called upon to make, and cannot attribute to them the moral seriousness of those decisions. So, that’s what the discussion of scientism has to do with the issue of assisted dying, which this blog is all about.