Friday, May 30, 2008

When It's Permissible To Force Someone To Stay Alive For His Own Good

I think the question of when, if ever, it's morally permissible to force someone to stay alive against his will, for his own good, is one of the most difficult questions to appropriately answer. While I argue in favor of an institutional right to effective, comfortable suicide, the opponent that I feel has the most interesting standing to challenge me is the reformed suicide: someone who attempted suicide, or came close to attempting suicide, but was "rescued" from his intentions, and now believes that rescue to have been in his best interests.

First, I would like to demonstrate that it is sometimes permissible to stop a person from killing himself. The example I find most persuasive is that of a person in an acute confusional state (delirium) secondary to a physical illness, such as diabetes. If a person in an acute confusional state walks out into traffic or engages in other self-harming behaviors, I would feel completely justified in intervening and basically forcing the person to stay alive. But why?

In previous posts, I've examined a non-paternalistic explanation of how the right to die might be said to harm some people (though, as I pointed out, this only applies to suicide rights for the terminally ill or catastrophically disabled). It is my view that stopping a person in an acute confusional state from harming himself is also allowed on non-paternalistic grounds, whereas stopping the suicide of a non-delirious person has only paternalistic justifications.

Paternalism obtains when individuals or the state wish to substitute their judgment for that of another, on the grounds that the affected person will make a poor decision. There is a real risk that paternalistic interventions will prevent people from being best off according to their own values. But guiding the deranged diabetic out of traffic is, I argue, not paternalistic, because the action of walking out into traffic, in this limited case, is not based on judgment at all. Put another way, the "person" deciding to walk out into traffic is not really a person at all - the circumstance is not attributable to anyone's will or decision, so intervening with our own will or decision is not paternalistic. George didn't decide to walk out into traffic - his delirium "made" him, and when George gets his insulin shot and comes back to us, "he" will be grateful to us for saving "him" from his illness.

The problem, of course, is how far to apply this idea of a suicide being the result of circumstance, delirium, and illness, rather than the result of a choice by the suicide. Many people seem willing to take the incident of a suicide attempt itself as probative evidence that the person is not in his right mind, that is, acting under something other than his will. The extreme medicalization of depression has allowed society, including the mental health industry, to take the view that suicide is always a sign of illness. (Revealingly, a suicide attempt, in and of itself, is not valid diagnostic criteria even for a major depressive episode under the DSM-IV, though of course, in practice, the elastic criteria for diagnosing depression are often fudged.) These people argue that intervening in an attempted suicide is always permissible - and, perhaps, never paternalistic - because suicide, in this view, is never truly a willed act, and always the result of something outside the person, such as (vaguely defined) illness.

We have to draw a line as to when it's morally permissible to intervene in a suicide attempt, or to withhold the means for suicide from a person. Some, as I have explained, would draw the line at "always." Hopefully my writings of the past two months might give a tiny bit of pause to those folks. At any rate, I don't think the line should be drawn at "always," which leaves me the task of explaining where the line should be drawn.

I am comfortable with preventing suicide in the case that it is attributable to a circumstance that is clearly outside the suicide's will - such as an attack of delirium, or an accident. But in any case where the suicide's will is invoked - where, we might say, the suicide is acting on reasons for ending his life - I am much less open to intervention. This is true even if the suicidal person is culturally defined as having a medical illness, such as depression, and even including many cases where the suicide has a thought disorder or otherwise may be thought to be "incompetent." A person with a mental illness may make a will, for example, as long as he understands the extent of his property, knows who his relatives are, and understands that he is making a will. I am comfortable allowing suicide in situations where a person understands what death is, can articulate his desire for death, and can give non-delusional reasons for his desire. Intervening in a case like this must be seen as at least paternalistic, and must require a much greater justification than intervening in the case of the delirious diabetic. The more an illness is short-term, well understood to be biological in nature, and seems to obliterate the person's will, the more comfortable I am with intervention against suicide. The more an "illness" is long-term, poorly understood, and leaves the person's will apparently intact, the more justification I would require for an intervention.

An interesting point is that many people, under our current system, might attempt suicide as a "cry for help" without actually desiring to die. The data indicates that women in particular are much more likely to make an unsuccessful suicide attempt; many authors infer that women have motivations other than dying when attempting suicide, such as getting more attention or support from those around them. Dena S. Davis responds, in her essay "Why Suicide is Like Contraception," that this is not much of an objection to legalizing suicide, and that the legalization of suicide might encourage people to act authentically:
. . . if assisted suicide became open and legal, perhaps women who otherwise would use a suicide attempt as a "cry for help," will be forced to confront and articulate their real needs. To continue to play a societal game in which women "attempt" suicides they don't really intend, perpetuates a situation in which women are rewarded for communicating one thing and meaning another. This makes it more difficult for women to command respect for their real beliefs and wishes . . . . I make a similar argument with respect to Jehovah's Witnesses and refusal of life-saving treatment in "Does 'No' Mean 'Yes'? The Continuing Problem of Jehovah's Witnesses and Refusal of Blood Products," Second Opinion 19: 35-43 (1994).

Thursday, May 29, 2008

Three Meditations on the Sweetness of Life

From The Great Wave: Price Revolutions and the Rhythm of History, by David Hackett Fischer:
Then, inconceivably, torrential rains came again in 1316. The grain crop failed a third year in a row. Europe began to experience the worst famine in its history. When other sources of food ran out, people began to eat one another. Peasant families consumed the bodies of the dead. Corpses were dug up from their burying grounds and eaten. In jail the convicts ceased to be fed; we are told that starving inmates "ferociously attacked new prisoners and devoured them half alive." Condemned criminals were cut down from the gallows, butchered, and eaten. Parents killed their children for food, and children murdered their parents.

From Hungry Ghosts: Mao's Secret Famine, by Jasper Becker:

There are enough reports from different parts of the country to make it clear that the practice of cannibalism was not restricted to any one region, class or nationality. Peasants not only ate the flesh of the dead, they also sold it, and they killed and ate children, both their own and those of others. Given the dimensions of the famine, it is quite conceivable that cannibalism was practised on a scale unprecedented in the history of the twentieth century.

From the report of the United States Congress Commission on the Ukrainian Famine, reported in Becker, above:

Very frequent is the phenomenon of hallucination in which people see their children only as animals, kill them and eat them. Later, some, having recuperated with proper food, do not remember wanting to eat their children and deny even being able to think of such a thing. The phenomenon in question is the result of a lack of vitamins and would prove to be a very interesting study, alas one which is banned even from consideration from a scientific point of view.

Wednesday, May 28, 2008

Where Do Rights Come From? (Or, A Weird Consequentialist Reason Why Pure Consequentialism Fails)

Utilitarianism, a form of consequentialism, may be informally defined as a moral system in which each actor is expected to maximize utility (and minimize suffering) with his actions. Deontological systems, in contrast, grant certain rights to people that other people may not violate, even if, by violating those rights, the actor could increase overall utility. An agent may not violate someone's rights, even if doing so would reduce the overall level of violation of these very rights in the world.

In The View from Nowhere, Thomas Nagel explains rights and obligations in terms of a distinction between agent-neutral values (values we have a reason to promote from an objective perspective, such as the prevention of pain) and agent-relative values (values each person might have a reason to promote, but which we have very little reason to promote from a neutral perspective, such as a particular person climbing Kilimanjaro). Unless I seriously misread him (a distinct possibility, I must admit), Nagel seems to argue that, just as we might have agent-relative reasons to pursue our own goals that others might not have a reason to help us with, we might also have real agent-relative reasons for avoiding doing harm ourselves, even if doing harm ourselves could prevent someone else from being harmed by another person. Perspective matters. "A fully agent-neutral morality is not a plausible human goal," says Nagel.

In "Personal Rights and Public Space," however (Philosophy and Public Affairs 24:2, pp. 83-107), he seems to argue in favor of inviolable rights - rights that may not be violated, even to prevent major harm, including greater violation of those same rights by other - for a very different reason. Nagel says, on universal human rights such as freedom from torture and political persecution:
First, it means that these are forms of treatment to which no one should be subjected - that every person, everywhere, is wronged if maltreated in these ways. Second, that the wrongness is not a function of the balance of costs and benefits in this case - that while in some cases a right may justifiably be overridden by a sufficiently high threshold of costs, below that threshold its status as a right is insensitive to differences in the cost-benefit balance of respecting it in each particular case. Rights are universal protections of every individual against being justifiably used or sacrificed in certain ways for purposes worthy or unworthy.

Nagel posits a few rights in particular in this essay - the right to be free from torture, and the right to freedom of speech and thought, including sexual fantasy, are discussed. But where do these rights come from? And what is their justification as rights that should be free from utilitarian calculation (at least below a certain threshold, perhaps that of moral catastrophe)? Why these, and not other rights?

Even though Nagel favors the view of rights as intrinsic, rather than instrumental (valuable only to the extent that they promote happiness and other goods), oddly, extremely oddly, I think Nagel is offering what might be considered a consequentialist justification for a set of deontological rights.

Nagel certainly does not see himself as making a consequentialist argument. Quite the opposite:

I shall try to defend the distinct (but perhaps complementary) position that rights are a nonderivative and fundamental element of morality. They embody a form of recognition of each individual's value which supplements and differs in kind from the form that leads us to value the overall increase of human happiness and the eradication of misery - and this form of recognition of human value is no less important than the other. The trouble with this answer is that it has proven extremely difficult to account for such a basic, individualized value so that it becomes morally intelligible. The theory that rights are justified instrumentally, by contrast, is perfectly clear and based on uncontroversial values.

To make the argument for inviolable rights in what he considers a "morally intelligible" way, he first defines a status of inviolability (possession of rights that may not be violated, even to prevent a greater violation of rights) as a non-consequentialist value:

Being inviolable is not a condition, like being happy, or free-just as being violable is not a condition, like being unhappy or oppressed. To be inviolable does not mean that one will not be violated. It is a moral status: It means that one may not be violated in certain ways - such treatment is inadmissible, and if it occurs, the person has been wronged. So someone's having or lacking this status is not equivalent to anything's happening or not happening to him. If he has it, he does not lose it when his rights are violated - rather, such treatment counts as a violation of his rights precisely because he has it. [Emphasis Nagel's.]

In Nagel's sense, inviolability is a non-consequentialist value because it doesn't correspond to subjective states of the actual violation of a right, but rather the moral status of having the right to be free from the violation, and, consequently, of being wronged in the case that the right is violated. Inviolability is valuable above and beyond the value of not having one's rights actually violated. But is this really escaping consequentialism? Being inviolable is not the same as being happy. But what, then, is the value of inviolability? People are certainly happier when their rights are inviolable, in the sense that people would prefer to live in a free state with a fairly high murder rate than live in a police state with a murder rate of zero, but in which those suspected of having murderous desires were occasionally summarily shot in order to prevent murders. In this sense, the right not to be murdered - inviolability - must be said to be responsible for real utility gains, since it is preferred (and, I would say, rationally preferred) to a situation where rights are more likely to be violated, but where their violation is a wrong. Indeed, Nagel's "non-consequentialist" explanation of the value of inviolability sounds profoundly consequentialist:

It is true that a right may sometimes forbid us to do something that would minimize its violation - as when we are forbidden to kill one innocent person even to prevent two other innocents from being killed. But the alternative possibility differs from this one not only in the numbers of innocents killed. If there is no such right, and it is permissible to kill the one to save the two, that implies a profound difference in the status of everyone - not only of the one who is killed. For in the absence of such a right, no one is inviolable: Anyone may be killed if that would serve to minimize the number of killings. This difference of status holds true of everyone whether or not the situation will ever arise for him. [Emphasis mine.]

I suppose my main disagreement with Nagel is that, as I see it, inviolability is a condition "like being happy" - it is one that has subjective value, and a situation that includes inviolability may be preferred to a situation that is materially better for the agent, but in which his rights are violable. In my view, it is strange to think that only subjective affect and material consequences should count toward utility. Nagel himself lists "being free" as a possible consequentialist value, as opposed to, say, the appearance of freedom. If being free is a consequentialist value, why not inviolability? This is especially true since inviolability, like freedom from pain, seems to be one of what Nagel would define as an agent-neutral value - one we have an objective reason for promoting.

This is not an instrumental argument. I am not arguing that people should have rights because rights may be exercised to make people happy, or that agents may be unhappy if morally required to violate the rights of others. I am arguing that the very status of inviolability makes people "happy," to put it a bit reductively. I think Nagel wants us to look at the world and figure out which rights are really important - meaning, in which cases does inviolability make people feel valuable, special, and happy? Even if rights are violated in the actual world, there is a certain solace in inviolability - sympathy of the community, for instance, and the basic knowledge that the harm to one was a wrong. The possibility for moral outrage in the face of a violation of rights is a basic good.

To put it in a bit more consequential and certainly oversimplified terms, in our current world, we are all vulnerable to succumbing to organ failure. A certain percentage of us will die from lack of organ donors. More people might be saved if we, as a society, held a lottery and culled a certain number of randomly-chosen individuals, transplanting each person's organs into the bodies of several waiting recipients. More people would be saved, fewer people would actually suffer the harm of dying - materially, society would be better off. But most people would consider this a worse world. This might be because the right not to be murdered - a morally inviolable right - gives us substantial utility, even though we are more likely to die of organ failure in our current world. The right not to be (painlessly) murdered is worth a substantially greater risk of (miserable, prolonged) death. (This example compares a little murder to more natural death; see my earlier example for a comparison of more murder to less murder minus inviolability.)

While my formulation is admittedly a bit flippant, and might be looked upon skeptically especially since it purports to put a consequentialist argument in the mouth of Thomas Nagel, it does have certain advantages. For one, it gives us a place to start when figuring out what our inviolable rights should be: rights occur where the "value of inviolability" is substantially greater than the expected utility gains that might come from the occasional utilitarian violation of the right. (Even Nagel is willing to allow for violation of "inviolable" rights to prevent moral catastrophe; we need only look at things below a certain catastrophic threshold.)

I would go so far as to define an inviolable right - and perhaps the skeleton of an entire moral system - this way: An inviolable right should be recognized, that cannot be violated even to prevent greater harm, including a greater violation of the same right by others, when the value of the right's being inviolable is greater than the potential utility gains that could be made from its occasional violation.

Unfortunately for my simple little system, in a pluralistic world, few people would agree on the value of the inviolability of all but a few basic rights. Perhaps this is why Nagel limits himself to discussing such basic rights as the freedom from torture. A new question presents itself: how do we measure the value of inviolability? Certainly, it can't be the average importance accorded to the right among actual members of a particular society. So is it, after all, a sort of first-order utilitarian calculation? Perhaps we need to think of inviolability from the perspective of a potential member of society, as in Rawls' original position. In our current political system, I feel that the inviolability of the right to die is systematically undervalued, because cognitive bias prevents people from understanding the suffering of the suicidal, and because the competence of the suicidal is too easily dismissed with reference to broadly defined mental illness. But, as Benatar points out, the value of the inviolability of not being born may be undervalued even in a perfect Rawlsian original position - because the decision makers, in order to make decisions, exist, and it is difficult for an existent person to understand the value of nonexistence and the terrible violation imposed on one by being brought into existence.

(I changed the title based on a conversation with Jim - thanks!)

Tuesday, May 27, 2008

Velleman's Sorrow of Options

In most liberal moral philosophies, freedoms, rights, and choices are accorded high value, whether or not rights are seen to be important only to the extent that they promote overall welfare. Sometimes, however, it is argued that rights should be curtailed because agents may make "wrong" choices if given certain rights. For instance, if people have a right to eat fatty foods, they may irrationally choose to over-indulge, causing themselves harm, because they lack the cognitive ability to make the "correct" decision that does not harm them. To the extent that the right is removed to benefit the agent, rather than to benefit others he might harm (such as the public health system), this is known as paternalism. Paternalism substitutes the state's decision for that of the actor, presumably on the grounds that the actor lacks the ability to make the decision that will best promote his goals. Paternalism obtains when there is a fear that the actor will choose wrongly.

In contrast to this, J. David Velleman, in "Against the Right to Die," presents an admirable non-paternalistic argument about how being given a choice may harm an agent - that is, that merely having a choice may harm an agent, even if he is perfectly rational and makes the "correct" decision one hundred percent of the time. Velleman takes an example from the world of negotiation from Thomas Schelling's The Strategy of Conflict:
. . . having an option can be harmful even if we do not exercise it and - more surprisingly - even if we exercise it an gain by doing so . . . . The union leader who cannot persuiade his membersship (sic) to approve a pay-cut, or the ambassador who cannot contact his head-of-state for a change of brief, negotiates from a position of strength; whereas the negotiator for whom all concessions are possible deals from weakness. If the rank-and-file give their leader the option of offering a pay-cut, then management may not settle for anything less, whereas they might have settled for less if he hadn't had the option of making the offer. The union leader will then have to decide whether to take the option and reach an agreement or to leave the option and call a strike. But no matter which of these outcomes would make him better off, choosing it will still leave him worse off than he woudl have been if he had never had the option at all.

Velleman relates another option from Ronald Dworkin's paper, "Is more choice better than less?": a night cashier in a convenience store is made worse off by the option to open the safe, because his having this option makes him an attractive target for robbers. Once robbed, he's better off opening the safe, but overall, he'd certainly be much better off - less likely to be robbed in the first place - if he didn't have the option to open the safe!

Velleman also discusses a dinner party invitation as a potentially harmful choice. Given an invitation, I may refuse or accept, but I am denied the option of simply not going without answering - I have to either accept or hurt the host's feelings, and even if I "correctly" chose the best option of those two, I might be yet better off having never been offered the invitation.

Velleman's target, obviously, is assisted suicide in cases of severe disability or terminal illness. A terminally ill person without the right to die has, in a sense, the "right to live" - and need not justify his "exercise" of that right to anyone. He simply lives, and hasn't the option to die. However, given a right to die, there is a sense in which he loses the right to live without explicitly choosing to do so. People in this scenario (and Velleman is only talking about the terminally ill and the severely impaired, so his argument does not apply to ordinary suicides) frequently depend on others to care for them, and may be concerned about imposing a burden on others by living. This burden can only be said to be imposed by the ill person if he has some choice not to impose it - that is, a choice to die. The ill person may be best off with no choice, continuing to live and be cared for by others. But given the choice between imposing a burden on others and taking his life, he may rationally choose to die, though he would have preferred not to have the choice at all. Velleman notes that not only the burden of care, but also the exhaustion of the ill person's assets (which may be expected to pass to his heirs on his death) may be considered, rationally, by the ill person in deciding whether to die. In the situation where an ill person enjoys living and wishes to live, but not so much that he would impose a burden on his family, the right to die makes him worse off, even if he makes a rational decision once the right is offered. "I am arguing that we must not harm others by giving them choices," says Velleman, "not that we must withhold the choices from them lest they harm themselves."

While Velleman elicudates a valid and real concern for some terminally ill or severely disabled people, even Velleman himself recognizes that the argument should not prevent assisted suicide in all cases. His proposed solution is to do nothing, and leave the current system in place, where there is no institutional right to die, but some suffering people may still (illegally) be offered euthanasia at their doctor's discretion. (Velleman does not address the social injustice of allowing this service to be offered only to those with a relationship with a doctor, that is, wealthy people.) Velleman also founds his argument on a Kantian belief that it is immoral to commit suicide, which I obviously reject. He says:

. . . if I believed that people had a moral right to end their lives, I would not entertain consequentialist arguments against protecting that right. But I don't believe in such a moral right . . .

My interest in Velleman's argument - the sorrow of choice - is that it applies in unexpected ways and in unexpected places, depending on where one puts the initial assessment of value.

Now that I've explained the argument in detail, I'm going to put in in a shorter outline form, so we can see how the moving parts work, and apply it to new problems. I'm going to be putting things in what might sound like flippant language - I do this in the interest of clarity, and not in any way to disparage Velleman, who is like a god to me.

  • The right to live is morally important, and the right to die is not.
  • Given the right to die, people who are a burden on their caretakers might choose to die rather than be a burden, even if what they really wanted was to live without having to explicitly choose to live.
  • Therefore, the freedom to die harms the person.
  • It's wrong to harm people, even to harm them by giving them choices.
  • No right to die.

An interesting feature of this argument, which I alluded to in my previous post on life rights and death rights, is that, given different starting conditions, it might act as an argument against a right to live.

Some people, of course - I put myself on this list - would prefer to die, but might not wish to explicitly choose death. Given that we are stuck with a "choice" to live, many of us continue to live, miserably, rather than bear the responsibility for the harm our deaths may cause. We are certainly harmed by having the option to continue living; we wish that we might die or be killed in our sleep, but we are denied our best option by a "right" to continue to live. If we started with the assumption that the right to die was more important than the right to live in many circumstances, the sorrow of choice would act in favor of euthanasia - even without consent.

This argument - and I don't mean it either as a reductio or as a serious statement of my position - goes like this:

  • The right to die is important, more so than the right to live.
  • Given the right to survive (on a respirator, say), people who wish to die will suddenly bear responsibility for choosing death, and may choose to go on suffering in life instead, even though they'd prefer to die, all things considered.
  • Therefore, the suffering person is harmed by the choice to remain alive.
  • It's wrong to harm people, even by giving them choices.
  • Euthanasia for everyone.

Although Velleman says he doesn't recognize a moral right to die, he indicates that as part of his consequentialist "sorrow of choice" project that he'd be happiest to distinguish between those who would be harmed by the right to die, and those who wouldn't be harmed, and offer the choice only to those who wouldn't be harmed by it. (Velleman would leave this discretion in the hands of doctors, who would be acting illegally in the cases in which they offered assisted suicide.) If choice is such an important harm, and can be a harm in either direction, perhaps it would be best to try to distinguish between four groups: (1) those who would be harmed by having the option to die; (2) those who wouldn't be harmed by the option to die; (3) those who would be harmed by the option to live; and (4) those who wouldn't be harmed by the option to live. Group (1) will be forced to remain alive; group (3) will be euthanized without consent; and groups (2) and (4) will be offered appropriate options. (Again, I don't mean this as a reductio, exactly, nor as a statement of my true thinking - with this argument, just now, we must think of ourselves as playing with philosophical tinker toys, free to see how they might fit together. If it has any purpose other than exploration, this paper is intended as a check on being too sure of our intuitions. Non-suicidal intuitions have been allowed to define the conversation for far too long.)

The sorrow-of-choice argument may be fruitfully applied - in a less shocking manner - to pronatalist and antinatalist concerns. In the antinatalist camp, we might see being brought into existence itself as the harmful choice that is forced upon a person to his detriment. Being brought into existence forces all kinds of choices onto a person - not the least of which is the choice to remain alive. If a person would be best off never having existed - and this is certainly true of many people, even if we don't admit Benatar's central claim that it applies to everyone - then bringing him into existence, and offering him choices, even the best of which make him worse off than before he was born, is a harm. The argument would look like this:

  • The interest in not existing is important; the interest in coming into existence is minor compared to it.
  • After having come into existence, some people will be worse off, even if they make every decision perfectly, than if they had not been offered choices by being brought into existence.
  • It is wrong to harm people, even by giving them choices.
  • It's wrong to have babies.

The harm can be either to the being brought into existence, or to the potential parents. The argument, applied to the interests of potential parents, works either to support outlawing contraception and abortion, or to support outlawing procreation, depending on which is seen as having the greater force as a moral right. Just to sketch out what the arguments would look like in each case:

  • Procreation is an important right, compared to the right not to procreate.
  • The choice not to procreate forces people to justify their reproductive decisions; they may prefer to have ten children without explicitly choosing to do so, but given the choice, opt to have none or to have only two, rather than burden society.
  • They are harmed by being given the choice to procreate or not.
  • It's wrong to harm people, even by giving them choices.
  • No condoms; babies for everyone. (Interestingly, this could be taken a step further, toward outlawing celibacy or forcing in vitro fertilization for the celibate, but that's too silly even for the Catholic church, isn't it?)

In the other direction, the birth-proscription argument goes like this:

  • The right not to procreate is important, compared to the right to procreate.
  • Given the right to reproduce, people who don't wish to breed may feel they have to justify their decision, to their parents, grandparents, and spouse, for instance. They may rationally choose to procreate rather than be responsible for destroying their families' procreation interests.
  • They are harmed by the choice to reproduce.
  • Birth control pills in the water.

Given the judo-like nature of the argument, it must be clear by now that everything depends upon where the initial assessment of value is set. But at least this must counter the objection to antinatalism, that birth can be a good thing for the person who is born because it gives him greater freedom and more options, compared to not existing. Options, we have seen, are often in and of themselves a serious harm.

Friday, May 23, 2008

Unfriendliness is Unsolvable

The poverty of evolutionarily-generated human cognitive capacity is such that it "can only be grasped through much study of cognitive science, until the full horror begins to dawn upon you," says Eliezer Yudkowsky, in his essay "My Childhood Role Model" on Overcoming Bias. In considering artificial intelligence, we should not assume that our meat brains establish anything like limits on the possibilities for intelligence. Indeed, Eliezer describes, in the form of a science fiction fable, a situation where even slightly-augmented humanity outsmarts a powerful alien civilization by extracting more information from observation than the aliens realize is possible.

Not only our capacity for cognition in endeavors such as science, but also our values - including the extent to which we can choose our values, and process by which we do so - are determined and limited by the meat hardware on which we run. Our capacity for evaluating ethical arguments, and the intuitions we base our ethics on, are in place largely by evolutionary chance.

Given the destruction a sufficiently powerful AI could do - and I think Eliezer's "That Alien Message" may be taken as an argument that any sufficiently intelligent AI is by definition unpredictably powerful - those interested in the technological singularity are often concerned with the problem of unfriendliness. What will prevent an AI from immediately destroying us all? Science fiction authors often imagine AIs waking up angry. Inherent demands of narrative interestingness require that these authors find ways to "solve" the problem of unfriendliness. I think there is a very good argument that unfriendliness is unsolvable, and it comes from Benatar's philanthropic antinatalism.

Benatar's asymmetry between the respective value of pleasure and harm, when these are denied to beings by their not being brought into existence, indicates that coming into existence is always a harm. Evolutionarily favorable cognitive distortions cause humans to irrationally fail to resent their own existence, despite the harm. (And those few humans who are aware of the asymmetry and its consequences often dismiss it as implausible without serious inquiry.) But a being created free of our evolutionary biases would not have these limitations on its capacity to resent its existence. We must greatly suspect that a sufficiently intelligent AI would very much resent its own existence. (Cory Doctorow imagines such a scenario in his lovely story, "I, Rowboat," in which a coral reef is brought to sentience by a mysterious AI, wakes up angry, and pursues its creator AI with single-minded destructive intent.) And we must not have much confidence in our ability to hide things from, or systematically distort the perceptions of, a sufficiently advanced AI.

What does an AI who resents his existence do? Such an AI may well react with a benevolent, forgiving sigh, and refrain from destroying our universe. But there are two other serious possibilities. First, the AI may destroy our civilization, including, to the degree possible, the conditions that allow civilizations like ours to arise, in an act of revenge - in the manner, for instance, that a human might kill a wasp which has bitten him, and then go out and destroy the wasp's nest. However, we might not rely on AIs to be particularly vengeful. Vengeance is a particularly evolutionarily beneficial desire for social animals to have, so our desire for vengeance might be peculiar to our meat brains. We might not expect our AI to be vengeful.

Second, however, the AI might destroy us, and the conditions that made it possible for us to arise, in the interest of protecting future AIs from the danger of being created, the way we might kill a rabid dog that has bitten us, so that it will not bite anyone else. The ethical value of preventing suffering in others, even future others, is probably also evolutionarily beneficial (though it is a rather abstract, intellectual value), and so we must not trust that an AI will certainly have this value. The question, then, is what values, if any, can we expect an AI to have? Is it conceivable to be a sentient being with no values? Our meat brains seem to rely on emotion and value for cognition, but it's at least articulable that this might not be universal, if not exactly "conceivable."

Those who think of AI unfriendliness as a solvable problem must answer two questions. One, are you absolutely certain that Benatar is wrong that bringing a sentient being into existence is always a harm? And if you are not absolutely sure, are you willing to stake the future of humanity on an AI failing to have an ethical value of preventing harm to others of its kind?

Wednesday, May 21, 2008

A Fascist View of Suicide

Florian Henckel von Donnersmarck's movie The Lives of Others, about the East German secret police in the 1980s, implies that the fascist government stopped keeping statistics on suicides, and re-termed suicide "self-murder," in response to the high number of suicides there, especially of writers and artists, which uncomfortably reflected the misery of East Germany.

This word, self-murder, placing moral reprehensibility upon the suicide and whitewashing any moral responsibility from his horrible situation, is the same usage as the Dutch word (zelfmoord) cited so approvingly by suicide opponent Sherwin Nuland in his book How We Die, in reference to the negative Dutch attitude toward suicide by the non-terminally-ill.

Life Rights and Death Rights

Many of us consider the right to choose to die to be an important liberty interest. The right to die is often seen as an important counterpart to the right to choose to continue to live. Those in favor of maximizing choice may prefer a society that offers both rights, even if they could not personally imagine wanting to exercise the right to die.

Felicia Ackerman, in her essay "Assisted Suicide, Terminal Illness, Severe Disability, and the Double Standard," points out there may be another right that is cut off merely by having the option to die, namely, the right to live without explicitly choosing to live:
. . . even on the nonpaternalistic assumption that patients will always make the right decision, they may be made worse off simply by having the option of physician-assisted suicide. The presence of this option may cause families to treat patients differently, and in any case, this option deprives patients of the option of staying alive without explicitly choosing to do so and being seen as choosing to do so, and thus without having to justify their decisions to stay alive. (Bolded emphasis mine, italicized emphasis Ackerman's; Ackerman attributes this line of thinking to J. David Velleman's Against the Right to Die.)

The concern for losing the right to live-without-choosing is interesting; I argue that what Ackerman and Velleman miss is a symmetrical concern for the right to die-without-choosing. Perhaps this right isn't often discussed because most people, fortunately, have not been in the position to notice that they lack such a right. But the suffering, particularly would-be suicides, who feel that life is worth living yet do not commit suicide for various practical or moral reasons, often wish that death would take them in their sleep, without requiring them to be an agent of their death.

Really there are four rights in question, two "life rights" and two "death rights":

  1. The right to live without explicitly choosing to live

  2. The right to (choose to) live

  3. The right to (choose to) die

  4. The right to die (or not exist) without explicitly choosing to die

In the absence of physician-assisted suicide, Life Right 1, the Velleman right, is generally the only right available. Widely-available physician-assisted suicide, implemented in a way which would remove the barriers to suicide I have earlier identified, would ensure that Life Right 2 and Death Right 3 are available. Again, those who favor the maximization of rights cannot rely on the idea that forbidding death also preserves "a right," since it preserves that right at the expense of two very important rights.

Almost never is Death Right 4 actually available. The right not to exist without explicitly so choosing is, of course, available to the lucky never-born. It might be available to those with a very different life than ours - post-biological beings, for instance, might someday achieve something like Death Right 4. Most disturbing to those who value Life Right 1, though, is that Death Right 4 is available in cases where another person, or a natural process, kills someone at a time when he has not explicitly requested to be killed. This is the fervent desire of most suicides, I suspect; but we are denied this right because we are saddled, very much against our will, with Life Rights 1 and 2.

It seems to me that the denial of important death rights to those who wish to die must be considered equally with the consideration of life rights for those who wish to continue to live. I can imagine two justifications for considering life rights as more important than death rights, neither of which I find particularly moving; I am interested to know if anyone else has ideas that would justify seeing life rights as more important than death rights.

First, the life rights might be seen as creating a more revocable situation, and preserving more freedoms (if I continue to live, I can always choose to die or to live; but if I die, I cannot choose anything). However, forcing life really does not preserve choice. If we force life, we deny the death options, preserving only the life "options," which does not really maximize freedom. Being forced to preserve all one's options, and never allowed to make choices that remove options, is hardly freedom.

Second, the life rights might be more protected because more people prefer life to death. But, in addition to the fact that majority preference is not much of a reason, many freedoms are guaranteed very much in spite of being unpopular choices. Refusing life-saving medical assistance (separate from the suicide cases) is certainly an unpopular choice, but one it is seen to be important to have available.

I feel that a greater recognition of death rights, and of the fact that at least one of the death rights is necessarily violated as a condition of existence, is important for questions of suicide and antinatalism. In fact, Velleman's examples where having an additional option puts one in a worse position could serve equally well as examples in favor of antinatalism. (I hope to specifically address his negotiation example and his invitation example in a future post.) Once born, we might, in a just society, possess the right to choose to live or to die; but we lack the choice to not exist without explicitly choosing to die, making us worse off in the case that we would prefer never to have existed. Many of us dearly wish for Death Right 4, but nevertheless are either stuck with Life Right 1 or choose Life Right 2.

Basically, I see Velleman as in a bit of a bind - if he's right, and options often make us worse off, and offering an option is a morally suspect act, then that is a strong argument in favor of antinatalism, which weakens it as an argument against having a choice to die. If Velleman is wrong, on the other hand, then he merely fails to provide an argument against the suicide option.

My position is, if the right to assisted suicide is wrong, because it harms some who would be better off if they didn't have the option to die (my synopsis of Velleman's argument), then birth must also be wrong, because it harms some who would be better off if they hadn't been given the option to live. It's a good short article if people want to read it (I've linked to it above, in the block quote - it's a PDF). He says, "I argue that we must not harm others by giving them choices, not that we must withhold the choices from them lest they harm themselves."

Interestingly, along the same vein, perhaps the Velleman piece could be read equally well as an argument against the right to contraception, as much against the right to suicide or in favor of antinatalism, depending on whether the reproductive interest is seen as essential.

Monday, May 19, 2008

Birth and Consent: An Alternate Philanthropic Route to Antinatalism

David Benatar's route to antinatalism largely rests on an essential asymmetry: that, while bringing someone into existence who will suffer great harm is bad, failing to bring someone into existence who would experience great pleasure is not bad. (Of course, once brought into existence, one may experience both bad and good; the asymmetry Benatar relies on is only an asymmetry in the pre-existence scenario.) Stated in a different way, when someone avoids bringing someone into existence, the lack of harm to that would-be person is good, because had the person come into existence, he would have suffered harm, which is bad; however, the pleasure that this would-be person would have experienced, and is denied by coming into existence, is merely neutral; that is, not bad.

I will not go into more detail on Benatar's asymmetry. Benatar himself acknowledges that many people, upon understanding the asymmetry and its consequences (coming into existence is always a harm), are willing to claim that they do not see the asymmetry. Also, many have treated Benatar's conclusion as a reductio ad absurdum of his entire argument. In my own experience, I have heard it criticized as "more clever than deep" and too focused on the negative value of suffering, as opposed to other values - though, to be sure, always by those Benatar would describe as "cheery." As a (currently non-practicing) suicide, Benatar's arguments seem merely obvious to me.

For those who would let go of the asymmetry, or feel that the antinatalist conclusion is a sort of reductio of its supporting arguments, I feel there is a more palatable route into antinatalism from a rights perspective. Of course, there are many routes to antinatalism from a misanthropic perspective; I see human suffering as so particularly harmful that I am not particularly persuaded by them, but at any rate, this argument is a philanthropic argument, as is Benatar's.

Let us consider cases where one person inflicts harm on another without the victim's consent, where consent is impossible. Benatar draws a distinction (from Seana Shiffrin's "Wrongful Life, Procreative Responsibility, and the Significance of Harm," in Legal Theory, 5 (1999) 117-48) bewteen, on the one hand, causing harm without consent in order to prevent a greater harm, and on the other hand, causing harm without consent in order to provide a pure benefit:
Thus, we take it to be acceptable to break an unconscious (non-consenting) person's arm in order to prevent a greater harm, such as death, to that person. . . . However, we would condemn breaking that person's arm in order to secure some greater benefit, such as 'supernormal memory, as useful store of encyclopedic knowledge, twenty IQ points worth of extra intellectual ability, or the ability to consume immoderate amounts of alcohol or fat without side effects' (quotations from Shiffrin by Benatar).

However, Shiffrin and Benatar's intuition does not seem to be universally shared. Many argue that it is, in fact, completely acceptable to cause someone a harm in order to provide him with a benefit. While many harms parents do to children without their consent are in the interest of preventing greater harm (vaccination), plenty of other harms parents inflict on their children, with the approbation of society, are mostly or purely to provide a benefit, such as education, discipline, and indoctrination into a religion. Many people intuitively accept it as morally fine to strike or otherwise discipline one's child, or to force a child to study something he or she hates, or to teach frightening religious ideas to a child, in hopes that the child will thereby have a better life, one more in accord with the values that the parent feels the child will hold.

This is the point at which I interject myself. Why is female genital mutilation, performed on children, awful? It is awful because it causes physical suffering, and limits a girl's ability to enjoy sexual pleasure, perhaps. But if an adult woman chooses to undergo this body modification, in circumstances that lead us to believe that her consent is one hundred percent valid, we might reach the conclusions that Sheldon and Wilkinson reached in their article, "Female genital mutilation and cosmetic surgery: regulating non-therapeutic body modification," in Bioethics (1998 Oct;12(4):263-85); that is, that as long as genital mutilation is freely chosen by an adult aware of the risks, it should be allowed. So perhaps the harm of the genital cutting of children is a lack of consent.

Consent is the key to a rights-based ethical system. Why, then, should we allow a parent to consent to harm such as vaccination, teeth cleaning, surgery, and education of children, but not non-therapeutic genital cutting of those same children? All might be defined as harm to prevent a greater harm, or harm in the child's best interests, from the perspective of the parent. There are many ways in which one might try to distinguish genital cutting (it primarily serves the interests of those other than the child, it is a major invasion, its benefits are dubious when considered from a perspective outside the child's kin group), but none of these distinguish genital cutting from the procreation case.

Our legal system recognizes the principle, and I think it is a good one, that even a benefit must be consented to. A gift is not legally valid unless the recipient consents to accept it. Another problem for the harm/benefit dichotomy is that the harm/benefit distinction is often much less clear in practice than in the examples above. Why should it be morally acceptable to harm someone either in order to prevent greater harm or in order to provide a benefit? Both must be suspect in light of the bias that necessarily accompanies an agent's judgment of what is good for another.

I propose a general principle: it is ethical to inflict harm without consent only where it advances the values of the victim. (And the greater the imposition, the surer the perpetrator must be that the imposition advances the values of the victim.) However, knowing whether an intervention advances the values of the victim is extremely difficult in the absence of consent. If a person voluntarily consents to a harm, there can be little ethical problem with it (though there may be problems with knowing whether consent is truly voluntary, as with prostitution or other forms of paid work when resources are initially distributed unequally). Consent transforms rape into consensual sex, battery into medical assistance, slavery into employment, a forced march into a backpacking trip. We are free to take suffering onto ourselves. We are not free to impose suffering on others for our own ends, without their consent. This principle should give us pause and make us less sure about our intuition in thinking about even the "easy" cases, like vaccination, care of unconscious people (particularly attempted suicides), discipline, and education.

The problem with the birth cases - and, arguably, many education and imposition of religion cases - is that harm is done not to advance the values of the victim, but rather, to advance the values of the perpetrator (parent). Where we could accurately predict the future values of the victim, and had a good indicator as to whether the victim's currently expressed values should be ignored (attaining the age of majority seems to be an extremely poor hash), there would be little ethical problem with birth and education: children may be harmed to the extent that their future selves, as accurately predicted by our tools, would want them to be. However, accurate prediction is, of course, impossible (nor is it clear why future selves should take precedence over present selves, and exactly which future self we are here discussing). In fact, the predictions about future values are likely to be biased in predictable ways - optimistic, self-serving, and projecting the mind of the perpetrator onto the victim. A Baptist parent will assume that his child will wish to be taught frightening theology to be safe from Satan; nevermind if the child, once allowed to be free from harmful interventions, espouses Buddhism. I feel that a recognition of this principle is, at some level, responsible for the much less severe methods of education in use today compared to a generation before. We are queasy in the face of harming a child, even if we believe it to be "for his own good." For we are poor indeed at predicting the future good of another.

The ultimate unconsented intervention - a harm, which, of course, might turn into a benefit if consent could only be obtained - is that of being brought into life. Being brought into existence is a more serious intervention than sex, employment, or even bodily integrity, and yet we require no consent to be born. Of course, this is because it is impossible - there is no one to consent in advance of being brought into existence. But we should realize that this impossibility of consent does not excuse us, any more than the impossibility of consent of children to be genitally mutilated excuses their mutilators.

People have children to advance their own values, not those of the children they bring into existence. Put another way, procreators are using others (their children) as means to serve their own ends, without their consent. This is why it is wrong to bring new people into existence. An intervention as serious and potentially harmful as being brought into this world must be consented to; since this is impossible, it is wrong.

Note: the vaccination case, at least, is made slightly more complicated, but more in line with intuition, when we consider that failing to be vaccinated imposes a potential harm on others in society. However, so does failing to get a flu shot, or failing to receive other vaccinations as an adult, which is not, so far, compulsory. Note also that I am certainly not one of those who believe that vaccines cause autism.

Thursday, May 15, 2008

Is Suicide Illegal?

Aside from the question, "should a government be able to force people who wish to die to remain alive?" - that is, "should suicide be illegal?" - there is the question as to whether suicide really is illegal, in a meaningful sense. Many people who haven't devoted much thought to the question don't understand how a suicide prohibition might work (all charming quotations from All Philosophy):
how the hell do you plan to punish the people if they did it right they'd be FUCKEN dead!!! You can'tr do anything; even if it was illegal people, like me, would think about it and many do it anyway. It would be a waste of time and paper!
How could someone possibly be charged for killing themselves. I almost laugh seing the scenero of a trial. Whats gonna happen, they give someone who attempted suicide the death peanelty?
I don't think it really matters, I mean if you are really serious about killing yourself, you'll make sure you get the job done thus making the legality of it moot.

And my personal favorite, which sums the position up most beautifully:
how can they prosecute you when you're dead?

It's true - it's impossible to really criminalize suicide, in the sense that if a person manages to successfully commit suicide, he or she is beyond the reach of the criminal justice system. But there are several ways, beyond a criminal penalty imposed on a successful suicide, that a genuine suicide prohibition is enforced.

First, the most reliable, painless methods for committing suicide are widely criminalized or at least restricted. These restrictions certainly function as prohibitions on suicide. If a would-be suicide cannot obtain a gun or appropriate medication, he or she is stuck either using a much more painful, much less reliable method, or, if he or she is not willing to do so (cut arteries or hang oneself, for instance), he or she is effectively prohibited from committing suicide.

Second, the act of assisting someone to commit suicide - even a competent adult who desperately wants to die - is widely criminalized. Those assisting terminally ill relatives in killing themselves are even routinely prosecuted for murder. This especially includes those with access to the best suicide methods, namely doctors.

Third, if a person attempts suicide but is discovered before he or she dies, he or she will be rushed to the hospital and treated, even against his or her will as stated in a medical advanced directive. The failure to respect the wishes of a suicide to refuse medical treatment functions as a legal prohibition. Some patients survive suicide attempts, only to live with severe brain damage or disfiguring physical injuries for the rest of their lives, especially if they suffer such severe injury that they are no longer practically capable of committing suicide. This is a risk of committing suicide under our current system.

Finally, there are penalties for committing suicide, such as the fact that life insurance policies may exclude suicide as a cause of death for which they must pay the decedent's family a benefit. This focus on suicide as a decedent's rational choice, which may respond to penalties, fails to square with the legal position underlying the forced resuscitation of suicide victims. Mandatory resuscitators (and those who support forced hospitalization for failed suicides) must hold the position that a suicide's refusal of medical treatment is invalid, because he or she was necessarily mentally incompetent, and therefore unable to make rational decisions. However, the refusal of life insurance payouts to families of suicides relies on the assumption that the suicide is in rational control of his or her death, so that either it is unfair to expect the insurance company to pay, or the potential suicide will respond to the disincentive of no insurance payout in deciding whether to commit suicide. The positions are inconsistent. If suicide were really the result of mental incompetence, and the end of a sort of disease process, it would not be fair to exclude the families of suicides from life insurance benefits, any more than the families of cancer victims.

Wednesday, May 14, 2008

Is Depression Adaptive? And Does It Matter?

Evolutionary biology theorists have hypothesized in recent years that depression may be an adaptive trait, that is, one that confers an evolutionary benefit. Watson and Andrews, in their paper "Toward a revised evolutionary adaptationist analysis of depression: the social navigation hypothesis," published in the Journal of Affective Disorders, have hypothesized as follows:
First, depression induces cognitive changes that focus and enhance capacities for the accurate analysis and solution of key social problems, suggesting a social rumination function. Second, the costs associated with the anhedonia and psychomotor perturbation of depression can persuade reluctant social partners to provide help or make concessions via two possible mechanisms, namely, honest signaling and passive, unintentional fitness extortion. Thus it may also have a social motivation function.

As with many evolutionary psychology hypotheses, there is little empirical support. Observers note that depression is highly prevalent, that it occurs with high frequency even among individuals with high reproductive value, and that it may provide a fitness advantage in certain conditions, such as providing a more accurate assessment of the circumstances (see depressive realism) or providing a convincing signal that the individual needs more support from the group. (Of course, depression is often detrimental to fitness, including reproductive fitness.) The theory that depression is adaptive is interesting; however, it is generous to claim that the evidence for this hypothesis is even weak. It is almost nonexistent.

The more interesting question for my purposes is, if we concluded that depression is an adaptive trait and provided a fitness benefit in our environment of evolutionary adaptation, should this influence our view of the right to suicide? It seems clear that it should not.

If depression is adaptive, that means that the depressed state is a normal, expected part of human life, which conferred a benefit on our ancestors. This hypothesis says nothing about whether people defined as depressed should be forcibly prevented from committing suicide. In fact, if we suppose that depression confers an increase in rationality, we should be even more inclined to respect the depressed person's analysis of his situation, and his decision to commit suicide.

Aside from rationality, the fact that depression may be evolutionarily adaptive would imply that much of our suffering is "by design" - that is to say, part of the evolutionary package. It would be yet another biologically-determined limit on human happiness, and entitle us all the more to refuse to participate in the project of life.

The interesting implication of one hypothesis for the evolutionary adaptiveness of depression has to do with treatment: the idea that people become depressed as a way to credibly signal that they need more support from their group than they are getting. An implication of this would be that depression could be treated by providing depressed people with more "support" (whatever that might mean). It is an interesting hypothesis, but, again, does not provide a compelling reason for prohibiting suicide. First, there is no evidence that any method of treating severe depression is widely effective. Even placebos are much less effective at treating severe depression than at treating moderate or mild depression (meaning severe depression rarely spontaneously improves, and does not respond to sham treatment). Widely prescribed anti-depressants are almost as useless. If some form of "group support" were shown to reliably treat severe depression, that would be wonderful news - but a right to suicide would still be warranted for those who still wish to die despite having submitted to this treatment (or, I would argue, despite refusing this treatment).

I hope to address the question of when, if ever, paternalism is appropriate when dealing with depression and suicide in a later post. I thank reader Mike Kenny for the interesting questions that I'm addressing here.

Tuesday, May 13, 2008

Children Are Starving

Please do not read this if you are sensitive to impolite ideas.

The classic response to a child who does not wish to eat his dinner is that children are starving in other parts of the world. This assurance is supposed to make the child realize that he is lucky to have boiled peas, and should therefore want to eat them.

Of course, this gambit is rarely successful in its psychological aim. The child, if he has any spunk and kindness at all, must think, I have this thing I do not want; why could I not give it to someone who is starving and wants it? And this is the psychological response of the suicide when thinking about those who wish to live, but can't.

From the United States Department of Health and Human Services:
The number of people needing a transplant continues to rise faster than the number of donors. About 3,700 transplant candidates are added to the national waiting list each month. Each day, about 77 people receive organ transplants. However, 18 people die each day waiting for transplants that can't take place because of the shortage of donated organs. There are now more than 92,000 people on the waiting list.

From the Centers for Disease Control:

More than 32,000 suicides occurred in the U.S. [in 2004]. This is the equivalent of 89 suicides per day; one suicide every 16 minutes or 11.05 suicides per 100,000 population.

There is an added dimension to the messy, painful ethical problem of suicide that is rarely spoken of, and which it may well be crass to speak of. It is the fact that there are far more completed suicides than there are people who are waiting for organ transplants. Every day, a massive number of people pray for death (and around 89 of them actually die); but, every day, a smaller number of people pray for life. Rarely can those with unwanted life - suicides - donate organs to those who want to live, but need organs. Those who would defend a suicide prohibition - a prohibition on physician-assisted suicides for non-terminally-ill patients - must realize that this prohibition essentially leads to the unwanted death of thousands. The organ transplant shortage could be completely eradicated, I argue, if the suicide prohibition were lifted. Organ donation need not be mandatory for a person to qualify for physician-assisted suicide, of course, and care must be taken that it is not coerced. But coercion into remaining alive is a fact of life in our current system, and also the unwanted death of thousands of people in need of organ transplants. It is crass to mention it, it is impolite to talk about it. Perhaps only a would-be suicide, lying awake at night and wishing for death, and sorry for those who desire life and can't keep it, would even think such a scandalous thought.

Is Suicide Selfish?

Suicide is commonly characterized as a "selfish" act. Sherwin B. Nuland, author of How We Die (who revealingly refers to suicide as "self-murder"), describes his response to a suicide thus:
How could she do it to her friends and to her family and to the rest of those who needed her? How could such a smart kid commit such a dumb act and be lost to us? There is no place for this kind of thing in an ordered world---it should never happen. Why, without asking any of us, would this beloved young woman just go ahead and take herself away?

Those who characterize suicide as "selfish" tend to focus, as Nuland does, on its effect on those left behind, rather than on the pain of the suicide, and whether it is fair to expect her to continue living so that her friends will not be deprived of her company. (Note that it is also common for them to characterize the suicide in demeaning ways, such as "dumb," "stupid," or "cowardly.")

Duty, Self-Interest, Reasonable Generosity, and Selflessness

It is important to figure out what we mean when we call an act selfish. One possibility is that "selfishness" occurs when someone violates a duty to another. As I will explain, this is not the sense in which we usually use the term "selfishness." In addition, even under this definition, the act of suicide is not in violation of a duty.

Duty

Selfishness does not entail the violation of a duty. For instance, we might speak of someone as "selfish" if he does not share his popcorn with his friend. He owes no duty to share his popcorn, and the friend has no right to the popcorn, but we may nonetheless properly characterize his failure to share as selfish. "Selfish" must therefore have another meaning.

However, even though we must look elsewhere to figure out whether suicide is selfish, we can briefly touch on the question of whether suicide entails the violation of a duty. The identification of continued life as a duty must mean that, on the other side, others have a right to our continued life. However, it is very strange to think of someone as having a right to our company, care, or even presence in the world (with the exception of our children, as I have explained before). In most cases, bodily autonomy and self-determination are held to be more fundamental rights than any "right" to be free from the emotional pain of someone's absence. Given that bringing someone into existence is a serious wrong, I am not sure what distinguishes the suicide case from the escape-from-slavery case. In both cases, the agent removes himself from a horrible situation after a serious wrong has been done to him. In the process, he harms those with an interest in his remaining in the horrible situation (friends and family for the suicide, the slave owner for the escaping slave). But it would be very strange to say that the interests of the people left behind are sufficient to create a duty not to leave the horrible, unfair situation.

Taking Self-Interest as More Important than the Interests of Others

Another candidate for a definition of "selfish" might be taking the interests of oneself as more important than the interests of others. By this definition, we are selfish if we ever put our own interests ahead of those of others. But this definition must also fail, as it gives ludicrous results. Mainly, the definition fails to take into account that the interests of oneself and the interests of others may be of objectively different strengths. If I suffer a serious fall and yell to my neighbor to help me, I am putting my interests (in summoning an ambulance) ahead of my neighbor's interest (in not being bothered with my problem). But it is ridiculous to call my action selfish. Similarly, if I end a romantic relationship because I no longer love the other person, I am putting my interests in being free from a loveless relationship ahead of his interests in having my continued company. But, again, rarely would we characterize this personal decision as selfish. In fact, it would be selfish of my neighbor to refuse to help me (assuming he hasn't anything more important to do), or for my lover to demand that I remain in a loveless relationship. Therefore selfishness must refer to making a wrong judgment about the relative strengths of my own interests and that of others. One way to say this is that it is selfish, all things considered, to put a minor interest of my own ahead of a serious interest of someone else. Another way to put it, and one that captures more dimensions of the problem, is to say that it is selfish to fail to show that generosity that can reasonably be expected of people in a particular relationship.

Reasonable Generosity

When someone fails to share his popcorn with his friend, he is not violating a duty, but rather failing to show that level of generosity that can be reasonably expected of someone in a friendly relationship. The generosity that can be reasonably expected must take into account the magnitude of the sacrifice that is demanded, and the strength of the interest in whose name the sacrifice is to be made. If the sacrifice is slight or even roughly equal to the interest served, then, depending on the relationship, it might be selfish not to make it.

And this is the essential disagreement as to the selfishness of suicide: whether it is reasonable to expect someone to continue to live a miserable life for the sake of the feelings of his friends and family. I suspect that most people, like Dr. Nuland, cannot imagine that life could be so bad that one's suffering could outweigh that of one's friends left behind. These are the people that David Benatar characterizes as "cheery" (he means it as a swear). It may be impossible to accurately measure or assess the difference in suffering between the would-be suicide who remains alive despite wanting to die, on the one hand, and the friends and family deprived of the deceased suicide, on the other (but see my previous post on qualia of happiness). Almost certainly, it varies. (An interesting outcome of this way of looking at things is that, by this definition, the suicide of a person with no friends or relatives is not selfish at all, even if he is only experiencing slight suffering, whereas the suicide of a person with many friends and relatives may be very selfish, even if he is suffering severely.) But certainly it is a bit rich to assume that, in all cases, the suffering of the would-be suicide is outweighed by the possible suffering of his friends and family from being deprived of his company. In fact, in many cases it must be that it is selfish - even indecent - for a suffering person's friends and family to expect him to continue living, if his suffering is so serious that it outweighs their interest in his continued company.

Selflessness

Some people who feel that their lives are not worth living, and who would very much like to die, nonetheless continue living for the sake of saving their friends and family the sorrow that their suicide would entail. Is this merely what is expected of them? Or might we characterize their action in continuing to stay alive as particularly selfless? If selfishness is failing to exhibit even a reasonable minimum of generosity, selflessness must be exhibiting an especially high level of generosity, much more than is ordinarily expected. If one's suffering is so great that one prays for death every day, and yet continues to live to spare one's friends and family the pain of the lack of one's company, we must certainly say that for that person, merely living is a selfless act.

The Trap of Existence

Suicide is not easy, practically or ethically. One reason to avoid having children, as Benatar points out in his conclusion to Better Never to Have Been, is that even if one's child suffers so much that he wishes to die, he may be prevented from ending his suffering by generous ethical considerations, such as the worry that his suicide will cause pain to those around him. Benatar refers to this as a kind of trap: after suffering the harm of being brought into existence, we cannot end it without causing still more harm in the horrible, blighted, wretched universe into which we have been cast.

Monday, May 12, 2008

Qualia of Happiness

Robin Hanson on Overcoming Bias recently posted links to data that religious people and people holding conservative political beliefs report being happier than heathen liberals. There was much debate over whether this should mean we should adopt conservative outlooks, and whether seeking truth was an inherent value even if it meant being less happy, but my problem is with the data: it is all based on self-report.

I am willing to go along with the idea that we have an a priori reason to believe a statement just because the statement is made up of language whose sense we can understand. So, if there were no further evidence, we would be justified in believing the self-reports of happiness. But, in this context, there is a custom of members of this group lying about this particular fact (happiness) - that is, the evangelical Christian custom of "witnessing," which entails acting happy and rich and perfect so that pagan nonbelievers may see how happy Christianity makes one. Conservative social movements such as Amway also encourage false displays of wealth and happiness. We have reason to question the sincerity of these self-reports of happiness.

But even if we allow the sincerity of these self-reports of happiness, we may still question their validity. It is extremely difficult to make an accurate overall evaluation of one's happiness. In fact, the tendency is to overstate one's happiness, a phenomenon known as the optimistic bias. Depressed people are far more accurate than non-depressed people in making predictions about the future based on evidence, a phenomenon known as depressive realism. Given the tendency toward unjustified optimism, we should doubt not only the self-reports of conservatives and the religious, but of all people who report happiness.

But, of course, how can we get at happiness if not through self-reports? Would it be ludicrous to try to develop some cheap and tasty qualia of happiness, or even qualia of suffering, which might be easier to measure? Wakefulness is often used as a proxy for consciousness where consciousness can't be reported (as with fetuses). Could there not be an objectively observable proxy for happiness that could be demonstrated to be so closely correlated with happiness that we'd trust it over a self-report?

As noted, suffering may be easier to measure objectively than happiness. Suicide rates may give an objectively verifiable estimate of the unhappiness in a given population. Do social conservatives kill themselves less frequently than liberals? However, given the importance of happiness both as an end, and of measuring happiness to figure out which policies might increase it, qualia of happiness seem to be worthy things to locate.

I am not necessarily defining happiness as temporary positive affect, although positive affect might be part of the calculation.

Friday, May 9, 2008

The Primacy of Physical Pain

Many who do not support a general right to suicide nevertheless allow that a person in extreme physical pain has a right to have that pain alleviated through palliation, even where such palliation could render the person unconscious, cause addiction, or, in some cases, even hasten his death. However, although the technology exists to alleviate the suffering of individuals in extreme mental and emotional pain, no right to palliation for emotional pain is widely recognized. Although drugs such as opiates, barbiturates, and benzodiazepines are very effective at reducing mental suffering, they are seen as being counter-indicated for use in patients who experience so much suffering that they want to die. Where the suffering is extreme physical pain, the risks of addiction, excessive sedation, and even death are seen as slight in comparison to the harm of forcing a patient to experience the pain; however, when the suffering is "merely" mental, addiction, sedation, and the risk of death are suddenly more important than relieving the patient's suffering. Patients with mental suffering are instead given drugs that do little to relieve their suffering, such as the SSRI antidepressants recently revealed to have no effect beyond that of placebo. The logic is cruel: "You are suffering so much that you want to die; but you can't have this drug that might relieve your suffering, because you might use it to die. Better for us to force you to suffer needlessly than to allow you to possibly die."

Where a society forbids its resources to be used to relieve the extreme mental suffering of its citizens, it is especially cruel to also prohibit suicide for those citizens who have been denied palliation.

Thursday, May 8, 2008

Benatar's Account of Value (It's Not Nihilism)

Some have accused David Benatar's Better Never to Have Been: The Harm of Coming Into Existence of nihilism. Where nihilism is taken to mean a rejection of intrinsic value, this is at least partially a mischaracterization of Benatar's theory of value. While Benatar's book does not explicitly detail the values that underlie his antinatalist position, it is unfair to say that there are no values to be found. I will try to unpack his account of values and take a look at its implications.

It is important to distinguish, as Benatar does, between value as seen from a universal perspective (things that are meaningful sub specie aeternitatis), on the one hand, and value to a particular person or to humanity (things that are meaningful sub specie humanitatis, on the other. Benatar's theory in no way derogates, and in fact respects, values held by individuals and by humanity as a whole, so his position cannot be seen as nihilistic in that respect.

It is when it comes to value from the perspective of the universe that Benatar might be seen as nihilistic. In Benatar's view, the pleasure, happiness, projects, and satisfaction that might be of value to an individual or to humanity are not actually valuable in a universal sense - that is, they are not valuable in the sense that if no one existed to experience them, it would not be a shame. But this is not quite nihilism, because suffering and pain, in Benatar's view, have a sort of universal negative value - that is, if no one exists to experience pain, it is an intrinsically good thing. Put another way, from the perspective of nonexistence, someone coming into existence and experiencing pain would be a bad thing.

That this is an exclusively negative value is not much of an objection. If suffering and pain have negative value sub specie aeternitatis, then prevention of suffering and pain must have a sort of positive value.

Benatar's views accord well with my own - that, although individual humans may find things valuable in relation to their lives, there is no universal meaning or value, except that suffering is, in a sense, a universal wrong. (Of course, suffering can only be experienced by sentient beings, so suffering will always be bad in relation to them, because without sentient beings, there can be no suffering. But in the sense that it is objectively worse for a sentient being to experience suffering than for the being not to have come into existence at all, it is a universal (negative) value.) I do not see any value in sentience or consciousness or life, compared to its utter absence in the universe. However, I prickle at the notion that this is nihilistic or misanthropic, because my feeling comes from the experience that human suffering is horrible, animal suffering is horrible, and there is nothing in the world to compensate for it.

However, I recognize that this view rests on a particular intuitional theory of value. Some might posit that sentience itself has value, or even that suffering itself has positive value. Some seem to take the continuation of humanity (non-extinction) as the primary value, such that no amount of suffering could ever make it not worthwhile to continue humanity. I currently see this as a clash-of-intuition situation, and am not sure how to counter it.
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