1. Prompting the Question
Recently, a woman in Georgia that had been kept on life support by a hospital—despite being declared brain dead—in order to bring her baby to term, gave birth. This was in June; she had been artificially kept ‘alive’ since February.
The hospital’s doctors view their course of action as a necessary means of complying with Georgia’s abortion law; the state’s Attorney General claims that the hospital is guilty of misinterpretation. From what I can gather, most experts believe the hospital erred on the side of extreme caution, and there was little evidence to suggest that terminating life support would constitute an abortion under state law.
Obviously, much of the interpretation of the case is informed by one’s views of fetal personhood, and when that obtains. If the baby has moral standing at the beginning of the case (the woman was 8 weeks pregnant, for context), then it is a significant source of reasons against terminating life support, and vice-versa. I want to bracket discussion about the strength of these reasons and will simply refer to them as the Baby’s.
Two other standpoints could plausibly generate independent reasons against termination, those being the Doctor (scared of liability) and the State (interested in population growth). The strength of the Doctor’s reason turns on the actual risk of prosecution, which, while we can only estimate it, seems to be low. The strength of the State’s reason is harder to suss out, but I’m going to bracket that too and (being a liberal) assume it is weak.1
Which standpoints are able to generate reasons for terminating life support? The Family is uncontroversial; they have an interest in honouring their daughter with a dignified send-off, avoiding the (expensive?) prolongation of their anguish, and getting to choose whether to take on the rearing of a prematurely-born grandchild.2
A deeper and more interesting question concerns the nature of the Mother’s standpoint. How much weight should someone’s residual reasons have in moral deliberation after they have passed? I want to probe that question in the rest of this essay.
2. Against Dead People’s Rights
Ari Shtein, the talented author of Mistakes Were Made, took the position last month that being dead eliminates your personal reasons, flat-out. It’s a good article and lays out the argument for thinking the case boils down to:
Our interest in the fetus’ potential future life, and
[the] family’s emotional desire to end her life.
There are good reasons to adopt this view. There are a number of important ethical properties dead people do not have. For example, they cannot (and will never again):
Act in the world
Experience pleasure or pain
Experience consciousness
Reciprocate
Reason
Form preferences
Due to this, their life as a moral agent is undoubtedly over. We may find out new information about that things they did during their life, but this will only serve to refine our judgement of them. They can’t acknowledge new obligations or reasons for action, since ought implies can. You must be capable of doing something in possibility space for it to be morally required.
There are two sorts of moral personhood. Moral agents are the beings we expect to acknowledge reasons and behave morally, while moral patients are the beings (or things) that can generate reasons and to whom moral behaviour is owed.
Most people accept there are many more patients than agents.3 Many think that colonies of bees, for example, can generate reasons not to be destroyed, despite not being capable of acknowledging the reasons of other beings. Babies similarly generate (stronger) reasons, as do pets.
Living beings are without question the easier case—more difficult is how to count beings in the future and from the past.
Shtein takes the position that the possibility of mental activity is the lowest prerequisite to be a moral patient, which entails that the Mother doesn’t factor into deciding the case, while the Baby does. This is not argued to be a robust moral patiency, but the salient point is that the Baby has reasons that count for something and the Mother doesn’t.
Note that the reasons the Baby generates must be strong enough to overcome whatever reasons the Family has to terminate life support.
3. Doing Better Beyond the Grave
3.1. Don’t Focus on the Baby
Defending Feminism, another publication worth reading, wrote this week to explain why so many take trouble with the neglect of the Mother’s standpoint.
On her view, the Baby and the Mother must have the same moral patient status in the case; either both or neither count. This is on account of neither having present mental activity.
I suspect this is mistaken. The potential for future, foreseeably complex, mental activity is an important difference between them, even if small. It’s also not a feminist line of argument, since if it succeeds in eliminating the Baby’s reasons from consideration, it must also do the same to the Mother’s. This leaves the fate of her body up to the Family, who could have chosen to not terminate her life support.4
Later in section 3.5. I want to look at her version of an argument from dignity, which I hope to strengthen in the following subsections.
3.2. Success Theory Tracks Intuition
In general, falling back to the more familiar motions of the abortion debate avoids confronting the matter of the ethical afterlife.
Take last wills; these are an odd thing in the moral universe I’ve been sketching. They are lists of wishes that we honour as though they were dispensed from a living person, despite in fact being dispensed from that person’s (former) representative. If the dead can no longer generate or maintain reasons, what exactly binds us to the content of any given will? Why aren’t the wishes acknowledged as attaching to no existing standpoint and disregarded, leaving the resources of the dead ownerless?
One explanation, which Shtein goes in for, portrays wills as an instrument of innovation. Societies honour them because the perception that one will be able to pass their belongings on to their kin encourages them to be economically productive for longer. In the world where the state redistributed everything postmortem, people would make more of an effort to burn through their life savings before death.
I buy this as an economic policy argument, but it’s not sufficient to eliminate the normative content of wills. We don’t “pretend that wills have moral worth”, we believe that they do!
The belief in the worth of wills could be taken as evidence that people accept success theory, which stipulates that a person’s life goes better insofar as their preferences about their own life are fulfilled. Thus by honouring someone’s will, we make their life go better.5
You could object that something cannot go better for someone without affecting them in the world, whether physically, mentally, or otherwise. The counter-examples to this are why we have success theory: false friends, cheating spouses, and other concealed behaviours are wrongs that can go undiscovered—they don’t become wrong by being discovered.
Parfit brings up the example of wanting to be a successful parent. This is a preference we could have where the relevant facts about its fulfilment may not be established until after we have died. Nonetheless, we accept that our life was more or less successful based on whether the kids turn out alright.
Even if the will is ugly and injurious to the deceased’s beneficiaries, taking success theory seriously does not mean treating it as overriding. There being a generic reason to respect the wishes of the dead does not mean it beats out other competing reasons.
3.3. A Note on Preferences
When discussing the success theory, Parfit distinguishes between its summative and global interpretations.
The first posits that all preferences count equally, implying it would be good to accept from me a pill that generates an overriding desire to take further pills. There aren’t other side effects. By keeping you stocked with these pills, I facilitate your life going very well in terms of summative success theory.
The second is interested only in global preferences, which pertain to how you want your life—or a substantial portion of it—to go. Stepping back from the pill case, which is a sort of less colourful Brave New World, we recognize that though taking the pill would continually satisfy our emergent preferences, it would diverge from the broader life course we want for ourselves.6 That course is what matters.
I am adopting the global interpretation when applying success theory.
3.4. The Mother’s Postmortem Success
You likely sense where this is heading. The reasons held by the Mother’s standpoint in the case are those future-oriented preferences she stepped back and formed about her life while she was alive that have yet to resolve one way or the other.
Ideally the relevant preferences are laid out in one’s will, but most people don’t have one and those that do are fourty-two on average. When a will does exist, it is often a form document written in legalese rather than a fully sincere statement of one’s wishes.
In lieu of a will, the best testament to the Mother’s wishes is likely those who knew her best—her Family. To be clear, this is an epistemic role they must serve; they are not substitute decision-makers. What can we speculate about their contents that would be relevant to our case? Here, we must necessarily be general. We have a sense of things most would value in the position, including:
Proper respect of one’s wishes
Proper respect of one’s body7
Deferral in matters of choice to the Family, not the State
And yes, potentially:
The health of the Baby
Things will go better for the Mother if her preferences are fulfilled, which maintains a reason to respect them and weigh them within the case. Since I grant the possibility that the Mother could genuinely want to be kept on life support if there is a chance of delivering the Baby, the direction the reasons favour cannot be deduced from the armchair.
3.5. An Argument from Dignity
Defending Feminism raised the important point that a general policy of applying life support in cases of this sort could commoditize enough women’s bodies to degrade women’s group dignity.8 This both seems right and increases the stakes of the case. However, I want to argue this should worry men (on their own behalf) as much as it does women.
The source of the commoditization under such a policy would be in its systematic disregard for the preferences of the various Mothers established prior to their death—most importantly the widespread preference for bodily respect.
Note that for the worries about commoditization to go through, it is only necessary that:
Many Mothers in fact have this preference,
This preference is widely understood,
This preference is consistently overruled.
Even if one adopts the view that the Baby has strong reasons of its own to keep life support going, the process can absolutely continue to commodify women’s bodies. The salient fact is that they are being used as an unwilling means to an end.
The larger worry here is that the use of bodies as tools in other contexts becomes much less objectionable when preferences like the Mothers are ignored or determined to be only weak reasons. Your body, or the body of a loved one, could be mangled for any number of reasons to prevent a dignified goodbye.
It is of course noble for someone to volunteer themselves as an organ donor, but there is something inhuman about desecrating corpses against the wishes of the dead. Sometimes, there will be standpoints with strong enough reasons to override such wishes; but it is important that we not let the argumentation to get to that point completely ignore or dismiss human dignity. A reason that is widely acknowledged and routinely defeated risks becoming a limp reason.
4. In Closing
Death does not eliminate all of a person’s interests and success theory better tracks this intuition. People have an interest in their life as a whole turning out to have been a successful project, and the success of that project is indeterminate in a number of key ways at the time of death. By respecting their preferences, we make it so their life goes better; analogous to how an artist’s life is made better by their work becoming posthumously recognized.
There’s articles worth of fertility crisis arguments out there—one of our contributors even wrote one—if you are interested in exploring this angle.
They could of course have an interest in raising their grandchild, which would count against termination. Much of their actual complaint against the hospital was rooted in a belief that they should have had the option of terminating.
Lance Bush lampoons philosophers for making claims like this, about what ‘most’ people think, but here I think it’s true. If you aren’t a sociopath, you don’t go around disregarding morality when you come across a child or someone who is quite mentally ill.
See n1.
See Appendix I ‘What Makes Someone’s Life Go Best’ of Derek Parfit’s Reasons and Persons. We can also, of course, dishonour their will, in order to make their life go worse. A final evening of the score, if grace isn’t in the cards.
See n2 again, though I grant this is a more contentious intuition.
I take it the vast majority of people want their burial or cremation to take place with reasonable haste.
I’m using the term commoditize to mean ‘instrumentalize’ (using bodies as tools), which is how I read Defending Feminism’s use of it.