Medical Ethics 565 Lecture 7

advertisement
I. Thomson’s case for the permissibility of abortion.
Thomson presents a defense of the claim that abortions are primafacie permissible, that is, if some particular abortion is morally
impermissible, this is not because it is an abortion, but because this
particular act of abortion does something else that is wrong.
She grants (for the sake of argument) that fetuses have a right to
life from conception, but argues that abortions are nonetheless not,
per se, morally impermissible. More precisely, Thomson claims:
1) Even if fetuses have rights to life, abortion will not in general
violate those rights.
2) Except in special cases, cases in which the mother has
intentionally undertaken an obligation to bring the fetus to
term, abortions will not violate any other right of the fetus.
3) Abortions will sometimes violate duties of beneficence, but
will not generally do so unless those duties are much more
stringent than we generally take them to be.
II. Background
Thomson’s defense proceeds in stages. She first argues for an
interpretation of rights to life on which not all killings violate
rights to life.
On that interpretation, abortions will violate fetal rights to life only
if the fetuses have a property right to their mothers’ bodies.
So she next argues for a principle about the transfer of property
rights on which mothers won’t confer such rights on a fetus
without explicitly intending so to do.
Finally, she considers whether duties of beneficence are violated
by abortions; she does not defend any particular formulation of
such duties, but rather says any cogent formulation will have to
count some particular abortions as permissible, and others as
impermissible.
In between those two kinds of cases there is a large grey area—her
position is that the debate about abortion ought to focus on what
duties of beneficence requires of mothers in that grey area.
Rights=a source for moral obligations.
Rights are rights to something, to some good (this can be a thing, a
service, a liberty, etc.).
Rights are also rights against someone else—a right is infringed in
that someone else deprives one of the good in question.
Put differently, rights generate obligations; if I have a right against
someone to a certain good, that someone is obliged not to infringe
on by use of that good.
Sometimes a right is against one particular person—a contractual
property right is a case in point. If I have sold the bricks in my
back yard to X, then X has a right against me that I should allow
her to retrieve the bricks; I have the related obligation. But you
may well not have that obligation. So I am obliged to unlock my
gate so she can get access to the bricks. But you are not obliged to
open the gate for her.
Other rights are rights against everyone—human rights are like
this; the right not to be tortured is a right against everyone, because
anyone who tortures X violates her right not to be tortured.
Some rights are positive—they are rights to be given the good in
question, while others are negative—they are rights not to be
interfered with while pursuing or using the good in question. The
right to a k-12 education is a positive right against all our fellow
citizens; the right to freedom of conscience is a negative right
against all our fellow citizens.
We also need a distinction between ‘active’ and ‘passive’ killing.
Roughly, a killing is passive if it is a ‘letting die’—one stands by
while other causes produce the death; it is active if one directly
causes the death.
So, e.g., if one motors by in one’s boat Igor, who is drowning,
without stopping to help, the killing is passive.
If one throws Igor out of one’s boat, and then motors off, the
killing is active.
As it turns out, the distinction is not well formulated, but it is
intuitive, and fairly commonly drawn.
Finally, some terminology. Thomson thinks there are two ways an
action can be wrong.
It can violate a duty of beneficence, in which case it is said to be
indecent and wrong for this reason.
Or
It can violate a right held by somebody, in which case it is said to
by unjust and wrong for this reason.
Actions can be both indecent and unjust, and so doubly wrong.
Unjust actions are always morally impermissible, for Thomson. So
too are indecent actions—TO SAY AN ACTION IS INDECENT
IS TO SAY IT IS MORALLY WRONG, IMPERMISSIBLE,
EVIL.
The difference between indecent and unjust acts is just that though
each violates some obligation, the source of those obligations
differs.
III. The argument for weak negative rights to life.
Thomson aims to defend a principle about what rights to life
require of us with respect to their bearers—just when does a killing
violate a right to life? She never explicitly formulates the
principle, but it can be put this way:
P: If X, or someone Z acting on X’s behalf, kills Y by depriving
Y of G, where Y requires G to survive, but X has a right to G while
Y does not, then Y’s right to life is not violated.
If principle P is correct, three things must be true.
Rights to life are negative; that is, they are rights against being
unjustly killed (whatever this turns out to mean), but they are not
rights to all that is required to survive.
Rights to life are not necessarily violated by ‘active’ killings.
Rights to life are not necessarily violated when third parties kill
one person to protect the property rights of another.
Thomson argues for each in turn. In each case she does so by
presenting a scenario, an ‘analogy’, about which (she thinks) we
will have very strong intuitions which are consistent with the
claims above, and so with principle P, but which are not consistent
with alternative principles about rights to life on which abortion
violates those rights.
A. Rights to life are negative—i.e. they are not rights to all that is
required to survive.
Thomson asks us to consider the case of the violinist: the most
famous violinist in the world is dying, but he can be saved if you
are used to filter his blood (you and only you have the right
genotype to do this). The society of music lovers kidknaps you
and, against your will, hooks you up to the violinist. At this point,
if you unhook yourself in order to make your escape, the violinist
will die. She then considers several versions which differ in the
amount of time you must be hooked up to violinist if he is not to
die—9 days, 9 weeks, 9 years, forever. She thinks that, in one of
these cases, you will agree that it is ok to unplug yourself. But if
you do, you kill the violinist. So you must think in that case no
injustice is done (for then the unplugging would be morally
impermissible, and so not ok). Hence, it cannot be that you violate
the violinist’s right to life when you do this. But you are depriving
him of that which he requires to survive, namely your body.
Hence, the right to life cannot be a positive right to all that is
required for survival. It is instead a negative right against being
unjustly killed. And in particular, one does not violate a right to
life if one deprives another of that which they require to survive,
provided one has a right to it and one’s victim does not.
B. Rights to life are not necessarily violated by active killings.
Thomson asks us to consider a case of active killing in self
defense. A women is trapped inside her own house with a growing
child. She is not responsible for the child being in the house;
someone snuck it in. She cannot escape except by killing the child;
if she does not kill the child the child will grow so big it crushes
her to death. Thomson thinks we will think that in this case it is ok
for her to actively kill the child in order to save her life. (The
example is implausible; it suffices here to think of any active
killing in self defense, of which there are any number of real
cases). If you say about this, or any other, active killing that it is
permissible, then it cannot be that a killing violates a right to life
simply because it is active—for if that were true, every active
killing would be unjust, and therefore morally impermissible.
C. Rights to life are not necessarily violated if some third party
acts to secure one’s property from a victim who requires it to
survive but does not have a right to it.
Thomson asks us consider Smith and Jones. Both are indigent, and
will freeze to death on this particular winter night without a coat.
Jones owns a coat, but Smith has taken it. Thomson thinks that we
will think that it is ok if a passer by takes Jones’s coat back from
Smith, and that certain people, e.g. police, are morally obliged so
to do. But doing that kills Smith, since he then freezes without the
coat. So this third party intervention, though a killing, cannot
violate Smith’s right to life, for if it did, the killing would be
unjust, and therefore impermissible.
IV. Application of principle P to Abortion.
Thomson makes one further, and more or less undefended
assumption: people own their own bodies. One has a property
right to one’s body, i.e. a right against everyone else that they shall
not infringe upon your use of your body.
Thomson is then in a position to argue for the prima facie
permissibility of abortion, i.e. that abortions do not, per se, violate
fetal rights to life.
In an abortion an doctor (third party) acts to secure for a woman a
bit of her property (her body). She has a right to her body, and her
fetus does not. But the (pre-term) fetus requires to the body to
survive. In depriving the fetus of the body, the doctor kills the
fetus. But this is not a violation of the fetuses’ right to life—it
does not have a right to that which it requires for survival, and so
when it is deprived of this and so dies, its right to life has not been
violated.
Possible Objections:
1. An alternative conception of the right to life on which abortions
violate that right, but the killings in the violinist, house, and coat
cases do not. Morally relevant facts to exploit—whether a death
results from the deprivation of that which is required to survive, or
is produced in order to deprive it of that which is required to
survive.
D2. Deny that people own their bodies.
V. Special Obligations.
One might respond to the case so far by claiming that while
Thomson’s case about rights to life is ok, and so to the claim that
women have property rights to their bodies, the claim that the fetus
does not have a right its mother’s body is mistaken. Mother’s
somehow have a special obligation to their fetuses, and those
obligations amount to a right of the fetus against the mother for the
use of her body.
Thomson considers such a line of response. She replies by
defending a principle about the transfer of property rights.
According to this principle, one transfers a property right to
another only if one implicitly or explicitly undertakes the
associated obligations, and one does this only if one intends to
undertake them. She defends the principle by arguing against an
alternative, which would, if it were right, provide a source for the
special obligation between mothers and fetuses. On this principle,
which we will call the risk principle, a women transfers to a fetus
the property right to her body if she engages in actions which risk
pregnancy.
The risk principle is motivated by the following thought. When
women voluntarily act in ways that risk pregnancy, they are in part
responsible for the existence of any resulting fetus. This
responsibility entails moral obligations, which amount to
transferring to the fetus a property right to the mother’s body.
A. Suppose you open a window, through which a burglar enters.
You have risked the burglar coming into possession of your
property. On the risk principle, you will therefore have transferred
to him a property right to your house and possessions. You cannot
now kick him out if he sits down to watch the game while drinking
your beer. This, we think, is absurd, so we must reject the risk
principle. One does not transfer a property right simply by
voluntarily acting in a way that risks another coming into
possession of your property.
B. If the risk principle were right, every pregnancy would involve
a special obligation—one can prevent pregnancy by seeking a
voluntary hysterectomy. Not doing so is a voluntary action that
risks pregnancy. Hence, given the risk principle, any pregnancy
involves the transfer of a property right to the fetus, and so
involves the associated obligations.
Since we must reject the risk principle, we need another. What is
common to all the cases in which our intuitions are inconsistent
with the risk principle is that while we act voluntarily in ways that
risk another coming into possession of our property, we do not
intend, either explicitly or implicitly, by those acts or any others, to
transfer a property right. So Thomson infers that property rights
are transferred only when one intends to transfer them, only when
one intends to undertake the obligations associated with such a
transfer.
It should be pointed out that, for Thomson, once a property right
has been transferred to a fetus, for whatever reason, the fetus may
not be aborted. Even if the life of the mother is threatened by
continued pregnancy, once she has transferred to the fetus a
property right to her body, the abortion would be an unjust killing
of the fetus, and so would violate its right to life.
VI. Beneficence.
Thomson draws a distinction between duties of beneficence and
duties generated by rights using the Henry Fonda, Chocolate, and
Kitty Genovese cases. Given the distinction, she says beneficence
requires minimal decency, but not good Samaritanism—small
sacrifices are required to do large benefits. Large sacrifices aren’t
required. So, e.g., Henry Fonda is morally required to walk across
the hospital hall to save Thomson’s life; he is not morally required
to fly across the country to do so. Similarly, the bystanders in the
Genovese case are morally required to call the cops; they are not
required to take baseball bat in hand and descend to fight on her
behalf. Doing this would be supererogatory, and so a case of
Good, rather than merely Minimally Decent, Samaritanism.
She does not say exactly how much sacrifice must be endured. But
she does say there are cases of abortion which clearly do, and other
cases which clearly don’t, violate our duties of beneficence.
If a women aborts a pregnancy in the eighth month in order to go
on a trip to Paris, and for no other reason, this would be indecent.
The trip is a small sacrifice, the life of the fetus is a large benefit.
The women is therefore morally wrong if she aborts.
On the other hand, a teen pregnant from rape is not morally
required to carry a pregnancy to term, and she is not indecent if she
aborts; on the contrary, she is a more than good Samaritan if she
carries the pregnancy to term, for doing this is supererogatory.
Objections:
1) find a principle about the transfer of property rights consistent
with the burglar and hysterectomy cases, but on which pregnancies
from voluntary sexual activity (or voluntary sexual activity without
use of birth control) does confer a property right to the fetus.
2) define a standard of decency on which all, or almost all,
abortions violate the standard.
Download