The 'Thou Shalt Nots' Matter

I was shocked that the two authors of this paper are ethicists. But it appears that up is down in the ethics world and that too often, the field of ethics is used to push ethical and moral boundaries and to break right through them, rather than to preserve high standards of ethics in the affairs of human beings.
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An employee of the federal government, working in the Department of Bioethics in the National Institutes of Health (NIH), has proposed with a coauthor who is a professor at Duke University that killing itself is not wrong unless it causes the loss of abilities.

"What makes an act of killing morally wrong is not that the act causes loss of life or consciousness but rather that the act causes loss of all remaining abilities. This account implies that it is not even pro tanto morally wrong to kill patients who are universally and irreversibly disabled, because they have no abilities to lose. Applied to vital organ transplantation, this account undermines the dead donor rule and shows how current practices are compatible with morality."

This paper has appeared in the Journal of Medical Ethics and the abstract is available on the British Medical Journal Group website. The paper has just been published and is protected by copyright. I paid $30 U.S. to obtain one day access to the paper and anyone else who wishes to access the whole text may be required to do the same.

When I read the study, I felt as though I was reading "A Modest Proposal" (1729) in which the author, Jonathan Swift, proposes satirically that the Irish poor sell their children to the rich English landholders to be eaten. The article was designed to illuminate British policy toward Ireland and the desperate and unaddressed situation of the Irish poor.

Except... somehow, the contemporary "What makes killing wrong?" question rings too sincere, too well argued, and too reminiscent of policies already being applied in some countries and states as well as historically in Nazi Germany.

The authors argue that killing itself should not be wrong -- only the taking away of an individual's abilities. If someone is totally disabled they are as good as dead anyway and might as well be put down so their organs can be harvested. They also argue that if killing "were wrong just because it is causing death or the loss of life, then the same principle would apply with the same strength to pulling weeds out of a garden." They go on to say if the rule is actually "killing sentient beings is wrong" then someone who is totally disabled falls outside that rule, even if they are a human because they no longer are sentient, having lost all their abilities.

The use of "ability" as the criteria for a right to live is especially dangerous. It is wholly consistent with the concept of "useless eaters," elaborated by a psychiatrist and a lawyer in Germany in 1920. Although Hitler had not yet come to power, the concept of useless eaters led to considerable academic debate and softened the nation's ethical restraints in regard to the eventual mass murder of the physically and mentally disabled by organized psychiatry shortly after Hitler came to power. After the establishment and acceptance of the murder of mental patients and disabled, the wholesale slaughter of Jews and others considered unacceptable to German society commenced.

Those who support disability rights in America should rise up in outrage. Where now we view the disabled as deserving of special accommodations, in the future we may view disability as a cause for withdrawing medical care and euthanasia.

Ethics is the discipline dealing with what is good and bad and with moral duty and obligation. At an even deeper level ethics is "the study of right and wrong in human endeavors ... the method by which we categorize our values and pursue them."

I'm naive. I was shocked that the two authors of this paper are ethicists. But it appears that up is down in the ethics world and that too often the field of ethics is used to push ethical and moral boundaries and to break right through them, rather than to preserve high standards of ethics in the affairs of human beings... from business and Wall Street to science and research and to government affairs. It appears that ethics is a sword with two edges and can be used destructively to rip holes in the fabric of society.

As is too often the case with "destructive ethics" (my term), "What Makes Killing Wrong" strives blatantly to dispose of one of the most basic of our nation and civilization's laws and moral codes. The article is cleverly argued, devilishly complex and seems to march the reader from one conclusion to the next, challenging at the end: "... having laid out our arguments for conceiving [of] morality and medical ethics without a norm prohibiting killing, we submit that the burden of proof is on our critics to demonstrate where and how we have gone astray."

I feel as though I am in the company of cunning college boys, arguing in a facile manner that might leave me tongue tied, were I still 18. But I'm not 18 anymore. And I know something more deeply now than I did at that tender age: Morality matters. The "thou shalt nots" of life matter.

We are a nation with a founding principle of "life, liberty, and the pursuit of happiness." And we are a nation based upon Judeo-Christian principles that include a prohibition against killing. Finally, we are a nation with a historical and cultural tradition of prohibition against killing. Argue with someone else about the contradiction of the death penalty -- two wrongs do not make a right, as my mother used to say.

In the U.S., as in medicine, the "shalt not" prohibiting killing is the rule of law, the historical precedent, and the expected moral approach.

Physicians and medicine -- the foundation upon which the National Institutes of Health sits, have a further tradition and principle: First Do No Harm.

There should be an outcry against a federally-employed professional participating in devising ways of overturning what may be the most fundamental moral declaration in the world: thou shalt not kill. Isn't there a moral code for federal employees? There are certain concepts that are so basically wrong that they do not deserve the light of day nor should they be argued. Among these moral concepts are the prohibition of killing, the prohibition against adults having sex with children, and the prohibition against cannibalism, to name three.

If the efforts of these facile, clever men take root and the prohibition against killing human beings is overturned, we will all be at grave risk. Without this fundamental and time-honored law against killing, facile and clever men will continue to debate and argue... and what constitutes "total disability" today will be a matter of mere semantics tomorrow.

For more by Ginger Ross Breggin, click here.

For more on mental health, click here.

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