Topics Ethics

Question I suffer from an inheritable condition which might shorten my life span if left untreated. My doctor has prescribed me a drug which, as it happens, might have adverse effects on my mental capacity; for instance, it might bring about amnesia and mild cognitive impairment. The minutiae of my particuar situation are not significant; what is interesting is the ethical question the general situation raises: Are we obligated to do what we can to stay alive for as long as possible, or may we—if the prior option necessitates potentially adverse effects on an aspect of life we hold dear—choose not to? And if the latter is true, does this translate to all other situations of this kind? As an example, consider the case of a smoker who refuses to give up smoking, regardless of the risk involved, because of the pleasure the act of smoking confers upon her. Her family and friends naturally wish for her to stay alive and remain healthy for as long as is possible—do their concern outweigh the pleasure she takes in the consumption of tobacco?

Accepted:
February 8, 2009

Comments

There are several fine questions here,it seems to me. I want to focus in to start with on just oneinteresting distinction that you make implicitly. One the one hand,there is the quality of life threatened by your disease; on the otherhand there is the pleasure afforded to the smoker. These are by nomeans the same kind of thing, first because the pleasure of smokingis replaceable (I can quitsmoking and yet can get similar pleasure in other, healthy ways) andsecond because it is merelypleasure, and thus often considered a lower grade of good thanothers. So, I think the example of smoking is not a good analogy forthe purposes of exploring your dilemma.

I cansee no good moral reason why either of your alternatives mustbe wrong. If it seems valuable to you to sacrifice certain thingsfor longevity, then that is not necessarily a bad decision; likewise,if you wanted to sacrifice longevity for quality of life, then againthat is not automatically ruled out. On Kantian grounds, for example,one would investigate whether one or the other course of action wasnot universalisable. However, I cannot see that the various actionsare sufficiently specified for this test to be made. In both cases,the moral judgement would come down not to some absolute rule, butprecisely to the 'minutae' of your specific situation. For example,there are a number of 'mights' in your question. What are theprobabilities and likely quantities of gain or loss? It is the job ofthe medical profession to talk you through these, allowing you tomake a rational and well-informed decision on precisely what youwould likely be gaining or losing.