For now have I my death: The "duty to die" versus the duty to help the Ill stay alive

Midwest Studies in Philosophy

Volumn 24, Issue 1, 2000, Pages 172-185

  Ackerman, Felicia ^a  

^a BROWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 0141924031     PISSN: 03636550     EISSN: None     Source Type: Journal    
DOI: 10.1111/1475-4975.00028     Document Type: Review

References (29)

1. Sir Thomas Malory, Le Morte D'Arthur (London: Penguin, 1969), v.2, 515.
2. As for the subtitle, for simplicity of exposition I will focus my discussion on the ill and their families. But note that the same issues can arise when people are severely enough disabled to need care, even when the disability arises not from illness, but from some other source, such as an injury. (Some disability rights activists set great store by the fact that they are disabled, not ill, and feel insulted when considered on a par with the ill. For examples of this attitude, see Joseph Shapiro, No Pity [New York: Times Books, 1993, 21, 22, and 49]. I consider this attitude to be morally on a par with that of a dark-skinned Caucasian who sets great store by the fact that he is white and feels insulted when considered on a par with blacks.)
3. Leo Tolstoy, The Death of Ivan Ilych (New York: New American Library of World Literature, 1960), 10. Tolstoy, of course, intended this remark (by a cancer patient's widow) to show monumental selfishness and callousness.
4. John Hardwig, "Is There a Duty to Die?" Hastings Center Report 27, no. 2 (1997), 36.
5. John Hardwig, "Dying at the Right Time: Reflections on (Un)assisted Suicide," in Hugh La Follette (ed.), Ethics in Practice (Cambridge, MA: Blackwell, 1996), 54.
6. Hardwig, "Is There a Duty to Die?" 41.
7. See B. Manard and C. Perrone, Hospice Care: An Introduction and Review of the Evidence (Arlington, VA: National Hospice Organization, 1994), 4.
8. John Hardwig, "What about the Family?" Hastings Center Report (March/April 1990), 5.
9. See Hardwig, "Is There A Duty to Die?" 35.
10. See the letters to the editor from Larry Churchill, Elizabeth A. Linehan, and Daniel G. Floury, Hastings Center Report (November/December 1997), 4-6.
11. See Hardwig, "Dying at the Right Time."
12. See Daniel Callahan, Setting Limits (Washington, DC: Georgetown University Press, 1987), What Kind of Life? (Washington, DC: Georgetown University Press, 1990)
13. and The Troubled Dream of Life (New York: Simon and Schuster, 1993).
14. Sherwin B. Nuland, How We Die (New York: Knopf, 1994).
15. Callahan, letter to the editor, Hastings Center Report (November/December 1997), 4.
16. Callahan, The Troubled Dream of Life, 218-9.
17. Callahan, Setting Limits, 43 (italics in original).
18. See my "Death, Dying, and Dignity," in K. Brinkmann (ed.), Proceedings of the Twentieth World Congress of Philosophy. Vol. 1: Ethics (Bowling Green, OH: Philosophy Documentation Center, 1999), 196, for another example of how Callahan professes disdain for quality-of-life considerations, but freely uses them when the issue is "letting die."
19. Joel Feinberg, "Duties, Rights, and Claims," American Philosophical Quarterly 3, no. 2 (1966), 139 (italics in original). Obviously, this general claim leaves much unanswered. Feinberg is not specifically discussing parents and children, but Callahan cites this passage in that context in Setting Limits, 91.
20. The general issue of what grown children owe their parents has many complexities that I lack space to go into here. For more discussion of the issue, see Jane English, "What Do Grown Children Owe Their Parents?" in La Follette, Ethics in Practice, 174-8;
21. Christina Hoff Sommers, "Filial Morality," Journal of Philosophy (1986), 439-56;
22. and Norman Daniels, Am I My Parents' Keeper? An Essay on Justice between the Young and the Old (New York: Oxford University Press, 1988).
23. Ellen Goodman, "Who Lives? Who Dies? Who Decides?" in E. Goodman, At Large (New York: Simon and Schuster, 1981), 161. (The first part of Goodman's statement is false. I want to live to be senile. I would rather be mentally intact than senile, of course, but I would rather be senile than dead.)
24. He gives a less sanguine picture in his earlier paper, "What about the Family?" 10. See also his reply to the letter from Daniel Callahan, Hastings Center Report (November/December 1997), 6.
25. Hardwig, "What about the Family?" 6.
26. For further discussion of this paradox, see my "Assisted Suicide, Severe Disability, Terminal Illness, and the Double Standard," in M. P. Battin et al. (eds.), Physician-Assisted Suicide: Expanding the Debate (New York: Routledge, 1998), 156
27. and my "Goldilocks and Mrs. Ilych: A Critical Look at the 'Philosophy of Hospice,'" Cambridge Quarterly of Healthcare Ethics, 6(1997), 319.
28. Malory, Le Morte D'Arthur, v.2, 172. Malory himself, as a devout Catholic, found a completely different sort of meaning in death as a passage to a better world, but when believers and disbelievers in an afterlife talk about death, what they take themselves to be talking about is very different.
29. This is a claim Hardwig makes about killing yourself in order to avoid burdening your loved ones: "Dying at the Right Time," 57.