Saving People from the Harm of Death PDF
Preview Saving People from the Harm of Death
Saving People from the Harm of Death POPULATION-L EVEL BIOETHICS Ethics and the Public’s Health Series Editors Nir Eyal, Harvard Medical School Dan Wikler, Harvard School of Public Health Editorial Board Dan Brock, Harvard University John Broome, Oxford University Norman Daniels, Harvard University Marc Fleurbaey, Princeton University Julio Frenk, Harvard University Frances Kamm, Rutgers University Daniel Hausman, University of Wisconsin- Madison Michael Marmot, University College, London Christopher Murray, Institute for Health Metrics and Evaluation, University of Washington Amartya Sen, Harvard University Volumes in the Series Inequalities in Health: Concepts, Measures, and Ethics Edited by Nir Eyal, Samia A. Hurst, Ole F. Norheim, and Dan Wikler Valuing Health: Well- Being, Freedom, and Suffering Daniel M. Hausman Identified versus Statistical Lives: An Interdisciplinary Perspective Edited by I. Glenn Cohen, Norman Daniels, and Nir Eyal Saving People from the Harm of Death Edited by Espen Gamlund and Carl Tollef Solberg Foreword by Jeff McMahan Saving People from the Harm of Death Edited by Espen Gamlund and Carl Tollef Solberg With a Foreword by Jeff McMahan 1 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America. © Oxford University Press 2019 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Names: Gamlund, Espen, 1976- editor. | Solberg, Carl Tollef, 1988- editor. | McMahan, Jeff, writer of foreword. Title: Saving people from the harm of death / edited by Espen Gamlund and Carl Tollef Solberg ; with a foreword by Jeff McMahan. Description: New York, NY : Oxford University Press, [2019] | Includes bibliographical references and index. Identifiers: LCCN 2018024331 (print) | LCCN 2018049747 (ebook) | ISBN 9780190921446 (online content) | ISBN 9780190921422 (updf) | ISBN 9780190921439 (epub) | ISBN 9780190921415 (cloth : alk. paper) Subjects: LCSH: Death—Moral and ethical aspects. | Death—Social aspects. | Mortality—Statistics. | Medical policy. | Values. Classification: LCC BJ1409.5 (ebook) | LCC BJ1409.5 .S28 2019 (print) | DDC 128/.5—dc23 LC record available at https://lccn.loc.gov/2018024331 9 8 7 6 5 4 3 2 1 Printed by Sheridan Books, Inc., United States of America Derek Parfit, who possessed a native genius for philosophy, was the great progenitor of the debates in the following chapters. We dedicate the book to him. CONTENTS Foreword by Jeff McMahan ix Acknowledgments xv List of Contributors xvii Introduction: Perspectives on Evaluating Deaths and Their Relevance to Health Policy 1 ESPEN GAMLUND AND CARL TOLLEF SOLBERG Policy PART I } 1. Quantifying the Harm of Death 21 ERIK NORD 2. The Badness of Death: Implications for Summary Measures and Fair Priority Setting in Health Care 33 OLE FRITHJOF NORHEIM 3. Life Years at Stake: Justifying and Modeling Acquisition of Life Potential for DALYs 48 ANDREAS MOGENSEN 4. Putting a Number on the Harm of Death 61 JOSEPH MILLUM 5. Age, Death, and the Allocation of Life- Saving Resources 76 ESPEN GAMLUND Theory PART II } 6. Epicurean Challenges to the Disvalue of Death 91 CARL TOLLEF SOLBERG 7. The Badness of Dying Early 105 JOHN BROOME 8. Early Death and Later Suffering 116 JEFF MCMAHAN 9. A Gradualist View about the Badness of Death 134 BEN BRADLEY viii { Contents 10. The Badness of Death and What to Do about It (if Anything) 146 F. M. KAMM 11. Deprivation and Identity 163 JENS JOHANSSON 12. How Death Is Bad for Us as Agents 175 SUSANNE BURRI Population Ethics PART III } 13. Against “the Badness of Death” 189 HILARY GREAVES 14. People Aren’t Replaceable: Why It’s Better to Extend Lives than to Create New Ones 203 MICHELLE HUTCHINSON 15. The Worseness of Nonexistence 215 THERON PUMMER Critical Perspectives PART IV } 16. The Badness of Death for Us, the Worth in Us, and Priorities in Saving Lives 231 SAMUEL J. KERSTEIN 17. How Much Better than Death Is Ordinary Human Survival? 243 IVAR R. LABUKT 18. Health Care Rationing and the Badness of Death: Should Newborns Count for Less? 255 TIM CAMPBELL 19. In Defense of the Time- Relative Interest Account: A Response to Campbell 267 JEFF MCMAHAN Index 279 FOREWORD Jeff McMahan Various philosophers in the ancient world—p articularly Epicurus and Lucretius but also Cicero, Seneca, and others— thought seriously about the nature and evaluation of death. They asked how, on the assumption that to die is to cease to exist, death could be bad for us and, if so, how bad. Their concern was not whether a person’s death could be bad for those who remain, but whether and to what extent it could be bad for the person herself. Epicurus and Lucretius concluded that it could not be, or at least that there is no reason for us to fear death for our own sake. Yet with the rise of certain religions, such as Christianity and Islam, that promised— or threatened— an unending afterlife, philosophers largely ceased to discuss whether death is bad for us, good for us, or neither. And even those who did discuss death, such as Montaigne and Schopenhauer, did not go very deep. I suspect that a significant part of the explanation of this philosophical neglect is that, particularly in those regions in which philosophy was most ardently pursued, it was for many centuries heretical and thus dangerous to profess or even to discuss the view that when we die we simply cease to exist. So even while people continued to fear death, sought to avoid it themselves and to save others from it, and grieved for those who had succumbed to it, they were unable to discuss freely whether their attitudes and practices were rationally justified. Together with a threat of eternal damnation as punishment for suicide, the refusal to permit questioning of the relevant theological dog- mas was self-p rotective for those religions that offered the faithful a blissful afterlife. For that offer certainly seems to provide a reason for believers to end their own lives and the lives of those they love, which would hardly promote church attendance or provide remunerative work for the clergy, apart from conducting funerals. So better to leave people’s instinctive aversion to death alone, even while asserting doctrines that suggest that the aversion is irrational. It was not until 1970, with the appearance of a short but brilliant essay by Thomas Nagel, which was closely followed by another by Bernard Williams, that serious philosophical discussion of death resumed after almost two millennia of reticence.1 Over the decades since Nagel broke the silence, the ix 1 Nagel (1970); Williams (1973).
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