"Duty to Die" (A Bioethics "Target" if there ever was one)

If the person has lost her moral agency/personhood as I argue, then the person who deserved reward is no longer present to receive it. It is the new moral entity, having done nothing, that receives the reward for what someone else did.

Seriously! "Someone else?"


Yesterday, I discussed the first of two "Target Articles" in this month's American Journal of Bioethics. The second Target Article, "A Kantian Moral Duty for the Soon-to-be Demented to Commit Suicide" by Dennis R. Cooley,Ph.D, seems a good demonstration of what happens when elitist minds forgo ethical boundaries in order to provoke discussion.

Cooley bases his essay on the discussion by Kant of personhood, moral agents, and a duty to one's life and self as an end in itself:

Kantian arguments for morally obligatory suicide are
extremely rare. Many believe that Kant thought suicide
was absolutely prohibited conduct, mostly on the grounds
that no agent could consistently will the generalized form
of any suicide maxim based on self-love as a law of nature.
Therefore, according to this interpretation, Kant would
never require someone to kill herself for any reason. However,
there is a plausible interpretation of Kant’s views
that states, under certain conditions, not only is the person
permitted to kill herself; she is required to do so
as a duty to herself qua moral agent. In situations in
which the agent cannot keep both her physical and moral
lives, killing her body preserves her moral life and dignity
as a person. I will first develop the Kantian suicide
duty to the self and then focus on why it pertains to
dementia patients before they lose their moral status as
persons.
...the example most closely related to dementia patients’
loss of moral agency is that of a man bitten by a rabid dog.
As in the case of the patients, the ill man is not responsible
for becoming ill. However, even though he is innocent
of any wrongdoing related to the illness, Kant states that
the man has a duty to take “his life lest he harm others as
well in his madness” (Kant 1797 [1996], 178). There are only
two choices—each of which is bad—open to the rabid individual:
suicide and madness/loss of personhood. For the
latter, the agent not only loses his humanity by becoming
the physical equivalent of a rabid dog, he poses a threat to
others, which in turn could cause them to lose their humanity
if they are also infected. Suicide, on the other hand, is a
duty he has to himself as a being with human dignity. Although
it is likely to cause harm to others due to the loss of
the individual, if performed with the right mental states and
reasons, the taking of his physical life preserves his moral
agency. He chooses to remain a person, instead of allowing
himself to be degraded by having a moral status lower than
that of a rabid dog.

The good news is that all of the Open Peer Comments object (with one, Ackerman, calling Cooley "elitist"), and it appears that Cooley, himself, believes that he only wrote the essay to provoke discussion. In his "Reply" to the Peer Comments, Cooley (who teaches philosophy and ethics at the North Dakota State University) explains his purpose behind writing the essay, as well as implying that he doesn't accept Kant's assertions:

I knew when writing “A Kantian Moral Duty for the Soon to Be Demented to Commit Suicide” that it would cause a great deal of consternation too (sic) many. First, my interpretation of Kant was heavily influenced by Korsgaard’s double-level theory so well explicated in her “The Right to Lie: Kant on Dealing with Evil (1998).” Second, and most importantly, any challenge to central beliefs on morality, especially when it involves vulnerable populations, always will have this effect. However, I take Mill seriously when he states that:

the only way in which a human being can make some approach to knowing the whole of a subject, is by hearing what can be said about it by persons of every variety of opinion, and studying all modes in which it can be looked at by every character of mind (Mill [1972], 88).

The goal is to understand what others think and argue, and then incorporate the useful parts into a fuller understanding of death duties.

......The position I consider only applies to people when they have dementia causing disease and their full self-hood with its inherent duties to themselves. The need now is to discuss the issue until some practical solutions that respects all those affected are found.

Actually, no, Dr. Cooley, we have no such need.