Who Am I and If So How Many? (16 page)

Imagine the following situation: you go to the hospital to visit a sick friend. You enter the elevator and press the wrong button. When you get out, you find yourself on a ward where volunteer donors are hooked up to patients who will not survive without the donors’ help, but you don’t really understand what is going on. After sitting in the waiting room for a while, you are called in, and a doctor inserts an IV with an anesthetic. When you wake up, you’re lying in a hospital bed, and in the next bed you see an unconscious man to whom you’re hooked up with all kinds of contraptions. You call for the doctor, who tells you that the man you’re hooked up to is a famous violinist with a serious kidney ailment who will survive only if his circulatory system is plugged into someone else’s with the same blood type, and you are the only person whose blood is a match. The staff at this renowned hospital apologize profusely for the misunderstanding – they thought you’d volunteered – and they offer to unhook you from the violinist, who won’t survive if you take them up on their offer. If you agree to remain hooked up to the man for nine months, he will recover, and you will then be freed from him without endangering his life. What would you do?

It’s an outrageous story, of course, nightmarish and unrealistic. After all, what visitor to a hospital would fail to notice that he is being hooked up to an IV? But as is always the case with moral dilemmas from the workshops of philosophers and psychologists, the point is not the details but the principle involved. This particular scenario is adapted from Judith Jarvis Thomson, a philosophy professor emerita at MIT, whose point is this: while it might be nice of you to make your kidneys available to the violinist and be confined to a hospital bed, you are in no way morally obliged to do so. As you can tell from the title of this chapter, this example is not about fictional violinists but about a subject of more universal import: you have been put into a situation – involuntarily, unintentionally, and perhaps even by force – that makes you directly – physically – responsible for another human being. This is most likely to occur not by being hooked up to renally challenged violinists, but with women facing an unplanned pregnancy.

According to Thomson, a woman with an unwanted pregnancy is in a situation quite similar to the involuntary bonding with the violinist. Just as you would not be forced to assume responsibility for the life of the violinist, neither would a pregnant woman be responsible for the embryo in her unwanted pregnancy. The right to decide what happens to her body, Thomson argues, outweighs an obligation to another life that she entered into involuntarily. This argument, which became very popular, inspired feminism to adopt the slogan ‘My body is my own!’

But even if one subscribes to this idea, Thomson’s justification seems rather flimsy. Let us picture a starving man at our doorstep, knocking at the door with his last ounce of strength and begging for food. Thomson might argue that while it would be nice of us to give him something, we are in no way obliged to take responsibility for the starving man, since the situation was not of our own making.

Certainly not everyone would buy this argument. Indeed, the German penal code rightly includes a paragraph condemning
‘failure to render assistance.’ The fact that a situation was not initiated by us and that we do not wish to deal with it is not a sustainable argument against meeting our obligations. The morality of helping someone or not depends on the specifics of the scenario. The dilemma with the violinist leads to an impasse, because it does not illustrate a convincing, overarching principle. The greatest drawback of this example, however, is its crucial mismatch: the violinist is a grown man with all the psychic and intellectual capabilities that go with adulthood, but what about the embryo and the fetus? Do they, too, have an unconditional and inviolable right to life? To answer this question, we can look to the ideas of three thinkers we’ve discussed so far: Kant’s concept of ‘human dignity,’ Bentham’s ‘utilitarianism,’ and Hauser’s intuitive ‘moral sense.’

Let us begin with Kant. There is only a single sentence about embryos in his voluminous writings, and it is found in his discussion of matrimonial law. Kant writes that the embryo is a being already endowed with the full complement of human dignity. If it weren’t, we would face the problem of specifying the point at which freedom and the dignity of man commence in the womb. According to Kant, self-awareness and freedom are specifically human qualities and do not exist anywhere else in nature. But how and when does freedom – and, with it, dignity – enter into a human being? Kant’s answer can be understood only against the backdrop of his era: the freedom of the embryo, he contended, depends on its parents’ freedom, because the parents conceived it of their own free will within a framework that they freely chose, marriage. The fruit of their union is an embryo. The flip side of his argument would state that embryos conceived by parents out of wedlock without their intention to create a child are not free and fully dignified human beings. This definition, which implies that children born out of wedlock don’t have ‘human dignity,’ was Kant’s reaction to a widespread problem in his era. In 1780, Adrian von Lamezon, a court official in Mannheim, Germany, posed a question and offered one hundred ducats for the essay that best answered it. The question was: ‘What is the most
feasible means to put a stop to infanticide?’ The overwhelming response – four hundred submissions – reflected the fact that abortion was a common practice in the eighteenth century, and infanticide even more so. In the great majority of these cases, the pregnancy had resulted from employers taking advantage of their maids. Homicide of illegitimate newborns occurred regularly, even though nobody talked openly about it. In another passage in his
Metaphysics of Morals
, Kant showed some sympathy for infanticide. Since the illegitimate newborn is not free in Kant’s full sense of the term, but rather ‘stolen into the commonwealth (like contraband merchandise),’ Kant wasn’t too concerned about infanticide, placing it on a par with other trivial offenses like killing in a duel and arguing for extenuating circumstances.

It is difficult to endorse Kant’s argument today. After all, embryos can be conceived unintentionally within marriage or intentionally outside of marriage. Moreover, Kant’s line of reasoning implies that the homicide of children conceived out of wedlock – or, for that matter, even the murder of adults conceived out of wedlock! – can be justified. Today we tend to look askance at Kant’s advocacy of the unconditional need to protect embryos conceived in marriage. Surely no one who invokes Kant in the current discussions about abortion shares his conclusion that we should regard illegitimate embryos and newborns in a lesser light, so why give credence to Kant’s line of reasoning, which is simply outdated and can only be understood within the context of his era?

Let us move along to the second route, utilitarianism.
Utilitarians
pose two basic questions. First: how capable of pleasure or pain is an embryo or fetus? And second: what carries more weight, the pleasure and pain of the child in the womb, or the pleasure and pain of the mother?

To answer these questions, we need to agree on the value of an embryo. No utilitarian would share Kant’s view that the worth of an embryo depends on the marital status of its parents. According to utilitarianism, an embryo isn’t unconditionally worthy of protection. The embryo is a human being in the sense that it
belongs to the species
Homo sapiens
, but it isn’t a human in the full moral sense, and hence is not a person. But what
are
people? How can I identify them? The notion of what constitutes a person does not come from Bentham himself. In his view, the action that was morally best was the one that resulted in the greatest possible happiness for the greatest number of human beings, but he was not judging the inherent value of individuals. His successors discovered two weak points and tried to remedy them, beginning with the question of how to define happiness. For Bentham, happiness was the experience of pleasure in the broadest sense of the term. But utilitarianism’s most effective exponent after Bentham, the philosopher and liberal politician John Stuart Mill, found that explanation wanting. He sought to liberate the utilitarian notion of happiness from its whiff of inanity and dullness by equating happiness with mental pleasure rather than with physical pleasure: ‘Better to be Socrates dissatisfied than a fool satisfied.’ But if the mind stands above purely physical pleasure, an adult human endowed with a highly developed mind is a more valuable entity than a newborn or a horse, and only a complex human being counts as a ‘person.’ A later generation of utilitarians incorporated this notion into their theory, which took into account not only the basic desires of sentient beings but also complex human ideals. This approach is known as preference utilitarianism, and virtually all modern successors of Bentham subscribe to it. For utilitarians who take highly developed desires and preferences into consideration, no one can kill a person (not even Aunt Bertha!) as long as the person desires to remain alive.

Embryos, by contrast, lack complex desires and preferences. Presumably they have an instinct to stay alive, but that does not distinguish them from salamanders. For preference utilitarians, there is nothing that in and of itself forbids killing an embryo or fetus. Of course fetuses begin developing a consciousness before they are born, but so do pigs and cattle, and we kill them to obtain food. Consciousness is not the same as a desire to live. As far as we know, fetuses do not possess self-awareness in the sense of having
complex preferences and desires. Thus a fetus may on principle be killed at any stage of its development – at least when it decreases the suffering of the mother or substantially increases her happiness.

This utilitarian argument makes more sense than Kant’s unconditional human dignity for fetuses conceived in wedlock, but it also has shortcomings. While an embryo’s intellectual level is about that of a salamander, it has the potential to become an Albert Einstein, and if it were not aborted, it would one day become a human being with desires and preferences.

This position, however, is not quite as persuasive as it first appears, because potentiality is not applied universally as a decisive moral criterion. If you held potential human life sacred, you would have to condemn masturbation and contraception, as the Catholic Church does (although only for the past 140 years). Consider this example to highlight the difference: is boiling a fertilized egg really the same thing as putting a living chicken into boiling water? Potentiality tells us nothing about current feelings of happiness or pain, nor does it produce a state of consciousness, so it shouldn’t be a true criterion in deciding questions of morality.

There are other grounds for objection as well. A major drawback of utilitarianism is its impact assessment. In order to strike a meaningful balance between pleasure and pain, I have to have a good idea of, and factor in, the consequences of my decision, which isn’t always so easy. Even when it comes to simple personal questions, I often have a hard time figuring out what makes better sense for me: should I go to my friend’s birthday party or to a reading by my favorite writer? How can I know what will ultimately give me more pleasure? It’s even harder to weigh complex moral situations and their potential chain of
consequences
. Who knows whether a woman who has an abortion will eventually regret it? Maybe it will take a heavier psychological toll on her than she had anticipated. And how about the father? Perhaps the decision will place a greater strain on the relationship than the couple had thought. That is one of life’s many risks, a utilitarian would argue, but not an argument for a blanket ban on abortion.

The weightiest objection to the utilitarian view lies elsewhere. If no absolute protection can be accorded to a fetus because it lacks complex preferences and desires and is thus not a person, doesn’t the same apply to a newborn infant? A baby becomes a self-aware free individual somewhere between the ages of two and three. Doesn’t preference utilitarianism throw the baby out with the bathwater and open the door not only to abortion but also to infanticide as late as in the third year of life?

There are preference utilitarians for whom the unconditional worth of a baby’s life does not begin until after the first birthday. Naturally, they do not endorse killing infants without compelling grounds, but their assessments of the infants’ value are not based on the value the person represents per se, but rather on the consequences for society. Small children are nearly always of great value to their parents and other family members. And even small children who do not have families and live in orphanages are needy individuals entitled to societal protection. But it isn’t easy for a preference utilitarian to say why we should go out of our way to protect infants but not animals. In the case of both infants and animals, you can argue that a society that deals with living creatures irresponsibly heads down a slippery slope. But that is not a compelling basis for the right to life of small children. This is preference utilitarianism’s Achilles’ heel.

At this point we come to the third route and take up Marc Hauser’s idea that every normal person has a moral sense, an ‘intuitive’ morality. As we have seen, utilitarianism takes a clear stand on the abortion question, but the consequences of this position – a lack of unconditional protection for small children – can be alarming. Moral philosophers generally balk at the concept of ‘intuition.’ Both Kantians and utilitarians argue that feelings are unreliable, differ from one person to the next, depend on a given milieu, and vary by culture and issue. Western philosophy in general has striven to establish a rational and universally
comprehensible
basis for its arguments. This determined rejection of feeling in moral philosophy is a legacy of the battle between
philosophy and the Church. To free themselves from religion, most philosophers sought rational explanations that were as free from feelings as possible and defined human beings by way of intellect and reason. But as we saw in the first part of the book, this view of human beings is wrong. Body and mind cannot be cleanly divided, nor can the unconscious and the conscious. If our morality invariably entails feelings, we cannot simply disregard them. Naturally, feelings cannot be used as the exclusive barometer of a satisfactory morality. But a morality that makes no attempt to mesh with our intuition and hence with the biological foundations of our sense of morality is surely worse than one that incorporates intuition.