ethics – Jeroen Bouterse

Why we ought to kill the healthy patient

We are fortunate to live in an equitable society, with high levels of trust and excellent administrative transparency. Many old diseases have been eradicated, and most people live healthily to old age. However, our utopia has been suffering for a long time from a peculiar and cruel illness, about which after a century of research the following is now known with moral certainty.

Everyone has a one in five chance of falling victim to this disease. No genetic or lifestyle factors predict it in any way, and it is undetectable until you are exactly thirty years of age. At that point, there are two days during which it is symptomless but detectable with advanced medical equipment, after which it is irreversibly fatal and kills rapidly. There is no cure except one: during these crucial two days, tissue from the vital organs of one healthy peer can save with certainty the lives of five diseased people. However, the required procedure inevitably kills the donor.

Cats And Kantians

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Without really looking into them, I have always felt sceptical of Kantian approaches to animal ethics. I never really trust them to play well with creatures who are different from us. Only recently, I cared to pick up a book to see what such an approach would actually look like in practice: Christine Korsgaard’s Fellow creatures (2018). An exciting and challenging reading experience, that not only made a very good case for Kantianism (of course), but also forced me to come to terms with some rather strange implications of my own views.

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Striving Or Suffering?

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The cover of Martha Nussbaum’s Justice for Animals (2023) shows a humpback whale breaching: a magnificent sight, intended to evoke both respect for the animal’s dignity, and interest in its particular forms of behavior. Here is a creature which has moral standing, without being a direct mirror of our human selves.

It is more than mere illustration of the argument. Nussbaum consciously relies on pathos as well as on philosophical reasoning: she announces from the outset that she seeks to awaken wonder and compassion in us with respect to our fellow animals, and productive outrage about how we treat them (9). No objection so far; our treatment of animals is, in many contexts (factory farming in particular), not at heart a philosophical issue, in the sense that there are no tenable metaphysical, anthropological, or ethical theories that can take a serious shot at justifying it. It is an issue that requires attention more than it requires deep or subtle thought.

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Can. They. Suffer.

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Human treatment of animals is a moral calamity at an outrageous scale, that I can get from zero to really quite worked up about in a matter of seconds. For fear of hurting the cause, I allow myself to take part in polite conversation about the dead bodies on the dinner table only if there is a more soft-spoken ally nearby. Two minutes into the conversation, when I find myself suppressing the urge to yell at a meat apologist how that kind of excuse might equally well be used to justify eating human babies, I am often grateful that there is somebody who can steer the conversation instead towards the socially acceptable topic of plant-based recipes.

It especially helps if they look fit (which they always do!), and are able to say with a straight face that “it’s perfectly simple to lead a healthy lifestyle and cook a tasty dinner without using meat”. Meanwhile, I don’t know how to cook a tasty dinner no matter the ingredients, and I have rarely given a moment’s thought to what it takes to lead a healthy lifestyle. It’s completely beside the point, is what I’m really thinking while nodding along. We were not talking about precisely how full of life everyone feels when their alarm clock rings, were we; we were talking about the food on your plate; about the moral issue, about the crime …

Luckily, things do not depend on my ability to express myself eloquently and effectively without alienating everyone present. I can also simply try to nudge people towards reading Peter Singer, especially now that he published an updated version of his Animal Liberation. What follows are basically my notes from reading this 2023 edition, with very few thoughts of my own mixed in. If you have immediate access to the book itself, switch to that; if not, you might as well keep on reading and buy or borrow it afterwards.

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