Peter Singer on Parental Choice, Disability, and Ashley X

This post kicks off a series of posts at What Sorts that we hope will appear every Tuesday and Friday over the next few months called Thinking in Action. In the first instance, this series will offer commentaries on talks and discussions at the recent conference Cognitive Disability: A Challenge to Moral Philosophy. The aims of these Thinking in Action posts will be to generate and advance discussion of specific issues that arise in taking up the themes of the conference. The posts will typically feature a relatively short clip from a talk or discussion at the conference, followed by a commentary; transcripts of all excerpted video clips will appear at the end of each post. In light of our experience with this first (extended) round of posts, we’ll see whether we continue the series with clusters of posts with other thematic focuses. We will both tag and categorize each post with the series label “Thinking in Action” so that you can review them together, if you like, and we encourage the use of posts in the series in classrooms, in local discussion groups, and in organizations at the interface of government, university, and community. We will aim to make each of these self-contained, with the conference podcasts themselves serving as a larger reservoir of perspectives on cognitive disability on which you can draw. We hope that you will join in the discussions, both on the blog and beyond it.

To help us get some idea of what readers know about the conference podcasts we’ll be discussing, here’s a quick poll that we encourage you to take before proceeding.

As one might expect, Peter Singer’s talk at the conference Cognitive Disability: A Challenge to Moral Philosophy, presents ideas that Singer is well-known for. Amongst these are views that draw parallels between animals, on the one hand, and individuals with disabilities, on the other, especially those with “profound mental retardation”, a medical category that includes, amongst other features, having an IQ of 25 or below. I want to kick off this series of blog posts not with a discussion of that general comparison—though Dick Sobsey might well take that up in the next few posts—but by concentrating on something in Singer’s talk focused on the issue of parental rights and disability. Here is Singer, toward the end of his talk, presenting the perspectives of parents. Singer points out that, as a group, parents of children with disabilities divide over their views of their own children. Although it is a little unclear, even from the fuller context, precisely what “this issue” is that parents divide over, it concerns pain, death, and quality of life:

[This clip is from Singer’s talk at the Cognitive Disability conference, podcast #15: 33.30 – 38.02] If you are having trouble playing the video above, the full transcript is provided at the end of the post, and you can also try Youtube directly by clicking right here.

I want to raise three points about what Singer says here.

The first is that although Singer is ostensibly concerned, in this talk at least, with cases that involve “profound mental retardation”, he introduces a range of cases in making the points he wants to make about parental choice and disability. He starts off with a consideration of Down Syndrome, moves onto cases that involve cerebral palsy (together with further complications), and ends with a brief discussion of the Ashley X case that we have blogged about in the past at What Sorts here and here. Of these, only the Ashley X case is one that either exemplifies or approximates one involving profound mental retardation; it is perhaps the only of these cases that involves a level of cognitive disability that many would regard as more than mild. (Not enough of a description of the second case is provided to allow one to make a definitive judgment here, though amongst the complications that come with cerebral palsy, “profound mental retardation” is very rare, and severe cognitive disability unusual; the parent’s own report of what she would have done, that Singer provides in part, does not determine that issue, a point that I’m happy to talk about more in discussion if anyone is interested.)

Why such a range of cases then? Well, that depends on what Singer’s general point is here. And that, in turn, depends on how one should understand his claim that “parental choice ought to have an important role in decisions. At least in decisions for those with profound mental retardation, maybe in others as well”. This can be made to sound trivial, as his parenthetical “obviously” in several places suggests: parents need to be consulted and deeply involved in decisions that are made about their children. This makes it sound as though the point is one about ensuring that parents of children with cognitive disability are afforded the same involvement in care for, and the guidance of, the lives of their children as are other parents. But what ARE these “decisions” here? Well, some of them might involve allowing your child to die, and others (like the Ashley case) to actively intervene to radically modify that child’s body in a way that would clearly be unacceptable were the child “normal”. Thus, rather than making a point about equal treatment, Singer here is surely making one about extreme decisions, decisions that simply would never come up in cases that do not involve cognitive disability at all. But then how are we being encouraged to think about cases that are not normal, in this case, those that involve babies, infants, and children with cognitive disabilities? If Singer really IS concerned primarily with cases involving “profound mental retardation”, as he says, then the views of parents of children with Down Syndrome or with cerebral palsy seem at best only indirectly relevant, if relevant at all, if not an outright distraction. But what about that ominous-sound “maybe in others as well”, suggesting that parental choice in “decisions”—such as the decision whether to keep a baby alive—extends into the realm of cognitive disability more generally? I don’t think that Singer can have this both ways, especially when it comes to the rights that parents have over their children on issues of whether those children survive, especially in a world (including a medical world that, in turn, has a huge impact on parental attitudes) that discriminates strongly against those with even very mild forms of disability, cognitive or not.

The second point concerns something that I was very surprised to hear near the beginning of this clip. Talking about what we might call pro-Down parents, parents like Anne Bradley ,who like their children so much that they wish “all their children had this extraordinary syndrome”. Singer says, “that’s fine for parents who have that view and make that choice”. Although Singer grants this concession in order to make the point that since “the views of parents on these issues go in both directions”, and so an appeal to “parental views” doesn’t resolve the issue in favour of protecting and promoting the lives of those with cognitive disabilities, and so against those who think that those lives need not be protected or promoted, I was struck by the concession itself. Does Singer really think that parents should have the right to actively promote conditions that many in society consider to be disabling? I haven’t managed to track down Singer’s views on, for example, cases involving deaf couples and their non-deaf fetuses, babies, and children, but I’d be curious in knowing whether this was a slip up here, or whether Singer’s endorsement of parental rights is really as strong as it sounds here. Taken at face value, it sounds as though Singer’s endorsement of parental rights–at least when it comes to cognitive disability (“profound mental retardation” only?)–gives it a reach that many would find contrary to respect for the basic rights of the infant or child.

The final point concerns Singer’s brief mention of the Ashley X case. Singer doesn’t have much to say about this, and what he does say may not seem that central to his broader message. But what struck me about this most immediately was the incredibly casual way in which Singer appropriates the case. Here’s a recent and ongoing case in the Seattle area, one likely involving a hospital’s violation of its own ethical protocols, surgical interventions that have only the most scant medical basis as treatments, and the violation of the right to growth that supposedly all children have under a number of charters of human rights–probably the best coverage of the case can be found at Huahima’s Ashley X Case blog (recommended: read it from earliest to most recent entry). And what does Singer extract from it? Only the proclamation that Ashley’s life is not one with dignity (in the sense in play), and the seeming endorsement of the parent’s rights to make that choice for their daughter, construed in terms of her “best interests”. I wonder how someone can afford to be both so cavalier about the case, so either unaware or unconcerned about any of these issues (and others) that arise in the case, and so sure that this represents a case in which parents have rightfully exercised their rights over, and acted in according with their duties to, their child. We don’t need to go to cases as extreme as that of Robert Lattimer to raise questions about the sorts of choices parents exercise that affect the lives of their children–indeed, whether they even have lives, and the basic rights that typically go with those lives. One can, of course, use an example, real or imagined, for whatever purposes one wants, but how one chooses to use these, what is extracted from them, does reveal something about what is seen as important and worth drawing attention to. The banality of Singer’s own discussion of the Ashley X case is perhaps what I find the most disturbing thing in his whole talk.

Transcript of the Video Clip: Peter Singer

“Now let me say something about the views of parents on this issue. Because that, of course, is relevant. And this is something about Down Syndrome. Obviously, people with Down’s are not profoundly retarded; it’s not the kind of category I am talking about at all. But I did want to just give you a couple of comments that I’ve had when I’ve spoken about this issue, in terms of the views that parents have. Parents obviously do have a say in how their children should be treated, and I think that that’s tremendously important. So that in debates about, for example, infants born with Down Syndrome and other complicating conditions that required surgery, some parents have said that they didn’t want surgery performed because they didn’t want to have a child with Down’s. Other parents have said that they did. And some have said, as Ann Bradley has said here , that some people with children with Down syndrome wish that all of their children had this extraordinary syndrome, which replaces anger and malice, deletes anger and malice, replacing them with human thoughtfulness and devotion to friends and family.

So that’s fine for parents who have this view and make that choice obviously. But there’s also the contrary view that I’ve had expressed to me in letters when I’ve … when my views have been publicized on these issues, about parents whose children have been saved by doctors when they were born, in this case, an extremely premature baby, although not actually as premature as many who are saved now, but who have had a lot of problems. And this woman wrote to me that had she known what was in store for her son, and had the doctors asked her whether they wished to incubate him, in other words, to keep him going on the ventilator so that he would survive, she would have said “No”. She would have would have said, that would have been a gut-wrenching decision, but it would have been for the best, both best for her son himself, and for the family and the other children. So, the views of parents on these issues go in both directions. And I don’t think, therefore, resolve the question in a way, if you like, in favour of protecting life, in all cases. Rather, the arguments that I have suggested imply that parental choice ought to have an important role in decisions. At least in decisions for those with profound mental retardation, maybe in others as well.

I want to mention also the case of Ashley that received a bit of publicity last year, for those of you who heard about it. This was a case of a girl in Seattle. There was some dispute about how profoundly or severely her cognitive disabilities were. It was said that she can’t walk or talk, keep her head up, roll over, or sit up by herself. She was fed with a tube, she didn’t swallow and the case was controversial because her parents used growth attenuation to make her, to keep her small, and make her easier to care for, which involved operations like hysterectomy, removal of breast buds, and some hormone treatment, to … so they could still pick her up and keep her with them. And they said that this was in her interest, for her benefit, so that she could travel on family holidays with them, and so on. Also, they said it would protect her from possible sexual abuse. Now, it was a controversial issue. But one of the things that I don’t really agree with is the claim made in this Los Angeles Times article about it, which says that “This is about Ashley’s dignity. Everybody examining the case seems to agree at least about that.” Well, I mean again, as I a said before the term “dignity” is a very vague term. I would say that it’s about what’s in Ashley’s best interests. We are prepared to use the term “best interest” for animals without too much hesitation. We know what that means . We’re not prepared to use it for nonhuman animals . And I don’t really think that someone as developmentally disabled as Ashley is described as being is actually someone with dignity in a sense we’re prepared to deny to nonhuman animals.”

10 thoughts on “Peter Singer on Parental Choice, Disability, and Ashley X

  1. I first of all want to thank everyone at What Sorts of People for expanding the discussion of the issues raised at the Conference I and Licia Carlson organized. We organized the conference precisely to give an airing to philosophical questions that concern cognitive disabilities of different sorts and to demonstrate the deep philosophical challenges posed by the issue of cognitive disability. Creating this space allows a public engagement of these issues in a still larger forum than a conference. I expect I will frequently be tempted to join in on the discussion.

    Now for a comment on Bob’s response to the Singer clip. I have long had a disagreement with Singer on many points concerning people with cognitive disabilities, but two of the points that Bob makes have been especially disturbing to me. The first is the easy slide between the kinds and levels of cognitive disability he (and others who take similar positions) make. The threshold of functioning is somewhere below “normal” — defined sometimes by IQ, sometimes by functioning that is considered as typically human, sometimes by reference to nonhuman animals (which can run the gammet from primates to pigs to rats). Where the arguments seem to require it, we are to be thinking of human beings who are barely conscious. Yet without changing the terms of the argument, we are given examples of people whose cognitive disabilities are rather mild.

    I think that two things lie behind these elisions: The first is the unstated view that anything below normal cognitive functioning is a sufficiently severe disability to make that life questionable. The second is a thick layer of ignorance about the lives and functioning of people with cognitive disabilities of any sort. In short it is never quite clear who is being talked about, in large part because Singer and others keep their philosophy insulated from these particular empirical matters.

    Which leads me directly to the second point that so disturbs me. In a recent interchange with Michael Berube, Singer expressed his delight to hear about all the things that Jaime is capable of, yet he wonders if Jaime is not an anomaly. There is now so much literature out there attesting to the sorts of things people with Down’s are capable of, one has to wonder why Singer expresses any surprise about the abilities Jamie manifests. After all, cognitive disability is something Singer writes about regularly. One would assume that he keeps up with the changing understandings. At the conference I invited Singer to pay a visit to a wonderful community where my daughter (who is among the more significantly cognitively impaired individuals that Singer frequently targets) resides. (Indeed I had brought a majority of the speakers there on the morning of the first day of the conference, but Singer declined that first invitation.) He wanted to know what he might (given his argurment) learn from visiting such a place. [would it be possible to show that clip–it comes at the very beginning of the Singer Q&A.] Perhaps that is a fair enough question, but I would think that the responsible thing to do would be to jump at the opportunity to become better acquainted with the subject of one’s perennial teaching and research interest. I don’t understand the willingness to remain insulated from such knowledge, and I don’t understand why we (philosophers) tolerate this willful ignorance. We do not tolerate philosophers of science who know very little about the science they write about. Why do we tolerate ethicists talking about people they know so little about?
    Eva Kittay

  2. I would like to respond to the first two points of Rob’s post. I think what is said about the Ashley X case is very persuasive, and I probably know less about that case than Singer, so I won’t comment on it.

    I want to offer an explanation of Singer’s views that I think will show why the casual slide from discussions of “profound mental retardation” to discussions of “moderate” cognitive disability in infants does not undermine Singer’s argument. The main point I would make is that Singer doesn’t believe there is a morally relevant distinction between adults or children who are “profoundly mentally retarded” and infants born with less severe forms of disability. In fact, there is no difference between people who are “profoundly mentally retarded” and any infant, disabled or not. The difference between “profoundly mentally retarded” people and infants will begin to emerge at a fairly young age (probably within the first two years of life for most children); this is when children go from being merely human beings to persons. Before this point, Singer thinks there isn’t a morally significant difference between “profoundly mentally retarded” people and infants, or many non-human animals for that matter. However, as soon as personhood begins to emerge, the kind of parental control over whether a child should be allowed to live no longer holds. What Singer argues is that people who are “profoundly mentally retarded” never make the shift from being human beings to being persons. Thus, the parental control is maintained even as the child becomes an adult.

    It might not come out very clearly in this particular talk, but Singer has, in fact, argued elsewhere that parents do no wrong when they kill their moderately disabled infants; hemophilia is the example he uses of a moderate disability. However, he also holds the same position about non-disabled infants. A couple might have a child, and one week later, the mother is offered a new job that would be difficult to manage while caring for the child. After discussing it, the couple may decide they will be happier if they wait for a few more years before having a child. Singer thinks they would do no wrong in killing the infant and having another child three years later. Probably most people would disagree with Singer on this; however, if the example involved a woman finding out she were pregnant and receiving a job offer one week later, I think many would not think the couple does wrong if they choose to put off having a child. It tends to depend on where you draw the line, conception, third trimester, birth, etc. Singer draws it at personhood, which is not present at birth, and for the “profoundly mentally retarded”, he thinks, is never present. I think this is why Singer so casually shifts his discussion from “profoundly mentally retarded” people to infants with moderate disabilities.

    Hopefully more briefly, on the second point about parents promoting conditions that are considered disabling, I think this was a “slip up” on Singer’s part. I believe what he intended was that it’s fine for Ann Bradley to have her view, and it’s fine for parents to choose to have surgeries performed that will save the lives of infants with down syndrome. I agree that, given the way Singer actually says it, his position isn’t very clear. However, he has argued in “Practical Ethics” that, all things being equal, it is worse to have a disability than to not have one. In other words, to some extent, however minuscule it may be, there is an increase in suffering and a reduction in happiness associated with disability – all other things held equal that is. So to choose disability over non-disability, for Singer, would be to bring more suffering into the world than would otherwise be the case, and would thus be wrong. This is how I think Singer would react to cases of parents selecting for disability.

    I hope this is helpful in clarifying some things and will generate further discussion.
    Marc Workman

  3. This is a wonderful topic and project for the What Sorts blog, and the discussion so far is terrific. I would like to respond to an argument Marc Workman has made in response to Eva Kittay’s post, and then relate that response back to another point in Singer’s remarks.

    I appreciate Marc’s explanation for why Singer does not draw a distinction between “profoundly mentally retarded” people and people with moderate or mild cognitive disabilities, but I’m not sure it actually solves the problem raised by Eva about the way in which Singer slides from one category to the other. It seems to me that Marc argues that the reason why Singer does not distinguish between “profoundly mentally retarded” people and people with moderate or mild cognitive disabilities is because Singer regards all people who are infant-like as non-persons. But this response only pushes the question back a step, because now the question becomes “are all people with moderate or mild cognitive disabilities infant-like”? In many cases, it seems to me, there can be important differences between infants and many people who are moderately or mildly cognitively disabled. Just as Singer cannot slide from talking about “profoundly mentally retarded” people to talking about people with mild or moderate cognitive disabilities without further explanation, he also cannot slide from talking about “infants” to talking about “people with moderate or mild disabilities” without further explanation. Moreover, justifying or explaining the slide from talking about infants to talking about people with moderate or mild disabilities would seem to require familiarity with what the lives of people with moderate or mild cognitive disabilities are like–a point Eva raised.

    I think that Singer’s slide from talking about “profoundly mentally retarded” people and people with moderate or mild cognitive disabilities is related to another slide that Singer makes in his comment about Ashley X, namely the one from “dignity” to “best interests.” The concept of dignity may be vague, as Singer suggests, but there may also be an important general difference between “dignity” and “best interests” (which I will try to explain in a moment)–a difference that suggests that Singer’s slide from “dignity” to “best interests” employs the same assumption that lies behind the slide from profound mental retardation to moderate or mild cognitive disability.

    In the classic Kantian sort of account, having dignity is connected to a person’s rationality, which Kant connected to a person’s ability to set his or her own goals, or to be the “king” (or queen) of his or her own realm of ends. (This view is embedded in the classic “kingdom of ends” formulation of the categorical imperative.) Dignity thus comes from the inside, so to speak–it is based on someone’s being a self-governing individual of some sort. “Best interests,” by contrast, need not come from the inside. Other people can determine someone’s best interests from the outside. A third party cannot make someone a self-governing individual, but can determine what someone else’s best interests are. I am not sure that I have done a good job of expressing the point here, but the idea is that when Singer slides from talking about “dignity” to talking about “best interests,” he has already presupposed what the discussion above suggests he needs to show, namely, that people with cognitive disabilities cannot govern their own lives or cannot be the kings or queens of their own kingdoms of ends in any important sense. He has already shifted the terms of discussion, so that now we need not treat people with cognitive disability as capable of governing their own lives, but can decide–from the outside–what is in their “best interests”. That is precisely the assumption that makes the slide from talking about people with profound mental retardation to talking about moderately or mildly cognitively disabled people troubling. The latter slide assumes that, like people with profound mental retardation (so the story goes), people with moderate or mild cognitive abilities cannot set their own goals or govern themselves in any meaningful sense. Singer’s slide from “dignity” to “best interests” predisposes us to accept that the class of people under discussion (infants, Ashley, people with cognitive disabilities) cannot be kings or queens of their own realms of ends in any important sense, and therefore do not have “dignity,” but only “best interests”.

    Julie Maybee

  4. Rob wrote:
    “The final point concerns Singer’s brief mention of the Ashley X case. Singer doesn’t have much to say about this, and what he does say may not seem that central to his broader message. But what struck me about this most immediately was the incredibly casual way in which Singer appropriates the case. … The banality of Singer’s own discussion of the Ashley X case is perhaps what I find the most disturbing thing in his whole talk.”

    Actually, Singer’s remarks about Ashley in the talk he gave are extracted almost verbatim from an Op-ed article entitled “A Convenient Truth” that appeared in the NY Times on January 26, 2007. In the article, he discusses the importance of the “best interest” principle in considering the surgical and other interventions performed on Ashley, as well as the idea that these violated Ashley’s dignity.
    Contra Rob, I would argue that the primacy Singer gives to “best interests” and the fact that he eschews the notion of dignity (which smells of Kantianism) are not at all surprising given that he advances a quintessentially utilitarian bioethics. We can see this starkly represented in the final paragraph of the January 2007 Op-ed, which I have copied below:

    “What matters in Ashley’s life is that she should not suffer, and that she should be able to enjoy whatever she is capable of enjoying. Beyond that, she is precious not so much for what she is, but because her parents and siblings love her and care about her. Lofty talk about human dignity should not stand in the way of children like her getting the treatment that is best both for them and their families.”

    The entire Op-ed by Singer on Ashley can be read here:

  5. In response to Julie, I think I should have made it clearer that I don’t think the slide is really one from talking about “profoundly mentally retarded” people to people with moderate cognitive disabilities. Rather, the slide was from talking about “profoundly mentally retarded” people to talking about infants with other forms of disability, and I tried to show how Singer thinks that moral decisions are similar in both kinds of cases.

    I don’t think Singer would argue that people with milder forms of cognitive disability are, in fact, infant-like. The class of humans Singer thinks is infant-like is the “profoundly mentally retarded”. I think it is a fairly common misunderstanding of Singer’s position that he denies personhood to all people with disabilities. He does actually think that people with downs, for example, are persons possessing dignity (whatever that means); so too are most small children and a number of non-human animals as well. For Singer, it would be just as wrong to kill a 5-year old child with downs as it would be to kill a child without downs of the same age. But he thinks it would be morally acceptable to kill either the child with or without downs within the first few weeks after birth. And because the debates are always about killing disabled infants, his views on killing non-disabled infants don’t ever arise.

    I think you’re right about the distinction between dignity and best interests. All I will say is that I don’t think Singer needs to show “”that people with cognitive disabilities cannot govern their own lives or cannot be the kings or
    queens of their own kingdoms of ends in any important sense.” I don’t think he needs to show this because it’s not what he is claiming. He is claiming that infants, people who are “profoundly mentally retarded”, and many non-human animals are not capable of governing their own lives. He would grant that people with milder forms of cognitive disability are more or less capable of governing their own lives, at least to a degree sufficient that it would be wrong to kill them or perform surgeries on them without their permission.

    It’s hard for me to imagine that a one-day old baby is able to be a queen of her own kingdom of ends any more than, for example, a cat is capable of governing his own life. Where Singer seems to run into a lot of difficulty is showing that people who are “profoundly mentally retarded” are also incapable of governing their lives. I think, however, that Singer would be happy, for the sake of argument, to lower the threshold to the point where we are only talking about people who are, as Eva says, “barely conscious”. So this will include only a small group of people, but the argument doesn’t go away just because we are talking about a small group of people.

    I generally think that liberals and utilitarians are going to have a hard time disagreeing with Singer’s conclusions. You have to challenge a lot of his fundamental premises, and the problem is that many of his premises are fairly intuitive in liberal democracies (e.g., don’t discriminate on morally arbitrary grounds, happiness is good while suffering is bad, and it is better to be disabled than non-disabled). On the other hand, I think that the conclusion Singer ends up with is fairly persuasive evidence that there must be a problem with the foundation. I’m interested to hear the ways in which people challenge the fundamental premises Singer holds.
    Marc Workman

  6. I agree that the problem rests in the premises rather than the application. Singer has believe that rights only exist if people are conscious of their rights and interests. Therefore, he has argued that newborn infants as well as individuals with little or no consciousness do not have a right to survival because they are not self-conscious. The fact that an infant might later become self-conscious is not part of his argument. Of course this would also mean that even if an individual is temporarily unconscious or asleep if is okay to kill that individual as long as e or she is not woken up. The one place his logic breaks down is the internal contradiction. Note that he says that parents can act in Ashley X’s “best interests” but if Ashley is truly a nonperson she can have no interests.
    He does not talk much about children as nonpersons. I don’t think this is accidental, but rather I suspect it is deliberate because neither liberals or conservatives are likely to endorse the right of parents to kill or mutilate their young children. In actual practice, it can be argued that children are legally neither persons or nonpersons, but are recognized as partial persons. In other words, they are generally not given all the rights and freedoms of adults but they do enjoy some rights, such as the right to survival.
    Singer’s other premise is that no rights should be based simply on being human, rather rights are granted on the basis of demonstrating awareness and participation in social interaction. I think this is a bad premise. I think that there are some rights that every living human should have. The idea that all rights depend on how smart an individual is seems no more acceptable to me than saying people who are not landowners, or who are not male, or who are not a particular color. I am willing to accept that some rights might be unique to landowners or some other group, but there is no reason to limit fundamental rights to some people while denying them to others.

  7. I want to say a few things in response to Dick Sobsey’s comments. It’s going to sound like I agree with Singer. I don’t. I do think his views present a serious challenge, and it sometimes seems to me like the only way to meet the challenge is to call into question the method and assumptions of all of contemporary moral philosophy, including the heavy reliance on human rights, a concept Singer uses to make his argument.

    I’m not sure it’s right to say that non-persons can have no interests. For Singer, every being that is capable of suffering has interests. As Julie pointed out, interests can be determined from the outside, and a being not need be aware of them. Moreover, every being capable of suffering has interests that are equally worthy of consideration. This, Singer thinks, is the true foundation of equality. However, despite that all suffering beings have equal interests, he thinks that persons have a unique set of interests that are worthy of greater moral consideration. Persons have goals, projects, an internal narrative history, perhaps even dignity, and so on. He thinks these are morally significant characteristics that set persons and their interests apart. Remember that these interests (i.e., achieving your goals, carrying out your projects, continuing your narrative story) do not disappear when a person is unconscious or asleep, and that is why it would be wrong to kill a person in those states.

    Regarding the argument from potential, I think Singer realizes that most of his interlocutors are “pro choice”, and so, to some extent, have already accepted that a potential person’s “rights” can be over-ridden if the mother so chooses. You can make the argument from potential, but I think it requires adopting a “pro life” stance, as potential exists from the moment of conception.

    I will say it is a little strange to talk about rights where Singer is concern because, I suspect, he does not think there are “real” rights (i.e., rights that exists pre-socially in the state of nature). He would want to know where these pre-social rights come from. At one time, the rights were said to come from God – man is made in God’s image. For many, this is still true, but these arguments don’t tend to carry a lot of weight in academia.

    Your last point is important. You said that basing rights on how smart we are is as wrong as basing them on property ownership, sex, or race. Singer will argue that basing them on humanity is just as arbitrary. Why should humans have rights that animals don’t have? Singer thinks he can point to morally significant characteristics that persons possess (goals, projects, narrative history, etc), but there is no justification for giving rights to human beings, as opposed to persons, that we deny to animals. So then many will say we shouldn’t deny them to animals, “just give animals the same rights.” I think this sounds nice but, in practice, is impossible. Many of us probably believe that we should spend more money on animal shelters, but I don’t think many would argue that we should cut current health care spending in half and redirect it towards protecting the welfare of animals. And there is of course the practice of eating meet that people probably aren’t going to want to give up. So as nice as equal human and animal rights sounds, I think we do want to draw a line around humans and give them special rights, but Singer thinks this can only be accomplished if we draw the line around persons and not all human beings. I don’t know if there is an argument out there providing morally significant reasons for including all humans and excluding all animals – one that doesn’t rely on God. I would like to hear it though.
    Marc Workman

  8. I agree that rights are socially constructed and not fundamental to nature, but they are no more socially constructed than moral status.
    Maybe it would be better to say nonpersons can have no personal interests. Than no interests. Some people might say that my car, which I definitely consider a nonperson, has an interest in having its oil changed, so in that sense nonpersons can be said to have interests, but I wouldn’t say it wants its oil changed.
    I know that Singer would prefer to talk about moral status than rights, but the two are inseparable. Part of the problem in this issue is that Singer uses profound mental retardation as a kind of philosophical notion rather than a clear notion of what it actually is. I want to assure you, him and everyone else that lots of people with profound mental retardation do have plans and desires. They may not be plans to design a cathedral or plans to swindle billions of dollars from investors, they may only be plans for a warm bath, or eating a piece of cake. But maybe these plans are just as important to them. The notion that these things aren’t important is like saying it is okay to rob poor people because they don’t have much to lose.
    Singer’s imprecision in describing people with disabilities seems to be uniformly in the direction of underestimating their lives. In the clip used here, for example, he informs people that Ashley X cannot swallow any food, but the picture on her parents website show her eating watermelon and strawberries. For Singer, not having his facts straight about whether Ashley could swallow or whether people with profound intellectual disabilities have plans is unimportant because he is only using them as abstract philosophical devices. When shown why his reasoning may not apply to one case, he just imagines another one and says, no matter where the line is drawn it will have to be drawn someplace. The philosophical concepts are more important than the individuals. For me, I know a lot about people with severe and profound disabilities, but very little about philosophy. So, we are coming from very different places.
    I disagree with the notion that abortion and weighing the mother’s rights or interest against that of the fetus is relevant here. I agree that this is a situation where the rights and interests of one may have to be given priority over another. There are many other situations where these kinds of choices need to be made and I have no problem with recognizing that reality. My concern is that trying to resolve the issue by pretending that someone is a nonperson without moral status is a dishonest rationalization. If Singer wants to argue that children with profound mental retardation should be deprived of life or subjected to treatments because we don’t have the resources to meet their needs or parents have a right to do other stuff besides take care of their kids, we can have that argument… but it is a totally different argument.
    I think there is an argument for including all humans as persons, but I don’t necessarily think that all nonhuman animals should be excluded. My reasons for including all humans is not very philosophical, it is social and psychological. Humans are social beings. We are not that impressive as single organisms, but we can do a lot as families, organizations, nations etc. We need some set of rules for dealing with each other. I believe that a set of universal human rights is a good place to start. Whether we want to include other nonhuman animals in this is an open question for me. I would extend at least some rights to nonhuman animals, and I would not be offended if we could work out a way to treat them as equals or at least more like equals. However, treating them better or more fairly does not require sacrificing the rights of others. So, Mark, I think we are pretty close on that part. I agree that there is no argument for including all humans and thereby excluding all nonhumans. However, I do say that human rights has progressed by including more and more humans as equals, with equal moral status) and that has been a good thing. If we can extend it further to other animals that will probably be good, too, but there is no reason to turn the clock back on universal human rights in order to widen the sphere.
    I fact, I think that the exclusion of people with profound intellectual disabilities will hurt the cause of animal rights for a simple but important reason. People with severe and profound disabilities differ from other groups who have previously been included in one big way, they have not been able to advocate articulately for their inclusion or negotiate their own way into the social contract. Neither can apes or other mammals. If we draw the line between humans who can negotiate their own way and those who can’t, the same line will exist for nonhuman animals. The inclusion of people with severe and profound disabilities sets a precedent that individuals can be included just because it is right and not because they can negotiate their own way in. Their exclusion sets the precedent that if human or nonhuman animals can’t articulate their arguments for inclusion, they will be excluded.

  9. Thank you for a great discussion. As some of you may already know, the Seattle Children’s Hospital and the University of Washington will have a symposium about growth attenuation next month. The title of the announcement page of the hospital site goes, ”Evaluating Growth Attenuation in Children with Profound Disabilities: Interests of the Child, Family Decision-Making and Community Concerns”. Your discussion has helped me to know what bothers me about it. There’s the same premises as Dr. Singer here. They believe discussing “interests of the child” instead of “dignity of the child” will be good enough because children with profound disabilities like Ashley do not deserve to have their dignity discussed. But I wonder if they have really proven that in their justification of the Ashley case. Did they prove by providing concrete and convincing evidences that Ashley doesn’t deserve dignity for lack of cognitive abilities? To do that they have to prove A) Ashley’s cognitive abilities are at an infant level and B) anyone with cognitive abilities at an infant level does not deserve dignity. I don’t see any evidences even for their claim that her mental level is 3-month old (or sometimes 6-month old, quite mysteriously.).

  10. Huahima,
    This comes back to one of the points I was trying to make in the original post, something underscored further by the link to the NY Times Op-Ed piece that Shelley pointed and linked to: the blase way in which “facts” about the Ashley X case are cited. It’s good enough just to pull some highly questionable data in about Ashley X, data usually fed from the very people and institutions who have promoted the ethically troubling “treatment”, and then you’re done. Why is it good enough to treat this case like it were a mere thought experiment, rather than the real example that it is? If you’re going to call on such an example to try to make a philosophical point, the onus is on you to probe at least minimally beneath the surface. But once one does that, the kinds of point-scoring that the example is used to do becomes a much more difficult game to play.

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