Title

Deciding not to treat handicapped infants: When is life not worth living?

Date of Award

1999

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Philosophy

Advisor(s)

Samuel Gorovitz

Keywords

Handicapped, Infants, Quality of life, Nontreatment

Subject Categories

Arts and Humanities | Philosophy

Abstract

The purpose of my dissertation is to examine under what conditions life sustaining medical treatment is in an infant's best interest. Specifically, if an infant is expected to be conscious and capable of experiencing pleasure, and her prognosis does not include great suffering, are there any further conditions that must be met for survival to be good for her? I call accounts that assert that there are further conditions "Having a Life" accounts. These accounts propose non-hedonic requirements which must be met for a life to be worth continuing. Are any such requirements defensible?

I survey and critique Having a Life accounts offered in the bioethics literature. None of them provide cogent reasons why continuing to live is not good for one who fails to meet the proposed requirements. I examine two promising non-hedonic requirements, meaningfulness and dignity, in more detail. I also examine the claim that, because one is a human (as opposed to a dog or an ape), having and developing certain characteristics is in one's best interest. Although we may have reason to believe that leading a meaningful life is good for one and that indignity is bad for one, there appears to be no good reason to conclude that meaningfulness and dignity are necessary for a life to be worth living (for the person living it). Similarly, even if there are characteristics which humans benefit from having and developing, this does not show that those who lack these characteristics derive no benefits from continuing to live.

I conclude that the case for non-hedonic requirements (for when survival is in one's best interest) is poor. The case is better for non-hedonic values : goods that make one's life better. Thus, although we cannot defend the claim that a life must contain certain goods in order to be worth living, possessing certain goods is evidence that a life is worth living. Lives that lack non-hedonic values may or may not be worth continuing. Whether they are depends on whether the sensory pleasures they contain outweigh the pain and discomfort. Epistemically, this is difficult to assess.

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