Medical Ethics
Michael Green
Manuel Vargas
phone, office information

03 April. The Basic Argument Against Abortion
06 April. The Extreme View
08 April. The Voluntariness Objection
10 April. Samaritanism and objections
15 April. Fetuses aren't persons?
20 April. Does Marquis have to say contraception is wrong?
20 April. Nicole's point, one more time.
22 April. Wrapping Up

Medical Ethics: 13 April. Warren's criticism, more voluntariness

General point Warren thinks that you can't grant that a fetus is a person and still defend the right to abortion. Her defense of abortion rests on denying that the fetus is a person. Today's class looked at her attacks on Thomson, who tried to defend a right to abortion while granting that a fetus is a person.

What happened? Most of what follows is a blow-by-blow recounting of a central part of today's class, largely to give more credit to Jesús's point than I did in class.

Warren thinks that the violinist case is unlike most cases of abortion because there is no voluntary behavior that might amount to your assuming responsibility for the violinist but there is (typically) voluntary behavior that might amount to a woman's assuming responsibility for her fetus.

Call Thomson's version of the violinist case "Violinist Case #1."

Warren proposed "Violinist Case #2," in which you voluntarily joined the Music Lover's Society, knowing that the Society might require you to hook yourself up to a sick violinist. If they do ask you, you would be obligated to hook yourself up, according to Warren, because you voluntarily agreed to do so.

Really, Warren vacillates: she says it isn't clear that you wouldn't be obligated. What she wants to do is show that Thomson's argument isn't as decisive as her own argument is; so even this wishy-washy position is good enough, for her purposes.

Since Violinist Case #2 is more closely analogous to most cases of abortion than Violinist Case #1 and it seems that you may well be obligated to stay hooked up to the violinist in Case #2, the violinist case doesn't present a clear argument in favor of abortion.

Thus, according to Warren, we need to address the issue of whether the fetus is a person or not. The whole point of the violinist case was to provide an argument in favor of abortion rights under the assumption that the fetus is a person with a right to life. If Warren has shown that it doesn't clearly succeed, she will have explained why she thinks a defense of abortion rights must hold that a fetus isn't a person.

Me I disputed Warren's conclusion about Violinist Case #2. I said I thought you could back out without treating the violinist unfairly. You'd have treated the Music Society unfairly, but not the violinist, since he didn't have a right to use your kidneys in the first place.

Why is it unfair to back out on a deal like this? One reason is that doing so frustrates other person's expectations. Say I agree to buy your house. You, in turn, buy a house in another city, move all of your stuff to the new house, and so on. If I were to back out, I'd have harmed you: you're stuck with two houses to take care of because I promised to buy one. You have frustrated expectations based on my promise. So, it would be unfair of me to back out.

What if the violinist case were like that? What if my backing out had harmed the violinist? Suppose he took his name off a kidney transplant list because he thought he'd be able to use mine for nine months? If I back out, I would unfairly harm him by frustrating his expectations just as I would have unfairly harmed you in the previous paragraph. Call this scenario Violinist Case #3.

I believe that it would be wrong to back out in Violinist Case #3. But it seems to me that Violinist Case #3 is unlike abortion: the fetus doesn't turn down other options because it is relying on its mother. So, the wrongness of backing out in Violinist Case #3 doesn't show that abortion is wrong, in my opinion.

Jesús Jesús pointed out that the fetus still depends on its mother, even if it didn't have any other options. (The fact that it doesn't have any other options may make its position seem even more poignant).

He proposed Violinist Case #4: the Music Lovers hook me up to the violinist during my sleep, I wake up hooked up, and I try to back out. That's the version that is most like abortion, he said, and it looks wrong of me to try to back out. Since I voluntarily assumed the risk of being hooked up to the violinist and the violinist depends on me for his life, I am obligated to remain hooked up.

Jesús's position goes something like this: voluntary assumption of risk + dependency = obligation.

Back to Warren Here, I made a transition to Warren's Principle of Voluntary Responsibility that may have struck you as unclear. Here's why I did that.

We need to know what drives Jesús's position, that is, what makes it seem so plausible?

Is it the fact that someone else depends on me for their life? No, that's just the violinist case -- we agreed from the start that even though disconnecting him would kill him I could do so. So, he depends on me, but that fact alone isn't enough to obligate me to remain connected.

So, the crucial point must concern the fact that the other person's dependency is a result of my voluntary behavior.

To assess that, we need a principle that connects voluntary behavior, dependency, and obligations. So far, we have exactly one such principle: Warren's "Principle of Voluntary Responsibility." So, I started talking about that.

Maybe that isn't the best principle for making the relevant connections. But we have to start somewhere. Can you improve on it? If so, go for it!


The Amended Principle of Voluntary Responsibility

I added a clause about other people's behavior. Roughly, the idea is that if other people's behavior brings about a result, I'm not responsible for it, even if my behavior made that result more likely to happen.

With the amended principle in hand, we found that we could use it to deny that we are responsible for Thomson's burglar; this is the intuitively correct result, so our principle looks good so far.

Interestingly enough, we could not use the Amended Principle in the same way to deny that a mother is responsible for her fetus. Thus, we could deploy the Amended Principle to try to break the parallel between the burglar and abortion cases.

Note that Thomson didn't give a principle. But she would need one in order to explain why the voluntary assumption of risk doesn't waive rights to control one's body or house. She's relying on the obviousness of her examples and the assumption that they're parallels to the abortion cases to make her point.

We could not use the Amended Principle to break the parallel between the people seeds and abortion cases.

But you may well have independent reasons for doubting that the people seeds example is relevant: I gave mine.

Proliferating Amendments As Manuel pointed out after class, my amendment could have odd results. Suppose my wife and I employ a doctor for in vitro fertilization. Read my Amended Principle of Voluntary Responsibility again. Would this mean that the doctor was responsible for taking care of our child and not us? It looks like it. Since that's the intuitively wrong result, we need to amend the Amended Principle again or abandon it as false.

I can think of two additional amendendments that would do the trick. First, we could add a clause to the original amendment like this:

"there is no intervening behavior by any other person that is not under X's control, command, or request to bring this human being into existence."

Since the doctor acts at our request, there is no intervening behavior that is not under our request, and we are still responsible for the child, not the doctor.

Second, we could allow for complete voluntary assumption of responsibility. In a real case, the doctor would insist that someone else sign a declaration taking complete responsibility for the child before she would provide her in vitro fertilization service. She doesn't want to be responsible for the child, after all. So, add another "and" clause:

"AND no other person has assumed complete responsibility for the human being."

Since someone else would have done so (my wife and myself), the doctor is not responsible.

Would we stop there? Probably not. I'll bet this principle leads to many more intuitively wrong results and requires many more amendments. It's a great example of how moral philosophers develop principles, however: start with a rough statement, think of a counter-example, amend the principle.

I'd love to keep going, but it's time for lunch.

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This page was originally posted on 4/24/98; 1:59:45 PM and was last built on 4/24/98; 1:59:50 PM with BBEdit and Frontier 5 on a Macintosh running System 8.0.