Choosing life, choosing death

Julian Savulescu and Peter Singer take a position that seems right to me on the question of Charlie Gard--see their opinion on the matter here. They think the parents ought to be allowed to take the baby to New York for further treatment. But their reasoning puzzles me. Here's how Savulescu and Singer support their stance on Charlie Gard: in cases of "reasonable disagreement, we believe that we should accede to the wishes of the parents and err on the side of a chance of life. The alternative is certain death." I'm puzzled because "acceding to the wishes of the parents" can't always go along with "erring on the side of a chance of life," since some parents prefer death.

There's a moving example of this in a (New York Times) Stone column written by Gary Comstock. In this case there was probably reasonable disagreement, but the parents' wish was to let their baby die. What then? Should the wishes prevail, or should we "err on the side of a chance of life"? I wonder how serious Savulescu and Singer are about the second part. Should we "err on the side of a chance of life" even against the preferences of parents?

How decisive is it that parents prefer life, or don't prefer life, in these kinds of tragic cases which involve reasonable disagreement? If Charlie Gard's parents turned around and decided they wanted to withdraw life support, I wonder what Savulescu and Singer would say. Now "acceding to the wishes of the parents" would mean supporting them, but "erring on the side of a chance of life" would mean wresting away control. I think parents get to make these decisions (when there is reasonable disagreement), and not just when they choose life.


Alan Cooper said...

In defence of Savulescu and Singer, I would suggest that the "and" in "accede to the wishes of the parents and err on the side of a chance of life" might not have been intended as a logical conjunction of independent criteria but rather as what might be called a consequential conjunction - as in "give the correct answer for 2+2 and say 4" or "hit the ball out of the park and score a home run".

Alan Cooper said...

On the substantive issue, my gut instinct is to agree with you and S&S, and DT and the pope. But this is tempered by lack of knowledge of the actual state of Charlie's brain and of the level of his current and prospective suffering (and by my suspicion that the experts challenging the hospital also seem to be talking without having directly examined the patient).

The unanimity and intransigence of those who have actually seen his current medical condition may be indicative of details that are not easily or appropriately conveyed - or just of defensive stubbornness. Who knows?

Jean Kazez said...

Thanks for your comments--both pretty convincing! I'm not sure about that "consequential conjunction" interpretation because it seems like their case is based partly on the second conjunct. We are to "accede to the wishes of the parents" partly because doing so would "err on the side of life." But maybe that's not really what they meant. They were just gilding the lily at that point and may as well have said "accede to the wishes of the parents and permit further treatment" (which is clearly a consequential conjunction).

Alan Cooper said...

Yes, you are right. An honest and clear-headed use of consequential conjunction would have been phrased as you did - or by following "err on the side of (a chance of) life" with something like "at the risk of actually just causing pointless suffering". And the following sentence about the alternative of "certain death" does seem to be hinting again at the "life" argument. So perhaps they did intend to appeal to both arguments (with the lucky break that in this particular case they both pulled in the same direction).

This leaves open the interesting question of what S&S really meant - and in particular, if the positions had been reversed whether they would be as quick to say "follow the wishes of the parents and not pointlessly extend the poor child's life. The alternative is certainly extended indignity and possible suffering with no real chance of recovery."

I suppose it would not be inconsistent for them to say that they would in fact use the "life" argument to at least raise the standard of proof required of whichever side is proposing cessation of treatment, while at the same time holding the parents to a lower standard than the medical system. Of course that would preclude the existence of a simple "rule" and would make the resolution of each case dependent on intimate details and unknowable probabilities. But such is life!