Can We Measure the Badness of Death for the Person who Dies?

I aim to show that the common idea according to which we can assess how bad death is for the person who dies relies on numerous dubious premises. These premises are intuitive from the point of view of dominant views regarding the badness of death. However, unless these premises have been thoroughly justified, we cannot measure the badness of death for the person who dies. In this paper, I will make explicit assumptions that pertain to the alleged level of badness of death. The most important assumption I will address is the assignment of a quantitative value of zero to death, which leads to the conclusion that there are lives not worth living for the affected person. Such a view interprets the idea of a live worth living in quantitative terms. It is in conflict with actual evaluations of relevant people of their lives.

The Badness of Death and What to Do About It (if Anything)

Chapter 1 discusses the pros and cons of four views about the badness of death on the assumption that it involves one’s ceasing to exist: Deprivationism, Willlhavehadism, Alloverism, and Insultism. It considers how these views bear on such questions as whether death is always bad for the person who dies, whose life to save when not all can be saved, how the distribution of goods and bads in a life matters, and whether it is reasonable to have an asymmetrical attitude toward death and prenatal nonexistence. The chapter also considers what the four views imply about the badness of the extinction of humanity (and all other persons).

A Gradualist View about the Badness of Death

In this chapter I introduce a view that has not been explored in detail and argue that it is a more plausible version of gradualism than extant views. It is based on the following simple thoughts: there is a difference between individuals that are susceptible to harm (by death or anything else) and individuals that are not. This difference is just the difference between individuals that are subjects of well-being and individuals that are not. And there is no sharp boundary between the individuals that are subjects of well-being and those that are not. In many cases it is vague whether an individual is a welfare subject. I attempt to formulate a view about the badness of death that takes account of this vagueness. I argue that this view, the Partial Welfare Subject View, has advantages over other gradualist views about death’s badness such as the Time-Relative Interest Account.

The Badness of Death and What to Do about It (if Anything)

This chapter surveys different accounts of the factors that make death bad and that make one death worse than another both intrapersonally and interpersonally. It focuses on (1) deprivation of future goods of life (Deprivationism); (2) having had fewer rather than more goods at the time of death (Willhavehadism); (3) being all over as a conscious person (Alloverism); and (4) vulnerability to loss and decline to nothingness (Insult). For each account of the badness of death, the chapter considers (a) possible problems with it and how they might be solved; (b) possible good and bad ways to remedy or ameliorate the bad; and (c) the morality of pursuing such remedies or amelioration. It also considers some related issues, including (i) whether to help those who are worst off; (ii) the role of moral rights; (iii) the significance of a human’s developmental stage; (iv) the value of mere conscious personhood; and (v) prenatal nonexistence.

The Badness of Death

In this chapter, I discuss the Time-Relative Interest Account (TRIA) and the Life Comparative Account (LCA) and their implications for summary measures of population health and fair priority setting in health care. First, I argue that an extreme interpretation of TRIA is incompatible with the standard practice of measuring population health by life expectancy at birth as an indicator. Implementing a policy of always saving adults before children would decrease life expectancy in a population. This implication is untenable. Second, I argue that a moderate interpretation of TRIA is compatible with earlier attempts to measure the burden of disease in populations by using marginal age weights in the valuation of Disability-Adjusted Life Years lost. The authors of the Global Burden of Disease study subsequently abandoned age weights. Third, I argue that marginal age weights used for determining social priority for health improvements may be appropriate.

Health Care Rationing and the Badness of Death

According to Jeff McMahan, health care professionals ought to save an individual, A, from dying as a young adult (e.g., at age 30) rather than save some other individual, B, from dying as a newborn, even if the latter intervention would give B twice as many years of full-quality life as the former intervention would give A. Call this claim Young Adults over Newborns. In this chapter, I argue that if we accept Young Adults over Newborns, then we must reject at least one of three other more plausible claims. This constitutes a strong reason to reject Young Adults over Newborns.

The Badness of Death for Us, the Worth in Us, and Priorities in Saving Lives

Carl Tollef Solberg and Espen Gamlund suggest that in allocating scarce, life-saving resources we ought to consider how bad death would be for those who would die if left untreated. We have moral reason, they intimate, to prioritize persons for whom death would be worse, according to the Time-Relative Interest Account of the badness of death. In response, I try to show that an allocation principle that specifies minimizing the badness of death among those vying for a life-saving resource would fail to respect the worth of persons. Solberg and Gamlund mention several other allocation principles. But, I argue, even when these others also come into play, allocations can fail to respect persons’ worth. A principle of respect for the worth (or dignity) of persons should, I contend, be employed in the allocation of scarce, life-saving resources. I sketch and apply a Kantian principle in an effort to allay the common worries that such a principle will be too vague to be useful and implausibly disallow length of future life to be a deciding factor in choosing whom to save.