In Defense of the Time-Relative Interest Account

This chapter defends the Time-Relative Interest Account of the misfortune of death against the two ingenious objections that Tim Campbell advances in chapter 18 of this volume. Campbell argues that this account, when combined with two other highly plausible claims, generates intransitive judgments about which options we ought to choose in a series of choices among pairs of options. He then argues that even if we can accept the intransitivity, our judgments must violate the principle of Contraction Consistency. I argue that there are good explanations of why the violations of transitivity and Contraction Consistency are innocuous.

Deprivation and Identity

Don Marquis famously argues that abortion is typically immoral because it deprives the fetus of a future like yours and mine. He bases his argument on “animalism,” the view that human persons are human animals. Correspondingly, some of Marquis’s critics reject the argument by rejecting animalism. I argue, however, that animalism is considerably less friendly to Marquis’s argument than he and others have assumed. The discussion also suggests several more general points—for example, that in order to reject moral views such as Marquis’s, we need not deny that death is typically worse for its victim the more well-being it deprives her of or the earlier in life it occurs.

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.

Life Years at Stake

In quantifying the global burden of disease in terms of Disability-Adjusted Life Years (DALYs), we must determine both Years of Life Lost (YLLs) and Years Lost to Disability (YLDs). In setting priorities for global health, many have felt that YLLs should not always simply equal life expectancy at death. To this end, Dean Jamison and colleagues recommend the use of a DALY metric that incorporates Acquisition of Life Potential (ALP). When an individual dies, the YLLs that we would otherwise count are multiplied by the value of the ALP function, which rises gradually from 0 to 1 during the first stages of an individual’s life. Jamison et al. do not provide a detailed philosophical justification for the use of gradual ALP. In this chapter I explain why I believe the Time-Relative Interest Account represents the most plausible ethical basis for the ALP approach and describe how we might model ALP in light of this account.

How Much Better than Death Is Ordinary Human Survival?

According to common sense and a majority of philosophers, death can be bad for the person who dies. This is because it can deprive the dying person of life worth living. I accept that death can be bad in this way, but argue that most people greatly overestimate the magnitude of this form of badness. They do so because they significantly overestimate the goodness of what death deprives us of: ordinary human survival. I proceed by examining four philosophical theories of why human survival matters: (1) non-reductionism, (2) the psychological continuity view, (3) the continuity of consciousness view, and (4) the physical continuity view. I argue that all these theories fail to offer something that is both deeply egoistically important and found in ordinary human survival. In the final section, I discuss how we should think about preventing deaths from a policy perspective if death is a lesser personal evil than what is typically assumed.

The Worseness of Nonexistence

Most believe that it is worse for a person to die than to continue to exist with a good life. At the same time, many believe that it is not worse for a merely possible person never to exist than to exist with a good life. I argue that if the underlying properties that make us the sort of thing we essentially are can come in small degrees, then to maintain this commonly held pair of beliefs we will have to embrace an implausible sort of evaluative hypersensitivity to slight nonevaluative differences. Avoidance of such hypersensitivity pressures us to accept that it can be worse for merely possible people never to exist. If this conclusion is correct, then the standard basis for giving no or less priority to merely possible persons would disappear (i.e., that things cannot be better or worse for them). Though defenders of Person-Affecting Views and their opponents may still disagree in theory, they could arrive at the same answers to many monumentally important practical questions.

People Aren’t Replaceable

According to commonly used global health metrics such as the Quality-Adjusted Life Year (QALY), saving an infant’s life seems to be no better than letting that infant die and bringing into existence another who will live for the same length of time. Yet we have a strong intuition that it is much better to save the infant—we believe that death is bad over and above the loss of healthy life years. I will consider both principles and empirical factors which might be driving that, and discuss what the implications might be for which global health interventions we should prioritize.

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.

Early Death and Later Suffering

In this chapter I sketch an account of the misfortune of death for which I have previously argued (the Time-Relative Interest Account) and defend it against objections advanced by John Broome in his contribution to this book. I then consider other objections and suggest the beginnings of responses to them. The general conclusion I draw is that issues about our continuing to exist cannot be separated from issues about our beginning to exist and that we therefore cannot fully understand certain issues raised by death without understanding certain deeply intractable issues in population ethics. I suggest, in particular, that a promising way forward is to accept a view about harming and benefiting that has its source in population ethics (either the familiar Asymmetry about procreation or, more plausibly in my view, a Weak Asymmetry) and to restrict the scope of the Time-Relative Interest Account so that it applies only to the conferral of what I call noncomparative benefits and not to the infliction of suffering or other intrinsic harms.

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.