Advance Directives
Buchanan and the Slavery Argument
Case: Marlise Muñoz
In November, Marlise Muñoz collapsed from a
blood clot. She was 14 weeks pregnant at the
time.
Shortly after being brought to the
hospital, Marlise was declared brain dead.
(Hat tip to Gabriela.)
Case: Marlise Muñoz
Her husband told medical staff that Marlise
would not want to be kept on life support.
But according to the Texas Advance
Directives Act, “a person may not
withdraw or withhold life-sustaining
treatment” from a pregnant patient.
Case: Marlise Muñoz
The hospital refused to take Marlise off life
support. Did they make the right decision?
Case: Marlise Muñoz
The hospital refused to take Marlise off life
support. Did they make the right decision?
The fetus had a deformed lower half,
hydrocephalus, and possibly a heart
problem.
Case: Marlise Muñoz
The hospital refused to take Marlise off life
support. Did they make the right decision?
The fetus had a deformed lower half,
hydrocephalus, and possibly a heart
problem.
Does the health-status of the fetus matter to
you? Why or why not?
Case: Marlise Muñoz
The author of the Texas statute in question
opined that the law did not apply to dead
patients.
A judge agreed that the law did not
apply and ordered that the life support
be discontinued.
Reasons for Advance Directives
Buchanan cites three reasons for valuing
advance directives.
Reduce needless suffering.
Allow self-determination.
Allow / promote altruism.
Three Asymmetries
Buchanan cites three differences between
contemporaneous choice and advance directive.
New knowledge?
Best judge?
Absent safeguards?
Three Asymmetries
Buchanan cites three differences between
contemporaneous choice and advance directive.
New knowledge?
Best judge?
Absent safeguards?
Persons, Identity, Slavery
What criteria should we use for deciding when
something is a person?
1. Possesses consciousness
2. Has preferences
3. Has conscious desires
4. Has feelings
5. Experiences pleasure and pain
6. Has thoughts
7. Is self-conscious
8. Is rational
9. Has a sense of time
10. Has self-memories
11. Imagines a future for itself
12. Has non-momentary desires
13. Deliberates
14. Is a moral agent
15. Changes traits systematically
16. Social
17. Communicative
Persons, Identity, Slavery
Necessary and sufficient conditions:
A condition, e.g. having preferences, is
necessary if being a person guarantees
that one has the condition.
A condition is sufficient if having the
condition guarantees that one is a
person.
Persons, Identity, Slavery
One might think that various conditions are
necessary for personhood.
In addition, one might think that
various conditions are necessary for
personal identity to hold.
Persons, Identity, Slavery
Two problems of personal identity:
If x is a person at time t1 and y is a person
at time t2, then under what circumstances
is x the same person as y?
If x is a person at time t1 and y is a thing
that exists at time t2, then under what
circumstances is x identical to y?
Persons, Identity, Slavery
Two problems of personal identity:
If x is a person at time t1 and y is a person
at time t2, then under what circumstances
is x the same person as y?
If x is a person at time t1 and y is a thing
that exists at time t2, then under what
circumstances is x identical to y?
Persons, Identity, Slavery
Psychological continuity is a necessary condition
for personal identity. Without psychological
continuity, two persons cannot be identical.
What is psychological continuity and why
think that the minimal proposal here is
correct?
Persons, Identity, Slavery
A Thought Experiment
Jonathan
Joseph
Persons, Identity, Slavery
A Thought Experiment
Persons, Identity, Slavery
A Thought Experiment
Persons, Identity, Slavery
A Thought Experiment
Jonathan ?
Joseph ?
The Slavery Argument
SA1. Applying the advance directive of Person A to
Person B is immoral unless A = B.
SA2. If A’s advance directive is applied, it is applied to B.
SA3. In some cases, Person A issues a directive and then
suffers serious trauma such that B  A.
SAC. In some cases, applying an advance directive is
immoral.
The Slavery Argument
SA1. Applying the advance directive of Person A to
Person B is immoral unless A = B.
SA2. If A’s advance directive is applied, it is applied to B.
SA3. In some cases, Person A issues a directive and then
suffers serious trauma such that B  A.
SAC. In some cases, applying an advance directive is
immoral.
The Slavery Argument
SA1. Applying the advance directive of Person A to
Person B is immoral unless A = B.
SA2. If A’s advance directive is applied, it is applied to B.
SA3. In some cases, Person A issues a directive and then
suffers serious trauma such that B  A.
SAC. In some cases, applying an advance directive is
immoral.
The Slavery Argument
Psychological
Discontinuity
Advance
Directive
New Person
Created
Setting the Bar
If the bar for personal identity is set high, then
we will have many cases where the Slavery
Argument applies in practice.
If the bar for personal identity is set low, then
we will have few (if any) cases where the Slavery
Argument applies in practice.
Setting the Bar
Two arguments for a high bar:
The Russian Nobleman
The Nobel Laureate
The Russian Nobleman Argument
Once upon a time, there was a young socialist
who was the son of a Russian nobleman. The
socialist knew that he would one day inherit his
father’s great wealth. So, the young man made
his wife promise that she would make sure that
he give the estate away. Later in life, he inherits
his father’s great wealth. He tells his wife that he
wants to keep the money and that he releases
her from her promise.
The Russian Nobleman Argument
SRN1. The wife cannot be released from her promise by
her husband after he inherits his father’s estate.
SRN2. If SRN1, then the rich inheritor is a different
person than the young socialist.
SRNC. The rich inheritor is a different person than the
young socialist.
The Russian Nobleman Argument
PRN1. The wife cannot be released by her postinheritance husband from her promise to her preinheritance husband.
PRN2. Person X can release person Y from a promise to
person Z if and only if X is the same person as Z.
PRNC. The wife’s post-inheritance husband is not the
same person as the wife’s pre-inheritance husband.
The Nobel Laureate Argument
Once upon a time, there was a rowdy youth who
attacked and injured a police officer. Many years
later, a saintly old man having the same body
and brain as the rowdy youth was awarded the
Nobel Peace Prize for his good works.
The Nobel Laureate Argument
NL1. The saintly old man should not be punished for the
crime of the rowdy youth.
NL2. If X is the same person as Y, then X should be
punished for all and only the crimes committed by Y.
NLC. The saintly old man is not the same person as the
rowdy youth.
Next Time
We will see what if anything neuroscience has to
tell us about personhood.