Monday, June 10, 2013

The Ethics of Dying

Are there "better" and "worse" ways to die? If so, how would Aristotle go about approaching the subject? Let's start with a few distinctions. More often than not the "ethics of dying" is understood in terms of how "survivors treat the dying" rather than how the "dying treat survivors." Although, both are relevant subjects of moral analysis, I'd like to focus primarily on the latter. But first, let's distinguish between how we individually and collectively "face death" (as a matter of fact) and how we ought to "face death." For example, we know that as a matter of fact, we all go through well-known stages when we internally deal with the "process of dying." That's certainly important to know, and it may have some bearing on how we behave in our final days. But that's not what I want to write about right now. So how would Aristotle look at the "ethics of dying?"

First of all, it's a fact that all human beings, at all times, and all places have always asked the same basic existential questions: What am I? Where did I come from? And, where am I going? The answer to that last question, "where am I going?" has been obvious for a long time. All living things die, therefore, so do humans! Aristotle and I would argue that ethics is (for the most part) about how our behavior effects others, and therefore there are both social virtues and social vices associated with how our behavior effects those who will remain alive after we're gone. Hence, there are "better" and "worse" ways to die. And of course, Aristotle argued that "good persons" serve as role models for virtuous behavior for survivors. Thus, when we die we are essentially teaching our survivors how to die.  

For Aristotle, virtue is bound by context: person, time, place, and degree. The ethics of dying, therefore, would be contingent upon details: Person: Who is dying? (personal variables such as age, degrees of moral and/or intellectual virtue). Time: When am I dying? (If there is a choice of when to die, is it better to die "sooner" or "later," at one time rather than another?) Place: Where am I dying? (If there is a choice of where to die? Are there better or worse places: in a hospital, at home, in the wilderness?) Degree: "what is the probability that I will, in fact, die? (Is death more-likely or less-likely to occur?) So how would Aristotle go about unpacking some of this stuff?

Aristotle taught that the end (or purpose) of life is happiness predicated over an entire life-time. Therefore, the question of whether or not we "have led a good life" can only be answered by those who remain alive after we're gone. Although Aristotle never really said so (to my knowledge) it follows that "how we die" is very important in terms of our personal moral legacy. Some virtues associated with dying are pretty straight-forward. Probably the central virtue associated with dying is how we deal with the emotion of fear. Hence, a couageous death is virtuous and a death marked by the vices of either cowardice (vice of deficiency) or foolhardiness (vice of excess) are not. In short, a "good person" aims midway between fearing death too much and not fearing it enough. Now moral virtue, according to Aristotle is achieved by deliberately establishing habitually virtuous behavioral patterns. Given that we only die once, we are naturally deprived of practicing that habit, therefore, we must cultivate the virtue of courage in other ways; often seeing how others die.

If Aristotle was around today, he would probably conclude that in the United States our collective "culture of death" is dominated by cowardice and spendthriftiness. Death is usually regarded as the worse thing that any person can undergo and therefore we do anything and everything we can to prolong life for ourselves and for others. That's why most Americans die in hospitals and nursing homes attended by and army of physicians, nurses, and others that "fight" to keep us alive as long as possible. In fact, most of our health care dollars are expended during the last six months of our lives. Thus the virtues and vices  associated with spending are also relevant; that is the virtue of moderation and the vices of spendthriftiness (vice of excess) and tightwadness (vice of deficiency).

If we look at how today's role models shape our culture of dying, what do we see? When we die, most of our role models will die under the influence of mind-numbing drugs designed to "artificially" ease their culturally induced fear of pain and dying. And after they die, their loved ones will expend extraordinary sums of money on funerals, embalming, and caskets. And the more money their survivors spend on that casket and funeral home the better. Unless I'm wrong...I think Aristotle would say that death as experienced in the U.S.models primarily cowardice and spendthriftiness.

So what can "good role models" do to alter our fear-mongered, spendthrift "culture of death?" Well, for a starter...a virtuous death does not necessitate that we welcome death with open arms, and/or hasten our own death via suicide of euthanasia. But it does require that we be mindful of how our dying behavior is effecting survivors and what kind of behavior we are modelling for the future. On the other hand, speaking as a libertarian, I would also point out that if you are wealthy (or poor) and choose to spend the remainder of your life savings fighting off an immanent death, you certainly have that right. It's your money! In fact, in some contexts it might be the best thing you can do with it. If you have a lot of money saved up, but have no friends or family, why not use it to pay the salaries of physicians, nurses, and funeral directors? But under most circumstances, it's neither courageous nor is it a very productive way to spend your last few dollars.

In conclusion, at a bare minimum Aristotle and I would almost certainly argue that we all must be mindful of how we live out those final days on earth, and remember that we are teaching the next generation how to die through our actions.