Open Forum
by Richard T. Hull
1982b "Open Forum," The Spectrum, October 25, p. 5.

Ed was deeply bothered by his friend's death-not so much by the fact of it, for he had become resigned to its eventuality some time ago, when his friend slipped into a coma, but rather by something his friend's parents had done. For, they had told the doctors that they wanted the chemotherapy and other treatments stopped and wanted no "heroic" measures performed in case their son stopped breathing or had some other crisis. To Ed it almost seemed that they had wanted their son to die, wanted to shorten rather than prolong the time they had left together. Sometimes Ed feels that his friend was killed by his parents.
     Sally nearly choked on the lump in her throat as she fought back the tears. Her neat, offbeat mother had been riding in a motocross race and had and an accident. Sally and her mother had just learned that her paralysis from the neck down was permanent. But what had shocked Sally was not just this news, but her mother's attitude. Dependent on an indwelling catheter for her continued existence, her mother had told the medical team that she wanted it out-that she wanted to die. Her mother had always been a fighter, a person with an incredible zest for life. Now she wants to die-almost as though she were pointing a gun at her head and squeezing the trigger. Sally had never opposed her mother's decisions before, but she steeled herself for the coming discussions with the medical team who had turned to Sally for the decision, as she had been giving the consent for her mother's treatment since she was hospitalized.
     Ed and Sally have confronted situations involving a growing number of Americans. Our medical technology has progressed to the point where much can be done to forestall death and prolong life in situations which, 20 years ago, would have resulted in a relatively quick death. But that same technology has not evolved to the point where it can assure a severely ill or injured person restoration to normalcy; often such patients are left with lives of constant pain, loss of important functions, and dependency on others. Such patients, their families and friends, and those that apply that technology, live in a generation in which technology creates moral dilemmas that it cannot yet resolve. This generation is thus forced to struggle with hard questions which past generations did not confront. One major question is that of passive euthanasia-the deliberate withholding or removal of life-prolonging measures knowing that a swift death will be the result.
     A further complication is involved in both Ed's and Sally's cases. The decision was made to discontinue chemotherapy and to withhold heroic measures in the case of Ed's friend without the latter's knowledge or explicit consent. Ed does not know whether his friend would have consented to or refused withholding of aggressive treatment and resuscitative measures had he been capable of considering the issue. In this respect the euthanasia was nonvoluntary. Sally's mother, on the other hand, did expressly request the cessation of life-sustaining treatment; euthanasia in her case would be voluntary, if it were allowed.
     The relevance of the voluntary/nonvoluntary distinction depends on another, prior question; whether it is permissible, either in oneself or another, to opt for an end to a life which one judges no longer worth living for that person. And this, in turn, may be seen as centering on the question whether one's life is one's property, to be disposed of in accordance with one's expressed (Sally's mother) or surmised (Ed's friend) wishes.
     According to certain theories of property, something is one's property when one's own labor is "mixed" with nature so as to modify some portion of it. On this criterion, an adult's life is his or her property to the extend that life represents the results of personal effort-as in education, training, working to realize some goal, etc. However, bare biological life is the result of the efforts of one's parents in procreation, and care and nurture of the resulting infant. And even education and training are often undertaken with public support in the form of scholarships, subsidization of part of one's educational costs, facilities built with tax dollars, etc. One presumably acquires "ownership" of one's life as one takes and exercises increasing responsibility for it and its development, but one lacks a "clear title" to the extent that one's life is the product of other's efforts of investment which has not been repaid.

     Another type of property theory, however, rejects and ownership view of the relationship between the individual and his or her property, holding that one's property is what one is entrusted with by another, usually some divine personage or the state. Such a relationship is called a fiduciary one. This view will emphasize responsibility and accountability rather than liberty with respect to what happens to one's property. On this criterion, an adult's life may be his or her property, but that person is not thereby entitled to do with it as he or she sees fit. Rather, that life is to be managed according to the wishes of the primary owner, God or the state, who has sovereignty over it.
     So, if one's life is one's property according to the first account, the question in the case of Sally's mother is decided; her life is hers to do with as she sees fit, without accounting to anyone else for her decisions. And the issue concerning Ed's friend is solely whether his parents were properly treated as his proxies, empowered by him to decide on his behalf.
     On the other hand, if one's life is one's property in the fiduciary sense, then both cases need to be supplemented by something else-namely, an account of the wishes of the property owner-God, or the state or society. Depending on the outcome of that inquiry, the decisions will be right or wrong as they accord with or run counter to the wishes of God, the state, or one's social responsibilities.
     Ed's feelings about his friend's parents would thus be appropriate only if the second account of property were correct and the wishes of God or the state had been violated, or if Ed's friend had social responsibilities which would go unfulfilled as the result of an early death, or, the first account of property were correct but the parents hadn't had their son's proxy to decide on his behalf. And Sally would similarly be justified in not siding with her mother's wishes only if the first account of property were correct but her mother had not acquired full ownership of herself from her parents or others who had contributed to her development in uncompensated-for ways, or the second account of property were correct and God's or the state's wishes were for her to live or she had overriding social responsibilities.
     We do not, as a society, have a commonly held theory of property which would apply to lives as to cars, houses, and other objects. Nonetheless, there are some indications that one view is being preferred or furthered rather more than the other at the present time.
     On the first account, the life of young child is his or her parent's property in a sense that implies their ownership (as Bill Cosby's father said, "I brought him into this world, I can take him out!"). It would seem to follow that their wishes are final as to whether that child shall live or not. Something like this view had considerable acceptance for a number of years in the context of deciding whether newborns with multiple defects would be treated or allowed to die. But a recent Federal order has gone out to all hospitals enjoying the benefit of any Federal funds to desist from neonatal passive euthanasia on parental authorization or face loss of those funds. And, both parents and physicians participating in such decisions have come under fire recently, being charged with murder and attempted murder by district attorneys responding to the values of pro-life groups. And, a New Jersey court ordered a transfusion for a Jehovah's Witness mother of a small child on the grounds that her voluntary death would constitute child abandonment, which was impermissible given her social responsibilities. Actions and cases such as these reflect a trend in the courts and the current administration to incline towards the fiduciary view of property in its application to human life.
     The question, "Whose life is it anyway?", is thus being answered increasingly in a manner that denies the self-ownership view. Increasingly the autonomy of the individual and of parents over their children is being replaced by stat-directed decisions. Whether we are prepared to surrender self-ownership as the price to be paid for seeking to control and limit individual and parental choices is a neglected but central dimension of the current debates over such federal regulations, the [proposed] Human Life Amendment, and similar restrictions of the freedom of the individual citizen and the autonomy of the family-a question that, if not squarely faced and debated, is likely to be decided by default.


Richard T. Hull is of the Departments of Philosophy and Medicine.