Morality, Mortality: Rights, Duties, and Status, vol. 2.

Hartle, Ann

This is the second volume of a two volume study on ethical issues concerning death. Volume 2 is subtitled Death and Whom to Save from It. In this second volume, Kamm deals with rights, duties, and status, developing an account of when it is permissible to harm others, especially when it is permissible to kill others. There is, however, a third book that must be considered if we are to fully understand the import of Volume 2 of Morality, Mortality. This third book is entitled Creation and Abortion. (The "creation" in the title refers to the human generation of children, not to any divine act.) It was originally intended to be included in Morality, Mortality, but, on account of considerations of length, the material on abortion was published separately by Oxford University Press in 1992. Creation and Abortion was prompted by Kamm's attempt to understand and modify Judith Thomson's "A Defense of Abortion."

Volume 2 of Morality, Mortality is divided into three parts. Part 1 consists of five chapters on the question of the moral equivalence of killing and letting the, harming and not aiding. Part 2 consists of two chapters: chapter 6, entitled "The Trolley Problem," and chapter 7, entitled "Harming Some to Save Others." Part 3 is made up of five chapters examining the justification of restrictions on conduct, prerogatives not to make sacrifices, constraints on rights, the status of inviolability, supererogation and obligation.

The two chapters of Part 2 especially require attention, for this is where Kamm develops her "Principle of Permissible Harm." In chapter 6, she presents a detailed discussion of the Trolley Problem and other such dilemmas and the numerous variations on them to be found in the literature of applied ethics and analytic ethics. The Trolley Problem is the problem of what one ought to do in the situation where a trolley is headed toward five people, and the only way to divert it is to redirect it toward one person. On the basis of her discussion of such cases, Kamm goes on to argue, in chapter 7, for her "Principle of Permissible Harm."

The principle is: "It is permissible for greater good to produce lesser evil." The principle then accounts for various permissible and impermissible killings. It is intended to cover cases involving harm to morally innocent individuals who will not die soon and who are not threats or parts of threats (p. 172), and it is a sufficient condition for permissibility to kill. If the PPH is correct, it implies that one may "sometimes kill rather than let die" (p. 188).

Kamm's regards her approach to ethical theory as "non-consequentialist." This type of approach has two components which distinguish it from theories that judge the rightness of acts by the standard of the maximization of good consequences. Nonconsequentialism includes "permission not to maximize the overall best consequences... e.g. the option not to make large personal sacrifices to produce the best state of affairs" and "constraints on promoting the best consequences" (Creation and Abortion, p. 11).

Kamm's discussion of the permissibility of killing, especially killing the innocent (indeed the innocent person who is not even a threat to one's own life), is typical of philosophical attempts to justify abortion. On the whole, they share certain presuppositions about what human beings are and how they are related to each other. These presuppositions are reflected in their "methodology." Kamm describes three methodologies: (1) begin with a theory and apply it to all cases; (2) begin with a theory, but the theory may be altered in light of its implications in particular cases Judgments about cases are often not theory-driven); and (3) begin with responses to cases and derive principles. Kamm's methodology is close to the third: "We present hypothetical cases for consideration and seek judgments about what may and may not be done in them. The fact that these cases are hypothetical and often fantastic distinguishes this enterprise from straightforward applied ethics, in which the primary aim is to give definite answers to real-life dilemmas. Real-life cases often do not contain the relevant -- or solely the relevant -- characteristics to help in our search for principles? (p. 10). Why do we want or need to search for principles? We acquire a deeper understanding of our pre-theoretical judgments, our responses, by way of principles or theories that explain them (p. 12). Above all, the hypothetical and fantastic cases are meant to eliminate any emotion from our responses. That is, the truly relevant aspects of a case would not be aspects to which we should have emotional responses.

This begins to reveal Kamm's presuppositions about what human beings are. So, for example, in Creation and Abortion she writes: "With the increasing use of such technology as sonograms, people claim to `bond' to fetuses as they do to infants. Pregnant women thus are encouraged to think of themselves as already being mothers . . . even though technically only someone who has given birth is a mother .... Nor does the fact that the fetus in some physical respects resembles a human person mean that it has capacities for consciousness, for example, that may be necessary to be deemed a person. It is ironic that if a fetus developed from the brain outward, so that the mental capacities most likely to qualify it for personhood were present even when a sonogram did not yet show any physical likeness to a baby, there would probably be less bonding to it" (p. 5). The scientific, species-neutral term "fetus" is, of course, used scrupulously to refer to the merely "potential" human life in the womb.

Fantastic cases (such as Thomson's violinist, as well as the trolley, transplant, and survival lottery cases) assume that the fundamental relation of human beings to each other is always competitive. Moreover, fantastic cases are necessary if one's aim is to arrive at principles or theories that explain, that is, justify, the pre-theoretical judgment that one ought to be permitted to kill the admittedly innocent and nonthreatening unborn child.