Wednesday, August 02, 2017

Death vs. Never Having Been Born

by Sherry F. Colb

Charlie Gard died last week. In my latest Verdict column I discuss his tragic life and the legal battle the ending of it occasioned. Charlie's parents disagreed with the boy's doctors because the former wanted to keep him alive to try an experimental treatment but the latter (the doctors) wanted to disconnect the boy from life support and give him a dignified death. In my column, I discuss what I regard as an optimal way to approach parental decision-making regarding a child's treatment, given that parents are generally the most likely people to have their child's best interests in mind.

In this post, I want to consider a different issue that emerges from Charlie's case. It is the "death versus never having been born" issue. Charlie was born with a genetic disease. His illness, mitochondrial DNA depletion syndrome, is a horrible disease that is incurable and typically kills children in infancy or early childhood. Assuming that Charlie's parents were unaware that he had this condition prior to his birth, it is possible that if his parents had known ahead of time, they may well have chosen to terminate the pregnancy. Doing so would have spared Charlie (or, more accurately, the child who would have been Charlie) the pointless suffering that he ended up experiencing.

Once he was alive, however, the calculus changed. Charlie's parents wanted to get Charlie treated for his condition in the hope that it might help a little, even if it offered no hope of a cure. They did not want him to die, even though they (by our hypothesis) might have prevented him from being born. Why the difference?

For some thinkers, there may be no difference between the two. Some consequentialists would say that the relevant question is what is the sum total of happiness and pleasure minus suffering in the world. If the existence of a particular child subtracts from the sum total of happiness, then it makes as much sense to terminate the child's existence as it does to prevent the child from coming into existence in the first place. Indeed, once the child is here having a life with more suffering than pleasure, it seems especially appropriate to terminate his existence and, if one is a strict utilitarian, subsequently to replace him with another child whose existence is filled with greater joy than sorrow.

But many of us would feel very differently about the two situations. Once a child is here in the world, we find ourselves more reluctant to end his life--even if he is suffering greatly--than we would have been to prevent his coming into the world at all. Once he is here, he has interests that might include an interest in continuing to live, by contrast to the nonexistent potential child who has no interest in coming into existence. We do not feel a sense of loss at all of the happy babies who never came into existence because their potential parents used birth control or failed to have sex. But we do, rightly, I think, feel a sense of loss when a child like Charlie Gard is ultimately allowed to die because he had no hope of getting better and might have been suffering. It makes sense, then, for the parents of a child who would, all things considered, have been better off never having been born, to make efforts to keep him alive and somewhat more comfortable so that they can be with him and he can be with them. Once he is alive, he has relationships with people and perhaps a will to live, and those developments ought to change the calculus going into a decision about whether he should be allowed to die.

This contrast--between dying and never having been born--is an important component of animal rights advocacy. People who defend the consumption of animal products sometimes say that if vegans had our way, then there would be no demand for animal products and farmers would no longer bring cows, chickens, pigs, and other farmed animals into existence. Yet once these animals are alive, vegans argue that we have no right to slaughter them. Defenders of animal consumption cite this as a contradiction: on the one hand, we aim to prevent the animals from coming into existence at all; on the other hand, once they are here, we argue for their right to live. Is that inconsistent? For some of the same reasons that I would distinguish between preventing the birth of a terminally ill child and ending the life of a born terminally ill child, I would distinguish between preventing the birth of farmed animals and killing those same animals. No potential being has an interest in coming into existence in the first place--potential cows, chickens, and fishes do not suffer a harm for never having existed. And the ecological space left open when animal farming stops would in fact allow for many wild species to multiply and flourish. Yet once an animal exists, he or she has an interest in living and in being free of our violence.

An analogy I have given to illustrate the point is that we prohibit the crime of rape. Yet if a woman is raped and becomes pregnant and has her baby, we welcome that baby into the human community. We do not have the right to kill that baby or otherwise harm him. And this is true even though our laws mandated behavior that would have prevented him from coming into existence in the first place. To never exist is to never have had interests or rights and thus to have lost nothing (even if people who would have benefited from the existence of this individual have lost something). We owe the non-existent nothing. But once someone exists, even if they never should have existed (if our conduct had conformed to norms of nonviolence), they have interests and rights that must be respected. Wanting a world in which children of rape are never conceived in the first place in no way diminishes the rights of such children who do come into existence. And the same is true for vegans wanting a world in which farmers no longer bring animals into existence for the purpose of exploiting and then slaughtering them at an early age. So long as such animals do exist, we will object to their use and to their killing and urge people to become vegan to reduce demand for that violence.


Joe said...

"Born" is apt because this can also be applied in various cases to abortion, particularly if we use the line there set forth in the Colb/Dorf book. That is, abortion before sentience.

It is sometimes said that we are not truly honoring the dignity of let's say the disabled if a woman aborts after finding a fetus has a severe disability, to the extent that we get emotional appeals regarding the born disabled existing. But, a woman having the right to abort doesn't mean we do not respect the dignity of (whomever). After all, it doesn't dishonor their dignity if a couple decides to not have children at all, perhaps the male having a vasectomy, if wife is statistically likely to have children with some serious condition.

I wonder if some do think we have duties to those not existing. I guess the closest thing is that we have a duty to those that are likely to come, such as not abusing the earth so that those who come after us will have it. This is a duty of sorts to those who will but are not currently existing.

JC said...

Interesting post, and I agree with/ like/ accept the analogy to animal rights. I wonder about this counter to your argument about potential beings not having an interest in coming into existence, whether babies or animals.

What if we set to one side the absolute non-existence of potential beings to the extent of offering them one choice: they can choose either to never exist or to exist for some time, experiencing pain and death. I think an argument could be made that many would choose existence despite the pain. This would be to dispute the "consequentialist" hypothesis in your post that a being can be a "net negative," i.e., that its pain can outweigh its pleasure so as to net "negative existence points."

Simply to be - to live, to think, to receive sensory inputs, may be such a net positive that it cannot be outweighed by the negatives of pain. Perhaps this is too rosy an outlook on life, naive optimism from someone who cannot imagine what Charlie went through. But I think, if I am given the (admittedly difficult) choice of having Charlie's life or never existing at all, I would choose the former. And perhaps I'd choose to be a tortured and killed cow over nothing at all. (again, very tough question). But I think this is the question you analysis needs to answer - not whether potential beings have interests.

None of this is to say I think the way we treat animals is ok. It is just a question I have mulled over for some time. Wouldn't I always choose some life for myself over none at all?

Joe said...

The hypo speaks of "choose" but that requires existence. Changes the equation.

I don't think everyone would choose to exist, some have actually said they rather not have been born, but again if we exist, we are sort of biased.

Various factors should be taken into consideration when considering whether to bring new life into the world. This would include the likely enjoyment life will bring to them. This would help determine if it would be a good thing. No one thing would factor in there. So, e.g., minimal enjoyment of cows that requires human to be cruel to them while harming the environment etc. is on balance a bad cost/benefit ratio.

Shag from Brookline said...

If "to be or not to be" is the question regarding those not in existence, then who is to answer? Can government answer, e.g., in some variation of China's "one-child" policy? [I don't buy into the animal analogy.}

Shag from Brookline said...

Here's an article titled: "Want to fight climate change? Have fewer children" at:

I think at least one late night comic has riffed on this subject.

And climate change is also impacted by animals and their methane production. Survival is getting more and more complex. Resolving the issues raised by this post is thus complex.