‘The Right to Death’

To the Editors:

In his January 31 commentary on the Cruzan case, Ronald Dworkin has trouble finding the meaning of our “sense that life is sacred.” He rightly points out that it cannot mean that the population should be increased—though he notes that to think great art valuable implies that more of it should be produced. But his second proffered interpretation of our sense of life’s sacredness, that we wish existing lives to go well, simply ignores the feeling he is trying to explain. We share two distinct intuitions, that life has sanctity and that it should be of high quality. We think our neighbors should not be killed and that they should be happy while alive. Neither feeling can be reduced to the other. Indeed, they may well come into conflict.

Our sense of sacredness or sanctity is in fact quite different from any feeling of value, as can be seen clearly by returning to Dworkin’s art example. Even art of low value may have sanctity. A friend who teaches the history of art tells me of a case in point. During the sale of a large piece of land, buyer and seller quarreled over who should pay the enormous costs of removing certain unsalable monumental sculptures which neither party wanted or valued. Clearly the simplest and cheapest solution would have been to destroy the sculptures and cart away the pieces. But “the sanctity of art” made this impossible. At the same time, the low value of the works of art justified doing little or nothing to preserve them from gradual destruction by the weather—and certainly neither buyer nor seller would have spent a cent to produce more of them.

The primary attribute of sacred things is that they may not be violated, not that they must be produced or preserved. But when someone (such as Nancy Cruzan) is wholly dependent on others, it is quite difficult to sort out and separate these two intuitions. The sanctity of her life requires that she not be destroyed, but the low value of her existence seems to justify not preserving it. Although we shrink from injecting her with poison, we think it possibly permissible to accomplish the same goal by depriving her of minimum necessities like food and water.

Dworkin is too casual in dismissing the secular claims of a sanctity which he has not fully understood. It is important that the often low quality or value of life not be allowed to eliminate our sense of sanctity. Sanctity is that which makes us treat others as givens, that which makes the human community a presupposition rather than the object of our evaluations, that which excludes the intentional elimination of people as part of the solution to the problems we face together.

The demand for a universal high “quality of life” masks a monstrous choice unless it is accompanied by the recognition of life’s sanctity. For there are two ways to ensure that everyone living has a high quality of life: raise the quality of all lives or eliminate those of low quality. Without the sanctity of life to exclude the less arduous second alternative, any increase in the urgency or degree of the quality of life demanded may lead to mass killing. Achieving top quality life may be felt too expensive, drawn-out, and problematic a process, and death may be found preferable. Without sanctity, we are all likely to be aided only when and to the extent that aid is cheaper than poison. Whether our “defects” are physical or mental, economic or educational, only sanctity can ensure that others see these lacks as reasons to help us rather than to destroy us.

Richard Stith
Professor of Law
Valparaiso University School of Law
Valparaiso, Indiana

Ronald Dworkin replies:

Professor Stith is worried that if society does not recognize the importance of the mere existence of life, as distinct from its quality, then it might be tempted to the “mass killing” of people whose lives are poor in order to insure “that everyone living has a high quality of life.” But of course my suggested interpretation of the sanctity of life—that once each life begins it is important that it not be wasted—would condemn, not license, any such mass killing. Stith has confused the aim of that principle, which emphasizes the independent importance of each separate person’s life, with the very different goal of one form of utilitarianism: that the quality of life be as high on average as possible. The latter goal might well be served by culling out those who are handicapped in various ways, but the sanctity principle, as I described it, would obviously be outraged by any such program.

Stith’s own instincts show the importance, moreover, of rejecting his suggestion that we should define sanctity so as to exclude any consideration of life’s quality. He says, at the end of his letter, that only sanctity can ensure that the handicapped are helped rather than destroyed. But if we adopted his view—that sanctity requires only that we do not kill, and has nothing to do with preserving or protecting—then though respect for the lives of handicapped people would require us not to kill them, it would give us no reason to help them at all. On the contrary, it would permit us to treat them like the bad statues of low value in Stith’s story: allowing them to decay and suffer, the victims of gradual destruction.

He says I do not understand the secular value of sanctity: it just means, he says, that it is wrong to kill people. But that is too crude: the idea of sanctity is meant to offer a special kind of reason why killing people is wrong, and any philosophical analysis of the idea must try to identify that special reason. Theological accounts find the reason in God’s will. Secular accounts must find some other reason by identifying a distinct value in life itself. This cannot be found, however, just in the idea that the existence of life is valuable in itself, because it would follow from the explanation that it is desirable to produce as much life as we can. I suggest that the explanation lies rather in an idea that guides our behavior generally and not just in life-or-death decisions: that once life has begun it should go well and not be wasted.

Stith’s letter itself illustrates why it is unsatisfactory just to insist that killing is always wrong with no account of why. He agrees with me that sanctity provided no reason why Nancy Cruzan should have been kept alive, though since he separates sanctity from concern so sharply, his explanation appeals to the “low quality” of her life rather than to concern for her past wishes and her best interests. But he suggests that the principle of sanctity nevertheless forbade injecting her with poison even if that would have been a more humane and dignified method of arranging for her death than terminating feeding and hydration. Why? Why does respect for life require that her life end in a way worse for her? If we say simply that that is what sanctity means—if we do not even try to explain why we must inflict that kind of harm on helpless people—we turn a principle of humanity into something that seems mechanical, pointless, and even cruel.