1 But Then They Are Told Michael Gorman School of Philosophy The Catholic University of America Washington, D.C. 20064 gorman@cua.edu The argument I want to discuss appears at the very end of the passage, beginning with I would rather rest my defense. Rachels asks us to consider two situations. In what I shall call Decision Situation 1, a couple is deciding whether to have two children in the belief that if they have only one, it will die as a teenager (see below for details). In what I shall call Decision Situation 2, a couple with two children is deciding whether to have bone marrow transplanted from their younger to their older child. Let us say that Decision 1 is the decision in favor of having two children, and Decision 2 is the decision in favor of having the bone marrow transplanted. And finally let us call what Mr. and Mrs. Ayala decided to do, namely, have a second child in order to have some of its bone marrow transplanted to their first child, the Ayalas s decision. Rachels s argument, then, is this. (1) Decision 1 is permissible. (2) Decision 2 is permissible. (3) If Decision 1 and Decision 2 are permissible, then the Ayalas s decision is permissible. As it stands, the argument is valid. There are many things one could say about this. Two issues I will not discuss are the following. First, one might ask whether ethics is really about what is permissible. That seems like aiming at an ethical C- instead of at an ethical A+. Second, one might ask whether (2) is true, i.e., whether it is in fact permissible to take bone marrow from a minor child to benefit someone else. I want to focus on (1), and I want to make two points overall. First, (1) is neither true nor false but instead empty. Therefore (4), the conclusion, has no support. Second, improved versions of (1) result in the argument s being either unsound or circular.
2 To see why (1) is empty, let us look more closely at what Rachels says about Decision Situation 1. A couple is considering whether to have one child or two. They are leaning towards having just one. But then they are told that if they have only one child it will die when it is a teenager. However, if they have two, both will probably live full lives. Rachels asks, Would it be wrong for the couple to decide, for this reason, to have two children? The first response I want to give to Rachels s question is a flippant one. Would it be wrong for a couple to decide to have two children for the reason that they have been told that, if they do, both will probably live full lives but if they have only one it will die as a teenager? I m not sure whether it would be wrong, but it would be stupid. Why should they put any credence in this? Who has told them? Have they been visiting Greek oracles on their honeymoon? And on the face of it, this thing they have been told is extremely implausible. Do children without siblings have high teenage mortality? And what would happen if the imaginary couple had three children? Would the middle one murder the other two but then repent and go on to become a great humanitarian or perhaps just a perplexed trolley-driver? Now of course this is a flippant answer. They ve been told that p is just a way of saying It is the case that p and they know it, or something like that. But the point of my flippant remark is that what Rachels says they know cannot be all they know. There must be some further facts that are partly constitutive of Decision Situation 1, further facts in virtue of which having one child will result in its untimely demise while having two children will probably result in two full lives. And these further facts will be morally relevant. Rachels says it is easy enough to argue that Decision 1 is permissible, but in fact it is not so easy, because we do not know why having the second child will result in full lives for the two of them. Perhaps the reason is this: the younger child will be a medical prodigy and will discover a new treatment that will save her older sister, a treatment that, alas, involves using the brains of hundreds of children (street children from Brazil, let s say). Rachels would certainly not consider Decision 1 permissible in that case. So, as a preliminary result, we have to admit that we do not know whether Decision 1 is permissible or not, and the reason we do not is that we do not know enough about Decision Situation 1. To switch from epistemology to ontology, Decision Situation 1, as stated by Rachels, is not a situation at all. There could not be a situation like that. It would have to be the case that having two children would have the desirable outcome because the second child would have usable bone marrow or because the second child would be a medical genius or because the second child s own medical needs would cause her family to move away from the city in
3 which the first child would have been exposed to the conditions that caused her leukemia or whatever. Decision Situation 1, as stated, is an abstract situation, which is to say that it is not a situation but instead an abstraction from a situation. There is nothing wrong with abstracting from certain elements of a situation, of course, but to return now to epistemic considerations in this case too much has been abstracted to allow us to know whether Decision 1 is permissible or not. Philosophers are often blamed for dreaming up bizarre situations as thoughtexperiments. But there are different sorts of problematic thought-experiments, and thinking about them will help us get clearer on what is troubling about Rachels s argument. Sometimes a philosopher conjures up a situation that is impossible given the laws of nature that hold sway in this world; the objection then would be that impossible situations are not ethically relevant. Decision Situation 1 does not have this drawback, but notice something else. At least some impossible situations, despite their impossibility, are (or can be made to be) sufficiently determinate to count as situations. If someone says, Suppose that humans could fly by flapping their arms?, we understand more or less the situation to be imagined. But Decision Situation 1 is not sufficiently determinate to be a situation at all. It could not be the case that having two children would result in life for both, etc., without this being true in virtue of some other facts. Now, I just said that some of the situations that philosophers dream up can be made sufficiently determinate. Perhaps we can help Rachels out by making Decision Situation 1 more determinate. Suppose, for example, we say that two children are better than one because the second child will earn a lot of money as an actress, enabling her parents to buy medicine for the first one. Suppose, in other words, that that is what the deciding couple is told. The argument would then look like this: (1*) It is permissible to have two children in order to have the second one earn money to support the first one. (2) It is permissible to take bone marrow from a second child in order to save its older sibling. (3*) If it is permissible to have two children in order to have the second one earn money to support the first one, and if it is permissible to take bone marrow from a second child in order to save its older sibling, then the Ayalas s decision is permissible.
4 The argument is unsound because (3*) isn t true. When Decision Situation 1 is made concrete after the fashion of (1*), it is not sufficiently relevant to the Ayalas s decision to allow (3*) to be true. The new Decision Situation 1 is quite different from the Ayalas s actual decision situation. Using your child s earnings is not sufficiently like using your child s bone marrow for us to conclude that if the former is permissible, the second is also. So this suggests that we should make the revised Decision Situation 1 more relevant to the Ayalas s decision situation. (1**) It is permissible to have two children instead of one for fear that one of them might turn out to need a bone marrow transplant. (2) It is permissible to take bone marrow from a second child in order to save its older sibling. (3**) If it is permissible to have two children instead of one for fear that one of them might turn out to need a bone marrow transplant, and if it is permissible to take bone marrow from a second child in order to save its older sibling, then the Ayalas s decision is permissible. This new revision of Decision Situation 1 is closer to the Ayalas's decision situation, but it is not close enough. Having two children because one of them might be needed to help the other is not the same as having a child in order to make use of its bone marrow. It is not a case of bringing a particular child into existence in order to have it be a donor for someone else. It is not, in other words, a case of conceiving someone with such a startling instrumental intent. But because that intent is what makes the Ayalas s decision so disturbing, this attempted improvement of Rachels s argument fails for the reason the first one did, i.e., because the third premise is false. So let us revise Decision Situation 1 once more: (1***) It is permissible to have two children in order to take blood from the second one for the benefit of the first one. (2) It is permissible to take bone marrow from a second child in order to save its older sibling. (3***) If it is permissible to have two children in order to take blood from the second one for the benefit of the first one, and if it is permissible to take bone marrow from a second child in order to save its older sibling, then
5 the Ayalas s decision is permissible. (4) Therefore, the Ayalas s decision is permissible. At last the decision situation under consideration is close enough to the Ayalas s decision situation to be relevant. But now the argument has begun to look circular. How do we decide the truth or falsity of (1***)? (1***) is relevant to the conclusion, but its relevance consists in the fact that it is extremely similar to the Ayalas s actual decision situation; deciding its truth is no easier than, indeed is hardly different from, deciding the truth of (4) itself. The same point can be stated in terms of Rachels s stipulation that the two Decision Situations are independent. In (1*) and (1**), we made Decision Situation 1 concrete in a way that left it independent of Decision Situation 2; the having of two children remained independent of the intention to use one particular child as a donor for the other. These attempts left Rachels s conclusion unsupported. In (1***), we made Decision Situation 1 concrete in a way that allowed it to support Rachels s conclusion, but at the cost of making it no longer independent of Decision Situation 2; the having of two children was then linked to the intent to have the second serve as a donor for the first. But Rachels was quite right to specify that they are to be independent if they are not independent, then the argument becomes circular. In other words, Rachels s conclusion is supported by (1) - (3) only if these premises work together, but if they are made to work together, then the argument is circular. The Ayalas were obviously in a horrible situation. I have not tried to settle the question of whether what they did was permissible or not. I have only tried to point out that Rachels s argument does not work, because there is no way of getting around the fact that what the Ayalas did was to have a child in order to use it as a bone marrow donor. We cannot break up their action into two (allegedly) innocent actions and then conclude that the joint action composed of each of them is also innocent. In making their decision, the Ayalas linked the procreation of the new child with the bone marrow donation. What the Ayalas joined, Rachels may not put asunder. 1 1 In writing this paper, I have benefited from comments by Anne-Marie Gorman, Daniel Maher, and Eric Reitan.