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Views & Reviews Between the Lines

Metaphysics and murder

BMJ 2012; 344 doi: (Published 21 May 2012) Cite this as: BMJ 2012;344:e3531
  1. Theodore Dalrymple, writer and retired doctor

Metaphysics, said the philosopher F H Bradley, is the finding of bad reasons for what we believe upon instinct. Nowadays, however, it seems more to be the finding of bad reasons for what we disbelieve on instinct.

In my youth I used to read metaphysics with an excitement that now seems to me strange and that I cannot recapture. Nevertheless, I have returned a little to philosophy, reading it in a desultory fashion according to what books I find in charity or second hand bookshops. Recently, for example, I found Peter Singer’s The Expanding Circle: Ethics and Sociobiology, published in 1981.

Singer is an Australian philosopher (whose mother was a doctor) who sprang to fame with his book Animal Liberation (1975), a powerful polemic that drew attention, among other things, to the cruelty entailed in the mass production of meat. He went on to pronounce controversial views about abortion and, in particular, infanticide, and euthanasia. The criterion of whether it is permissible to end a person’s life should not be whether he was alive, but whether he exhibited the attributes of so called personhood; that is to say, rationality, autonomy, and self consciousness. This would seem to make it permissible to kill people while they sleep; however, I am no philosopher.

In The Expanding Circle, Singer expounds a view of ethics that would undermine or destroy most medical practice, at least in a relatively rich country such as Britain. Ethical thought, he says in this book, has—since the dawn of thought—expanded the locus of its concern, rather like the ripples in a bowl of water that, from a central disturbance, eventually affect the whole surface of the liquid. At one time we believed that only our group—whether it be our family, our tribe, our village, our town, our country, our coreligionists, our race, our class, or our species—was the proper object of our ethical concern and behaviour, and only its good should concern us in our ethical decision making.

But, says Singer repeatedly, ethical thinking (and conduct) requires that we now include all sentient beings in our concern, and that the interests of no one, including ourselves, should count for more than the interests of any other sentient being merely by virtue of proximity to us. It is our duty to maximise the fulfilment of as many interests as possible; thus if I have the choice between contributing to famine relief or buying an antiquarian book, I should do the former, for the interests of the starving count more than my interest in possession of said book.

To some people, this view might seem humane and generous of spirit, but actually it would sanction (if, impossibly, it were put into practice) the greatest cruelty, and destroy civilisation and all hope of progress into the bargain. A surgeon who saved someone’s life with a technically complex and costly technique would not be a hero but a villain (and let us remember that routine medical care in a country such as Britain is costly by comparison with what is available in much of the world). The surgeon could not defend himself by saying that he relieved suffering where he found it, namely in the vicinity of his hospital; he should have been using his skill, and the resources, to relieve a much greater amount of suffering elsewhere. Far from being a saviour, he is in fact a murderer.


Cite this as: BMJ 2012;344:e3531

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