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Down the Slippery Slope: Arguing in Applied Ethics

This is a book about a form of argument that occurs in many areas of practical concern. Whether the issue be euthanasia, the use of tactical nuclear weapons, providing a tax exemption for some group of persons, or experimenting on fetal tissue, someone is sure to raise an objection of the form: But if we allow this, then how will we prevent that? And since that is presumed to be something we do not wish to allow, the objection is taken to show that we should not allow this either. The argument gets labeled by an amazing assortment of metaphors-thin edge of the wedge, allowing the camel's nose into the tent, the domino theory, the tip of the iceberg, the primrose path-but the most common metaphor is that of the slippery slope. Here the picture is of the person at the top of the slope, who once committed to the first step, inevitably finds herself at the awful) bottom.

In biomedical ethics recently the argument has acquired a rather shady reputation. Philosophers interested in making exceptions to the traditional doctrine of the sanctity of life, such as Rachels, Singer, and Tooley, have argued that the slippery slope objection does not provide good reasons against, say, allowing voluntary euthanasia. David Lamb is concerned to show that the argument has more force than usually allowed.

As a number of authors have pointed out, it is not one argument but several. One must distinguish, for example, between the psychological and logical forms of the argument. The former claims that if some exception is made to a traditional rule then as a matter of fact there will be a tendency or likelihood that unwanted exceptions will follow. The logical form of the argument says nothing about what is likely to happen but about the grounds available to deny further exceptions. It claims that if we allow this, then we have no principled or rational or reasonable grounds for not allowing that.

Lamb's main theoretical contribution is to give a new interpretation of the logical form of the argument It is not, he argues, that in many cases one cannot point to a plausible basis on which to distinguish the wanted from the unwanted exception-as many have pointed out, there is all the difference in the world between a case of requested euthanasia and a case of forced euthanasia-but that once one moves from an absolute prohibition against, say, all killing to exceptions based on concepts such as "voluntariness," "terminal illness," or "intractable pain" there is much more indeterminacy in the modes of reasoning employed. Bad results are likely, independently of people's motives, because in replacing an absolute rule one moves from determinate

concepts and descriptions to loose concepts and "definitions and determinations [that] are inherently arbitrary" (7).

Lamb attempts to illustrate this theoretical point with reference to the arguments for euthanasia. One of his objections to moving from a sanctity-of-life ethic to a quality-of-life ethic is that quality of life concepts fall into that category of undetermined concepts which are even less likely to provide an unequivocal guide for our action" (42).

When one combines this with the asymmetry between the two mistakes of killing someone who would be better off alive, and not killing someone who would be better off dead (one is dead forever but one is condemned to life for only a finite time), Lamb believes the slippery slope argument supports no departure from a principle that forbids killing patients.

There are a number of difficulties with his arguments. First, there is no reason to suppose that absolute prohibitions only involve determinate as opposed to indeterminate concepts. The absolute principle, relative to the issue of euthanasia, is "it is always wrong to kill an innocent person." Is there any reason to suppose that kill," innocent," and "person" are more determinate than "voluntary," "terminal," and "intractable"? In both cases there will be ambiguities, areas of vagueness, border-line examples.

The same issue arises with respect to Lamb's discussion of the right to refuse treatment, which he favors, as compared to assisted suicide. For he does not exhibit the same qualms about how "voluntary" or "informed" or "free" such decisions are as compared to the comparable decisions in the case of assisted suicide.

Consider also the asymmetric confidence in allowing an exception for self-defense but not for euthanasia: Unlike arguments in favor of killing in self-defense, which deal with a very limited range of situations, the arguments for beneficient euthanasia by virtue of their reliance on abstractions such as "human dignity" can extend to an indefinite number of cases and the reasons for restricting them are not likely to achieve universal assent (94).

If one looks at how the self-defense justification is phrased in the criminal law, however, one finds phrases such as "reasonable fear" or "grave harm." And, of course, the statement of the exception for euthanasia will not involve terms such as "human dignity," even if the arguments in favor of the principle make reference to such concepts.

Second, the asymmetry between mistakenly killing and mistakenly leaving alive while correct as far as it goes must be handled sensitively. One must not suppose that the only alternatives are in one case a person who recovers fully from his or her illness and leads a long and productive life and in the other, a person who dies shortly with only marginally more pain than he otherwise would have experienced. For it is just as possible that the former lives on in a severely impaired mode, while the latter survives like a Karen Quinlan--shriveled, without consciousness, devoid of human contact and experience.

Those who argue against euthanasia can fall into a certain callousness, no doubt sometimes matched by those who favor iL Lamb offers what seems to me an example of such callousness: For the [exponents of the fight to suicide] the choice is simply between dying and living, when the only alternative to suicide ever considered is more of a worthless painful life. But other alternatives might include praying, cursing, changing one's physicians or nurses, and many other possibilities (51).

I should think these are not very helpful alternatives for a patient dying of bone cancer.

Third, as the above reference to an unequivocal guide for our actions" indicates there is an unspoken assumption that rules are somehow supposed to avoid the necessity for us to make judgments about their application. But no rule is self-applying; our understanding of the limits and scope of a rule, as well as its key concepts are mediated by our prior knowledge of the way the rule has been applied, by the common central cases, by the understandings we share about the purpose of the rule, by our beliefs about the likely consequences of extending the rule, and so forth. Now it is true that if we are pessimistic about the good judgment or the motives of those who must interpret rules, we will want to restrict their discretion. And it is certainly true that a rule which says doctors shall never intentionally take the lives of patients requires less discretion than one which allows them to do so in certain instances. But no rule provides unequivocal guidance; and although allowing exceptions may open the way to the possibility of more mistakes, more wickedness, this fact alone cannot bypass the need to provide empirical evidence about the likely possibilities for abuse, and to weigh possible risks against possible benefits. Claims such as the following are just too weak: In the absence of any clear-cut objective criteria for drawing a distinction between those who genuinely desire death and those whose desire is only apparent, there will be an inevitable risk of starting on a slope which begins with a proposal to extend individual freedom and ends in the ultimate extinction of freedom (68).

Lamb performs a genuine service in calling attention to the difficulties of translating principles into practice. Unfortunately, the rigor of the arguments falls considerably short of the level required to show that, at least with respect to euthanasia, the slippery slope is dangerous ground. Down the Slippery Slope: Arguing in Applied Ethics. By David Lamb. New York. Routledge Chapman & Hall, 1988. 112 pp. $45.00 text ed. Gerald Dworkin is professor of philosophy, University of Illinois at Chicago.
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Author:Dworkin, Gerald
Publication:The Hastings Center Report
Article Type:Book Review
Date:May 1, 1990
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