Udo Schüklenk - This Is Bioethics

3.45 John J. Michalczyk, a medical historian, warns that ‘those who invoke the Nazi analogy in a broad or general fashion are pressing the limits of valid analogy simply because the broader the scope of their reference, the harder it becomes to understand exactly what they think the Holocaust was, and thus why it is of moral relevance to the current issue’ (Michalczyk 1994).

3.46 Others have suggested that if we began taking Singer’s views seriously and implemented them as a matter of government policy we would inevitably be led down the slippery slope toward a Nazi kind of end result. We will now turn to slippery slope type arguments in bioethics.

3.47 Probably the most frequently used rhetorical tool in bioethics debates comes in the shape of slippery‐slope type arguments. Slippery‐slope type arguments come in various forms, but typically they are claims that something terrible would happen if we did a certain arguably desirable thing. A good example of this is: ‘If we introduce voluntary euthanasia for mentally competent terminally ill patients soon the mentally disabled will get murdered, just like the Nazis did.’ A conservative Canadian newspaper editorialized against euthanasia in that country, warning against ‘ the slippery slope of assisted dying 55 ’.

3.48 Usually slippery‐slope type arguments are both emotionally appealing and invalid. There are two broad types of slippery‐slope arguments that you quite likely will come across in bioethical arguments. The first type of slippery slope argument is conceptual in nature. It is not as common as the causal slippery slope type argument in bioethics. Conceptual slippery slope arguments claim that the criteria that are proposed to govern new legislation or a new policy are sufficiently imprecise as to open the door to abusive practices. We will come across examples of this kind of slippery‐slope argument in Chapter 11because conceptual slippery slope arguments appear frequently in discussions about end‐of‐life issues ( Somerville 2014 56 ). The same holds true for causal slippery slope arguments ( Somerville 2014 57 ). Causal slippery slope type arguments typically claim that if a given (possibly sound) policy were introduced, this would invariably trigger a chain of events leading to actions or outcomes that are unacceptable (Schüklenk 2011, 47–50).

3.49 Conceptual slippery‐slope arguments are difficult to evaluate as a matter of principle. If you were to legislate that only legally competent individuals suffering from a terminal illness would be allowed to request a medically assisted death, would that really lead to a slippery slope endangering the mentally incompetent or people with depression, say, because competence assessments are not as reliable as mathematical proof? It is difficult to address this argument, except by noting that we undertake competency assessments of individuals in a large number of situations on a daily basis. The proposition that we should never implement legislation unless the concepts are as clear as the laws of physics would in effect prevent us from legislating at all.

3.50 Causal slippery slope arguments are much clearer in nature. They stipulate that if you do X, Y will invariably follow. The claim here is, of course, empirical. The inevitability is what typically is in doubt. ‘For example, opponents of genetic testing and screening say that there is no way to control the slippery slope from therapeutic uses of these new techniques to eugenic ones’ (Schüklenk 2011, 47). There are several problems with these kinds of argument. For starters, we do not know whether the empirical slope that is claimed here does actually exist. Is the inevitability of what is claimed truly inevitable, let alone likely? Given the slippery slope concerns raised would it truly be beyond our capacity to regulate and legislate against such outcomes? Even if there were actions that could be described as eugenic, would they necessarily be unethical? One problem with this line of reasoning is that it often is rhetorical in nature. A label is attached to a particular outcome, typically in a question‐begging manner, with the obvious aim being to persuade us to reject both the outcome and the slippery slope event that led to it. This we are supposedly only able to achieve by rejecting a particular proposed policy or action. Last but not least, there is always the possibility that X occurred, and that Y occurred, and that we concur, on reflection, that Y is undesirable, yet Y turns out to be not actual causally related to X. An example for this scenario could be problematic cases in jurisdictions that have decriminalized assisted dying. Say there was a case where a homeless person was euthanized against their wishes. Opponents of assisted dying legislation would need to do more than point to this case to have a sound argument. They would have to show that there is a causal link between the decriminalization of assisted dying and the case in question. Typically causal slippery‐slope arguments fail on this count. Correlation is no proof of causation.

3.51 You should be on high alert whenever someone introduces slippery‐slope arguments in discussions not only of matters bioethics, but of any issue. Slippery slope arguments can be (logically) valid, but often they are not. Their weakness usually is lies in the lack of detail , all they do is to claim that something might happen, on the sketchiest of evidence, or lacking any evidence (Burgess 1993). You will find fine examples of slippery‐slope rhetoric in Chapter 8in our discussion of reproductive human cloning as well as in Chapter 11dealing with ethical issues at the end of life.

3.52 It is not uncommon to find the thought expressed that it is wrong to treat someone as a means, with a (possibly brief) reference to Kant. As Onora O’Neill has pointed out, what goes under the name of Kantian ethics today sometimes bears little relation to what Kant actually said (O’Neill 1991). According to Kant’s Categorical Imperative, we should never treat humanity, whether in ourselves or in others, as a means only, but always at the same time as an end in itself.

3.53 We cannot avoid treating each other as means; we do this all the time, for instance when we take public transport or use delivery services to get a pizza. The point is that we should not treat people merely as means. What is involved in treating another human being as an end is unsurprisingly a matter of debate, but involves at least respecting them as an autonomous being with goals of their own, whom it would be wrong to use in a way merely to satisfy our own ends. Difficult questions tend to arise in situations where it seems to us as agents that a person is not treating themselves with proper respect, e.g. by their choice of ways to make a living. If that is their choice, does it have to be respected in order to treat them as an end?

3.54 In bioethics it might be argued that a savior sibling (see Chapter 5) is being used as a ‘mere’ means. Is that right? The sibling may not have had a life if it were not for the need for a source of tissue. What conditions need to be satisfied in order for the sibling to be treated as an end in themselves? This will be discussed further in Chapter 5.

3.55 Two other questions arise, at least. The first is the range of application. What must be treated as an end, for Kant, is an autonomous being. This might seem to rule out from the start the possibility of applying the argument to fetuses. But a Kantian‐ inspired ethic might try to make that move.

3.56 The other question is what it can mean to treat oneself as an end. Kant himself had many examples of duties towards our bodies, which seem strange to the modern more liberal minded reader, but this demonstrates that for him, one’s body should be treated with proper respect, as it is not ‘mine’ it is ‘me’. This type of consideration may be appealed to in arguments about prostitution, as well as in discussions about selling parts of the body for profit.