Health Care Analysis 9: 4163, 2001. 2001 Kluwer Academic Publishers. Printed in the Netherlands.

Is There a Moral Duty to Die?

J. ANGELO CORLETT
Department of Philosophy, San Diego State University, 5500 Companile Drive, San Diego, CA 92182-8142, USA (E-mail: corlett@rohan.sdsu.edu)

Abstract. In recent years, there has been a great deal of philosophical discussion about the alleged moral right to die. If there is such a moral right, then it would seem to imply a moral duty of others to not interfere with the exercise of the right. And this might have important implications for public policy insofar as public policy ought to track what is morally right. But is there a moral duty to die? If so, under what conditions, if any, ought one to have such a duty, and why? In this paper, I distinguish between different moral grounds for the putative moral duty to die: deontological, intuitionist, and contractarian. Subsequently, I argue in support of Paul Menzels theory of health care distribution. More precisely, I concur with his claim that there is a moral duty to die inexpensively in health care contexts. Then I provide and defend a philosophical analysis of the conditions in which such a duty could exist. Key words: Ability Condition, Agency Condition, Categorical Imperative, contractarian, deontological, Desert Condition, deserve, die, duty, harm, Harm Condition, Intrinsic Moral Worth Objection, intuitionist, moral right to die, moral duty to die, negative and positive moral duties, right, utilitarian

Introduction In recent years, much has been made of the alleged moral right to die.1 Whether it is derived from a cluster of fundamental moral interests/claims2 to self-ownership, freedom, and/or equality,3 a putative moral right to die has been the subject of many debates in philosophical circles. If there were such a right, then it would seem that it might in some circumstances imply a correlative moral duty4 of others to refrain from interfering with the right holders morally legitimate exercise or benet of the moral right to die. But is there a moral duty to die?5 If so, under what conditions might one have such a duty, and why? In this paper, I shall distinguish between different philosophical grounds for the putative moral duty to die. Then I argue in favor of Paul Menzels theory of health care distribution. More specically, I argue that he is correct in arguing that in health care contexts there is a prima facie moral duty to die. Following this, I discuss the putative moral duty to die in

42 certain medical and criminal justice contexts. In an effort to generalize the moral duty to die, I analyze the conditions in which such a moral duty could exist in more global contexts. In so doing, I set forth and defend a desertbased analysis of the moral duty to die in a global context. For my present purposes, death shall be taken to mean the intentional death of a human being.6 It is crucial to distinguish between at least two questions for purposes of philosophical analysis of the putative moral duty to die. First, there is the question of the nature of this duty. This is the problem concerning the conditions in which such a duty accrues, morally speaking. Then there is the question of the conditions in which one knows that she has a moral duty to die. These questions ought to be answered separately. For not doing so might well result in confusing the questions and answers to them. For example, it might lead to the sneaking into the denition of the putative moral duty to die a property that is not essential to it, but is rather a feature which tells us what it takes for one to know that she possesses such a duty. In this paper, I concern myself with the problem of the nature of the alleged moral duty to die. I shall not address the epistemological question. However, before an answer is given to the query of whether or not there is a moral duty to die, it is helpful to consider the nature of both duties and moral duties more generally. Joel Feinberg argues that a duty, whatever else it be, is something required of one (1980: 136). Like an obligation, it requires one to do or to refrain from doing something. It imposes on our inclinations and it is something we must do whether we like it or not. Moreover, Feinberg avers, a duty is something we must do or else we face certain consequences (1980: 136). But what precisely is a moral duty? On some accounts, such a duty is derived from moral rules (Feinberg, 1992: 195). Carl Wellman adds, one has a moral duty when morals constrain ones choice by the way in which it applies to the alternative acts one is in a position to choose among (1985: 131). More specically, a moral duty is, Wellman argues, The constraint imposed upon a moral agent by some applicable moral reason that is both a reason for the agent to act and for other members of the moral community to impose negative sanctions in the event that the agent fails to act in accordance with this moral reason (1985: 136). In essence, then, a moral duty is based on moral reasons which impose on a moral agent an action or omission. And if Immanuel Kant is correct in what he writes about moral duties in his Groundwork of the Metaphysics of Morals, 400, then moral duties require us to act out of respect for the moral law.7 Let us delve more deeply into the nature of these putative moral duties in general, and of the putative moral duty to die in particular.

43 Is There a Moral Duty to Die? The moral duty to die, if it exists, is complex. It might be grounded in deontological, intuitionist, contractarian, or some other moral theory. Let us consider some of these ways in which a putative moral duty to die might enjoy philosophical support. Deontological Grounds for the Moral Duty to Die To have a moral duty, on deontological grounds, is to be under the obligation of a valid moral rule. Are there such rules that might ground moral duties? If so, then what are the rules? And do such rules ground a moral duty to die? Duties of justice and duties of virtue Kant argues that there are duties of justice (outer duties) and those of virtue (inner duties). Kant discusses the former principally in The Metaphysical Elements of Justice, while he discusses the latter in The Metaphysical Elements of Virtue. These categories of duties differ in multifarious ways. First, a duty of virtue involves the free adoption of some end which pure practical reason directs (Korsgaard, 1996: 19). It is true that, on Kants view, virtue encompasses the duties of justice. But as Christine M. Korsgaard writes of Kants view: Duties of virtue are of broad obligation, while duties of justice are of strict obligation. Duties of justice require particular actions or omissions, and the obligation is strict because it can be discharged. . . . Duties of virtue, by contrast, tell you to adopt and pursue certain ends. Such a duty cannot simply be discharged, for the ends in question cannot be completely achieved (1996: 20). There are four species of duties of virtue: perfect duties to oneself (for example, on Kants view, to not commit suicide); imperfect duties to oneself (for instance, to develop ones humanity, holistically);8 duties of love for others (for example, to promote the happiness of others, of gratitude and of sympathy (Kant, 1983: 452); and duties of respect for others (for instance, respecting the rights of others). And a moral agent typically fullls each of these categories of duty to one extent or another. As Korsgaard states, The degree of ones virtue is measured by the extent to which one succeeds in doing all of these duties from the pure moral motive of regard for humanity(1996: 21). A moral duty to die, if it does accrue, might in certain circumstances be a duty to oneself, say, to bring oneself to a peaceful and satisfying end (to either ensure ones death or to let death come (Menzel, 2000: 95114). Or, it might be a moral duty to promote the happiness of others9 out of respect for them.

44 Perfect and imperfect moral duties to die Within the broader classication of duties of justice and of virtue, Kant distinguishes between perfect and imperfect duties. As Korsgaard notes, . . . Perfect duties require denite actions or omissions, while in the case of imperfect duties inclination is allowed to play a role in determining exactly what and how much we will do to carry them out. Duties of justice are all perfect, but there are both imperfect and perfect duties of virtue. We have an imperfect duty of virtue when there is a positive end to promote, but the law does not say exactly how. . . . Perfect duties of virtue arise because we must refrain from particular actions against humanity in our own person or that of another (1996: 2021). There are perfect duties to ourselves,10 and those to others. On Kants view, for one to commit suicide is to violate ones perfect duty to oneself (to remain alive), and failing to respect another is a violation of a perfect duty to others. Why? Because such actions or omissions run counter to the humanity version of the Categorical Imperative, i.e., to treat persons always as ends in themselves. In light of Kants distinction between perfect and imperfect duties, one might distinguish between a perfect moral duty to die and an imperfect one. To have a perfect moral duty to die is for one to have such a duty in every occasion of a particular circumstance, no matter what. On the other hand, to have an imperfect moral duty to die is for one to have such a duty under some but not all circumstances.11 Negative and positive moral duties to die From the humanity formulation of Kants Categorical Imperative can be derived both negative and positive duties (Sullivan, 1994: 53). Negative duties specify what is morally forbidden and require us to limit our pursuit of happiness by the demands of morality(Sullivan, 1994: 96). Positive duties also obligate us absolutely just as seriously as negative duties(Sullivan, 1994: 97). There are negative duties to not inict harm and corresponding positive duties to prevent harm (Feinberg, 1992: 194).12 Translating this language of negative and positive duties to a putative duty to die, we might say that a negative moral duty to die is ones duty to die in not inicting further harm to self or others, such as when a terminally ill patient has a moral duty to die based on the moral consideration that she has an obligation to prevent further physical harm to herself and further scal hardship to family members whose lives would be signicantly and negatively effected should she not die. A positive moral duty to die amounts to ones duty to act or attempt to act in order to harm self or others.13 An example of this sort of positive moral duty to die would be where I am morally obliged to, say, reach and maintain good

45 physical health and avoid unreasonably risky situations that might eventuate in my requiring health care that would lead me to a context of the previouslymentioned negative duty to die. Furthermore, the putative moral duty to die might be either a duty to self, a duty to others or both a moral duty to self and to others. In the former case, one would have a duty to oneself to end ones life, either by suicide or by some other means. For example, I might make a promise to myself to commit suicide if I were to commit an act so heinous that I do not deserve to live. In the latter instance, I owe it to others to die in one way or another. In such a case, I might owe it to others to die or to give others (society) permission to kill me because, say, I deserve it for reasons of retributive justice, or because I caused an enormous amount of disutility in an otherwise decent society (or because by not dying I promote great disutility), and/or because I violated a social contract stipulating that my violation requires that I die. It might be argued that these are possible grounds for the moral duty to die. In either case, it would appear that my moral duty to die implies a moral duty of others to not interfere with my carrying out my duty. Thus not only are moral duties often correlated with moral rights (sometimes with the moral rights of others, other times with the moral rights of oneself as a duty-bearer), but such duties sometimes correlate with certain positive or negative moral duties of others. Intuitionist Grounds for the Moral Duty to Die One response to Kants theory of moral duties comes from F. H. Bradley, who argues that the theory of duty for dutys sake carries with it little or no plausibility (1951: 87). It is fundamentally mistaken, he argues, to think that moral duties are based on universal laws. Bradley writes, . . . the view which thinks moral philosophy is to supply us with particular moral prescriptions confuses . . . reective with intuitive judgement. That which tells us what in particular is right and wrong is not reection but intuition. We know what is right in a particular case by what we may call an immediate judgement, or an intuitive subsumption (1987: 67). Since our moral judgments are intuitive subsumptions (Bradley, 1987: 67), what makes something a moral duty is not that it is based on a universal moral law, as Kant would have it. Rather, it is that something is a moral duty for us at an intuitive level of experience: dutys universal laws are not universal, if that means they can never be overruled (Bradley, 1987: 64). This is because we often face a collision of moral duties wherein we may have several such duties. Yet we can perform only one at that time (Bradley, 1987: 6263). Bradley avers that no moral philosophy based on universal moral laws would

46 be able to inform us how to act where there are conicts of moral duties. For moral duties are grounded in moral judgements, and such judgements are not discursive. Bradleys intuition here is articulated as follows: If any one thinks that a mans ordinary judgement, this is right or wrong, comes from the having the rule before the mind and bringing the particular case under it, he may be right; and I can not try to show that he is wrong (1987: 66). In realizing the ideal self, Bradley argues, we recognize moral duties to self that are not social in nature and those that are social (1987: 73). In either case, there can be conict between moral duties which are taken to exclude one another . . . (Bradley, 1987: 77).14 Rights and duties of one sphere collide with those of another sphere, and again within each sphere they collide in different persons, and again in one and the same person (Bradley, 1987: 143).15 And these cases of collisions of moral duties are practical matters, unresolved by universal moral laws. Why? Because moral practice is not in abstracto, and the highest moral duty for me is my duty; my duty being the one which lies next me, and perhaps not the one which would be the highest, supposing it were mine (Bradley, 1987: 7778). So the issue is often which duty trumps or overrides the others (what duty is to be done and left undone here), (Bradley, 1987: 78) all things considered and morally speaking. Conicts of moral duties cannot, according to Bradley, be resolved by an appeal to abstract moral laws or principles: The highest type we can imagine is the man who, on the basis of everyday morality, aims at the ideal perfection of it, and on this double basis strives to realize a nonsocial ideal. But where collisions arise, there, we must repeat, it is impossible for mere theory to offer a solution, not only because the perception which decides is not a mere intellectual perception, but because no general solution of individual difculties is possible (Bradley, 1987: 79). Moreover, Bradley insists that duties are correlated with rights (1951: 144),16 and that rights and duties do not exist outside the moral world (1951: 143). For rights and duties are elements in the good; they must go together (Bradley, 1951: 146). Now what, if anything, does Bradleys view of duties imply about a putative moral duty to die? It is clear that what Bradley does not offer us is a positive theory of the nature of moral duties. However, what he does provide is a caution about the complexities of common moral duties, namely, that they often conict one with another. This tends to count against a simple view of moral duties such as one that would have us believe that no moral duties can conict with others, so that, for instance, we have a moral duty to never lie. For such a duty might well, in some circumstances, conict with a moral

47 duty to preserve the life of another person in the face of danger, where such lying would not pose a serious threat of harm to anyone. In cases such as the inquiring murderer, the moral duty to not lie is trumped by the moral duty to save anothers life whenever practically possible. Thus Bradleys point about conicting moral duties is well taken. Moreover, Bradleys point concerning the collision of duties assists us in our understanding of what Kant apparently failed to notice about what he refers to as perfect moral duties to not commit suicide, on the one hand, and to administer death (in some cases, such death amounts to suicide) to deserving murderers, on the other hand. For surely there are instances where such duties conict, and one such duty outweighs the other, all things considered. I shall return to this point later. Yet it is unclear that Bradleys criticism of Kants moral idealism is itself plausible. For it might well be the case that valid moral rules would inform us as to which moral duties trump others, and when and why they do. For it might well be, a Kantian could argue, that it is the strength of a moral rule which would ground the trumping moral duty that one has in a given time and place.17 Contractarian Grounds for the Moral Duty to Die Furthermore, a contractarian might argue that there is a duty to die to the extent that there is a moral agreement amongst persons that such a duty exists under certain prescribed circumstances.18 Moreover, it might be argued on such a view that it is rational to agree to the conditions in which such a duty to die exists. For there are a number of cases in which the quality of life for terminally ill patients families and society as a whole would be increased should the patient exercise her duty to die. Put bluntly, the cost of keeping a terminally ill patient alive could otherwise cover educational and other more promising healthcare costs to family members and for others in society. Moreover, the overall quality of life is increased if the duty to die is exercised in such cases because the adverse psychological effects on family and friends are minimized, as opposed to there being protracted. Thus on economic and psychological grounds, it is rational for parties to agree to there being a moral duty to die in certain circumstances. It would perhaps, though not necessarily, be morally egoistic for a terminally ill patient to not exercise her duty to die in such contexts. The Moral Duty to Die Inexpensively in Medical Contexts Having considered some general grounds for the putative moral duty to die, I will consider one leading view of it. Menzel has argued for a subtler (and beyond the purposes of this article, a more developed) version of the contrac-

48 tarian approach to the nature of the putative moral duty to die (Menzel, 1990: Chapter 11). Given the realities of the age of delayed degenerative diseases, and in light of the importance of considerations of the need to conserve valuable resources, we have a personal moral duty to die inexpensively (Menzel, 1990: 95114). This duty would be a special instance of the more general moral duty to die.19 Menzel argues, All of us would be better off in the long run if we would have agreed that sometimes even when there is still net value left in life, we should let people die (1990: 193) He continues, . . . sacricing the benet of time in life might be attended by a compensating positive benet of knowing that one is parting with a small share of life for the benet of others (1990: 194). Arguing that it is egoistic at times to cling to the preservation of life come what may, Menzel states, If preserving lives of declining quality in old age is much less a benet to the aged patient than the resources saved can be for others, then it will be in the mutual self-interest of all to have a general practice of letting death come more efciently (1990: 194). According to Menzel, then, it is egoistic for me to preserve my life when it is declining in quality if the cost of doing so would mean signicant adverse effects to others. Indeed, I have a personal moral duty to die cheaply under such circumstances so that the economic and other resources saved by my cheap death could be used to enhance the quality of other lives. Moreover, Menzel avers, . . . dying more cheaply and less expensively is not just admirable sacrice; sometimes it is morally required (Menzel, 1990: 195). But precisely what is the moral duty to die cheaply on Menzels account? Whatever else it is, it is grounded in moral consent. Moreover, it is justied on the grounds that such a duty maximizes resources, presumably, for society at large, including future generations. It is a prima facie personal moral duty to allow death to come to one relatively inexpensively (Menzel, 1990: 195). It is personal in the sense that, unlike various other sorts of duties, it is unenforceable by others. Others are therefore not in moral positions to blame those having personal moral duties to die when they do not fulll those duties. That the personal moral duty to die is a prima facie one means that it is not a perfect one, nor an absolute one, and it can be overridden by other moral considerations. Menzel argues that the prima facie personal moral duty to die is neither a decision imposed by others, nor a societal moral obligation. But neither is it a merely good or saintly thing to do. It seems that Menzels arguments, if plausible, support an imperfect moral duty to die cheaply, rather than a perfect one. For his analysis appears to allow some role for inclination to play in determining when one has such a duty. Furthermore, the right to die cheaply appears to be a positive moral duty.

49 If, as Menzel argues, there is sometimes a moral duty to die inexpensively, then we might expect this duty to obtain under circumstances both medical and non-medical in nature. Regarding the moral duty to die cheaply in medical contexts, it might be argued that such a duty accrues to a patient to the extent that medical costs are delimited to only what is morally justied, all things considered. In other words, there is a moral duty to die inexpensively to the extent that medical costs are made inexpensive relative to justiable costs of, say, a particular procedure that is needed to sustain or even to end! a patients life. This claim is meant to follow from ought20 implies can. 21 Here it is assumed that, not only can the prolonging of a patients life become overly expensive, but (especially for indigent patients) the medical costs of even dying are too much to bear, either for her or for society. There cannot be a moral duty to die inexpensively where medical costs even to die are prohibitive. In a society where medical costs to die are affordable, then in certain such circumstances a moral agent has a perfect moral duty to die. But where such a condition does not obtain, the moral duty to die, if it accrues at all, cannot be a strict one. For there can only be a moral duty to die cheaply where dying cheaply is possible, all things considered.22 So if there is sometimes a moral duty for persons to die inexpensively, then it seems that there is a moral duty of society to ensure that medical costs are as inexpensive as good quality of health care (for either sustaining or ending life) will permit. Here we ought not to assume that the more expensive the medical treatment, the higher its quality, or that the less expensive it is, the lower its quality. Moreover, if medical costs are extravagant, then both living and dying in medical contexts is overly costly. And this would appear to make impossible (for practical purposes) the imperfect moral duty to die cheaply. Thus Menzels arguments in favor of the moral duty to sometimes die inexpensively in medical contexts implies a moral duty to make medical costs of both living and dying affordable. As Margaret P. Battin argues, a redistributive policy cannot be just without adequate guarantees that resources will in fact be redistributed as required (Battin, 1987: 340). There are various ways in which the costs of health care might be made more affordable. One way to reduce such costs is to reduce the costs of medical technology and research. Another is to reduce the costs of medical/hospital administration. Yet another is to reduce the costs of physicians services. I shall focus on the latter two prospects. Menzel argues that, At a time when talk of cost containment is common, little serious and comprehensive literature has been produced on the normative justication of physicians incomes, as opposed to the mere description of what they are or the explanation of what causes them to be that way. . . .

50 . . . If life, lifesaving, and health have a nite price, doctors earnings are less likely to be worth our money. Who gets paid what is just as crucial an allocation question as how many of our resources are used on health care, and for whom. Asking the most difcult and basic questions about the cost of health care will inevitably lead us to a discussion of physicians incomes (1983: 214). And what Menzel argues concerning physicians salaries (1983: 224226)23 might also hold for medical/hospital administrators and their respective incomes. For based on a plausible principle of justice as distributive equality,24 physicians incomes are not justied to be as high as they are, generally, whether or not they are based in the free market. Thus there is a kind of logical coherence between Menzels major contributions to medical ethics, and if his arguments are plausible, then the prima facie personal moral duty to sometimes die cheaply grounds the moral duty to make medical costs of living and dying affordable. And this in turn implies that physicians and medical/hospital administrators incomes be set objectively at only that mark which is morally justied, all things considered. Now it might be argued that there is no moral duty to reduce medical costs, contrary to Menzel, and that lacking such a duty, there is no moral duty to die inexpensively. Medical providers, physicians, etc., deserve, the argument goes, whatever they can get, come what may. After all, the argument continues, if ought implies can is plausible, then there is no moral duty to die cheaply. However, what grounds this laissez-faire argument in medical contexts? If the argument is not to fall prey to a moral arbitrariness objection, it must endorse, it would appear, a more general laissez-faire view of costs of living and dying in a society, costs which take us beyond medical contexts. But this more general point might well be refuted by a plausible version of social contract theory, whether Thomas Hobbes25 or another.26 Thus the laissezfaire argument for unrestricted health care costs seems problematic, or is at least in need of adequate rational support. There appear, then, to be good reasons to infer that medical costs require delimitation, and in multifarious ways. These reasons include the problematic nature of a laissez-faire system of politics and economics, not to mention the plausibility of there being a moral duty to die affordably in certain contexts. This makes room for Menzels arguments for reduced physicians salaries, and for my extension of his point to medical/hospital administrators incomes as well. Given that ought implies can, there is good reason to think that there is a moral duty to sometimes die inexpensively, as Menzel argues. And it is precisely this sort of argument that seems to serve as a foundation for our attempting to discern deaths meaning in even the most vexing circumstances.

51 Perhaps an element of deaths meaning would be that, when I choose to die inexpensively, I would not sacrice the futures of my loved ones or of others who might benet from my dying expensively. Altruistic citizenship is more meaningful than egoistic self-fulllment, even if self-interest might at times override ones duty to die inexpensively for the sake of others. The Moral Duty to Die in Criminal Justice Contexts The putative moral duty to die has been discussed philosophically and primarily in terms of specied medical contexts. But the moral duty to die also accrues, if it accrues at all, in some contexts of criminal justice. So for one to have a moral duty to die implies, among other things, that one ought to act or refrain from acting in a particular way, under certain circumstances, such that the end result of ones act or omission is that one is dead, whether by ones own hand or by anothers. If there were such a duty, then it would imply that society has a prima facie moral obligation to refrain from interfering with the agents exercise of her duty to die. Thus if a criminal has a duty to die, for reasons of, say, social utility or desert, then society and the legal system have a prima facie moral obligation to not interfere with the agents duty to die. The moral duty to die might accrue in contexts of retributive justice (on a Kantian account of retributive punishment), where I commit an act so untoward and deserving of my death that I am, morally speaking, required to die. This would imply that no amount of forgiveness or mercy27 would sufce to neutralize my duty to die. In fact, it might be argued that the state has a duty to not interfere with my duty to die. If I have a duty to die based on my criminal mind/conduct which makes me deserving of death, this assumes that I satisfy strongly the conditions of criminal and moral liability. Given these conditions, the state has a duty to punish me by death. This duty is based on my breaking rules in a manner that makes me morally deserving of death such that my death is not a moral prerogative,28 but a requirement.29 Furthermore, contrary to Kants absolute prohibition against suicide (i.e., his claim that each of us has a perfect moral duty to ourselves to not commit suicide), it might be argued that there are instances where, on Kantian retributivist grounds, one has a moral duty to commit suicide. And such a case might be borrowed from Kants The Metaphysical Elements of Justice, 333, where he argues that a society seeking to disband itself must rst put to death all of those rightly convicted of murder (1965: 102). But suppose a murderer knows she has murdered and has fully satised, while murdering, the conditions of criminal liability. Clearly she deserves to die (on Kantian grounds), and knows it. But what if the state cannot put her to death? Perhaps the state is experiencing political revolution, or secession, making its ability

52 to administer retributive justice practically impossible for an indeterminate amount of time. Does not the murderer have, on Kantian grounds, a perfect moral duty of virtue to commit suicide under these circumstances? Or alternatively, what if the state decides itself to not put to death this murderer? Could it not, for all Kantian justice says (short of pardoning her), sentence her to suicidal capital punishment? Moreover, does not the murderer under such circumstances have a perfect moral duty of virtue to commit suicide? After all, Kantian retributive justice requires that all murderers receive a death sentence (Recall Kants own words regarding murderers: If, however, he has committed a murder, he must die (Kant, 1965: 333) unless there are signicant mitigating circumstances that would dictate otherwise. And what grounds such proportional punishment is the notion of moral desert. So in such cases the murderer deserves death. And if the state cannot or will not administer capital punishment on a murderer deserving of it, then this surely would not, for all Kant says, relieve the murderer herself of the perfect moral duty of retributive justice to commit suicide. Murderers deserving of death have a perfect moral duty to die, whether by the hand of the state, or by some other means, including suicide. Although this point is not logically entailed by Kants view of punishment, it is consistent with his position on punishment to hold that murderers deserving of death have a perfect moral duty to die, whether by the hand of the State, or by some other means, including suicide. Assumed here are the Socratic claims that: (1) (some forms of) injustice and wrongdoing are (among) the greatest of evils; (2) (appropriate or proportional) punishment rids the wrongdoer of the evils of her wrongdoings; and especially (3) wrongdoers ought to seek their own (appropriate or proportional) punishment for their wrongdoings to prevent the distemper of evil from becoming ingrained and producing a festering and incurable ulcer in his soul(Plato, Gorgias, 479d480a). If this reasoning holds true, then Kants claim that we have a perfect moral duty of virtue to not commit suicide is questionable. Note that in medical contexts such as the ones Menzel has in mind, the moral duty to die is personal, prima facie, and imperfect. However, the moral duty to die in criminal justice contexts (such as the one I describe pertaining to certain murderers) is perfect, absolute, and impersonal. While others are not in moral positions to pass negative moral judgment on those who have a personal moral duty to die when they fail to perform their moral duties to die in certain medical contexts, others are in moral positions to blame (even to death!) deserving murderers who fail to at least attempt to commit suicide when the State is unable or unwilling to do so. So there might be a moral duty to die based on a rule the breaking of which means the rule-breaker deserves30 to die. And there are a number of other

53 possible grounds for the moral duty to die, including utilitarian, contractarian, and other such grounds. To be sure, the duty to die might be grounded in a hybrid of such views. Analyzing the Moral Duty to Die What are the general conditions in which I have a moral duty to die? It might be argued that I have no moral duty to die unless I, being a moral agent, have the capacities to know, intend and act freely. I shall refer to this as the Agency Condition. Although some might think that the Agency Condition is unnecessary in that it is precisely a human who lacks such agency capacities who has a moral duty to die, it seems to be true of moral duties in general that the Agency Condition is required for duty-bearers. It is, moreover, the Agency Condition that makes it difcult for moral duties to accrue to non-human animals. It would seem, then, that this capacity is a necessary condition of my having a duty to die. But what else is necessary, and what is sufcient for my possessing such a moral duty? It might be argued that if ought implies can, I must be able to die at a given time and in a given place if I indeed have a moral duty to die at that time and in that place. I shall refer to this as the Ability Condition. Thus I have no moral duty to die if I am unable to die. If I am, at a particular time and place, unable to effect my own death, directly or indirectly, or if there is no other means for me to die at that time and in that place, then I have no duty to die then and there. Another person, thing, or I must be able to somehow cause my death, either directly or indirectly, for me to have a moral duty to die. However, this condition, if satised, is not sufcient for me to have a moral duty to die. For simply because I am able to die, inexpensively or not, this in itself does not morally require me to die. Additionally, I have a moral duty to die, expensively or not, by some means if either I deserve to die because, say, I have caused sufcient unwarranted harm to others to justify my death (Desert Condition), or because I, in remaining alive via medical assistance, would cause sufcient unwarranted harm to others such as others pain or impoverishment (Harm Condition). But this is only a necessary condition for my having a moral duty to die, given that ought implies can. There might well be circumstances in which my death cannot, practically speaking, be intentionally caused even though I deserve to die. Nonetheless, the Desert Condition is an important one, especially in light of the fact that the duty to die, if it does accrue, should be taken in a global context.31 What counts for my having a moral duty to die must include, among other things, various sorts of things I have done or failed to do which

54 would make me deserving of death, all things considered. For example, someone such as Mother Theresa would, presumably, have no duty to die, unless perhaps she nds herself in a circumstance such as the one(s) Menzel envisages. But someone who has engaged in sufciently intentionally, knowingly and voluntarily evil acts that have gone inadequately punished is hardly in a moral position to hold that she has no moral duty to die. To the extent that she deserves to die for her conduct over her lifetime, she has a duty to die regardless of the fact that her dying would not maximize social utility in any signicant way. Furthermore, even if society could easily afford to cover the costs of keeping everyone alive without sacricing quality education, adequate military defense, etc., those who deserve to die have duties to die. This claim implies that those who knowingly, intentionally and voluntarily reside in countries which exploit harshly others in the world and who are in some relevant sense parties to that exploitation have, in general, stronger duties to die than their victims, even if, say, in medical contexts the victims of such exploitation dying would eventuate in more of a net gain in social utility than if the exploiters exercised their duties to die. This desert-based notion of the moral duty to die globalizes considerably the factors which comprise whether or not one has such a duty. My putative moral duty to die is not simply a matter of how much can be gained or lost by my family or society from my dying. It is, rather, a matter of global justice. I might be an outstanding moral citizen by the standards of my own family or society, though I might well have failed the test of global justice because I failed altogether in standing up for justice when my society committed evils against others, making me a complicitor in those evils as I beneted from them. In such cases, I do have a moral duty to die, especially in medical contexts where the cost of keeping me alive would be expensive. Examples of evils that would generally qualify here would include genocide, slavery, and signicantly uncompensated evils such as these. Thus it is true that the discussion of the moral duty to die in medical contexts ought to be globalized beyond the family and society. But when this is done, the content of the putative moral duty to die must be extended beyond the medical sphere to matters of justice. For it is counter-intuitive to think that an evil person whose death in medical contexts would not maximize utility is morally immune from her duty to effect her death. Medical context or not, then, the moral duty to die accrues, if it accrues at all, to those who deserve to die. The Desert Condition, then, is both a necessary and sufcient condition of the duty to die. Those who do not deserve to die have at best what Menzel refers to as a prima facie personal moral duty to die in certain medical contexts. However, those who are deserving of death for what they

55 have done or failed to do (as the case may be) have duties to die that are enforceable by others. Collectively, these factors amount to a cluster of criteria that, when satised, indicate a complex moral duty to die that can accrue in certain medical and non-medical contexts.32 It suggests, among other things, that the discussion of the duty to die must range over more than medical circumstances. It must cover an array of contexts that include the concept of desert, especially if it is true that those who deserve to die have moral duties (of one kind or another) to die. Note that the analysis just given is signicantly deontological in content. Although the Agency and Ability Conditions are congruent with various models of the moral duty to die, the Desert Condition makes the analysis distinctively deontological. More specically, what sort of moral duty to die one has will be contingent on a case by case basis, given an array of factors.

Objections and Replies It might be argued that the above analysis of the moral duty to die ignores a crucial factor about morality and humans. The fact is, the objection goes, humans have intrinsic worth, and anything resembling a putative moral duty to die is always trumped by a fundamental and absolute right to life shared by every moral agent. The very notion, then, of a moral duty to die is nonsense, whether in medical or non-medical contexts. I shall refer to this as the Intrinsic Moral Worth Objection. In reply to the Intrinsic Moral Worth Objection, it might be argued that it not only begs the moral question concerning whether or not there can ever be a moral duty to die, but it also fails to see that the human right to life is not absolute. For there are various circumstances in which we would have no right to life, such as if we are on the morally wrong side of a war, or as the Moral Liability Condition has it, if we ought to die based on retributivist reasons. Thus the Intrinsic Moral Worth Objection seems to be problematic. For it appears that its reason for the absolute moral right to life of each moral agent is neutralized by considerations in favor of the moral duty to die. Furthermore, the Intrinsic Moral Worth Objection to the above analysis of the moral duty to die appears to be contingent for its overall plausibility on there being a plausible notion of intrinsic moral value. After all, it is humans who are said to have intrinsic moral worth, value in and of themselves, according to this objection. However intuitively appealing the concept of intrinsic moral value is, there are some important doubts raised concerning its overall plausibility.33 Thus there is reason to doubt the potency of the

56 Intrinsic Moral Worth Objection as a defeater of the above analysis of the moral duty to die. Moreover, it might be argued that the Desert Condition which plays so important a role in my analysis of the moral duty to die is based on the problematic concept of desert. The controversial nature of the concept of desert makes it anything but an adequate ground for the moral duty to die, regardless of context. Without providing a defense of the concept of desert, a defense which is surely beyond the scope of this project, it might sufce to argue that to the extent that the concept of desert is sensible or plausible, that is the extent to which the Desert Condition legitimately serves as the basis of the moral duty to die. This reply converts the Desert Condition into a conditional one. However, this nonetheless points to a vital difference between those who, in medical contexts, might have a prima facie personal duty to die yet who at the same time do not have any fatal moral claims against them versus those who are morally blameworthy (in some signicant sense) yet who face relevantly similar medical circumstances. This distinction is overlooked by those who have written on the moral duty to die. Yet intuitively, it seems that what a moral agent deserves ought to gure into whether or not they have a moral duty to die, regardless of context.

Conclusion Having set forth a basic notion of a moral duty, I articulated the nature of a moral duty to die according to deontological, intuitionist and social contract standpoints, respectively. Then I argued for a particular desert-based analysis of the moral duty to die, defending it against some important objections. Perhaps this analysis will better enable lawmakers to devise legal rules that will enjoy the support of objectively true moral principles that will in turn better enable us to understand the conditions under which each of us ought to choose death over life as a matter of moral character and integrity.34

Notes
1 For some recent research on this topic, see Battin, M. P. (1994). The Least Worst Death. New

York: Oxford University Press (1995). Ethical Issues in Suicide. Englewood Cliffs: PrenticeHall; Keown, J. (Ed.) (1997). Euthanasia Examined. Cambridge: Cambridge University Press. 2 For philosophical analyses of the various views of rights, see Dworkin, R. (1977). Taking Rights Seriously. Cambridge: Harvard University Press; Feinberg, J. (1980). Rights, Justice, and the Bounds of Liberty. Princeton: Princeton University Press (1992). Freedom and Fulllment. Princeton: Princeton University Press, Chapters 810; Hohfeld, W. (1919). Fundamental Legal Conceptions. New Haven: Yale University Press; Lomasky, L. (1987). Persons, Rights,

57
and the Moral Community. Oxford: Oxford University Press; Robert Nozick, R. (1974). Anarchy, State, and Utopia. New York: Basic Books; Raz, J. (1986). The Morality of Freedom. Oxford: Clarendon Press; Sumner, L. W. (1987). The Moral Foundation of Rights. Oxford: Oxford University Press; Thomson, J. J. (1990). The Realm of Rights. Cambridge: Harvard University Press; Waldron, J. (1993). Liberal Rights. Cambridge: Cambridge University Press; Wellman, C. (1985). A Theory of Rights. Totowa: Rowman & Littleeld (1999). Real Rights. New York: Oxford University Press (1999). The Proliferation of Rights. Boulder: Westview Press. A special issue on rights is found in The Journal of Ethics (2000), 4 (pp. 1165). 3 For philosophical analyses and discussions of these concepts, see Cohen, G. A. (1995). Self-Ownership, Freedom and Equality. Cambridge: Cambridge University Press. For a critical discussion of Cohens analyses of these and related concepts, see The Journal of Ethics (1998), 2 (pp. 198). 4 For a discussion of the correlation between rights and duties, see David Lyons, D. (1970). The Correlativity of Rights and Duties. Nous (pp. 4555), 4; On a generous interpretation, a version of the weak correlativity thesis about rights and duties is found in Bradley, F. H. (1951). Ethical Studies. Indianapolis: Bobbs-Merrill (p. 144). Furthermore, not all duties are correlated with rights, as Joel Feinberg notes: . . . duties of indebtedness, commitment, reparation, need-fulllment, and reciprocation are necessarily correlated with other peoples in personam rights. Duties of respect and community membership are necessarily correlated with other peoples in rem rights, negative in the case of duties of respect, positive in the case of duties of community membership. Finally, duties of status, duties of obedience, and duties of compelling appropriateness are not necessarily correlated with other peoples rights (1980, p. 139). Feinbergs denial of a strict correlation between moral and legal duties and rights is also found in Feinberg, J., 1980, p. 186. 5 Throughout this paper, I do not distinguish between duties and obligations, though some rather subtle distinctions are made between them in Brandt, R. B. (1964). The Concepts of Obligation and Duty. Mind (pp. 374393), 73; Lemmon, E. J. (1962). Moral Dilemmas. The Philosophical Review (pp. 139598), 71. 6 For discussions of the concept of death, see Feldman, F. (1992). Confrontations With the Reaper. Oxford: Oxford University Press (1991). Some Puzzles About the Evil of Death. The Philosophical Review, C (pp. 205227); Fischer, J. M. (1997). Death, Badness, and the Impossibility of Experience. The Journal of Ethics, 1 (pp. 341353); Kamm, F. M. (1993). Morality, Mortality, Volume 1. Oxford: Oxford University Press, Chapter 1; Nagel, T. (1979). Mortal Questions. Cambridge: Cambridge University Press, Chapter 1; Persson, I. (1995). What is Mysterious About Death? The Southern Journal of Philosophy, XXXIII (pp. 499508); Silverstein, H. (1980). The Evil of Death, The Journal of Philosophy, 77 (pp. 401423); Yourgrau, P. (1987). The Dead. The Journal of Philosophy, LXXXIV (pp. 84 101). 7 Kant, I. (1996). Groundwork of the Metaphysics of Morals (Gregor, M., Trans. and Ed.). Cambridge: Cambridge University Press (pp. 160161). See also Immanuel Kant, I. (1983). Groundwork of the Metaphysics of Morals (Ellington, J. W., Trans. & Intro. Wick, W. A.). Indianapolis: Hackett Publishing Company, 13; Kant, I. (1993). Groundwork of the Metaphysics of Morals (Paton, H. J., Trans. & Analysed). London: Routledge, 66. 8 Perhaps this is what Bradley, F. H., has in mind when he writes that It is a moral duty to realize everywhere the best self, which for us in this sphere is an ideal self; . . . it is coextensive with self-realization in the sense of the realization of the ideal self in and by us. Bradley, F. H. (1987). Collision of Duties. In Gowans, C. W. (Ed.), Moral Dilemmas. Oxford: Oxford University Press (p. 72).

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9 John Hardwig, argues similarly in Hardwig, J. (1997). Is There a Duty to Die? The Hastings

Center Report, 27 (pp. 3442).

10 Duties to oneself are also discussed in Kading, D. (1960). Are There Really No Duties to

Oneself? Ethics, LXX.

11 Moreover, there might be a universal moral duty to die. In this case, everyone everywhere

would have a moral duty to die. If there were such a duty, then morality would seem to dictate that all humans everywhere ought to die. There might also be a prima facie moral duty to die that can be overridden in light of special considerations. This kind of moral duty is compatible with ones having an imperfect moral duty to die, though they are dissimilar. For one can have an imperfect moral duty to die without its being a merely prima facie one. This would be a duty that one does not always have, but when one has it, it trumps all other duties one has at that time. Furthermore, one can have a merely prima facie moral duty to die without its being merely imperfect. Such a duty would be one that, on the surface, one has; yet it can be overridden and is a duty one has only in some circumstances. For more on prima facie moral duties, see Ross, W. D. (1930). The Right and the Good. Oxford: Oxford University Press (pp. 1634) (pp. 4142). For a helpful distinction between prima facie and all-thingsconsidered moral duties, see Brink, D. O. (1994). Moral Conict and Its Structure. The Philosophical Review (pp. 103, 216), where Brink distinguishes between these sorts of moral duties in the following way: . . . prima facie obligations can be, and often are, defeated by other, weightier obligations, individually or in concert. A prima facie obligation to do x that is superior to all others constitutes an all-things-considered obligation to do x. An all-thingsconsidered moral obligation to do x means that on balance, or in view of all morally relevant factors, x is what one ought to do or that x is supported by the strongest moral reasons. 12 For a discussion of negative and positive legal duties, see Alexander, L. (1996). Afrmative Duties and the Limits of Self-Sacrice. Law and Philosophy, 15 (pp. 6574). 13 Of course, ones dying is not necessarily a harm to self or others. For a philosophical analysis of the concept of harm, see Feinberg, J. (1984). Harm to Others. Oxford: Oxford University Press; Lyons, D. (1997). Liberty and Harm to Others. In Dworkin, G. (Ed.) Mills On Liberty. Totowa: Rowman & Littleeld (pp. 129130). 14 Other discussions of conicts of moral duties include: Alexander, Afrmative Duties and the Limits of Self-Sacrice; Brink, Moral Conict and Its Structure; Carey, T. V. (1985). What Conict of Duty is Not. Pacic Philosophical Quarterly, 66 (pp. 204215); Malm, H. M. (1989). Killing, Letting Die, and Simple Conicts. Philosophy & Public Affairs, 18 (pp. 238 258); Russell, B. (1977). On the Relative Strictness of Negative and Positive Duties. American Philosophical Quarterly, 14; Van Fraassen, B. (1973). Values and the Hearts Command. The Journal of Philosophy, LXX. 15 This collision of moral duties is especially prevalent when they are actual and in-force. See Weber, T. B. (2000). Tragic Dilemmas and the Priority of the Moral. The Journal of Ethics, 4, forthcoming. For more on conicting moral duties, see Nussbaum, M. (1986). The Fragility of Goodness. New York: Cambridge University Press; Williams, B. (1973). Problems of the Self. New York: Cambridge University Press (pp. 166186) (1981). Moral Luck. New York: Cambridge University Press (pp. 114123) (1985). Ethics and the Limits of Philosophy. Cambridge: Harvard University Press, Chapter 10 (1993). Shame and Necessity. Berkeley: University of California Press. 16 He writes that where I have no duties I have no rights. He goes on to deny that there can be rights where there are no duties. 17 For a further defense of the Kantian position on moral duties, see Baron, M. (1984). The Alleged Moral Repugnance of Acting From Duty. The Journal of Philosophy, 81; Jeske, D. (1998). A Defense of Acting From Duty. Journal of Value Inquiry, 32 (pp. 6174).

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There are, of course, different senses of the utilitarian grounds for there being a moral duty to die. First, it might mean that X has a duty to die if Xs not dying will result in much greater disutility than if X were to die. Consider a version of the case of the inquiring murderer, where the murderer will kill everyone in a room unless someone informs her as to where a certain person is, whom she will kill. In such a case, and assuming that the only possibilities are that either the murderer will kill everyone in the room or simply kill the person about whom she is inquiring, the utilitarian might argue that there is a moral duty for the one person to die, that is, the person for whom the inquiring murderer has come seeking. Secondly, there might be a duty to die where death brings about livable circumstances where they were before unlivable (martyr case). One instance of this sort of moral duty to die, it might be argued, would be for a revolutionary cause that is morally right, all things considered. Where conditions are such that a group of persons has nothing to lose but their chains, a utilitarian might argue that if the death of one person (say, by suicidal revolutionary terrorism) would enhance the lives of the oppressed group, then that one person has a moral duty to attack (an oppressor) suicidally, which seems to under such circumstances imply a moral duty to die. This kind of case bears a resemblance to familial ones where a parent might well believe there are instances where he has a moral duty to die to save the lives of his family members. This might lead us to infer that in some cases the martyr case leads to a duty to die where the martyr, in dying, brings about a signicant change in social utility from horrible to acceptable or better. Although it is certainly possible, in principle, for rational parties to agree on certain conditions in which there is a duty to die, it is unclear that such an agreement would constitute a moral duty. For it is unclear that rational agents would indeed agree to there being a duty to die when they themselves might nd that it is against their own interests to adopt such a policy. For example, those who are risk averse and simultaneously desiring of their own lives to continue for a rather long duration, might nd such a duty irrational. Suppose that a moral agent valued her life itself most supremely, no matter what the quality of that life for herself. Then there would be no generalizeable conditions in which she would agree that there is a duty to die. Thus it is unclear that such parties would contract for a moral duty to die. Indeed, it would then be irrational for her to consent to there being such a duty, that is, unless it can be shown that the value that she placed on her own life is itself irrational. Realizing that one has only one life to live, and that it is intrinsically valuable, one might argue rationally that one never has a moral duty to die, though one might have a moral right to do so. Thus a contractarian notion of the duty to die along these lines is problematic. 18 Contractarian accounts of the duty to die are found in Battin, M. P. (1987). Age Rationing and the Just Distribution of Health Care. Ethics, 97 (pp. 317340) (2000). Global Life Expectancies and the Duty to Die. In Humber & Almeder (Ed.) (pp. 6178); and Ehman, R. E. (2000). The Duty to Die: A Contractarian Approach. In Humber & Almeder (Ed.) (pp. 6178). 19 Menzel articulates and defends a conception of the duty to die inexpensively in medical contexts. Such a duty differs, however, from the duty to die generally in at least the following ways. First, Menzel argues for a personal moral duty to die cheaply, one which, unlike the more general moral duty to die, is not exercised at all by enforcement activities of others (such as when the State punishes criminals). The person, moreover, who has a moral duty to die cheaply desires still to live, whereas those who have a more general moral duty to die need not desire to live. 20 By ought I mean a word expressing moral obligation, just one possible meaning of the term, according to Harman, G. (1977). The Nature of Morality. Oxford: Oxford University Press (pp. 8487). 21 Cornman, J., Lehrer, K. & Pappas, G. (1992). Philosophical Problems and Arguments, Fourth Edition Indianapolis: Hackett (p. 304). For more on ought implies can, see Carey,

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What Conict of Duty is Not; Keilkopf, C. F. (1967). Ought Does Not Imply Can. Theoria; Sinnott-Armstrong, W. (1984). Ought Conversationally Implies Can. The Philosophical Review, XCIII (pp. 249261). 22 This point holds true, it seems, even though it is true, in general, that the medical costs for prolonging life are greater than those for ending it. 23 Menzel is careful to focus his discussion on a specic type of physician, namely certain specialists whom he believes are overpaid for a variety of reasons. However, I believe that Menzels arguments concerning the unjustiedness of certain physicians salaries are sound and apply to physicians more generally. The same arguments, I believe, apply in general to medical/hospital administrators. 24 Perhaps consistent with the egalitarianism articulated and defended in Cohen, G. A. (23 May 1991). Incentives, Inequality, and Community. The Tanner Lectures on Human Values, Stanford University, 21 (1995). The Pareto Argument for Inequality. Social Philosophy & Policy, 12 (pp. 160185). 25 Gregory Kavka, G. (1986). Hobbesian Moral and Political Theory. Princeton: Princeton University Press. 26 Gauthier, D. (1986). Morals By Agreement. Oxford: Oxford University Press (1990). Moral Dealing. Ithaca: Cornell University Press; Rawls, J. (1993). A Theory of Justice; Political Liberalism. New York: Columbia University Press (1999). Collected Papers. Freeman, S. (Ed.) Cambridge: Harvard University Press (1999). The Law of Peoples. Cambridge: Harvard University Press. For commentaries on Rawls version of contractarianism, see Blocker, H. G. & Smith, E. H. (Ed.) (1980). John Rawls Theory of Social Justice. Athens: Ohio University Press; Corlett, J. A. (Ed.), (1991). Equality and Liberty: Analyzing Rawls and Nozick. London and New York: Macmillan and St. Martins; Daniels, N. (1975). Reading Rawls. New York: Basic Books; Pogge, T. (1990). Realizing Rawls. Palo Alto: Stanford University Press. 27 Murphy, J. G. & Hampton, J. (1988). Forgiveness and Mercy. Cambridge: Cambridge University Press. 28 For a discussion of agent-centered moral prerogatives and agent-centered moral requirements, see Schefer, S. (1982). The Rejection of Consequentialism. Oxford: Oxford University Press; Samuel Schefer, S. (Ed.) (1988). Consequentialism and Its Critics. Oxford: Oxford University Press. 29 This view seems to be consistent with the analysis of punishment found in Kant, The Metaphysical Elements of Justice (p. 102). For a critical analysis of Kants philosophy of punishment, see Murphy, J. G. (1987). Does Kant Have a Theory of Punishment? Columbia Law Review, 87; Corlett, J. A (1993). Foundations of a Kantian Theory of Punishment. The Southern Journal of Philosophy, XXXI (pp. 263284). 30 I take the concept of desert as a primitive one. It is beyond the scope of this paper to provide a defense of it. For discussions of the concept of desert, see, Pojman, L P. & McLeod, O. (Ed.) (1999). What Do We Deserve? Oxford: Oxford University Press. 31 The need to globalize the discussion of the duty to die is made by Battin, Global Life Expectancies and the Duty to Die. 32 My knowing that I have a moral duty to die (What I shall refer to as the Epistemic Condition) is neither a necessary nor a sufcient condition of my having such a duty. It is not necessary because I can indeed possess the duty but not know it, and it is not sufcient because my knowing that I have such a duty will not ground it, if I, say, cannot die by other than natural causes at a particular time and place. 33 Kagan, S. (1998). Rethinking Intrinsic Value. The Journal of Ethics, 2 (pp. 277297); Hurka, T. (1998). Two Kinds of Organic Unity. The Journal of Ethics, 2 (pp. 299320); Lemos, N. (1994). Intrinsic Value. Cambridge: Cambridge University Press; (1998). Organic

61
Unities. The Journal of Ethics, 2 (pp. 321337); Feldman, F. (1998). Hyperventilating About Intrinsic Value. The Journal of Ethics, 2 (pp. 339354); Audi, R. (1998). The Axiology of Moral Experience. The Journal of Ethics, 2 (pp. 355375); ONeill, J. (1992). The Varieties of Intrinsic Value. The Monist, 75 (pp. 138161); Quinn, W. S. (1974). Theories of Intrinsic Value. American Philosophical Quarterly, 11 (pp. 123132). 34 I am grateful to Robert Almeder, James Humber, and Paul Menzel for their helpful comments on an earlier draft of this paper, and to Angela Feres for her diligence in the preparation of this article for publication.

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