I am indebted to many people, especially Dorsey Armstrong, Shannon French, and Kenneth Hodges, for helpful discussions of this material. An early version of this essay was read at the Thirty-Sixth International Congress on Medieval Studies.This essay is dedicated to the glorious memory of Nina Lindsey.

Fiction can help make students better thinkers about some philosophical issues, but this does not mean it will make them morally better people.

Anyone who thinks contemporary American society is hopelessly contentious and lacking in shared values has probably not been paying attention to the way the popular media portray the hospice movement. Over and over, we are told such things as that “Humane care costs less than high-tech care and is what patients want and need,” that hospices are “the most effective and least expensive route to a dignified death,” that hospice personnel are “heroic,” that their “compassion and dedication seem inexhaustible,” and (...) that “few could argue with the powerful message that it is better [for dying patients] to leave wrapped in the love of family and care givers than locked in the cold, metallic embrace of a machine.“. (shrink)

My little girl has leukemia; she has had it for over a year, and now she needs at least five pints of blood a day. Not the whole blood, just the platelets. Most of our relatives and friends have given at least a few times. But we need more. Now I have to go to strangers.So begins Roberta Silman's short story, “Giving Blood,” a story about illness and charity. When the narrator's husband solicited blood donations at his workplace, “he thought (...) everyone would help…He must have asked a hundred people. Thirty gave. His officemate…turned green and said, ‘Oh, no, anything but that. I'm scared of needles.'”. (shrink)

Death can be good— I’ll tell you how. Just have it come Decades from now.1 Full disclosure: The above poem expresses my outlook, and I have trouble empathising with people who want to die. But that does not make me unable to evaluate objections to the expressivist argument against PAS. Reed sets forth the expressivist argument as follows: ‘[W]hen we allow PAS for individuals who are terminally ill or facing some severe disease or disability, we send a message of disrespect (...) to all individuals who face such adversities in that we imply that they are inferior or their lives are not worth living (or at least less worth living than they otherwise would be) precisely insofar as they are diseased or disabled’.2 The passage of mine that Reed quotes, however, was not intended to set forth an expressivist view. Rather than saying the double standard of selective legalisation ‘send[s] a message of disrespect’,3 it says this double standard in fact involves a systematic devaluation of some people’s lives. I will argue that there are conditions under which this double standard does send a message of disrespect, but first I want to disassociate myself from the expressivist formulations of Coleman and Keown that …. (shrink)

The prelims comprise: Rationality Morality Advance Directives Conclusion Notes References Suggested Further Reading.

Each of these hospice officials makes several criticisms of my paper, Philosophy of Hospice I will treat these criticisms in turn.

The word ‘dignity’ is a staple of contemporary American medical ethics, where it often follows the words ‘death with’. People unfamiliar with this usage might expect it to apply to one’s manner of dying—for example, a stately exit involving ceremonial farewells. Instead, conventional usage generally holds that “death with dignity” ends or prevents life without dignity, by which is meant life marked not by buffoonery, but by illness and disability. Popular examples of dignity-depleters include dementia, incontinence, and being “dependent on (...) machines”—provided the machines are respirators rather than furnaces, refrigerators, and computers. (shrink)

This article deals both with greatly extended finite life and with immortality and uses the term ‘greatly extended life’ to cover both. Except where indicated, it proceeds from some assumptions adapted from Christine Overall. First, people would know the life expectancy in their society or would know that they were immortal. Second, everyone would have the opportunity to choose greatly extended life. Third, greatly extended life would not be mandatory; people would be able to opt out at any point.

Anyone who thinks contemporary American society is hopelessly contentious and lacking in shared values has probably not been paying attention to the way the popular media portray the hospice movement. Over and over, we are told such things as that “Humane care costs less than high-tech care and is what patients want and need,” that hospices are “the most effective and least expensive route to a dignified death,” that hospice personnel are “heroic,” that their “compassion and dedication seem inexhaustible,” and (...) that “few could argue with the powerful message that it is better [for dying patients] to leave wrapped in the love of family and care givers than locked in the cold, metallic embrace of a machine.“. (shrink)

. Conventional wisdom in our society is that a good death involves accepting it as natural rather than striving to stave it off as long as possible. An alternative view is “Death can be good / I’ll show you how / Just have it come / decades from now.” In this essay, I discuss how I use this poem and other light verses of mine in teaching philosophy. These poems offer unusual viewpoints in several additional areas of philosophical and bioethical (...) interest, including growth through adversity, old age, family relations, obesity, envy, inequality, and ambition. Such poems can supplement traditional philosophical writing by presenting these alternative viewpoints in an amusing way that can capture students’ attention and relieve the solemnity that often pervades philosophy courses. (shrink)

Consider these three positions about physician-assisted suicide:Physician-assisted suicide should be illegal for everyone.Physician-assisted suicide should be legal for only the terminally ill.Physician-assisted suicide should be legal for all competent adults.So far, the debate in America has been primarily between positions 1 and 2. I think it should be between positions 1 and 3. Both those positions embody reasonable viewpoints, and I will not try to decide between them in this chapter. But I will argue that the double standard embodied in (...) position 2 is morally untenable. (shrink)