This article explores the formal and functional characteristics of narratives of ‘good’ and ‘bad’ deaths as they were told by 13 UK-based hospice managers in the course of semi-structured interviews. The interviewees’ responses include a variety of remarkably consistent ‘narratives of successful/frustrated intervention’, which exhibit distinctive formal characteristics in terms of the starting point and core of the action, the choice of personal pronouns and metaphors, and the ways in which positive and negative evaluation is expressed. In functional terms, the (...) hospice managers’ narratives play an important role in representing and constructing their professional views, challenges and identities. Overall, the narratives argue for the role of hospices and professional hospice staff in facilitating a ‘good’ death, and, by presenting a relatively unified view, may potentially preclude alternative perspectives. (shrink)

This study was an investigation of which distinctive elements would best describe good and bad death, preferences for life-sustaining treatment, and advance directives. The following elements of a good death were identified by surveying 185 acute-care hospital nurses: comfort, not being a burden to the family, a good relationship with family members, a readiness to die, and a belief in perpetuity. Comfort was regarded as the most important. Distinctive elements of a bad death were: persistent vegetative state, (...) sudden death, pain and agony, dying alone, and being a burden to the family. Of the 185 respondents, 90.8% answered that they did not intend to receive life-sustaining treatment if they suffered from a terminal illness without any chance of recovery; 77.8% revealed positive attitudes toward advance directives. Sixty-seven per cent of the respondents stated that they were willing to discuss their own death and dying; the perception of such discussions differed according to the medical condition (p = 0.001). The elements of a bad death differed significantly depending on the disease state (p = 0.003) and on economic status (p = 0.023). (shrink)

That which constitutes a ‘good death’, or dying well, has long been of interest to philosophers and clinicians alike. While difficult to define due to its deeply personal nature and dependency on spiritual and cultural beliefs and past experiences, Wilkinson1 has drawn parallels from art and music to consider key ethical components. Few in clinical practice would dispute that a ‘good death’ is one that does not rob the person of a valuable life, is aligned with the preferences (...) of the patient and/or their family, where comfort and solace is provided, distress to family and caregivers is minimised or even that dying is not prolonged. However, what is more contentious is how tensions within the principles of a ‘good death’ should be managed or prioritised. In the context of caring for critically ill babies and children, the tension often takes the form of prolonging the dying process through providing life-sustaining interventions to meet the needs of, and to lessen the longer term distress of, the bereaved family, who must live with the decisions that are made. Though often justifiable, such interventions may result in considerable moral distress within caregivers—particularly, as often the case, when interventions are perceived by some clinicians to be of greater benefit to the family than the patient. Some clinicians may have difficulty …. (shrink)

BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation (...) between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

Some have argued (following Epicurus) that death cannot be a bad thing for an individual who dies. They contend that nothing can be a bad for an individual unless the individual is able to experience it as bad. I argue against this Epicurean view, offering examples of things that an individual cannot experience as bad but are nevertheless bad for the individual. Further, I argue that death is relevantly similar.

According to John Martin Fischer and Anthony Brueckner’s unique version of the deprivation approach to accounting for death’s badness, it is rational for us to have asymmetric attitudes toward prenatal and posthumous nonexistence. In previous work, I have defended this approach against a criticism raised by Jens Johansson by attempting to show that Johansson’s criticism relies on an example that is incoherent. Recently, Duncan Purves has argued that my defense reveals an incoherence not only in Johansson’s example but also (...) in Fischer and Brueckner’s approach itself. Here I argue that by paying special attention to a certain feature of Fischer and Brueckner’s approach, we can dispense of not only Johansson’s criticism but also of Purves’s objection to Fischer and Brueckner’s approach. (shrink)

A popular view about why death is bad for the one who dies is that death deprives its subject of the good things in life. This is the “deprivation account” of the evil of death. There is another view about death that seems incompatible with the deprivation account: the view that a person’s death is less bad if she has lived a good life. In The Ethics of Killing, Jeff McMahan argues that a deprivation account (...) should discount the evil of death for previous gains in life. I argue against discounting evils, and show how a version of the deprivation view can accommodate McMahan’s examples. (shrink)

I argue that death can be (and sometimes is) bad for cattle because it destroys relationships that are valuable for cattle for their own sake. The argument relies on an analogy between valuable human relationships and relationships cattle form with conspecifics. I suggest that the reasons we have for thinking that certain rich and meaningful human relationships are valuable for their own sake should also lead us to think that certain cattle relationships are valuable for their own sake. And (...) just as death is bad for us when it destroys our valuable relationships, so death is bad for cattle when it destroys their valuable relationships. This argument is important because it pinpoints something that is bad about death for cattle that is overlooked by popular accounts of the badness of death for non-human animals that focus exclusively on the impact of death on lifetime well-being levels. Thus, the argument reveals an overlooked moral cost of some of our farming practices. (shrink)

One popular rival to Epicureanism is deprivationism, which maintains that a person’s death at a given time is bad for her to the extent that, and because, it prevents her from having a longer life that would have been, on the whole, good. Deprivationism has the surprising implication that we can lessen how bad a person’s death is for them by changing the life they would have had if they lived longer (for example, by convincing a person’s favorite (...) author to stop writing additional books). Some have found this possibility to be “self-defeating”; Egerstrom defends deprivationism against this objection. (shrink)

It seems that, whereas a person's death needn't be a bad thing for him, it can be. In some circumstances, death isn't a "bad thing" or an "evil" for a person. For instance, if a person has a terminal and very painful disease, he might rationally regard his own death as a good thing for him, or at least, he may regard it as something whose prospective occurrence shouldn't be regretted. But the attitude of a "normal" and (...) healthy human being - adult or child - toward the prospect of his death is different; it is not unreasonable in certain cases to regard one's own death as a bad thing for oneself. If this is so, then the question arises as to why death is bad, in those cases in which it is bad. (shrink)

Epicurus seems to have thought that death is not bad for the one who dies, since its badness cannot be located in time. I show that Epicurus’ argument presupposes Presentism, and I argue that death is bad for its victim at all and only those times when the person would have been living a life worth living had she not died when she did. I argue that my account is superior to competing accounts given by Thomas Nagel, Fred (...) Feldman and Neil Feit. (shrink)

In this article I defend innocuousism– a weak form of Epicureanism about the putative badness of death. I argue that if we assume both mental statism about wellbeing and that death is an experiential blank, it follows that death is not bad for the one who dies. I defend innocuousism against the deprivation account of the badness of death. I argue that something is extrinsically bad if and only if it leads to states that are intrinsically (...) bad. On my view, sometimes dying may be less good than living, but it is never bad to die. (shrink)

Deprivation accounts of death's badness, such as Feldman’s (1992), that purport to avoid questionable life-death comparatives Silverstein warns against (1980) by comparing only the values of various alternative life-wholes, implicitly depend upon assigning greater comparative value to periods of these life-wholes (for the person who lives) than is assigned to periods when the person is not alive, and thus are simply special cases of the problematic life-death comparative. Life-death comparatives undermine any deprivation account if (1) there (...) is no way things are (good or bad) for one who does not exist, and (2) values are comparative in the way specified by VC. Rejecting VC is not an option for the standard deprivation account, since this account uses VC to show that since continued life is good for the person who continues to live, death must be worse for that person. The non-standard deprivation account, dubbed by McMahan the reconciliation strategy, does not employ VC, but it also fails to vindicate common sense attitudes towards matters of life and death, and is in the main a capitulation to the Epicurean position. The remaining option for one who wishes to defend the view that death is typically bad for the person who dies is to directly target the Epicurean starting point, that things cannot be good or bad for a person when he does not exist. (shrink)

RésuméLa mort d'une personne peut-elle être intrinsèquement mauvaise pour la personne qui meurt? Et pourquoi est-il mal de tuer une autre personne? Je soutiens qu'une réponse adéquate à l'une ou l'autre de ces questions requiert d'apprécier l'importance morale de l'autonomie. J'examine ici la conception dominante de ce qui rend la mort mauvaise — la théorie de la dépossession —, ainsi que deux conceptions rivales de ce qui fait qu'il est mal de tuer — la théorie de la dépossession appliquée à (...) l'acte de tuer, et la thèse des droits liminaux de Judith Thomson. Bien que mon objectif principal dans cet article soit d'établir l'importance de l' autonomie pour expliquer à lafois que la mort est mauvaise et qu'il est mal de tuer, je pense également qu'une réflexion sur ce qui rend la mort mauvaise nous apprend quelque chose au sujet des droits et de leur force, et qu'une réflexion sur les droits nous apprend quelque chose quant à ce qui fait que la mort et l'immortalité sont toutes deux de mauvaises choses. (shrink)

After examining arguments for and against the view that death is a bad thing, Mikel Burley tentatively endorses the Epicurean claim that death cannot rationally be judged bad. For moral reasons, however, this conclusion is acceptable only with regard to one's own death.

Since at least the time of Epicurus, philosophers have debated whether death could be bad for the one who has died, since death is a permanent experiential blank. But a different puzzle about death’s badness arises when we consider the death of a person who is paradise-bound. The first purpose of this paper is to develop this puzzle. The second purpose of this paper is to suggest and evaluate several potential attempts to solve the puzzle. After (...) rejecting two seemingly attractive suggestions, I argue that there are two types of solution to the puzzle that can succeed. The first type of solution simply denies that death can be bad for the paradise-bound. I argue that the main worry for this type of solution, namely that it gives up the common-sense view about death’s badness, is only a prima facie worry. The second type of solution maintains that death can be bad for the paradise-bound because it can deprive her of certain goods, which allows those who are attracted to this type of solution to adopt the deprivation account of death’s badness. I consider three views of the relation between the paradise-bound and paradise that are consistent with the deprivation account, connecting my discussion of paradise with the extant literature on death’s badness. (shrink)

On a view most secularists accept, the deceased individual goes out of existence. How, then, can death be a bad thing for, or harm, the deceased? I consider the doctrine of subsequentism, according to which the bad thing for the deceased, or the harm of death to the deceased, takes place after he or she has died. The main puzzle for this view is to explain how we can predicate a property at a time (such as having a (...) misfortune or being harmed) to an individual who does not exist at that time. This is the Problem of Predication. I consider alternative attempts to solve this puzzle, including one suggested by Ben Bradley, and I argue that they do not succeed. I go on to provide a new way of addressing the Problem of Predication and thus defending subsequentism against this specific threat, contrasting my approach with others currently on offer. (shrink)

I argue that excessive reliance on the notion of “the badness of death” tends to lead theorists astray when thinking about healthcare prioritisation. I survey two examples: the confusion surrounding the “time-relative interests account” of the badness of death, and a confusion in the recent literature on cost-benefit analyses for family planning interventions. In both cases, the confusions in question would have been avoided if (instead of attempting to theorise in terms of the badness of death) theorists (...) had forced themselves first to write down an appropriate value function, and then focused on the question of how to maximize value. (shrink)

This chapter discusses the metaphysical view referred to by Harry Silverstein as “four-dimensionalism,” but referred to in this chapter as “eternalism.” In contrast to presentism, eternalism posits that purely past and purely future objects and events exist. If a person goes out of existence at the moment of death, the problem arises as to how death is bad for its victim. According to Silverstein, this problem arises from the truth of the “Values Connect with Feelings” thesis, according to (...) which it must be possible for someone to have feelings about a thing in order for that thing to be bad for that person. The badness of death may entail eternalism, but it is for an entirely different reason. Eternalism must be true in order for there to be a time at which death is bad for its victim. These two conflicting views are discussed in this chapter. (shrink)

In The Solace, Joshua Glasgow’s main claim is that life has “radiant value” and that death inherits some of that value; this provides us with a source of solace. He also argues that death is bad not only in virtue of depriving us of good things, but also in virtue of depriving us of opportunities for good things. I raise difficulties for these claims.

One way to defend humane animal agriculture is to insist that the deaths of animals aren’t bad for them. Christopher Belshaw has argued for this position in the most detail, maintaining that death is only bad when it frustrates categorical desires, which he thinks animals lack. We are prepared to grant his account of the badness of death, but we are skeptical of the claim that animals don’t have categorical desires. We contend that Belshaw’s argument against the badness (...) of animal death relies on overly simplistic thought experiments and isn’t sufficiently careful in how it attributes mental states to animals. We present some cases of animal behavior from recent work on animal cognition that are most plausibly understood as spurred by categorical desires and we show how an independently plausible account of mental content—Ruth Millikan’s teleosemantics—supports our attribution of categorical desires in those cases. We end by arguing that even if you’re wary of our reliance on teleosemantics, you should still accept it due to considerations about moral risk. (shrink)

Suppose that at the moment of death, a person goes out of existence.1 This has been thought to pose a problem for the idea that death is bad for its victim. But what exactly is the problem? Harry Silverstein says the problem stems from the truth of the “Values Connect with Feelings” thesis (VCF), according to which it must be possible for someone to have feelings about a thing in order for that thing to be bad for that (...) person (2000, 122). But in order for a person to have feelings about a thing, the person and the thing must coexist in some way. Thus Silverstein feels compelled to endorse a metaphysical view he calls “four-dimensionalism,” but which I prefer to call “eternalism”: the view that purely past and purely future objects and events exist.2 I agree with Silverstein that the badness of death entails eternalism. But the reason is different. Eternalism must be true in order for there to be a time at which death is bad for its victim. Death is bad for its victim at all those times when the victim is worse off for having died: namely, the times when he would have been living a good life had that death not occurred.3 Silverstein rejects this view; he thinks there is something wrong with the very question of when death is bad for its victim. In what follows I argue that Silverstein has not shown the relevance of eternalism to VCF or the badness of death, and I defend my view about the time of death’s badness against Silverstein’s arguments. (shrink)

I aim to show that the common idea according to which we can assess how bad death is for the person who dies relies on numerous dubious premises. These premises are intuitive from the point of view of dominant views regarding the badness of death. However, unless these premises have been thoroughly justified, we cannot measure the badness of death for the person who dies. In this paper, I will make explicit assumptions that pertain to the alleged (...) level of badness of death. The most important assumption I will address is the assignment of a quantitative value of zero to death, which leads to the conclusion that there are lives not worth living for the affected person. Such a view interprets the idea of a live worth living in quantitative terms. It is in conflict with actual evaluations of relevant people of their lives. (shrink)

Those who endorse the view that death is in some cases bad for the deceased—a view that, as I shall explain, has considerable bearing on many bioethical issues—need to address the following, Epicurean question: When is death bad for the one who dies? The two most popular answers are "before death" (priorism) and "after death" (subsequentism). Part of the support for these two views consists in the idea that a third answer, "at no time" (atemporalism), makes (...) death unsatisfyingly different from other evils. I argue that this objection is mistaken, and that priorism and subsequentism face problems that atemporalism avoids. Moreover, I argue that if it is nonetheless insisted that we must find a time at which my death is bad for me, we can appeal to periods that begin before my death and end after my death. I end with some implications for posthumous harm. (shrink)

This paper offers an account of the property Feuerbach and Marx called “species-being,” the human being’s distinctive tendency to identify herself as a member of her species, and to think of the species as a “we.” It links the notion to Kant’s theory of rights, arguing that every claim of right commits the maker of that claim to something like world government, and therefore to the conception of humanity as a collective agent. It also links species-being to the concept of (...) practical identity, arguing that the conceptions under which we find our lives and actions valuable are ones according to which we make a positive contribution to the life of the species. It then argues that the resulting conception of humanity, together with certain considerations about the nature of the good, provides grounds for challenging the familiar claim that death is generally worse for human beings than for animals. On the other hand, because of species-being, the extinction of our species is a much worse prospect for human beings than for the other animals. (shrink)

Typically, the determination of death by neurological criteria follows a very specific protocol. An apnea test is performed with further confirmation as necessary, and then mechanical ventilation is withdrawn with the consent of the family after they have had an opportunity to “say goodbye,” and at such a time to permit organ retrieval (with authorization of the patient or consent of the next of kin). Such a process maximizes transparency and ensures generalizability. In exceptional circumstances, however, it may be (...) necessary to deviate from this protocol in order to spare family members unnecessary suffering and to reduce moral distress felt by clinical staff. It may also be appropriate, we argue, to refrain from even inquiring about organ donation when the next-of-kin is not only certain to refuse, but lacks the decision-making capacity to potentially consent. The case described in this article calls into question generally reliable assumptions about determination of death by neurological criteria, where the best the clinical team could do for the patient and his family was “the least bad option.”. (shrink)

As a cognitivist about emotions, Socrates takes the fear of death to be a belief that death is a bad thing for the one who dies. Socrates, however, thinks there are reasons for thinking death is not a bad thing at all, and might even be a blessing. So the question considered in this paper is: how would Socrates explain the fact that so many people believe death is bad?