Passive Aggression

In this posting I want to investigate the harm caused by passive aggression. However there can also be some benefits of passive aggression and these benefits must be weighed against any harm. In a previous posting I argued that rudeness is harmful because it damages civil discourse. I will attempt to show here that passive aggression is a form of rudeness and as a result damages discourse. I will conclude that in most circumstance any benefits of passive aggression are outweighed by the damage it does to civil discourse. Before commencing my investigation I will examine what is meant by passive aggression and the sort of circumstances in which it might be useful and why.

What is meant by passive aggression? According to Rebecca Roach passive aggression “is an expression of hostility, resentment, contempt, etc, that are indirect.” Hostility, resentment and contempt are all related to anger but it is important to note that acting with passive aggression is not the same as expressing anger. Perhaps passive aggression is a means of expressing repressed anger. Someone’s expression of anger sometimes is also an attempt to elicit a response from those who have angered him. Anger is connected to conflict. Passive aggression tries to avoid conflict by limiting action. Pure anger is an emotion requiring no reflection whilst the passive aggressor has to reflect on how he is going to react. Of course passive aggression might be a manifestation of anger which is an emotion but passive aggression remains a response to an emotion rather than the emotion itself. Roach defines passive aggression as an expression of hostility, resentment and contempt. It might then be argued that because hostility, resentment and contempt are emotions that passive aggression is really a second order emotion and that I am wrong to suggest otherwise. I would reject this argument by suggesting even if hostility, resentment and contempt are emotion passive aggression remains a reaction to these emotions rather than a higher order emotion. Someone can be unemotional when reacting with passive aggression. Lastly I will assume that passive aggression must be verbal because otherwise sullenness could be regarded as a form of passive aggression. Some might disagree with the last point but I won’t pursue it further here.

In what sort of circumstances is passive aggression usually employed? I would suggest that these circumstances fall into two broad sets. Firstly passive aggression is often employed when there is an asymmetry of power making the expression of anger difficult.  For instance an office worker might employ passive aggression towards his tyrannical boss. In these circumstances passive aggression is used because civil discourse appears to be impossible. Secondly passive aggression might be employed by someone who wishes to limit the damage full scale confrontation might do to relationships but also wishes to register his displeasure about someone else’s behaviour. These relationships are usually close relationships. For instance Andrew’s partner Bernice fails to attend Andrew’s sister Clair’s wedding due to some prior commitment. At a later date Clair says he can’t attend the christening of Andrew and Bernice’s baby due to another prior engagement. However had Bernice attended Clair’s wedding then Clair would have been pleased to attend the christening. Clair wishes to register him displeasure whilst at the same time avoiding a family row.

What harm does passive aggression cause? I will now argue that passive aggression harms us in three ways. Firstly I have suggested above that passive aggression is connected to hostility, resentment and contempt. These are harmful emotions. By seeking to avoid conflict passive aggression doesn’t address the issues underlying these emotions resulting in these issues remaining unresolved and the associated harmful emotions retained to some degree. It follows that passive aggression is harmful. Secondly it might be argued that expressing anger sends a message to someone that something is wrong. Repressed anger muddles the message. Expressing anger also focusses our attention on addressing the wrong. Repressed would seem to be less effective in doing so. However when there is an asymmetry of power even the expression controlled anger is difficult. It might then be argued that in these circumstance even if we can’t overtly express our anger that passive aggression enables us to do so covertly. It follows that if passive aggression is the covert expression of our underlying anger that expressing it might be of some limited benefit to us by permitting some limited venting of our feelings. Thirdly it might be argued that passive aggression might harm some people by causing a sense of a loss of agency because they are unable to directly express themselves. In response I would suggest that an asymmetry of power might causes someone feel a loss of a sense of agency and that passive aggression might benefit someone by restoring a limited sense of agency. Some sense of agency, even a limited one, might benefit us more than simply adopting a sullen attitude.

I have argued that passive aggression harms us because it fails to address underlying issues which means we retain harmful emotions, it fails to fully address the perceived wrong and damages agency. I then suggested that the harm of passive aggression might be counterbalanced by allowing us to covertly vent our anger leading to a reduction in the harmful emotions we are experiencing and restore a limited sense of agency. It follows that on balance passive aggression might benefit us. I now want to argue that passive aggression harms us in another way by damaging civil discourse. First I will argue that passive aggression is an indirect form of rudeness. Secondly I will argue that rudeness damages discourse which causes harm.

What do we mean by rudeness? In a previous posting I defined rudeness as someone knowingly not considering the needs, views and wishes of another and at the time of this inconsideration the other being aware of this inconsideration, see wooler.scottus . If we adopt this definition then it isn’t immediately obvious than passive aggression is a form of rudeness. After all passive aggression is triggered by the views and wishes of others. However even if passive aggression is triggered by the views and wishes of others it isn’t concerned with their needs. Passive aggression is only concerned the views and wishes of others in a limited way, it is only concerned with the perceived wrongness of these views. It follows that someone expressing passive aggression fails to properly consider the needs, views and wishes of the person the aggression is directed at. Must someone at whom the aggression is aimed at be aware of the aggression? It might be suggested that passive aggression is an indirect way of expressing hostility, resentment and contempt those who the aggression is aimed need not be aware of it. If this is so then passive aggression is simply a private venting of feelings. I would reject the above suggestion as passive aggression is only indirect aggression because the person expressing the aggression is aware that the person at whom the aggression is aimed is aware of it. Passive aggression is a way of making someone aware of your dissatisfaction with his behaviour whilst at the same time trying to limit the damage done to your relationship with him. In light of the above passive aggression seems to be a form of rudeness.

I now want to briefly argue that rudeness harms someone by damaging civil discourse. It might be argued that rudeness benefits the rude person by enabling him to freely express his true feelings free from the fetters of politeness. It might even be suggested that the free expression of feelings means rudeness is connected to honesty, I would reject this second suggestion because the focus of the rude person is partial and by knowingly ignoring the views of others he might deprive himself of further knowledge of the situation and increase the possibility of self-deception. However let us accept that rudeness can benefit the rude person by simply allowing the unfettered expression of his feelings. Unfortunately rudeness also involves an inattention to the views of others and as a result damages discussion by shifting the focus of our attention from the issues involved to the tone of the discourse. Rudeness means we talk at each other rather than engage in a meaningful civil discussion and fail to address the underlying long term issues. Let us accept that civil discourse promotes the meaningful discussion of difficult issues which benefits individuals. The pleasure of rudeness is short lived whilst the resolution of difficult issues matters in the long term. Issues that aren’t fully addressed can cause long term harm. It follows that the short term pleasure of rudeness is outweighed by the long term damage it does to individuals by a failure to address difficult issues. It further follows that if passive aggression is a form of rudeness it harms us by damaging discourse

It might be objected that in some circumstances civil discourse isn’t possible. For instance if someone has a tyrannical employer then he might be unable to engage in civil discourse about his grievances. In other circumstances someone’s extreme sensitivity might make it difficult for others to engage in meaningful discourse with him. In circumstances like these the pleasure of passive aggression cannot be outweighed by the harm done to civil discourse because civil discourse isn’t possible. Whilst being passively aggressive makes no sense to the powerful it makes perfect sense to the powerless. It follows that passive aggression might benefit some people in some circumstances.

The above conclusion depends on the premise that in some circumstances meaningful civil discourse is impossible. Let us accept this premise. However even if we accept the premise if the above conclusion is to be useful we must define these circumstance more rigidly. I argued above these circumstances in which passive aggression might be useful fall into two broad groups. Let us consider the first of these groups in which there is an asymmetry of power. In a totalitarian regime such as Stalinist Russia discourse about the regime’s policies is impossible and passive aggression might be justified. Jokes at the regime’s expense might be regarded as a form of passive aggression. However I would suggest that in most circumstances where there is an asymmetry of power civil discourse isn’t impossible but merely difficult. I would further suggest that just because civil discourse is difficult we shouldn’t abandon it and fall back on passive aggression to relieve our negative feelings. If we simply use passive aggression then we might be accused of taking the easy option, mental laziness or being lacking in courage. We might also be accused of failing to address the underlying issues which are the cause our passive aggression. How might we engage in civil discourse when there is an asymmetry of power? I would argue that this can be done in two ways. Firstly we should ask those we are aggrieved with simply to confirm what we are aggrieved about. This allows us to be sure our grievance is justified and may also alert those who aggrieve us to the fact that we are aggrieved in a non-confrontational way. Secondly we should ask those who aggrieve us why they are acting this way. We ask them to justify their actions again in a non-confrontational way. This might make those who aggrieve us reflect on their actions. It might also give us reason to question our negative feelings. I have argued elsewhere that such questioning can be repeated, see civil discourse . However all conversations come to an end and if the underlying issues cannot be resolved we should end the conversation by asking the person who has aggrieved us does he really ‘mean that’. It follows in most cases when there is an asymmetry of power civil discourse is possible even it is difficult. It further follows that because passive aggression damages civil discourse that we should try to avoid acting this way. Let us now consider the second group of circumstances in which passive aggression is often employed. These are when someone who wishes to limit the damage full scale confrontation does to close relationships whilst at the same time registering him displeasure. In these circumstances someone tries to limit the damage by avoiding the full expression of his anger. However repressing anger doesn’t eliminate it and it might manifest itself latter. I now want to argue that if when we are aggrieved if we adopt the strategy outlined above of asking for confirmation and then for further explanation then we shouldn’t do any greater harm to relationships than we would by the use of passive aggression. Firstly by simply asking someone to confirm something that aggrieves us might be slightly annoying but doesn’t seem to be confrontational. Secondly asking someone for an explanation might be confrontational to some degree but no more so than employing passive aggression. It would appear that asking for confirmation and explanation is no more confrontational than passive aggression but has the additional benefit of addressing the underlying issues rather than postponing discussion of them.

I have argued that passive aggression damages civil discourse. I also argued that except in exceptional circumstances discourse is possible when conducted carefully. I further argued that even if discourse is difficult it is better to try and engage in meaningful discourse rather than react with passive aggression because discourse helps resolve contentious issues whilst passively aggressive merely postpones addressing them. Lastly I argued that the use of passive aggression is a lazy way of dealing with contentious issues. It follows that except in very limited circumstances we should avoid the use of passive aggression.

Love me for a reason

Love is all around us, love matters to us and we value loving and being loved, but why love matters so much to us isn’t immediately clear. In this posting I want to offer a sketch of why love matters to us. Before proceeding I must consider three question. Love has many variations, we can have erotic love, parental love and affectionate love to name but a few. Are these completely different types of love or have these variations all evolved from a common basis or perhaps these apparently different types of love are in reality different ways of expressing a general idea of love in different domains?

According to Aristotle there are three types of love erotic, philia and agape. If we accept Aristotle’s position then on first appearance it would appear that there isn’t a single unified idea of love. According to Aristotle erotic love is a passionate desire for another, usually a sexual desire. Philia is more a fondness and appreciation of another and is important in friendship. Agape refers to the love of God for man or man for God. However it is still possible to argue that there is a unified concept of love. Firstly it might be suggested that these types of love are in reality identical and that the apparent differences in love might be due to the intensity of loving rather than differences in type. Secondly it might be suggested that apparent differences in love might be due to love being expressed differently in different domains. It seems possible that a more modern version of agape might be that of unconditional love of all. It follows that it is at least possible that there is an underlying unified concept of love.

I now want to argue that there is indeed a unified primitive concept of love. I will argue love isn’t just some concept that arose recently or is limited to human beings. Let us that assume “caring about” is a primitive form of loving. Animals can care about their offspring and if you accept group selection, as Darwin did, then animals which care about their offspring have an evolutionary advantage. It follows that a primitive type of love has a very long history. However even if a plover’s behaviour when it pretends to have a damaged wing in order to lure a predator away from its chicks is a primitive form of love it isn’t what we usually mean by love. Perhaps Aristotle was right after all and there are different types of love. I will now argue that love has evolved some sort of structure rather than being differentiated into different types. Let us accept us accept that many creatures including us possess a primitive kind of love, the ability to “care about”. This basic form of loving need have no affective or cognitive elements and might simply be based on some on ancient neurochemical systems that evolved to serve our ancestors' reproductive needs. It might be objected that such a basic system isn’t what we mean by love. Love as we know it can’t be defined in such a basic way. I accept my objectors point but my acceptance doesn’t mean we no longer retain this basic system. Nature is parsimonious and doesn’t usually replace ancient systems but adapts and modifies them to serve new purposes. It might then be suggested that what we mean by love is this ancient primitive system of “caring about” which has had its structure modified and built upon. It is hard to see how such a simple structure could be modified so let us assume it has been built upon. Firstly our primitive love has been expanded by our capacity to feel empathy. Let us be clear what we mean by empathy. I don’t mean empathic contagion such as that when one baby cries and another simply follows. I also don’t mean the ability just to understand how another feels which can be exploited by a sociopath. I mean having a disposition to feel as another feels. Secondly our primitive love has been expanded by our increasing cognitive abilities. A bird might only care for its chicks and perhaps its mate. Human beings increased cognitive abilities enable them to see others as much the same as themselves allowing them at the very least to question why they shouldn’t care about them hence increasing love’s domain. Lastly our primitive love has been expanded by the culture we live in. Let us accept that love can be regarded as an emotion. According to Lisa Feldman Barrett,

“An emotion is your brain’s creation of what your bodily sensations mean, in relation to what is going on around you in the world.” (1)

If we accept Feldman Barrett’s position then love depends on concepts and our concepts are partly constructed by the culture we live in. Her position can be supported by noticing that the dominant view of love in culture has changed over the last hundred and fifty years from romantic love to parental love. Let us accept that what we mean by love is our ancient capacity to “care about” which has been built on and had its domain extended by our capacity for empathy, our increased cognitive abilities and the culture we inhabit.

Let us now consider why we value love as outlined above. We can care about both loving and being loved. I now want to argue that loving is more important than being loved. The above seems counterintuitive. However we can imagine someone who isn’t loved but loves someone or something living a meaningful even if somewhat unhappy life. We can’t imagine someone living a meaningful life if she doesn’t care about anything at all. Let us assume that we must “care about” our ideals. According to Frankfurt having ideals, “caring about” or loving is essential to being a person.

“He can make whatever decision he likes and shape his will as he pleases. This does not mean that his will is free. It only means that his will is anarchic, moved by mere impulse and inclination. For a person without ideals, there are no volitional laws he has bound himself to respect and to which he unconditionally submits. He has no inviolable boundaries. Thus he is amorphous with no fixed shape or identity.” (2)

If we accept the above then we should value loving firstly because by loving we make ourselves into persons. Secondly what we love defines what sort of persons we are. On a somewhat speculative note it might be suggested children keep teddy for reasons of love. Teddy bears can’t love children so perhaps children keep bears because of their need to love. I have also suggested elsewhere that this need to love is one of the reasons some people keep pets, see the philosopher's dog .

I have argued that it is more important to love than be loved. Nonetheless to human beings and perhaps some other creatures such as dogs being loved is also of major importance. To be loved means that a lover must care about the interests of his loved one. Could someone be said to love another person if he remained completely indifferent to the interests of that person? It follows one reason we value being loved is because it advances our interests. However our interests can be advanced by others acting from duty and doing so needn’t involve love. Moreover even if most people want to be cared about they would nonetheless regard simply being cared for as an incomplete form of love. Husbands, wives, romantic partners, friends and children don’t want to be simply cared for in the way someone cares about a pet, they want to be cared about because of the particular people they are. It would appear that people want to be loved for a reason and they want that reason to be based on the sort person they are, their characteristics. Sven Nyholm expresses this want,

“Love is, in this way, a sort of confirmation that we are, as we might put it, ‘lovable’ in the sense of being able to inspire or call forth such dispositions in another (namely the lover).” (3)

A lover doesn’t love everyone but specific persons. What sort of specific qualities does a loved one need in order to create a disposition in his lover to love her? Prima Facie it might seem what creates such a disposition is the attributes the loved one possesses, for example someone might be loved because of her humour, tenacity and straight talking. 

Unfortunately accepting the above raises three problems. First someone’s loved one might be fungible. They can easily be replaced by someone else who has the same attributes but to a greater degree or someone who has some additional attributes. Using the above example above the loved one might be replaced by someone who is funnier, has greater tenacity and whose conversation is even more to the point. Or alternatively by someone who is just as funny, tenacious and to the point but additionally is courageous. Nyholm seems to be suggesting that someone want to be loveable because of certain attributes she possesses but do we really love her or her attributes? If we love the attributes do we really love the person at all? This echoes Platonic love with all its problems.  Of course it might be suggested that we can’t separate a person from her attributes. A second problem arises if we love someone for her attributes then we should also equally love someone else who possesses identical attributes. Theoretically we could love a very large number of people who possess these attributes. It might be argued that in practice we don’t have the cognitive abilities to assess the attributes of a very large number of people meaning that in practice we are only likely to love a subset of the people who possess the same attributes. The number of people we can love might also be limited by the Dunbar number. Nonetheless in practice we could end up loving several people because they possess identical attributes. Of course such a situation might be perfectly acceptable for the friends we go to watch football with but does the same apply to romantic partners? Lastly do we love our children because of their good qualities or simply because they are our children? If we choose the first option then our love is conditional and I would suggest that this would cause problems with childrearing.

Nonetheless in spite of the above it is natural to see our children as possessing lovable qualities. However more generally do we see these qualities as lovable prior to loving our loved ones? If we don’t then perhaps we are labelling these qualities as lovable partly in order to explain to ourselves why we love our loved ones. Our loved ones don’t naturally possess lovable qualities we create them.

In the light of the above problems it might be suggested either that the account of love I have outlined love above is an inadequate one and that it should be replaced by a more adequate one or that there are different accounts of love in different domains as proposed by Aristotle. I am reluctant to accept either of these suggestions and will now give reasons for my reluctance. According to Simon May love is an ancient emotion but that over the last hundred and fifty years the dominant view of love has changed. Romantic love has been replaced by love of our children, parental love (4). I have suggested above that far from being a modern interpretation of what we mean by love that parental love forms the basis of all other forms of love. Let us accept that parents caring about their young offspring is a basic form of love. It is important to note caring about isn’t equivalent to caring for, someone may care for another without caring about him. Caring about means being vulnerable to the fate of the loved one caring for doesn’t. I will now argue that this primitive form of love when its domain is extended can account for our desire to be loved because of the specific persons we are.

What are the reasons someone has for loving us? It might be suggested that this question splits into two further questions. First, what sort of reasons might someone have for coming to love her loved one? Secondly what sort of reasons might have to continue loving her loved one? It might be objected that the reasons are identical in both situations. Accepting this objection means either that our original question doesn’t really split into two as I have suggested or if it does the same reasons satisfy both questions. Let us accept that the original question might split into two. Someone might come to love her loved one because of his beauty and years later continue loving him for another reason once this has faded. I now want to argue that we need reasons to come to love someone but that once we have done so we just continue loving her. We must have reason to come to love, to bestow love, but that we don’t need reasons to continue loving. Once we come to love someone we are simply satisfied with our love and we would need reasons to come to stopping loving someone, becoming dissatisfied with our love. If we accept the above then it is possible to explain why some people find it hard to stop loving. For instance the mother of a paedophile might continue to love her child in spite of the crimes he has committed. She came to love him because he was her child and once her love was established she became satisfied with her love.

What reasons do we have to come to love someone? I would suggest one sort of reason is the relationship between the lover and the loved one. A parent comes to love her child because he is her child, a friend loves her friend because he is her friend and romantic partners love each other because they are romantic partners. The fact that parents love their own children rather than other children who are just as cute, intelligent and charming seems to support the above. This suggestion is based on Niko Kolodmy’s idea of love as a valuing relationship (5). These reasons define the domain of love rather than love itself. It might be objected that some prior relationship isn’t a necessary condition for coming to love a loved one, one simply does it. Accepting the above raises the possibility of love at first sight. It might be argued that the type of love I have outlined above is unable to explain love at first sight. In response to this objection it might be argued that love at first sight is illusory. However even if we accept that love at first sight exists it can be explained by the type of love outlined above. I have argued above that we have a need both to be loved and to love. I argued above that we have a greater need to love than be loved. It follows that the reason for love at first sight can be satisfied by our need to love.

I have suggested that love was originally a simple emotion which has changed as we have evolved. It has been changed by our empathy, increased cognitive powers and we fact we live in a particular culture. I would now suggest that these changes have altered what we love, expanded the domain of our love, but haven’t changed how we love. I have also suggested that whilst we have reasons why we come to love someone we don’t have any reason to continue loving. Relationships give us reason to love someone but our love simply persists because we are satisfied with our love. If we accept the above what does this mean for Nyholm’s contention that we have a desire to be lovable. It certainly means we can’t be considered lovable because of some of the attributes we possess. But do we really want to be loved for our attributes? If we are wise and loved for our wisdom we would still want to be loved if we lost our wisdom. If we are loved for our caring we would still want to be loved when we become old have to be cared for rather than care for others. Perhaps we simply want to be loved rather than loved for some of our attributes. We simply want to be loved rather than loved for a reason. Accepting the above means there are reasons why we come to be loved but no reasons our continuing to be loved. We come to be loved because of we are the children of someone, the parent of a child or simply a friend. Accepting the above also helps explain why the parents of severely handicapped child love and regard him as irreplaceable even if he possesses few lovable properties. Perhaps we should be grateful for being loved and the benefits it brings.

1. Barrett, Lisa Feldman, 2017, How Emotions Are Made: The Secret Life of the Brain, Pan Macmillan, page 30
2. Harry Frankfurt, 1999 Necessity, Volition, and Love. Cambridge University Press. Page 114
3. Sven Nyholm,‘Love troubles: Human attachment and biomedical enhancements’, Journal of Applied Philosophy, 32, 2 (2015): 190–2
4. Simon May,2019, Love, a New Understanding of an Ancient Emotion, Oxford University Press, page 21[js1] 
5. Niko Kolodny, 2003, Love as Valuing a Relationship, The Philosophical Review, Vol. 112(2).
   

Afterthoughts

the need to love and be loved are both important and are intertwined but perhaps the need to love is the more important. Perhaps loving someone creates a desire for mutual love, a desire to be loved. Does it natter to us if we aren't loved by someone we don't love? Narcissists excepted. Does the need to love explain the difference between a nihilist and a terrorist? Nihilists have lost their need to love and be loved whilst terrorists have retained theirs even if this is misplaced.

 the

Civil Discourse

We live in a fractious age in which people are often rude to those who hold views opposed to their own. Indeed on some social platforms such as Twitter it would seem that being rude is necessary in order to be noticed. In this posting I don’t want to consider the nature or the causes of rudeness. In the philosophy of rudeness I argued that whilst rudeness isn’t immoral that nonetheless it damages discourse and as a result is on the road to immorality. In this posting I want to consider ways in which discourse can be improved with those who hold views which are radically opposed to our own. I will consider how we should talk to our opponents. This isn’t an easy task for as Amy Olberding points out people often enjoy being rude to one another for by being rude they escape from the constraints of politeness. They excuse their escape by believing that they are being true to themselves, being authentic. She suggests such excuses are usually poor excuses and almost all rudeness is unjustified. Moreover if rudeness is ever justified then we should feel regret when doing so rather than smug satisfaction. Olberding also points out that sometimes people are unaware that they are being rude. She advocates that in order to improve civility and reduce rudeness we should respect our opponents by adopting a well-mannered approach. In doing so she is echoing the ancient Chinese philosophy of Confucius and Mengzi. Let us agree with Olberding that being well mannered is a pre-condition for engaging in any meaningful discourse which questions some the views of our opponents. According to Olberding any well-mannered discourse must be pro social and involve respect, consideration and toleration. Perhaps if rudeness damages meaningful discourse civility fosters it. However even if the tone of our discourse is polite what we talk about matters. Even if our arguments are good ones telling people why they are wrong and why we are right is unlikely to be effective. In this posting my arguments will not be primarily about the tone of what we talk to our opponents about but the methods we employ when discussing the issues involved. I will suggest three ways which might make a discourse more meaningful. Firstly I will argue that we should simply and politely explain our own views together with our reasons for holding them. I will then counter argue that such an approach is unlikely to succeed in changing many minds. Secondly I will argue that in certain cases we should simply ask our opponents to confirm their views which we find objectionable, “do you really mean that”. Lastly I will argue that we should politely but firmly press our opponents about what justifies their views. My comments are meant to apply to face to face conversations and those on social media.

Let us briefly examine the first approach. We might try to convince our opponents that our values are sensible values and that the force of our politely expressed arguments will challenge them into changing their own views. We hope that the force of our argument alone will bring about change and that we shouldn’t challenge or directly attempt to discredit our opponents’ views. The hope being that good arguments win out in the long term. For instance, we might challenge opponents of gay marriage by pointing out that gay people have the same rights as other people in most areas of life and suggest that these rights ought to be extended to marriage. We might then hope that the logic of our argument will mean the opponents of gay marriage change their minds. Such a suggestion seems to be hopelessly naive and I am unconvinced that such an approach would be either right or successful. We may be polite to our opponents but we aren’t really trying to improve discourse, indeed it might be questioned whether we are really attempting any sort of meaningful discourse at all because we aren’t paying any attention to the views of our opponents. It might be suggested that we are really doing is preaching and that we aren’t being particularly polite to our opponents by ignoring their views. I would suggest what we wrong our opponents because by not considering their views we fail to respect them as persons. Moreover such an approach is unlikely to be successful because even if we supply good arguments supporting our views we aren’t giving our opponents any reasons to reject their own views. If someone has no reason to reject her current views then she is unlikely to do so. Good arguments don’t alone change minds they must be shown to be better arguments.

A second approach which we might adopt in any discourse questioning the views of our opponents we find objectionable would be simply to ask them to confirm these views, “do you really mean that”. Perhaps we should repeat their views in our own words to ensure clarity. This approach at least has the merit of being directed at their views which our first approach didn’t do. Such an approach seems to morally justifiable because we are being respectful, considerate and tolerant towards our opponents. Unfortunately such an approach seems unlikely to be successful in changing the views of people who are strongly committed to their views. Nonetheless sometimes people express views which reflect underlying unconscious biases. These biases can sometimes come out inadvertently in sexist or racist remarks. If we simply ask the agent “do you really mean that” then this might combat some more mild biases by doing two things. Firstly we are asking the agent to examine her views. If the these views are unconscious views which conflict with her more reflective ones then our question might lead her to reflect more fully on her views by bringing them into focus. Secondly we are expressing our disapproval in a polite manner. If we accept that one form of shame is fear of social disapproval then if the agent feels some shame this might once again cause her to question her views.

However simply asking our opponents to confirm their views which we find objectionable is unlikely to make the majority of them seriously question these views. How then might we more effectively question these views in a polite non-confrontational manner? One approach might be to adopt the position of Socrates and politely ask our opponents why they hold these views, to ask for justification, rather than telling them directly why these views are wrong. Perhaps this approach might be used in conjunction  with the one outlined above of asking out our opponents whether they really mean that. One benefit of such a composite approach is that we are talking with our opponents rather than preaching to them. If someone is asked to provide an explanation in order to help us understand some of her views then the explanation she provides must also offer some sort of justification which she believes supports her views. It might be thought such questioning is a simple task but such a thought would be premature. Our task isn’t simply to listen impatiently and then move on to our own agenda. Out task is to understand our opponent’s views and understanding requires paying attention and listening to her justification with a certain degree of humility. Such a discourse is likely to be a slow one because after listening we must only think of our response after listening. Once again our approach seems to be morally justifiable because it treats our opponents with respect, consideration and toleration. Returning to my example of gay marriage an opponent of gay marriage might justify her views by explaining to us that the purpose of marriage is to provide a safe environment for the creation and rearing of children. We must listen carefully and understand that her opposition to gay marriage is based on a particular view about the purpose of marriage. We might then ask her how this purpose justifies marriage for couples whose children have grown up or are childless. However I would suggest that such an approach is unlikely to change the minds of those who hold strongly held views for three reasons. Firstly the confirmation bias means those such as fervent Brexiteers or Trump supporters instead of changing their minds will seek alternative justifications for their views. Secondly someone’s strongly held views help make someone who she is, help in defining her, and relinquishing them involves a loss of pride. Nonetheless our questioning might help to erode some of our opponent’s most extreme views which would be a useful thing to do. Lastly some people have strongly held views which seem to be based on faith and don’t require justification. This last group is particularly hard to engage in civil discourse because there appears to be no place for the discourse to start. Some might argue that because this approach is unlikely to change many minds that we should adopt a much more aggressive approach towards our opponents in the hope of at least changing a few minds. Perhaps, instead of simply asking our opponents to justify their views, we should robustly tell them why we think these views are unjustifiable. Unfortunately such an approach means we end up simply “talking at” or preaching to our opponents rather than talking with them. Once again such an approach seems to be wrong because we fail to respect our opponents. Moreover the confirmation bias makes it unlikely that it will be successful in changing many minds. However a more strident approach might help convince those who are yet to form a settled view.

What are the consequences of adopting the above approach? One consequence of accepting the above is that we must be prepared to provide justifications for our own views when asked to do so. Moreover, if the justifications we provide seems on reflection to be inadequate ones then we must be prepared to exchange our defective views for more defensible ones. Secondly because we mustn’t simply listen to the justifications of our opponents views but try to understand them then if we find these justifications convincing we must be prepared to accept their views or at the very least amend our own.

1. Amy Olberding, 2019, The Wrongness of Rudeness, Oxford University Press

The Doctrine of Informed Consent and Respect for Autonomy

In this posting I want to examine the relationship, if any, between the doctrine of informed consent and respect for autonomy. In doing so I will try to answer three important questions. Firstly is the doctrine of informed consent based on respecting autonomy or is it a sui generis doctrine? The fact we talk about a doctrine of informed consent seems to suggest the latter. Secondly if informed consent isn’t based on respecting autonomy should it be so based? Lastly if informed consent is based on respecting autonomy what type autonomy should that be?

Is informed consent based on respecting patient autonomy? According to Charles Foster the doctrine of informed consent is in a mess.

“Informed consent, in practice, is a bad joke. It’s a notion created by lawyers, and like many such notions it bears little relationship to the concerns that real humans have when they’re left to themselves, but it creates many artificial, lucrative, and expensive concerns.” Practical Ethics

Let us accept that the principles underlying informed consent are unclear. Let us try to start understanding these underlying principles by examining the process of informed consent in practice. When taking informed consent a patient’s doctors propose some form of treatment and provide the patient with the information he needs in order to make a good decision. The patient then agrees or refuses to agree to this treatment. What is the purpose of this process? The purpose of the agreement part of this process seems clear. The agreement part prevents the patient being treated against his will and his doctors from being accused of assault. The purpose of the information part is different. The purpose of this part is to enable patients to make good decisions. What exactly do we mean by a good decision? A decision which is in the patient’s best interests or an autonomous decision? In a medical setting a decision which is in a patient’s best interests is one which minimises harm to the patient,  maintains or improves his physiological health. The amputation of a patient’s gangrenous leg would be an example of acting in a patient’s best interests by minimising harm. The provision of drugs to control a patient’s blood pressure would be an example of acting in a patient’s best interests by maintaining his physical health. A kidney transplant would be an example of improving a patient’s health. Autonomy is concerned with self-government and very roughly speaking an autonomous decision is one by which someone governs himself. However self-government is simply governing oneself and need not always be good government. We can govern ourselves badly. Let us assume that a patient simply wants to accept his doctors’ judgement about his treatment and doesn’t want to receive any additional information. Intuitively such a decision can be seen as a decision by which he governs himself and as a result is an autonomous decision for after all we can simply choose to follow our lawyer’s advice and most would regard such a decision as autonomous. However under The General Medical Council’s proposed guidelines such a decision might not be seen as a valid informed consent decision.

“If, after discussion, a patient insists that they don’t want even this basic information, you must explain the potential consequences of them not having it. This might include being unable to proceed if you are not confident that their consent would be valid, or if you are not confident that the proposed course of action would be beneficial to the patient overall.” (1)

In the light of the above it would appear that The General Medical Council’s guidelines are not really based on respecting autonomy and the purpose of providing information when taking informed consent is to enable patients make decisions which are in their best interests.

It might be objected that I have only briefly sketched a certain account of autonomy and that a different account might mean that the doctrine of informed consent could be based on respect for autonomy. After all in my brief account the patient in my example above who fully trusted his doctors to make a decision on his behalf might wake up to unexpectedly find himself with only one leg. It might be suggested such a decision isn’t an autonomous one and that we should adopt a more substantive account. For the sake of argument let us assume an autonomous decision must be one that concurs with some generally accepted set of norms. If these norms are to be generally accepted then they must concern what is good for people. Autonomous decisions become linked to good decisions. An autonomous decision must be a good decision and a bad decision cannot be an autonomous one. I now want to argue against accepting such a substantive account of autonomy. If an autonomous decision must be a good decision because it must concur with some accepted norms then it might be questioned whether such an account of autonomy is really doing any useful work. A substantive account of autonomy puts itself out of business because we only need to consider good and bad decisions. We don’t need to consider autonomous decisions at all. Using a substantive account of autonomy an autonomous decision must of necessity be a good decision according to some accepted norms whilst on a content neutral account of autonomy an autonomous decision can be a bad decision. Of course it is preferable that an autonomous decision, using a content neutral account of autonomy, is a good decision which benefits the decision maker but the purpose of respecting autonomy remains simply to respect the decision maker as a person and the actual decision doesn’t of necessity need to be a good one. If we accept the above then we have two options. Firstly we could abandon the pretence that underlying the doctrine of informed consent is respect for autonomy or secondly we could accept that underlying the doctrine of informed consent is respect for a content neutral or primitive account of autonomy and modify the doctrine accordingly.

If we accept the above then there is not only a difference in complexity between substantive and primitive accounts of autonomy but more importantly these different accounts have a different focus. A substantive account focusses on respecting good decisions, a primitive account focusses respecting persons by simply accepting their decisions. Adopting a primitive account requires adopting a certain degree of humility. Let us accept that if the concept of autonomy is to remain a relevant one that it must be a primitive or content neutral concept based on respecting persons. Such a concept might be classed as a Millian concept. In the rest of this posting ‘autonomy’ will refer to such a concept. Let us also accept the first of the above options that the doctrine of informed consent is a doctrine in its own right and isn’t based on respect for autonomy. The informed consent process starts with a patient’s doctors proposing a course of treatment which they believe to be in his best interests, the patient then consents or refuses to consent to the proposed treatment. I argued above that the purpose of informed consent is to get a patient to consent to treatment which his doctors believe to be in his best interests. In almost all cases the patient simply consents and no problems arise. What is interesting are cases in which the patient refuses to consent. In these cases according to the doctrine of informed consent a patient’s doctors must be sure, or take steps to ensure, that the patient knows the consequences of his actions. However let us assume that the patient maintains his refusal of consent. By what standards is his competence to refuse treatment measured by and how is it assessed? If someone takes a driving test his competence to drive is based on his actual driving. This is not true when assessing someone’s ability to give informed consent. Someone’s competence to give informed consent isn’t based on his actual decisions. His decision might of course trigger a competence assessment but his competence isn’t dependent on his actual decision. Someone’s competence to give informed consent is based on his ability to make good decisions based on his best interests. I would suggest that someone who has the ability to make good decisions based on his best interests is self-governing, is autonomous.

As mentioned above the purpose of a driving test is to measure someone’s competence to drive and the criteria by which his competence is measured is by his actual driving. The same isn’t true of informed consent. I have argued above that the purpose of informed consent is to enable patients to make good decisions. I have further argued above that the way in which a patient’s competence to make good decisions is assessed is by his ability to make autonomous decisions. Such a mismatch creates problems and perhaps is one of the reasons why the doctrine of informed consent is in a mess. Two solutions might be suggested to remedy this mismatch. First the purpose of informed consent should be to enable a patient to make a good decision in particular circumstances and the patient’s competence should be assessed by his ability to make a good decision in these circumstances. Secondly the purpose of informed consent is to enable a patient to make an autonomous decisions and his competence to do so should be assessed by his ability to make an autonomous decision.

Let us consider the first of these options. Let us accept that a good decision is one that is in the decision maker’s best interests and that a decision is a competent one only if the decision is in the decision maker’s best interests. Clearly if someone makes a decision to do something which he believes isn’t in his best interests then he isn’t making a good decision. If a patient’s competence depends on him making a good decision then he is incompetent. Perhaps he is paralysed by fear. However in practice most people make decisions which they believe to be in their best interests. Moreover in a medical setting there is usually agreement between the patient and his doctors about what these best interests are. Unfortunately in a few cases in which there might be disagreement about what is in a patient’s best interests. Let us accept that a patient who makes a decision which he believes to be in his best interests, but which is generally believed not to be in his medical interests by his doctors, is making an incompetent decision. In practice if a child or cognitively challenged adult makes a decision which others believe isn’t in his best interests his competence might be questioned and he might be treated against his will. Unfortunately if a competent decision must be a good decision then the same considerations would seem to apply to all patients. Accepting the above would mean that if any patient makes a decision which is generally regarded as not being his best interests then his decision is an incompetent one. In these circumstances the patient’s doctors might be accused of paternalism or even epistemic arrogance. Fortunately in most cases a patient’s medical best interests and what the patient believes are his overall best interests concur. However this isn’t true in all cases. In cases in which these interests don’t concur do we insist that a competent decision is based on a patient’s best medical interests or what he believes to be in his overall best interests? Practical considerations and the need to avoid the charge of paternalism suggest that we should choose the second option. However if we accept that a patient is making a competent decision when it concurs with what he believes are in his overall best interests we are back to assessing a patient’s competence to make a good decision by assessing his ability to make an autonomous one and the above mismatch remains unresolved.

The above difficulties suggest that we should choose the second option. The purpose of informed consent should be to enable patients to make autonomous decisions about their treatment and that any competence assessment should be based on their ability to make autonomous decisions. This provides an answer to the second of my three initial questions. Informed consent should be based on respect for patient autonomy. Moreover if a substantive account of autonomy makes itself redundant as I have argued above the type of autonomy underlying informed consent must be a primitive or Milliian account. This answers the third of my three initial questions. Accepting this option has consequences for the amount of information which needs to be supplied to patients when taking informed consent. In the past under the doctrine of informed consent a patient’s doctors determined what risks the patient should be made aware of. However the Montgomery ruling Montgomery ruling stated that a patient’s doctors must ensure that the patient is aware of any and all the risks involved. If patients are to make informed consent decisions based on respect for autonomy they don’t always need to be aware of any and all the risks and the Montgomery ruling seems to suggest that informed consent shouldn’t be based on respect for a primitive account of autonomy. However if we accept that if an account of autonomy is to remain a meaningful account that it must be a primitive account then if informed consent is based on respect for autonomy  it must be based on a primitive account. Accepting the above means that a patient’s doctors should have a dialogue with him about any suggested medical procedure. How this dialogue proceeds shouldn’t be preordained by some doctrine but driven by the patient’s needs. In most cases this will include informing him about any major risks and life changes he faces. However some patients might need less or more information in order to make an autonomous decision. As mentioned above an autonomous agent can make an autonomous decision to trust the advice of his lawyer or financial advisor. If someone is non-autonomous someone else might be given power of attorney to act on his behalf. Are doctors any less trustworthy than lawyers or financial advisors? It would seem to me they aren’t. Does then the context in which informed consent takes place differ from other contexts such as the law and finance in respect of an agent’s ability to make autonomous decisions? Provided the patient isn’t incapacitated by fear it isn’t. It follows if informed consent is based on respect for autonomy that a patient should be able to make a competent decision simply to take his doctors’ advice. Other patients might need more information than is usually supplied in order to make an autonomous consent decision. Doctors should make it clear that they are willing to supply more information when this is requested. For instance it might matter greatly to a Jehovah’s witness whether there would be any possibility of a blood transfusion however remote this possibility might be.

It might be objected that I have already introduced an example which shows that it would be absurd to base the doctrine of informed consent on a non-substantive or Millian account of autonomy. Let us agree that if we accept such an account that a patient can make a competent decision simply to trust his doctor. Let us recall the patient with the gangrenous leg. Let us assume that this patient simply wants to trust his doctor and refuses to listen to any information provided. He wakes up and unexpectedly finds he has only one leg. Such a scenario seems absurd. Perhaps then the basis of informed consent should be a substantive account or the doctrine of informed consent should be a self-contained doctrine. Let us assume the patient still wants to simply trust his doctors and refuses to listen to any information concerning his procedure. Should he should be forced to listen to brief details connected to his proposed treatment? Do doctors really want to force someone to listen? Is it possible to force someone to listen and digest information? Should he be left to die? In this situation it seems more likely that the patient would be judged as incompetent. He would then be treated in accordance with his best interests and his leg removed. He wakes up with only one leg. In this case adopting a substantive account of autonomy or considering the doctrine of informed consent as a sui generis doctrine changes nothing. It follows that whilst adopting a non-substantive might lead to some highly undesirable consequences in a few rare cases that it doesn’t lead absurd ones.

1. Supporting patient choices about health and care: Draft Guidance for consultation, GMC, 2019, [33]-[35]

Lying and Autonomy

  

We live in a world surrounded by fake news and lies. According to Terry Pratchett in the Truth “A lie can run round the world before the truth has got its boots on.” However even if lies sometimes spread more easily than the truth, perhaps in part because they are more palatable and we want to believe them, in the long term the truth matters because the truth has persistence which lies don’t. Perhaps the dwindling number of climate change deniers supports the above. Are there any circumstances in which lying is beneficial? Stephen Rainey writing in practicalethics  suggests that some lies “can also be a kindness, when the truth might serve no good”. Let us accept that in most circumstances lying damages both individuals by depriving them of the truth and trust. Nonetheless is Rainey correct when he suggests some lies might be beneficial in some circumstance? For instance might a government be acting beneficently if it lied about the harm done by the coronavirus to prevent panic? The fact that lying hasn’t been eliminated from human culture over time suggests it isn’t harmful in all circumstances. In this posting I want to examine what these circumstances might be. It might be thought that this is merely an interesting rather than important question, however in seeking to answer this question raises a further question about the balance between acting beneficently and respecting autonomy. I will argue that if I lie to someone and even if my lie benefits him that I also fail to respect him by failing to respect his autonomy.

Most people have no problems with defining a lie. The definition I shall adopt here is that of Sam Harris

“To lie is to intentionally mislead others when they expect honest communication.” lying

Lies so defined can explicit when liars intentionally give someone false information. Lies can also be acts of omission when the liar intentionally withholds information others expect him to provide. Perhaps passive aggression can be a form of lying if it involves withholding information. Liars can be practised by individuals, institutions or even governments.

Let us now consider whether it is ever acceptable to lie for beneficent reasons. Because lying is so prevalent our intuitions suggest that it is. Everyday examples seem to confirm our intuitions. For instance the mother who lies to her child by saying she has no money left when her child demands a second ice cream. Someone who lies to his partner about a surprise party. A government which lies to its citizens about the seriousness of some disease outbreak, such as that caused by the coronavirus, in order to prevent mass panic. Nonetheless as Harris points out we need to be extremely cautious about our intuitions. Firstly we must be sure about our motives being really beneficent. Is the mother above really worried about her child becoming obese or simply taking an easy option? Secondly we must be careful not to damage trust. The government above might avert mass panic but in the future its pronouncements on health matters might not be so readily trusted. If a lie cannot be maintained then it is better not to lie at all in order to retain trust. The Chinese government’s attempt to suppress the full extent of the coronavirus outbreak in Wuhan seems to support the above. However let us accept that there are at least some cases in which we might lie for beneficent reasons in which our motives are clear and we don’t damage trust. For instance it would be perfectly acceptable to lie to a stalker carrying a knife about the whereabouts of his ex-girlfriend.

Let us accept that in certain circumstances we can act beneficently by lying, telling white lies. Let us further accept that in some of these circumstances trust isn’t damaged. In such circumstances is Rainey correct when he suggests that lying might be an act of kindness? It certainly seems that because we are behaving beneficently that our actions might be classed as acts of kindness. However I now want to argue even if our lies serve a beneficent purpose and can be classed as acts of kindness that nonetheless it is almost always wrong to lie. Most pet owners are kind to their pets and act beneficently towards them but most people don’t want to be treated in the same way as pets however kindly. They want to be recognised as the sort of creatures who can make their own decisions. To be autonomous. Autonomous people govern themselves and this requires making decisions that matter to them. To make decisions that matters to someone requires information and lying deprives him of some of that information. It follows if we lie to someone we fail to respect his autonomy. Moreover if someone becomes aware of being lied to this lack of respect is a form of rudeness see the philosophy of rudeness.html or form of contempt. It further follows if we believe it is right to respect someone’s autonomy that we shouldn’t lie. It further follows if a government lies to or intentionally misleads the electorate over some issue such as Brexit that it not only deprives the electorate of some of the information needed to make a good decision it also shows a lack of respect for the electorate and perhaps even democracy itself. This lack of respect is similar to the lack of respect many colonialists showed for native people even if their motives were beneficent.

I now want to consider two objections to accepting the above conclusion. My first argument will be based on respecting autonomous persons and my second on respecting autonomous decisions. Firstly it might be objected that we should give precedence to acting beneficently over respecting autonomy and that sometimes lying is the only effective way to act in someone’s best interests. I now want to present two counter arguments against accepting the above. Let us accept that if we need to lie to someone in order to act in what we believe to be their best interests that there must be a clash between what we believe to be in their best interests and what they perceive to be in their best interests. It would appear that we believe we know better than the agent about what is in his best interests or should be in his best interests. In this situation we might be accused of epistemic arrogance. Secondly I would argue if we accept the above objection we don’t really understand what respect means. We can sometimes act beneficently towards someone but part time respect isn’t respect we can’t respect someone only some of the time. We can of course respect someone’s courage but not her wit. However when we respect her as a person we can’t respect her only some of the time. Part time respect just isn’t respect at all. It follows if we lie to someone in order to act beneficently we are not giving precedence to acting beneficently over respecting autonomy we are in reality failing to respect autonomy at all.

Now let us consider respecting autonomous decisions. Let accept to respect an autonomous decision means to accept it. It might be objected that any difference between respecting someone’s autonomous decisions and acting beneficently towards him is largely illusory. This objection depends on accepting a substantive account of autonomy in which autonomous decisions must concur with some accepted norms, autonomous decisions must be good decisions. Accepting such an account means that if we lie to someone, who is making a bad decision, in order to act beneficently towards him we are still respecting his autonomy. Bad decisions just aren’t autonomous decisions. However I am reluctant to accept a substantive account of autonomy. A substantive account has become more prominent recently largely in order to make respecting autonomy concur better with the doctrine of informed consent. Unfortunately as I have argued elsewhere a substantive account of autonomy puts itself out of business, see autonomy and toleration . If autonomous decisions must be good decisions in accord with some accepted norms then we can just consider good decisions and autonomy becomes a redundant concept. Of course if someone is to make an autonomous decision he mustn’t be misled or coerced but it follows that if autonomy is to remain a meaningful concept that we should adopt a primitive or Millian account. It further follows if autonomous decisions needn’t be good decisions that if we lie to a mature adult in order to protect him from a bad decision that we are failing to respect his autonomy. I would suggest accepting the above has implications for apology. Insincere apology is a form of lying. Perhaps in most circumstance apologising without really mean it is a form of white lying. Nonetheless such apologising just compounds any wrong by showing a lack of any real respect to the one lied to.

I have argued that it is always wrong to lie if this means we fail to respect someone’s autonomy even this is done for beneficent reasons. The question now arises is lying ever acceptable? If the mother of a young child who pesters her to buy another ice cream lies then her lie can be justified. The child isn’t autonomous yet and having two ice creams isn’t in her best interests. However caution is needed if we accept a primitive account of autonomy as I suggested above then slightly older children who are capable of making autonomous decisions and lying to them fails to respect their autonomy. Sam Harris uses an extreme example and asks should we lie even if with “Nazis at the door and Anne Frank is in the attic”. Of course we should lie. We should lie to protect Anne Frank and her autonomy. Lying to someone who is infringing someone else’s autonomy is perfectly acceptable, lying to protect autonomy is lying to respect autonomy.

What conclusions can be drawn from the above? Firstly we should never lie if this means failing to respect autonomy even if our lies might be in what we consider to be someone’s best interests. Even white lies are wrong. Secondly if autonomy is to remain a meaningful concept we must always give precedence to respecting autonomy over acting beneficently. Lastly lying to autonomous agents can never be kind.

Different Degrees or Different Types of Rape?

Rape is an offence which can vary greatly in the degree of its seriousness. Unlawful killing is split into two different offences, manslaughter and murder. In this posting I want to examine whether it might also be beneficial to split rape into two different offences or continue to accept a single definition. If we continue with the later course then because the seriousness of the rape can vary greatly this variability might lead to some less serious cases not being prosecuted. Perhaps if we allow for different types of rape these less serious cases might become more likely to be prosecuted. Perhaps also if we define different types of rape it might be clearer to some potential rapists that cases which might be considered as borderline cases under a single definition are indeed forms of rape.

I want to start my examination by considering four examples which are all very different. These differences suggest that our concept of rape is really an umbrella one. These examples highlight the differences involved. The first case was used by Mike LaBossierre.

“They’d now decided — mutually, she thought — just to be friends. When he ended up falling asleep on her bed, she changed into pyjamas and climbed in next to him. Soon, he was putting his arm around her and taking off her clothes. ‘I basically said, “No, I don’t want to have sex with you.” And then he said, “OK, that’s fine” and stopped. . . . And then he started again a few minutes later, taking off my panties, taking off his boxers. I just kind of laid there and didn’t do anything — I had already said no. I was just tired and wanted to go to bed. I let him finish. I pulled my panties back on and went to sleep.” talking philosophy

My second example is that of 78 year old man who had sex with his wife who was suffering from Alzheimer, see Hastings Center  . She didn’t resist his advances but was incapable of giving any form of consent. My third example is of someone who is violently raped by a stranger. My last example is that of a paedophile having sex with an underage child.

Do these examples suggest any ways in which how different types of rape might be defined? Firstly it might be suggested that different types of rape might be differentiated by the amount of violence is involved. If we accept the above suggestion then my first two examples would be considered as a less serious type of rape and my third example a more serious type. Unfortunately my fourth example shows any such a suggestion to be unsound. Consider a paedophile having sex with a child who is neither forced nor unwilling. If we accept that rape can be differentiated by whether violence is involved then this case might be classed as a less serious type of rape. However this seems to be a clear example of extremely serious rape. It follows that different types of rape cannot be differentiated by the use of violence.

Next it might be suggested that different types of rape might be differentiated not simply by the violence involved but by the actual harm inflicted. Let us accept that not all the harm involved in rape need be physical harm. Accepting the above would mean that my example of the paedophile need not be considered as a less serious type of rape. Let us now consider this suggestion using my other examples. In my third example the victim would suffer physical harm and great psychological trauma. However the victims in my first two examples wouldn’t suffer the same degree of harm. The student in my first example suffered no physical harm and only believed she was raped in retrospect and so any psychological trauma would seem to be slight whilst in my second example we are even unable to say if any trauma took place at all. In spite of the above I would be reluctant to accept that different types of rape might be differentiated by the harm involved for two reasons. Firstly theft is not split into different types based on how much the thief steals, theft is theft, and I can see no obvious reason why rape should be different in this respect. Secondly the old man having sex with his demented wife might not be considered as a less serious form of rape but not an example of rape at all.

Lastly might different types of rape might be defined by differences in the refusal of consent. In what follows I will assume that a refusal of consent can not only be verbal but take the form of active resistance to sexual intercourse. According to the Oxford English Dictionary rape is,

“Typically committed by a man, of forcing another person to have sexual intercourse with the offender against their will.”

Let us consider my first and third examples. Let us assume in my third example that the victim fought back and maintained her refusal of consent provided she wasn’t prevented from doing so. In my first example the victim refused to consent but it might be questioned whether her actions maintained that refusal. She wasn’t prevented from maintaining her refusal to consent but didn’t do so. It might be suggested that type one rape should be defined as one in which the victim refuses consent and that whilst undergoing sexual intercourse maintained her refusal or is prevented from doing so. Type two rape might be defined as one in which the victim refuses consent but whilst undergoing sexual intercourse but fails to maintain her refusal whilst remaining capable of doing so. This division of rape into two different types might appear attractive because by allowing these two different types might mean some cases of rape might be prosecuted as type two rapes which wouldn’t have been prosecuted if we retain a unified concept of rape. However these are incomplete definitions because they fail to deal with cases in which the possibility of consent doesn’t exist such as in my second and fourth examples. It might be suggested that this difficultly might be avoided if we define type one rape as one in which the victim is unable to give valid consent or if she is able give consent refuses to so and whilst undergoing sexual intercourse maintains her refusal or is prevented from doing so. Initially his suggestion seems to be an attractive for one for in most cases in which sexual intercourse taking place without the possibility of consent are serious cases. Sex with children or adults unable to give consent due learning difficulties are serious offences. Unfortunately my second example gives us a reason to question adopting this approach provided we accept that the old man having sex with his demented wife was a form of rape. Intuitively it seems wrong to class his rape as the same type of a rape as that of a violent rapist for whilst we might still blame the old man for his actions we can also pity him. We would have no such pity for the violent rapist. Perhaps then we should include cases in which consent is impossible with type two rapes. Type two rape might now be defined as rape defined cases in which the victim is unable give valid consent or if she is able do so refuses to consent and her refusal of consent is not maintained whilst undergoing sexual intercourse when it is possible for her to do so. Unfortunately my fourth example shows the difficulties with adopting this approach. It would seem to be wrong to put a paedophile having activity with a child in the same class of rape as that of someone having activity with a victim who only comes to realise that she has been raped in retrospect. At this point it might be objected that my first example isn’t a less serious type of rape, it isn’t a type of rape at all. Underlying my definition of both types rape is the idea that consent can sometimes be implicit rather than explicit. It might be argued that the student in my first example by not maintaining her refusal of consent was in practice giving implicit consent. Perhaps if the student in question hadn’t initially refused consent then her actions might be construed as giving implicit consent. I would suggest that explicit and implicit consent cannot be mixed up and that an explicit refusal of consent can only be changed by the explicit giving of consent. Explicit consent is stronger than implicit consent. It follows the student was indeed raped. Her failure to maintain her refusal of consent doesn’t show she wasn’t raped but I would suggest it does show her rape was a less serious type of rape than some others. It also illustrates why the idea of type two rape could be a useful concept.

In the light of the above it seems my initial intention to split rape into two types fails. It fails because of difficulties in accommodating cases in which no consent is involved within either of these two types. When I started writing this posting my intention was to show that rape should be split into two types, the above shows that in philosophy one must always be prepared to change one’s mind. Can anything be salvaged from the above discussion? Perhaps if we want to prosecute an increased number of rape cases then rapes might be split into three types. Category one rape might be defined as one in which the victim refuses consent and whilst undergoing sexual intercourse maintains her refusal of consent or is prevented from maintaining her refusal. Category two rape might be defined as one in which the victim refuses consent but whilst undergoing sexual intercourse fails to maintain her refusal of consent whilst remaining able to do so. Category three rape might defined as any form of sexual intercourse in which the victim is unable to consent. What might be the consequences of adopting these three different types? One consequence might be a greater number of prosecutions for rape. Cases such as the student in my first example might be prosecuted whilst he might not have been prosecuted using the current definition. Splitting rape into three types would have an effect on sentencing. The sentencing of rapists guilty of category one rapes would remain unchanged. The sentencing of rapists guilty of category two rapes might be best dealt with by restorative justice. It might be objected that restorative justice doesn’t deal with the serious of the crime. In response I would point out restorative justice is not easy for the offender. The offender doesn’t simply have something done to him but has to seriously address behaviour, doing so means confronting the sort of person he is and learning to make changes. One of the aims of restorative justice is not just to make the offender feel he has done wrong but also feel the wrongness itself. I would also point out that whilst category two rape isn’t a trivial offence it is a much serious offence than category one and should be considered as such. I have suggested that the severity of sentencing for category one and two rapes should have a fairly tight domain the same isn’t true of category three. A paedophile might attract expect a severe sentence whilst the old man having sex with his demented wife is to be pitied and simply needs to learn his actions were wrong.

What conclusion can be drawn from the above? Clearly splitting rape into three different types is a messy business. However life is sometimes a messy business and this messiness might be a price worth paying if it leads to the prosecution of some cases which might not otherwise be prosecuted and a clearer understanding of what it means to rape someone. Should we do so? I’m not sure

The Logic of Relieving Suffering and Voluntary Euthanasia

Recently a seventeen year old Dutch girl, who had been repeatedly raped as a child and who suffered from post-traumatic stress disorder, anorexia and depression, starved herself to death. This was widely reported as an example of euthanasia, see BioEdge . Simply starving oneself to death isn’t euthanasia. It was unclear in this case whether her doctors helped to control her suffering. In this posting I want to explore whether doctors who relieve the suffering of a patient who starves himself to death should be regarded as assisting in suicide. In order to make my argument I will first explore what can be considered as the legitimate use of medical skills. Let us start with the premise that the decreasing of someone’s suffering is a legitimate use of medical skills. However accepting this premise is too simplistic. Surgery might actually increase someone’s suffering in the short term and surgery is clearly a legitimate use of medical skills. Let us revise the premise so that decreasing someone’s overall suffering is always a legitimate use of medical skills when this is possible.

Let us now agree that decreasing someone’s suffering is usually a legitimate use of medical skills but is it always so? I now want to examine two arguments suggesting it isn’t. Firstly it might be argued that some people deserve to suffer and that it would be wrong to alleviate their suffering due to dessert. Consider a convicted rapist who became infected with HIV when committing his crime. Let us assume that he is now serving his sentence in relative isolation due to the hideous nature of this crime and as a result is unable to infect others. Would treating him for his HIV would be an illegitimate use of medical skills? What reason could be advanced for illegitimacy of treatment in this case? It might possibly be argued that in this case the rapist deserves to be HIV positive and that as a result treating him for this state should be an illegitimate use of medical skills. This extreme example might concur with many people’s intuitions but seems to run counter to the caring ethos of medicine. I would argue linking the legitimacy of the use of medical skills to dessert is problematic in all circumstances. Accepting that it is illegitimate to treat some people whilst it is legitimate to treat others because of dessert appears to imply that it is legitimate to use medical skills to achieve dessert. The domain in which the employment of legitimate medical skills is extended from simply treating suffering to treating suffering and ensuring just dessert. We might link suffering and dessert together but nonetheless they remain independent conditions. Someone can suffer without deserving to do so and someone may deserve to suffer without actually doing so. If we accept that the legitimate use of medical skills is linked to dessert in addition to suffering then provided a death sentence could be considered as just it would be a legitimate use of medical skills to carry out this sentence. An interesting account of the death penalty and the proper ends of medicine is to be found can Silver (1).

Secondly it might be argued that medical professionals have no duty to alleviate suffering when this is caused by self-harm and the sufferer is fully aware his behaviour is the cause of his suffering. In practice accepting this argument might mean that there is less of a duty to treat conditions when these conditions are caused by alcoholism, obesity and anorexia. Clearly alcoholics, the obese and anorexics suffer even if this suffering is caused by their own behaviour. What reason could be advanced as to why treating them would be regarded as an illegitimate use of medicals skills? One reason might be that because their suffering is self-imposed they can simply stop the suffering by changing their behaviour and there is no need to employ medical skills. I’m doubtful whether the eating habits of anorexics or the obese can simply change their behaviour and alcoholism is an addiction.  However let us assume that someone’s suffering is self-imposed and that can change his behaviour and he will cease to suffer. In this context is the use of medical skills to alleviate his is an illegitimate use? It might be suggested he deserves to suffer because his suffering is self-imposed. However if we accept this suggestion it would re-introduce all the problems of dessert outlined above. Both of the above arguments as to why medical professionals don’t always have a duty to alleviate suffering when this is possible appear to be unsound. It follows that we should accept the premise that the decreasing someone’s overall suffering is always a legitimate use of medical skills when this is possible. It is of course possible that there are other legitimate uses of medical skills, see Cosmetic Surgery, Enhancement and the Aims of Medicine . 

I now want to consider the relationship between the relief of suffering and voluntary euthanasia. In particular I want to focus on the relief of suffering of those people who voluntary stop eating and drinking (VSED). Most people who adopt VSED do so because they have a terminal illness but this isn’t true in all cases as the Dutch girl shows. Let us assume that the relief of someone’s suffering caused by VSED is assisting in voluntary euthanasia. I have argued above that decreasing someone’s overall suffering is always a legitimate use of medical skills. It follows relief of someone’s suffering caused by VSED is a legitimate use of medical skills. It further follows that assisting in voluntary euthanasia is a legitimate use of medical skills. Some might be unhappy to accept these conclusions but being unhappy about these conclusions has nothing to do with the logic of the argument or the validity of the conclusions. 

Lastly let us assume that the relief of someone’s suffering caused by VSED isn’t assisting in voluntary euthanasia. If this is the case then there would seem to be no reason to be unhappy about the deployment of medical skills to alleviate someone’s suffering caused by VSED. However I find hard to see how alleviating someone’s suffering, when this suffering is caused by a desire to die, shouldn't be regarded as a case of physician assisted suicide without using the principle of double effect.

1. Silver D, (2003) Lethal Injection, Autonomy and the proper ends of Medicine, Bioethics 17(2), pp. 205-211.