J Med Ethics 39:15-16 doi:10.1136/medethics-2012-100807
  • Current controversy

Dependent relational animals

  1. Michael Bevins
  1. Correspondence to Dr Michael Bevins, Palliative Care, Scott & White Healthcare, 2401 S 31st St, Temple, TX 76508, USA; mikebevins{at}
  • Received 8 May 2012
  • Accepted 21 July 2012
  • Published Online First 10 August 2012

Typically when a person dies, a number of negative consequences result. Some of these consequences can be framed in terms of loss: lost opportunities, lost income, lost abilities and lost relationships, to name a few. In addition, dying often involves physical and existential suffering, causes grief for loved ones and may result in temporary or eternal damnation. In fact, it may be that killing is considered so very wrong—relative to other harmful actions—because of the many varieties of harm it causes.

In a recent article in the Journal of Medical Ethics, Walter Sinnott-Armstrong and Franklin G Miller claim ‘we need an explanation that captures the full extent of what is wrong with killing’.1 But of course we don't. There is no shortage of reasons why killing is wrong and there is no reason to think something must be wrong for only one reason. Their contention that ‘there is nothing bad about death or killing other than disability or disabling’ simply defies common sense. While disabling someone is indeed harmful, from a moral standpoint there is more to death than disability and there are always other negative consequences to killing that can be legitimately offered as reasons why it should not be done. Rather than a full account of why killing is wrong, I suspect what Sinnott-Armstrong and Miller are after is a sufficient explanation of the wrongness of killing. Such an account would allow for other negative consequences of killing, but in no case would it need them to explain why killing is wrong. Unfortunately, as I discuss below, their account fails both as a full and as a sufficient explanation of the wrongness of killing.

To argue their point, Sinnott-Armstrong and Miller begin with a thought experiment in which Abe robs and fatally shoots Betty. Why is Abe wrong to do this, they ask? Sinnott-Armstrong and Miller consider two consequences of Abe's act—namely, that it causes Betty's death and that it causes Betty to be totally disabled, that is, universally and irreversibly disabled. They then examine which of these two consequences explains why Abe was wrong. Since Betty would be no worse off dead than totally disabled, they reason, then that what makes killing immoral is the fact that it totally disables, not that it causes death. This ‘total disability view’, they conclude, fully explains why killing is wrong, since there is nothing about death that is worse than total disability. Killing is wrong for no other reason than that it renders the deceased totally disabled.

But there are several problems with Sinnott-Armstrong and Miller's argument. First, they set up a false choice by considering only two of the many negative consequences resulting from Abe's action. Yes, Abe totally disables Betty, which is wrong, but his action has many other negative consequences. In fact, killing Betty may be wrong for more than one reason. A single criterion, such as total disability, cannot fully explain all of what is wrong with killing in every instance.

Whether killing in any particular instance is wrong is a moral judgement based on many factors. To say that killing is wrong is not to say that it must always be prohibited, but that there is a general prohibition against it, or that there is always something wrong with killing. This allows that what is wrong with killing can be outweighed by other considerations. After all, we commonly allow and even cause death and any plausible account of the wrongness of killing must not preclude exceptions, for example, in cases of self-defence or intractable suffering.i

Sinnott-Armstrong and Miller deal with several objections to their view. But they inadequately address one objection in particular—namely, that killing a totally disabled Betty would harm other people. Ultimately, they dismiss the objection because ‘these kinds of concerns do not show that killing her would be a wrong to Betty’. In other words, the question they have is this: If Betty is totally disabled, is there anything that could make killing her wrong to Betty?

There are at least two ways to address this question, neither of which supports Sinnott-Armstrong and Miller's view. (1) If, for something to be a wrong to Betty, it must matter to her, then Sinnott-Armstrong and Miller beg the question, since by their description nothing at all can matter to a totally disabled Betty. (2) Even if killing Betty is not a wrong to her, it can still be a wrong to others. I will defend this last contention and in the process give an alternative account of what makes killing wrong.

Sinnott-Armstrong and Miller claim that it is just as horrible to have a loved one totally disabled as it is to have her killed, thus there can be no harm in killing a totally disabled Betty. If Betty has no control over anything in her life, they continue, then it is not obvious that her loved ones would feel any worse or be harmed if she were then killed. But this is implausible. Imagine that Betty is 16-years-old and has been rendered totally disabled. Betty's mother cares for her. She bathes, feeds and toilets Betty; she brushes Betty's teeth and washes her hair; she sings to Betty and tells her stories. It is likely that Betty's mother would think it wrong in this case for Betty to die or be killed. She might say something like: ‘I realise my child is totally disabled, but she is still my child and I love her. I have cared for her for 16 years and want to continue doing so. If she were to die, it would be a tremendous loss for me and cause me grief. Therefore it would be wrong for you to kill her’. As Michael Stocker has observed, ‘in many cases, adverting to the out of may be more illuminating and determinate that adverting to the teleological’.2

Indeed, many people say as much about a loved one in a permanent vegetative state. It is unclear if by ‘totally disabled’ Sinnott-Armstrong and Miller mean something other than a permanent vegetative state, but conventional medical knowledge holds that someone in a permanent vegetative state fits the description of total disability. There are tens of thousands of such patients in the USA alone, many of whom have loved ones who would clearly suffer harm were they to die. But even if total disability is something more than the permanent vegetative state, it is easy to see that others might be harmed by the death of a totally disabled loved one. Note that one could not legitimately claim no meaningful relationship is possible with a totally disabled person. Not only does this defy common experience, but it begs the question.

If not total disability, what makes killing wrong?

Killing someone renders her totally disabled, which is a bad thing. But total disability is insufficient to explain the wrongness of killing, since killing a totally disabled person can still cause harm and therefore be wrong. What is it that makes killing a totally disabled person wrong? As alluded to above, killing a totally disabled person is wrong because it destroys her relationships. This view—call it the destruction of relationships (DOR) view—sufficiently explains why killing is wrong in general, because killing someone always and completely destroys all of her relationships. Furthermore, this view explains what is wrong with killing a totally disabled Betty, and also what is wrong with killing a fully functional Betty, or Betty's pet cat, or Betty's fetus. In short, the DOR view more accurately reflects common sense notions of what is bad about death and by extension why causing death is harmful and wrong.

Relationships are the sine qua non of the moral life. It remains unclear, however, just what relationships count as morally relevant. My initial sense is that the destruction of any relationship that involves at least one conscious being would entail morally relevant harm. Thus destroying a relationship between Bob and his wife would harm Bob (and his wife), but so would destroying his relationship with his horse or with his car. Just so, the relationship between my chair and my desk can be destroyed with no morally relevant consequence to either. Less straightforward are relationships like those between animals. The DOR view then does nothing to settle who or what belongs within the sphere of morality.

At the same time, common experience yields some guidance about specific aspects of the DOR view. For one, relationships seem to be vulnerable to varying levels of harm. Thus causing marital strife between your brother and sister-in-law is harmful, but not has harmful as breaking up their marriage completely.

Second, it seems that the stronger the relationship, the more harm its destruction causes. The strength of a relationship depends on many factors. Longer relationships are generally stronger than shorter ones—for example, a 20-year friendship is stronger than a 20-day friendship. Some relationships are stronger by their very nature—for example, parent–child relationships are stronger than those between coworkers.

Third, the greater the number of fully conscious beings in a relationship, the stronger it is on the DOR view. Thus it would be worse to kill Julie's husband than to kill her cat.ii Killing Julie's husband would harm two people, while killing her cat would only harm one person. This is not to say that relationships between humans and animals or between two or more non-human animals are underserving of moral consideration. But just how much harm destroying such a relationship would cause is not clear.

Application to abortion and to organ donation

Say Jane knows she is 12 weeks pregnant but hasn't told anyone. She and no one else has a relationship with her fetus. In the DOR view, destroying that relationship by aborting her fetus would be a bad thing.iii The resulting harm might be outweighed by other considerations, of course, like Jane's right to control her own body. Thus the DOR view neither requires that abortion be permitted nor prohibited; it is compatible with either viewpoint. The DOR view does, however, explain why it is worse to kill a neonate than a fetus. We are born in the presence of others. The act of being born is formative of relationships with conscious beings, a relationship that is strengthened by seeing, hearing and touching an infant over time. Similarly, in cases of intrauterine fetal demise, the further along in gestation a fetus is at the time of its death, the more tragic the loss. At 34 weeks of gestation, for example, more people will have formed some sort of relationship with the fetus and those relationships will be stronger than at, say, 10 weeks.

Sinnott-Armstrong and Miller claim that the total disability view renders acceptable the practice of harvesting organs from totally disabled persons. I have argued, however, that this case is not so simple. Harvesting organs from a totally disabled person, because it would cause her death, does indeed cause harm. The harm caused by destroying the relationships of the totally disabled person must be considered in any judgement about causing her death.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • [i] I will follow Sinnott-Armstrong and Miller is assuming that the wrongness of killing can be explained based on its consequences and that what makes killing wrong is just what is bad about death.

  • [ii] This presumes nothing of Julie's feelings about her husband or her cat.

  • [iii] Allow that the fetus has no interests of its own and, having never been conscious, has formed no relationships.


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