Table Of ContentSaving People from the Harm of Death
POPULATION-L EVEL BIOETHICS
Ethics and the Public’s Health
Series Editors
Nir Eyal, Harvard Medical School
Dan Wikler, Harvard School of Public Health
Editorial Board
Dan Brock, Harvard University
John Broome, Oxford University
Norman Daniels, Harvard University
Marc Fleurbaey, Princeton University
Julio Frenk, Harvard University
Frances Kamm, Rutgers University
Daniel Hausman, University of Wisconsin- Madison
Michael Marmot, University College, London
Christopher Murray, Institute for Health Metrics and Evaluation,
University of Washington
Amartya Sen, Harvard University
Volumes in the Series
Inequalities in Health:
Concepts, Measures, and Ethics
Edited by Nir Eyal, Samia A. Hurst, Ole F. Norheim, and Dan Wikler
Valuing Health:
Well- Being, Freedom, and Suffering
Daniel M. Hausman
Identified versus Statistical Lives:
An Interdisciplinary Perspective
Edited by I. Glenn Cohen, Norman Daniels, and Nir Eyal
Saving People from the Harm of Death
Edited by Espen Gamlund and Carl Tollef Solberg
Foreword by Jeff McMahan
Saving People from the
Harm of Death
Edited by Espen Gamlund
and
Carl Tollef Solberg
With a Foreword by Jeff McMahan
1
1
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Library of Congress Cataloging-in-Publication Data
Names: Gamlund, Espen, 1976- editor. | Solberg, Carl Tollef, 1988- editor. |
McMahan, Jeff, writer of foreword.
Title: Saving people from the harm of death / edited by Espen Gamlund and
Carl Tollef Solberg ; with a foreword by Jeff McMahan.
Description: New York, NY : Oxford University Press, [2019] |
Includes bibliographical references and index.
Identifiers: LCCN 2018024331 (print) | LCCN 2018049747 (ebook) |
ISBN 9780190921446 (online content) | ISBN 9780190921422 (updf) |
ISBN 9780190921439 (epub) | ISBN 9780190921415 (cloth : alk. paper)
Subjects: LCSH: Death—Moral and ethical aspects. | Death—Social aspects. |
Mortality—Statistics. | Medical policy. | Values.
Classification: LCC BJ1409.5 (ebook) | LCC BJ1409.5 .S28 2019 (print) | DDC 128/.5—dc23
LC record available at https://lccn.loc.gov/2018024331
9 8 7 6 5 4 3 2 1
Printed by Sheridan Books, Inc., United States of America
Derek Parfit, who possessed a native genius for philosophy, was
the great progenitor of the debates in the following chapters. We
dedicate the book to him.
CONTENTS
Foreword by Jeff McMahan ix
Acknowledgments xv
List of Contributors xvii
Introduction: Perspectives on Evaluating Deaths and Their Relevance to
Health Policy 1
ESPEN GAMLUND AND CARL TOLLEF SOLBERG
Policy
PART I }
1. Quantifying the Harm of Death 21
ERIK NORD
2. The Badness of Death: Implications for Summary Measures and Fair
Priority Setting in Health Care 33
OLE FRITHJOF NORHEIM
3. Life Years at Stake: Justifying and Modeling Acquisition of Life Potential
for DALYs 48
ANDREAS MOGENSEN
4. Putting a Number on the Harm of Death 61
JOSEPH MILLUM
5. Age, Death, and the Allocation of Life- Saving Resources 76
ESPEN GAMLUND
Theory
PART II }
6. Epicurean Challenges to the Disvalue of Death 91
CARL TOLLEF SOLBERG
7. The Badness of Dying Early 105
JOHN BROOME
8. Early Death and Later Suffering 116
JEFF MCMAHAN
9. A Gradualist View about the Badness of Death 134
BEN BRADLEY
viii { Contents
10. The Badness of Death and What to Do about It (if Anything) 146
F. M. KAMM
11. Deprivation and Identity 163
JENS JOHANSSON
12. How Death Is Bad for Us as Agents 175
SUSANNE BURRI
Population Ethics
PART III }
13. Against “the Badness of Death” 189
HILARY GREAVES
14. People Aren’t Replaceable: Why It’s Better to Extend Lives than
to Create New Ones 203
MICHELLE HUTCHINSON
15. The Worseness of Nonexistence 215
THERON PUMMER
Critical Perspectives
PART IV }
16. The Badness of Death for Us, the Worth in Us, and Priorities
in Saving Lives 231
SAMUEL J. KERSTEIN
17. How Much Better than Death Is Ordinary Human Survival? 243
IVAR R. LABUKT
18. Health Care Rationing and the Badness of Death: Should Newborns
Count for Less? 255
TIM CAMPBELL
19. In Defense of the Time- Relative Interest Account:
A Response to Campbell 267
JEFF MCMAHAN
Index 279
FOREWORD
Jeff McMahan
Various philosophers in the ancient world—p articularly Epicurus and
Lucretius but also Cicero, Seneca, and others— thought seriously about the
nature and evaluation of death. They asked how, on the assumption that to
die is to cease to exist, death could be bad for us and, if so, how bad. Their
concern was not whether a person’s death could be bad for those who remain,
but whether and to what extent it could be bad for the person herself. Epicurus
and Lucretius concluded that it could not be, or at least that there is no reason
for us to fear death for our own sake.
Yet with the rise of certain religions, such as Christianity and Islam, that
promised— or threatened— an unending afterlife, philosophers largely ceased
to discuss whether death is bad for us, good for us, or neither. And even those
who did discuss death, such as Montaigne and Schopenhauer, did not go very
deep. I suspect that a significant part of the explanation of this philosophical
neglect is that, particularly in those regions in which philosophy was most
ardently pursued, it was for many centuries heretical and thus dangerous to
profess or even to discuss the view that when we die we simply cease to exist.
So even while people continued to fear death, sought to avoid it themselves
and to save others from it, and grieved for those who had succumbed to it,
they were unable to discuss freely whether their attitudes and practices were
rationally justified. Together with a threat of eternal damnation as punishment
for suicide, the refusal to permit questioning of the relevant theological dog-
mas was self-p rotective for those religions that offered the faithful a blissful
afterlife. For that offer certainly seems to provide a reason for believers to end
their own lives and the lives of those they love, which would hardly promote
church attendance or provide remunerative work for the clergy, apart from
conducting funerals. So better to leave people’s instinctive aversion to death
alone, even while asserting doctrines that suggest that the aversion is irrational.
It was not until 1970, with the appearance of a short but brilliant essay by
Thomas Nagel, which was closely followed by another by Bernard Williams,
that serious philosophical discussion of death resumed after almost two
millennia of reticence.1 Over the decades since Nagel broke the silence, the
ix
1 Nagel (1970); Williams (1973).
