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What is Locked in Locken-In Syndrome ?

Shinya Tateiwa 2015/11/20
The boundaries (limits, conditions, extensibility)of human beings (humanity), at Ritusmeikan University

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◆2009/08/10 Decision on Ventilator?, Yumiko Kawaguchi & Momoe Konagaya (eds.) August 10, 2009 Pocket Guide of Using Ventilators at Home: Life and Support, Ishiyaku Shuppan, 212p. ISBN-10:4263235290 ISBN-13:9784263235294 2730 [Japanese][Chinese]

『私的所有論  第2版』表紙
◆from On Private Property, Chapter 5 The Problem of Demarcation
5.1 The Ability of Self Determination is not a Condition of Being an Other
5.2 Demarcation is Impossible, but Exists
5.3 The Line between What is Human and What is not
5.4 The Point at which Human Life Begins

5.1 The Ability of Self Determination is not a Condition of Being an Other
5.2 Demarcation is Impossible, but Exists
 5.2.1 The Impossibility of Demarcation
 5.2.2 Being Same / Close
5.3 The Line between What is Human and What is not
 5.3.1 The Human Species or the Qualifications Needed to be Human
 5-3-2 Human who Respond to a Being which has been Born and Raised by Human
 5-3-3 The Limits of Definition Based on "Qualifications"
 5-3-4 The World Extending from the Human
5.4 The Point at which Human Life Begins
 5.4.1 The Problem of Beginning
 5-4-2 Rights regarding what is Produced
 5-4-3 The Experience of the Appearance of the Other
 5-4-4 Ownership and Qualifications

"We must presumably understand that it was not that first there was a definition of ‘human being' and then this kind of 'human being' was cared for, but rather that there was an 'internal aspect' that first arose through our providing care. I think it was this 'internal aspect' that became 'ethics'."(Murase [1985→1991:184-185])

"'Respect for life' is a political slogan that implies your opponents' murderous intentions cannot be punished. 'Life' is one of the keywords most often used to promote everything from powdered soaps to bathtubs. c today the word 'life' is both contentless and overflowing with content, and has become a hotly contested term even though it is hardly worth analyzing."(Duden[1991 = 1993:162])

There is an important issue that arises when this topic is addressed in the way I have laid out in chapter 4. What kinds of beings must not be eliminated or violated? What is the boundary or domain of this set of beings? If we say that everything is part of the other and that the existence of the other must be respected, does this not seem to indicate that we should treat everything equally and without discrimination? In this chapter I consider these questions and the issues surrounding them. This includes considering how we should think about assigning humanity special status or privileges and attempts to answer the question of when life should be considered to begin. This is a fundamental question in the field of "bioethics", but here I take a different approach from what has been said in this "field" in the past.

In section 1 I begin by responding to the assertion that the current discourse on private property already contains enough respect for the other and to the question of how what has been previously asserted in this discourse differs from what I claim in this book. I reassert that the former stipulates having a "personality" or "individual characteristics" as a condition [of being human] while the latter does not. Once this claim is made, however, we are then faced with the problem of how to determine the extent of the domain of what is not to be destroyed.

In section 2 I say that the fact that we cannot find objective criteria for what is to be considered human is not changed by employing the criterion of something being the "same" as us. This "being the same" is not irrelevant; there are differences in how the being in question appears to each of us, and here I confirm that these differences change in relation to the position of the beings in question and then state that there is a method of dealing with these issues based on respecting the importance of the assertions of people in the position of hesitating to destroy or interfere with another being

In section 3 I consider the question of whether or not there is a reason for giving humans special treatment. I examine assertions based on the human "species" and those which point to the unique characteristics and abilities of humanity as "qualifications" and point out some of the problems with both of these approaches. I then suggest that there is nothing for us to focus on here beyond the simple fact of being born and growing up as a human being among other human beings.

In section 4 I consider the limits of what should be considered human, in particular the point at which what can be considered a human being begins, and also the question of "who" should be allowed to make decisions in these cases. After pointing out the impossibility of establishing when a thing "becomes" human and some of the problems with approaches which rely on arguments for ownership of the body and children (embryos/fetuses), I assert that it is possible to justify the "rights of self determination" of women in regard to these kinds of situations through their being in a position to experience the coming into existence of a child as an other.


5.1 The Ability of Self Determination is not a Condition of Being an Other

To begin with, the other is an individual. If so, in what sense is accepting the other different from accepting the rights of the individual? Are they not the same thing? Also, to the other I am an other. We are then faced with the question of whether accepting the other is not then the same as each of us accepting ourselves, and if not in what way(s) is it different? I have already discussed the fundamental answers to these questions in chapter 4, but there are a few points I will return to before moving on.

It is clear that even in approaches based on the "I" in most cases it is difficult to see the self through because we come up against the opposition of other things and people we encounter in the world around us. But this can be seen as being caused by external circumstances and conflicting interests. My inability to fully realize myself is due to circumstances which are coincidental and external, and if these obstacles were removed I would no doubt be able to go on pursuing my desires without limit. A world in which the satisfying of these desires reached its apex would ultimately be a world that exists as an extension of the self. On the other hand, however, while we do indeed possess these kinds of desires, when we are asked whether this sort of world would be a good world we have the sense that somehow it would not be, and that it is in fact due to our inability to exercise control that we are able to accept and appreciate the world and the other (see chapter 4 section 1).

But this is not enough. Those who defend the right of private ownership would likely say that, even if not by reason of the fact that I should respect the other as something other than myself, the principle of private ownership is the principle of respecting, separately from actual conflicts that may arise, the other as a being equal to myself. Actions carried out in regard to the other cannot be permitted without their agreement. If so, how does what I have stated in chapter 4 differ from this "respect for independent individuality"? In the case of the former as well as in the case of the latter when the will of an individual is made clear it is accepted. There is a wide area of overlap between what is allowed and not allowed according to what is stated in chapter 4r and what is permitted and forbidden according the rules we generally accept. To a certain extent they both defend and criticize the same things.

But there are nonetheless differences between these principles, differences which may in fact be larger than expected. If "humanhood" is defined in terms of the will and decision making ability of the person in question - we will see this kind of statement many times throughout this chapter - then the scope of "individuality" and that of "the other" are not the same. In chapter 1 I raised the question of what is to be said in regard to people or other beings who do not make decisions, and in sections 2 and 3 of chapter 4 I offered a preliminary answer. It is not because they possess something that we accept the other (for example, because they possess "life"), nor is it because they are conscious and can exercise control. When something is owned it exists separately from the person who owns it. The other is not made the other by way of something which is owned. The existence of the other is not something created by the person in question. Nor does it require their freedom. The other can exist as a being without freedom. It also need not possess unique characteristics, abilities, "creativity" or "individuality" which I myself do not. Things which I possess are for the most part also possessed by other people. There are not so many things which are really unique. What I have stated is that we do not respect the other because of its possessing some kind of active quality, but rather because of its passive quality of being something which is not the same as the self, or, to be more precise, because it is not the self. In other words, we do not require that the individual in question make decisions (or be able of making decisions) as a basis for the other being the other or a person being a person. The making of decisions (or the ability to do so) is only one part - albeit no doubt an important part - of what constitutes the being in question which is not me. This being need not necessarily be a being which exercises "self determination"[in order for me to consider it an other].

The sense at work within us here can perhaps be spoken of as "respect for the other". It might also be considered a "conception of human rights". But this other, this person, need not necessarily be a being which already possesses some kind of concrete individuality or personal qualities. The phrase "human rights" can indeed be used if it seems appropriate. It may be easier to use words which already exist than to constantly invent new terms which will invite confusion. If I were to attempt to phrase my position in terms of this discourse, what I want to assert could perhaps be stated as a desire to affirm that while the concept of human rights, being a principle developed in our era of emphasizing the active, may be seen by some as something that exists only in this light, it is also necessary to include its passive aspects and qualities in our consideration of this principle and in its application◆1.


5.2 Demarcation is Impossible, but Exists

5.2.1 The Impossibility of Demarcation

This being said the case problems related to lines of demarcation arise once again. If everything is part of what is other, and if we say that the other is to be accepted and affirmed, would this not also indicate that we must treat everything indiscriminately? For example, if we do not define the other as possessing consciousness, does this not mean that there is no longer any fundamental difference between what is human and what is not human? We have also seen that we do not distinguish the other based on biological species; the other cannot be defined as human. There is therefore no absolute distinction between what is human and what is not in terms of who or what can be killed and who or what must not be. The other is furthermore not even limited to living beings.

In practice, however, we do in fact distinguish between which beings can be killed and those which must not be killed in terms of what is human and what is not human. Is this kind of distinction not indeed inevitable? If this is the case there are two points that may be raised here. First, does what I have stated so far not in fact say nothing about this distinction? Second, if we are to say something about this distinction are we not obliged to bring in some concept of "sameness"? Do we not in practice tend to be considerate of beings similar to ourselves? Even within the school of thought that urges us to go beyond the "narrowness" of race and ethnic identity in favor of "universal human rights", is there not still a presumption of a common "human" sameness or identity? Is our "progress" not found within the expansion of this sense of unity? In regard to the first point I would say that there is indeed no answer to be given to this question [based on I have asserted so far]. In regard to the second point I would say that there can also be no answer to be found from the point of view of positing a "sameness". This being the case, in what follows I will examine what can nevertheless be said on this topic.

There are no "objective" criteria for deciding what may be destroyed and what must not be destroyed. First, as perhaps is obvious enough to go without saying, this is the case because the question posed here is one involving "norms". Even if "scientific" methods can be used to determine whether or not a particular state exists (to determine, for example, whether or not a person is in a state of brain death), this confirmation of a particular state or determination based on specific criteria does not in itself in any sense provide us with a criterion for deciding what may be killed/destroyed.

Second, there are also other problems that arise here apart from general questions surrounding the establishment of norms. In the previous chapter I discussed the acceptance of the other. At the same time, I also stated that we use various objects in order to survive. There are cases where we hesitate to destroy something or feel that something must not be destroyed. At the same time, we live by using and killing. There are therefore cases in which we know that something (or someone) is an other but kill it (or him or her) anyway.

Let us here confirm two things about the former, this ethics that asserts we must not be alter or destroy the other. First, it is anthropocentric. Second, it cannot exist as a "social norm" on its own and by itself is an impossible, self-negating ethics.

To begin with, this is an ethics which fundamentally applies only to human beings. Is there any basis for making humans the only subject of adherence to this ethical system? If we take the position that regarding what exists apart from myself there is no fundamental difference between what is human and what is not human, then why not designate for inclusion in this ethical system not only human beings but also other animals and plants as well? This would amount to extending the system to all beings. If so we should consider it wrong for any of the many kinds of beings which exist in the world to interfere with or violate the existence of any other being. There are several points to be raised here. First, this ethics is a human ethics in the sense that only human beings could conceive of it. Second, to demand that other beings apart from humans adhere to it would mean that it could not be seen as anything other than an anthropocentric ethics in the sense that it forces a human concept of ethics on other kinds of beings. Third, if on the contrary we consider this ethical system as one which applies only to human beings - even if it is not used in a way that gives an advantage to humans and on the contrary proves a hindrance - it indeed becomes a system which treats humans as possessing a special status. Fourth, in a practical sense it is impossible to demand that beings which are not human adhere to this kind of ethical system. For the reasons outlined above it is clear that this is an ethics that is restricted to humanity.

It is also an ethics which cannot be used on its own as a governing rule of human (society). To demand others adhere to this ethical precept [of total non-interference] would mean their destruction. If the destruction of others is not my intention, this ethics is one which can only be applied to me. There are no truly thoroughgoing fundamentalists of this kind to be found living in the real world. Therefore all living creatures are not thoroughgoing fundamentalists. It is nonetheless possible that at least some individuals may choose to accept this ethical principle and with it their own weakening and death. Even in such cases, however, these individuals would be destroying the many cells which compose their own bodies. In other words, this is an ethical position the adherence to which is impossible. It is an ethics which ultimately can only exist as an impossibility. This does not in itself mean that this perspective is meaningless. Providing we do not stipulate the condition that something cannot be called a norm unless it is possible in practice, the fact that something is impossible does negate its validity. Most people do not think about these sorts of things, but there are in fact some people who do. We possess something within us which can lead us to take this kind of position. This is connected to the rejection of everything, which is to oppose that which makes demands itself.

Our sense of the other is therefore not the only sense operating within us. We desire that our own lives continue. In order to live we use and kill both non living and living things with the exception of human beings. This itself is something which cannot be justified by reference to anything else, but it is also something which makes it possible for us to carry out the process of justifying and not justifying.

Stating the fact that two things coexist does indeed not provide any unequivocal answers in regard to the problem of drawing distinctions between them. If we acknowledge that both parties exist simultaneously no clear answer to the question of which of the two is to be given priority emerges. If two incompatible things/beings are brought forward and distinguished for their use based on whatever is most expedient at the time then any sort of answer can be given. As a result it is of course possible to make the criticism that stating things in this way in the end does not amount to saying anything at all. It is, however, also a fact that, while we are beings that use and kill, at the same time we are beings that hesitate to use and kill. The fact that this attitude is found in practice does not justify or validate it. However, since we have nothing else to use in its place we are left with no choice but to make this fact one of our premises.

Can some kind of absolute line of demarcation be drawn between what is to be killed/used and what is not? If there is no alternative to drawing such a line, how is it to be done?

5.2.2 Being Same / Close

Is it that we are the "same thing"? In any case it is true that in practice we extend special protection to the category of beings called "human" and that other people are human in the same way that the self is. It would seem that the idea that we are in some sense the "same" is being employed here.

However, when it comes to deciding on what criteria this similarity is to be based, it is not as though these criteria have already been established in principle. Therefore it is clearly not the case that claims dependant on us being "the same thing" will provide an answer to the question of how to establish the kind of lines of demarcation discussed above.

Apart from the question of whether it is "correct" or not, we clearly do feel greater "sympathy" and "compassion" for beings similar to ourselves as well as a tendency not to feel that their affairs and interests have "nothing to do with me". This fact seems to indicate that "being the same" holds some kind of meaning for us. But let us consider this for a moment. Is what is found here really something at the level of magnitude of the other person being the same as the self? Or is it rather a certain proximity in terms of physical distance/personal connection? And do we really discover within these relationships that the other person is the same us? At very least, is it not the case that this is not all that occurs when we relate to other people, and that on the contrary we may come to feel more strongly that the people we interact with exist as beings which are distinct from ourselves? Is this intermediary idea of "because they are the same as me" really needed here? Can we not come to have feelings like, for example, "I must not kill" when we think of the person in question as "other" or independent of ourselves, and is it not indeed through seeing the person in question in this light that we do so? I cannot feel your pain, but I can know that you are in pain or assume that you must be in pain. This does indeed seem in a sense to be the result of our being "the same". However, the fact remains that you are in pain and I am not. This feeling of "closeness" to another being and simultaneous sense that I am "not the same being" do not contradict each other - what I asserted in chapter 4 was not that the other person in question is "different" from me as opposed to being "the same" as me, but rather that he or she is "not" me.

Therefore the problem is not a conflict between what is the "same" on the one hand and what is "different" (in the sense of being the simple opposite of what is the "same") on the other. Even when seen through the medium of something being the "same", an awareness of the other nonetheless remains. This awareness differs in regard to the position of the thing/person in question. This differing in regard to position is connected to the beings involved in establishing of lines of demarcation.

Judgments differ depending upon the position and relationship of the people or things in question. What are we to make of such cases? There are many situations in which these differences in judgment are not problematic. For example, some people think of a pet as being a member of the family. This in itself is not a problem. Their claim will not encounter opposition and will be accepted as long as it does not interfere with other people's interests or values. But there are also other cases in which "lines of demarcation" must indeed be drawn. Disputes will arise surrounding the pros and cons of eliminating a given existence, and the question then becomes whether or not this elimination is to be prohibited. How are we to resolve questions such as whether or not to kill or whether or not to interfere in certain situations where there is no alternative to arriving at a societal decision? As I have already stated, there are no "objective" criteria to be employed here. There will be differences in judgment. What are we to conclude in such cases?

While a being is one which kills, at the same time a part of it may resist this inclination. A boundary demarcating what must not be killed does not exist beforehand, but if we know that a certain person has accepted a certain being as an other and we attempt to respect this, the criterion or standard which can be posited here is that when we do not know how a judgment should be made, or when different opinions are in conflict, we should listen to the people close or closest (although they may at the same time also be closest in terms of interests) to the being in question who (because of this proximity) hesitate to destroy it.

This approach will not always allow us to draw lines of distinction, and the results that follow from it will not always agree with each other. However, when there are people who live in a place and for this reason cannot bear to see it destroyed, for example, and even people who refuse to move even when offered a much more advantageous location, if we consider the suffering these people experience, can we not within it see evidence of the sense of value discussed above?◆2 And if we find ourselves unable to avoid respecting the way of life of people who make their living hunting whales, although they do not need to kill whales in order to survive, and pay respect to the whales they kill (albeit in an anthropocentric sense because ultimately the whales are something which can be eaten) while at the same time killing them, can this value not be seen in our reaction to this situation as well?◆3

Here, and in section 3 and 4 as well, my perspective may be similar to what is referred to in the field of ethics as "ethics of relationship"◆4. However, since this of course means giving the power over life and death to those closest to the individual in question, and since these people may in most cases benefit from killing him or her, this perspective is potentially dangerous. What I am taking here is not simply the position that we should respect the feelings of the people closest to the person in question, but rather the point of view that, in cases where decision making cannot be left up to the other itself (him or herself), we should listen to the being or beings which (through their closeness to the other in question) express the greatest reticence in regard to the killing or elimination of this other.


5.3 The Line between What is Human and What is not

5.3.1 The Human Species or the Qualifications Needed to be Human

All of this being the case, why should human beings be given special status? There is no particular reason why it should be acceptable to kill what is not human. In any case there are many kinds of living things we kill in order to survive. But even if we do not say that killing other species is acceptable, we nonetheless put human beings in a category of that which must not be killed. Here, unlike the position stated in the previous section, what is claimed is not simply that a certain person respects something, or that we should respect a person respecting something, but rather that, at least superficially, we must reject the killing of human beings in general no matter who the individual in question may be. Humanity is given a special status or set of privileges. I think this is probably appropriate, and indeed may very well be impossible to avoid◆5. But how can this special status be expressed within the context of what I have stated so far?

In answer to this question, Robert Nozick proposes that it is justifiable for those belonging to a given group to respect or favor others who belong to the same group.

"The traits of normal human beings (rationality, autonomy, a rich internal psychological life, etc.) have to be respected by all, including any denizens of Alpha Centauri. But perhaps it will turn out that the bare species characteristic of simply being human, as the most severely retarded people are, will command special respect only from other humans--this as an instance of the general principle that the members of any species may legitimately give their fellows more weight than they give members of other species (or at least more weight than a neutral view would grant them). Lions too, if they were moral agents, could not then be criticized for putting the interests of other lions first." (Nozick [1983:11])

In his book (Rachels [1986 = 1991:139-140]) in which he cites this passage Rachels discusses "the euthanisia"◆6 of disabled newborns, and in response to Nozick's assertion he argues that it is difficult to find definitive reasons why the domain of the group that "have to be respected"and "command special respect" is human "species". For example, by the same logic a particular race can be thought of as one such group, and if so would this approach not also seem to affirm racism?◆7 This criticism Rachels offers in response to Nozick's assertion is an effective one.

If so, are we then to accept a different assertion which holds the condition or qualification that are unique to human species - "rationality, autonomy, a rich internal psychological life, etc."

To proponents of utilitarianism whose standards are based on pain and pleasure, that which is painful is viewed as something bad. Beings which cannot experience suffering, on the other hand, pose no problems. This kind of position is put forward by Singer◆8. For Rachels death is a bad thing for beings able of various actions because death would mean they would no longer be able to exercise these abilities◆9. This kind of establishment of conditions is not limited to proponents of utilitarianism. There is also the assertion that a being must be rational and possess self awareness as a condition of receiving privileged status◆10. In practice there is no great difference between these two positions.

If pleasure and pain are to be used as standards it becomes necessary to protect creatures which can (presumably) experience these sensations. This not only expands the range of what is not to be killed beyond humanity but at the same time contracts it as well. When this contraction takes place a part of "humanity" is excluded. Nevertheless, this kind of explanation can in any case be seen as possessing a certain amount of explanatory power to the extent that it proposes an answer to the question of why humanity (albeit not in its entirety) is to be given special status. Human life is to be (exclusively) respected because we are different from other species; we are special because, for example, we are conscious beings.

5.3.2 Human who Respond to a Being which has been Born and Raised by Human

Is this perhaps the only way to consider this issue if we deny that our "species" is privileged?◆11 But is there not, however, indeed a kind of "reduction" being carried out here? This argument can be carried further to question where distinctions are to be found and whether in fact they even exist. A "species" can be considered to exist, but the basis for its distinction is fragile, and if this is the case the argument then moves to the question of whether there is no alternative but to rely on the "characteristics" of the species in question in making meaningful distinctions. To the extent of my knowledge this is all that has been proposed within the discourse surrounding "bioethics". However, there is another distinction which does exist, although it may not be caught in the net cast by these thinkers. The following single distinction clearly exists, putting aside for the moment the question of whether it justifies human exceptionalism.

Humans are given birth to by humans and cannot give birth to anything other than humans. What is given birth to by a human is a human being, and what is not given birth to by a human being is not human. Even if there are no other differences, this distinction remains. And in these cases it is already assumed that humans are beings which should go on living.

This simple distinction answers the question Rachels poses to Nozick. Does this amount to a discussion of what is possible regarding hybridization, what is "biologically" possible, in this case the claim being that while people of different races can bear children together members of two different species cannot? I think a slightly different claim can be made. Even if we had no understanding of biological concepts like genes, it would still be possible to consider the existence of the world of sex and reproduction without such knowledge. Here the fact of it being possible or impossible for particular organisms to interbreed is incidental. If, for instance, a child were born after sexual intercourse with a creature from another planet or after a pregnancy had been bestowed by a god, such a child would still perhaps be accepted as a (human) child.

But is this not a tautology? Does it not in fact explain nothing? In other words, while if humans are a group which is not to be killed, let us call them group 'α', and if the children of humans are also humans and therefore belong to α, it is obvious that the children of humans are not to be killed. The question, however, is why beings belonging to α are not to be killed in the first place (while killing beings that do not belong to α is allowable), and the argument outlined above provides no answer to it. Nor does this argument say that from the start a child belongs to group α. It states that there is a process by which it comes into existence as a being which is not to be killed.

At the beginning of this chapter I quoted a text by Manabu Murase. It is easy to begin by criticizing his assertion. First, some will no doubt object that while he claims that through caring for a being we come to the awareness of its being human (i.e. to the awareness that it is not to be killed), in fact an acknowledgement that the being in question is human (i.e. should not be killed) must already exist for this care itself to be carried out. Second, others may say that we take care of lots of beings which are not human, like cats and dogs for example, so by the logic of Murase's assertion these beings too should be considered human (i.e. beings which are not to be killed). Third, it could also be pointed out that other animals like dogs and cats also give birth and raise their own young. But I think Murase's assertion says something nevertheless. We carry out actions in regard to a being and have experiences in which this being plays a role, and I think there is a connection between this and our thinking of this being as a person, or, in other words, our thinking of this being as an existence which must not be eliminated.

Let us begin with the third point. Dogs do indeed raise puppies, and cats do indeed raise kittens. But here the humans who experience this belong to the group or category of human beings. I think there is a connection between this fact and the already stated claim that these kinds of "ethical" issues only arise as ethics existing within the human world and that these conflicts are conflicts which take place inside this world. These disputes are between humans and only occur within a world created by humans. This is the only way in which these kinds of questions can arise. These conflicts occur within the group of human beings who are inclined to argue in this way. Person A, who becomes a mother when person B is born, is a member of this group.

In chapter 4 I stated that the experience of a certain being as "other" (person B) is something which arises in the self and only in the self. A child, while connected to me, seems to go beyond me. My connection to that child is something which appears to go beyond me; while I sense that they will become or already are independent of me at the same time this independence is connected to me. While these sorts of feelings may not only be directed at this kind of existence (a child), it is only in the case of a human being's child, or more specifically in the case of person A's child, that person A is involved in their origin in the manner described above. A gives birth to B, and B comes into existence through A. Person A then takes charge of person B's survival. While person B's being born may not be equivalent to their status as other as far as person A is concerned, the two are nevertheless connected.

We acknowledge person A, who experiences the emergence of a being in this way, as one of the parties in disputes concerning the boundary between which beings are to be killed and which are not. We accept person A's feelings towards B and her role in B's emergence as a being and as a being which is not to be killed. We are the only beings to consider and debate questions of ethics, and this relationship between A and B arises within our species as do the people who play the role of A in maintaining it. In which case can we not then say that we accept (or that we cannot help but accept) B as a being which is not to be killed? (See figure 5.1).

Looked at in this way, a child coming into existence through a person and a kitten coming into existence through a cat are different from the point of view of the person who gives birth and the entire group of human beings which includes that person. Perhaps it cannot be said that the feeling we have towards other creatures is definitively different. But there is a difference. The sense that we must not kill a person is different from the sense that we must not kill a dog. Something similar can be said in answer to the second criticism raised earlier which pointed out that other animals besides humans give birth and raise offspring.

Regarding the first point, it is indeed the case that in terms of individual relationships the decision to raise or take care of another being precedes the carrying out of these activities. However, there is also the simple fact that in practice I do not live only with my own child but rather within a community in which the lives of many different people are intertwined throughout the process of living. It should be possible to use this fact to answer the first criticism raised above◆12.

Do we presume B is a being which will meet certain requirements? If asked we might likely reply that we presume B will be a being similar to ourselves. But is this presumption directly related to B's existence as a being which is not to be killed? Is it not perhaps that there is simply a topology in which it appears to us as a human?

What is the "true nature" of taking B in this wa, and acknowledging that we take B in this way? I do not know. Those who want to do so may try to explain it in terms of "instinct", but I myself do not think the posing of this kind of question itself is very meaningful. There is also the question of whether I can give a reason for why what I have stated is properly "justified". I do not know whether Rachels and others in the field would accept my conclusions but I suspect perhaps they would not. However I think it can be said that to begin with these sorts of realities exist or also exist. The discourse on this topic has involved assuming that in general the special status of humanity is to be accepted and then attempting to come up with an explanation for why this is the case. I have examined assertions based on "species" and "characteristics" and then gone on to claim that these are not the only approaches which can be imagined. I therefore think it is at least possible to say that we are not forced to choose one of these two options, and therefore that rejecting one of them does not leave us with no choice but to accept the other.

5.3.3 The Limits of Definition Based on "Qualifications"

The next kind of definition which can be offered, arguments which propose "qualifications" (I give some of my thoughts on how these kinds of arguments has ended up being employed within the discourse in section 3 of chapter 7), is no more persuasive than the other approaches outlined above. What proponents of this kind of approach say does indeed have a certain appeal. I think it is true that our sensations and consciousness are important aspects of our lives (I will return to the idea that we cannot discard these qualities later). The reason that I do not want to die seems to be that I still have things I want to do or pleasures I want to enjoy. But this fact is distinct from the claim that it is not wrong to kill beings which (apparently) do not possess consciousness.

First, if we look at the list of beings they say it is acceptable to kill we see that at least some of the beings included are not "insensate" or beings "without consciousness". To begin with they often make judgments about whether or not a being is "insensate" or "without consciousness" in cases where to do so is extremely suspect. This is particularly evident in cases in which I.Q., for example, is offered as a standard of qualification. In other words, even if we assume that the being in question having some particular kind of relationship with itself or the world around it is to be seen as important, in most cases the proponents of this kind of approach define this connection quite narrowly and without indicating any basis for the standard(s) they establish. Even if we assume that higher levels of awareness and consciousness are better, it remains unclear why lower levels of these qualities should make it acceptable to take the life of the being or beings in question.

Second, if in a particular instance this "content" is not expected to be found in the being in question then this is all this approach can say; it cannot be considered an approach based on the being in question itself. If the guiding principle adopted is respect for self determination, it can then be said that"we must not do anything to a being against its will". If so all we can say about the state of lacking consciousness is that self determination and decision making ability are not present; we cannot say, of course, that the being in question has itself come to the decision that dying would be acceptable since to go on living would have no value. Therefore the criterion being put forward here cannot be seen as something that conforms to or is based on the being in question itself. If the judgment of the person in question is to be used as a criterion, then it is not acceptable to kill them [in cases where they cannot exercise self determination]◆13. We are the ones who establish these standards and we are the ones who demand that beings satisfy these conditions in order to be allowed to survive.

The above are some of the problems which arise concerning the connections between the various premises and elements of this approach. Another method which is sometimes employed when this approach is asserted or examined is to describe the connections between a generally accepted principle or common judgment concerning practical situations and the assertion in question. The proponents of this approach attempt to justify their own assertions by either using our "common sense" to gain a foothold for their argument or by appealing to it directly. Should we accept the conclusions drawn from these kinds of assertions?

If we must choose, for example, between killing a very clever chimpanzee or a less clever human being, if the question is one of possessing certain "qualifications" then we will conclude that it is the latter who must die. In other words, asserting the importance of "qualifications" does not justify giving human beings a privileged status. Some people may not have a problem with this (see notes 8 and 9) - assuming that all people would agree with an assertion regarding this kind of subject is itself difficult, and this is part of the difficulty that must be faced in dealing with this sort of issue. But if this rejection of human privilege is not acceptable to a relatively large number of people then the scheme used by proponents of this approach in which they put forth the validity of their own claims by relying on what is generally accepted will not be successful.

Furthermore, when they assert that the killing of newborns is not murder (not an unjustifiable killing) because these beings are not yet conscious, while in most cases these beings which are seen as being permissible to kill are beings which will (probably) not ever become conscious, if their logic in allowing the killing of fetuses is held to there should be no problem with killing beings who are at present without consciousness whatever sort of being they might be or become. To kill something without consciousness is to peremptorily cut off the possibility of a life lived in the possession of consciousness before this life itself has begun, and as a result to this extent should not create problems according to this logic. Also, if a being can be modified in such a way that it does not feel pain or experience consciousness, under this approach there is then no problem in killing it or making use of it as, for example, a source of organs for transplantation◆14. There are in fact also those who are consistent on this point and do not accept a right to life for newborns in general◆15. But if we do not accept the killing of newborns, is it because a being which might one day become conscious and fear death is being denied this potential future? Is it because the happiness that would likely be experienced (as a sum total of the happiness of all of the beings) is being decreased? If either of these explanations is accepted, however, this potential future experience is something which must not be taken away starting at the point of conception or possibly even earlier◆16. Perhaps the killing of newborns is rejected because, since we too at some earlier time did not possess consciousness, it would amount to a negation of "ourselves". But if we at least are already safe (since we are already self aware) this killing of newborns should not really worry us. Nonetheless, this kind of action is not to be carried out. Do we entertain the sort of complex considerations described above when it comes to the killing of older infants? Also, a sufficiently small child may not be aware of death. If such a child dies, the fact that he or she was this kind of being, and as a result could not experience a fear of death, may be of some comfort to us. But can we consider this a good reason to say that it is not wrong to kill such children?

To repeat what was stated earlier, even in the case of the proponents of these other approaches it is ultimately they themselves as individuals who make the judgment that certain lives may be taken or certain beings destroyed, and the approach I have stated above also involves a person or people making the judgment that certain lives may not be taken. To this extent both are the same. The method used in most cases where the validity of this kind of claim is asserted is to put forward a generally accepted (or rejected) principle or list of individual rules ("in such and such a case we must not do such and such"), and then show a connection between this conventional wisdom and the principles or activities which are problematic and make positive or negative assertions based on these connections. The assertions of those who support these other approaches being discussed can be connected to the sorts of conclusions I have just stated. If someone finds these conclusions unacceptable he or she supports a position contrary to what is being asserted.

What I have stated above is that, even without bringing up approach A, the idea that the human "species" is to be given special stats, or approach B, the proposal of qualifications required to be considered a "person" (and therefore entitled to special consideration), there is another topology (which I will call A? because while in practice the domain of the group of beings to be protected here does not differ from that found in approach A, the implication is nevertheless not the same)in which we accept people as beings which are not to be killed. This offers in outline the possibility of an explanation of the privileged status given to humanity, and the explanatory power of this approach does not appear inferior when compared with other arguments of this kind. A preliminary answer is thus provided regarding the topic of this section. We know from the start that the thing in question is a human being. We then subtract from this idea, and after subtracting deny what we had previously known. The concepts of "pleasure and pain" and "rationality" are used as tools in conducting this subtraction. There is then a position which can be taken in opposition to this kind of approach and its addressing of the issue as a question of the "properties" or "qualifications" of the being in question (even if the consideration of such concepts is not necessarily to be rejected). To the extent that this is claimed what is being asserted is a position which more fundamentally acknowledges our "knowing that something is human".

5.3.4 The World Extending from the Human

Are we then to conclude that those who make these kinds of assertions regarding certain "properties" of human beings are not saying anything? I do not think this is the case. There is a world I could never reach, a world that exists beyond me, which I can sense is opened up for me by the other (let us call this B'), and I think that it is indeed true that my seeing things in this way plays a large role in my feeling that this other's life should not be taken. This is not the same thing as the others in question themselves being aware of this existence of a world belonging (only) to them. Whether or not they are aware of or can reflect on themselves, whether or not they can make judgments about what is in their own best interests, there is always some manner in which they are experiencing the world. Nonetheless, here we are assuming the presence of a "property", albeit of a most minimal nature, being present within the being in question (for this reason I call B'). Earlier I stated approach A? as the assertion that, as beings born from other human beings, people are beings whose lives are not to be taken. At the same time, the fact that there is a world open only to the being in question is an important part of the composition of the other as a human being whose life is not to be taken.

Whenever we draw or do not draw a line, and whatever kinds of lines are drawn, the reasons for these decisions always come from within us. It is an "I" that thinks of the other as human and therefore a being which is not to be killed and it is also an "I" that thinks the opposite. To this extent both positions are the same. We must keep this in mind whatever point of view we take. Those who propose various "qualifications" for beings that are not to be killed do not understand this or are ambiguous on this point. What we claim or attempt to claim is not that a being without certain qualifications does not have a right to live, but rather that beings without certain qualifications may be killed. This much even those who put forward these qualifications must accept. This being the case, whichever of these views you adopt all of them can only be described as arising from within human beings. All of them involve my relationship with the other. Both B and A?, the idea that the death of beings who lack certain qualifications is acceptable and the idea that it is not, are ideas conceived of by us. If the method of discourse begun in chapter 4 and continued in this chapter is one which makes any kind of judgment (for example, that human beings are to be given special status at least to the extent that they are to be considered a set of beings which are not to be killed) regarding our existence (for example, regarding the set of beings which are not to be killed), it would be on the side of approach A?. Whereas B has been already put forward by others as a clearly stated perspective A? has not, and since I furthermore think that the sense asserted by A? exists as a very fundamental value within I have therefore attempted to put it into words.

There is also B', and what it expresses can be thought of as having special meaning even given the fact that all of these ideas are things we have thought up ourselves. In chapter 4 I said that there are beings in the world which are not me (I referred to them as "other") and claimed that because of this otherness there is value in accepting the existence of such beings. I would not want to obscure this. But I think that when we consider the existence of what is other not only in this sense but in the stronger sense of the existence of other human beings, along with the simple fact of the existence of something which is not me and the existence of something which is born from a human being, the fact that another world exists within this kind of being is also an important part of our conception of this human other. I think that when we think there is a world inside this other we feel more strongly that its life must not be taken. It is true that even this sense is something conceived of by us, but I think that it is slightly different from something that is merely a conception; the existence of the other appears as a stronger reality and something which cannot be surpassed or overcome. It could be said that what occurs in this other world is also found in the world of what I see and feel, but we are nonetheless aware of the fact that there in the other is a world we ourselves can never experience. Although I can never have direct knowledge of it I believe that in the other there is a world different from my world. I know that at very least a world exists only within the other in the same sense that my world exists only within me.

Stating things in this way is separate from the debates surrounding approach A - separate from arguments over, for example, whether young infants are not qualified to be considered humans. In practice the domain of what is to be considered a being which must not be killed indicated by approach A' largely overlaps that indicated by approach B'. There are connections between children being born and beginning to live and a world beginning to exist within them. However, if we subtract the state described in approach B' (a world exists within the person in question) from the situation found in approach A' (the person in question is considered a human being because he or she appeared within a human being) a resulting "blank" state is not inconceivable. In such cases we cannot say that a world exists within the other. Even in such cases I am liskely to think of this being as a person and as an other. Since there is only blank space within the person in question, only I am thinking about this other's existence, all that remains is my thinking of it as other, and thus to this extent I think what occurs here can be seen as different from my thinking something based on or conforming to this other itself.

What are we to make of this state ? This question is connected to the difficulties that arise when we think about "brain death". Putting aside all of the questions which are being addressed and must be addressed in regard to the [biological] facts regarding this subject and the verifiability of these facts in practice, and disregarding the dangers of assuming it is possible to measure something which is so difficult to measure and the additional danger of the fact that this dangerousness is bound up with the various interests of those around the person in question, what are we to conclude if it were possible to confirm cases of brain death in which the mind of the person in question is completely blank and there is no possibility of their making any kind of recovery? I think some people would be able to turn off the life support systems of the person in question. Here it is an 'I' that comes to the judgment that this is not a problem. I (we) am also the one who will use his or her organs, and the desire for these organs to be used in this way does indeed come from me (us). Those who on the other hand do not address the problem in the same way also do so according to their own inclinations; once again the judgment in question is made by an 'I'. It is also I (we) who do not think of the body of such a person as a corpse or inanimate object and who continue to think of them as a being which has not died (a being whose life must not be taken) and require the so called "three signs of death" to confirm they are no longer alive. Of course it is in no way the case that the former point of view is correct because it is "scientific" and the latter is incorrect because it is not. "Science" can only provide information regarding the biological state of the person in question, and since both approaches to dealing with this kind of situation arise from our ideas or attitudes it can be said that to this extent they are of equal value.

In addition to this it can also be said that within this blankness all unique or distinctive qualities of the being in question are lacking. Therefore to think that the latter point of view is based on some kind of "cooperation" with the being in question would be mistaken. To cooperate with this being is impossible; on the contrary, could it not in fact be said that this idea, if it is an idea which can only come from me (a criterion or set of criteria different from those based on using the being in question for some purpose or allowing them to die because their continued existence would be somehow inconvenient) is an idea which is in fact more "egocentric" than the other approaches discussed?◆17

What are we then to think having acknowledged the above? On the one hand there are those who when faced with a being in a state of blankness feel that this is a life which must not be taken. We cannot say that in these instances these people's way of thinking is strange or bizarre. If what I have stated earlier is accepted it is indeed true that we (at least some of the time) experience this kind of sense as well. And of course in this case no positive reason will arise to take the lives of those in a state of blankness. B? not being the case does not provide a positive reason to accept the elimination of the being in question. It only serves to weaken the reason that such eliminations should not occur. Do we give priority to A?? To what extent do we take into consideration the fact that the stronger (narrower) condition B? places on what should determine whether the being in question should not be killed is not satisfied in these cases? There is no absolute answer regarding which approach should be taken here. We can think of this as being the case because both points of view are deeply rooted in our actual experience.

Putting aside the topic of organ transplants from people in a state of brain death which is not being addressed here, we can always simply wait for the time required to pass from B? to A?, and as a result leaving the answer to this question undetermined is in practice not so problematic. But it is possible to take our consideration of it a bit further. It is possible to continue thinking of a being as alive and not wanting to destroy it not only after brain death but also after the complete cessation of all biological and physiological life. We may even be able to preserve their body as if it were alive. But what becomes clearer and more explicit in such cases is that these attempts to preserve the being in question arise solely as a result of our own thoughts and desires. Is this attempt to preserve this body, which has already ceased to be something lived in and received by the being in question, not in fact an activity which aims to separate this body from that being which had received it and lived with it and attempt to bring it within my own domain? Can I really be said to posses the right to do this?

At very least, if the individual in question wants to renounce any life that might continue after the world of their experience ceases completely or any preservation of their body after their life has ended, then from the perspective of the claim that we must respect the existence of the other itself and not only the other in the sense of something related to the self we must no doubt adhere to the will of the person in question.

I have somewhat carelessly taken this discussion a bit beyond what I had intended to cover in this section. But I think if I am to consider this topic I must extend it as least as far as I have done above. In chapter 9 I will consider the not at all cheerful topics of "prenatal diagnoses" and "selective abortion" and will return to some of what I have stated here as well as exploring other aspects of these issues. I think that to view of all of these issues as the same and as questions of the qualifications or conditions of life which is to be protected is a crude approach, and what is referred to as logic does not address the realities of what we think about and are troubled by - these thoughts, feelings and doubts are no doubt more complicated than what those who manipulate logic for a living would call logic but nevertheless possess a certain logic of their own.


5.4 The Point at which Human Life Begins

5.4.1 The Problem of Beginning

Whether or not there is agreement on what is stated above, let us assume for the moment that it is accepted that human beings are to be given special status or privileges. If so, however, what are we to do about the question of at what point a being should begin to be considered human? The focus of what has been said regarding this topic until now has been the question of when we are to acknowledge the being in question as a "person". In the continuous process beginning with conception and ending in death from what point to what point is the being in question a person? In other words, from what point to what point in this process is the being in question one that must not be killed? It can even be said that this has been the most important topic in the field of "bioethics"◆18.

Various criteria can be proposed in answer to this question, but none of them can point to a solid basis for claiming to be superior to all of the others. There is no way for us to establish an absolute standard for determining the point at which a given being becomes a being whose existence is not to be eliminated. To say this is to make a claim about value judgments and not judgments regarding matters of fact. The chain of cause and effect goes on without limit. When we mark one point in this chain and emphasize it as the start of a human life, whichever point we mark is in principle arbitrary. As Shuichi Kato has stated, there is no basis for asserting that, for example, life begins at the point of conception◆19. This is only one possible sense or intuition regarding where life begins, even if we agree that it is not a sense which has no basis whatsoever.

However, we must nonetheless decide on a criterion or set of criteria to establish when life begins. Various debates continue to be carried out regarding these criteria. But is this really necessary? Must we really always decide on a single standard? Of course, even if we agree that to the extent that a society is a society it cannot avoid establishing the range of beings whose existence must not be eliminated and the range of killings which are to be considered murder, it is still not clear what must be done about the areas which cause problems here.

This is not to say that if an unequivocal decision cannot be arrived at these matters should be left up to each individual (who are we to consider individuals in the first place?). I am also not claiming that it is meaningless to debate these questions because they involve value judgments. When there are opposing points of view debate is inevitable as is our ultimately arriving at some sort of decision as a society. What I have reservations about are judgments regarding attributes which give "humanity" its definition in terms of special characteristics, a view of the chain of cause and a effect as a process in which these attributes gradually arise, and debates carried out within this context concerning the definition of these attributes and the establishment of norms regarding to what extent a being must possess them to be considered sufficiently similar to us [to be considered a "person"]. There is another kind of approach we can take which differs from the kinds of claims made in these debates. We can address the question of the position of the being which makes the judgment in question rather than the attributes of the being about which the judgment is made. I want to think about these issues with this as my starting point. We give priority to certain people's decisions regarding these matters. I want to look at what sorts of things are occurring when we do so.

On point which can be raised here is that even if we put aside the point at which a life is not to be taken, the issue of who is to make decisions about what happens before this point is reached remains, and as a result we must consider the question of this "who". Also, I do not want to look at these two forms of discourse as being totally unrelated to each other; I want to consider what sort of understanding of "humanity" both of them are connected to. In doing so I want to bring greater clarity to the question of "what kinds of values are there?".

5.4.2 Rights regarding what is Produced

We sometimes say "I cannot say anything" about a particular issue or question. I think this feeling is one of the keys to answering this question. This might seem to be an avoidance of direct debate and an evasion of the "ethical" problems that arise here. It is not. I think that the determination that we have no choice but to leave these decisions to the person in question is itself an ethical judgment. For example, consider what it means to accept "self determination". It is not the same as saying that whatever judgments the person in question makes are "right" or "correct". Here the universality of "two things which are the same must be treated in the same way" is broken. This being the case everyone who accepts self determination must reject this universality. It is therefore mistaken to assert that we always establish or must establish a single standard or set of criteria. (I stated my basic thoughts on this in chapter 4, and in chapter 8 section 5 I give my opinion regarding the topic of how to address the concept of justice that states "[treat] things which are equal equally and things which are unequal unequally").

There are things we leave up to certain individuals. So why are these particular things left up to these particular people? If we leave decisions regarding giving birth up to the woman in question, why do we do this?

Some have construed a woman's right to self determination in this regard as her right of ownership of her own body. An individual owns their own body, and as a result an individual has the right to determine what occurs within that body. What kind of argument is being made here?

First, there is the claim that "things which belong to me" (my body, for example), are things which I am able to dispose of as I wish (I have the right of self determination). But here no basis is given for why my body "belongs to me". Second, this problem of a lack of basis does not arise in regard to the statement "whatever I make (whatever I control...) belongs to me (I can dispose of it as I wish)". This is first stated as a fact, and the rights that follow from it are added later. One example of this kind of argument is the claim that the woman in question produces the child or embryo/fetus and therefore has certain rights in regard to this being. This is the scheme of Locke and his followers in which rights of distribution are conferred on the producer of the thing in question. Even in this second formulation, however, it is possible to raise the question of whether this primary assertion itself can be shown to be correct. The argument itself has nothing to say in response to this objection. Furthermore, the body regarding which these problems arise cannot be said to be either the object of the production of the person in question or an object of their ability to exercise [exclusive] control. His or her own body is something which has been given to the person in question, and there are cases in which control of this body can itself be performed by other people. And if we try to emphasize the role of cause and effect in the assignation of rights regarding embryos/fetuses, then a man who enlists a surrogate mother, for example, must also be considered as part of the chain of cause and effect leading to the existence of the being in question. More importantly, before considering any of this do I really feel that I own my body or that I own an embryo? Also, the idea that I should have the right of disposal over the things I control not only fails to address the question of the commercialization of the body, for example, but on the contrary justifies this practice. Is this acceptable?

Next, it is obviously possible to object (and this objection has in fact been raised) that if the embryo/fetus in question is already a human being, in other words if it is already a life which must not be taken, then this being is already not a part of the body of the woman in question but rather a being whose existence must be respected.

In regard to this objection J.J. Thomson evaluates the justifiability of abortion of embryos/fetuses based on the argument that, with the assumption of the private ownership of the body, even if the embryo/fetus in question is a person the woman cannot be told that she must preserve this being if it means sacrificing her own body. In other words, he asserts that abortion can be justified even if the embryo or fetus is a person. But first there is the question of whether the body can be said to be the object of private ownership. And even if the body in question is owned by the woman in question it might not be possible to say that she has no duty to use her body to save the life of another human being. Even if we cannot compel her to go so far as sacrificing her own life to save the life of another person, it is not impossible to say that in cases where her own life can be preserved while doing so she has a duty to save the life of this other◆20. In summary, both the justifiability of self determination, which is often taken for granted as a premise in various approaches to these issues, and the nature of this self determination which must be justified are not in fact as clear as one would expect. Here we must look carefully at feminists' assertions of the "right of self determination" and opposition to subjugation and invasion. It was because of starting from this kind of position that it became necessary to say that the body in question is "mine". But was this not perhaps different from what they actually wanted to say?◆21

5.4.3 The Experience of the Appearance of the Other

Why do we leave certain things up to the person in question? It can be thought of as coming from our desire to accept the person in question as an "other" - a being which is not me and which I do not control.

"Person A thinks x", "person A does x", "person A lives life x", "x dwells within person A", "person A dwells within x". Person A either cannot extricate themselves or does not try to extricate themselves from these situations. There is no attempt to transfer A's situation and experiences to others; they are accepted as things which cannot help but be accepted. Even if I can feel sympathy or disdain in relation to these experiences of person A it is impossible for me to experience these experiences themselves. These are simple facts of which we are all aware. We assign value to these facts and establish norms. In other words, we give A priority in regard to x and acknowledge that x belongs to A. We do this because to control or destroy these experiences would be to destroy the existence of A as a being which is not me - to destroy the existence of A as "other". This is distinct from the question of whether or not A is able to control x. What is being defended here can be thought as being not the right of self determination as a right of disposal, but rather the duty of others not to exercise control over or appropriate elements of A's experience and the rights which simultaneously arise in A in relation to this duty. The right of self determination is one part of recognizing the person in question as an other and acknowledging their manner of living in this light (see chapter 4 section 2).

However, 1) when we leave an individual's manner of living up to the individual in question we impose the condition that they must not harm others, or at very least that they must not harm other human beings. Do a woman's decisions regarding giving birth not violate this condition, and does it not follow that we are forced to reject self determination in these cases? Can we then say 2) that we must respect the "mother's" decision here and not that of other people around her? Here I will return to some of what I have said earlier.

Regarding (1), we have already established that it is impossible to determine a single point at which a being "becomes a person". In other words, we are not dealing with the question of how we must treat something which is already a "person". The being in question is not yet anything (anyone) other than "being x". This being soon begins to inarguably exist as an "other". The being in question exists within this chain of events. At some point in this process "being x" ceases to be "being x" and becomes, for example, "person B". But there is no definitive method of deciding where the border between these two beings should be drawn. The question is how we are to determine this line of demarcation. As a result I stated that 1) cannot be used as an argument against abortion or other decisions affecting a fetus/embryo.

Regarding (2), when it comes to a particular incident we are aware of the fact of whose experience it is, and we give priority to the feelings of the person who directly experiences the event in question where these feelings differ from our own. In other words, we accept "self-determination". For example, in regard to the causes and symptoms of a particular illness a doctor is more knowledgeable than his or her patient. Nevertheless, we accept the self determination of the patient regarding his or her illness. The person in question is the one who experiences the life and illness in question, or must accept their own body, and this being unavoidable leads us to acknowledge their demands for self determination. Not all of us are in the same position. We acknowledge these differences and let different people make their own decisions.

The experience of "being x" beginning to exist becomes the experience of something which is not the self, an "other", coming into being, and there is a subject who experiences this process. For the woman in question, in other words, a person being born, the coming into existence of a being which is not the self, exists as an experience which occurs within her. This experience is different from the experience of the other people around her. We acknowledge this difference in regard to this experience, and think that we should try to leave, or have no choice but to leave, these sorts of judgments or decisions up to the woman whose concrete relationship to the being in question is closest and who is in the best position to experience a person coming into existence.

Some may think, however, that it is still not clear why we should give priority or special status to the woman in question's experience of what occurs within her own body. Those on the outside of this process do indeed also have feelings about it. For example, when person A engages in behavior "a" it is possible for us to make judgments about whether "a" is good or bad. In this sense we are no further from "a" than person A is. In the case of surrogate motherhood, for example, the men and women who enlist the help of a surrogate mother no doubt have (strong) feelings about the "child" in question. To this extent it might be possible to say that they are no different from the woman who bears the child. But I think that when we acknowledge a difference here it is a difference in regard to the experience of the existence of the "other"[and not a difference in strength of feeling or emotional involvement].

When those who have enlisted a surrogate mother demand that their contract be fulfilled, for example, what they are demanding is a realization of their own desires. When we suppress women's decisions or right to make decisions, what is being demanded is the realization of our own desires, our own ideas of justice, and the realization of our own values. I am not saying that there is anyone who can get away from this kind of behavior. All of us, including the woman in question, have this propensity. However, it is the woman in question who first experiences the emergence of a being which interrupts my (our) previous existence. While related to things like physical changes in her body and the movement of the fetus within her◆22, simply stated what occurs within a pregnant woman is the appearance of "a being which is not me". Therefore, our giving responsibility to the woman in question is not because of the appearance of the other as it relates to our own desires, sense of justice, or genetic relationship to the child in question, nor as it relates to some degree of similarity to some quality we ourselves posses, but rather because of the appearance of a being which is not me whose existence must be accepted regardless of my own values and ideas of right and wrong.

I acknowledge the existence of the other. This other is "other" in the sense of existing separately from me (my desires, my values, etc.). It is because of this separation that the decisions of the person in question are accepted. This was asserted in chapter 4. I think that it is the woman in question who first feels the other emerge in this sense. We leave certain decisions up to the woman in question out of our acknowledgment of the fact that she is the first being to know of the existence (or the coming into existence) of the other. Here it is the woman who decides and not the being itself (a being able of making decisions does not yet exist), but what is being left up to the woman is our understanding of the existence of the other and values regarding what kind of other will be brought into existence.

This sense or feeling can be thought of as defending the "self determination of women" in regard to giving birth. It can be stated as the assertion that we should (or cannot help but) leave up to the woman in question all decisions that must be made before the being in question reaches a point at which it is acknowledged as a being whose life must not be taken by anyone◆23.

I stated the following in the preface to this book:

(2) Consider, for example, surrogate motherhood contracts. On the whole these do not seem to be good things. At very least I think the right of the parent who gives birth to baby M (see to chapter 3 note 8) to change her mind should be protected. In other words, self determination is not be accepted at face value here [i.e., the surrogate mother should not be able to give away all right to change her mind in regard to giving up the child even if she desires to do so at the time of signing the contract] .

(3) I think that in regard to abortion we must accept the self determination of the woman in question

(7) Even if I do not oppose "pre-natal diagnoses/selective abortion" to the point that I think it should be prohibited, I nonetheless feel some sense of opposition to these kinds of practices

I then stated that (2) and (3), for example, might seem to contradict each other. But based on what I have observed in previous chapters I think I have been able to show that this not the case. I have just stated my position regarding 3). This same sense leads me to support (2) a surrogate mother's ability to change her mind (see chapter 4 section 3). I think this sense also leads us to think of (7) the choosing of what kind of being will be born as separate from the decision discussed in (3). This is the case because even if there is not yet an other able of experiencing things and suffering injury directly, and even if the decision to abort is made before the being in question is determined to have become a person, to the extent that this decision making process is based on particular qualities of the other in question it is a process which makes assumptions and determinations about what the other is or should be and in doing deprives it of its existence as other. In chapter 9 I examine the topics of "pre-natal diagnoses" and "selective abortion" further along with the question of what sorts of decisions can be made regarding beings that do not yet exist.

Put another way, if we accept (2), (3) and (7) as I have stated them then we possess the sense I have been describing. I think that even though this sense exists as a fundamental sentiment within this society it has not so far been adequately expressed in words within our discourse. I began the work of putting into words in chapter 4 and have continued this explication in the discussion above.

5.4.4 Ownership and Qualifications

In chapter 2 I stated and then examined one of the answers which has been proposed in response to the question of what belongs to whom: "there are things which I have control over, and these things belong to me". In this chapter I looked at the assertion that "the 'I' which consciously controls something (the 'I' which understands what it is doing) possesses the qualifications of a being whose existence should be protected". How are these two ideas connected?

The arguments in chapter 2 lacked a solid basis or grounding, and in practice there is likewise no basis which justifies these assertions regarding qualifications. In one sense they are both independent claims and there is no necessary connection between them. The former assertion deals with attempts to justify "rights of ownership" while the latter addresses the issue of the "right to life" (or other related rights like that of "citizenship"). However, while these two ideas are not logically connected to each other they are nonetheless connected in other ways and are sometimes brought together when they are discussed.

First, a person who owns nothing cannot survive (assuming he or she cannot receive sufficient voluntary donations from others on which to live). This conclusion can be reached if we follow the arguments for the justification of private ownership (see chapter 2 section 2) exactly as they have been stated (I touched on how these thinkers argue this aspect of their approach in chapter 4 section 3). If we continue to follow this line of argument and take it at face value, we see that through this argument for the justification of private ownership the existence of those who reject such ownership is rejected. Even if we do not explicitly state certain qualifications which must be present or not present for a being to be given the right to exist, as a matter of fact it may become impossible for the person in question to survive if certain qualifications are lacking.

This is not all. Second, in chapter 6 section 2 I will look at the promotion of the idea that I am given value by my producing something. The "value" of a person and the "qualifications" needed to be considered a person (to be considered a being with a right to survive) are not the same.

But they are connected. Third, in chapter 7 section 3 I will address opposition to intervention, and look at demands for a subject which is able of arguing against or opposing intervention. Here "qualifications" will again be stated. This is related to arguments over "Sanctity of Life (SOL)"versus "Quality of Life (QOL)". These two ideas are compared and contrasted with each other, the standard approach being that while the former, a more traditional approach, points out the "dangers" of the latter, at the same time it is impossible to ignore the latter (as a form of opposition) when we consider the "simple prolongation of life". It can no doubt be said that when something is alive the higher its quality of life the better. Depending on their circumstances a person may want to be left as they are without receiving treatment which prolongs their life but does not improve it, and there are no doubt cases in which these desires of the person in question may be accepted by those around them. This does not mean, however, that it is acceptable for those whose quality of life is seen as inferior to cease to exist. Nonetheless this kind of connection is made. When this is done the argument becomes crude and the dichotomy employed overly broad. It makes no sense to use "quality of life" as it is perceived by the person in question themselves as a qualification or condition of their own survival. Arguments surrounding "quality of life" are, however, sometimes intertwined with arguments involving "qualifications for life", either through this distinction not being clearly made or through a "quality of life" being established in advance and then used as a "qualification" (of citizenship etc.)◆24.

There is no logical necessity in either point two or three above. It is possible to assert that there is no necessary connection between the value/qualifications of people and the fact that people control and produce, and it cannot be said that the person in question must themselves possess the ability to oppose intervention in order for intervention in their affairs to be opposed. In practice, however, these values and their implementation do indeed exist. Since these concepts and values are not the product of deductive reasoning it is necessary to understand them in terms of how they exist in reality. It is necessary to examine their expression and implementation as they have appeared in society.

The system of private ownership discussed in chapter 2 is not the only such system found in this society; there is knowledge and practice related to influencing the qualities of individuals and autonomy and intervention based on the requirement of production in a broad sense. Many different ways of practicing intervention are lined up together on the same plane and combined with each other - this being the case it is possible to suppose that this requirement of production has connected things which otherwise would not be connected. These issues are discussed in chapter 6. There have also been attempts to modify or correct possession individualism and raise further opposition to attempts at influencing [the qualities of individuals]. These will be examined in chapter 7. In section 3 of that chapter we will see how once again "qualifications" arise through the opposition to intervention (which depends on whether one is in the position of opposing a system or constructing it and is therefore necessarily relative) and how this and the individual's deciding to accept intervention are connected forming a kind of loop or torus. Following the above I will claim that what stands in contrast to private ownership and the apparatus of intervention is not the criticisms and corrections which have been offered in the past but fundamentally only that which is found in chapters 4 and 5 of this book. Building on these claims in chapter 8 I will discuss meritocracy and in chapter 9 examine technology related to quality of life.

Notes Chpter 5

  1. "The human world accepts as an unconditional assumption that each individual's life is complete within them without serving some external purpose. This assumption has stood as the foundation of the protection of human rights and the protection of the existence of human beings as individuals, and it is on this basis that society and culture have been created. This idea is of course also the basis upon which discrimination is rejected. The reason this assumption has been adopted in this way is that a human life is not something which is made but rather something which simply exists. A human being is born autonomously through the internal power and inevitability of their own life, and then lives autonomously as a being that simply exists until it dies. The fact that society views murder as the most heinous of crimes is also due to this taking away of an autonomous death". (Fukumoto [1988:20]). But are "living and dying autonomously" and "simply existing" really the same thing? I examine issues related to this question in chapter 3 section 4.
  2. There may however be cases where the person in question cannot maintain their existence without accepting conditions of exchange put forward by another party. In such cases he or she may reluctantly accept these conditions and choose to part with something in his or her possession. Since here too the decision is made by the person in question is there then no problem with what occurs? No: it is awful for someone to have to choose between two things which are vital to their own existence (even if there is some difference between the two things being chosen between in that one is needed to survive and one is needed to live well or happily) and this situation is not justifiable. This is also stated in sections 2 - 4 of chapter 4.
  3. In the present circumstances, however, there is a separation between those who kill (and raise) the animals and those who eat them. As a result what is stated in this section may sound like the pastoral assertions of an earlier era. Since we cannot return to total self sufficiency, all that seems possible is a kind of "second-hand experience" (for example, knowing how what we eat is raised and how it is killed). But to what extent are these seemingly hypocritical acts or postures really false or self-contradicting? For example, Dagognet introduces various techniques used in livestock engineering such as the "systematic elimination of the claws and beaks of young chickens" and states that while we find these techniques quite revolting "nonetheless we take a favorable stance towards livestock engineering" and "what is important to us is not the humanization of animals but rather the post-animalization of humanity" (Dagognet [1988]), but is this too not a substantial betrayal of his own sentiments? For other discussions of the killing and eating of animals see also Toriyama [1985], Morioka [1994:106-111] and Tsuchiya [1996].
  4. On "the ethics of relation" see Tanida [1990], cf. Morioka et al. [1990] and Tsuchiya [1990]. For more on "philosophy of the family" see Donaldson [1993] and Jecker [1993] (both are included in Meyers et al. eds. [1993]). For more on the "philosophy of care" see Gilligan [1982], cf. Kakegawa [1993] and Kawamoto [1993].
    One of the things I have tried to consider in this book is the dividing line between what is left up to individual relationships and interactions (the texts cited above are related to this) and what is dealt with uniformly. Everything considered in this chapter relates to this topic, as does the short discussion of "justice" in chapter 8 and the discussion in section 5 of that chapter of "discrimination caused by the other being the other".
  5. "I think it can be said that the life of a bacteria and the life of a human being are the same thing. I think that in fact this view carries a great danger. This danger lies in the fact that we Japanese subscribe to an Eastern perspective. This has resulted in a certain kind of academic backing for this way of thinking existing in contemporary biological science. I think this is very dangerous, however, since the more strongly we hold to the concept of all life being the same the less relative importance we are likely to accord human life. I would thus say the following about this issue... is it not precisely because of this situation that we must draw a rigid distinction between human life and other kinds of life? ...regarding the manipulation of non-human life, providing that such research poses no danger to human beings why shouldn't we continue to pursue genetic recombination? ...and as for the manipulation of human life limit this to medical treatment." (Watanabe [1982:133-135]. See also Watanabe [1980]).
    This is of course an assertion that it is inconvenient for humans not to privilege human life and not the statement of a basis upon which to say that the human species or the convenience of the human species must be given priority. Feinberg [1980] and Harris [1983] refer negatively to the "species criterion" while Warnock [1983] takes a positive view of this approach.
  6. Weir [1984] includes a comprehensive discussion of the problems surrounding the selective cessation of treatment of disabled newborns.
    On what has come to be referred to within the literature on this topic as the case of "baby John Doe" see Weir [1984], Kipnis and Williamson [1984], Beauchamp and McCullough [1984], Maruyama [1985], Akiba [1987], Takagi [1991], Yonemoto [1988d:168-169], Tsuchiya [1995b:159-160], and Gallagher [1995]. (The baby in question was a boy born with Down's syndrome (a condition caused by the presence of an extra chromosome) on April 9th 1982 in Bloomington, Indiana. His esophagus and Trachea were closed and his parents refused to allow surgery. The hospital deferred the case to the courts and the boy died on April 15th while it was being adjudicated). Weir evaluates the action of the courts including the government response. As the translator of Weir's book Takagi describes what occurred after it was published. Akiba pursues a thorough account of what occurred both in this case and in the case of "baby Jane Doe" discussed below. Yonemoto discusses the movement to establish ethics committees within hospitals.
    Following this incident a long and convoluted process eventually led to the passage of child abuse amendments in October of 1984 and the "Child Abuse Prevention and Enforcement Act" in April of 1985. These "regulations" stipulated that life-saving treatment could only be refrained from or terminated in cases where ' (1) the patient has suffered a permanent loss of consciousness. (2) the patient's death is inevitable and treatment would be futile. (3) regarding the patient in question treatment is essentially futile and providing it would be more inhumane than refraining from providing it/terminating it if already in progress." (Takagi [1991:345-346]). For criticism of the newspaper coverage of these regulations see Yamao [19851986]. Akiba [1987] provides a detailed account of this issue including a discussion of incorrect reporting. For a criticism of the regulations passed in 1985 see Moscop and Saldahna [1986].)
    The case of "baby Jane Doe" involved a baby born in October 1983 in New York state who according to Rachels "...suffered from multiple defects including spina bifida (a broken and protruding spine), hydrocephaly (excess fluid in the brain), and, perhaps worst of all, microencephaly (an abnormally small brain)."(Rachels 1986). After her parents decided that surgery should not be performed a nurse asked a lawyer for help and he brought suit to try to have the procedures carried out. He was successful in the first case he brought but lost on appeal, the court finding his suit "offensive". The supreme court declined to hear his case and after he continued to pursue legal means of compelling the treatment he was eventually fined under a "...rule that allows judges to discipline lawyers who are trying 'to harass or to cause unnecessary delay or needlessly increase the cost of litigation'"(Rachels [1986]). Rachels' "...conclusion about Baby Jane Doe, then, is this. The facts are (1) that she is human, (2) that she is innocent, (3) that she is alive, and with constant care can remain alive for perhaps twenty years, and (4) that she does not and never will have a life. The first three are not enough to confer any value on her 'life', either singly or jointly. And the fourth means that her 'life' in the morally important sense will never exist; so, sadly, there is nothing to be concerned with, from a moral point of view" (Rachels [1986]).
    Other texts such as Masia [1985a:59-] [1985b:163-167] [1987:61] refer to the "Johns Hopkins Hospital case" in which the parents of a baby born with Down's syndrome and a closed duodenum did not agree to surgery and the child died 15 days after being born (see also Weir [1984] and Kawai [1989:242]). Masia asserts that there were errors in the assessment of "quality of life" in this case and that "labeling this child's quality of life as 'low' and allowing him to die can only be viewed as weeding out the weak". Regarding the Howl case, on the other hand, in which the a child with a deformed left side, abnormal trachea/esophagus and other health issues died after surgery was performed by court order (in opposition to the parents and at the recommendation of a group of doctors) Masia states that it "is a case in which it would be better to allow the child to die naturally rather than engage in futile efforts to prolong his life" and "the idea of the 'sanctity of life' has been misapplied" (Masia [1985b:164-166]). In response to this Inoue writes "there are unavoidable questions about his [Masia's] views in relation to the distinction between these two cases" (Inoue [1987:48-49]).
    One section of Colen's book (Colen [1976]) on the so called "Karen case" (in which the parents of Karen Ann Quinlan sought to remove the artificial respirator from their daughter who was in a vegetative state) addresses the topic of cessation of treatment of disabled newborns. For more on the Karen Quinlan case see also Bai [1990] which includes Bai [1983].
    For a discussion of the 1981 "Dr. (Leonard) Arthur case" in which a group called "Life" sued a doctor who had prescribed dihydrocodeine to a Down's syndrome infant see Ienaga [1995a]. Johnson [1990] also references this case.
    While few such "incidents" have been publicized in Japan, one account of these sorts of cases can be found in the newspaper reportage, including letters from nurses, of Shigeo Saito collected in Saito [1985]. Tsuchiya [1995b] examines the letters to the editor (also included in Saito [1985]) elicited by these stories when they were first published.
    For more on debate over these issues in Germany see Hojo [1992a] [1992b] and materials referenced in note 8. For more on this subject see also Brandt [1978] and Kawakami [1991] [1993].
    Attempts by doctors to create medical treatment guidelines corresponding to the condition of newborn infants include Lorber [1971], Campbell and Duff [1979a] [1979b] and Duff [1979]. Gallagher [1995] criticizes this kind of undertaking. One of the few such attempts made in Japan can be found in Nishida [1985] [1987] (see also Nishida [1988] [1991]). An overview and examination of these texts can be found in Tsuchiya [1995b:161-165]. The example of the long-term survival of children with 18-trisomy syndrome who have been designated as "class C" (standard nursing care with no further treatment than what is already being given) is also raised in Kawamura and Nishida [1994]. Gallagher [1995] introduces an "experiment" using the standards (see formula below) proposed by Anthony Shaw (a pediatric surgeon and chairman of the ethics committee of the American Association of Pediatric Surgeons) in which children with spinal bifida are divided into those who should be given treatment (and survive) and those who should not be given treatment (and die). The term "quality of life (QOL)" has sometimes been used in this kind of approach (cf. note 24).
    QL: the quality of life the child will have if it survives.
    NE: the innate intellectual and physical abilities of the child.
    H: the support the child can be expected to receive from its family and home life based on the emotional stability of his or her parents' marriage, their level of education and their financial resources.
    S: the quality of social services the child will be able to receive from the community in which he or she lives.
  7. "Suppose it were suggested that we are justified in having special regard for members of our own race? That suggestion would rightly be rejected; but why? To resist the suggestion, it might be said that members of other races are rational, autonomous, and have rich internal psychological lives, as we do; therefore they should be treated with equal regard. But the Nozickian reply is that this only places us with respect to them as a 'denizen of Alpha Centauri' would be placed with respect to us. Since we have a special relation to members of our own race, which those denizens do not have, it may be reasonable for us to give them special treatment, even if the Alpha Centaurians have no reason to do so. If this way of thinking is to be rejected with respect to race, I see no good reason to accept it with respect to species. (The point is not that Nozick is a racist. He is not. The point is that, in attempting to justify discrimination based on species, he has inadvertently produced an argument which, if accepted, would justify racist discrimination as well.)" (Rachels [1986]).
    After arguing in chapter 1 of this book from a utilitarian perspective for the acceptance of Euthanasia in opposition to its rejection within the Christian tradition, in chpter 2 Rachels asserts that the value of a life is the value the individual in question places on it and in chapter 3 states that "death is an evil for the person who dies because it forecloses possibilities for his or her life; because it eliminates the chance for developing abilities and talents; because it frustrates desires, hopes, and aspirations; and because it leaves parts of lives pointless and whole lives incomplete." (Rachels [1986]. The passage cited above comes from a text in which Rachels asserts that regarding the case of baby Jane Doe (see note 6) neither the baby's "innocence" or the fact that it can be considered a person can be used to assign value to its life. Rachels also addresses euthanasia in Rachels [1975]. For an argument against his position see Beauchamp [1978].
  8. Singer divides beings into three categories: those who exist without feelings or awareness, those who feel only pleasure and pain, and those who in addition to feeling pleasure and pain also possess reason and self-awareness. From the standpoint of preference utilitarianism in the case of those in the first category the being in question itself possesses no interests which must be given consideration, in the case of those in the second category care must be taken to avoid causing them pain, and in the case of those in the third category consideration must be given both to their interests related to pleasure and pain and their interests regarding their own futures (Singer [1979]). This position has led to claims that animals (as beings who feel pleasure and pain) have a right to exist (see Singer [1973] [1975] [1990b], Mason and Singer [1980] and Singer ed. [1985]) and at the same time has also provided a basis for arguments in favor of euthanasia in the case of newborn infants with certain kinds of disabilities (see Singer [1991b], Singer and Kuhse [1984] and Kuhse and Singer [1985]. See also Kuhse [1987] which criticizes the idea of the "sanctity of life" (discussed in chapter 4 section 4) and Kuhse and Singer [1990] and Singer and Dawson [1990] which support experiments using human embryos while rejecting arguments based on "potentiality").
    These assertions have been criticized by disabled people's organizations in Germany and their protests during one of Singer's lectures forced its cancellation. He has of course complained about this (Singer [1990a] [1991a] [1992]). For an examination of this "Singer incident" and Singer's assertions see Ichikawa [1992a], Tsuchiya [1992] [1993] [1994a] [1994c] [1995a] and Kawamoto [1996]. Kawamura [1996] address these issues and also includes a report on the current state of affairs within German philosophy. These texts also introduce the arguments made by those who oppose Singer's views). I do not think that "freedom of expression" must always be given priority over other considerations, but in this case I do not think banning the expression of the views in question itself is the best approach. While the degree to which they are made explicit may differ, his claims are present within our society and prohibiting their expression will not make them go away. A more effective approach is therefore to examine these kind of claims and provide a contrasting viewpoint. Almost the same assertion is made in Tsuchiya [1993:338-339].
  9. "...the more complex the life, the more objectionable the killing....Complexity matters because, when a mentally complex thing dies, much more can be said about why its death was a bad thing. A young woman dies: it is bad because she will not get to raise her children, finish her novel, learn French, improve her backhand, or do what she wanted for Oxfam; her talents will remain undeveloped, her aspirations unfulfilled. Not nearly so much of this kind could be said about a less sophisticated being. Her death is worse because there are more reasons for regretting it. Thus, if we had to choose between the death of a human and the death of a dog, there is reason to choose in favour of the human....the life of a mentally defective human will typically be simpler than the life of a normal human, in the same way that the life of a non-human animal is simpler; and so this idea would dictate that, in a situation of forced choice-if you must choose between the death of the retarded person and the death of the normal person-there is reason to choose in favour of the normal person." (Rachels [1986]).
    Rachels calls this the "less radical" implication of this view of the importance of complexity, with the more radical implication being that in some cases the lives of animals would be preferred to those of severely mentally retarded humans. This discussion comes at the end of chapter 3, and Rachels concludes by saying that in chapter 4 he will address the question of whether "there is something morally special about being human-an idea that I believe should be rejected"([Rachels 1986]). After stating this he goes on to take the position described in note 7.
  10. ..... In a paper published in 1985 Iida points out the importance of what is argued in (2) and in examining (1) and (2) states "it is a mistake from the beginning to impose on the meaning of the existence of a distinct self together with each fetus, which is illustrated by the expectations, consideration, anguish and sadness felt regarding fetuses still inside their mother's body, things which are unrelated to this meaning; we should not here invoke things such as a legal concept of the right to survival which are external and not directly related to the meaning of the existence which is being addressed or to the concrete content of the choices made by a free subject" (Iida [19891994:132]).
    Masahiro Morioka introduces and criticises (2),(3) and (4) in Morioka [19871988:209-238]). He makes three distinct criticisms of these views but the first is the most fundamental "Why should being a 'person' be connected to having the 'right to live'?.... Unless the concept of 'person' carries an a priori implication of the concept of 'right to live' proponents of 'person theories' must explicitly prove the necessity of the identification of these two concepts". For another text which presents and examines (1) and (2) see Suitani [1989]. 1) is criticised as part of a consideration of issues surrounding abortion in Molm [1989] and the person theories of (2) and (3) are referenced in Hiraishi [1989]. Shoko Mukai describes Tooley's person theory and then adds that "one has the feeling, however, that this theory does point to something essential which cannot be completely condemned or eliminated based only on the shocking impression it gives on superficial inspection." (Mukai [1990:146]).
    "Person theories" and "quality of life" are also discussed in Bai [1984], Kato [1992:93-98] [1994] [1996b:31-35], Shinagawa [1992:199-203], Muraoka [1992:231-233] and Takeuchi [1995]. Solomon [1983] points out that the assertions of person theories arise within specific cultural contexts. On the topic of "the beginning of life" see also Lockwood [1985a].
  11. "If the doctrine of 'not employing requisites for survival' is thoroughly adopted then all forms of life must be equally respected. In practice, however, those who take this view do in fact discriminate in their treatment of human and non-human life". (Inoue [1987:49-50).
    Inoue concludes that if some special quality or qualities possessed by humans are used to justify this discrimination it would amount to a resurrection of the idea of requisites for survival which has already been rejected, but on the other hand appeals to the identity of the human race are also problematic. "For example, would there not then be the danger of a biological definition of humanity which would be extremely cruel to disabled people with abnormal chromosomes?... moreover this view would be subject to being criticized as human egoism" (Inoue [1987:50]).
    What is being raised here is the same question I am addressing and no answer is provided. The "answer" I propose in this book may be a view "subject to being criticized as human egoism" but it does not exclude people with Down's syndrome and abnormal chromosomes from the range of what is considered human.
  12. Manabu Murase, quoted at the start of this chapter, in a different book says the following:
    "...for these parents, there is something which can only be found in their calling their child by name. There is something which cannot be seen except when they call her 'Yuri'.
    Having said this, are there not indeed many uses of the name 'Yuri'? It is a name which can be used for both people and plants, and there may be some who ask how it can express the unique life of this one girl. Seen as a 'label (attached to a certain group of things or people)' this is indeed the case. But we cannot understand it only by examining it as this kind of "label". A 'label' is sometimes recognized as a 'name (of an individual thing or person)', and there times when this kind of 'name' brings a certain sort of self awareness as the opportunity to refer to a form (face+body). This opportunity is created by a 'place (position)'.
    Kukaijyoudo there is the 'place' (position) of the parents who remain close to their child with arms and legs like a 'lizard'. When the child in question is called by the 'name' of 'Yuri' from this kind of 'place', a 'form' seen only from this 'place' is referred to, and this 'form' is revealed as one which is "incomparable".
    To put it another way, there is a sense in which what is found in a 'name' can only be thought of not as a personal act of naming but rather as collective action undertaken in order to refer to the 'human form (archetype)'. This collective action could also be described as the creation of the 'human form (archetype)'. But here there is a problem surrounding the 'place' of this act of creation. I think that people in the past may have had a sensitivity which allowed them to share this 'place' as a 'collaborative space'. Today, however, this place increasingly appears to be a personal one in which the parents who raise each child become aware [of their child] individually. I myself cannot take such a simple view. I cannot help but think that the 'place' in which a 'name' is given and awareness of a 'form' arises can only ever exist as a 'collective' or 'shared' space. This follows from the fact that awareness of the "human form (archetype)" acquired through the use of a 'name' is only possible within the context of human communal activity." (Murase [1995:35-36].)
    A nearly equivalent passage can be found in Murase [1996:132-133] in which the author states that "I 'treat as precious' that which I name myself and discusses this selfish symbiotic power of 'naming'". Kukaijyodo is a book by Reiko Ishimure (Ishimure [1969]).
  13. This was also pointed out by the Japanese translator of this text.
    "The basis of his argument for the justification of euthanasia where consent is not obtained is quite different from the basis of his argument for the justification of voluntary euthanasia. Put broadly, regarding the latter case he asserts that since the patient in question is a human being in charge of their own life it is right for us to facilitate euthanasia out of respect for their wishes, and regarding the former case he asserts that since the patient is not a human being in charge of their own life euthanizing them would not constitute a violation of their will". (Kamo [1991:382]).
    See also what is stated in Ehara [1996:346ff] which to some degree overlaps the point made by Morioka discussed in note 10.
  14. On the use of brain-dead bodies see Gaylin [1974], Akabayashi and Morioka [1988], Morioka and Akabayashi [1989], and Morioka [1994:127-142]. On the use of infants with anencephaly as a source of organs for transplantation see Shewmon et al. [1989]. On their use in pediatric medical research see Shinagawa [1988a].
  15. Philosophers like Singer and Tooley have rejected the assertion that infants have a right to life. Engelhardt establishes the category of "social persons" to define the set of individuals whose right to survive is to be recognized (cf. Note 10).
  16. Hare uses "potentiality" to argue that fetuses should not be killed, and then compares the interests of parents and other parties including the future interests of the current fetus with the same set of interests of a second fetus [conceived by the same couple], concluding that if the latter exceed the former aborting the current fetus (if for example it has a high chance of being disabled) is acceptable (See Hare [1975] [1988]. For a description and analysis of this view see Yamauchi [1991:196-212]). Moraczewski [1983] also includes an attempt to justify fetuses' right to life by invoking potentiality. For more on the perspective of Singer and others who share his views see note 8. I do not make any arguments on the basis of potentiality (see chapter 9).
  17. I do not affirm the assertions made in Komatsu [1996] in their exact formulation. Regarding the question of whether or not to think of brain dead people as belonging to the category of disabled people, Morioka [1989] for example argues that they should be included in this category and Oku [1993] rejects this way of thinking. In this book I omit examination of arguments by some in the disabled movement that treating brain death as actual death and thus accepting the harvesting of organs from what is considered a dead body constitutes discrimination against the disabled. For a collection of materials related to brain death/organ transplantation in general see Nakayama ed. [1992]
  18. Particularly within America there is a context of social controversy surrounding this issue. For more on this see Rosenblatt [1992]. On the US Supreme Court decision in the case of "Roe vs Wade" which affirmed a woman's right to have an abortion on the basis of the right to privacy stipulated in the US constitution see Ishii [1979]. On what has ensued following the Roe decision see also Veach [1991b].
    On British law as it relates to abortion see Ishii [1981] [1983a]. On laws in Canada see Dickens [1991]. On the state of affairs in Germany see Terazaki [1991], Horiuchi [1993]. On laws and debates surrounding legal issues in Britain, America, Germany and Japan see Ishii [1994:105-201] (see also Ishii [1983b] [1985] [1994]). On the movement to legalize abortion in France see Association Choisir ed. [1973]. On the history of abortion see Tama [1991] and Ogino [1991c]. Potts et al. [1977] takes a wide-ranging view of this issue.
    See chapter 9 for a discussion of the Japanese Eugenic Protection Act (for information on the Mother's Body Protection Act of 1996 see the arsvi website). This issue is also discussed within the context of the history of pediatric healthcare in [1972]. See also Ishii [1994:169-196] [1982], Shakaihyoronshahenshubu ed. [1983] and Agora 28 [1983]. For a bibliography/guide to texts on this subject see Kato [1993a].
    On views regarding this issue in bioethics see notes 19 and 20 below and Veatch [1991a]. A concise presentation of the views of ethicists can be found in Kagawa [1995b]
  19. Some point to a fertilized egg and others to possession of consciousness or intellectual abilities as what should be considered the essential requirement. In Inoue [1987] the former is asserted and this is criticized in Kato [1991b].
    "There is certain kind of existential identity relationship between me and the fertilized egg that I came from" (Inoue [1987:521996:14]).
    "While rejecting reliance on the drawing of this kind of line, before long he has smuggled the 'line' of the instant of conception back into his view" (Kato [1991b191996:53).
    For an account of the nature of this problem see these two texts as well as Inoue [1996] and Kato [1996] (these four texts are all included in Ehara ed. [1996]). In Kato's paper what is actively argued is the fundamental arbitrariness of this sort of line, but reading it I also learned a lot about the sort of stance which should be taken in regard to this issue.
  20. Thomson [1971]. This is argued in Feinberg [1980] and cited in Brody [19751983], Inoue [1987:59-611996:21-23], Iida [19891994:128-129], Nagata [1995a:151-152].
    "Thomson's argument rests on several unproven premises: 1)A mother's body is an object to which rights of private ownership apply. 2) The owner of a mother's body is the 'mother' and not the fetus. 3) A 'mother' bears a special responsibility for a fetus only in cases where she gives at least tacit approval to the use of her body by the fetus in question. Even if it is acknowledged that there are limits to the right to life it is not clear that these limits should be as restrictive as Thomson argues.
    However, even if this point is accepted, the overtuning of any of the closely intertwined premises (1)-3)) listed above would result in the failure of her argument. I do not have space to get into this here, but any of these three premises could be the subject of debate". (Inoue [1987:601996:21-22]).
    "...J Feinberg makes a very detailed argument against Thomson from the perspective of a woman's responsibility in relation to pregnancy. " (Iida [19891994:128]).
    "...changing the question from 'whether or not the woman in question has the right to kill her fetus' to 'whether or not the woman in question has an obligation to continue to carry the fetus within her body' allows us to avoid the question of whether or not a fetus is a person. This is an example of a successful rearranging of concepts." (Nagata [1995a:152])
    My opinion is close to the first two given above. Engelhardt [1986] (cited in Kato [1989b:584-585] [1992:96-97]) also asserts that a fetus is the property of the woman who is carrying it.
  21. "Feminists have uniformly sought to create a conceptualization in which the body is not spoken of as something owned by a subject, and as a result at the same time repositioned the concept of 'subject' itself. 'My body itself is me (not something that belongs to me)' is an earnest expression of this intention" (Kato [1991b:28], cf. [1990a] [1990b] [1990c] [1991c]). Regarding children, the body and ownership see Rothman [1989]).
  22. Duden [1991]. In the same text the author writes as follows.
    ""Life," which accentuates that of ethical and high-handed arguments of today, belongs to the history of fraud and contemplation, and perhaps the history of religion, and it is unworthy for the history of body." (Duden [1991=1993:155], for more on Duden see Ogino [1993].
    And the following which Kato [1991b:191996:52] also referenced.
    "As a physical sense on the part of the sex which bears children, "conception" is first felt not as a condition related to another person but rather overwhelmingly as "something occurring within my own body". Can we not in fact say that the definition of the creation of life through conception as the emergence of the other is a misapprehension based on the effect of abstract images?" (Ozawa [1987:340-341]).
  23. Does this sort of statement not amount to prioritizing "proximity"? Does it not imply that when a disabled child is born and there is disagreement about whether or not it is a person we should accept the cessation of treatment or "death with dignity" if the parents of the child say it is not a person? I think the answer to both of these questions is "no". What is being asserted here is that there are cases where we cannot determine exactly when an other comes into existence, and in such cases (and such cases only) we should defer to those "closest" to the being in question. It is not being asserted that regarding decisions concerning the being in question we should give priority to proximity (to the being in question) itself. If we assume that the other appears as an other more often to those closest to it, and that things done to it from afar are ultimately things done from "my (our)" perspective for the sake of my (our) welfare or happiness, this "ethics" does not ignore the latter but rather deals first with the former.
    What is occurring here, on the other hand, is what comes after the being in question has already begun to exist as an other and the question is then whether or not to let this other die. Both are indeed chronologically connected but in fact are carried out on a different level. We see the person in question and then see for example that they have brain damage. Nothing apart from this occurs here. Therefore we cannot eliminate the person in question as something which is not a person. In response some may hold up the historical fact of infanticide. The killing of infants and young children is indeed a historical (and current) reality (see Ota [1991], Nakatani [1982]. On the killing of disabled people see Namase [1993]). When children are killed in such cases, however, is it really because they are not people or lack the requisites needed to be considered a person?
    It is indeed the case that the fear and suffering held up as necessary requirements of personhood are things which are very important in our lives. We can thus understand that it is important not to cause fear in a being which is able of being afraid and not to cause pain in a being able of suffering. For the same reason the assertion that we should avoid killing other creatures like chimpanzees and dolphins is not incomprehensible. This does not mean, however, that there is no need for us to treat those who (we believe) do not feel pain or those who (we believe) do not possess consciousness with the same consideration given to other people. The fact that it is possible to assert that feeling pain and being conscious are only part of what makes a being a person and thus that we can respect these attributes as part of what constitutes a person while also respecting beings which do not (seem) to possess them means that acknowledging their importance does not necessarily mean that there is no need for us to treat those who lack them as human. We know from the start that the person in question is a human being. After that we begin to "subtract" from this fact. Ultimately this subtraction is carried out not from the person in question. What conceals this is sometimes referred to as "abstraction". Not recognizing those with severe disabilities as people is a more abstract position (while nonetheless one which is taken based on concrete practical interests).
  24. Philosophers like Kant are cited by those who attempt to assert the "dignity" of each individual in opposition to utilitarianism. I understand why this approach is taken. Due to the invocation of the idea of the "person", however, there is not such big difference between the two viewpoints. Keiserlingk, for example, states that there is no contradiction between "Quality of Life (QOL)" and "Sanctity of Life (SOL)" (Keiserlingk [1983]), and while as Kurosaki points out this compatibility is achieved by altering the concept of SOL to bring it in line with an approach based on QOL (Kurosaki 19871991] this sort of manipulation is often carried out. Kant and bioethics are discussed in Tsuchiyama ed. [1996]. In Inoue [1996] it is claimed that Keiserlingk's perspective is that of Kant (see also Tsukasaki [1996]), and in Hirata [1996] it is asserted that Kantian ethics are fundamentally based on a QOL perspective. In Tarui [1996], on the other hand, it is asserted that the Kantian view does not require that some appropriate level of ability be present in individuals: "Rights, according to Kant, amount to an 'assumed' relationship between members of a community, a 'relationship between each individual and all other individuals' in which each person accepts an obligation to protect and not to harm other individuals, even those who lack (as most people do) the 'empirical' ability to maintain their own lives and resources"(Tarui [1996:61]. See also the symposium summary in Oguma [1996]). I do not deny that this kind of interpretation is possible. If this approach is taken, however, the question of what is being designated as the subject of rights and what is being designated as the object of ownership arises (cf. chapter 2 note 4). For an examination of the arguments of Kant and Hare see Niita [1994] [1996]. On Engelhardt's criticisms of Kant's writings concerning suicide/deontology see Marutani [1996]. On "autonomy" and "enlightenment" see Tanida [1996]. On the relationship between Kant and bioethics in the English speaking world see Kurata [1996]. Related issues are also discussed in sections 3 to 5 of chapter 7.

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