10 - Heroic measures and false hopes

Summary

“Heroic measures” refers to the deployment of unusual (rare, experimental, expensive, nonstandard) technologies or treatment regimes, or of ordinary ones beyond their usual limits. The examples ordinarily offered concern care for the terminally ill, a heart-lung machine hooked up to someone who is brain dead, and so on. But, philosophically, special complications are posed by people who would otherwise (and who may, anyway) cease to be. Here I shall focus instead on cases where such complications are absent – on extraordinary measures for creating life (in vitro fertilization and such like), and on extraordinary measures for improving the quality of the lives of the handicapped (e.g., electrical stimulation of paraplegics' muscles to simulate walking).

Such heroic measures represent an unattractive aspect of utilitarianism. They amount, if not quite to killing people with kindness, at least to torturing people with kindness. Yet insofar as it is a kindness, insofar as people's well-being is indeed promoted by the intervention, there would seem to be no utilitarian grounds for ending the torture. This chapter is aimed at correcting that shortcoming. Here I shall be offering considerations, internal to utilitarianism, which militate against deployment of heroic measures. Those considerations do not always prove conclusive. But they must always be weighed in the balance, and they may occasionally (in certain classes of cases, they may even characteristically) tip that balance.

It seems distinctly odd to be arguing against heroic measures.