Rachels proposes a minimum conception of morality that focuses on impartial consideration of individuals' interests and making decisions guided by reason rather than feelings. He analyzes three medical ethics cases - Baby Theresa, conjoined twins Jodie and Mary, and Tracy Latimer who had cerebral palsy. For each case, he outlines various moral arguments and principles that could apply, such as whether it is wrong to use people as means, kill one to save others, or discriminate against the handicapped. Throughout, he emphasizes the importance of impartiality, examining implications carefully, and accepting only principles that can be justified by reasons.

1. What Is Morality?
James Rachels
&
Stuart Rachels

2. The Problem of Definition
 There are many rival theories, each expounding a
different conception of what it means to live
morally, and any definition that goes beyond
Socrates’ simple formulation (“how we ought to
live”) is bound to offend at least one of them.
 Rachels proposes a ‘minimum conception’ of
morality: a core that every moral theory should
accept, at least as a starting point.
First, some moral controversies. . . .

3. First Example: Baby Theresa
 Anencephalic infants: ‘babies without brains’
o Cerebrum, cerebellum, and top of skull are missing
o Have a brain stem, thus autonomic functions
(breathing, heartbeat, etc.) are possible
o Usually aborted in the US; otherwise, half are
stillborn and usually die within days

4. Full Detail
– Florida1992, anencephalic (without a brain-no cerebrum or cerebellum, but
does have a brain-stem, so autonomic functions like breathing and heartbeat
go on)
– Most detected and aborted
– Of those not aborted, are still born�
– 300 a year born and usually die in few days
– Can know these babies not live long and that they will have no conscious life
– Parents volunteered her (and doctors agreed) for organ transplants (kidneys,
liver, heart, lungs and eyes) for other children who would benefit from it
(2000 need transplants a year, never enough available)
– Florida law prohibits removal of organs until donor is dead
– Taking organs out would kill her
– When Teresa died after 9 days, her organs had deteriorated and were
worthless

5. Baby Theresa’s parents
volunteered her organs for
transplant. BUT. . .
 Florida law forbids the removal of organs until
the donor is dead.
 Baby Theresa died after nine days. Her organs
were too deteriorated to be harvested or
transplanted.
? Should she have been killed so that her organs could
have been used to save other children?
(Thousands of infants need transplants each year.)

6. Surprisingly few ethicists sided
with the parents and physicians.
 “It just seems too horrifying to use people as
means to other people’s ends.”
 “It’s unethical to kill person A to save person B.”
 “What the parents are really asking for is, ‘Kill
this dying baby so that its organs may be used
for someone else.’ Well, that’s really a
horrendous proposition.”

7. The Benefits Argument
 If we can benefit someone without harming
anyone else, we ought to do so.
 Transplanting the organs would benefit the
other children without harming Baby Theresa.
∴Therefore, we ought to transplant the organs.

8. What about Baby Theresa’s life?

9. The Argument That We Should Not Use People as Means
 It is wrong to use people as means to other
people’s ends.
 Taking Theresa’s organs would be using her to
benefit other children.
∴Therefore, it should not be done.

10. How is Baby Theresa being ‘used’?
? Vague sense of ‘use.’ What does it mean?
Violating Baby Theresa’s autonomy?
Baby Theresa has no autonomy to violate. She
has no preferences about anything, nor has she
ever had any.

11. The Argument from the Wrongness of Killing
 It is wrong to kill one person to save another.
 Taking Theresa’s organs would be killing her
to save others.
∴So, taking the organs would be wrong.

12. However. . .
? Shouldn’t there be an exception to the rule?
Baby Theresa is not conscious; she will never
‘have a life’; she is going to die soon anyway; and
taking her organs would help other babies.
? Should we regard Baby Theresa as already
‘dead’?
Perhaps we should revise our definitions of
‘death.’

13. Second Example: Jodie and Mary
 Conjoined twins, joined at the lower abdomen;
spines fused; one heart and one pair of lungs
between them.
 Without an operation to separate them, both
twins would die within six months.
 This would save Jodie, but Mary would die.
 The parents refused permission for the
operation, but courts okayed it.
 Jodie lived, and Mary died.

14. Full detail
– August 2000, woman discovered carrying twins joined at lower
abdomen (spines fused, had one heart, and one set of lungs between
them).
– Jodie the stronger was providing blood for her sister
– Some sets of conjoined twins do well (grow to adulthood and marry
and have children themselves)
– W/o intervention, Jodie and Mary die in 6 months
– Only hope was to operate and separate them
– Save Jodie, but Mary would die immediately
– Parents refused permission to operate as this would hasten Mary's
death and believed that "if it is God's will that both our children
should not survive, then so be it"
– Hospital believed it had an obligation to save one of the infants and
got the courts to agree to operation to separate them
– Jodie lived and Mary died

15. The Argument That We Should Save as Many as We Can
∴There is a choice: save one or let both die.
? Isn’t it plainly better to save one?
Not from the parents’ perspective.

16. The Argument from the Sanctity of Human Life
 All human life is precious, regardless of age,
race, social class, or handicap.
 The prohibition against killing innocent
humans is absolute.
 Mary is an innocent human being.
∴Therefore, she should not be killed.

17. However. . .
Mary would not be ‘killed’ during the operation
but merely separated from Jodie. Her death
would be due to her body’s inability to sustain
her life.
Perhaps it is not always wrong to kill innocent
human beings. . .
o If the innocent human has no future because she is
going to die soon no matter what. . . AND. . .
o She has no wish to go on living (perhaps because she
has no wishes at all). . . AND. . .
o This killing will save others who can go on to lead ‘full
lives.’

18. Third Example: Tracy Latimer
 12-year-old victim of cerebral palsy, killed by
her father with exhaust fumes while the rest
of the family were at church.
 Tracy weighed less than 40 lbs. and was
described as “functioning at the mental level
of a three-month-old baby.”
 Robert Latimer was sentenced to 10 years in
prison.
? Did Mr. Latimer do anything wrong? Wasn’t
killing her an act of mercy?

19. Full detail
– Was a 12 year old in Saskatchewan who had cerebral palsy (brain
disease that leads to muscle malfunction)
– In 1993, her father (Robert Latimer) killed her (piped in exhaust fumes
into pickup cab)
– She weighed less 40 pounds
– Had mental level of a three month old baby; nutrition via feeding
tubes, rods in back, bedsores, "leg cut and flopping around"
– Had major surgery on back, hips, legs and more surgery planned
– Difficult to control her pain
– Mother was relieved to find Tracy dead
– Local jury and judge wanted to be lenient (one year in prison and one
year probation), but Supreme Court overruled and sentenced him to
mandatory 25 years in prison.
– Still in prison

20. The Argument from the Wrongness of
Discriminating against the Handicapped
 Handicapped people should be given the
same respect and the same rights as everyone
else.
 Tracy was killed because she was
handicapped.
∴Therefore, killing her was wrong.

21. However. . .
Tracy was not killed because of her cerebral
palsy but because of her pain and suffering
and because there was no hope for her.

22. The Slippery Slope Argument

23. Beware of slippery slopes!
! This kind of argument is all too easy to abuse.
If you are opposed to something but have no
good arguments against it, you can always make
up a prediction about what it might lead to; and
no matter how implausible your prediction is, no
one can prove you wrong.

24. Reason and Impartiality
 Moral judgments must be backed by good
reasons.
 Morality requires the impartial consideration
of each individual’s interests.

25. Moral Reasoning
 We cannot rely on our feelings, no matter
how powerful they might be.
 Our feelings may be irrational and may be
nothing but products of prejudice, selfishness,
or cultural conditioning.
 Our decisions must be guided as much as
possible by reason.
 The morally right thing to do is always the
thing best supported by the arguments.

26. How can we tell if an argument is really good?

27. The Requirement of
Impartiality

28. The Minimum Conception of Morality

29. The Conscientious Moral Agent. . .
 Is concerned impartially with the interests of
everyone affected by what he or she does.
 Carefully sifts facts and examines their
implications.
 Accepts principles of conduct only after
scrutinizing them to make sure they are justified.
 Is willing to “listen to reason” even when it
means revising prior convictions.
 Is willing to act on the results of this deliberation.

30. Study Questions for Ch1, Rachels:
What is Morality?
• 1. What does Rachels think about the relationship
between morality and feeling? Do you agree with him
on this? Why or why not?
• 2. According to Rachels, is morality a matter of
personal taste? Why or why not? Do agree with him?
Explain.
• 3. According to Rachels, what determines if an act is
right or wrong?
• 4. Describe the three cases Rachels analyzes in
chapter one (e.g., Baby Teresa, Jodie and Mary, and
Tracy Latimer) and identify and assess some of the
moral principles that might be applied in these cases.