July 4, 2022

The puzzle of locked-in happiness

Hi there,

Heading up our list this weekend is a remarkable
story about locked-in syndrome (LIS). Personally, I cannot think of anything
worse. Even quadriplegic Christopher Reeves was able to give speeches, run a
foundation and inspire supporters of his favourite causes. But someone with LIS
can only communicate by blinking. A French journalist, Jean-Dominique Bauby, made
it better known in his book (later turned into a film), The Diving Bell and the

But I might be wrong about this. Belgian
neuroscientist Stephen Laureys has surveyed several dozen LIS patients in
France and found that most of them believe that they are leading happy lives. This
challenges preconceptions about unbearable suffering and about the usefulness
of living wills. Only 7% were interested in euthanasia.

There are some caveats to this optimistic
picture and the main one is that happiness comes only with time. The shock of
suddenly becoming utterly immobile and dependent is devastatingly demoralising.
It probably leads many patients initially to think that they would be better
off dead. However, after a year or so, most of them feel that they are living
happy and meaningful lives.

It is this caveat that Oxford’s utilitarian
bioethicist Julian
Savulescu seizes upon
in his response to this research. He makes the radically pro-choice argument that LIS
patients should be able to have euthanasia whenever they want. This is the case
even if their subjective well-being will be substantially greater if they wait
a while.

I am not a philosopher, but shouldn’t an
informed choice lead you to choose something good? If the content of a choice
makes no difference to a moral decision, what exactly is the point of ethics
anyway? Whatever I choose is going to be the right choice, so why bother
thinking about it? Perhaps some philosophers out there can enlighten me.

Michael Cook