or herself, “the individual is not a person”);
• A sense of futurity (“subhuman animals do not look forward in time”);
• Memory (“It is this trait alone that makes man . . . a cultural instead of instinctive being”);
• Concern for others (“The absence of this ambience is a clinical indication of psychopathology”);
• Communication (“Disconnection from others, if it is irreparable, is dehumanization”); and
• Neocortical function (“In the absence of the synthesizing function of the cerebral cortex, the person is non existent. Such persons are objects, not subjects”).
Fletcher also fashioned five “negative” points that he believed indicated true humanhood. For example, he claimed that man is not “anti-artificial.” To the “anything goes” Fletcher, “to oppose technology is self-hatred.” Thus, “a baby made artificially by deliberate and careful contrivance, would be more human than one resulting from sexual roulette—the reproductive mode of subhuman species” (my emphasis).38 Fletcher also dismissed the notion of innate human rights: “The idea behind this is that such things are objective, pre-existent phenomena, not contingent on biological or social relativities.”39 In other words, Thomas Jefferson was all wet.
To understand how dangerous that thought of bioethics’ “patriarch” really is, one need only read Fletcher’s 1975 essay, “Being Happy, Being Human,”40 in which he describes participating in a panel discussion of the treatment of babies born with serious birth defects. A physician who cared for a profoundly mentally retarded boy reported that while he possessed a very low IQ, the lad was clearly happy and clearly a human being. Fletcher coldly dismissed the human worth of this defenseless child—and that of many other developmentally disabled people: “Idiots are not, never were, and never will be in any degree responsible [because they cannot understand consequences of action]. Idiots, that is to say, are not human. The problem they pose is not lack of sufficient mind but of any mind at all. No matter how euphoric their behavior might be, they are outside the pale of human integrity. Indeed, sustained and ‘plateau’ euphoria is itself prima facie clinical evidence of mindlessness.”41
Such a provocation had a purpose: to gain support for the notion that killing “idiots” could, depending on the facts of each individual case, be ethical and right—decisions that Fletcher described as a merely “clinical” matter.42 In the case of disabled infants, he wrote elsewhere that killing should simply be considered “postnatal abortion.”43 As I will describe later, calls within bioethics to permit infanticide have proliferated in the years subsequent to Fletcher’s advocacy.
Not every bioethicist agrees with all of Fletcher’s ideas. Nor will every radical policy Fletcher promoted eventually become culturally or medically acceptable—although many of them, such as dehydrating to death cognitively disabled people, which Fletcher proposed as early as 1974,44 already have. But it is particularly telling that Fletcher was not dismissed by the fledgling bioethics movement as some fanatic kook when he advocated infanticide, “research on living fetuses outside the womb,”45 combining human and animal DNA,46 and dehumanizing cognitively disabled people. In fact, his ideas received immediate respect, allowing them to travel from the realm of the unthinkable, to borrow Richard John Neuhaus’s terminology, into the debatable, from whence many have become justifiable. Some are now unexceptional.
That is not to say that there was no intellectual resistance within the early bioethics movement to the steady growth of this sort of secularist, radically utilitarian thinking. A strong countermovement led by theologian Paul Ramsey provided a significant challenge to the Fletcher school for many years.
Ramsey believed that people owed each other a duty of fidelity based upon “covenant responsibilities” based in “justice, fairness, righteousness, faithfulness, canons of loyalty, the sanctity of life, hesed, agapé [steadfast love], or charity.” This meant, according to Ramsey, that there is “sacredness and in ‘bodily life’ from which flow our mutual duties to care for each other, including the most weak and vulnerable among us.”47
Where Fletcher’s approach was a bioethical version of anything goes, Ramsey stood firmly against the idea that the ends justify the means. Where Fletcher sought to create invidious divisions among people based on purported humanhood criteria, Ramsey explicitly rejected the entire approach as immoral: “Fletcher is simply a sign of the times,” Ramsey worried, as he asserted that creating criteria to judge how people should be treated in health care is wrong because it was to “play God as God plays God.”48 “To use such indices in the practice of medicine is a grave mistake,” Ramsey warned, because it would lead to inequality and “add injustice to injury and fate.”49
Gilbert Meilaender, the theologian and ethicist who has been a part of this struggle for decades, characterized this internal struggle for the soul of bioethics as a three-decade war. To make a long story short, the amoral Fletcher school (my term) prevailed over traditional moralists such as Ramsey, illustrated by the sad fact that few of Ramsey’s books remain in print while most of Fletcher’s books and articles are readily obtainable. In the end, Fletcher, not Ramsey, became the “patriarch” of modern bioethics. It is Fletcher’s views that predominate within the field. Fletcher, not Ramsey, was the one who “articulated where bioethics was heading well before the more fainthearted were prepared to develop the full consequences of their views.”50
Once Fletcher secured a beachhead, it was only a matter of time before someone like Peter Singer would stage his much-publicized landing in bioethics. If this were a movie, Singer’s appearance would be entitled “Son of Fletcher.” Beginning in the mid-1970s, Singer rose quickly in prominence to become one of the world’s most influential contemporary utilitarian bioethicist/moral philosophers. But being the radical that he is, Singer took Fletcher’s original formula and extended it to even more subversive ends. Where Fletcher sought to determine who had moral value strictly for the benefit of humans, Singer expanded the “moral community” into the world of animals.
Singer contended that being human in and of itself is irrelevant to moral status; what counts is whether a “being” is a “person.” Toward creating a formula to make this determination, Singer simplified Fletcher’s multi-point formula to “two crucial characteristics” that earn human being or animal the status of “person” (e.g., “rationality and self consciousness”).51 Species membership is irrelevant, Singer claimed. Indeed, he asserted that some animals are persons, including “whales, dolphins, monkeys, dogs, cats, pigs, seals, bears, cattle, sheep, and so on, perhaps even to the point which it may include all mammals.”52 On the other hand, some humans would not qualify, including newborn human infants (whether disabled or not), people with advanced Alzheimer’s disease or other severe cognitive disabilities—since Singer claimed they are not self-conscious or rational—along with other nonpersons that exhibit similar relevant characteristics (e.g., clams or sardines).
Yes, Singer explicitly made a moral comparison between some people and fish, writing, “Since neither a newborn infant nor a fish is a person the wrongness of killing such beings is not as great as the wrongness of killing a person.”53 Thus, to Singer, a newborn infant is the moral equivalent of a mackerel and an advanced Alzheimer’s patient is comparable to a pigeon. As we shall see later in the book, Singer, like Fletcher, asserted that his theories justify infanticide and non-voluntary euthanasia of cognitively disabled people.
In another world and time, Singer’s advocacy would make him an intellectual outcast. He actually is in bad standing in Germany and Austria, where he cannot speak without generating angry protests from people who consider his opinions Nazi-like.54 But many in academia
