The relational threshold: a life that is valued, or a life of value?

Wilkinson, Dominic; Brick, Claudia; Kahane, Guy; Savulescu, Julian

doi:10.1136/medethics-2019-106017

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…If she is so profoundly impaired that she lacks 'relational potential' [20], including the capacity to recognise and interact with others, then the objective value afforded by deep interpersonal relationships may also be absent. In that case, as one of us has argued elsewhere, there may be little or no prudential value to her life [21]. and the awareness of true beauty' [8, p. 499], all of which will potentially be absent for Esther.…”

Section: How Does Profound Cognitive Impairment Impact On Well-being?mentioning

confidence: 99%

“…Perhaps more frequently, however, uncertainty (combined with an understandably precautionary approach) may lead to undertreatment of pain in infants. 21…”

Section: Scientific Uncertaintymentioning

confidence: 99%

“…This 'silent suffering' problem may be relevant not only for physical pain or discomfort, but for other negative emotional states as well. Adults can experience fear, anxiety, and distress while sedated or anaesthetised[27] 21. Similar uncertainties potentially affect treatment of pain in children with severe neurological impairments.…”

mentioning

confidence: 99%

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Valuing life and evaluating suffering in infants with life-limiting illness

Wilkinson

Zayegh

2020

Theor Med Bioeth

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In this paper, we explore three separate questions that are relevant to assessing the prudential value of life in infants with severe life-limiting illness. First, what is the value or disvalue of a short life? Is it in the interests of a child to save her life if she will nevertheless die in infancy or very early childhood? Second, how does profound cognitive impairment affect the balance of positives and negatives in a child’s future life? Third, if the life of a child with life-limiting illness is prolonged, how much suffering will she experience and can any of it be alleviated? Is there a risk that negative experiences for such a child (suffering) will remain despite the provision of palliative care? We argue that both the subjective and objective components of well-being for children could be greatly reduced if they are anticipated to have a short life that is affected by profound cognitive impairment. This does not mean that their overall well-being will be negative, but rather that there may be a higher risk of negative overall well-being if they are expected to experience pain, discomfort, or distress. Furthermore, we point to some of the practical limitations of therapies aimed at relieving suffering, such that there is a risk that suffering will go partially or completely unrelieved. Taken together, these considerations imply that some life-prolonging treatments are not in the best interests of infants with severe life-limiting illness.

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Section: How Does Profound Cognitive Impairment Impact On Well-being?mentioning

confidence: 99%

“…Perhaps more frequently, however, uncertainty (combined with an understandably precautionary approach) may lead to undertreatment of pain in infants. 21…”

Section: Scientific Uncertaintymentioning

confidence: 99%