The Great Slippery-Slope Argument
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Journal of medical ethics 1993; 19: 169-174 J Med Ethics: first published as 10.1136/jme.19.3.169 on 1 September 1993. Downloaded from The great slippery-slope argument J A Burgess University of Wollongong, New South Wales, Australia Author's abstract If this example is atypical, it is so only because it is Whenever some form ofbeneficent killing-for example, more detailed than is usual for arguments of this voluntary euthanasia - is advocated, the proposal is kind (2). And one finds the argument, in some form greeted with a flood ofslippery-slope arguments warning or other, almost everywhere in applied ethics: ofthe dangers of a Nazi-style slide into genocide. This indeed, a book has recently appeared by David paper is an attempt systematically to evaluate Lamb (3) which is structured entirely around the arguments of this kind. Although there are slippery-slope argument which appears there literally dozens of arguments that are sound and convincing, typical times. formulations of the Nazi-invoking argument are found Many slippery-slope arguments in applied ethics to be seriously deficient both in logical rigour and in the are simple in structure, highly specific in scope and social history and psychology required as a scholarly modest in the practical counsel they offer us. A good As an an attempt is made both example involves the question whether to prescribe underpinning. antidote, copyright. to identify some of the likely causes ofgenocide and to drug A or drug B to a patient. For the condition isolate some of the more modest but legitimate fears that concerned, A might score best on almost all relevant lie behind slippery-slope arguments of this kind. criteria whilst B does adequately on all, if less well on some. Suppose, further, that there is no realistic possibility of switching drugs in mid-treatment. Whenever the question of the legalisation of volun- Now, if A leads to tolerance, eventually needing to tary euthanasia is raised, the proposal is greeted with be administered in a lethal dose, a simple and sound a flood of slippery-slope arguments. Here is a recent slippery-slope argument leads to the conclusion that example from William Reichel and Arthur J Dyck: drug B is to be preferred. But, Reichel, Dyck and http://jme.bmj.com/ Lamb (4) - with many others - are not much 'If euthanasia were legalised, might we not then interested in such modest and intuitively compelling regard certain individuals as unworthy of life? Such a arguments. They prefer to go for broke, offering the concept laid the foundation of the euthanasia move- 'One Great Slippery-slope Argument' (hereafter, the ment that began in Germany before the National Great Argument) as the only example of the genre Socialist movement and before Hitler's rise to power. worth writing about. The argument is simple in This single idea of life devoid of value was influential form: if we adopt such-and-such a particular change in the German medical profession's snowballing in our practices it just might start a slide into a moral on October 1, 2021 by guest. Protected involvement with euthanasia. Before the Holocaust, deterioration that ends with our committing Nazi- physicians were the ones who selected patients and style atrocities. Clearly if such a charge were just - carried out this practice. To those who say "it cannot and we have already seen that some slippery-slope happen here", we reply: imagine the easy marriage arguments are good arguments - then this would be between respect for autonomy - for example, assist- a very good reason not to adopt the change, at least ing the AIDS patient who requests euthanasia - and if the threat of deterioration were at all serious. the need for greater cost-containment - ie, the Further, we know that such moral degeneration does patient's care is disproportionately expensive. What occur - in Germany under the Nazis, as so often begins for the patient's own wishes, may later be elsewhere, it did occur - so it is always a serious endorsed for economic reasons. If euthanasia were question of great practical importance how such legalised, individuals themselves might believe that degeneration is caused. society does not want them to live' (1). Unfortunately, purveyors of the Great Argument rarely if ever work it into a detailed slippery-slope argument. They rest content with the sketchiest of formulations, leaving the detailed work to their Key words opponents: we've shown you (sketchily) that it might Slippery slopes; euthanasia; genocide; cost-benefit analysis. happen; now show us (in detail) that it couldn't. But 170 The great slippery-slope argument J Med Ethics: first published as 10.1136/jme.19.3.169 on 1 September 1993. Downloaded from this is a fraud. The mere presentation of a slope does in contemporary America and the British Common- nothing to show that the onus of proof is on the wealth (5), the Milgram experiments in the USA in reformer to demonstrate that a proposed change will the '70s in which some experimental subjects not lead to disaster. This mistake, although of no inflicted what they believed to be great pain on great intellectual importance, sophistication or pro- others when instructed by scientists to do so (6), fundity in itself, is nonetheless encountered often jingoism in British newspapers during the Falklands enough to deserve analysis and diagnosis and it is war (7). To invite us to contemplate a slide into clearly of great practical importance, for many have Nazi-style atrocities on the basis of evidence pre- been persuaded of its soundness. At the other sented in this way is like warning us of the danger of extreme we have those who regard any slippery-slope a bomb exploding whose explosives are in Sweden, argument as nothing more than a hollow rhetorical whose casing is in the USA and whose detonator is flourish. No doubt, the prevalence of sketchy and in Rio. implausible examples - usually versions of the Great What, then, is required of a successful slippery- Argument - has led many to this attitude, but we slope argument of the ambitious kind? To be have already seen that some modest slope arguments successful, it would simply need the backing of good are good arguments so the attitude must be aban- psychology, political sociology and social history. To doned. Nevertheless, what we need is what non- achieve this would be no mean feat, of course, and extremists have wanted all along: some sound and would be ofimmense value. It would provide us with (preferably) non-technical practical advice in sorting a genuine insight into the preconditions and causes the good slippery-slope arguments from the bad. of communal moral deterioration. This is a phenom- Here I shall concentrate only on the 'Great enon that is not rare but commonplace - there have Argument' and I shall attempt to show why it is a been numerous examples since the Nazis - and it bad argument. would be good to understand how and why it occurs. As a first step towards our objective, we should But the sloppy presentation of slope arguments note two reasons why the slippery-slope argument obscures rather than illuminates these important presented earlier as an example of a good argument processes. copyright. was indeed good. First, it was modest: it showed how I have suggested that ambitious slope arguments some particular good could be obtained or some bad are unlikely to be good arguments - their very avoided. Second, it was detailed. We did not merely ambition leads to a fatal lack of detail in formulation. gesture obscurely towards the possible existence of a To eliminate the suspicion that this is no more than force propelling us down a dangerous slope; we a minor defect, let us examine the detailed provided enough details for the reader to see that considerations Lamb does supply. there would indeed be a force operating sufficient Lamb has a general consideration which he takes eventually to produce disaster if a certain course of to support his position - a worry about the framing action were taken. The two virtues I have isolated of (laws enshrining) moral positions in vague http://jme.bmj.com/ are not unconnected: unsurprisingly, slope argu- language. Vague criteria can be stretched - presum- ments with modest conclusions are easier to provide ably without anyone noticing - until they can be with the detail needed for adequate appraisal. made to apply to cases never intended by the original We are now in a position to see why the 'Great legislators. There seem to be two kinds of Argument' is not a good argument. Its conclusion is mechanism by which this happens. First, the stretch- highly immodest and it is typically undetailed. Lamb ing of a boundary can be on the (hidden) agenda of one or argument involved in the original used another version of the literally parties not actively proposed on October 1, 2021 by guest. Protected dozens of times in his book but nowhere gives a reform. So, without needing to attribute sinister description of the forces purportedly propelling us motives to someone who advocates, say, euthanasia, down the slope sufficiently detailed for us to appraise on compassionate grounds, such a proposal would them for efficacy. Yet the conclusion - that we, as be dangerous because of the capacity of those who a community, are in danger of complete moral would take life for less defensible reasons to exploit collapse - is one that would appear to require the lack of a total prohibition against killing. This is detailed and subtle substantiation. an implausible suggestion unless further supported. Was Lamb unaware, then, of the need to provide If legislators are aware ofthe kinds of active taking of evidence that the threat of a moral collapse is a life they do not want to encourage, then they will take serious possibility? He was not entirely unaware of care that safeguards are in place clear enough to the need to provide evidence - he realised that ensure that opportunistic boundary stretching will parallels between social conditions in pluralistic, be seen for what it is.