Non-judgmental Ethics Sunday: Should I Help My Sister End Her Life?

January 24, 2016 by Joshua
in Ethicist, Nonjudgment

Continuing my series of alternative responses to the New York Times column, The Ethicist, looking at the consequences of one’s actions instead of imposing values on others, here is my take on today’s post,”Should I Help My Sister End Her Life?


I have a 50-year-old sibling with multiple medical conditions (uncontrolled epilepsy, a stroke that left her physically and mentally impaired, paranoid schizophrenia, to name a few) that have left her isolated and miserable. My 80-plus-year-old parents are her caretakers. She has the very best doctors, social workers and therapists — but none can give her a fulfilling life. She calls me crying every night, often threatening to commit suicide, a threat she has tried to make good on dozens of times. I’m struggling to know if I should stop talking her out of suicide and instead give her options for a death with dignity. If she were dying of a terminal illness, the discussion could be more frank. But what of these chronic conditions with no end in sight? Name Withheld

My response: I have never found it helpful to take responsibility for another adult’s actions or emotions. If she’s sane enough to choose her actions, she can choose on her own. If she’s not sane, you probably have to talk to a lawyer about choosing for her, but that doesn’t sound like the case.

The New York Times response:

Your sister’s situation sounds awful. So is the quandary you face as her caring sibling. But I’m afraid there is no straightforward way out. When people are in possession of their mental faculties, they are the experts on whether their lives are worth living. One reason is that they normally know more than anyone else about what their lives are like. Another is that some things in people’s lives matter only because they themselves care about them — and they know best what they care about. Someone might find it worthwhile to endure a great deal of physical suffering in order to live long enough to hold her first grandchild or see her poetry collection appear in hardcover. So, in a wide range of circumstances, we should defer to a person’s view about whether her life is worth living and, on that basis, let her end it if she chooses.

That’s not only because she’s best placed to judge whether it’s worth going on but also because only she has the authority to decide whether to do so. Even if you are correct that someone’s life is not worth living, you don’t have the right to end it. She alone has this right. Yet she can exercise it only if she has the capacity for the appropriate deliberation. I’m not a psychiatrist, but given the problems you describe, I wonder if this condition has been met. Her multiple failed suicide attempts, moreover, might give you reason to think your sister isn’t committed to carrying it through.

I work in a school that is part of a larger religious organization. A colleague who works part-time, ‘‘Gina,’’ also works as a freelance graphic artist. Recently, the director of the religious-education arm of my organization (not the director of the school) asked Gina to make signs for the school. I saw her working late on these projects and suggested to her that she should be paid. A week later, my boss (the director of the school) told me that she was approached by Gina about being paid, and she was not pleased that I was the one who suggested it. She said that doing ‘‘favors’’ like this is how you get ahead and that I was supporting a nonhelpful work environment.

I am disappointed with myself for speaking to Gina before giving my boss a chance to rethink the appropriateness of the ‘‘favor.’’ I am also disappointed in my boss for thinking that asking to be paid for work is fomenting an ‘‘unhelpful’’ environment. Is the performing of favors just ‘‘how the world works,’’ or is there an ethical boundary in there somewhere that could guide us? Name Withheld

My response: The situation started out interesting, then derailed again with the abstract philosophical questions about labels, like “ethical.”

Your relationships with your coworkers seem the issue. Unless I misunderstand you, you want to have productive relationships, enjoy your work environment, not be surprised, and so on. These things come from social and communication skills, not definitions of abstract philosophical concepts.

You, Gina, and your boss have different ideas on compensation, helpfulness, how the world works, and so on. Let’s say a New York Times columnist gave you his opinion too. Now you have four sets of opinions. What if he says there is an ethical boundary but others disagree? Do you think everyone will start agreeing because one of those opinions comes from a newspaper?

Instead, you can talk to these people, learn their interests, come to agreement, learn from each other, and so on. It seems to me improving your relationships and communications would improve your life.

I write about and teach leadership because I found listening and interacting with people improved my relationships. Abstract philosophy didn’t. Your experience may differ, but I suspect that if you reached agreement with your coworkers through communication, you wouldn’t care about opinions on ethical boundaries from newspaper columnists.

The New York Times response:

Exploitation doesn’t necessarily involve villainy. The director who asked Gina to help out probably thought this was a fine way to support a valued institution. Your superior probably thought she was making a point about the benefits that can come to staff members who go above and beyond.

The fact remains, however, that when a boss asks for ‘‘favors,’’ she is often abusing a position of power. She ought to know that employees might wonder whether their prospects might be affected by how they respond. And so there are opportunities here for exploitation by the boss and for currying favor by the employee. Each of these involves defects in the relationship between people who are supposed to be working together respectfully toward an organization’s goals. Indeed, talk of ‘‘how you get ahead’’ seems to acknowledge the manipulative nature of what’s going on.

You might think that being at a religious organization makes all this less likely, but the opposite may be the case. The exalted public purpose of the institution can make it seem simply reasonable to ask someone to be ‘‘helpful.’’ So I don’t find your boss’s attitude all that surprising. But the main way someone who works for such an enterprise ‘‘helps’’ is by doing her job properly. I agree that you might have broached the subject with your boss first. But one reason managers need to think these things through is that failing to do so leads to exactly the sort of workplace tension you’re describing. It would have been fine if Gina had been asked to provide professional services free to a religious institution she didn’t work for. The fact that she was an employee — even a part-time one — made it much less so. Thoughtful leadership requires reflecting on how things look from below.

The longtime girlfriend, ‘‘Janet,’’ of an old friend, ‘‘Dave,’’ called and swore me to secrecy: She had found another love but did not want to tell Dave, as he was ill. She asked me to stay in touch with Dave as he needed help with his health issues.

Honoring my word to Janet made talking with Dave difficult. I wanted to tell him the truth, but I had given her my word. I was agonizing over what to do when another friend spilled the beans. What was the ethical thing to do, keep my word to Janet or tell Dave the truth? Name Withheld

My response: Not your question, but an issue I see causing the problem: did she ask you to give your word before she told you the secret, as in something like, “Can I tell you something, but first you have to swear you won’t tell anyone?” If so, there’s your problem. I recommend never agreeing to such a request. My usual response is, “For all I know you murdered someone so no, I can’t give you my word.” Eventually I say something like “If you trust my judgment, tell me. Otherwise don’t.”

They know the risk and I don’t. I recommend letting them make the calculated judgment I can’t. They always tell me without the blind trust and no one has come to regret it.

When you consider your actions and their results instead of worrying about labels like “ethical,” you come up with solutions that work. I recommend you do the same. Talking to them will improve your relationships more than writing newspaper columnists.

The New York Times response:

Janet was making a mistake. Sick or well, you’re not better off believing people love you when they don’t. Of course, she was right to think that, given his medical condition, Dave might have suffered physically as a result of discovering that she no longer loved him. But physical health and subjective happiness are only part of well-being. And being in the dark about the central relationships in your life is a very bad thing. On balance, I would have urged Janet to free you from your promise. After all, the secret was getting in the way of your helping Dave — which is what she wanted you to do.

But if she didn’t free you, your telling Dave what you learned would have violated an important form of confidentiality. People often need help assessing their situations, and they wouldn’t be able to get it if they thought others felt free to pass their confidences on. Janet’s desire for secrecy might well have been self-serving, but you weren’t wrong to honor your word.

A general lesson here: When people ask to swear you to secrecy as a preamble to a disclosure, you might want to think twice before letting them proceed.

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