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Experience, Narrative, and Ethical Deliberation*

David Velleman, in “A Right of Self-Termination?” opens with a story. While undergoing treatment for cancer, he gave a talk at a philosophy department and found himself reacting severely to a conversation at dinner. One of his hosts had lit a cigarette and waxed lyrical about his right to choose whether to live and die smoking or to quit and merely survive. Velleman felt that “a few months with cancer taught me that a tumor rarely invades a region smaller than an extended family. . . . Listening to my host laugh at his future cancer, I wondered if he realized how many others would share it.” He resented his host’s taking his right to be a right to make his own life shorter in order to make it better, for this accounting failed to consider harms and benefits to others. He also resented his host’s assumption that only accounting for harms and benefits was relevant. He thought that his host had failed to see that what is of value in a human life cannot be entirely captured by cost-benefit talk. If a life is to be more than a mere instrument, there must be something that makes a claim on us—something that we try to live up to. Velleman questions whether “one may end one’s life simply because one isn’t getting enough out of it” and urges the consideration of whether one is doing justice to one’s life. In “ICU Psychosis and Patient Autonomy,” I also recount personal experience—my month-long encounter with multiple organ failure, full