One might suggest that what make her decisions rationally compromised, if it is compromised, in the ‘torture case’ is similar to an example where a person is suffering pain from terminal cancer. But, I think that it is certainly conceivable, and has in fact happened, that a person in this type of situation where she is going to die in some period of time, and that she will continue to suffer during that period of time, might very well reason that shortening that time frame is a good thing for her to do. I am reminded of Rachels’ argument here.

It seems rational to make it a conditon of a life plan that one might want to choose to die if certain conditions prevail. Using Kant, this would be part of a hypothetical imperative wherein one chooses to live a life within certain parameters and acts accordingly within the parameters of the categorical imperative (CI) to meet that objective or goal. It seems consistent with the CI that one of these parameters might include some physical/mental issues arising that might compromise her abilty to act on her own accord and deciding that if these conditons prevail she will choose to end her life. I think that this can be universalized into a normative principle.

Can rational people disagree on what can be universalized or what are the parameters wherein people can choose to live? It seems plausible to maintain, based on empirical evidence, that people do disagree and can support their positions with sound reasons. Where disagreement exists the choice is left up to the person(s) directly affected. If condition x (terminal cancer for example) exists, one person may choose to die while another may choose to live. I think that each can be rationally defended.

A final point; the criteria for determining competency are important in order to avoid to problems discussed in the lasst paragraph of your reply. In orde to know if a person fails to meet certan criteria one needs to test that person utilizing some firm criteria. I should note that the criteria I mentioned where derived from those developed by Roth and Meisel to help health care professions deal with questions of a patient’s ability to make important decisions. They indicated 7 criteria, I gave only 3. Maybe more are needed. I think that a crucialpart of understanding the situation one is in is understanding disclosed information from others concerning that situation and available outcomes.
Guy; thanks for an enjoyable exchange of ideas.

So it seems to me right to say that under these conditions a person’s rational agency is deeply compromised. We need a substantive view of rational agency to be able to say more. We need to decide, for example, whether rational agency might be a matter of degree, and even if so, if it needs to meet certain a minimal threshold or minimal criteria. And the initial worry was that a person under long enough unbearable pain would fail to meet such criteria, and thus, on certain accounts of what matters in survival, would no longer preserve enough of the self.

I am wondering if we can make the following claim regarding determining the rational ability of a person : In order to determine if a person is rational we need to determine their compentency to make decisions. There exists questions that can test for competency, for example, 1)does the person understand the situation she is in, 2) does the person understand the consequences of taking certain actions, 3) can the person give supporting reasons why she wants to choose one outcome over another?

It would seem permissible that if a person were able to successfully answer these questions then she should be able to choose the outcome that best serves her deired objective regardless of whether she is in ‘unbearable’ pain or not.

The problem was to find a normatively relevant difference between a person in interminable unbearable pain (for short, a person in pain), and an animal or demented person, where rational capacities are simply lacking.

The first point to make is that your suggestion addresses this version of the problem, but not the version of the problem that is stated in terms of psychological continuity. But let’s set this aside and focus on rationality, as Velleman does.

The simple answer is to point out that the person in pain has the intrinsic potential to exercise rational capacities and the demented person (or ‘post-person’) doesn’t. I raised the doubt about this that merely having the potential isn’t enough if one is never in a position to actualize it. People in a permanent coma also have such a potential. And I also doubted that this could be the whole difference. The rational capacities of a person under unbearable pain are somehow present, if irretrievably blocked.

You offer a solution. A demented person is arational, but a person under unbearable pain is irrational, which implies he is failing to exercise rational powers which is in possession, and not only in potential.

The word ‘irrational’, however, is not very precise. It is used to refer to very different things. Weakness of the will is a paradigm form of practical irrationality. Here, irrationality typically implies rational culpability. The person can be held to blame for his error. But consider even a brief episode of unbearable pain. Structurally, this is similar to weakness. But I don’t think we hold people rationally (or morally) blameworthy for their mistaken choices in such conditions. In this respect they are closer to arational subjects.

Moreover, what we are considering is not a person’s irrational choice when undergoing a short episode of unbearable pain, but a person who will continue to remain in such a state. So attribution of irrationality to choices here is not done against a background of rational or even minimally rational choice. The person, if you wish, is in a permanent state of irrationality, a state that is not so easy to distinguish from arationality. And further, as you note, his rational capacities, even if active, making possible attribution of irrationality, are exercised in the narrowest, pain and present focused way. So there is some case for describing a person in such a state as akin to an animal.

Imagine an animal whose sole ends are the satisfaction of present impulses and avoidance of present pain, but which, unlike existing animals, can exercise fairly sophisticated cognitive capacities in pursuit of these narrow ends. Would we think of such an animal as a rational being?

We’re concerned only to deny that the rational self disintegrates under unbearable pain. I don’t know what there is to being a rational self, in the relevant sense, but for there to be intact rational capacities and sentience. The unbearable pain is not disintegrating this self but confining it (and that is part of what is bad about it).

You then go on to say ‘It is not plausible to simply deny that unbearable pain compromises rational agency’. I think you’re failing to distinguish the difference between rationality contrasted with arationality, which latter is what premiss 4 says is the upshot of unbearable pain but is not true, from rationality contrasted with irrationality, which latter is what unbearable pain may indeed bring about. So maybe the argument turns on an equivocation. Unbearable pain may make you an irrational agent, but what the argument needs is that it makes you no longer an agent.

1. Claims about psychological continuity can go into accounts of metaphysical identity, and they can go into accounts of ‘what matters in survival’, or, as this could be more appropriately put, the object of self-concern. As is well known, the two can come apart. To my mind, if metaphysical identity is not the object of self-concern, then it’s doubtful that it is of much normative interest. In particular, I find it hard to see how an organism could be the object of self-concern. I’ll confess to having at most derivative concern to the human animal I inhabit, considered apart from my psychology.

Many, including many who reject a psychological account of metaphysical identity, seem to agree. No doubt there will be those who disagree, and they will not find this paradoxical conclusion much of a threat.

You note that on McMahan’s view, all that’s needed for some prudential concern is (roughly) the continuation of consciousness or the brain parts that sustain it. But note that this is all that’s needed for SOME such concern. On McMahan’s view, absent significant psychological continuity, this would only call for minimal concern, and an only slightly weaker version of the paradoxical conclusion might still follow.

Also notice that Velleman is talking here about unbearable pain that continues until death, not about periods of such pain. So even if the subject could still be said to have a range of beliefs, memories, or desires — of such dispositional states — they would virtually never manifest themselves. Arguably, their potential presence is not sufficient for psychological continuity, though it’s not as if there is some very definite agreed account of what this must involve.

2. I agree with your remarks about rationality under ‘duress’. In the post I did not think that such observations are sufficient to show that the self lingers on. Nevertheless, a subject with rational capacities that is suffering unbearable pain is interestingly different from an animal and not only in potential. It’s hard to say in exactly what way.

3. I did not mean in this post to directly criticise Velleman’s argument — I think your point hits the target, and both Kamm and McMahan have raised similar objections. (Though remember that Velleman does not deny that pain is bad, only that it is ever bad enough to in itself justify death.)

But I’d like to say something about ‘unbearable pleasure’ — something I’ve written something about somewhere. Strictly speaking, this is itself a paradoxical notion. Would pleasure that is unbearable be, in some sense, UNPLEASANT? If we wanted the pleasant mirror of unbearable pain, we might rather consider ALL ABSORBING pleasure. If unbearable pain is pain such that one would do virtually anything to end it, all absorbing pleasure would have to be self-effacing pleasure that one would do virtually anything to keep going.

1. First, you said that by self, you do not mean “metaphysical sense.” Then, in your discussion of the Paradoxical Result, you mention “psychological continuity.” Isn’t the notion of “psychological continuity” typically used in the context of discussing the metaphysical sense of self?

This is important because one can deny (4) if one uses self in the metaphysical sense. In particular, arguably, the metaphysical self would not disintegrate when facing unbearable pain.

You did go on to say that “unbearable pain can also erase psychological continuity—at least in its occurrent form.” First of all, “psychological continuity” is not the only available account of the metaphysical self – there is, for example, also the Organism View. Secondly, I don’t see how unbearable pain would erase psychological continuity. Take McMahan’s bare-capacity account as an example, you would still exist even when facing unbearable pain, as your consciousness would still be there. Indeed, if a consciousness was not there, how there be an experience of unbearable pain? Or take a mental-state account of psychological continuity, it seems that your mental state would still be there while you experience unbearable pain. Although it can happen, most people do not lose all their memories after an experience of unbearable pain.

2. Your “solution” to the Paradoxical Result is also to deny (4) by claiming that the self “lingers on.” You argue that “a person facing unbearable pain can choose to do what he knows is morally forbidden or prudentially irrational.” But is this individual really choosing what he would have chosen under normal circumstances? Or is he just choosing to stop the pain? If so, does the “true” self really linger on?

3. A comment on Velleman’s argument. Imagine a case in which there is self-disintegration as a result of unbearable pleasure. On Velleman’s account, it would appear that this would be just as bad as a case in which there is self-disintegration as a result of unbearable pain. But arguably, common sense tells us that the latter is worse than the former. If this is right, Velleman’s argument misses a crucial aspect of what is bad about unbearable pain, namely, that pain is bad in and of itself.