The Slippery Slope Argument
What is a slippery slope argument? Critically discuss the use of such arguments in one area of biomedical ethical controversy.
The slippery slope argument is amongst the strongest voiced and possibly the most emotive of arguments in opposition to legalising voluntary active euthanasia (VAE, the act of accelerating the death of another, usually by lethal injection, for their own good and with their consent). In fact, in discussion on practically any change in social policy it is common place to hear objections to the effect, "if this, then that, and finally that" . But how valid is this form of argument? To answer this question, I will examine the nature of the slippery slope argument in its two major forms (empirical and logical), see how it has been applied to the debate on permitting voluntary active euthanasia and determine the validity of these applications.
It is not easy to apply a strict definition to the term slippery slope argument as it is used so loosely . The image it conjures is that of speeding hastily out of control in a direction few would want to venture without a means of stopping. A paradigmatic form of the argument is suggested by Hartough :
I propose and you oppose that action A (let us say, voluntary active …show more content…
euthanasia) which
is currently prohibited (this is not necessarily so, but is usually the case), yet
is not deemed to be objectionable in itself by either you or myself and
may be referred to as the top of the slippery slope should, in fact, be permitted. Your objection arises because you believe that in allowing actions of type A, a causal mechanism exists (very much like a chain reaction) which will lead us to accept action N (e.g. the killing of incompetent patients who explicitly refuse euthanasia) which
is clearly unacceptable to us both and
lies at the bottom of the slope
The nature of the links (for example, killing people who are "not terminally ill or suffering [and then] those who cannot decide for themselves" , etc.), the force or causal mechanism forming the reaction (maybe the increasing disregard for the sanctity of life) and what lies at the bottom of the slope (mass genocide) is also proposed by he who puts forward the argument.
This causal (or empirical) form of the argument is distinguished from the logical form which basically states if we were committed to being rational and consistent (supposedly held to be rather agreeable traits) in our moral reasoning we would again end up at the squalid foot of the slope; if on some rationale we accept proposition A, then by the same rationale we are committed to accepting the closely related proposition B, accept B and we are committed to accepting C and right on through to N, which is clearly unacceptable. Therefore, we should not accept A. The important difference is that while the causal form of the argument depends on a prediction that if we accept A then we will, the world being the way it is, accept N, the logical form depends on a commitment to consistency and rationality in our decision making. It is, perhaps, interesting to note that the metaphor of the slippery slope becomes somewhat less relevant in relation to this logical form of the argument. A synonym of the slippery slope argument often used is the thin end of the wedge argument' and seems to me to better convey the irresistible force (as opposed to a lack of control) of logic which forms the thrust of the argument.
A discussion of some of the slippery slope arguments opposing voluntary active euthanasia that feature in the Assisted Dying and Terminally Ill Bill (ADTIB) provides a useful framework for critically assessing the validity of such arguments. The Bill sets out provisions under which, following its enactment, voluntary euthanasia may be legally performed by a medical doctor. The provisions require that, amongst other things: it is the patient himself who expresses the wish to be assisted to die; the patient is competent, has a terminal illness and is suffering unbearably as a result of that terminal illness.
One mechanism, it has been argued, that could lead us from VAE under the provisions of the Bill to an uncontrollable move towards less desirable forms of intentional killing is the "elastic interpretation" of vague terms contained within the provisions of the Bill.
These terms include "competent", "unbearable suffering" and "terminal illness . Such a mechanism has been identified in the practice of abortion since its legalisation under the Abortion Act 1967. While the intention of the act was to permit abortion as an exceptional procedure in specific circumstances, at the last count as many as 180,000 abortions were carried out annually in the UK and are, according to Lord Walton, available "virtually . . . on demand"
.
There are two points being made here; one is the hypothesis that due to the vague nature of the terms used, the intention of the Bill will be perverted in its application to practice. The second is the pointing to a past slide down a slippery slope in which the same mechanism was at work as evidence to increase the plausibility of this argument. I will deal with the latter first.
The main problem with this type of argument is that "while we may be able confidently to explain afterwards why things went wrong, that does not mean that we could confidently have predicted this beforehand" . I would agree that the similarities between the two bills, particularly the shared reason advanced in support of their introduction (that each would better regulate the illegal practice of abortion and euthanasia via legislation) highlight a need for caution. However, "given that our knowledge of social psychology is very limited" , it would be a mistake to attach too much weight to this tale from history, especially given that numerous other factors are at play. For example, "whereas it was, perhaps, to be expected that there would be growing pressures to apply the Abortion Act with growing elasticity in an age of increasing secularity, most people have a natural desire to remain alive" . Indeed, in any case in which we foresee our future destination would it not be wise to recall the advice of Perelman and Olbrechts-Tyteca, that "[s]tress will be laid on the ambiguity of development and, consequently, on the arbitrariness of seeing only a single direction."
Let us now return to the hypothesis itself; that the vague nature of the terms contained within the Bill will lead to the perversion of the Bill's intentions and ultimately towards the practice of less desirable forms of killing. The authors, in recognizing the issue, have suitably adapted the Bill in ways to ameliorate the potential problem. Firstly, by "limit[ing the Bill] to terminally ill patients who were already suffering terribly and had a very short time to live" despite their "prefer[ing] it to be of much wider application" . Secondly, they suggest the use of more stringent definitions of the terms used to describe the criteria under which authorization to proceed with euthanasia may be granted . These will inevitably be cut-off points or boundaries which may well be deemed as arbitrary by opposers. But is there a justification in passing legislation which falls so far short of what the legislators recognize to be its full moral potential and to construct arbitrary boundaries which hold no moral value? This is a question I will come to address shortly.
Other than through elastic interpretation of vague terms, the Bill, if enacted, may be applied to those for whom it was not intended due to "deliberate flouting of the law" . "If (as has been alleged) covert euthanasia is taking place when there is an absolute legal prohibition of it, the opening of the door via limited legal provision will encourage the de facto barriers to be pushed further" down the slippery slope. Those who hold this concern draw upon "empirical data from The Netherlands which indicate that around 1,000 cases of euthanasia occur annually in the country without an explicit request " and therefore, outside of the law. Perhaps the most salient flaw of the empirical slippery slope argument is that to be formidable, it must rely on empirical data to make its causal mechanism "a plausible one" . Thus the crudest method of contesting such an argument is to refute that the negative consequences will in fact occur with empirical evidence in support of this . In this case, the search for empirical data to contest this need only go as far as a closer look at this same data: "looking at the 900 deaths which occurred without explicit request to the doctor; they may not have gone through the formal process but they will have gone through an informal discussion ". The defendant may at most concede that the potential for abuse of the law does exist but the empirical evidence in support of this merely demonstrates that though Dutch practice may have faltered in keeping to the letter of the law, it has yet kept within its spirit and, therefore, determine that the argument is far from being a critical one.
As opposed to the widening interpretation of the provision of the Bill as discussed above, another cause of a tumble down a slippery slope towards less desirable forms of killing may be the result of subsequent changes in the actual provisions themselves with the effect, once again, of gradually widening the scope of the conditions under which euthanasia would be lawful. Dr Fiona Randall argues that, "if we are saying that the entitlement to assisted suicide and euthanasia . . . is thought to be of benefit for those who are terminally ill, it must be extended to others who feel they are suffering unbearably but are not in the last few months of their life [otherwise the law would be inequitable]" . This is quite different to the previous line of argument because as opposed to saying what will or may happen, say as a result of "the human tendency to test the limits of any regulation" , it is instead questioning the validity of the boundaries determined by the Bill as well as appealing to the notion of what should happen. It does of course come under that subtype of argument which I have already discussed, the logical slippery slope / thin end of the wedge argument.
But how logical is this argument and is it really so unjustified to draw a definitive line, however arbitrary? If the legislators believed it is compassionate and, therefore, permissible to terminate the life of somebody who is terminally ill, suffering terribly and has only 10 weeks left to live, one can argue that, being rational and consistent, surely it is equally as permissible and compassionate to terminate the life of such a person who has 11 weeks left to live. What's in an extra week you might ask? What about 12 weeks, and 13, 14, 15 . . . . What about somebody who is predicted to live for another 1560 weeks (30 years) in such a condition. At this point, many more would be opposed to such action; they would claim we are robbing her of the rest of her life, that she would adapt to her burden. "Still, we are not allowed to call [it uncompassionate]; for we couldn't meet the requirement of pinpointing the exact moment at which [the action became uncompassionate]" . We see that such an argument is, in fact, a fallacy that relies on invalid logic- "the requirement to locate the exact stopping place on the slope should simply be ignored" - and since ancient times has been named the Sophism of the Heap. So where is the cut off? Of course it is difficult, if not impossible, to say precisely when such an action would cease to be compassionate. But that is not to say that one cannot confidently judge to which camp these extremes at either end belong. It seems that there is a grey area and the closer one approaches that, the less sure one can be of their moral justification in such an action. So drawing a hard line, however arbitrary, well before the grey area with full knowledge that somebody stepping over that line may be reprimanded without necessarily being morally unjustified in his actions seems, in fact, a particularly logical (and not at all arbitrary) solution to the problem. It also provides a cushioned barrier between the limits of the elastic interpretation of the Bill in practice and moral depravity.
The Bill specifies that the patient requesting assistance to die be competent so that the decision is truly autonomous. So what of the patient who wishes to die "in the interests of others (in particular, family members) rather than because they themselves positively wish to die in this way?" The authors of the Bill describe such "hidden pressures" as the concern which was raised most frequently during consultation on the Bill in the context of the slippery slope. It does, indeed, challenge our notion of autonomy. What if the pressure was not from family members but the highly resource-conscious doctor wishing to spare the NHS budget the strain of another slow and expensive death? It could become hospital policy for a councillor to come and visit in one's end stages of life to advocate the benefits of a quick and painless death, representing one's final contribution' to society. What about a monetary gift to give to your loved ones in appreciation of all the resources that you saved in letting you go early on. But if we were not to advocate autonomy in the first place by allowing voluntary euthanasia, what then? Is it possible the reverse could occur? Could we find ourselves in a position where patients lose the right to request the withholding / withdrawing of treatment? Might a patient's refusal to begin a regime of nauseating chemotherapy be disregarded in the doctor's own pursuit of what he thought would be best for the patient. Could such a failure of recognition of autonomy not result in those who are terminally ill spending their last days under hospital arrest' in case their determination to end their own life should be recognised if let loose. We can see that the concept of autonomy in regard to euthanasia can be seen as a double edged sword, with two slippery slope arguments running in counter-direction to and, I would argue, undermining one another.
In conclusion, I would suggest that the slippery slope argument does have a value in providing one perspective of a complex issue as well as providing a narrative tool for extrapolating our viewpoint to a theoretical extreme, thus subjecting it to further critical analysis. However, as with any matter of substantial controversy, especially one with such wide reaching implications as VAE, a single viewpoint will rarely suffice in providing a comprehensive account of the considerations and implications requiring deliberation. Therefore, its use should be limited to constituting a single aspect of the triangulation of methods required to reach a decisive judgement as to our course of action such as that, I believe, contained within the ADTIB.
The slippery slope argument is amongst the strongest voiced and possibly the most emotive of arguments in opposition to legalising voluntary active euthanasia (VAE, the act of accelerating the death of another, usually by lethal injection, for their own good and with their consent). In fact, in discussion on practically any change in social policy it is common place to hear objections to the effect, "if this, then that, and finally that" . But how valid is this form of argument? To answer this question, I will examine the nature of the slippery slope argument in its two major forms (empirical and logical), see how it has been applied to the debate on permitting voluntary active euthanasia and determine the validity of these applications.
It is not easy to apply a strict definition to the term slippery slope argument as it is used so loosely . The image it conjures is that of speeding hastily out of control in a direction few would want to venture without a means of stopping. A paradigmatic form of the argument is suggested by Hartough :
I propose and you oppose that action A (let us say, voluntary active …show more content…
euthanasia) which
is currently prohibited (this is not necessarily so, but is usually the case), yet
is not deemed to be objectionable in itself by either you or myself and
may be referred to as the top of the slippery slope should, in fact, be permitted. Your objection arises because you believe that in allowing actions of type A, a causal mechanism exists (very much like a chain reaction) which will lead us to accept action N (e.g. the killing of incompetent patients who explicitly refuse euthanasia) which
is clearly unacceptable to us both and
lies at the bottom of the slope
The nature of the links (for example, killing people who are "not terminally ill or suffering [and then] those who cannot decide for themselves" , etc.), the force or causal mechanism forming the reaction (maybe the increasing disregard for the sanctity of life) and what lies at the bottom of the slope (mass genocide) is also proposed by he who puts forward the argument.
This causal (or empirical) form of the argument is distinguished from the logical form which basically states if we were committed to being rational and consistent (supposedly held to be rather agreeable traits) in our moral reasoning we would again end up at the squalid foot of the slope; if on some rationale we accept proposition A, then by the same rationale we are committed to accepting the closely related proposition B, accept B and we are committed to accepting C and right on through to N, which is clearly unacceptable. Therefore, we should not accept A. The important difference is that while the causal form of the argument depends on a prediction that if we accept A then we will, the world being the way it is, accept N, the logical form depends on a commitment to consistency and rationality in our decision making. It is, perhaps, interesting to note that the metaphor of the slippery slope becomes somewhat less relevant in relation to this logical form of the argument. A synonym of the slippery slope argument often used is the thin end of the wedge argument' and seems to me to better convey the irresistible force (as opposed to a lack of control) of logic which forms the thrust of the argument.
A discussion of some of the slippery slope arguments opposing voluntary active euthanasia that feature in the Assisted Dying and Terminally Ill Bill (ADTIB) provides a useful framework for critically assessing the validity of such arguments. The Bill sets out provisions under which, following its enactment, voluntary euthanasia may be legally performed by a medical doctor. The provisions require that, amongst other things: it is the patient himself who expresses the wish to be assisted to die; the patient is competent, has a terminal illness and is suffering unbearably as a result of that terminal illness.
One mechanism, it has been argued, that could lead us from VAE under the provisions of the Bill to an uncontrollable move towards less desirable forms of intentional killing is the "elastic interpretation" of vague terms contained within the provisions of the Bill.
These terms include "competent", "unbearable suffering" and "terminal illness . Such a mechanism has been identified in the practice of abortion since its legalisation under the Abortion Act 1967. While the intention of the act was to permit abortion as an exceptional procedure in specific circumstances, at the last count as many as 180,000 abortions were carried out annually in the UK and are, according to Lord Walton, available "virtually . . . on demand"
.
There are two points being made here; one is the hypothesis that due to the vague nature of the terms used, the intention of the Bill will be perverted in its application to practice. The second is the pointing to a past slide down a slippery slope in which the same mechanism was at work as evidence to increase the plausibility of this argument. I will deal with the latter first.
The main problem with this type of argument is that "while we may be able confidently to explain afterwards why things went wrong, that does not mean that we could confidently have predicted this beforehand" . I would agree that the similarities between the two bills, particularly the shared reason advanced in support of their introduction (that each would better regulate the illegal practice of abortion and euthanasia via legislation) highlight a need for caution. However, "given that our knowledge of social psychology is very limited" , it would be a mistake to attach too much weight to this tale from history, especially given that numerous other factors are at play. For example, "whereas it was, perhaps, to be expected that there would be growing pressures to apply the Abortion Act with growing elasticity in an age of increasing secularity, most people have a natural desire to remain alive" . Indeed, in any case in which we foresee our future destination would it not be wise to recall the advice of Perelman and Olbrechts-Tyteca, that "[s]tress will be laid on the ambiguity of development and, consequently, on the arbitrariness of seeing only a single direction."
Let us now return to the hypothesis itself; that the vague nature of the terms contained within the Bill will lead to the perversion of the Bill's intentions and ultimately towards the practice of less desirable forms of killing. The authors, in recognizing the issue, have suitably adapted the Bill in ways to ameliorate the potential problem. Firstly, by "limit[ing the Bill] to terminally ill patients who were already suffering terribly and had a very short time to live" despite their "prefer[ing] it to be of much wider application" . Secondly, they suggest the use of more stringent definitions of the terms used to describe the criteria under which authorization to proceed with euthanasia may be granted . These will inevitably be cut-off points or boundaries which may well be deemed as arbitrary by opposers. But is there a justification in passing legislation which falls so far short of what the legislators recognize to be its full moral potential and to construct arbitrary boundaries which hold no moral value? This is a question I will come to address shortly.
Other than through elastic interpretation of vague terms, the Bill, if enacted, may be applied to those for whom it was not intended due to "deliberate flouting of the law" . "If (as has been alleged) covert euthanasia is taking place when there is an absolute legal prohibition of it, the opening of the door via limited legal provision will encourage the de facto barriers to be pushed further" down the slippery slope. Those who hold this concern draw upon "empirical data from The Netherlands which indicate that around 1,000 cases of euthanasia occur annually in the country without an explicit request " and therefore, outside of the law. Perhaps the most salient flaw of the empirical slippery slope argument is that to be formidable, it must rely on empirical data to make its causal mechanism "a plausible one" . Thus the crudest method of contesting such an argument is to refute that the negative consequences will in fact occur with empirical evidence in support of this . In this case, the search for empirical data to contest this need only go as far as a closer look at this same data: "looking at the 900 deaths which occurred without explicit request to the doctor; they may not have gone through the formal process but they will have gone through an informal discussion ". The defendant may at most concede that the potential for abuse of the law does exist but the empirical evidence in support of this merely demonstrates that though Dutch practice may have faltered in keeping to the letter of the law, it has yet kept within its spirit and, therefore, determine that the argument is far from being a critical one.
As opposed to the widening interpretation of the provision of the Bill as discussed above, another cause of a tumble down a slippery slope towards less desirable forms of killing may be the result of subsequent changes in the actual provisions themselves with the effect, once again, of gradually widening the scope of the conditions under which euthanasia would be lawful. Dr Fiona Randall argues that, "if we are saying that the entitlement to assisted suicide and euthanasia . . . is thought to be of benefit for those who are terminally ill, it must be extended to others who feel they are suffering unbearably but are not in the last few months of their life [otherwise the law would be inequitable]" . This is quite different to the previous line of argument because as opposed to saying what will or may happen, say as a result of "the human tendency to test the limits of any regulation" , it is instead questioning the validity of the boundaries determined by the Bill as well as appealing to the notion of what should happen. It does of course come under that subtype of argument which I have already discussed, the logical slippery slope / thin end of the wedge argument.
But how logical is this argument and is it really so unjustified to draw a definitive line, however arbitrary? If the legislators believed it is compassionate and, therefore, permissible to terminate the life of somebody who is terminally ill, suffering terribly and has only 10 weeks left to live, one can argue that, being rational and consistent, surely it is equally as permissible and compassionate to terminate the life of such a person who has 11 weeks left to live. What's in an extra week you might ask? What about 12 weeks, and 13, 14, 15 . . . . What about somebody who is predicted to live for another 1560 weeks (30 years) in such a condition. At this point, many more would be opposed to such action; they would claim we are robbing her of the rest of her life, that she would adapt to her burden. "Still, we are not allowed to call [it uncompassionate]; for we couldn't meet the requirement of pinpointing the exact moment at which [the action became uncompassionate]" . We see that such an argument is, in fact, a fallacy that relies on invalid logic- "the requirement to locate the exact stopping place on the slope should simply be ignored" - and since ancient times has been named the Sophism of the Heap. So where is the cut off? Of course it is difficult, if not impossible, to say precisely when such an action would cease to be compassionate. But that is not to say that one cannot confidently judge to which camp these extremes at either end belong. It seems that there is a grey area and the closer one approaches that, the less sure one can be of their moral justification in such an action. So drawing a hard line, however arbitrary, well before the grey area with full knowledge that somebody stepping over that line may be reprimanded without necessarily being morally unjustified in his actions seems, in fact, a particularly logical (and not at all arbitrary) solution to the problem. It also provides a cushioned barrier between the limits of the elastic interpretation of the Bill in practice and moral depravity.
The Bill specifies that the patient requesting assistance to die be competent so that the decision is truly autonomous. So what of the patient who wishes to die "in the interests of others (in particular, family members) rather than because they themselves positively wish to die in this way?" The authors of the Bill describe such "hidden pressures" as the concern which was raised most frequently during consultation on the Bill in the context of the slippery slope. It does, indeed, challenge our notion of autonomy. What if the pressure was not from family members but the highly resource-conscious doctor wishing to spare the NHS budget the strain of another slow and expensive death? It could become hospital policy for a councillor to come and visit in one's end stages of life to advocate the benefits of a quick and painless death, representing one's final contribution' to society. What about a monetary gift to give to your loved ones in appreciation of all the resources that you saved in letting you go early on. But if we were not to advocate autonomy in the first place by allowing voluntary euthanasia, what then? Is it possible the reverse could occur? Could we find ourselves in a position where patients lose the right to request the withholding / withdrawing of treatment? Might a patient's refusal to begin a regime of nauseating chemotherapy be disregarded in the doctor's own pursuit of what he thought would be best for the patient. Could such a failure of recognition of autonomy not result in those who are terminally ill spending their last days under hospital arrest' in case their determination to end their own life should be recognised if let loose. We can see that the concept of autonomy in regard to euthanasia can be seen as a double edged sword, with two slippery slope arguments running in counter-direction to and, I would argue, undermining one another.
In conclusion, I would suggest that the slippery slope argument does have a value in providing one perspective of a complex issue as well as providing a narrative tool for extrapolating our viewpoint to a theoretical extreme, thus subjecting it to further critical analysis. However, as with any matter of substantial controversy, especially one with such wide reaching implications as VAE, a single viewpoint will rarely suffice in providing a comprehensive account of the considerations and implications requiring deliberation. Therefore, its use should be limited to constituting a single aspect of the triangulation of methods required to reach a decisive judgement as to our course of action such as that, I believe, contained within the ADTIB.