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Joseph Fletcher (1905–1991) was one the most influential philosophers and bioethicists of the twentieth century. His advocacy blazed the path for many of the radical social transitions we are experiencing today. He gained fame as the prime proponent of “situational ethics,” popularly known as social relativism. But his work in bioethics eroding the sanctity of human life and promoting a utilitarian hedonism was just as society-altering.

Starting in the early 1970s, and continuing for the rest of his life, the Episcopalian priest turned atheist mounted a frontal intellectual assault on the Judeo-Christian ideal of universal human equality. 

His 1975 essay “Indicators of Humanhood” was profoundly persuasive in this regard. Published in the Hastings Center Report, an influential bioethics journal, Fletcher argued that people should be divided between “truly human beings” and the “subpersonal”—those among us whom we should deem of little consequence because of their lesser capacities. Fletcher even proposed a loose formula with fifteen “criteria or indicators” by which an individual’s moral worth—or humanhood—could be judged. These included:

  • minimum intelligence (score too low, and one is deemed “mere biological life”)
  • self-awareness (“essential to the role of personality”)
  • a sense of futurity (“subhuman animals do not look forward in time”)
  • memory (“It is this trait alone that makes man . . . a cultural instead of instinctive being”)
  • communication (“Disconnection from others, if it is irreparable, is dehumanization”)
  • neocortical function (“In the absence of the synthesizing function of the cerebral cortex, the person is non-existent. Such persons are objects, not subjects”)

Fletcher was not coy about the consequences that would follow from society’s acceptance of his premises. In another 1975 essay, “Being Happy, Being Human,” he described participating in a panel discussion of the treatment of seriously disabled babies. A physician who cared for a developmentally disabled boy reported that though his patient had a very low IQ, the lad was clearly happy and, without doubt, a fully human being. “So what?” Fletcher essentially said, as he coldly dismissed the worth of developmentally disabled people:

Idiots are not, never were, and never will be in any degree responsible [because they cannot understand the consequences of action]. Idiots, that is to say, are not human. The problem they pose is not lack of sufficient mind, but of any mind at all. No matter how euphoric their behavior might be, they are outside the pale of human integrity. 

There was a purpose to such blatant dehumanization: to gain support for killing these “subpersonal” beings, the decisions about which Fletcher described as a merely “clinical” matter. In the case of disabled infants, he wrote elsewhere, infanticide should simply be considered “postnatal abortion.”

In Fletcher’s last book, The Ethics of Genetic Control, he prophesied that breakthroughs in biotechnology would generate a transformation “of such a radical nature” that biotechnologists would become more powerful agents of change than “Presidents and Parliaments and Pentagons.” How would this new awesome power be exercised? Through “quality control” via genetic screening:

There is no such thing as a right to bring crippled children into the world. If we choose family size, we should also choose family health . . . . If the State is morally justified in repelling an unwelcome invader . . . why shouldn’t the family be protected from an idiot or terribly diseased sibling?

This may sound awful to readers, but Fletcher’s influence was so pronounced that Albert R. Jonsen, author of The Birth of Bioethics, once described him as the “patriarch of bioethics.” He could also be called its most prescient prophet. Indeed, it is stunning to consider how fundamentally society has accepted Fletcher’s philosophical advocacy. 

Consider: 

  • Bioethics—and, in some circumstances, the law—now generally accept that human beings should be divided between “persons,” who have optimal value, and “non-persons,” who can be treated as objects. Thus, late-term abortion is permitted in many areas of the country, even when the unborn baby is viable. People judged to be in a persistent vegetative state or with minimal consciousness are denied sustenance so that they dehydrate to death.
  • Assisted suicide has been legalized by statute in five states, and several countries allow doctors to perform lethal injections on the sick, disabled, and mentally ill. Belgium and the Netherlands have combined euthanasia with organ harvesting—fully in keeping with Fletcher’s utilitarian philosophy.
  • There is a definite Fletcher-like eugenicist streak to the abortion regime. Fletcher would undoubtedly smile if he knew that, in 2018, people with Down syndrome are being wiped off the face of the earth by means of abortion. For example, Iceland boasts that no Down babies are born there anymore, while Denmark has a zero Down birth rate as an official public policy goal. Here in the U.S., approximately 90 percent of diagnosed Down fetuses are aborted.
  • Meanwhile, “postnatal abortion” is now such a respectable idea that bioethicist Peter Singer, its primary contemporary advocate, was brought from Australia to teach at Princeton University in part because of his infanticide advocacy, with further intellectual support appearing in the world’s most influential bioethics and medical journals. Meanwhile, babies born with serious disabilities and terminal conditions are actually being terminated by doctors in the Netherlands, where doctors have created a bureaucratic killing checklist called the “Groningen Protocol,” chillingly published with all due respect in the New England Journal of Medicine. 
  • Procreation, just as Fletcher proposed, is becoming increasingly technological and infused with the values of eugenics. Preimplantation genetic diagnosis (PGD) after IVF has led not only to efforts at preventing genetic disease, but also to “quality control,” including for sex selection. Human cloning has been accomplished, and its technique is continually being improved upon. Scientists are on the verge of creating “three-parent” embryos, again with the primary purpose of preventing disease, but also with the potential to allow polyamorous collectives to have a child genetically related to all members. The gene-editing technique known as CRISPR will soon permit blatant genetic engineering of our progeny, not only for health purposes, but also with the potential goals of increasing intelligence, controlling temperament, and modifying appearance. And now, scientists are on the verge of creating sperm and ova from skin cells, possibly opening the door to women’s becoming biological fathers and men biological mothers.

Many of us are appalled by these developments. But an increasing number agree with Fletcher that abiding by natural boundaries isn’t wisdom but oppression—and they are acting on those values, supported by a robust bioethics advocacy and substantially unregulated scientific inquiry. Joseph Fletcher may be dead, but his dark dreams are becoming our reality.

Award winning author Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. His most recent book is Culture of Death: The Age of “Do Harm” Medicine.


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