The Nature, Scope, and Implications of a Personal Moral Duty to Die

Abstract

In the relevant circumstance of both relatively high burden or cost to others and low prospective gain for themselves, people have a prima facie duty to die sooner rather than later. This duty is a personal moral duty, not a “societal” duty, and thus, it in no way implies that others may demand that it be exercised. It is literally a duty to let death come, not a more general duty to die that encompasses active measures to ensure death. A person can owe this duty not only to close family and loved ones when they are heavily burdened, but in the right circumstances also to more distant persons, even to “society”; the fundamental reason is fairness to others in the society or insurance pool, given one’s own evaluative preferences about trade-offs involving expensive, low-chance-of-benefit care. This personal moral duty to die does not extend to incompetent patients, at least not in any literal sense. The duty to die also does not jeopardize the marital vow, “for better or worse, in sickness and in health”; the creative and mutual relationship envisioned in a marital promise does not bar people from ever coming to think that they may be obligated to accept death because of effects on a spouse. Finally, although this duty is rooted in sensitivity to considerations of quality of life, it need not threaten the “special” value of individual life and lifesaving.