Living and Dying in a Post-Traditional World

Abstract

Individuals increasingly find themselves alone in large-scale societies that do not have the moral and metaphysical resources to aid them in finding meaning for their lives and deaths. Between these individuals and their surrounding societies there are increasingly fewer well-founded moral communities that can indicate the possibility for meaning and moral orientation. People who approach end-of-life decisions increasingly lack sufficient value commitments in order unambiguously to guide their choices. They find themselves in a state of anomie without direction or moral community. The result is that difficult choices, if they are to have a principled normative character, become impossible: decision-makers at the end of life often no longer possess a point of moral orientation that can provide definitive moral guidance. They know they have important choices to make, but they do not know how to characterize what is morally at stake, and therefore no idea of how to make a good choice. As a consequence, life-and-death choices in health care can lead to endless puzzles about what treatments to accept, what procedures to decline, and what forms of treatment are morally appropriate. When people no longer possess a clear view of the morally good life, they will have no clear view of when it no longer makes sense heroically to struggle against death. That is, they will lack an understanding of when attempts to postpone death are morally dangerous as well as what should morally be secured while dying, so as to have a good death.