Princeton bioethicist Peter Singer has put himself into the media spotlight again. This time, he’s gone to defend the idea that professional judgment and state interests can trump individual autonomy. The “case example” he uses in his latest op-ed is the highly publicized case of Sam Golubchuk, an elderly man whose family has been fighting in the Canadian courts to guarantee he gets appropriate medical treatment when he falls ill.

Writing in the Malta Independent, Singer shows (probably to the shock of many of his fans) how little Utilitarians like Singer actually value autonomy:

Normally, when patients are unable to make decisions about their treatment, the family’s wishes should be given great weight. But a family’s wishes should not override doctors’ ethical responsibilities to act in the best interests of their patients.

Golubchuk’s children argue that he interacts with them. But establishing their father’s awareness could be a double-edged sword, since it could also mean that keeping him alive is pointless torture, and it is in his best interest to be allowed to die peacefully.

The other important issue raised by Golubchuk’s case is how far a publicly-funded health care system, such as Canada’s, has to go to satisfy the family’s wishes. When a family seeks treatment that, in the professional judgment of the physicians, is not in the patient’s best interest, the answer should be: not far at all.

If Golubchuk’s children can convince the court that their father is not suffering, the court might reasonably order the hospital to grant them custody of their father. They can then decide for themselves, at their own expense, how much more treatment he should have. What the court should not do, is order the hospital to continue to care for Golubchuk against the better judgment of its health care professionals. Canada’s tax-payers are not required to support the religious beliefs held by their fellow-citizens.

This puts him in direct contradiction to his stance in an earlier case. However, his apparent aim in the documentary was to show a more varied and humane presentation of his views. Here is an excerpt from a transcription of the documentary “Singer: A Dangerous Mind.” The transcribed segment deals with David Glass, whose parents were convicted on assault charges as a result of having to physically fight medical personnel attempting to give their son drugs that would have killed him:

And what I thought was really wrong about the doctors’ refusal to support David, when he needed life support, was that they were putting themselves above David’s mother in being the judges of whether his life was worth continuing.

He reinforced the point later when he said:

I think for doctors to make those decisions independently of the wishes and views of parents will normally be the wrong thing to do.

Contrary to what both detractors and fans of Singer might think, it’s not all that unusual for Singer to say one thing in a given setting only to modify it or contradict it in another. Most people don’t keep track of the times he’ll concede points in a debate, only to “forget” that he conceded them when in front of another audience. Singer seems to rely on the fact that most people don’t keep track of his contradictions and inconsistencies.

This pattern became evident even as he first came to Princeton. And it came with his conflicting accounts of a situation he faced with his own mother. In 1999, Michael Specter wrote in the New Yorker that Peter Singer spent money to support his mother, who had advanced Alzheimer’s – and the apparent contradiction of him providing that care in the face of Singer’s views on personhood.

Singer’s comments, which became widely circulated in subsequent coverage of him, explained the contradiction this way:

Singer has spent his career trying to lay down rules for human behavior which are divorced from emotion and intuition. His is a world that makes no provision for private aides to look after addled, dying old women. Yet he can’t help himself. “I think this has made me see how the issues of someone with these kinds of problems are really very difficult,” he said quietly. “Perhaps it is more difficult than I thought before, because it is different when it’s your mother.” (emphasis added)

This was a “humanizing” portrait of Singer – although sometimes used to brand him a hypocrite as well.

Whether or not Singer is a hypocrite, it’s clear that he unpacks certain statements, revelations and positions at times that certainly seem aimed to please the audience in front of him. How else to explain the December 2000 interview with Ronald Bailey in Reason Magazine that gave a very different account of why Peter Singer’s mother got the support she needed to live even with advanced dementia:

Rigorous adherence to a single principle has a way of hoisting one by one’s own petard. Singer’s mother suffers from severe Alzheimer’s disease, and so she no longer qualifies as a person by his own standards, yet he spends considerable sums on her care. This apparent contradiction of his principles has not gone unnoticed by the media. When I asked him about it during our interview at his Manhattan apartment in late July, he sighed and explained that he is not the only person who is involved in making decisions about his mother (he has a sister). He did say that if he were solely responsible, his mother might not be alive today. (emphasis added)

(Note: Singer’s sister is Joan Dwyer, a lawyer whose career has involved strident advocacy for people with significant disabilities, some of which she writes about in the Law Review article “Access to Justice for People with Severe Communication Impairment.”

The statements in the Bailey interview did not get circulated in the media – and the earlier story of it “being different when it’s your mother” still plays out in most people’s background knowledge of Singer.

But if you follow his articles and speaking gigs closely, it probably won’t be long until you’ll find your own examples of Singer blithely contradicting himself and hoping the audience has either the ignorance or the good manners not to notice. –Stephen Drake