How Can We Assess How Much Someone Is Harmed by Death?

Original text Luciano Carlos Cunha · Volume III, p. 18 of the PDF edition · English translation

5.1. The magnitude of the harm of death: future and past aspects

In chapter 2 we discussed what the conditions are for death to be a harm. We will now discuss a distinct but related question: how can we assess how much someone would be harmed if they died?

Let us begin with an example. Imagine that someone has just been born and has two possible futures ahead: either they live 10 years, or they live 80 years. Imagine that both lives would be very positive. It seems worse to die at 10 than to die at 80. There are at least two ways of explaining why. Both will be presented below.

5.1.1. The future-focused explanation

If we die at 10, the amount of positive things that we would still have to experience and that will not happen is greater than if we die at 80. If death is a harm because it prevents the enjoyment of what is positive, then the more enjoyment is prevented, the greater the harm of death.

5.1.2. The past-focused explanation

If we die at 10, we have enjoyed less so far. According to this explanation, the assessment of the magnitude of the harm of death would be guided by the principle “the less someone has enjoyed, the more they are harmed if they are prevented from enjoying more.”

5.1.3. When the explanations converge and when they diverge

The two explanations will converge when whoever has enjoyed less would also have more ahead of them to enjoy. Comparing a 10-year-old child and an 80-year-old, the child seems to be more harmed if she dies, both because she would have more to live and because she has lived less. However, if the child has lived 10 years so far but would only have another 10 ahead, and the elderly person is now 70 but could still live another 15, the appeal to the future would say that the elderly person is more harmed if he dies, whereas the appeal to the past would say that it is the child.

How should we establish the appropriate relation between future factors and past factors in measuring the magnitude of the harm of death? We will return to this question in section 5.4. First, however, we will discuss in more detail how to compute the magnitude of the harm of death separately for each of the factors (future and past).

5.2. Factors in assessing the magnitude of the harm of death: time and quality of life

For the sake of simplicity, in the previous section we relied only on time: how much longer someone would have to live and how long they have lived so far. However, length of life (past, future, or both) does not seem to be all that matters in assessing the seriousness of the harm of death. Quality of life also matters. This can be illustrated by the following example.

5.2.1. Adding the quality-of-life factor with regard to the future

Suppose that A and B have lived the same amount of time so far, and that A would have 20 years ahead and B would have 5. Taking only future time into account, A loses more if he dies now (20 years). However, imagine that, of those 20 years, 16 would be spent in extreme torment. Thus, as far as lifetime with a minimum quality is concerned, A has only 4 years ahead. Suppose that B's remaining 5 years would all be of satisfactory quality. Thus, if we add the factor of quality of future life, it is B who would have more enjoyment ahead, not A.

5.2.2. Adding the quality-of-life factor with regard to the past

The same holds for the past. Imagine that C and D would have 30 equally satisfactory years ahead of them. Imagine also that C has lived 50 years so far, and that D has lived 30. At first glance it seems that D is more harmed if she dies, since she has lived less. But suppose that the 30 years D lived were satisfactory, and that C spent 25 of his 50 years in constant suffering. Thus, taking into account the quality of past life, it is C who has enjoyed less (25 years, compared to D's 30 years).

Of course, in real life years of life (whether future or past) are not entirely good or entirely bad. In real life, each year has good moments and bad moments (and the intensity of the good and bad moments also varies). Below we will see a way of measuring this more precisely.

5.2.3. Measurement based on quality-adjusted life years (QALYs)

One way of assessing the magnitude of the harm of death is to measure it in QALYs (Quality-Adjusted Life Years), which involves multiplying time by quality of life²². This kind of assessment can be applied both to future factors and to past factors²³. By multiplying time by quality of life, we can then say that someone has already enjoyed an amount “x” of QALYs and would have an amount “x” of QALYs ahead of them to enjoy. The fewer past QALYs someone has already enjoyed, the more they are harmed if they die; the more future QALYs they would have to enjoy, the more they are harmed if they die²⁴.

5.3. Why past factors should also be taken into account

If death is a harm because of the positive things it prevents one from experiencing, then the greater the value someone would be deprived of by death, the greater the magnitude of the harm of death. One might think this would imply taking only future QALYs into account when assessing the magnitude of the harm of death. However, it could be argued that past factors also influence the size of the future loss. For example, it could be said that the fewer QALYs someone has enjoyed so far, the more valuable to that person are the QALYs they still have left.

One way of explaining the importance of considering past QALYs is to imagine the moments of enjoyment in a life as a cake. Imagine that A was given 20 slices of cake, and that B was given 100. Suppose that A has so far eaten 10 slices (because he started eating later), and that B has already eaten 80 (because she started eating earlier). Now imagine that both lose the slices they have left. Who was harmed more? It seems it was A, since he has eaten only 10 slices so far, even though all he had left was just 10 slices.

Individual B, in turn, seems to have been harmed less, since she has already eaten much more, even though she still had 20 slices left to eat.

5.4. Establishing the relation between future and past factors

How should we establish the relation between future and past factors in order to measure the magnitude of the harm of death? There are many possible ways of establishing this relation. One example is the following formula²⁵: g(T) – g(P), where T is the total well-being of the individual's life if they lived to the maximum of their life expectancy, P is the well-being the individual has lived so far, and g is a strictly increasing and strictly concave function. It is strictly increasing because the more well-being an individual has had so far, the greater the value of the total well-being, and it is concave to represent the idea that the less well-being someone has had so far, the greater the harm of not having an additional unit of well-being.

5.5. QALYs and comparisons between the harm of death for humans and nonhumans

The QALY theory could in no way serve to argue that humans are always more harmed by death than nonhuman animals.

If we took only future factors into account, perhaps this would be so in many cases, given that humans have a longer life expectancy than animals of many other species. But even if we took only future factors into account, sharks, whales, and turtles of various species would normally have more ahead of them to enjoy (since their typical lifespan is much longer). Moreover, even if the average life expectancy of members of the human species is greater than that of members of various other species, there would still be situations in which, comparing two individuals, it is the human who would have fewer QALYs ahead. This would happen if we were comparing, for example, an 80-year-old human and a 5-year-old pig.

Moreover, we have seen that there are strong reasons to take past QALYs into account as well. It is crucially because of this factor that the QALY theory leads us to conclude that nonhuman animals are generally quite unfortunate with the lives they have had, since,

besides dying, in the overwhelming majority of cases, very prematurely, they typically live lives that contain nothing but suffering from beginning to end (both under exploitation and in the wild).

5.6. How important is the question of the magnitude of the harm of death?

It is not uncommon to believe that, for us to have to revise our attitudes toward the death of nonhuman animals, it is crucial to show that they are as harmed by death as humans are. According to this belief, if it is shown that, for some reason, humans are more harmed by death than nonhuman animals, then killing nonhuman animals and failing to save their lives is justified.

This common belief is mistaken for a very simple reason: showing that A is more harmed by death than B does not show that B is only slightly harmed by death. Although assessing the magnitude of the harm of death is important in certain situations (for example, in questions of prioritizing whom to save), it is not essential for recognizing that we should change our attitudes toward killing and failing to save nonhuman animals. For that, it is enough to recognize that animals are greatly harmed by death. We will discuss this point in more detail in chapters 9, 10, and 11.

In the next chapter we will discuss some objections to measuring the magnitude of the harm of death on the basis of QALYs.