Primum Non Nocere Mortuis: Bioethics and the Lives of the Dead

While many people are skeptical that we can harm the dead, much of our discourse depends on it. I defend the claim that we can harm the dead by presenting a new way to think about how the dead can be harmed, and I show that the reasons we can harm the dead shed light on many issues in bioethics, including organ donation, posthumous reproduction, end-of-life decisions, and advance directives for dementia. While the idea of harming the dead will conclusively decide few issues, it will rule out some options, and it will make some positions more or less attractive than they otherwise would be. At the conclusion of a particularly trying clinical ethics consult that ended with the death of the patient, one of my colleagues assured me, “Don’t worry. He’s dead. We can’t harm him now.” That remark was innocent enough, but on reflection, it puzzled me. My initial response had been that it was a banality, since obviously we can no longer create pain in someone who is dead. But that banality may lead us to infer that the dead are beyond our ability to harm them. That inference is, I think, mistaken—perhaps profoundly so. In this paper, I defend the claim that we can harm the dead by presenting a new way to think about how the dead can be harmed, and I then show that the reasons we can harm the dead shed light on many issues in bioethics, including organ donation, posthumous reproduction, end-of-life decisions, and advance directives for dementia. While the idea of harming the dead conclusively decides few issues, it rules out some options, and it makes some positions more or less attractive than they otherwise would be.