Letting terminally ill people die will do little to slow population growth because the vast majority of these people are not going to have (additional) children anyway. But there are other solutions that would actually work.

You write that there seems to be no slowing of procreation. This is quite false. Total fertility rates (average number of children per woman) have fallen spectacularly since 1955 ... but only in countries and regions where poverty has been meaningfully reduced. For example, the TFR of East Asia fell from 5.42 to 1.72 (below the rate of reproduction) -- and East Asia is the most populous region on Earth. So this is highly significant. There were large drops also in Portugal, Australia, Botswana, Italy, and so on. Where poverty persists, on the other hand, so do high TFRs. Many African states are good examples of this. Niger's TFR has increased from 6.86 to 7.15, and other high-poverty countries (Mali, Senegal, Equatorial Guinea) are not far behind. The evidence is overwhelming, and the lesson is clear: ensure that people have some social security, so they need not depend in their old age on having surviving children; ensure that infant mortality is low, so people need not get lots of children to ensure that a few will survive; ensure that women have good educational and employment opportunities so that they have important social roles other than that of bearing and raising children.

I think it is unethical for psychologists to lie to their clients about such test results. It would be best practice for a psychologist to ask their client why they want to take such a test and what they think the result means, as part of the process of consent for taking the test. Apparently this was not done in your case, and this is regrettable, since you seem to think that the test has great significance.

A well known book you might enjoy is Howard Gardner's "Frames of Mind" which discerns seven different kinds of intelligence.

We have been grappling with these ethical issues since the mid-nineteenth century and the beginning of the Eugenics movement. You have obviously done some deep thinking yourself, and perhaps it is time for you to engage with some texts in history and ethics in order to see how to take the questions further. I suggest Diane Paul's "Controlling Human Heredity" and "The Politics of Heredity" (both cheap paperback books) and an essay by Erik Parens "The Goodness of Fragility" widely reprinted in bioethics texts (there are many other bioethics resources, such as bioethics.net and http://bioethics.georgetown.edu/publications/scopenotes/

What can be considered ethical will, of course, depend on what conception of ethics (and also, perhaps, what metaphysical assumptions) one brings to bear on the question. So, for example, if one believes in the absolute sanctity of (human) life, then the fact that the loved one continues to be (biologically) human and alive will provide the answer. On the other hand, if you think that what makes something human (in the ethical sense) is the ability to make decisions (I think it can be argued that Aristotle, for example, believed this), then it would seem that it is ethically open to end the biological life of the loved one, since their human life had already ended, in your scenario. However, it would also follow from the Aristotelian view that there is nothing wrong with terminating the life of a fetus (or even infant!) until the time it is able to engage in decision-making.

In other words, a proper answer to your question must flow from having, first, an adequate conception of what sort of being we are dealing with here. The fact that something is biologically human and alive does not seem to be enough to make a confident ethical judgment--we wouldn't, for example, afford a "right to life" for living tissue samples, for example. Once we get a grip on that question, then we also need to make some basic ddecisions about how things of that kind are to be recognized within our ethical theories.

Speaking just for myself, I am inclined to be very suspicious of "all or nothing" answers to these sorts of questions, as if there is some clear conceptual breaking point between what deserves to be afforded a right to life and what does not. But certainly ethical theories that recognize a central role for "rights" not only exist, they continue to flourish within the philosophical community.

In the ethical approach I favor (virtue theory), questions about when and what circumstances merit which sorts of actions are understood, instead, in terms of desirable characteristics of agents. In this way of looking at things, your sort of question would turn into something like this: What would an excellent human being decide to do about a loved one in such a circumstance? I expect that the questioner might find this version of the question not much help, because it is difficult to try to get a grip on all that an excellent human being might bring to bear on such a decision. So, virtue theorists, I think, have to concede that there may be no such thing as fixed and fully general answers to such questions--nothing that might be regarded as an "algorithm" or decision principle for making ethical judgments of the sort you seek here. That may be simply a failing of virtues theories, and some critics have held it to be such. But some of us, anyway, think that it is actually a virtue of virtue theory--it recognizes the necessity of the exercise of human judgment, because the morally relevant circumstances of any given situation may be such as to merit different answers in different cases.

In other words, your question seems to want to force a "yes" or "no" answer, and I am suggesting that either answer is likely to be artificial and forced. Does the loved one have medical insurance that will indemnify his or her heirs against the likely heavy medical costs of continuing his or her life? Are there other loved one's whose opinions and feelings about this very question matter, and if so, how do they feel about it? Would the limited resources that are going to be used in maintaining the life of this person be such as to be better assigned to something (or someone) else? Did this person leave a living will, or some other document that proposed an answer to this very question, if such a situation arose? And so on... I suspect that if we tell the rest of the story in such a way as to capture all of the morally relevant details, we might find we are prepared to offer different answers to different cases, precisely because of the effects (potentially incommensurable, but still significant to the agent practicing judgment) of these morally relevant details.

In brief, then, I think you should be wary of the very idea that questions like this one can be given clear, definitive, and ethically defensible answers! Not so fast!

The Hippocratic Oath says a number of things, not all of which doctors swear to today (for example, the Hippocratic Oath forbids any kind of surgery). Perhaps you are thinking of the most well-known part of the Hippocratic Oath, that forbids harm. This is regularly interpreted as forbidding "unnecessary harm," e.g. vaccinations hurt, but they are a necessary harm to prevent a greater harm. Cosmetic surgery involves harm to the patient--the pain of surgery and the risks of surgery--so the question is, does it prevent a greater harm? The right people to ask about this is the people who undergo cosmetic surgery--both the ones with successful and the ones with unsuccessful results. They should be fully informed so as to balance the potential harms and benefits for themselves.

We tend to regard the will as something that is marked off from the rest of the person, because, somehow, it is a direct manifestation of the person's being. So an ADHD drug could not be described as "strengthening people's will", because it if were described in this way it could not then be said to be be their own will that was being strengthened; they would be having it down for them.

Similarly, one might think, you can do my work for me, but not my thinking, because then it would not be my thinking that was being done. (Still, in that sense you would not be doing my work - my working - and it is just as impossible for you to do my work as it is for you to think my thoughts or even perhaps to wear my boots, taken to be the ones I am wearing ("Look, his boots (borrowed boots) have mud on them")).

One might on the other hand regard the will as the energy or strength to carry something through. Or one might regard it as determination, though here too the paradox shows through. If my determination is bolstered by a drug, is it really determination? But one can surely lack psychic energy or strength for just the sort of reason (anaemia, say) that one lacks physical energy. In such a case, one could well speak of "strengthening a person's will" or ability to carry through.

It seems to me possible by the way that one could learn from a drug, as Peter Kramer seems to imply can happen with Prozac, in his 1993 book Listening to Prozac. So the possibility seems to exist that the drug can actually teach someone who lacks it what strength of will is, and perhaps then they could do more easily "on their own" later.

Your problem is very interesting and difficult.

I agree with Professor Smith. The only thing I would add may be obvious and may be something you've already tried. It sometimes helps to have third parties intervene to provide all the facts and arguments you would use to try to persuade your wife to change her mind. Here, your knowledge of who might influence her is useful. Would she trust your family's pediatrician or react harshly against him/her as a member of the 'vaccine conspiracy'? Her parents or yours? Mutual friends? While an 'intervention' would be extreme, making friends and family aware of a serious issue that affects the health of your children (and others) and enlisting their help might make it easier for your wife to back down without feeling pressured to do so solely by you. But should these methods fail, then Prof. Smith's suggestion seems appropriate.

Oh boy, I really feel for you. I also have a son with autism spectrum, and as we both know, it is difficult enough dealing with that, even without the additional problem of an unreasonable spouse.

My advice is that you do a little homework and find some support in your area (and not among the nutbags who have bought into the antivaccinationist nonsense, because it has been medically proven that nonsense is absolutely what it is). Because your wife needs help, to put it rather bluntly. She is feeling victimized by something that is just terrible luck and that has nothing whatsoever to do with where she is pointing the finger of blame here.

But the other thing is that you really, really have a serious ethical problem here, which your questions shows you are aware of. Because your wife's adamant views now affet your otheer children, which puts not only them at risk--it also puts at risk any other children who might be exposed to your own children's (preventable) diseases. This could get really nasty, and could result in death and disability that is entirely preventable. if you think with compassions about the other children and those who love them, I think you will see that going along with your wife's mandate is simply not an ethical option for you.

I don't know if you feel that you two have talked this out, so that your powers of persuasion are exhausted. (Maybe you could present her with some of the medical evidence I mentioned--it's all over the internet, so find it!) But if you are at that point, then, as tough as this may sound, I think you are actually ethically obligated to take your children in for their vaccinations. And once you have done this (but not before, lest she try to do something to prevent you), then you must tell her that you have done it, and face the music of what this does to your relationship.

I realize that my advice may lead you into a world of difficulty with her. But I frankly see no other ethical option. You do not have the right to put minor children (yours or those of other parents) at risk for such grave diseases, which are preventable.

I think it is time for some "tough love," unless you still think you might be able to convince your wife to be more flexible heere!

Certainly. The fact that women have children does not mean that they are obliged to be the main carers for those children once they are born, nor does it mean that while pregnant they are in any way incapacitated. If childcare were to be shared equally, or adequately organized by the state or community, the fact that women have children would be no hindrance to any of their other putative activities.

Thanks for this thoughtful question, and I'm sorry for what you're all going through!

However I'm not convinced this is, in the end, a 'philosophical' matter -- it sounds more like one that's for the professional psychologists and therapists .... and I wonder if it might be useful even for YOU to consult with one, to get some useful advice about how to deal with this complicated situation! (There are some philosophers with some psychology expertise, but I don't know if any of the panelists on this site are those!)

best of luck!
ap