Rethinking Life and Death: The Collapse of Our Traditional Ethics

Singer argues that the traditional 'sanctity of human life' ethic is no longer coherently held or consistently applied in modern medicine. The book rejects the assumption that all human biological life has equal and absolute value regardless of its quality or the capacity for suffering. Singer's alternative is a quality of life ethic: the ethical treatment of beings depends on their sentience, their capacity for suffering and enjoyment, and their preferences, not on species membership alone. He proposes a series of 'new commandments,' including that if you must take human life you must take responsibility for the consequences, that all human life is not of equal worth, and that a person's desire to live or die should be respected [citation:7]. The argument is continuous with his utilitarian method but applied specifically to medical and end-of-life dilemmas.

Singer argues that the sanctity of life ethic has already been abandoned in practice, even while it is still proclaimed in public rhetoric. He points to the acceptance of brain death as a legal definition of death—a definition that is not a purely medical judgment but an ethical choice shaped by the need for organs and the futility of keeping bodies alive [citation:3]. He notes the inconsistency of permitting the withdrawal of treatment with the intention of ending life while forbidding active euthanasia, and the tolerance of abortion alongside the prohibition of infanticide in cases of severe disability. The book uses case studies, including the case of Tony Bland and the Dutch experiment with voluntary euthanasia, to show that the old ethic no longer describes what doctors, courts, and families actually do.

A review essay in the Stanford Law Review argued that Singer creates a straw man. The reviewer contended that Singer's account of the dominant ethic of death and dying is inaccurate: rather than portraying the existing order, he constructs a simplified 'sanctity of life' position that no sophisticated defender actually holds, and then demolishes it [citation:2]. The reviewer also argued that Singer defends his own 'new ethic' only superficially, and that the book's critique of existing medical practice, while identifying genuine anomalies, does not establish the need for the radical reconstruction Singer proposes. The Washington Post Book World was harsher, describing the book as 'a road map for driving down the darkest of moral blind alleys' [citation:7].

Rethinking Life and Death extends the applied ethics project of Practical Ethics (1979) into the specific domain of bioethics and end-of-life decision-making. Practical Ethics provided the systematic utilitarian framework and treated abortion, euthanasia, and the value of human life as separate topics among others. Rethinking Life and Death focuses exclusively on those topics, developing them in greater depth and integrating them into a single narrative about the historical collapse of the sanctity of life ethic. The later book is also more rhetorical and case-driven, using vivid clinical examples to unsettle the reader's confidence in traditional moral categories. It applies the method of Practical Ethics rather than revising it.

Singer proposes a quality of life ethic grounded in the interests of sentient beings. The key distinction is between being biologically human and being a 'person' in the morally relevant sense: a being with self-awareness, preferences about its own future, and the capacity to experience suffering. On this view, a brain-dead patient or an anencephalic infant may not be a person, while many non-human animals are. Singer's 'new commandments' include the principle that all human life is not of equal worth and that ethical treatment should be determined by the situation at hand rather than by species membership [citation:7]. He also defends voluntary euthanasia as a recognition of a person's right to determine the end of their own life, and argues that the Dutch system offers a model that has not led to the abuses predicted by critics.

Rethinking Life and Death sits between philosophy and advocacy. It is published as a trade book by Text Publishing and St. Martin's Press rather than an academic press, and its style is more accessible and journalistic than Practical Ethics. The book uses case studies and clinical narratives to build its case, and it advances a specific policy agenda: the replacement of the sanctity of life ethic with a quality of life approach. This hybrid genre shaped its reception. The New England Journal of Medicine praised Singer's popular reach, calling him the most widely read professional philosopher since Bertrand Russell [citation:7], while critics in law reviews treated the book as a philosophical argument and found its scholarly apparatus insufficient. The book's influence has been primarily in public debate and bioethics pedagogy rather than in technical philosophical literature.