The individual with Female Sexual Arousal Disorder may have little or no subjective sense of sexual arousal. The disorder may result in painful intercourse, sexual avoidance, and the disturbance of marital or sexual relationships.
Dr. A has identified a syndrome (a cluster of symptoms) common to a subgroup of his FSAD patients with a particularly severe version of FSAD - Criteria A, B, C, and D. Members of this subgroup, he believes, are unable to achieve sexual arousal except in cases of forced sexual contact. A highly statistically significant number of patients who meet Criteria A, B, C, and D who have been raped report the rape as their only enjoyable sexual experience, compared to rape victims who do not meet the criteria. Dr. A labels his syndrome Forced Sexual Contact Arousal Syndrome (FSCAS). Based on his research, Dr. A has statistical grounds to believe that, of FSAD patients who meet Criteria A, B, C, and D, 99.9% will experience sexual enjoyment exclusively from forced sexual contact. Beyond that, Dr. A notices that his FSCAS patients who have been raped are much more socially and emotionally well-adjusted than those who have not. It is statistically reasonable for him to believe that, out of 1000 patients with FSCAS who have not been raped, 999 will experience a great deal of sexual enjoyment and a much better quality of life if raped; one will experience the usual extreme distress that rape would cause a normal woman.
You can probably guess where I'm going with this. Should Dr. A rape his FSCAS patients?
I think it's hard to answer anything but CHRIST, NO! to this one. The harm of rape is so intrusive and severe that any possible benefits to its victims simply do not count against the harm that may be sustained. It is not conscionable that one person should be raped to provide a pure benefit to even 999 others. (Note, however, that it may be moral to allow the rape of one person in order to prevent extreme harm to an enormous number of others.) Both those who identify as consequentialists and those who subscribe to a more deontological perspective would likely share this conclusion (though some more extreme consequentialists would not).
I have highlighted the common intuition that, in the case of a serious violation or harm, the possible benefits do not count against the possible harms (in an essay about dosing someone with ecstasy against his will - see Inflicting Harm and Inflicting Pleasure on Strangers). My correspondent Arthur Tilley points out that there is a limit to this intuition, however. While the intuition about the ecstasy case is strong, he says, "we probably can't say that doing nothing is ALWAYS better than taking a (teeny tiny) chance at doing harm." His example:
Consider my setting up a cookie stand by the side of the road and offering free cookies to passersby. It is probably reasonable to
assume that a percentage of the population (one not nearly as high as the percentage that doesn't like being dosed, but still nonzero) has some sort of phobia of cookies or aversion to being offered free things.
But it seems that in these cases where the probability of harm is really low, the action (in this case, having the cookie stand) is morally permissible.
Arthur's insightful example illustrates that, though the intuition that inflicting serious harm to strangers cannot be offset by providing them pleasure, taking a chance on inflicting minor harm to strangers can definitely be balanced by the probability that one will do them good. How could we live otherwise, since all actions or inactions entail some possible unconsented harm? The morally restricted action is one that will produce serious or especially intrusive harm.
One antinatalist argument, propounded by Seana Shiffrin, is based on just this intuition: that, while it is fine to inflict harm on a stranger in order to prevent greater harm (e.g., to break his arm in order to rescue him from a burning car), it is not permissible to inflict harm on a stranger in order to provide a pure benefit.
A major, though often unspoken, point of contention between pronatalists and antinatalists is what counts as harm. Pronatalists often only admit that harm has occurred through procreation if, on balance, the person brought into existence finds his life not worth living. Since most people report finding their lives worthwhile, to a pronatalist, the risk of "harm" in bringing a being into existence is slight.
Antinatalists, on the other hand, recognize as harm all suffering inflicted on a being who is brought into existence - pain, hunger, unrequited love, violence, sickness, aging, and ultimately death. Most lives include positive aspects such as pleasure, love, and a sense of meaning - but the persons experiencing these benefits also experience extreme harm - at the very least, the harm of death.
Dr. A may not chance inflicting the harm of rape on a patient in order to likely provide her with pleasure and increased quality of life. It follows that, since the harm of life (separate from its pleasure and meaning) is so serious and so great, it may not be inflicted on a person in order to provide him with a pure benefit (that is, the pleasure and meaning of life). The harm of life is not slight or unlikely. It is extremely great. The pleasures and benefits are also likely and extremely great; what I wish to illustrate is that, in similar cases, that simply does not matter.