A Philosopher's Blog

Opioids, Heart Surgery & Ethics

Posted in Ethics, Medicine/Health, Philosophy by Michael LaBossiere on March 24, 2017

While pharmaceutical companies and their stockholders have profited greatly from flooding America with opioids, this has come at a terrible cost to others. Showing that the idea of gateway drugs can prove true, there has proven to be a clear path from legal opioids to illegal opioids (such as heroin). As would be expected, the use of opioids can have a terrible impact on health. One example of this is endocarditis.

Endocarditis is, roughly speaking, an abscess on a heart valve. While not limited to drug users, it is not an uncommon consequence of injecting opioids. Since the abuse of opioids is increasing, it is no surprise that the number of drug users suffering from endocarditis has increased significantly.  As would be imagined, the treatment of endocarditis involves a very expensive surgery. As would also be imagined, many of the drug users getting this surgery are on Medicaid, so the taxpayers are footing the bill for this expensive treatment. To make matters worse, people typically return to using opioids after the surgery and this often results in the need for yet another expensive surgery, paid for by Medicaid. This does raise some serious moral concerns.

There is, of course, the very broad moral issue of whether Medicaid should exist. On the one hand, a compelling moral argument can be made that just as a nation provides military and police protection to citizens who cannot afford their own security forces or bodyguards, a nation should fund medical care for those who cannot afford it on their own. On the other hand, a moral argument can be made that a nation has no obligation to provide such support and that citizens should be left to fend for themselves in regards to health care. Naturally enough, if the nation is under no obligation to provide Medicaid in general, then it is under no obligation to cover the cost of the surgery in question. On this view, there is no need to consider the matter further.

However, it does seem worth granting for the sake of argument that the state should provide Medicaid and then consider the ethics of paying for endocarditis surgery for opioid addicts. Especially when they are likely to continue the behavior that resulted in the need for surgery. It is to this discussion that I now turn.

While it certainly appears harsh to argue against paying for addict’s heart surgery, a solid moral case can be made in favor of this position. The easiest and most obvious way to do this is on utilitarian grounds.

As noted above, the surgery for endocarditis is very expensive. As such, it uses financial and medical resources that could be used elsewhere. It seems likely that a great deal of good could be done with those resources that exceed the good created by replacing the heart valve of an addict. This argument can be strengthened by including the fact that addicts often return to the very behavior that resulted in endocarditis, thus creating the need for repeating the costly surgery. From a utilitarian perspective, it would be morally better to use those resources to treat patients who are far less likely to willfully engage in behavior that will require them to be treated yet again. This is because the resources that would be consumed treating and retreating a person who keeps inflicting harm on themselves could be used to treat many people, thus doing greater good for the greater number. Though harsh and seemingly merciless, this approach seems justifiable on grounds similar to the moral justification for triage.

Another approach, which is even harsher, is to focus on the fact that the addicts inflicting endocarditis on themselves and often doing so repeatedly. This provides the basis for two arguments against public funding of their treatment.

One argument can be built around the idea that there is not a moral obligation to help people when their harm is self-inflicted. To use an analogy, if a person insists on setting fire to their house and it burns down, no one has a moral responsibility to pay to have their house rebuilt. Since the addict’s woes are self-inflicted, there is no moral obligation on the part of others to pay for their surgery and forcing people to do so (by using public money) would be like forcing others to pay to rebuild the burned house.

One way to counter this is to point out that a significant percentage (probably most) health issues are self-inflicted by a lack of positive behavior (such as exercise and a good diet) and an abundance of negative behavior (such as smoking, drinking, or having unprotected sex). As such, if this principle is applied to addicts in regards to Medicaid, it must be applied to all cases of self-inflicted harms. While some might take this as a refutation of this view, others might accept this as quite reasonable.

Another argument can be built around the notion that while there could be an obligation to help people, this obligation has clear limits. In this case, if a person is treated and then knowingly returns to the same behavior that inflicted the harm, then there is no obligation to keep treating the person. In the case of the drug addict, it could be accepted that the first surgery should be covered and that they should be educated on what will happen if they persist in their harmful behavior. If they then persist in that behavior and need the surgery again, then public money should not be used. To use an analogy, if a child swings their ice cream cone around playing like it is a light sabre and is surprised when the scoops are flung to the ground, then it would reasonable for the parents to buy the child another cone. If the child then swings the new cone around again and the scoops hit the floor, then the child can be justly denied another cone.

An obvious counter is to contend that addicts are addicted and hence cannot be blamed for returning to the same behavior that caused the harm. That is, they are not morally responsible for what they are doing to themselves because they cannot do otherwise. This does have some appeal, but would seem to enable the justification of requiring addicts to undergo treatment for their addiction and to agree to monitoring of their behavior. They should be free to refuse this (which, ironically, assumes they are capable of free choice), but this should result in their being denied a second surgery if their behavior results in the same harm. Holding people accountable does seem to be cruel, but the alternative is unfair to other citizens. It would be like requiring them to keep rebuilding houses for a person who persists in setting fires in their house and refuses to have sprinklers installed.

These arguments can be countered by arguing that there is an obligation to provide such care regardless of how many times an addict returns to the behavior that caused the need for the surgery. One approach would be to build an analogy based on how the state repeatedly bails out big businesses every time they burn down the economy. Another approach would be to appeal to the value of human life and contend that it must be preserved regardless of the cost and regardless of the reason why there is a need for the medical care. This approach could be noble or, perhaps, foolish.

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Medicine & Markets

Posted in Ethics, Medicine/Health, Philosophy, Politics by Michael LaBossiere on March 22, 2017

As a point of ideology, many conservatives advocate the broad application of free market principles. One key part of this ideology is the opposition of regulation, at least regulation that does not favor businesses. Since health care is regarded as a business in the United States, there is an interesting question in regards to the extent that health care pricing should be regulated by the state.

Because of the high cost of health care in the United States, there have been proposals to place limits on the cost of health care services. Some areas have implemented such proposals, but there is a general lack of such regulations on pricing. Those who oppose such regulations often contend that pricing should be set by free competition between health care providers and that consumers of health care should be savvy shoppers. The idea is that savvy health care shoppers will take their business to providers that offer better services or lower costs, which will force the competition to lower costs or improve quality.

There are various problems with the idea of savvy health care shoppers. The first is the challenge consumers face in finding the prices that health care providers charge. While it can be difficult to predict what services a consumer might need, health care providers often have a range of prices depending on who is paying for the services. For example, insurance companies negotiate prices with providers and these differ from what consumers without insurance would pay. Health care providers, although they always have a database of billing codes and costs, are generally reluctant to provide this information. This makes savvy shopping difficult.

A second problem is that health care consumers typically lack the medical knowledge to make informed decisions about health care. While a person might have some challenge in sorting out what sort of phone or laptop they should buy, sorting out what sort of medical care they might really need is typically beyond the skill of most people. That is why people go to medical professionals. As such, being a savvy shopper is rather difficult.

A third problem is that it is something of a mistake to describe a health care consumer as a consumer; it is usually more apt to call them a patient. While this might seem to be a mere difference in labels, the difference between consumer and patient is significant.

A rather important difference is that a patient is typically in duress—they are injured or ill and thus not in a very good state to engage in savvy shopping practices. While an informed rational consumer will be looking for the best deal, a suffering patient is concerned primarily with getting better. As people say to not go grocery shopping on an empty stomach, it would be best to not shop for health care when one is not healthy—but that is exactly when one needs health care. There are also the more extreme cases. For example, a person who is badly injured in a car crash is not going to be shopping in a savvy manner for emergency rooms as they are being transported in the ambulance.

It can be countered that there are cases in which a person can engage in savvy shopping, such as elective surgeries and non-emergencies. This is a reasonable point—a person who is not in dire need can take the time to shop around and be a savvy consumer. However, this does not apply to cases in which a person is sick or injured enough to impeded such savvy shopping.

Another important difference between consumer and patient is that the consumer often has a reasonable choice between buying a good or service and doing without. In contrast, patients usually have a real need for the good or service and doing without would be a real hardship or even fatal. When one must buy the good or service and the provider knows this, it makes it much harder to be a savvy shopper. This also provides a segue into the matter of regulating prices.

While free market pricing can work when consumers can easily do without the good or service, it runs into obvious problems for the consumer when the goods or services are necessities. To the degree that the patient cannot do without the health care goods or services, the patient is at the mercy of the provider. So, while a person can easily elect to do without the latest iPhone if they cannot afford it, it is much more difficult for a person to do without their chemotherapy or AIDS medication. True, a consumer could do without liposuction or breast implants, but such elective surgery differs from non-elective treatments.

The stock counter to such concerns is that if a consumer finds the price of a good or service too high, they can go to a lower priced competitor. Assuming, of course, that there is real competition. In the case of health care, the opportunity to find a lower priced competitor can be problematic. A patient might not have the time to shop around on the way to an emergency room. In many places, there is not any local competition with lower prices. As such, this free market advice is not very helpful.

In the case of pharmaceuticals, patients often find that there is no competition. When a company has a patent on a medication, the United States’ government uses its coercive power to enforce that patent, ensuring that the company retains a monopoly on that medication. Because of this, a patient who needs the medication has two basic choices: do without or pay the price. There is no free market competition, so without regulation on the part of the state, the company can decide to charge whatever is desired—subject to the cost of bad press, of course.

This monopoly system does create something of a quandary for a principled proponent of the free market. On the one hand, without such patents a free market of drugs would make it irrational for for-profit companies to invest in costly research. This is because as soon as the drug was developed, the competition would just duplicate it and can sell it cheaper because they would not need to recoup the cost of development. A solution, which would not be very free market, would be to have the state fund the expensive research and then provide the results to companies who would then compete without monopolies for consumer dollars. Another “solution” would be to let the market remain free and hope that medications would somehow be developed.

On the other hand, if the state stepped in to regulate prices as part of the agreement for using its coercive power to protect the monopoly, then there would also be no free market competition. But, the state could see to it that the companies charged prices that allowed profits while not gouging patients.

My own view, as might be suspected, is that since patients are essentially a coerced market when it comes to health care and medication, the state should act to regulate prices. In the case of pharmaceutical companies, this should be part of the bargain with the state that allows them to maintain their monopolies. After all, if taxpayer dollars are to be used to protect monopolies, then they should get something in return—and this something should be reasonably priced medication. In the case of health care providers, while they do not usually have a monopoly, they do have a coerced market. Just as the state justly steps in to prevent price gouging during large scale natural disasters, it can justly do so in regards to personal disasters—that is, injury and illness.

I am certainly sensitive of the desire of health care providers and pharmaceutical companies to make a profit and, as such, I would certainly advocate that the regulations on pricing leave them a reasonable margin of profit. While it might be objected that a reasonable margin of profit it hard to define, my reply is that if price gouging can be recognized in other areas, it can (and is) be recognized in the realm of medicine.

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Trump Supporters as Moral Heroes

Posted in Ethics, Philosophy, Politics, Uncategorized by Michael LaBossiere on March 20, 2017


While Trump claimed that he would help the forgotten people of America, his rural and small town supporters will most likely be harmed by the implementation of his agenda. Trump also ran hard on repealing Obamacare and engaging in what some would characterize as trade wars. If the administration makes good on these promises, many of his supporters will be harmed. Some have gone as far as asserting that Trump’s presidency will prove to be a disaster for the white working class.

Since these are factual claims, they can be countered by evidence to the contrary and it is worth considering that the predictions of woe might prove to be in error. That is, the Trump administration will lead the working class and forgotten people to a new age of prosperity, health and wellbeing. While not logically impossible, this does seem unlikely. As such, the most reasonable bet is that the Trump administration will prove to be good for Trump and his fellow economic elites but not so good for everyone else.

After Trump won, a cottage industry of writing articles explaining why people supported him when doing so seemed contrary to their interests. It is, of course, tempting to liberal intellectuals to explain this support in terms of such things as racism. It is also tempting to think that people were willfully ignorant of Trump’s long history of misdeeds (such as how students were exploited by Trump University), that many of his supporters were pathologically delusional in believing that he would truly act in their interests or that they were simply stupid. I will, however, advance a different account, that the Trump supporters who will be hurt by Trump and the other Republicans are moral heroes.

While there are many ways to be a moral hero, one standard way is for a person to willingly suffer harm for the sake of the good of others. The stock philosophy 101 example is, of course, the soldier who throws themselves upon a grenade to save their fellows. This is often presented in utilitarian terms: the willing suffering of the few is outweighed by the good this generates for the many. If the Trump supporters knew they would be hurt by his policies, but believed that their suffering would make America great again, then they could be regarded as moral heroes for their sacrifice. If, however, they thought they would benefit from Trump’s policies and got it wrong, then they would not be moral heroes, but merely have been acting from self-interest.

While a noble sacrifice for the good of the many would be heroic, it does not seem that Trump’s policies will be good for the many Americans. Rather, it seems that Trump and his fellow Republicans will be crafting policies that benefit the rich at the expense of the many. For example, his tax plan will be amazing for the rich but harmful to those who are not well off. As such, without an assumption of ignorance, those who supported Trump and will be harmed by his policies cannot be considered moral heroes. At least in the context of utilitarianism. However, there are other moral theories and one of these might make them moral heroes.

Trump, like most people, does not seem to operate based on a considered moral theory. This is no more surprising than the fact that most people do not operate based on considering theories in physics, biology, medicine or engineering. However, these theories still apply to what people do and it is reasonable to consider what sort of moral theory Trump and his fellows would fit into.

The way Trump has treated contractors, students at Trump University, women and others indicates that Trump operates from selfishness. This would suggest that the most likely moral theory to apply to Trump would be ethical egoism. This is the view that a person should act to maximize value for themselves. Alternatively, that each person should act entirely in their own interest. This is in contrast with altruistic ethics, which include the view that each person should not always act solely in their own self-interest, but should consider others.

Ethical egoism seems to fit many Republicans and hence it is no surprise that the frat-bro Republican philosopher Paul Ryan has embraced the ethical egoism of Ayn Rand. To be fair, after John Oliver critiqued Rand, Ryan did assert that he does not embrace her objectivism. However, consideration of Rand’s policies show that they are consistent with the ethics of Rand as expressed in her view that selfishness is a virtue.

While Trump would seem to fit within ethical egoism, this moral theory would make the Trump supporters who will be hurt by Trump chumps and not heroes. After all, a moral hero in ethical egoism would be a person who acts to maximize their self-interest. This will typically be at the expense of others. A moral hero of an ethical egoist would not back Trump if they believed that doing so would be contrary to their interests and would not maximize value for them. However, there is still a chance for moral heroism.

While Trump certainly has the selfishness part of ethical egoism down, classical ethical egoism enjoins everyone to maximize their self-interest. In the ideal laid out by Adam Smith, this would result in competition that is supposed to benefit everyone by the magic of the invisible hand of the market.

It is true that Trump, Ryan and their ilk are presenting polices that do not just benefit themselves. Many of these polices do benefit others, but it is a select group of others, namely the economic elites. While this could be explained in terms of ethical egoism, that Trump and Ryan are doing the right thing because benefiting these elites benefits them (Ryan, for example, enjoys the financial backing of these elites and this enables him to get re-elected) there is also an alternative. This could be called “ethical oligarchism.” This is the moral view that people should act to maximize value (or in the interest of) the oligarchs. This can, of course, be a nationalistic ethics—that people of a country should act in the interest of their oligarchs. It could also be a general view that transcends borders—that everyone should act in according with the interests of the oligarchs of the world.

On this view, the Trump supporters who will harmed by Trump’s policies are moral heroes—they have sacrificed their own good for the good of the oligarchs.

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Scantily Clad Heroes

Posted in Philosophy by Michael LaBossiere on March 17, 2017

Wonder Woman 2017cFeminists have long been critical of how female superheroes are presented in comics. In terms of appearance, they have expressed concerns about the body types of female heroes, the way they are posed, and the skimpy costumes most wear. One interesting visual response is the Hawkeye Initiative in which Hawkeye (or another male superhero) is drawn in the same pose and costume type as a female superhero. As would be imagined, the male hero looks absurd when so posed and costumed, which is exactly the point.

While the presentation of female superheroes in comics is certainly a first world problem, it does raise some important concerns. These concerns normally focus on such matters as the impact on body image, but my interest here is with considering the superhero costume from a practical standpoint. That is, what such costumes should be like when considered from a realistic perspective. While I am no expert on fashion, I will draw on my experiences as an athlete, martial artist and gamer to guide the discussion.

In the realm of fiction, being a superhero generally means being very physically active (running, swimming or flying after villains) and engaging in combat. This means that a sensible superhero would have a costume designed to take these into account.

While I am not a superhero, decades of competitive running have given me considerable insight into what sort of clothes are best to wear. One important factor is mobility—you need to be able to move properly in athletic clothing. One approach is looser fitting clothing that allows a lot of motion (such as running shorts) while another is the tight-fitting spandex (such as running tights) that also allow free motion. As such, the idea of heroes wearing tights makes sense—for the same reason that it makes sense for runners to wear them. Another important factor is temperature management. If a hero is like a normal human, they will generate body heat and sweat when they are active. As such, they will need to be able to stay cool while active but also remain warm when they are just patrolling or engaging in dramatic dialogue.

As a runner, I wear as little as possible when I am running in warm weather (for me, “warm” is anything over 55 degrees). This typically means just shorts, socks and shoes.  Many other runners are the same, with women generally adding at least the legally necessary coverage. Presumably a superhero that runs about would also want to wear as little as possible. As such, in warm weather superheroes dressed in super versions of running clothes would make sense—skin tight clothing with lots of skin exposed.  This, of course, assumes that the super heroes have the human need to stay cool when being active. A superhero that had no need to sweat could wear whatever they wished—the concerns of mere sweaty mortals would matter not to them.

Considering this, it would make sense for female superheroes to wear the same amount of clothing as competitive runners—that is, not much. However, the same would also apply to male superheroes.

While wearing minimal clothing is a good idea when active under warm conditions, like runners facing cooler weather, superheroes would need to cover up more to remain comfortable and perhaps avoid hypothermia. Practical and sensible superheroes should also consider following a standard practice of runners: wearing more clothing to warm up or when waiting to compete, then shedding clothing when it is time to get down to business. Since hanging out all day in sweat-soaked clothes is uncomfortable, sensible heroes would also change costumes when they can. And shower.

Unlike runners, superheroes spend much of their time in combat and this would impose another set of practical considerations in regards to clothing. Since superheroes tend to fight hand to hand, it would be unwise to have costumes that provide a foe with easy handholds. As such, tight costumes without extraneous material would be the best choice. Capes would, as always, be a poor choice.

When engaging in combat, it has always been a good idea to have protective gear. Some of this protection is intended to deal with the incidentals of combat, such as ending up in contact with rough surfaces (like being knocked down in the street) but most of it is supposed to provide protection against attacks. This protection usually takes the form of armor, ranging from ballistic clothing to powered armor (like Iron Man wears).

Armor does have the usual trade-offs: it tends to restrict movement, tire out the wearer quicker, and create overheating problems. As such, heroes that rely on speed and freedom of movement might be inclined to avoid armor or at least keep it to a minimum. The classic Batman, for example, did not wear any armor. However, as anyone who plays games like D&D knows or faces combat in the real world, armor is generally a good idea for those who are going to end up in combat. Otherwise all those knifes, bullets and ray blasts will be hitting your skin.

To be effective armor must at least cover the important parts (usually the head and torso) and that means that exposing a lot of skin (especially cleavage or the abdomen) is a bad idea when you are counting on your armor. As such, the typical fantasy drawings of heroines in armor are absurd. Or, as a veteran D&D player put it, “if the enemy can see your cleavage, they can cut your boobs.” And no one wants their boobs cut.

Superheroes who have powers that make them invulnerable or otherwise grant great defensive powers do not need to rely on armor and they can safely wear whatever they like; such as Power Girl’s famous cleavage window costume. While the classic Wonder Woman relied on her magical bracelets, the updated version seems to be close to Superman in her ability to withstand damage—as such, she would not need to rely on armor for protection. Superman, of course, does not need armor—his skin is almost certainly stronger than anything he could wear. As such, a superhero who still had to deal with the sweating problem but did not need armor would want to wear as little as possible, be they male or female. Perhaps this explains why Wonder Woman still dresses the way she does.

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Stealing Jobs

Posted in Ethics, Philosophy, Politics by Michael LaBossiere on March 15, 2017

One stock talking point is that illegal immigrants are stealing jobs from Americans. This point is then used as part of the justification for “building the wall” and escalating the enforcement of immigration laws. As with any talking point, it is reasonable to ask whether it is true.

One approach to this question is to consider what it would mean for immigrants to steal jobs. To facilitate the discussion, I’ll offer an analogy to another type of alleged theft, that of stealing someone’s girlfriend (or boyfriend).

While I will change the names to protect the innocent and not innocent, when I was in school Dick was dating Jane.  Jane was at my school and Dick was attending a school in a different state. Jane started spending a lot of time with John, and eventually John was dating Jane. An angry Dick showed up to confront John about “stealing his woman.” Jane’s response that she was not stolen because she was not anyone’s property—she chose who she wanted to be with. In this case, it was John. For those who are wondering, I am not John. And definitely not Jane, but thanks for asking. While there were certainly some moral concerns about how Jane and John had done things, Jane was right: she was not anyone’s property and could not be stolen. So, Dick’s charge of theft did not apply. If John had kidnapped Jane, then that would have been another matter entirely—but still not theft.

Turning back to jobs, a job is also not something that can be stolen. Yes, I can imagine scenarios where someone steals a person’s identity and thus steals their job, but I am focusing on the normal course of employment. Like affection, a job is something that is provided by someone else and hence is not something that can (typically) be stolen. So, when an illegal immigrant is hired by an American employer, the immigrant is not stealing the job. The American employer is choosing to hire the illegal immigrant rather than hiring an American (or a legal immigrant). Going back to the girlfriend analogy, the American worker would be like Dick—he thinks the job is rightfully his. But, the employer is like Jane—she is the one deciding who gets her affection (in the case of the employer, the job). So, the American did not have their job stolen; the American employer decided to give it to someone else. The job, after all, belongs to the employer.

This argument could be countered by going back to the girlfriend analogy. Suppose that Dick and Jane are engaged and are committed, but smooth John is willing to do so much more for Jane and ask far less in return, so he is much more appealing. It could be claimed that John is not playing fair—he should respect the special relationship between Dick and Jane and not outcompete poor Dick.

The easy and obvious reply that it would be morally problematic for John to intentionally move in on Jane when she is in a committed relationship.  However, it is still Jane’s choice whether to stay with Dick or move on to John. As such, most the responsibility would rest on Jane. It is fair to note that John did outcompete Dick, but Dick could have stepped up to compete if he really wanted Jane to stick with him.

In the case of the job, it is clearly morally problematic for illegal immigrants to seek jobs in America. However, most the responsibility lies with the employers. While illegals tempt them by being willing to work for less, it is up to them to stick to their commitment to the law or to break it. As such, it is not illegal immigrants that are stealing jobs. Rather, employers are choosing to hire illegal immigrants and if any wrong is being done, the majority of it lies on the employers.

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The State & Health Care

Posted in Ethics, Law, Medicine/Health, Philosophy, Politics by Michael LaBossiere on March 13, 2017

One way to argue that the state is obligated to provide health care (in some manner) to its citizens is to draw an analogy to the obligation of the state to defend its citizens from “enemies foreign and domestic.” While thinkers disagree about the obligations of the state, almost everyone except the anarchists hold that the state is required to provide military defense against foreign threats and police against domestic threats. This seems to be at least reasonable, though it can be debated. So, just as the United States is obligated to defend its citizens from the Taliban, it is also obligated to defend them against tuberculous.

Another approach is to forgo the analogy and argue that the basis of the obligation to provide military defense and police services also extends to providing health care. The general principle at hand is that the state is obligated to protect its citizens. Since anthrax and heart failure can kill a person just as dead as a bullet or a bomb, then the state would seem to be obligated to provide medical protection in addition to police and military protection. Otherwise, the citizens are left unguarded from a massive threat and the state would fail in its duty as a protector. While these lines of reasoning are appealing, they can certainly be countered. This could be done by arguing that there are relevant differences between providing health care and providing armed defenses.

One way to do this is to argue that the state is only obligated to protect its citizens from threats presented by humans and not from other threats to life and health, such as disease, accidents or congenital defects. So, the state is under no obligation to protect citizens from the ravages of Alzheimer’s. But, if ISIS or criminals developed a weapon that inflicted Alzheimer’s on citizens, then the state would be obligated to protect the citizens.

On the face of it, this seems odd. After all, from the standpoint of the victim it does not seem to matter whether their Alzheimer’s is “natural” or inflicted—the effect on them is the same. What seems to matter is the harm being inflicted on the citizen. To use an obvious analogy, it would be like the police being willing to stop a human from trying to kill another human, but shrugging and walking away if they see a wild animal tearing apart a human. As such, it does not matter whether the cause is a human or, for example, a virus—the state’s obligation to protect citizens would still apply.

Another approach is to argue that while the state is obligated to protect its citizens, it is only obligated to provide a certain type of defense. The psychology behind this approach can be made clear by the rhetoric those who favor strong state funding for the military and police while being against state funding for medical care. The military is spoken of in terms of its importance in “degrading and destroying” the enemy and the police are spoken of in terms of their role in imposing “law and order.” These are very aggressive roles and very manly. One can swagger while speaking about funding submarines, torpedoes, bullets and missiles.

In contrast, the rhetoric against state funding of health care speaks of “the nanny state” and how providing such support will make people “weak” and “dependent.” This is caring rather than clubbing, curing rather than killing. One cannot swagger about while speaking about funding preventative care and wellness initiatives.

What lies behind this psychology and rhetoric is the principle that the state’s role in protecting its citizens is one of force and violence, not one of caring and curing. This does provide a potential relevant difference; but the challenge is showing that this difference warrants providing armed defense while precluding providing medical care.

One way to argue against it is to use an analogy to a family. Family members are generally obligated to protect one another, but if it were claimed that this obligation was limited only to using force and not with caring for family members, then this would be rightfully regarded as absurd.

Another approach is to embrace the military and police metaphors. Just as the state should thrust its force against enemies within and without, it should use its medical might to crush foes that are literally within—within the citizens. So, the state could wage war on viruses, disease and such and thus make it more manly and less nanny. This should have some rhetorical appeal to those who love military and police spending but loath funding healthcare. Also to those who are motivated by phallic metaphors.

As far as the argument that health care should not be provided by the state because it will make people dependent and weak, the obvious reply is that providing military and police protection would have the same impact. As such, if the dependency argument works against health care, it would also work against having state military and police. If people should go it on their own in regards to health care, then they should do the same when it comes to their armed defense. If private health coverage would suffice, then citizens should just arm themselves and provide their own defense and policing. This, obviously enough, would be a return to the anarchy of the state of nature and that seems rather problematic. If accepting military and police protection from the state does not make citizens weak and dependent, then the same should also hold true for accepting health care from the state.

As a final point, an easy way to counter the obligation argument for state health care is to argue that the state is not obligated to provide military and police protection to the citizens. Rather, the military and the military, it could be argued, exists to protect and advance the interests of the elites. Since the elites have excellent health care thanks to their wealth and power, there is no need for the state to provide it to them. Other than the elites in government, like Paul Ryan and Trump, who get their health care from the state, of course. On this view, support for using public money for the military and police and not health care makes perfect sense.

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Free Speech & Universities II: Heckler’s Veto

Posted in Ethics, Philosophy, Politics by Michael LaBossiere on March 10, 2017


While the debate over free speech is a venerable one, recent events have served to add a new drama to this matter. When Middlebury invited Charles Murray to speak, the event was disrupted by student protestors and both Murray and Professor Allison Sanger were attacked on campus. This incident has sparked considerable reflection on the campus and beyond. Peter Singer, a philosopher who is no stranger to controversy, also found his talk disrupted by people who disagree with his views. This shutting down of a speaker by protestors has become known as the heckler’s veto.

One of the narratives about these sorts of disruptions is that the left believes that free speech extends only to those they agree with. On the one hand, this does have some merit: recent disruptions have been aimed at speakers whose view are generally regarded as being out of step with the most vocal of the left. On the other hand, there has been strong opposition against these disruptions from people who would also be considered on the left. As such, to say that the left opposes free speech on the part of those they disagree with is no more (or less) accurate than saying that Republicans oppose local control when it goes against the interests of oil companies and the NRA. That said, it is fair to note that the opposition to speakers seen as being on the right does unsurprisingly come from the left. While speculating about whether “the left” is against free speech is interesting, what is philosophically important is the ethics of the heckler’s veto in the context of the right of free speech.

The most extreme version of the heckler’s veto is violence, such as that directed against Murray and Sanger. Richard Spencer, who is regarded by some as a Nazi, was famously punched for his views, igniting a debate about the ethics of punching Nazis. The usual version of the heckler’s veto is revealed by the name: to engage in heckling to prevent the speaker from being heard or interfering with the speaker until they give up trying to speak. The hallmark of this sort of heckler is that they are not trying to engage and refute the speaker, they are endeavoring to prevent the speaker from being heard.

The easy and obvious approach is to follow a stock position on free speech: as long as the speaker is not engaged in such directly harmful speech such as slander or calls for violence, then the speaker should be free to speak without disruption. This can be made more sophisticated by taking the classic utilitarian approach of weighing the harms and benefits of allowing the speaker to exercise the right to free speech. For example, if punching Nazis to silence them sends the message that Nazism will not be tolerated and this reduces the hate crimes committed in the United States, then such punching would seem to be morally good.

An alternative to the utilitarian approach is to argue that there are some things, such as Nazism and sexism, whose inherent badness entails that people should not be permitted to speak in favor of them even if doing so created no meaningful harms. While I do see the appeal in the “there are things we must not allow to be said” approach, there is the significant challenge of showing that even without any harm being caused, such speech is simply wrong. I will not endeavor to do so here, but I am open to arguments in favor of this view.

One interesting approach to heckling is to point out that it seems to be a tactic for those who cannot refute the views they oppose; it is the noisy refuge of the logically or rhetorically incompetent. If the views being expressed by the offending speaker are wrong, then they should be refutable by argumentation. If all someone can do is yell and disrupt, they should remain silent so that someone with the ability to refute the speaker can engage in this refutation. For example, those who disagreed with Murray should have made their points by arguing against him.

A practical reply to this is that a member of the audience might not be given the opportunity to engage in a possibly lengthy refutation of the speaker. As such, they must engage in the rapid and effective means of heckling to prevent the speaker from even getting the words out. A reasonable counter to this is that while a person might not have the chance to engage at the actual event, they have an opportunity at refutation via such venues as Twitter, a blog, or YouTube.

Another reply to this is that allowing the speaker to speak on a campus lends legitimacy and normalizes the speaker’s views, even if the views are not explicitly endorsed. As such, if a speaker cannot be prevented from being invited, then they must be silenced by disruption.

While this does have appeal and schools should consider the educational merit of speakers, having a person speak on campus does not entail that the school endorses the views and does not make them legitimate. To use the obvious analogy, using the Communist Manifesto and Mein Kampf in a political science class does not endorse or legitimize these works. Likewise, inviting someone with “alt right” views to a debate on American political thought does not entail that the school endorses the “alt right” or make it legitimate. Just as reading books containing ideas one might not agree with (or even hate) is part of education, so too is listening to speakers expressing such ideas. As such, heckling speakers to silence them would be on par with censoring books to keep people from reading them or movies to keep people from seeing them.

This can be countered by making use of one of Plato’s classic arguments for censorship in the Republic. Plato argued that exposure to certain types of art would corrupt people and make them worse. For example, someone who was exposed to violent works of art could become corrupted into becoming violent. Plato’s solution was to ban such art.

In the case of speakers, it could be argued that they must be silenced by heckling because their speeches would corrupt members of the audience. For example, one might claim that listening to Murray talk about his work would corrupt audience members with racism and poor methodology. This argument assumes, as does Plato’s, that most people lack the ability to defend themselves from such corrupting power. Since the hecklers think the speaker is wrong, they presumably think that most people are either incapable of discerning right from wrong or are just awaiting the right trigger to cause them to embrace evil. On this view, the hecklers would be heroes: those strong enough to resist the siren song of evil and loud enough to drown it out. For those who agree with Plato, Aristotle or Stanley Milgram, this argument should be appealing: most people are easily swayed towards misdeeds and few are influenced by either arguments or fine ideals. Those who dislike Trump and attribute his election in part to defects in voters would also find this approach appealing. And, of course, no discussion of this sort would be complete without a mandatory reference to Hitler and his ability to win over the people.

But, of course, no discussion of this sort would be complete without noting how heckling is like any other tool—it can be used by the good and the evil alike. Naturally, the people using it will think they are on the side of good and their foes evil. Their foes, of course, are likely to think the opposite. Since sorting out what is good and bad requires consideration and discussion, silencing people would interfere with sorting out this rather important matter. As such, I am opposed to heckling, even if I disagree strongly with the target. That said, my more cynical self is tempted by Plato’s argument that the ears of the many must be protected from corrupting words and that it is up to the philosophers to decide which words are corrupting and which are wholesome.

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Free Speech & Universities I: Invitations & Exclusions

Posted in Ethics, Politics, Universities & Colleges by Michael LaBossiere on March 8, 2017


While the right to free speech is considered fundamental in classical liberalism, contemporary liberals have been accused of being an enemy of this right. Some recent examples include incidents at Berkeley and Middlebury. As always, the matter of free speech is philosophically interesting, especially when it involves higher education.

One important distinction in regards to rights is that of the negative versus the positive. A negative right is not an evil right; rather it is a freedom such that the possessor is not entitled to be provided with the means to exercise the right. It is, roughly put, a right to not be interfered with. A positive right, in contrast, is an entitlement to the means needed to exercise the right. For example, the United States currently grants citizens a right to public K-12 education—in addition to having the liberty to seek this education, it is also provided to students. In contrast, college education is currently a negative right: students have the liberty to attend college, but are (generally) not provided with free education.

The right to free speech is generally taken to be a negative right; it is intended as a protection from impediment rather than an entitlement to the means to communicate. To use an obvious example, while I have the right to express my views no one is obligated to provide me with free radio or TV time in which to do so.

While university personnel have no right to unjustly interfere with free speech, they are also under no obligation to provide people with speaking opportunities on campus. Decisions about who to invite and who to allow to speak in official venues are often made on pragmatic grounds, such as which speakers will boost the reputation of the school or who happens to be friends with top administrators. There are also practical concerns about the cost of the speaker, the likelihood of trouble arising, and the extent of the interest in the speaker. While these practical concerns are important, decisions about who to invite (and who to exclude) should certainly be made on principled grounds.

One reasonable principle is that decisions should be made based on the educational value of having the speaker on campus. Since universities are supposed to educate students, it makes excellent sense for them to operate on this principle. Speakers who would offer little or nothing in the way of educational value could thus be justly denied invitations. Of course, education is not the only concern of a university in terms of what it offers to the students and the community. Speakers/presenters that offer things of artistic value or even mere entertainment value should also be given due consideration.

One obvious concern about deciding based on such factors is that there can be considerable debate about which speakers have adequate merit to warrant their invitation to campus. For example, the incident at Middlebury arose because some regard Charles Murray’s co-authored controversial book The Bell Curve as being based on pseudoscience and bad methodology. While these matters can be clouded with ideology, there are already clearly established standards regarding educational merit in regards to such things as methodology and legitimacy. The main problem lies in their application—but this is not a problem unique to picking speakers. It extends across the entire academy. Fortunately, the basic principle of educational merit is reasonable clear—but the real fights take place over the particulars.

Another seemingly sensible principle is a moral one—that those invited should reflect the values of the institution and perhaps the broader society. At the very least, those invited should not be evil and should not be espousing evil.

This principle does have some obvious problems. One is the challenge of deciding what conflicts with the values of the institution. Another is the problem that it is problematic to speak of the values of the broader society, given the considerable diversity of opinions on moral issues. When people use this approach, they are often simply referring to their own values and assuming that they are shared by society as a while. There is the enduring problem in ethics of sorting out what exactly is evil. And then there is the classic concern about whether academic or artistic merit can offset moral concerns. For example, a Catholic university might regard a pro-choice philosopher as endorsing a morally wrong position, yet also hold that having this philosopher engage a pro-life advocate in a campus debate to have educational merit. As another example, a liberal institution might regard an extreme libertarian as having morally problematic views, yet see educational merit in having them present their arguments as part of a series on American political philosophy.  As with the matter of merit, there are rational and principled ways to approach ethical concerns—but this area is far more fraught with controversy than questions of assessing educational merit.

While I do agree that speech can cause harm, I hold to a presumption in favor of free expression. As a principle, this means that if there is reasonable doubt as to whether to merit of a speech outweighs moral concerns about the speaker or content, then the decision should favor free expression. This is based on the view that it is better to run the risk of tolerating possible evil than to risk silencing someone who has something worth saying. As such, I generally favor a liberal (in the classic sense) approach to inviting speakers to universities.

In the next essay I will consider the matter of the “heckler’s veto”, which occurs when the crowd silences a speaker.

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Voice-Directed Humans

Posted in Technology by Michael LaBossiere on March 6, 2017

In utopian science fiction, robots free humans from the toil and labor of the body so that they can live lives of enlightenment and enjoyment. In dystopian science fiction, robots become the masters or exterminators of humanity. As should be expected, reality is heading towards the usual mean between dystopia and utopia, the realm of middletopia. This is a mix of the awful and the not-so-bad that has characterized most of human history.

In some cases, robots have replaced humans in jobs that are repetitious, unfulfilling and dangerous. This has allowed the displaced humans to move on to other jobs that repetitious, unfulfilling and dangerous to await their next displacement. Robots have also replaced humans in jobs that are more desirable to humans, such as in the fields of law and journalism. This leads to questions about what jobs will be left to humans and which will be taken over by robots (broadly construed).

The intuitive view is that robots will not be able to replace humans in “creative” jobs but that they will be able to replace humans in nearly all physical labor. As such, people tend to think that robots will replace warehouse pickers, construction workers and janitors. Artists, philosophers, and teachers are supposed to be safe from the robot revolution. In some cases, the intuitive view has proven correct—robots are routinely used for physical labor such as constructing cars and no robot Socrates has shown up. However, the intuitive view is also in error in many cases. As noted above, some journalism and legal tasks are done with automation. There are also seemingly easy to automate tasks, such as cleaning toilets or doing construction, that are very hard for robots, but easy for humans.

One example of a task that would seem ideal for automation is warehouse picking, especially of the sort done by Amazon. Amazon and other companies have automated some of the process, making use of robots in various tasks. But, while a robot might bring shelves to human workers, the humans are the ones picking the products for shipping. Since humans tend to have poor memories and get bored with picking, human pickers have been automated—they wear headsets connected to computers that tell them what to do, then they tell the computers what they have done. For example, a human might be directed to pick five boxes of acne medicine, then five more boxes of acne medicine, then a copy of Fifty Shades of Gray and finally an Android phone. Humans are very good at the actual picking, perhaps due to our hunter-gatherer ancestry.

In this sort of voice-directed warehouse, the humans are being controlled by the machines. The machines take care of the higher-level activities of organizing orders and managing, while the human brain handles the task of selecting the right items. While selecting seems simple, this is because it is simple to us humans but not for existing robots. We are good at recognizing, grouping and distinguishing things and have the manual dexterity to perform the picking tasks, thanks to our opposable thumbs. Unfortunately for the human worker, these picking tasks are probably not very rewarding, creative or interesting and this is exactly the sort of drudge job that robots are supposed to free us from.

While voice-directed warehousing is one example of humans being directed by robots, it is easy enough to imagine the same sort of approach being applied to similar sorts of tasks; namely those that require manual dexterity and what might be called “animal skills” such as object recognition. It is also easy to imagine this approach extended far beyond these jobs to cut costs.

The main way that this approach would cut costs would be by allowing employers to buy skilled robots and use them to direct unskilled human labor. For simple jobs, the “robot” could be a simple headset attached to a computer. For more complex jobs, a human might wear a VR style “robot” helmet with machine directing via augmented reality.

The humans, as noted above, provide the manual dexterity and all those highly evolved capacities. The robots provide the direction. Since any normal human body would suffice to serve the controlling robot, the value of human labor would be extremely low and wages would, of course, match this value. Workers would be easy to replace—if a worker is fired or quits, then a new worker can simply don the robot controller and get about the task with little training. This would also save in education costs—such a robot directed laborer would not need an education in job skills (the job skills are provided by the robots), just the basics needed to be directed properly by the robot. This does point towards a dystopia in which human bodies are driven around through the work day by robots, then released and sent home in driverless cars.

The employment of humans in these roles would, of course, only continue for as long as humans are the cheapest form of available labor. If advances allow robots to do these tasks cheaper, then the humans would be replaced.  Alternatively, biological engineering might lead to the production of engineered organics that can replace human; perhaps a pliable ape-like creature that is just smart enough to be directed by the robots. But not human enough to be considered a slave.  This would presumably continue until no jobs remained for humans. Other than making profits, of course.

 

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DeVos & HBCUs

Posted in Ethics, Philosophy, Politics, Race, Universities & Colleges by Michael LaBossiere on March 3, 2017

As a professor at Florida A&M University, I was cautiously optimistic when Secretary of Education Betsy DeVos had a luncheon with presidents from some HBCUs (historically black colleges and universities).  As might be suspected, HBCUs often face funding issues and increased support would be very welcome. This is especially relevant in Florida since the state has not only cut education funding, it has also imposed a punitive performance based funding system in which state schools must compete. While the top three schools are rewarded with more funding, the bottom three schools are punished. Since there must always be a bottom three, there will always be three schools being punished—even if they are doing a good job.

While this should have been an easy public relations victory for DeVos, she ignited a firestorm with her attempt to whitewash the history of HBCUS and link them with her ideology of school choice. Apparently ignorant of history, she said that HBCUS “are real pioneers when it comes to school choice,” and added that “They are living proof that when more options are provided to students, they are afforded greater access and greater quality. Their success has shown that more options help students flourish.”

The obvious problem with her remark is that HBCUS were not pioneers of school choice; they were the result of a system of segregation that denied black students access to white colleges and universities. This segregation also extended to black educators, because “when segregation was rampant some of the most brilliant black educators had to come to [black colleges] in order to have an opportunity to teach. They couldn’t go any place else.” DeVos’ remarks about choice are thus both ironic and ignorant—HBCUs arose in a situation in which there was very little choice for black students. While there were a very few white schools that accepted black students, the real choice for most blacks was a black school or no school.

DeVos was, however, correct to claim that “more options help students flourish” in that having an option to attend college helps students flourish more than having no option. This is, however, rather different than the school choice she envisions as a model for education. As such, her effort to draw an analogy between HBCUs and her vision of school choice fails. While her remarks might have been a result of mere unforgivable ignorance (the secretary of education should have at least a basic grasp of the major historical facts of American education), they could also be taken as expressing a view that favors segregation.

While this might seem like a stretch, it is well worth considering the history of the sort of private schools that DeVos praises. While the Brown decision led to desegregation in the public schools, the ruling did not apply to private schools. As the public schools desegregated, white began to flee to “segregation academies.” This has contributed to a significant increase in public school segregation. While some might argue that using public money to fund private schools will address the problem of segregation, the data shows that private schools are even more segregated than public schools. Shifting public funds to private schools will result in an even more unequal system: well-funded, highly segregated private schools and poorly funded highly segregated public schools.

While I am not accusing DeVos of racism, it is tempting to see her praise of HBCUs and support for them in sinister terms. That is, that there is an intent to mirror the segregation at the K-12 level with segregation at the college and university level. Somewhat ironically, the desegregation of higher education had left HBCUs in search of a new mission to replace that of providing education to black students who lacked opportunities at white schools. DeVos, it seems, might be interested in making the old mission relevant again.

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