Monday, November 19, 2007

When doctor's hate informed patients

A doctor, Scott Haig, published an essay in time magazine titled "When the Patient is a Googler" on November 8. The doctor describes a prospective patient who is "well spoken and in good shape, an attractive woman in her mid-40s." He then says that she "launched into me with a barrage of excrutiatingly well-informed questions."

In the course of the essay, Dr. Haig describes Susan's child as a "little monster" and her as a "brainsucker." He says patients like Susan are full of "half-baked ideas" and are suspicious and distrustful. He also says that patients like Susan are full of "misused, mispronounced words and half-baked ideas" (what happened to her being "well spoken" and informed?) He knew these things about patients like Susan not because of anything she said (she was well spoken, after all) but because "a seasoned doc gets good at sizing up what kind of patient he's got." He decides not to treat Susan but to refer her to another doctor. When he declined to treat her, he says she was "disappointed and annoyed," but she already had an appointment with the doctor he planned to suggest.

It is obvious to anyone but the doctor that she was vetting prospective doctors just as he was vetting prospective patients. It may be that knowledgeable patients get good at sizing up what kind of doctor they have. Based on the essay, her questions were a good way to ferret out a megalomaniacal doctor who could not handle a patient who may know a little too much. He asks whether such patients exist in countries where doctors are in short supply. It is possible that Susan is a selfish prig who wants everything in life on her own terms.

It does not appear, however, that Dr. Haig is one of those doctors who travels to a war-torn country to give his services to those who need them most. Nor does it appear that Dr. Haig has any humility in the face of patients who may know more about their own pain than he. Susan isn't the only patient Dr. Haig doesn't like, you see. He describes others as "non-compliant Bozos." This is a doctor who gives orders and expects them to be followed.

Paternalism, indeed, is not dead.

Monday, October 8, 2007

The Value of Simplicity

Many political, social, and religious movements advocate simple living as a way of reducing demand for financial resources, increasing spiritual awareness, and placing fewer demands on environmental resources. For some, simplicity is a matter of interior design or architecture that emphasizes a lack of clutter and distraction. For examples, consider some Buddhist monasteries and temples, and meeting houses of the Religious Society of Friends. Architects design buildings to help people focus on their own thoughts and revelations while meditating or praying. Some practitioners will extend simplicity of design to clothing, gardens, and other spaces. In some ways, this first concern focuses on the benefits to the individual, especially with regard to spiritual growth. The spiritual growth of the individual should then provide benefits for others or for the universe as a whole, or so some believe.

Another argument for simple living focuses primarily on what is good for others. By living simply, we can leave more resources for current inhabitants of the world, including animals, and for future generations. Our commitment to simplicity also takes us out of competition with our neighbors. We no longer struggle to have the best clothes, homes, or cars. If everyone practiced this type of simplicity, it is argued, we could feed the world's hungry and provide medical care for the world's sick. People as diverse as Buddha, Jesus, and philosopher Peter Singer have argued for simplicity as a moral imperative.

These two arguments for simplicity cannot be separated. The spiritual growth or enlightenment of the individual should benefit others and be aimed, ultimately, at relieving suffering and providing comfort. The benefit of meditation and prayer is not to be a sense of calm or relaxation. The goal is to be a better person, not to feel better. I should perhaps qualify this last sentence and say that I believe the goal of meditation and prayer should be to become a better person rather than a more relaxed person. A feeling of calm can help one see reality with greater clarity, but calm in itself is not the end goal of meditation. Right thought is necessary to produce right action, and right action is driven by compassion for all that suffer, which is to say all that live.

The Religious Society of Friends (Quakers) has a long and rich tradition of simplicity (known as the "Testimony of Simplicity"). From the inception of the tradition, Friends met in unadorned buildings, wore plain clothing, and waited in silence to be inspired by the "light within." The benefits of simplicity were described in the 17th century by Quaker William Penn:
"Personal pride does not end with noble blood. It leads people to a fond value of their persons, especially if they have any pretense to shape or beauty. Some are so taken with themselves it would seem that nothing else deserved their attention. Their folly would diminish if they could spare but half the time to think of God, that they spend in washing, perfuming, painting and dressing their bodies. In these things they are precise and very artificial and spare no cost. But what aggravates the evil is that the pride of one might comfortably supply the needs of ten. Gross impiety it is that a nation's pride should be maintained in the face of its poor. ”
It was important to Penn that the money saved on adornments could be used to help those in need. Recently, pride has come to be seen as a virtue, but William Penn obviously considered pride to be a sin that encumbered any attempt to achieve justice or moral goodness.

Another Quaker, Richard Gregg, was equally clear on the value of simplicity in 1936. He said:
To give a concrete instance of what I mean by unity and disunity, it would be consistent with a real awareness of human unity if I should invite into my house for a meal and a night's lodging a starving man who has knocked at my door. But if my rugs are so fine that I am afraid his dirty shoes may ruin them, I hesitate. If I have many valuable objects of art or much fine silverware, I also hesitate for fear he may pocket some of them or tell men who may later steal them from the house. If my furniture and hangings bespeak great wealth I mistrust him lest he hold me up; or perhaps if I am less suspicious and more courageous and more sensitively imaginative, I fear lest the contrast between his poverty and my abundance will make him secretly envious, or resentful, or bitter, or make him feel ill at ease. Or perhaps he is so very dirty that I fear he has vermin, and I am revolted by that thought and am so far from him humanly that I do not know how to deal with him humanely. In this case it is clear that my lack of simplicity acts as a barrier between him and me. The prolonged lack of simplicity of our whole society has increased the distance between his thoughts, feelings and ways, and mine, and so adds to the social barrier. That troubles me.
It is clear that Richard Gregg saw acquisition of "things" to be a problem. While forced poverty is not the goal of simplicity, detachment from items of material value is a goal of simplicity. Attachment to expensive housing, artwork, clothing, or other ornaments interferes with one's ability to act morally. The money saved can be used to help the plight of those suffering in the world, and the lack of attachment to ornaments frees one from being "owned" by one's own property. It also means that one does not need to live in debt or with obligations to others. It means one is not required to ask for gifts from others who may or may not be dishonorable. In this sense, simplicity is both a form of liberation and a method for helping to liberate others from poverty or extreme suffering. The teaching on simplicity by Friends is rather unambiguous.

A 2001 New York Times article describes how the Live Oak Friends Meeting in Houston, Texas came to build a $1.5 million meeting house based on the principles of simplicity. The article notes that the 100 members of the meeting raised $500,000 through internal efforts and the remaining $1 million came from donations from "individuals, corporations and foundations making contributions to a nonprofit corporation set up for the purpose of the project." The article does not specify who the individuals, corporations, and foundations were or whether they were screened for social responsibility.

The meeting house was designed by architect Leslie Elkins, but the cost is due largely to the James Turrell "skyspace" integrated into the meeting house. Turrell is a Quaker artist who uses light as his medium. The skyspace is like an open-air atrium with a retractable roof. When the skyspace is open, there is simply an open square in the center of the ceiling. Anyone can look at a section of the sky at any time for no cost at all, of course. Turrell creates an aesthetic experience of light in the sky in the same way my favorite composer, John Cage (influenced by Taoism and not a Quaker), creates an aesthetic experience of silence for audiences. The value of the art, as Taoists would say, lies in what is not there.

At Turrell's insistence, any trees that obstructed the view through the skyspace were cut down. Turrell's art, and the skyspace, attract visitors from around the world. Visitors may view the skyspace for free but donations are accepted. At the insistence of the artist, photography is not allowed as the rights to any images of the skyspace are retained by James Turrell.

Due to the expense of repairs to the skyspace and the cost of the building, the members of the meeting are understandably concerned with protecting the investment in this work of art. When I say "understandably," I mean to imply that Richard Gregg, for example, would understand.

The meeting house follows simplicity by design. Does it fulfill the testimony of simplicity as described by William Penn and Richard Gregg? Could $1.5 million be better spent? Does the skyspace serve a greater purpose of promoting social justice and environmental sustainability in the world? I think the questions are worth considering, even six years after the fact.

Randall Horton

Monday, September 17, 2007

I don't know what I was thinking

If nothing else is certain, we must know the contents of our own minds. Descartes was unable to doubt the existence of his mind, and it seems quite impossible for me to doubt the thoughts I am thinking right now. As I produce thoughts, I am aware of them, and it is impossible for me to escape them. My thoughts, formed by language, express the contents of my beliefs and desires precisely, because that is how I have intended to express them to myself. I can’t imagine I am deceiving myself or that I am an automaton. I am a thinking being immersed in my conscious life. If the language I use in thinking expresses my beliefs accurately and rationally, then this is what enables me to develop moral principles and behave in a morally responsible manner.

But what of our “unconscious” thoughts? Hume demonstrated that our belief in cause and effect seems to exist in a precognitive state. We don’t use language and reason to develop a belief in cause and effect—in at least some cases, language merely expresses what is built into us. Our moral reasoning, though, is based on careful consideration and tediously crafted arguments. Surely our language is not expressing a precognitive instinct or intuition. In Kinds of Minds, Dennett quotes Elizabeth Marshall Thomas saying, “For reasons known to dogs but not to us, many dog mothers won’t mate with their sons” (10). Dennett rightly questions why we should assume that dogs understand this behavior any better than humans understand it. It may just be an instinct, produced by evolution. If the dog had language, it might come up with an eloquent argument on why incest is wrong, but the argument would seem superfluous—just following the instinct works well enough.

By the same token, human moral arguments may do nothing more than express or at best buttress deeply held moral convictions instilled by evolution or experience. In a Discover magazine article titled “Whose Life Would You Save?” Carl Zimmer describes the work of Princeton postdoctoral researcher Joshua Green. Green uses MRI brain scans to study what parts of the brain are active when people ponder moral dilemmas. He poses various dilemmas familiar to undergraduate students of utilitarianism, the categorical imperative, or other popular moral theories.

He found that different dilemmas trigger different types of brain activity. He presented people with a number of dilemmas, but two of them illustrate his findings well enough. He used a thought experiment developed by Judith Jarvis Thompson and Phillipa Foote. Test subjects were asked to imagine themselves at the wheel of a trolley that will kill five people if left on course. If it is switched to another track, it will kill one person. Most people respond that they will switch to another track in order to save four more lives, apparently invoking utilitarian principles. In the next scenario, they are asked to imagine they can save five people only if they push one person onto the tracks to certain death. Far fewer people are willing to say they would push anyone onto the tracks, apparently invoking a categorical rule against killing innocent people. From a purely logical standpoint, the two questions should have consistent answers.

Greene found that some dilemmas seem to evoke snap judgments, which may be the product of thousands of years of evolution. He notes that in experiments by Sasrah Brosnan and Frans de Waal capuchin monkeys who were given a cucumber as a treat while other monkeys were given grapes would refuse to take the cucumbers and sometimes would throw the cucumbers at the researchers. Brosnan and De Waal concluded that the monkeys had a sense of fairness and the ability to make moral decisions without human reasoning. Humans may also make moral decisions without the benefit of reasoning. It appears evolution has created in us (at least in those who are morally developed) a strong aversion to deliberately killing innocent people. Evolution has not prepared us for other dilemmas such as whether to switch trolley tracks to reduce the total number of people killed in an accident. These dilemmas result in logical analysis and problem solving. Zimmer writes, “Impersonal moral decisions . . . triggered many of the same parts of the brain as nonmoral questions do (such as whether you should take the train or the bus to work)” (63). Moral dilemmas that require one to consider actions such as killing a baby trigger parts of the brain that Greene believes may produce the emotional instincts behind our moral judgments. This explains why most people appear to have inconsistent moral beliefs, behaving as a utilitarian in one instance and as a Kantian the next.

It may turn out that Hume was correct when he claimed, “Morality is determined by sentiment. It defines virtue to be whatever mental action or quality gives to a spectator the pleasing sentiment of approbation” (Rachels 63). His claim is that we evaluate actions based on how they make us feel, and then we construct a theory to explain our choices. If the theory does not match our sentiment, however, we modify the theory—our emotional response seems to be part of our overall architecture. The work of philosophers, then, has been to construct moral theories consistent with our emotions rather than to provide guidance for our actions.


Language gives us access to our conscious thought. Language permits us to be aware of our own existence and to feel relatively assured that other minds exist as well. It is through language that we make sense of ourselves and the world. We may be deceived, though, into thinking that thought is equivalent to conscious thought. Much of what goes on in our mind is unconscious. Without our awareness, our mind attends to dangers, weighs risks, compensates for expected events, and even makes moral judgments. Evolution has provided us with a body that works largely on an unconscious level. However, humans, and perhaps some nonhuman animals, have become aware of their own thoughts, and this awareness has led to an assumption of moral responsibility. This awareness should not be taken to prove that we are aware of the biological facts that guide our moral decisions.

Stephen Stich explores the development of moral theory in his 1993 paper titled, “Moral Philosophy and Mental Representation.” In the essay, Stich claims that while most moral theories are based on establishing necessary and sufficient conditions for right and wrong actions, humans do not make mental representations based on necessary and sufficient conditions. He says, “For if the mental representation of moral concepts is similar to the mental representation of other concepts that have been studied, then the tacitly known necessary and sufficient conditions that moral philosophers are seeking do not exist” (Moral 8). As an alternative, he suggests that moral philosophers should focus on developing theories that account for how moral principles are mentally represented. He writes:
These principles along with our beliefs about the circumstances of specific cases, should entail the intuitive judgments we would be inclined to make about the cases, at least in those instances where our judgments are clear, and there are no extraneous factors likely to be influencing them. There is, of course, no reason to suppose that the principles guiding our moral judgments are fully (or even partially) available to conscious introspection. To uncover them we must collect a wide range of intuitions about specific cases (real or hypothetical) and attempt to construct a system of principles that will entail them. (8)
On this view, moral theories represent beliefs that are not only unconscious but are unavailable to the conscious mind. In order to make a determination of the content of our own moral beliefs, then, we must examine our own moral decisions and infer the content of our beliefs. In this approach, we find that humans are deciphering their own beliefs in much the same manner the Brosnan and De Waal determine the moral beliefs of capuchin monkeys. Not only does language fail to give a full accounting of our belief states, but our conscious thoughts may be an impediment to determining our actual beliefs, so that we must consider prelinguistic or nonlinguistic cues to discover what we actually believe.

Friday, September 14, 2007

Suffering and Meaning

In other posts I have pointed out that life is the source of all suffering. I can't claim to be profound; this is the First Noble Truth of Siddhartha Gautama. I'm only convinced that he was correct. Some Christians, of course, also see life as a "vale of tears," only to be survived in order to be rewarded with relief in the afterlife. Hinduism and Theosophy also see existence in the flesh as something to be endured rather than a gift in and of itself.

So, why do we cling so tightly to this gift or trial or punishment, depending on one's beliefs? Evolutionary psychologists and biologists would most likely agree that clinging to life aids the survival of the species (or of the "selfish genes" as Richard Dawkins would say). Surely, this is correct, but it may not be the entire answer.

Very soon after we are born, we also begin to form attachments. We not only love our own lives, but we love the lives of others. Many people resist the temptation of suicide because they "could never do that" to their parents, children, spouses, or friends. Some give in to the temptation of suicide because they care for no one and feel no one cares for them. Or, in some cases, people come to believe that their death will bring more happiness to those they care about. In some cases, they are correct in this as well.

So, love makes life extremely valuable but also excruciating. Our obligation, then, is to recognize the sorrow that is life. Recognize that it is a common feature of human existence. Recognize that all suffering is our own and do our best to help each other through. In so doing, we may find joy, bliss, and comfort along the way.

We may, in the end, feel that it is all worth it.

Randall Horton

(Some have said the Buddhist view is pessimistic. I'm not sure whether most Buddhists would agree, but I know that Arthur Schopenhauer, who was greatly influenced by Buddhism, classified Buddhism as a pessimistic religion. He also based his moral and ethical writings on the principle ideas of Buddhism.)

Sunday, September 9, 2007

The Value of Life

Many bioethicists accept the Judeo-Christian view that human life and human life only has great intrinsic value. As a corollary it is taken that anything thing that is both alive and human possesses a right to respect and continued life.

These assumptions are powerful and pervasive, but go against the intuition of many people. The assumption that human life has great value and is even sacred would lead one to assume that it is proper to create as much human life as possible, but only a few people actually believe this. The prevalence of contraception and encouragement of abstinence belies an underlying belief that perhaps not every human life is of great value simply because it is possible for it to exist.

Similarly, rights are not granted uniformly to all that are human and alive, although many pretend that they are. When consciousness ceases to exist or fails to begin in living human tissue, many people will regard this being as perhaps being worthy of dignified treatment, but the idea that it is of the same value of all other human life is not represented through everyday actions of most people.

Concern for the “right to die” is some circumstances also implies a rejection of the view that life is sacred in all cases.

Alternative views of the value of life can be useful in resolving the apparent contradiction between the actions many people take and their declared respect for life and individual rights.

Not all people see life as sacred and valuable. The first noble truth of Buddhism, for example, is that life is suffering. We seek continued existence as a result of desire, which intensifies our suffering. Life becomes valuable, then, because it fulfills a desire which is itself irrational. Other views see life as the inevitable consequence of physical laws or nature. The fact that humans exist and desire life is a brute fact that is morally significant only because of the suffering generated by the desire for life.

We may recognize that life is valuable for reasons that are not metaphysical. A pre-embryonic collection of cells may be of great moral significance to a certain man who is hoping, with a bit of desperation, to become a father and see his child before he succumbs to a life-threatening disease himself. For this man, these human cells are not morally significant because they are endowed with rights and dignity at their first creation. He is not concerned with the metaphysical status of the cells. He is concerned, instead, with their ontological status. They exist and he wants them to survive because he is interested in their continued existence. In this case, we may feel morally obliged to take great measures to ensure the survival of these cells because they mean so much to this hopeful father. We are concerned for this father and he is concerned for his progeny. The moral commitment arises from concrete human relationships.

For similar reasons, non-human life may become of great moral concern to us. Police officers who have worked with service animals for many years will often refer to a deceased animal as a “partner” and such animals sometimes receive funerals and memorials. Few would claim that service animals are accorded respect and value because of the sanctity of life.

In both the cases I’ve given above, it can be claimed that the duties accorded to life are indirect duties to the ones who care about the life. While that is true, the moral commitment could arise from a direct concern for a life. An individual may value her own life because she enjoys being alive and wants to continue her existence. Her own concern for her life makes her life something of value. Out of a concern to reduce her suffering at the thought that her life may not be preserved, medical professionals will devote themselves to preserving her life.

In such cases as outlined above, it is compassion, sympathy, empathy, or care that creates moral demands for the preservation of life. This view of the value of life will not appease the demanding vitalist, but it may be accepted by many people from different faiths and philosophical backgrounds. It helps us reconcile the strong drive to preserve and extend life with our belief that some people have a right to die, that some non-human life deserves extraordinary care and respect, and the view that some human cells are precious while others are less precious.

Friday, September 7, 2007

Language of Machines

Daniel Dennett argues that we can use language, through the “intentional stance,” to describe the beliefs of people, animals, or artifacts including a thermostat, a podium, or a tree (Brainchildren 327). It is easy to construct sentences to describe the beliefs of these objects (“The thermostat believes it is 70 degrees in this room”). If the thermostat is working properly and conditions are more or less normal, we should be able to predict the temperature based on the actions of the thermostat, or we should be able to predict the actions of the thermostat by knowing the temperature in the room. We recognize the possibility of error, however. As the thermostat may be broken, we are likely to say, “According to the thermostat, . . .” If the room does not feel warmer or cooler than the thermostat indicates, then we assume all is well. If we want to know the true nature of belief, being able to describe the beliefs of a thermostat is outrageously unsatisfying. Unless the thermostat is able to describe its own beliefs using language, we are loath to even suggest it has beliefs.


But given the capacity for human language, machines might appear to have beliefs and desires similar to human beliefs and desires. In fact, if a machine could use human language in a manner indistinguishable from human use, it is difficult to see how the consciousness of the machine could be denied with any certainty. Of course, the claim that such a machine is impossible goes back at least to Descartes, who wrote, “It is not conceivable that such a machine should produce different arrangements of words so as to give an appropriately meaningful answer to whatever is said in its presence, as the dullest of men can do” (CSM II 140). Surely Descartes did not imagine 21st century computer programs when he provided this early version of the Turing Test (in which a computer is held to be conscious if it can master human conversation), but so far his challenge has not been met.


In John Searle’s Chinese room argument, we are challenged to accept that even a computer that could pass the Turing Test would not prove the computer is conscious. Although he does not deny that machines could someday be conscious, a language program would not be proof of it (Searle 753-64). Our best reason for believing the machine is not conscious is that it is not similar enough to a human to be considered conscious by analogy. Even if we can’t deny beliefs and desires to a machine with certainty, we are equally ill equipped to accurately ascribe beliefs and desires to machines, or trees, or stones.

Wednesday, September 5, 2007

Language and Belief

Human language brings clarity and understanding to human thoughts and beliefs. In fact, many have argued that without language, humans have no capacity for thought or belief. Descartes expresses a firm conviction that language is necessary for any thought:
There has never been an animal so perfect as to use a sign to make other animals understand something which bore no relation to its passions; and there is no human being so imperfect as not to do so. . . . The reason animals do not speak as we do is not that they lack the organs but that they have no thoughts. It cannot be said that they speak to each other but we cannot understand them; for since dogs and some other animals express their passions to us, they would express their thoughts also if they had them. (CSMK 575)

While the idea that language is necessary for the emergence of belief has been accepted for centuries, philosophers and others have begun to use the term “belief” more permissively, making the assertion much less obvious. While to say a cow had beliefs may have once implied the cow ascribed to some creed or doctrine, the claim has a much more mundane connotation in contemporary philosophy. For example, using the language of belief/desire psychology, we might say that a group of cows and humans gathering under a cover after hearing a thunderclap share a common belief that it is about to rain.

We will also say they desire to stay out of the storm. Cows do not need the ability to express their beliefs to want to avoid a storm that appears to be imminent. In this case, it is easy to describe the cow’s behavior using the language of belief/desire psychology, but it is also easy to imagine that the humans under the cover are in a far different position than the cows; they understand their position, have plans and fears for the future, and have a sense of what it is right and wrong to do. We want to say the humans are conscious, and the cows are not. We know the humans are conscious because we assume them to be more or less like us, and we are conscious. Language expresses our thoughts and beliefs, and we assume that other humans use language and experience consciousness as we do.

Language does more than provide evidence of consciousness, though; it is the structure of consciousness. A sophisticated study of human language and behavior should produce a powerful and accurate psychological theory. If language sets humans apart from machines and animals, then language is quite likely the feature of human consciousness that produces moral agency and responsibility. If animals and machines are not capable of beliefs and thoughts, then humans are the only known creatures to have any concept of moral responsibility. However, if consciousness is not unique to humans, or if language is not the stuff that makes consciousness, then we may not be able to construct an adequate description of beliefs and desires, much less moral agency.

Thursday, August 30, 2007

The Ethics of Medication

Yesterday, I went to the doctor, and he prescribed medication for reflux disease. When I went to pick up my prescription, the cashier told me the pharmacy could not fill it until they received authorization from the doctor. I asked whether the doctor's prescription was not authorization. It turns out, according to the pharmacist, that the insurance company will not pay for the medication without a written justification from the doctor.

Rather than needing doctor's authorization, the insurance company was rejecting his authorization. So, I get no treatment for my reflux, which hardly seems fair, but the situation is exasperatingly complicated.

It could be that my doctor, under the influence of pharmaceutical reps, prescribed an expensive medication that is no more effective than cheaper alternatives. If so, it may be in the best interest of everyone, except the doctor and pharmaceutical company, to reject payment for an expensive medication that offers no additional benefits over other medications. Praise to the insurance company for holding the line on costs.

It may be that the doctor knows that the new and expensive medication is more effective and has fewer side effects than alternatives. He may have prescribed what he feels will promote my health and healing better than any other treatment available. In this case, all thanks go to my doctor, and the insurance company is really quite evil.

Or, it could be that the insurance company rejects any expensive treatment with the hope that patients will give up and find cheaper treatments or go without treatment. This, of course, might save money in the short run, although rejecting claims costs money in itself. Sometimes, rejecting a claim is more costly than simply paying it. the amount of staff time and resources tied up on this one prescription is enough to give one pause. The pharmacy says the insurance company won't pay for the prescription, but I did not press them on how they know this. It is possible they simply consulted a list of preferred medications. It may be that they checked a computer database. Or, they may have actually made a phone call. Any of these options require employee time.

After determining that the drug was not a "preferred" drug, the pharmacy faxed a form to my doctor. If things go as planned, a member of the doctor's staff will obtain a statement and signature from him before completing the form and faxing it back to the pharmacy. This is an inefficient system at best.

In this case, the patient, me, is going without treatment for reflux, which is causing real problems and can lead, if untreated, to serious problems such as esophageal cancer, which frequently terminates in death. So, who is to blame for the suffering of the patient? Greedy pharmaceutical companies? Doctors under the influence of greedy pharmaceutical companies? Greedy private insurance companies? Or pharmacists who raise problems when there is no problem? I really don't know the answer.

Monday, August 27, 2007

Prairie Restoration

I've had a couple of blogs on the evils of lawns. After a nice trip to Wisconsin this weekend, I came back more knowledgeable about a number of things, one of them being Prairie Restoration. This is a movement to restore natural habitats. If you are interested in doing this, you can get help here: http://www.prairieresto.com/. If you don't live in an area associated with prairies, you can get information on restoring other natural habitats as well (wetlands, for example).

Thanks to the fine folks in Wisconsin who gave me an education on prairie restoration efforts!

Wednesday, August 22, 2007

Texas dismisses EU concerns over the death penalty

The European Union thinks Texas should consider halting executions before reaching the 400th killing by the state. In a BBC article, we learn that Robert Black, a spokesman for the Texas governor, said: "Two hundred and thirty years ago, our forefathers fought a war to throw off the yoke of a European monarch and gain the freedom of self-determination." How many fallacies are contained in this response? Well, it certainly has nothing to do with the death penalty, so it is missing the point or a red herring or something along those lines. It raises the specter of nationalism (I want to say "jingoism"), so it is flag waving (if it were directed at an individual, it would be an ad hominem attack).

It doesn't really matter. The real point is that the response from Texas ignores the primary arguments against the death penalty, which the EU stated clearly: 1. The death penalty is not a deterrent and 2. It is impossible to rectify a miscarriage of justice. According to the Innocence Project, 206 individuals convicted of capital crimes have been exonerated. We can only speculate as to how many more innocent people have been convicted and killed.

Our leaders feel no hesitation to comment on the actions of other countries' decisions. In the sense of fair play, we might expect Texas leaders at least attempt to defend the use of what appears to me to be an unjust practice rather than merely issuing proclamations that Texas does what Texas (or it's governor, anyway) wants.

Tuesday, August 21, 2007

What does it mean to believe in God?

When I ask what it means to believe in God, I am really being superfluous, because it is impossible to say what it means to believe in God without first answering what it means to believe. Stating it means to believe something is notoriously difficult. One hypothesis is that beliefs are thoughts about facts that occur to us in the form of sentences. For Descartes, thoughts that weren't expressed in language were not thoughts at all, though they may be passions or feelings.

The first objection, though, may be that not all thoughts or beliefs are actually expressed in sentences but that they could be. For example, most everyone believes that a regular-sized automobile is larger than a normal basketball, but few people ever express that belief in the form of a sentence. It is averred that someone holds the belief if they would answer "yes" when asked whether a car is larger than a basketball. We might complicate things by asking whether a dog would believe a car is larger than a basketball, and it seems many dogs act as if they believe cars are bigger than basketballs, but they can't express it in a sentence, even when queried.

So, is it enough to "act as if" something is true to substantiate belief in that something? Back to the original question, can we say someone believes in God if that person acts as if God exists? So, we might say someone believes in God if we see them praying, avoiding sin, or something else. On the other hand, we might run into serious conflict. Most people claim to believe in God and that God will provide a blissful afterlife. In other words, they express these beliefs in sentences. Their behavior, on the other hand, tends to reflect a general dread or terror of death or the afterlife. The behavior of many but not all self-proclaimed believers would indicate that they think death is the finality of life or the beginning of an awful punishment rather than a reward for a life well led.

Or, perhaps, these same people sincerely proclaim their belief in God, but their actions reveal a hidden belief that their lives have not been properly spent.

Wednesday, July 25, 2007

Do We Choose Belief?

Many state blithely that they choose to believe this or that. The statement, on the face of it, is absurd. It is impossible for most of us to believe, for example, that 2 + 3 = 6. This proves easily that some beliefs are impossible, but it does not prove that it is impossible to choose some beliefs. Some people believe blue is attractive and other find it much less attractive. If I am forced to live or work in an environment where nearly every thing around me is blue, it is in my interest to believe that blue is attractive. It may or may not be possible for me to choose to be attracted to blue, but it does not really matter as this does not seem to be a belief in the important sense most people want to assign to belief.

When people say they choose to believe something, they are generally talking about something like the existence of moral value or God or mathematics. William James famously declared that our first act of free will is to believe in free will. His point is well taken, by some anyway. Life is filled with choices, and we make choices based on our beliefs. If we do not believe we have control over our beliefs, then we do not believe we have control over our choices. If we do not believe we can make choices, we are rather stuck in the mud. The fact that we carry on with our lives is evidence that most of us at least behave as if free will is possible.

Of course, free will, and freedom of belief are hardly one and the same. Is it possible for someone who believes recreational homicide is wrong to come to a different conclusion by an act of will? It is conceivable (though just barely) that some argument or experience might change ones mind, but this is not an act of will. If I move to a society where disbelief in Odin is punishable by death (no, I am not aware of any such society), I would certainly choose to avow publicly that I believe in Odin, but this avowal would be made much easier by actually being able to believe in Odin, for it is easiest to avow an occurrent belief.

Perhaps if we cannot simply choose a belief, we can choose to examine a belief in more detail in order to move closer to a new belief. I live where belief in Odin is required, but I do not as yet believe in Odin. In fact, I do not have the requisite experience or knowledge to believe in Odin, so I may begin to read texts on the basic tenets of Odin’s followers. I may attend worship services devoted to Odin. I may mimic prayers and sacrifices to Odin, if such are appropriate. I may discuss the virtues of Odin belief with his followers. When I come to understand Odin better, I may come to believe in Odin and declare honestly and proudly, “I choose to believe in the infinite power and mercy of Odin.” I may congratulate myself on discovering ways to choose beliefs. Now, I need only to define a belief.

Monday, July 23, 2007

Conceptual difficulties regarding God

Many people are committed to the idea of theism. When a person claims to be a theist, though, we learn nothing regarding the person’s position to any particular conception of God, so all we know about this person is that she prefers to not be described as an atheist. Some people are intentionally vague claiming only that there is “something bigger than myself” or that there are universal mysteries that the human mind cannot comprehend. Others claim that they cannot conceive of ethical principles being true without the existence of some God, so God must exist in order to be good. It is not possible to prove these claims right or wrong because they are incoherent.

When one refers to the mystery of the universe, for example, what claim can such a person possibly make by this statement? The universe is, indeed, quite large and complicated. The human mind has many limitations that prevent any accurate perception of the universe. We can imagine that there is a mind that can perceive the universe, but we cannot imagine constructing any argument or test that would give evidence of this infinite, or at least quite large and complicated, mind. The only thing as large and complicated at the universe is the universe, unless we conceive of God to be larger and more complicated than the universe, then the mystery would be how something smaller than something else could come to be called the universe, for “universe” seems to be an all-encompassing term. If God is larger and more complicated that what we know is the universe, then the universe is not universal, and God is the universe, whatever that may be.

Now, we can claim that God does encompass all and also claim that with out limited minds we can observe and understand at least parts of God (the part that commands or desires us to be kind to one another, for example), but when we observe things in this way, we must always be aware that God’s observations may not look at all like our observations of even small and simple matters. Unfortunately, humans cannot see any perspective other than the human perspective. We could even challenge this view further and say that one cannot perceive any perspective other than one’s own.

The fact that we have perceptions, though, is evidence for some that God is necessary. All perceptions must come from somewhere, so there is a source for all of experience. Some call that source of perception God, but reasons for calling it “God” are not readily apparent. This appears to be motivated only by desire for something that can be called “God.” That our perceptions exist cannot be denied, for we cannot deny what we are experiencing. It seems natural to assume that all perceptions (and everything else in the world) has a cause, but this is a notoriously problematic claim.

Thursday, June 21, 2007

Bad medicine or cultural difference?

According to an article in The Guardian, an Indian couple permitted their 15-year-old son to perform a Cesarean section in order to get in the Guinness Book of Records. I don't have a lot to say about this, but I wanted to share it.

I think it is clear that permitting an untrained 15 year old perform surgery is unethical. I thought briefly that some might think it "cultural imperialism" to tell Indians how to conduct medicine, but I really have no evidence that Indians don't find it as appalling as everyone else in the world. According to the article (quoting the Hindustan Times), when confronted with his actions, the doctor (the father of the "surgeon") replied, "If a 10-year-old [in India] can drive a car and a 15-year-old can become a doctor in the US, what is wrong if my son, though not qualified, performs a surgery?" He answers his own question--if his son were 15 and qualified, the issue would be much more complicated. We might then be asking whether an otherwise qualified 15 year old can be mature enough to perform surgery, which raises all sorts of issues not present in the current case.

The parents now deny that their son performed the surgery, by the way, and claim instead that he only watched the operation. If it is proven he did perform the surgery, the parents could lose their licenses.

Wednesday, June 20, 2007

How to have a lawn that won't kill us all.

I've had several things to say about lawns. In the spirit of trying to offer alternatives, I will simply point you to an article from the UK both about the problems of lawns and the possible ways to deal with the problems. It is possible to live with beautiful gardens without pesticides, herbicides, fossil-fuel-burning and polluting lawn equipment, and water waste.

Of course, in the US, homeowner associations call the shots and insist on the destructive practices that the Guardian article is warning against. What is the solution? Fight the HOAs. Demand an end to environmentally destructive deed restrictions. We are not fighting to save the Earth. We are fighting to save ourselves.

Tuesday, June 19, 2007

More problems with lawns

Lawns continue to cause problems for the survival of animals such as humans. A New York Times article today reports on the problem of water conservation in Florida. In the article, Abby Goodnough notes that Florida residents use up to 75 percent of their water outdoors, mostly on lawns. Drought-resistant ground cover and artificial turf have both failed to catch on in big numbers. Why? Homeowner associations prohibit both. Instead, HOAs insist that homeowners have grass lawns, which require not only enormous amounts of water but also chemicals in the form of pesticides and fertilizers.

In other words, most Floridians (read: US citizens) are required to create environmental hazards around their homes. These hazards are harmful to animals, including humans, and are aesthetically bland at their very best. The fact that spending 75 percent of fresh water to maintain lawns is an unjust distribution of natural and financial resources seems self-evident to this author, but I've grown accustomed to being in the minority.

Perhaps HOAs are resistant because attractive alternatives do not exist. Artificial turf may not be the panacea some hope for as many find it less than beautiful. At least, many think they will find it less than beautiful. Perhaps to see it is to love it, but who knows? Some residents have also experimented with gardens made of rocks and hardy, ground-resistant ground cover. This gives a garden the look of a natural setting, which also seems upsetting to HOAs. A Zen garden filled with gravel and a few well-placed boulders might be attractive and encourage mindfulness at the same time, but I doubt HOAs will embrace the idea of Zen gardens soon, either.

What's to be done? Some ideas: 1. pass laws limiting water consumption. 2. pass laws limiting the use of environmentally harmful chemicals on lawns. 3. eliminate HOAs. 4. encourage creative lawn maintenance. 5. remove all laws or deed restrictions requiring maintenance of grass lawns.

We will have greater property rights, lawns will reflect more diverse forms of beauty, water will be more abundant, and we will have a more just world. Not bad for a days work. Just let property owners do what they want to do, anyway.

Thursday, June 14, 2007

Is health care better when you pay more?

In a New York Times article today, Reed Abelson makes the bold statement that a new hospital study provides "stark evidence" that higher payments do not translate to better medical care. He is citing a Pennsylvania government study of the 60 hospitals in Pennsylvania that perform heart bypass surgery. Two of the highest paid hospitals also had the highest death rates. This could be for many reasons. These hospitals might take the most difficult cases or the most costly. Either example would cause higher costs and poorer results.

So, the study is too narrow to make sweeping generalizations about health care costs, but it does raise some questions. Noting that this particular study does not prove much, Abelson goes on to say, "Still, the Pennsylvania findings support a growing national consensus that as consumers, insurers and employers pay more for care, they are not necessarily getting better care. Expensive medicine may, in fact, be poor medicine."

Implied in the article is a call to adopt a pay-for-performance model for health care. The idea is that physicians and hospitals with better outcomes would receive higher pay. On the surface, this seems like a good idea, but there are potential problems. One way to improve outcomes is to deny service to high-risk patients. Abelson's article notes that Geisinger Health Care is offering a 30-day warranty on its cardiac surgery. Private hospitals are able to choose the best candidates for surgery and have a much better chance of making good on the warranty.

Public hospitals face other dilemmas. Hahnemann University Hospital now says that its record keeping probably did not give an accurate picture of how sick its patients were before coming for surgery. Public hospitals and teaching hospitals take all patients and do their best to save them. Those with the sickest patients are likely to have the worst outcomes. This is not proof of poor care.

The question of how to compare care at different facilities or among different doctors is not one easily answered. Most will agree that better performance should be rewarded, but getting an accurate picture of care quality will require more than counting deaths and dollars. Dr. Richard Snyder of Independence Blue Cross, is quoted as saying, "Philosophically, you're not going to get an argument from us. We believe we should pay more for high quality than poor quality." Implicit in his statement is frustration over how to measure quality. Recognizing the complexity of the question is the first step to formulating possible answers.

Monday, June 11, 2007

The Personal is Political

For decades now, feminists have been telling us that what goes on in the private sphere affects the public sphere. The rallying cry of "The personal is political!" was heard by many. Some, such as Susan Okin, even predicted the problem this would cause for men. In order for women to enter the public sphere, men would have to enter the private sphere. If women were paid less and given less respect because their commitment to their jobs was diluted somewhat by family obligations, employers were likely to be even more harsh with fathers who wanted to be part of family life.

Though the warnings were unheeded, they were not unjustified. Katherine Reynolds Lewis has just published an article describing the struggles modern fathers face. It was assumed in the past that fathers would rather not take responsibility for changing diapers, taking sick kids to the doctor, and going to meet with teachers. This assumption turned out to be false. Fathers in the past were afraid that if they were more involved in the private sphere of home and family, they would be punished by their employers. Their fears have been realized. Fathers have been passed over for promotions and even fired after insisting on taking leave to be with their children.

Liberating women for equal pay will require liberating men as well. As society we should assume that all parents love their children and want to be with them to ensure their healthy development. Some fathers and mothers are not good parents to be sure, but rewarding rather than punishing those who are will benefit us all.

Friday, June 8, 2007

How free can we be?

I'm a little behind the curve on this, but a Jan. 2 article by Dennis Overbye in The New York Times deals with free will and the latest developments in cognitive science regarding free will. Overbye cites the work of Benjamine Libet who demonstrated (to his satisfaction, anyway) in the 1970s that people act before becoming consciously aware of their choices. Consciousness and apparent free choices seems to follow the mechanism we call our body rather than direct it. It is compared to a monkey riding the back of a tiger and making up a story about how the monkey directed the tiger's actions.

To some extent, I guess we all believe that actions are caused by physical laws and past events. Whenever someone commits a horrible crime, we ask, "What would cause someone to do such a thing?" We believe there is an answer, and scientists seek the answers. People who argue most strenuously for free will will generally back off when confronted with their own shyness, depression, impatience, or other trait they've tried for years to modify.

A simple test for free will involves the compulsion to crunch on ice. For reasons I don't understand, people with an iron deficiency will crunch ice compulsively, annoying co-workers, family members, and passers-by. Give them iron, and suddenly they "choose" to stop crunching ice all the time.

So, is this cause for despair or optimism? Understanding the causes of our actions gives us more tools to help control them (giving iron supplements, for example). At the same time, knowing our actions are caused makes us doubt the free will of the soul (or mind, if you prefer). We feel a loss of dignity, for some reason. Daniel Dennett argues consistently and persistently that recognizing and understanding causal relationships gives us more freedom, not less. When he says "more" freedom, though, he really means more than none, which isn't comforting to the hard-core indeterminists in the world.

One problem is that punishment becomes meaningless if people are not free, or so it is claimed. Spinoza answered this by saying that you would control the actions of a rabid dog in the same manner regardless of whether the dog chose to be rabid. The same, he claimed, should apply to humans. Punishment is no longer retribution, though, it is now simply a necessary condition of life.

On the other hand, William James claimed that we are forced to believe in free will because we are forced to make choices every day. If we do not believe in free will, we cannot make any choices, so we are paralyzed. From a practical standpoint, we feel we are free and must act as if we are free.

This may be as good as it gets.

Wednesday, June 6, 2007

Is your lawn actually yours?

Linda Ballew went to court rather than mow her back lawn, but now she is reconsidering. Most people, including the judge, seem to think she is unable or too poor to mow her grass. This seems unlikely. She agreed to mow her front yard and made good on the promise. This is most likely a moral choice (0ne she feels strongly about) rather than mere negligence. Her neighbors are complaining that she has created a habitat for wildlife including nutria, skunks, and snakes. Apparently, neighbors don't enjoy having wildlife experiences in the neighborhood.

This begs the question of what property rights owners have over their own property? If Ms. Ballew wanted to create a habitat for wildlife, is this not her right? Why do the rights of developers to destroy animal habitats seem to take legal precedence over those who would create or replace habitat? Ms. Ballew's yard is described as "overgrown," which means it is full of green plants that will reduce temperatures and cleanse the air. She is creating a green environment, an apparent evil in the US.

Millions of people around the world live in concert with nature rather than in a position of domination. Ms. Ballew challenges her neighbors to learn to live with nature rather than against it. She also challenges them to respect the idea that property owners can make choices about how their property is maintained. If she is, indeed, endangering her neighbors, there is a case to be made that she must stop endangering them, but this may not mean she must completely eliminate the wildlife refuge she has created.

Her righteously indignant neighbors probably have lawns filled with pesticides and dangerous additives that seep into the soil and everything else surrounding the lawn causing damage to animals, including animals of the human variety. These same neighbors surely never even question whether their actions may be causing harm to the environment, wildlife, or humans. Certainty is good when you can find it, but it is rare and should always be held in suspicion.

It is time to question the commitment most in the US have to the bland, overly-manicured lawn, and evaluate what values promote a better good overall. It is also time to recognize that those with differing values may have something to teach us. The answers to life's questions are rarely clear, and opposing views help us explore our own ethical intuitions.

Thursday, May 31, 2007

What can ethics courses achieve?

In a Houston Chronicle commentary titled "Where's Right and Wrong in Ethics?," Donald Bates explores why required university courses in ethics fail to produce ethical business practices. Bates lists many familiar examples of unethical behavior in public life (Enron and WorldCom, for examples) and blames them conveniently on the separation of church and state.

Bates claims that ethics is taught from a position of Utilitarianism (the greatest good for the greatest number), egoism (what most benefits the long-term interest of the individual), rights (deontological forms of duty to others or entitlements for oneself), or abstract principles of justice. This is his first mistake. University ethics courses teach the theories listed by Bates, although his list is far from exhaustive, but ethics instructors are not wont to teach "from a perspective." To understand the study of ethics, students must be familiar with competing theories, but universities provide education, not indoctrination.

Bates goes on to say, "Trying to teach ethics without a religious underpinning means absolutes do not exist, everything is situational." This is his second mistake. The fact that many competing ethical theories (and religions, for that matter) have emerged over the centuries is not evidence that absolutes do not exist. It is evidence only that absolutes are extremely difficult to discover and agree upon. Teaching ethics from the standpoint of a "religious underpinning" is to teach from a standpoint of absolute knowledge of right and wrong and good and bad, which would require professors to claim to know the mind of God, a claim that would be met with suspicion for good reason.

Expecting ethics courses to make the world more ethical is a little like expecting professional athletes and pop stars to be good role models. Ethical solutions and agreement are not easy to come by. Claiming that the state should enforce morality founded in religion begs the question of which religious perspective is correct and who will decide on the proper perspective. Rational people of good will disagree on ethical practices each day, and this is a good foundation of a pluralistic society.

If we are lucky, we might be able to teach a few students a little humility and respect for the efforts of others to discover right from wrong. Many students will claim that ethics is just a matter of common sense. Oddly enough, Bates seems to agree. In each case he presents, he believes there is a universally accepted opinion of what is right and wrong. If he is correct, students do not need to be taught what is right, they need to be prevented from being evil. It is unlikely that the leaders of Enron and WorldCom made a mistake in ethical thinking. More likely, they decided to do something that showed no concern for the harm it caused others.

An ethical society requires skeptical humility from its leaders and educators, recognition of the humanity of others, and a desire to limit harm to all. This lesson is not easily taught but it is easily shared by the way we live.

Tuesday, May 29, 2007

Future of Bioethics

Many problems of bioethics revolve around the value of life. Many bioethicists accept the Judeo-Christian view that human life and human life only has great intrinsic value. As a corollary it is taken that anything thing that is both alive and human possesses a right to respect and continued life.


These assumptions are powerful and pervasive, but go against the intuition of many people. The assumption that human life has great value and is even sacred would lead one to assume that it is proper to create as much human life as possible, but only a few people actually believe this. The prevalence of contraception and encouragement of abstinence belies an underlying belief that perhaps not every human life is of great value simply because it is possible for it to exist.

Similarly, rights are not granted uniformly to all that are human and alive, although many pretend that they are. When consciousness ceases to exist or fails to begin in living human tissue, many people will regard this being as perhaps being worthy of dignified treatment, but the idea that it is of the same value of all other human life is not represented through everyday actions of most people.


Concern for the "right to die" is some circumstances also implies a rejection of the view that life is sacred in all cases. Alternative views of the value of life can be useful in resolving the apparent contradiction between the actions many people take and their declared respect for life and individual rights. Not all people see life as sacred and valuable. The first noble truth of Buddhism, for example, is that life is suffering. We seek continued existence as a result of desire, which intensifies our suffering. Life becomes valuable, then, because it fulfills a desire which is itself irrational. Other views see life as the inevitable consequence of physical laws or nature. The fact that humans exist and desire life is a brute fact that is morally significant only because of the suffering generated by the desire for life.


We may recognize that life is valuable for reasons that are not metaphysical. A pre-embryonic collection of cells may be of great moral significance to a certain man who is hoping, with a bit of desperation, to become a father and see his child before he succumbs to a life-threatening disease himself. For this man, these human cells are not morally significant because they are endowed with rights and dignity at their first creation. He is not concerned with the metaphysical status of the cells. He is concerned, instead, with their ontological status. They exist and he wants them to survive because he is interested in their continued existence. In this case, we may feel morally obliged to take great measures to ensure the survival of these cells because they mean so much to this hopeful father. We are concerned for this father and he is concerned for his progeny. The moral commitment arises from concrete human relationships.

For similar reasons, non-human life may become of great moral concern to us. Police officers who have worked with service animals for many years will often refer to a deceased animal as a "partner" and such animals sometimes receive funerals and memorials. Few would claim that service animals are accorded respect and value because of the sanctity of life.


In both the cases I've given above, it can be claimed that the duties accorded to life are indirect duties to the ones who care about the life. While that is true, the moral commitment could arise from a direct concern for a life. An individual may value her own life because she enjoys being alive and wants to continue her existence. Her own concern for her life makes her life something of value. Our of a concern to reduce her suffering at the thought that her life may not be preserved, medical professionals will devote themselves to preserving her life.


In such cases as outlined above, it is compassion, sympathy, empathy, or care that creates moral demands for the preservation of life. This view of the value of life will not appease the demanding vitalist, but it may be accepted by many people from different faiths and philosophical backgrounds. It helps us reconcile the strong drive to preserve and extend life with our belief that some people have a right to die, that some non-human life deserves extraordinary care and respect, and the view that some human cells are precious while others are less precious.

Monday, May 28, 2007

Cartesian Ethics: Concern for Self and Others

Cartesian Ethics: Concern for Self and Others

When examining the ethics of Descartes, it is easy to focus exclusively on his interest in virtue and concern for self-interest. As a result, discussions of his ethics often have what Cecilia Wee called “a persistent image of the Cartesian agent as a selfish or egoistical individualist” (255) in her essay titled “Self, Other, and Community in Cartesian Ethics.” According to Descartes, by using reason to understand the nature of God and the moral order of the universe, humans are able to control their passions and accept their fate in life with equanimity. We may not be happy in the sense of being exuberant. Rather, the virtuous person is rewarded with a “satisfied mind.” Virtue and contentment is not the end of the story, however. In a typical description, Donald Rutherford describes Cartesian ethics in this manner:

In agreement with the ancients, he takes philosophy's practical goal to be the realization of a happy life: one in which we enjoy the best existence that a human being can hope to achieve. Descartes characterizes this life in terms of a type of mental flourishing, which he calls "contentment of mind," or "tranquility." Here the influence of Stoic and Epicurean ethics is evident. (1)

In Descartes’s philosophy we find some echoes of previous moral views such as the virtue ethics of the ancients, but we also see that Descartes anticipated many modern moral theories, including Kant’s respect for persons and utilitarianism.

Many have lamented the fact that Descartes was never able to develop his moral theory in the formal manner of his metaphysics and epistemology. There is no cause for despair, however, as Descartes has left us plenty of grist for the grind. If we take as a given that the aim of philosophy is to enable us to live better lives, we cannot only examine Descartes’s comments on morality, but we must also evaluate how his metaphysical and epistemological claims promote eudaimonia. By this, we do not mean to see whether Descartes has found a way to make us all happy but whether he promotes a sense of being better off and flourishing, for it is clear that cheerfulness is not the supreme good. He writes to Princess Elizabeth, “Seeing that it is a greater perfection to know the truth than to be ignorant of it, even when it is to our disadvantage, I must conclude that it is better to be less cheerful and possess more knowledge” (CSM III, 268).

In this, we can see that epistemological concerns have a moral dimension for Descartes, so it is appropriate to evaluate his epistemology from a normative standpoint. His epistemology, of course, rests on his metaphysical assumptions. For the purposes of this paper, I will take his metaphysical assumptions as discoveries that are proven through his writings. He counsels Elizabeth that although there are many things we cannot know, we must content ourselves with the most useful truths. Most importantly, he argues that “there is a God on whom all things depend, whose perfections are infinite, whose power is immense, and whose decrees are infallible” (CSM III, 265).

If we take Descartes at his word and accept that the provisional morality expressed in the Discourse is truly provisional, then the value of examining his comments there is dubious. On one view, the provisional morality is nothing more than a literary or rhetorical device designed to heighten excitement for the epistemological project. The need to take a provisional morality implies that skepticism is extremely risky. With the proper preparation, however, one can be sure to make things no worse than they are. Descartes reassures his readers both that he is doing something extremely bold and also that he is taking no chances with the stability of society and morality. Descartes is giving his promise that he will not abandon all standards of behavior while completing the skeptical experiment. On the other hand, he does seem to be claiming that the provisional morality is good enough for himself until his metaphysical and epistemological foundations can be established.

Further, he suggests that others may choose to embark on a similar project, so he seems to be endorsing his provisional morality for anyone with the proper will and disposition for the project. Excluded from the endeavor, as he notes in the Discourse, are those who believe themselves “cleverer than they are” so that they judge too hastily and those who recognize they are better to “follow the opinions of others rather than seek better opinions themselves” (CSM I, 118). For himself, and anyone wishing to follow his lead, he laid out “three or four” maxims. The confusion over the number may stem from the fact that the fourth is more of a decision than a maxim.

One value of the Cartesian metaphysical project is that it gives a sense of serenity in knowing we only accept what is certain as true. We can know that there is a good God, free will, and a moral order to the universe. Since God is perfect, we know we are never being deceived. We also know that God does not create evil, as evil is not a thing. Further, we know that we can always choose what is good and correct. Error is the result of will, not intellect, which derives truth from God.

Descartes’s metaphysical argument regarding evil and free will is, unfortunately, incoherent. The problems with his view of humans become apparent when compared to the lives of animals, angels, and the human mind when separated from the body. Animals, lacking free will or intellect, act in a perfect manner and are not capable of evil. In his early writing, he says, “The high degree of perfection displayed in some of their actions makes us suspect that animals do not have free will” (CSM I, 5). Of course, animals also lack moral agency and are of no concern morally. The suffering animals endure has no moral significance. He makes this point distressingly clear when he describes a vivisection by saying, “If you slice off the pointed end of the heart in a live dog, and insert a finger into one of the cavities, you will feel unmistakably that every time the heart gets shorter, it presses the finger” (CSM I, 317). An animal’s behavior is never to be faulted. However, it also should never be praised.

Angels, lacking bodies, are not subject to the errors that arise from preconceived opinions. Angels do not contain all the perfections of God, else they would be God, but they are immune from the confused and obscure thinking that plagues those of us burdened with sensation. Their ideas must be clear and distinct, as they are pure intellect. In a letter to Chanut, Descartes declares, “We regard the least of the angels as incomparably more perfect than human beings” (CSM III, 322). Angels also have free will. They are not part of the mechanistic material of the universe. Given that angels have free will along with an intellect that is not clouded by obscure and confused ideas, it is difficult to see why the existence of humans in the universe is of any value.

Humans are burdened with an infinite will, a finite intellect, and an unreliable body that gives rise to false opinions. Through great effort, humans are able to enumerate and simplify their ideas until they are left only with clear and distinct ideas that are true and certain. This process of elimination of error from the human mind is supposed to be of obvious value. By coming to certain knowledge, we are able to make accurate and positive judgments, and these result in proper virtue. This is the source of esteem for humans. In The Passions of the Soul, he writes, “I see only one thing in us which could give us good reason for esteeming ourselves, namely, the exercise of free will and the control we have over our volitions. For we can reasonably be blamed only for actions that depend on this free will. It renders us in a certain way like God by making us masters of ourselves, provided we do not lose the rights it gives through timidity” (CSM I, 384). Here Descartes seems to imply that angels, “incomparably more perfect” than humans, are less praiseworthy since they need not struggle against the limitations of the physical body. In this case, it is not clear why we should consider it a blessing to be praiseworthy.

Being more perfect seems to be a good alternative to being praiseworthy, as being capable of praise brings with it a host of afflictions. Having a soul connected to a body and a body whose actions are imperfect as a result of free will leads to no small amount of suffering. For Descartes, this is not cause for alarm or self-pity.

Rather than feeling remorse over the afflictions and inconveniences of life, Descartes sees things differently. In a letter to Princess Elizabeth, he says, “There is a God on whom all things depend, whose perfections are infinite, whose power is immense and whose decrees are infallible. This teaches us to accept calmly all things which happen to us as expressly sent by God” (CSM III, 265). Given that suffering results from the soul being connected to body, it may seem that God is responsible for evil, but Descartes rejects this notion as well. God is not the author of evil, because evil is not a thing. In the Principles, Descartes claims that God is the source of all things, but he hastens to assure us, “When I say ‘everything,’ I mean all things: for God does not will the evil of sin, which is not a thing” (CSM I, 201). Sin is, rather, the result of bad judgment and movement of the will. God could have given us perfect judgment, but “we have no right to demand it of him . . . we should give him the utmost thanks for the goods which he has so lavishly bestowed upon us, instead of unjustly complaining that he did not bestow on us all the gifts which it was in his power to bestow” (CSM I, 205). Humans are the authors of and remedies for evil.

Evil is only a privation of our perfections, rather than a thing created by God. This scholastic account of evil is a rather cold comfort for the miserable wretch suffering a multitude of afflictions. Still, even contemporary theologians offer us the same reassurance. John Hick, for example, tells us that the world without suffering might be quite pleasurable, but it would be “very ill adapted for the development of the moral qualities of human personality. In relation to this purpose, it would be the worst of all possible worlds” (115). This ignores the possibility of a universe with neither pleasure nor pain—a universe with no sentient life.

Arthur Schopenhauer, under the influence of Indian religious and philosophical writings, sees this scholastic view of evil as being completely backward. He says, “I therefore know of no greater absurdity than that absurdity which characterizes almost all metaphysical systems: that of explaining evil as something negative. For evil is precisely that which is positive, that which makes itself palpable; and good, on the other hand, i.e. all happiness and all gratification, is that which is negative, the mere abolition of a desire and extinction of a pain” (42). Taking a moral framework that seems diametrically opposed to the view of Descartes, Schopenhauer sees compassion as the greatest moral good. He says:

Boundless compassion for all living beings is the firmest and surest guarantee of pure moral conduct, and needs no casuistry. Whoever is inspired with it will assuredly injure no one, will wrong no one, will encroach on no one’s rights; on the contrary, he will be lenient and patient with everyone, will forgive everyone, will help everyone as much as he can, and all his actions will bear the stamp of justice philanthropy, and loving kindness. (229)

Further, Schopenhauer points out that it would seem illogical to claim that a person was unjust and immoral and still claim that person to be very compassionate. In this way, morality supervenes on compassion. At first look, it appears Schopenhauer has made a huge departure from the kind of morality perceived by Descartes (this is confirmed if we look at their views of animals), but Descartes makes some statements that are surprisingly similar. In following passage, Descartes almost appears to be a precursor to Schopenhauer:

Those who are generous in this way are naturally led to do great deeds, and at the same time not to undertake anything of which they do not feel themselves capable. And because they esteem nothing more highly than doing good to others and disregarding their own self-interest, they are always perfectly courteous, gracious, and obliging to everyone. Moreover, they have complete command over their passions. (CSM I, 385)

We might object, though, that Descartes is merely advocating compassion as an appropriate emotion or virtue. He may not be arguing that we should set aside our self-interest for others. Descartes is often viewed as an egoist and virtue ethicist (Wee 255). There is plenty of textual evidence to support such a claim, but it is also clear that putting the interests of others out of compassion or duty is, in itself, a virtue. He makes this clear in a letter to Princess Elizabeth:

That each of us is a person distinct from others, whose interests are accordingly in some way different from those of the rest of the world, we ought still to think that none of us could subsist alone and that each one of us is really one of the many parts of the universe, and more particularly a part of the earth, the state, the society, and the family to which we belong by our domicile, our oath of allegiance, and our birth. (CSM III, 266).

In our pursuit of virtue, which is in turn a pursuit of the good life, we must be compassionate and, at least occasionally, put the interests of others ahead of our own interests. In this regard, Descartes takes a step toward the utilitarian theories of Bentham, Hume, Mill, and even contemporary philosophers such as James Rachels and Peter Singer. We will not go so far as to claim Descartes is an early utilitarian, but we can see the rudiments of utilitarian thought in a these passages.

Descartes’s ideas on moral agency also predicted later ethical theories. The material universe, for Descartes, is a mechanical system governed by necessary physical laws. Humans are in a unique position in this universe as humans are the only beings possessing both body and mind. When we consider the interests of others, we consider only the interest of those who are worthy of esteem and blame, i.e. humans. As John Marshall puts it in his book, Descartes’s Moral Theory, “Because they possess intelligence and will, others merit our esteem as beings of a certain kind, beings having the potential for a specific kind of development, both intellectual and moral” (152). Simply possessing free will gives one the potential for virtue, which deserves respect. Because all humans have intellect and will, we must treat them with a measure of respect, even if they behave badly. As mentioned above, Descartes tells us that we are only worthy of praise or blame because we have control over our volitions. This control makes us somewhat like God by “making us masters of ourselves” (CSM I, 384). Thus, all humans deserve respect, but it is only through the intellect and the will that humans choose appropriate actions. Animals, of course, are not capable of such actions, so all humans are in a special category of respect. Even animals can be trained, he says in article 50 of the Passions, to have some control over their impulses. They are not acting rationally, of course, but merely responding to training. He says, “For since we are able, with a little effort, to change the movements of the brain in animals devoid of reason, it is evident that we can do so still more effectively in the case of men. Even those who have the weakest souls could acquire absolute mastery over all their passions if we employed sufficient ingenuity in training and guiding them” (CSM I, 348).

This interplay of reason and will, available only to humans, sounds similar to more modern ethical theories, especially those related to Kant and his categorical imperative. Rutherford describes the relationship by noting Cartesian ethics “is crowned by a principle of moral universalism: in virtue of their free will, all human beings have the same moral status and deserve equal moral respect. In this we find an important anticipation of Kant's ethics, which emerges from a similar consideration of the unconditional value of a rational and free will” (12).

For Kant, our intellectual abilities and virtues of courage, resolution, and so on will be of no value if our will is mischievous. Rather than saying a good will and rationality will make us happy, he says, “A good will appears to constitute the indispensable condition of being worthy of happiness” (445). This echoes Descartes’s claim that we are praiseworthy when our will chooses what is evident to the intellect. Kant also insists that moral thought “is only possible in a rational being, in so far as this conception, and not the expected effect, determines the will” (448). It is only humans who receive praise or blame for their actions, and concern for non-human beings is of no moral significance. Kant says, “Beings whose existence depends not on our will but on nature’s, have nevertheless, if they are irrational beings, only a relative value as means, and are therefore called things; rational beings, on the contrary, are called persons, because their very nature points them out as ends in themselves” (452). Non-human beings are of concern only with regard to what goods they can provide humans. Kant would, of course, have no objection to the vivisection described by Descartes.

On the question of suicide, Descartes and Kant take a different approach, but it seems unlikely that Descartes would object to Kant’s argument. First Descartes tells Princess Elizabeth that suicide is to be avoided because “natural reason teaches us also that we have always more good than evil in this life, and that we should never leave what is certain for what is uncertain. Consequently, in my opinion, it teaches that though we should not seriously fear death, we should equally never seek it” (CSMK 276). In contrast, Kant claims that anyone who seeks suicide would be acting from a self-contradiction. He says, “Now we at once see that a system of nature of which it should be a law to destroy life by means of the very feeling whose special nature it is to impel to the improvement of life would contradict itself, and, therefore, could not exist as a system of nature” (450). Kant’s rational argument would surely not contradict Descartes’s vision of will, intellect, and virtue.

Descartes’s position in the history of normative ethics is similar to his position in the history of philosophy as a whole. Although he set out to establish a new philosophy, he never fully broke with the ancients of the scholastics. Still, he broke new ground and provided fertile fields to be plowed and cultivated by thinkers such as Schopenhauer, Bentham, Mill, and Kant. Even if Descartes was not able to provide a fully developed account of how we should live, he gave considerable details as to what the good life is and how it can be achieved. Rather than trying to determine what his ethical system might have been, philosophers might be better served by trying to determine how Descartes’s ideas can serve contemporary ethical theories. We must be committed to the idea that philosophy can make life better, and Descartes at the very least provides sufficient detail for us to ponder his larger questions.


Works Cited

Descartes, Rene. The Philosophical Writings of Descartes: Volume I. Trans. John Cottingham, Robert Stoothoff, and Dugald Murdoch. Cambridge: Cambridge UP, 1985.

---. The Philosophical Writings of Descartes: Volume II. Trans. John Cottingham, Robert Stoothoff, and Dugald Murdoch. Cambridge: Cambridge UP, 1985.

---. The Philosophical Writings of Descartes: Volume III. Trans. John Cottingham,

Robert Stoothoff, Dugald Murdoch, and Anthony Kenny. Cambridge: Cambridge

UP, 1991.

Hick, John. “There is a Reason Why God Allows Evil.” Philosophy of Religion.

Englwood Cliffs, NJ: Prentice Hall, 1963. Rpt. in Philosophical Questions. Ed.

William Lawhead. Boston: McGraw Hill, 2003. 111-16.

Kant, Immanuel. The Foundations of the Metaphysics of Morals. Trans. T. K. Abbott

(1873). Rpt. in Philosophical Questions. Ed. William Lawhead. Boston: McGraw

Hill, 2003. 111-16.

Marshall, John. Descartes’s Moral Theory. Ithaca: Cornell UP, 1998.

Rutherford, Donald, "Descartes' Ethics", The Stanford Encyclopedia of Philosophy

(Fall 2003 Edition), Edward N. Zalta (ed.),

URL = .

Schopenhauer, Arthur. Essays and Aphorisms. Trans. R. J. Hollingdale. New York:

Penguin, 1970.

Schopenhauer, Arthur. Philosophical Writings. Ed. Wolfgang Schirmacher. New York:

Continuum, 1994.

Wee, Cecilia. “Self, Other, and Community in Cartesian Ethics.” History of Philosophy

Quarterly 19.3 (July 2002) 255-73.

Thursday, May 24, 2007

Nozick and the Problem of Moral Progress

Nozick and the Problem of Moral Progress

In attempting to achieve a new and objective approach to ethics, Nozick eschews discussion of many of the standard elements of moral philosophy: compassion, agency, harm, and sentiment. He may have been trying to avoid the nearly sentimental excesses of less rigorous approaches, but he perhaps reflects too strongly what Genevieve Lloyd refers to as “the chillingly abstract character of Reason.” The result is a provocative account of what ethics is and how it has arisen. What is missing is an account of how ethics should proceed and how one should lead one’s life, which leaves the reader intrigued but ultimately dissatisfied. Although Invariances reflects a slight retreat from Nozick’s more extreme classical liberalism of the past, his nods to libertarianism seem to prevent him from developing his moral philosophy further. He is also hampered in his project by concern over the is-ought debate, which he does not fully resolve.

Can Ethics be Objective?

Nozick’s approach to ethics is limited, at least in part, by his attempt to gain an objective standard for discovering invariant truths. His approach is stated as the following:
Unbiased and distanced choice of ethical principles leads to ones with invariance properties that, in virtue of those invariance features, are effective in achieving the goals of ethics: the protecting, fostering, or maintaining of cooperative activities for mutual benefit; the guiding of such activity (as with principles for dividing benefits); mandating behavior for response to deviations from the first two goals listed; and fostering virtues and dispositions that maintain patterns of behavior. (290)

He effectively demonstrates that competing approaches to ethics yield results that are far from invariant. Although both Rawls and utilitarians try to achieve an unbiased method that provides some distance, one arrives at very different conclusions when applying Rawls’s difference principle or a utilitarian approach. The distinction between the two, however, highlights a failing of utilitarianism, which is a focus on benefit, or pleasure. If any feature of ethics is invariant, it is more likely to be a desire to reduce harm than to promote pleasure. Although he was perhaps not the greatest philosopher in history, Arthur Schopenhauer presented a fairly compelling argument that harm, not pleasure, is the positive force in life, saying, “Evil is precisely that which is positive, that which makes itself palpable; and good, on the other hand, i.e. all happiness and all gratification, is that which is negative, the mere abolition of pain” (42).
Indeed, utilitarian philosophers often meet with widespread agreement when arguing for the reduction of suffering when discussing world hunger and medical ethics. However, the rancor of opposing sides emerges when the discussions turn to topics such as sexual ethics or sacrificing a few for the benefit of many. In discussing a utilitarian model for sexual ethics, Alan Goldman says, “Certainly I can have no duty to pursue such pleasure myself, and while it may be nice to give pleasure of any form to others, there is no ethical requirement to do so” (97). While utilitarians are unlikely to suggest that promiscuity is a moral requirement, the discussion does highlight the problem of focusing on pleasure rather than reducing harm. And Goldman goes on to note that sexual acts become immoral only when someone is harmed through force, deception, or exploitation. To achieve an objective explanation for the nature and function of ethics, Nozick must find features that are not theory-dependent but are invariant across theories. Looking toward evolutionary psychology and biology, he feels the best feature to meet this test is coordination and cooperation to mutual benefit.

Nozick anticipates the problem of describing ethics as coordination of activities to mutual benefit. He notes, “Some ethical principles do not operate to mutual benefit, and some modes of coordination (such as Thomas Schelling’s ‘coordination games’ may not strike us as ethical” (283). Simply coordinating activities to achieve some mutual benefit frequently falls outside the circle of ethical behavior, unless one reconceptualizes ethics in a radical manner. Nozick is not prepared to make such an immodest proposal. Nozick is trying to establish connections among existing ethical theories and develop an approach that will overcome past dilemmas. In order for this to work, however, there must be some qualifications on what is cooperation to mutual benefit. Without a concept of harm, cooperation often seems less than ethical. Cooperation to mutual benefit might better be described as a mutual agreement to not hurt one another. When cooperation does not reduce harm, it is rarely considered a matter of morality or ethics. If two people lose their kites in a tree and cooperate to get them out or make a mutually beneficial business transaction, this may seem desirable and good, but not a moral choice. In this example, it is assumed the kites are of little value and losing them is not considered a great harm. By changing the example slightly, getting the kites might reduce harm, and the choice might seem more like a moral choice. If the kite had been passed down to a child from a recently-deceased parent, causing the child to have great sentimental feelings for the kite, and someone helped him get the kite down to help relieve his grief, this would seem a moral choice, and most would consider it a moral obligation.

While competing moral theories are couched in various terms, reduction of harm is the underlying value for the overwhelming majority. Ethical egoists (objectivists are included here) focus on harm to the individual. Protecting one’s own self-interest generally involves cooperation with others for mutual benefit, which entails an agreement to not do harm to one another. It would be nice to say that concern for harm is an invariant feature of the human species. Unfortunately, some hold other views. Peter Singer addresses the problem in “Famine, Affluence, and Morality”:

I begin with the assumption that suffering and death from lack of food, shelter, and medical care is bad. I think most people will agree about this, although one may reach the same view by different routes. . . . People can hold all sorts of eccentric positions, and perhaps from some of them it would not follow that death by starvation is in itself bad. It is difficult, perhaps impossible, to refute such positions, and so for brevity I will henceforth take this assumption as accepted. (582)

Kant also warned against indifference to suffering. In his discussion of the categorical imperative, he describes a man who is fairly well off and who decides that the suffering of others is of no concern to him. Kant notes that the man’s decision is contradictory since “instances can often arise in which he would need the love and sympathy of others, and in which he would have robbed himself, by such a law of nature springing from his own will, of all hope of the aid he desires” (80). While humans may be greedy and selfish, it is the desire to avoid harm that generates morality and ethical theories, not a desire for benefit. It may be argued that any benefit does, in fact, reduce harm and suffering, but it is no small matter to describe benefit as the positive and quantifiable value while suffering is actually of much greater concern. It is the emphasis on suffering that gives an ethical theory both its normative force and emotional appeal.

Given that coordination to mutual benefit might better be an agreement to reduce harm, is it possible to meet Nozick’s criteria for objective ethical statements? In order to do so, Nozick demands both intersubjective agreement and invariance. He notes, “Intersubjective agreement was epistemologically prior—it was our route to discovering that a truth is objective—while invariance was ontologically prior—it specified the nature of objectiveness and it underlay and explained intersubjective agreement” (291). The desire to reduce, and therefore avoid, harm will pass fairly rigorous tests for invariance and will demonstrate nearly universal intersubjective agreement. Anyone who does not wish to agree to reduce harm in exchange for being protected from harm is generally considered to be a sociopath. When defining harm, however, intersubjective agreement breaks down. Nozick rather deftly avoids examining too many specific issues related to coordinated effort. However, when exploring the question, problems occur with disheartening frequency. Physicians tend to abide, or at least claim to, the notion that they should, above all else, do no harm. When faced with a patient who has no chance of survival, some physicians give false hope while others are brutally honest. In an effort to avoid harm, they come to opposite conclusions. The confusion is perfectly rational, though, considering the views of various patients. When interviewed, some patients will say they would not want to be told there was no hope. They would rather enjoy their remaining days in blissful ignorance. Others say they would want to know the unvarnished truth and would feel violated and degraded if misled by a physician. The physician/patient relationship is an important example of cooperation to mutual benefit, one that has brought our species and society great advancement and advantage. Nozick would do his readers a favor by providing some guidance as to how to resolve such dilemmas.

How Do We Account for Moral Progress?

According to Nozick, Ethics is, in brief, coordination and cooperation to mutual benefit. Ethics progresses by widening the circle of agents who participate in such cooperation. The progression is limited, however, by a prohibition against enforcing any ethical rules that go against an individual’s free choices. While someone may elect to act out of a caring sentiment for others, there is no moral force requiring such actions. Nozick makes no attempt to distinguish between social coercion in the form of laws and social coercion in the form of adopting a higher moral standard. Many who are opposed to legal requirements to perform any given action still feel that such actions must be performed only because it is the right and the only right thing to do. For example, many would argue that if one can save a life through minimal effort without placing one’s own life at risk, then that person is morally obligated to do so. An ethical theory that did not account for at least this level of obligation to others would seem a failure to many.
This omission seems a bit strange, given that Nozick appears to value moral progress and expresses support for including women, gays, and ethnic minorities in the circle of cooperation to mutual benefit (he even mentions the possibility of including animals and fetuses in calculations of mutual benefit). Other moral philosophers who want to substantially raise the bar for ethical standards have not advocated government coercion to enforce such standards (Rachels, Unger, Singer). Nothing prevents Nozick or any other ethicist from suggesting that moving to higher levels of ethics is something one ought to do, but Nozick seems to find this a noxious proposition at best.

Still, he seems to place some value on the higher levels of ethics. He even gives a suggestion as to how we may move to higher levels of ethics. He says:
Perhaps each layer effortlessly (though not inexorably) gives rise to the next. The domain of coordination to mutual benefit is expanded ever more widely, and the basis for this is found in traits common to all human beings. We hypothesize a basis in value for our evaluations that it would be good to extend cooperation more widely. (281)

He also notes that our actual behavior is contingent on our capacity for emotional responsiveness, which results in compassion for all people or all creatures and an “adherence to nonharm to them” (281). Some individuals will become more developed emotionally and will rise to the higher levels of ethics and assume a caring role toward other people, the world, or even animals.

Nozick also gives some hint of how moral progress can occur on a wider social scale. He uses a game-theory model whereby cooperation can be gradually extended over generations. In this model, a group previously excluded from cooperation (immigrants or slaves) will benefit from any cooperation from the dominant group, which acts, of course, from its own accord. The dominant group has shown moral progress, presumably, by merely replacing slavery, as an example, with extreme exploitation. In stark opposition to Rawls’ view of justice, Nozick appears to see it as immoral to demand anything more for the least advantaged than some participation in cooperation to mutual benefit, even if the benefit to the least advantaged is barely better than nothing. He says, “The new distribution need only surpass what each got under the old distributions for cooperation to be mutually beneficial. The principle of the first stage says that cooperation should be extended when it results in a joint distribution that is (weakly or strongly) Pareto-better than the existing one of no extended cooperation” (261-262). Still, in Nozick’s view, no group may work ethically to ensure the detriment of another group. The norms he has proposed “encourage the extension of such coordination and cooperation. And they also forbid one kind of interaction that is not to mutual benefit, namely, interacting with another (or with others) in a way that forces that other (or them) to be worse off” (264). While many would agree that moral progress does follow a pattern of exclusion, partial inclusion, and finally full cooperation with subgroups, there is a nagging feeling that humans could do better. Even where it is not possible to achieve, we still desire an ethical theory that demands inclusion of subgroups, even when the dominate social groups desire no cooperation at all or when cooperation is not necessarily mutually beneficial. While Nozick holds that we must not coerce cooperation under any circumstances, others take the opposite view. In Ruling Passions, Simon Blackburn warns against trusting a natural progression to maximum cooperation:

The advice to limit our concerns might go along with the happy belief in an “invisible hand” or mechanism by which a number of independent agents, each acting on their own narrow concerns, in fact maximize the social good. . . . This mechanism is the great buttress to free markets and laissez-faire capitalism. Unfortunately. . . there are situations in which instead of an invisible hand there is an invisible boot, ensuring that the same agents do worse than they would under a more generous regime of concern for each other.


In Nozick’s system, cooperation for mutual benefit is not exactly contractarianism, but it appears to have some of the same limitations. Cooperation for mutual benefit can be extended to groups heretofore excluded, but only by free choices. The risk is great that excluded groups will be left out of such cooperation completely or will be given only limited opportunity for benefit. Those who hold the most resources (or legal rights, prestige, status, consideration) will have all the advantages in any cooperative venture. Those with nothing will be forced to “voluntarily” accept even the smallest distribution. Groups in power could, and historically have, exclude the least advantaged for generations. Nozick notes, “Certain extensions should have taken place earlier, even when it did not benefit the extending group” (395). In this case, he is referring to slavery, women’s rights, gay rights, and civil rights. He does not, however, provide a basis for moral compulsion to motivate extending groups. Given the overall structure of his theory, it is difficult to understand his use of “should” in the above quotation. This echoes the contractarian approach, which holds that moral rules are established through voluntary consent, which is quite similar to mutual cooperation. Tom Regan describes this approach by saying, “The result is that this approach to ethics could sanction the most blatant forms of social, economic, moral, and political injustice, ranging from a repressive caste system to systematic racial or sexual discrimination. Might, according to this theory, does make right. . . . Such a theory takes one’s moral breath away” (474).

Although he does not state it directly, Nozick implies that forcing cooperation against the free choices of individuals would violate the rights of adult humans. The first level mandates “respecting another (adult) person’s life and autonomy, forbidding murder and enslavement, restricting interference with a person’s domain of choice, and issuing in a more general set of (what have been termed negative) rights” (280). The explanation of how these rights arise is not provided. It might be a fairly simple matter to explain what non-humans or non-adults might be denied these rights based on the lack of ability to cooperate for mutual benefit, but it is a more challenging task to explain how adult humans have come to have these rights. Some have argued that the rights come with conscious awareness, which is a product of evolution, but this leaves us in a precarious position. At what point in the stages of evolution are rights (or consciousness, for that matter) bestowed? Negative rights exist only because humans, in cooperation or not, want them to exist. Our desire to be protected from murder causes us to declare that murder is a great moral evil. On this count, both non-humans and non-adults might readily agree.

Extending cooperation to new groups is a matter for the higher levels of ethics. Nozick apparently feels these higher levels have something to contribute to the benefit of society. He says, “I do not say that the ethics of each higher layer is more obligatory. It just is lovelier, more elevating” (281). In Nozick’s system, ethical behavior based on compassion and genuine concern for others is nice when it occurs, but it is more a lagniappe than an obligation. Nozick hints at the importance of compassion in rising to higher levels of ethics, but he does not fully explore the topic. Given his reliance on evolutionary biology, one might expect him to examine the possibility that compassion is selected for through evolution. Indeed, when one shows a particularly high level of concern for the well being of others, it is popular to describe such a person as being “highly evolved.” And this is in turn intended to indicate a person of high moral stature. It is impossible to imagine morality without compassion and impossible to imagine moral progress without increasing human responsiveness to the suffering of others.

Schopenhauer gives the idea clear expression:
Boundless compassion for all living beings is the firmest and surest guarantee of pure moral conduct, and needs no casuistry. Whoever is inspired with it will assuredly injure no one, will wrong no one, will encroach no one’s rights; on the contrary, he will be lenient and patient with everyone, will forgive everyone, will help everyone as much as he can, and all his actions will bear the stamp of justice. (Philosophical Writings 229)
Schopenhauer goes on to say that it would be an obvious contradiction to say that someone is virtuous but knows no compassion or that someone is unjust and malicious, yet very compassionate. Ethical vegetarians are extremely aware of this feature of ethics. People who want to become vegetarians will often ask for advice on food preparation, restaurants, and so on. It is distressingly common for such people to assure the ethical vegetarian upon whom they are imposing that they care not a whit for the suffering of animals, but that they only want to improve their own health a little bit. They proudly declare their lack of compassion, lest someone perceive their actions as ethically motivated. It is simply impossible to imagine moral behavior in the absence of compassion. In Nozick’s view, though, someone’s behavior may be guided only by the desire to avoid social sanctions, rather than by compassion. While it is certainly the case that many people act only to avoid social sanctions, their behavior cannot be described as ethical in any satisfying sense. However, it is impossible to know whether one feels compassion, but it is possible to observe whether one is acting in a manner consistent with social standards. This leads to a bifurcated approach to the study of ethical behavior. Nozick, in keeping with the aim of his project, maintains an objective stance, which is at least partly empirical. We can observe and evaluate the behavior of others, and they must be sanctioned when their behavior violates the principles of coordination to mutual benefit. Many who focus on evolution as an explanation for how ethical theories have emerged and how moral behavior can be explained tend to see the universe as unfeeling and full of competition for survival, ignoring the need for cooperation to survive. Richard Dawkins, for example, describes the world as “a universe of electrons and selfish genes, blind physical forces and genetic replication, some people are going to get hurt, other people are going to get lucky, and you won't find any rhyme or reason in it, nor any justice. The universe that we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but pitiless indifference.”

Some then conclude that ethics is merely the behavior that helps propagate the species. From this “is” there is great difficulty explaining any sort of “ought.” Nozick, who takes Hume’s claim that one can never derive an “ought” from an “is” seriously, struggles with this throughout his section on ethics. He states, without any supporting explanation or argument, that one is bound to pursue the widest possible cooperation to mutual benefit, apparently suggesting only that all adult humans should be considered agents in such cooperation. As much as he denies it, he seems to be saying that evolution has produced certain characteristics that should be what they are because things are as they should be. Evolution has given us certain behaviors that helped us be successful in the past, so we should continue to maximize those behaviors. He also attempts to explain why an individual should be ethical. In some sense, he feels we should be ethical for the same reasons that we should believe things that are true. He acknowledges that there are some cases in which this will not have the best result, but in general we are most successful when we are ethical and attempt to only hold true beliefs.

The claim is, in part, that evolution has instilled in us the capacity for success. Our instincts and biological functioning have ensured our survival this far, so we can be fairly confident that we perceive the world in such a way that success is likely if we trust our perceptions. On these grounds, we take it that our beliefs about the world are probably true beliefs or we would not be successful in negotiating our way through the world. There are plenty of examples of false beliefs giving advantages over true beliefs (overestimating one’s ability in competition, for example), but we still do well by believing that our perceptions give us the best picture of reality that is possible. This raises some interesting questions for both epistemology and ethics. For example, some have suggested that there is a biological basis for religious belief. When a portion of the temporal lobe in the brain is stimulated, an individual is likely to have an intense emotional response to the world, ascribing great meaning to everyday objects and experiences. This biological basis could account for religious experiences of humans around the globe. Some claim that religious experience and belief motivate people to form societies, find meaning in life, and even to coordinate effort to mutual benefit. However, since religious beliefs vary widely and are directly contradictory, it cannot be that most humans hold religious beliefs that are true. If religious beliefs have helped ensure the survival of humans, then, it cannot be that true beliefs have helped us, but it must be that false beliefs are crucial to success. Religion cannot be viewed as one of the rare occasions where false beliefs might help success—religion is a pervasive, though not universal, characteristic of humans. If evolution is our guide to what we ought to do, then it holds that we should form some kind of religious belief, and many have argued this is the case. Others would say that religious belief is precisely that which most threatens our survival. Only by shunning the supernatural can we achieve an objective and workable picture of reality and of each other. Nozick, of course, places a high value on objective truths that are, as much as possible, invariant and value free. This would exclude religious belief. It would seem, though, that excluding religion here would also exclude evolutionary biology as our guide to the objective world.

Nozick’s objective stance prevents him from accounting for an individual’s progress to higher levels of ethics. Developments in society may make it possible for societies to advance to higher levels. In extremely poor and desperate conditions the most ruthless forms of ethical egoism often replace coordination to mutual benefit. The struggle for survival is so fierce that concern for others only threatens one’s own life. In stark contrast to Nozick, Kai Nielsen believes that the ability to extend cooperation, including care, to disadvantaged groups entails an obligation to those groups to meet their needs. Further, he claims that when we can, we should satisfy all wants of all groups in a society: “We should, that is, provide all people equally, as far as possible, with the resources and social conditions to satisfy their wants, as fully as possible compatible with everyone else doing likewise.” (Nielsen 390) Nielsen feels it is morally imperative that we extend benefits equally to as many people in society as possible. To refuse is to be morally remiss. Rawls takes a comparatively moderate approach, claiming only that the least advantaged must not suffer needlessly when it can be prevented. Rawls is concerned primarily with reducing harm, while Nielsen wants to maximize benefit. If it were not for the coercion required to redistribute benefits, we might think Nozick would prefer Nielsen’s approach because it requires a wider circle of coordination. Of course, any forced redistribution of wealth gained through free choices will be anathema to Nozick. Interestingly, he might have more approval for Singer’s plan to reduce world poverty. Singer’s claim is that we must eliminate poverty by voluntarily giving our money away. According to Singer, governments cannot be trusted to solve the problem. As humans, we have an obligation to reduce the suffering of our fellow creatures. Of course, Singer is insisting that each individual has an obligation to rise to the higher levels of ethics (a position he shares with Peter Unger). Nozick only allows that we are able to rise to higher levels, never required to do so.

Nozick makes some references to extending concern to animals and fetuses. These are matters for only the higher levels of ethics, as neither animals nor fetuses are capable of coordinating effort to mutual benefit. This raises the question of agency and reveals a weakness in Nozick’s view of ethical progress. Animals and fetuses are similar in their ability or effect coordination of effort, but are quite dissimilar in other respects. Agency is frequently determined by the ability of an individual or group to enter into an agreement for standards of behavior. In this respect, most recognize that while fetuses have no ability to reach any agreement, they have the potential to make such agreements at some time in the future. Unless evolution is suddenly accelerated beyond anyone’s expectations, animals are sadly bereft of any potential for reaching any agreements or of coordinating activities. But animals cannot be thrown out of the agency circle just yet. Others (Bentham, Singer) will argue that the ability to suffer, not the ability to enter into agreements, is the basis for moral agency. On this count, fetuses are likely to have a lesser capacity than fully developed non-human animals. As cooperation with animals and fetuses is not possible, ethical choices must be guided by another principle, and reduction of harm (or suffering) suits the purpose.

The problem now is that it is difficult to quantify harm. A fetus, if permitted to survive, has the potential to experience great benefits and to benefit others. It also has the potential to cause great harm. While cooperation is not possible at the moment, the promise of future cooperation might endow the fetus with “rights” that will later impose obligations and duties. In a sense, rights are granted now for delayed obligations and duties. In the effort to reduce harm, one might argue that denying the potential adult human the opportunity to enjoy all the benefits associated with life is to do great harm to the potential human. Many see the elimination of potentiality to be of little concern. Reducing the number of humans on the planet may be the only way to ensure the survival of the species. Having the child born could cause harm to society, harm to the parents, and harm to the child. All life is filled with suffering, and being born is hardly of any intrinsic value, or so it is argued. A child who is a hardship to its parents could cause them a great deal of grief (the product of rape is only a further illustration of the same point), and a child born into poverty could become a burden on society as a whole.

On the other hand, it is argued that animals are capable of experiencing harm right now. What’s more, millions of animals are needlessly tortured and brutalized each day. While animals can be used for the benefit of humans, they do not coordinate their activities for mutual benefit, and they will never be able to do so. The only way to reduce the suffering of animals is for humans to take a caring role toward them. While humans act out of compassion for animals, no one believes animals will be able to return the favor. Still, it is argued that having evolved from lower animals, our experience of pain must be similar to the experiences of at least the higher order of mammals. Understanding the pain of animals compels us to try to reduce it, understanding that we would want our pain to be reduced whenever it is possible.

These problems illustrate the importance of agency in an ethical theory. Nozick’s mandate for the widest coordination possible does not address genuine moral problems that we must face on a daily basis. If the ability to participate in cooperative activities determines whether one is deserving of consideration, then what is the status of adults with brain damage (from diseases such as Alzheimer’s Disease or from injury), children, fetuses, or animals? There must be some normative force behind the idea that we must rise above the first level of respect and show some concern for the suffering of those who are able to suffer.

How Should We Live?

Nozick makes the claim that people should be moral in order to be valuable:
Being moral instances and realizes a more general kind of value, and you should be moral because it is . . . a better way to be. The unethical person may not care about being more valuable (when he realizes what value is), but his not caring about this just reinforces his lesser value. The unethical person, then, is not getting away with anything. (283)

Nozick goes on to claim that this value sanction is an “attractive and promising theoretical route to giving normative force to ethics” (283). It is true, in general, that those who refuse to coordinate activities to mutual benefit are valued less by society, but it is hard to see that this will give normative force to ethics. Snipers, corporate marauders, and petty thieves seem to thrive on the lack of value society gives them. The value sanction itself seems to compel them to greater and greater crimes. Psychological egoism claims that people act only from their own self-interest. Both moral and immoral individuals choose the actions that benefit them in the most direct way. Those who have risen to the highest level of ethics of caring and responsiveness do this only because it makes them feel good to do so. In Nozick’s view, these people are probably those who are concerned with value and being valued. Being valued by society, according to egoists, is a selfish motivation for acting in a moral manner. The counter claim, of course, is that wanting to be valued and desiring value is the definition of a moral person in the first place, so this cannot be a sign of selfishness, but only of moral worth. No one should apologize for being the type of person who feels good when doing the right thing. Unfortunately, the unethical person might feel just fine by taking advantage of weaker people, using deceit to gain objectives, and even of using violence and force for sheer pleasure. The unethical person, then, derives pleasure from being wicked. In order to give our theory moral force, we almost need to say that everyone should want to have moral value and derive pleasure from doing works that coordinate to mutual benefit.

Existentialists have made the claim that humans always choose “the good.” By choosing an action, one gives that action a stamp of approval. The CEO who plunders the wealth of his stockholders has consciously chosen this action as better than all competing options. Each person is responsible for his own actions, and there can be no universal standard by which actions are evaluated. There is a catch, however. Each individual lives in a world of other people, and these others can often perceive the individual just as she is. As Sartre put it in No Exit, “Hell is other people.” The person who lives with no concern for others, who violates even the most basic level of ethics, must live with the nagging fear that others will perceive him as he really is, and shame is his lot. Unfortunately, many feel neither shame nor remorse, and no one has found a way to instill these feelings (or compassion) in people who do not have them. We can explain why ethical behavior is good for humans and, therefore, should be encouraged. We cannot explain why an individual who is unethical can be compelled to become ethical.

It is possible, however, to examine how one comes to be unethical in the first place. If compassion is essential to ethical behavior (or concern for having a greater value), then we could look at people who lack this feature and try to determine why. This might lead to a deterministic view that shows that ethical behavior is only the product of genetics, environment, and training. Such a view could still be of great value, though. The discovery of genetic markers that prevent the development of compassion, or finding educational methods that inculcate a value for reducing suffering, or manipulating the environment to produce more caring individuals might be seen as an advance. Many (libertarians, for example) will see any efforts to create ethical individuals to violate the first level of respect for persons. The most likely approach will be to label unethical behavior as a symptom of a disease, and then interventions will be medical interventions, rather than political or social coercion. The gloss that ethical behavior gives life would likely disappear in such a world of manufactured behavior. Nonetheless, suffering might be greatly decreased.

On the subjective individual level, and individual is likely to develop a sense of whether moral behavior is of value or not by interacting with other people. A person who is honest, compassionate, and concerned for mutual benefit might have a variety of experiences. In a positive and loving community, this person will be valued and will be successful in relationships, contracts, and personal fulfillment. This person’s sense of morality is likely to grow stronger and stronger. In other environments, the compassionate person will be abused, manipulated, and exploited. This person is likely to learn the lesson quickly and become hardened and disinterested in either the approval or the suffering of others.

Nozick has provided a brilliant descriptive framework for ethics, giving plausible explanations for the function and origin of ethics. If someone were so inclined, Nozick’s ideas could probably be developed into a comprehensive theory for describing ethics. It is likely that the theory would pass most tests for objectivity and might even have a number of invariant features. The system would still lack, however, all but the weakest moral force. Using evolutionary biology as a basis for this theory and combining it with concern over the is-ought debate prevents Nozick from developing a more robust ethical system. Add to this a libertarian perspective that shuns all but the weakest ethical obligations, and the system is limited almost entirely to descriptive ethics, but Nozick is trying to establish something more than a mere description. He is trying to establish something that is morally binding. In order to do so, it is necessary to bring in ideas such as agency, compassion, and harm. The concept of harm is essential to developing an idea of what is ethical. Compassion, or a similar sentiment, is necessary for distinguishing between ethical choices and choices that are merely beneficial. And agency is necessary for determining what individuals or groups are to be considered a part of the ethical realm. At the minimum, an ethical theory should compel individuals to reduce harm and consider the interests of all sentient beings, though this consideration does not entail that all sentient beings are in any sense equal. With or without social sanctions, efforts to compel individuals to be compassionate are doomed to failure. An ethical society, then, should examine what actions and conditions nurture compassion and work toward a more compassionate world. Advances in technology, communications, medicine, and science all create increased opportunities to extend cooperation and show compassion to a greater number of groups. Where it is possible to reduce harm, nurture compassion, and widen the circle of cooperation, it should be undertaken. This is not to say that social sanctions should be in place to coerce individuals, but it is to say that anyone who fails to reduce harm, nurture compassion, and widen the circle of cooperation is not acting ethically. To be ethical requires this much at least.