Tag Archives: deontology

Dec 30 2015
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biology, medical ethics, medicine, Moral Anti-Realism, moral realism, philosophy, psychology

The Harder Problem

I have a purple shirt, or maybe it is royal blue. I was never in doubt about the color until my wife called it blue one day. Up until that point, I never even contemplated calling the shirt blue, or that there might be a difference between my perception of the shirt’s color and her’s.

Maybe there still is not a difference. Maybe our perceptions are the same and the words we use differ unnecessarily. If I look hard, though, I can see how she would call the shirt blue.

Her and my perceptions are almost certainly not the same, nor are anyone’s. The alternative – that people disagree about colors, and so much more, because our language is massively mistaken – seems too incredible. Shouldn’t we have ferreted out even the most minor issues by now? After all, we do so well at finding agreeable words for so many things, even in the realm of aesthetics.

Plus, there is a good explanation for the source of disagreement between me and my wife on my shirt’s color. If one tracks back how each of us learned to classify blue and purple experiences, there are substantial differences. And, those differences do not only effect our use of words; those differences also condition our purple and blue perceptions .

Yet there is another problem lurking. Even if I could magically take a snapshot of my brain at the moment in which I saw the shirt as purple, and show it to my wife, not as a map or photo, but as exactly the same state of affairs imposed upon her neurons, she could still differentiate it upon reflection. The brain state in question would always be her experience of my experience, rather than simply her experience. My experience of the shirt’s color cannot be captured, as mine, by means of physical reproduction.

One might ask, who cares? The upshot of our limitations is tolerable. Big truths may be a little counterfeit by implication, but we are accustomed to working with flawed notions already, and do fine by it. For example, Newtonian mechanics serves us beautifully, even if it is not ‘really true’.

Yet, we do not tolerate our flawed notions. An optimist would say that we are not satisfied with lesser things, and are constantly trying to improve our understanding. Our behavior suggests otherwise, however. We want big truths in principle, and the certainty, the reality, that comes along with them. In physics, we don’t just want quantum mechanics and relativity, we want a theory of everything. In ethics, we want good and evil, and duties to serve.

So, the hard problem does matter, because it is motivating. And, it moves us to a harder problem. We want things to be true which are not merely false, but which are incapable of being true or false. The idea of a concept not being truth-apt is slippery, so an illustration is in order.

Consider the case of Baby K. Baby K was born over two decades ago without a brain. Not only was she(?) born, she pulled off a feat which few anencephalics manage; she lived more than briefly. Or, she maintained a metabolism more than briefly, because her status as a living thing, much less a living human infant, was in question. She would never see a purple shirt, or a blue shirt, or have any experience at all. And since our personal experience is what we value above anything (what choice do we have, after all?) some people felt that a creature without experience and incapable of it was not truly alive, much less human.

Baby K’s mother disagreed. She felt that K was born of a human, exhibited some behaviors, had a heartbeat, and therefore fit into the human peg-hole, albeit imperfectly. K’s remarkable persistence owes to her mother’s insistence on aggressive medical interventions for K, based on K’s status as a human baby. For K’s mother, the rules of classification were categorical. There are Forms in the world, according to this school of thought, and the Forms suck their creatures in, even the most flawed copies.

When Baby K had trouble breathing, her mother took her to the ER and demanded that Baby K be saved, put on a ventilator, and nursed back to health in the ICU. But was health one of K’s capabilities? She needed saving, but for what, and from what? We could not ask K about any of this, ever, even in principle. As her physiology counted down to its end, what was there to distinguish this tick from the following tock, and so provide a basis for valuing more of the physiological process?

When K came in to the ER, the professionals on duty did not want to treat her. Since she was incapable of experience, she had nothing to value (there wasn’t even anyone there to value anything). Efforts to ‘help’ K were therefore empty. There was nothing to help with and no one to accept the helpful gesture.

Remarkably, some argued that further medical interventions merely prolonged K’s suffering. Perhaps they meant to say that further interventions caused the staff to suffer. More properly, futile actions degraded the integrity of the medical professions. We become what we practice, and if the medical professionals practiced service to the beating heart, then they rightfully feared that they would become servants to the beating heart.

The hospital also expressed concerns about the resources that K consumed. This argument was a utilitarian argument and failed in the usual fashion. If K did not occupy the ICU bed, the bed would not move to an under-served area, nor would the unexpended cost of K’s breathing tubes and procedures be converted into mosquito nets for children in malaria-afflicted territories. Values are not generally translatable, any more than their costs are portable.

But the missing cipher in the professionals’ calculation was K’s value to her mother. Someone did experience K’s physiology after all. To waive K’s value on that account was just as degrading as crass service to the beating heart. If the medical professions seek to serve health, and health is function, then the milieu is everything. It was a mistake to consider K’s value on the basis of K’s intrinsic capacity for experience, just as much as it was a mistake to think that the ventilator was saving K herself from or for anything. However mistaken she was about Forms and their efficacy, K’s mother valued K’s beating heart in a consistent way. Harm would come to the mother from K’s heart stopping. It would be the same sort of harm – loss of experience and the possibility of experience – to which the professionals referred in their assessment of K’s lack of value.

All along, the players in the Baby K saga evaluated her with standards that did not apply – that were not truth-apt. It was never the case that Baby K was human or not, alive or not. Her case nicely demonstrates the nature of the harder problem. Our standards – good, evil, human, matter, energy, mine, yours, blue, purple – are not stand-alone things. They are made of their circumstances (our circumstances). Without a doubt, the standards serve us well, since our circumstances are necessarily shared. If the standards refer to the specifics, and the specifics are near enough alike, it’s just good fudging to defer to the standards. It is easy to forget that the standards defer to their instances. And we are motivated to forget, because we value our experience and we value our standards, and we are prone to equate the two.

 

 

 

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Dec 12 2015
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climbing, moral realism, philosophy, psychology

Realism in the Time of the Troonians

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My son pointed at the massive dwelling crouched on the mountainside below us.
“Just one mortar round…,” he said, “Wouldn’t you like to see it?”
He was having some trouble adjusting to our move from rural Wyoming to the swanky part of the Southwest desert. He took little comfort in my assurances that all the car washes and golf courses would soon (in geologic terms) suck the metropolis dry and leave its snotty, effete denizens to perish on the parched dust like beached fish gasping for water. Even the fact that we were hastening the demise of this false oasis by our presence, did not satisfy him.
I, on the other hand, felt a certain degree of fulfillment from participating in the great blooming and dying-back.
But, I had to admit, I would like to see the house explode.
It was offensive to me, for a number of reasons.
The house was part of a cluster of housing developments and country clubs which had sprouted below a small range of granite crags north of Scottsdale. All were emblems of wretched excess, with the concomitant nomenclature: “The Estates at Xanadu”, “Regent Manors”, and the like. I had taken to lumping the lot under the oddest of their labels – “Troon”.
It wasn’t just a funny name; it designated a private golf course and a gated community, so it represented the entire syndrome nicely. The homes all cost millions, and they sprawled. The square footage stood for the worst aesthetic arrangement which our society had to offer, which was the joy of possession over the joy of experience.
Worse, though, was the history of the Troons relative to the surrounding crags. They had posed a serious risk to climbing access.
Most of the problems had been resolved with the creation of Pinnacle Peak Park. However, it was the idea behind the threat to climbing access that was offensive. The threat implied an equivalence, at least, between the Troonians’ appreciation for the crags, and my own.
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Clearly, that was not the case. For them, the rock constituted part of a lifestyle badge. It was kind of nice to look at, and living beneath it gave the Troonian status. He could feel a little removed, and above it all, like the proud peak in his backyard. He didn’t want climbers ruining the image of the rock, much less disturbing his sense of splendid isolation otherwise by yelling ‘off belay’ during his afternoon tea.
I understood the beauty of distant peaks, too. But I also knew the beauty of the rock close up, under finger and foot. It was something more, and forever unavailable to the Troonian. He had no right to impinge on my more complete and superior aesthetic.
But how could one convince a Philistine that he was a Philistine? The problem was intractable. He would always have some rejoinder about a set of related values which justified his being a rotten little twerp. In this case, it would be property, the rights of exchange which came with hard- earned (hah!) wealth, and liberty. Forget the fact that he could not own the rock in any meaningful way. He had to either bring it down or squat below it. Forget the fact that his array of goods for purchase was already limited by the aesthetics of his society, which found it distasteful, for instance, for him to buy humans for any purpose. Forget the fact that he had already sacrificed the greater portion of his liberty in the process of becoming a Troonian (the chances of one of those poor, business-softened bastards even scrambling up the Pinnacle Peak approach trail, were practically nil).
The Troonian’s frame of reference could not encompass my own. He would never be able to appreciate the inferiority of his aesthetic relative to mine, and so he would continue to hold his own values precious by mistake. If ethics boiled down to the reconciliation of intentionality and motivation with truth, there could be no ethical resolution between myself and the Troonian. There was no commonly held truth between us.
Traditionally, that class of differences has been settled with mortar shells. The Trooninan’s annihilation would be a consensual truth. But it would be a superimposed truth, and an impolite way of changing the subject. It missed the intention, since it was no longer about me and the Troonian and our aesthetic differences, but about the prejudicial elimination of those differences. And it was discordant with my motive, which was to appreciate the climbing experience.
The relevant truth was that the Trooinian and I valued something about the peaks, and generally valued our valuations in a similar way. That last bit was the truth that our difference was about, and it was not the truth to which my impulse to see his house explode and to hack him to death with a machete as he stumbled, flaming, from the wreckage, appealed. It did not feel as good, acting on this second-order stuff – the valuation of values – as would a good hacking which made its own truth. I could see how one would come to think that feeling anything about a moral decision was a red herring. And from there, I could see how one would come to think that moral decisions had a real and objective life of their own.
I looked back at my son.
“Hmmm,” I answered, “I’d rather climb the Y-crack.”
And I would. I would rather climb, keep my voice down, leave the crag before dark and choose to see the little McMansion at our feet as a quaint feature of the landscape. Hell, who knew? Maybe the squishy critter in the cage below us was really an old dirt bag who’d hit it big in the lottery and looked up at us with a sense of appreciation and nostalgia.
Maybe, but I doubted it.

Besides, there is always something better in Sedona

Besides, there is always something better in Sedona

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May 11 2014
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atheism, medical ethics, Moral Anti-Realism, moral realism, philosophy, psychology, theism

Can You Keep It Real?

On a cold morning, a little girl named Suzy is waiting for the School Bus at the bottom of a steep hill. It was raining the night before, and water has been flowing next to the curb. The water froze in the early hours of the morning, forming a sheet of black ice. The ice sheet extends all the way down to Suzy, and unfortunately for her, passes under the tires of a Cadillac Coupe DeVille parked in the middle of the hill. As the sun hits the hill, the ice loses its grip on the tires and the car slides silently and rapidly down the hill, striking Suzy and killing her instantly.
Now suppose the same chain of events ensues, except this time, the car breaks loose just as the cars owner, Andy, sits down in the driver’s seat and closes the door. The inside door handle is broken, so he can’t just jump back out again. The power windows are up and the horn doesn’t work, so he has no way to warn Suzy of her impending doom. He desperately turns the wheel, but it’s too slick for the tires to grab. Suzy dies just as in scenario #1.
Again, suppose the circumstances are the same, but this time, the owner of the car is different. Let’s call him Brian. When Brian realizes that he is sliding out of control, he thinks, “You know, I’ve always hated that little bitch anyway,” and he turns the wheel to direct the car toward little Suzy. Again, the tires have no purchase on the ice and the chain of events is unaltered.
Is there a moral distinction in the incident between the unoccupied car and the occupied car? Between the incident with Andy and the incident with Brian? If so, where is the independent and objective moral fact in each case?
To take things a little further, suppose Suzy doesn’t die. After the car launches her through the air, she manages to stick a perfect landing in the grassy median, apparently uninjured. But Suzy’s parents soon notice that something is amiss. When they ask her, “Did you enjoy your dinner dear?” she replies, “The meal was such that it would produce an enjoyable sensation in a person so disposed.”
When they ask her, “Are you comfortable dear?” she answers, “My condition is such that a person capable of it would feel cold.” Suzy appears completely impassive throughout. She eats, sleeps, and goes to school just like she did before the accident. A full medical workup turns up nothing. Gradually, Suzy’s parents stop feeding her anything fancy. She does not complain. They dress her in a burlap shift every day. She’s apparently fine with it. They turn off the heat in her room and only crank the thermostat back up if she begins shivering. They say they still love Suzy; the extras just don’t matter anymore.
Are Suzy’s parents behaving immorally? What is Suzy’s moral status and why?
Let’s go one step further. Suppose Suzy lands in a heap, but survives. She is apparently comatose. Her doctors think that they can help though. They begin an infusion of medication that will awaken her. As the medication flows into her vein, she bolts upright with a look of horror.
“What have you done?” she demands, “Put me back. I’ve been grown for years, I have children of my own and they need me.”
What should Suzy’s parents do? Does Suzy’s inner world have any value? If so, why? If not, why?

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Nov 27 2013
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atheism, medical ethics, Moral Anti-Realism, moral realism, philosophy, psychology, theism

Chaos Theory

The last several centuries have seen the rise of a perverse vision of morality. Going by various aliases this modern moral concept tells us that moral terms refer to something other than good and evil. Instead, the adherents of this viewpoint would ask us to believe that good and evil are mere descriptions, applicable to fashion choices as much as acts of benevolence or depravity. But the modern viewpoint is a lie. Descriptions have no power. They cannot motivate us to do anything. Of course, one suspects that the agenda driving our modern metamorphosis aims at a world where morality is not motivating. With moral focus dimmed, people can be motivated by those things which bring them pleasure and worldly profit. However, the agenda merely trades upon the normalizing effect of objective morality. We could not live as we do by following the path of moral relativism in real life.
Without objective moral terms, chaos would ensue. We do not have chaos, because moral terms refer to real things. Consider the alternative. If good and bad only operate within local frames of reference, we have a cascade of conflicting claims. Sometimes an act is good, sometimes bad. Sometimes an arrangement between individuals is evil, sometimes it is not. We cannot know which is which on the face of it. The authority of moral adjectives saves us from this fate. We need that authority to explain ourselves, and without it, we haven’t the motive power and clarity demanded by the moral challenges we face.
For example, walking among us is a small class of persons without remorse. They have no aversion to murder, and so require a reason outside themselves to condemn killing other people for any reason at all. Without objective moral terms, we have little to tell the psychopath. We can waffle about relationships and ties that bind, hoping to lash the psychopath to us with weak logic referring to dependencies. But what’s to stop him from replying in our own terms, like a serial-killing Popeye, “I am what I am and that’s right for me.”?
With objective moral terms at our disposal, we may respond with authority. “Murder is evil,” we may say, “and evil must be opposed.” A good moral concept is not just explanatory. A good moral concept tells us that we ought to do something, not just why we should think something is preferable. A good moral concept is solid, not riddled with re-words to the point of hollowness.
The moral troubles of the world require something with heft. Consider an even more difficult problem than individuals prone to violence: organized violence. Sadly, war is a fact of life. Our morality must confront it with an obligation powerful enough to justify such a monstrous activity . We can’t reasonably bomb the citizens of Dresden or Hiroshima and say to them or ourselves, “It is inconsistent with your identity as a human being that your group destroy other humans – the very source of that identity. Therefore you must die.”
We must provide a proper justification. We must say, “You have proven yourselves a proper medium for the perpetuation of evil. That is what we are bombing. Your deaths are regrettable, but that’s the best we can do and we are obligated to do our best when it comes to opposing evil.”
We cannot escape the reality of our moral terms, nor should we try. They are bound to catch us, because they do carry the obligations which we see at work in a just war. Nothing demonstrates our situation in that regard better than the way we deal with animals which kill humans.
If a bear kills a child, we execute the bear. We don’t kill the bear for any qualities relative to its bearishness, i.e. being a carnivore, needing to fatten up for hibernation, having an instinct to protect its young. We don’t care about the bear’s reasons; we care about the act. It has destroyed something invaluable. It has shown itself a creature with evil in its nature, and so must die. We are not angry at the bear. This is not revenge. This is justice.
Objective moral entities will finally allow no re-words at all. No relative merits, relations, revenge or reconsideration apply. Nor does scale. Absolutes do not mind scale. Evil is evil, and must be expurgated. What differentiates big evils from little ones is the ease with which they may be expurgated, not the strength of their demand on us.
The analysis at hand extends even to the smallest evils. Every year, 11,000 invaluable human lives are lost to infection with the bacterium Staphylococcus Aureus. We execute these tiny monsters with antibiotics. For the microbes which succumb, that’s the end of it, they have proven themselves minor evils and our obligation has been concomitant. But some do not succumb. Some of the bacteria are resistant to our antibiotics. In the case of the resistant bacteria, our duties are more complicated.
The bacteria in question, the resistant and the susceptible, live in people’s noses. The carriers of these bacteria are therefore complicit in the mediation of the evil which Staph. Aureus perpetrates. We may start by treating the carriers’ complicity as a minor evil and employ appropriate methods. We inform the carriers of their status and offer them the chance to eradicate the evil in their noses. History tells us that some of them will be unsuccessful. In those cases, a greater evil confronts us. The bacteria are persistent because they are resistant and so are better able to kill. As accomplices, we may treat the sub-group of carriers more leniently, though we are obligated to deal with the associated evil. These people have the choice of exile or suicide. These options neatly close the circle of obligation, but that’s not the important thing. What matters is that we have answered to our obligation. We have successfully solved the moral calculus and maximized human thriving. We can answer the carriers as we can answer the citizens of Dresden or Hiroshima. Your excision is regrettable, but that’s the best we can do, and we are obliged to do our best when it comes to opposing evil.

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Mar 30 2012
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medical ethics, philosophy

Three Puzzles

“Goddamnit! Hold him down,” said the Chief.

His tone, which had been ironic and jovial as he bantered with the patient moments before, was now weary and annoyed.

 As the Chief rammed the blunt plastic rod beneath the skin of the man’s chest, under his collar-bone and into the incision in the hollow of his neck, the man bucked and screamed again. Nurses and medical students grasped his limbs to keep him on the table. The surgeons had taken every necessary measure to make the procedure safe and painless. They chose to place the catheter into the patient’s jugular vein under sedation to avoid the greater risks and side-effects of general anesthesia. They had even injected local anesthetic at the incision site and along the track the catheter would take from his mid-chest to the point where it entered the vein in his neck.

Not that local anesthesia could deaden such a large area. It mostly helped tamp down soreness after the procedure. But it needed do no more, because of the type of sedative used. Besides making a patient sleepy, the chemical was an amnestic; it reduced a human’s powers of memory to those of a goldfish.

As we wheeled him back to the recovery room, I leaned over the patient and asked, “Uh, how do you think that went?”

“Beautifully,” he said.

“No pain?”, I inquired.

“Not a bit,” he chirped, “and you know, I’m surprised how lucid I was. That was the best operation I’ve ever been through.”

I stopped dead in the hallway. At that moment, I understood the feeling my friend  had a week previously when he found out his parents aspired to zombiehood. They were, he had discovered, people who wanted ‘everything done’. He had tried to explain the predicament this created for him, and though I thought I had understood the situation based on our common experience as medical students, his complete perspective eluded me at the time. I thought his parents were just wrong because they knew no better.  Of course, we two medical students were horrified, since we knew what ‘everything’ really was and where it led: dull suffering, delirium, dead eyes in a live body, chest heaving to the click and hiss of a ventilator, then death, inescapable in spite of  ‘everything’. I hadn’t seen the other side of my friend’s dilemma: what is it like for the zombie? To become a zombie – a dying person bent on continuing to die – was to abandon a previous, more natural course but perhaps it was not a wrong act. Perhaps the transformation was like telling a goldfish in a bowl that it was doomed to swim in a twelve-inch circle until it died. The goldfish would suffer withering psychic agony for the three seconds it could recall the revelation, then it would return to contentment, unharmed. The vicarious regrets of the living  just might have a similar effect on a zombie, even the regrets of their former, living self.

And as the gurney bumped against the recovery room doors, I realized that I had faced this riddle once before and failed to resolve it. The riddle had come that time in the context of a story a co-worker told me. We worked together at a landscaping business. The guy was a mechanic, so he worked in the shop, while I worked in the field. Still, I got to know him well enough through shared lunch hours and down time with broken equipment to decide he was a decent guy. He was honest and, as a practicing Catholic, always trying to be good. And he was good, sometimes to a fault as he freely lent money to people who were unlikely to ever pay it back. Then he told me a story about when he was in the service.

He was stationed at a boring, isolated post. For miles around, there was nothing but irrigated fields, sage brush, and a few abandoned missile silos. Nothing moved on the landscape but jack rabbits and a few stray domestic animals. The jackrabbits were wary and hard to catch, but the strays would come to a kind word and an offer of food, so they were the ones that got tossed down the missile silos for fun. At first, the fading echos of the animals’ cries and the sparkling static on their fur were entertaining enough. Later, gasoline on that crackling fur added novelty to the routine.

He saw nothing wrong with ‘dog toss’. These were animals, after all, not conscious beings with a soul. As such, they could not truly suffer. What happened to them, as long as it was relatively quick and served a human need, didn’t matter. He thought this because he had been raised a moral realist and a deontologist. Good was a ghost in the ether, inhabiting certain acts and objects, imbuing them with its nature. All else was morally neutral. Other things rated only via human largess backed by tenuous relationships drawn between the hosts of good and those other things that his moral educators felt uncomfortable excluding from their calculus. Other things rated as bonus points. No one was going to hell for ‘dog toss’.

No one was going to hell for what happened under sedation with an amnestic agent either. The healthy body (even just a relatively healthy body) was a host for good, and that end didn’t just justify the means, it made them irrelevant. Proof  lay smiling on the gurney in recovery, ready for the next step in his embodiment of good, where his catheter would carry toxins to his blood to kill his tumors, his appetite, his hair follicles, his sense of smell, the lining of his mouth and colon, all to clear a space for good between his diagnosis of metastatic cancer and his death from it.

The doors swung shut and the surgical team turned away toward the suite of operating rooms where the next case waited. I did not follow. These three were related riddles, but they were not quite the same. Though I could now see it whole, the third puzzle still remained, and it was still the hardest. My friend’s parents were motivated by moral realism to have everything done. But whether their end came by age, chronic illness or catastrophe, the change from living to dying would come to them and sweep away any thought of ghosts and duty to ghosts just as surely as an amnestic sedative swept away all memory of pain and indifference to pain. Then it would be up to us – family, friends, doctors, hospitals – to tend to the ghost, or not. That was the hard part. Because we could deal with the creature before us, be it living or not, on its own terms, instead of trying to realize an apparition. And that meant denying metaphysical duty.

I stood for another moment while the surgical team gained some distance on me.

“I ought to walk out that door and just keep going,” I thought.

Instead, I put my head down and set off after the surgeons. I knew that I wasn’t doing the dutiful thing, but I was pretty sure that didn’t matter. Maybe all I could do was deal with what was in front of me, zombies and all. But even if I wasn’t up to the task of replacing them, I couldn’t keep serving  ghosts, theirs or mine.

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