Morality and Medical Malpractice

One of the traditional thought experiments leveraged against utilitarianism goes as follows:

A surgeon has five patients, each with a different organ which has stopped working. Each is in need of having a working organ transplanted into them, and will die if they do not receive this. At this point, a person with a fully working body happens to enter the surgery. The surgeon could kill this person quickly and painlessly, and give each of the patients a working organ from this person's body. Thus, they would give up one life but would save five lives; utilitarianism implies that the surgeon must surely do this. But this course of action would be monstrous. Hence, utilitarianism is false.

Most utilitarians are not too keen to bite the bullet by admitting that this would be the moral course of action, and tend to argue that there are advantages to a system where you can see a doctor without risk of being murdered. Non-utilitarians would respond by stipulating that absolutely no-one finds out about the murder, so that this system of cooperation is not disturbed. I don't know the utilitarian response to that, but basically it all gets very messy and unclear.

I have a better response to this thought experiment.

Killing the healthy person is stupid! What you need to do is kill one of the people who is already dying, and give their organs to the other people who are dying. Select this person at random, so there's no disincentive to go into the surgery - it's a choice between going in and facing a one-in-five chance of dying, and staying out and being sure to die. Five people survive, one person dies, and no-one can complain that their rights are being ignored. Just tell the patients: "You're all going to die if you don't take part in this raffle, because your organ will give out completely and you won't get a transplant. If you take part, then you may end up being killed right now but providing someone else loses, you will get one of their organs and you will live." Far cleaner, with no need to unilaterally violate the rights of an innocent.

Review: The Voyage of the Dawn Treader (2010)

Perhaps the people who made this film had something of an intention to make an adaptation of the book, but it felt far more like a poorly-scripted Dungeons and Dragons campaign. A full list of things I dislike about this film would be long, impractical, and would arguably require me to watch the whole film rather than just the first hour and the last few minutes. However, here are some lowlights:

• As happened in the book, Lucy becomes desirous to use a spell which will give her the beauty of her sister Susan. As in the book, Aslan chides her for this. But whereas in the book the problem was with her jealousy, in the film this is somehow represented as a mere lack of self-confidence. But she still feels the need to apologise to Aslan over it.
• The changes to the relationship between Coriakin and the Dufflepuds. In the book, the Dufflepuds turned themselves (and, as an unintended consequence, Coriakin) invisible because they believed themselves to be ugly. In the film he unilaterally turns them invisible - and sure, it's for their own protection, but would it have been so difficult to explain what he was doing? - and is presented as being unquestionably justified.
• On a related note, Coriakin is, above all else, what leads me to compare the film to a D&D campaign. He is quite literally a Mr Exposition, launching with next to no explanation into a description of exactly must the main characters must do.

With my dislike of the film sated, I'll just note two things which amazed/shocked me. First, look at these pictures of Eustace Scrubb:

After you've finished being creeped out by how much a boy can look like a lizard, would you guess that the actor playing him was 16 at the time of filming?

Second, note the girl on the right. That's Lucy Pevensie, as portrayed by Georgie Henley. This is a picture of her looking incredibly cute upon first encountering Narnia:

This is a picture of her looking incredibly cute while talking to Mr Tumnus after her coronation:

And this is the picture which appears at the top of her page on TV Tropes;

CHILDHOOD. RUINED.

My philosophical views

Having an hour to spare and nothing better to do, I've decided to write down my current answers to the questions on the PhilPapers survey of philosophers' views. First, a couple of notes and caveats:

• At first, I wasn't going to look at any (potentially new-to-me) arguments for the positions while doing this. However, upon reflection it seems strange to reject a chance to be motivated to learn.
• One of the options on the original survey was "insufficiently familiar with the area." This really ought to be my default answer - I am, after all, a mere undergraduate student - but where would be the fun in that. Instead, for any given issue you should assume that I am probably not as familiar with the issue as I ought to be.

A Priori knowledge: yes or no?

Umm... lean no, maybe? I lean towards the view that logic, maths etc are constructed rather than discovered, and given that they are supposed to be the paradigm cases of a priori knowledge, I guess that places me in the No category.

Abstract objects: Platonism or nominalism?

Is this asking whether I believe that there are no abstract objects, or which of these positions I lean towards on a greater number of subjects? I'm not willing to completely rule out abstract objects (fictional objects in particular strike me as things which might exist but be abstract) but I don't believe in the existence of numbers, of propositions, or of many of the other abstract objects which have been postulated to exist. Put me down as leaning towards nominalism.

Aesthetic value: objective or subjective?

I have actually put serious effort into trying to work out why anyone might think that aesthetic value is objective, and the closest I've seen to an argument is SEP's mention of the fact that "people tend to agree about which things are beautiful." Sigh. Accept subjective.

Analytic-synthetic distinction: yes or no?

I don't believe in it, the only question is whether I go down as Lean No or Accept No. Quine was very convincing... go on, put me down as Accept No.

Epistemic justification: Internalism or Externalism?

I can never remember which is which. Assuming I correctly understand the issue, one of them is the view that knowledge-seeking has intrinsic value, the other is that we should seek knowledge because it is useful to us. Yudkowsky put this very nicely in the Sequences, saying that seeking knowledge out of curiosity has a certain purity to it, but the advantage of seeking knowledge because it is useful is that it creates an external criterion by which to measure our success. Accept whichever one it is which says we should seek knowledge because it is useful.

External world: idealism, skepticism, or non-sceptical realism?

Accept non-sceptical realism. You can't achieve absolute certainty that you aren't being deceived by a demon, but (a) there is no reason to believe you are either and (b) in any case, suppose you were. You don't know anything about what the demon wants, so there's no particular reason to change the way you act.

Free-will: compatabilism, libertarianism, or no free will?

I'm fairly well convinced that if determinism is true, then (a) people cannot act differently than they do but (b) they are still morally responsible for their actions. I believe this makes me a compatibilist, although it strikes me as a bit weird that this is counted as believing in free will rather than denying that free will is necessary for moral responsibility.

God: theism or atheism?

Damn, no option for deism. Lean deism if that's acceptable, otherwise I place higher probability mass in atheism than in any of the "revealed religions".

Knowledge: empiricism or rationalism?

Given that I deny a priori knowledge, it would be rather odd if I were to say rationalism. (At least, it appears that way; perhaps this is one of the many things on which I shall come to be corrected.) Accept empiricism.

Knowledge claims: contextualism, relativism, or invariantism?

No familiarity with the subject area.

Laws of nature: Humean or non-Humean?

Accept Humean.

Logic: classical or non-classical?

This is an interesting one. As said above, I lean towards the view that logics are constructed rather than discovered, and that different logics may be appropriate for different purposes. The philosophical justification for intuitionistic logic is something I find very appealing, so let's say Lean non-classical.

Mental content: internalism or externalism?

No familiarity with the subject area.

Meta-ethics: moral realism or moral anti-realism?

I lean towards constructivism. I believe this makes me a moral realist, although that's a bit weird since I started working out my metaethics by explicitly assuming there were no genuine moral facts floating around.

Metaphilosophy: naturalism or non-naturalism?

Is the question "Which is it more fruitful for us to assume as a default?" or "Which do I beliee is actually true?" Accept naturalism on the first, lean non-naturalism on the second.

Mind: physicalism or non-physicalism?

Next to no familiarity with the subject area.

Moral judgement: cognitivism or non-cognitivism?

I looked at this at some point, but I can't remember much of what it was about.

Moral motivation: internalism or externalism?

Is this related to the amoralist's challenge? I've been thinking about that for ages, and still don't have a satisfactory answer despite reformulating my metaethics at least partially in an attempt to produce an answer to this question.

Newcomb's problem: one box or two boxes?

Accept one box. Although even if I were the type of person who would two-box, would I go around telling people that?

Normative ethics: deontology, consequentialism, or virtue ethics?

Virtue ethics, subject to deontological constraints, and with the choice of virtues justified on pluralist-consequentialist grounds. Yes, really.

Perceptual experience: disjunctivism, qualia theory, representationalism, or sense-datum theory?

When I studied this in first year, it seemed like a slam-dunk for sense-datum theory. However, given that (a) that was before I had read The Sequences, (b) I can't even remember what the first two of these were or if they were even mentioned, and (c) I have rejected almost every other view I picked up on that course (belief in the a priori, epistemological foundationalism, free-will libertarianism, near-universal scepticism... I must just about hold to a sensitivity condition regarding knowledge, so not quite everything), I'm inclined to take that past belief with rather a lot of salt.

Personal identity: biological view, psychological view, or further-fact view?

I don't hold to a biological view, but I' not greatly satisfied by the leading psychological accounts (though if I had to choose one, I would go with Schechtman's). I don't even know what the further-fact view is, and looking at the relevant SEP and Wikipedia articles suggests that either I'm misunderstanding the question, or that there is something odd about it. I was reading section 3 of Reasons and Persons, but my Kindle has gone missing.

Politics: communitarianism, egalitarianism, or libertarianism?

Accept libertarianism. Have you read my blog?

Proper names: Fregean, or Millian?

I prefer the Millian view, and I believe that Nathan Salmon's discussion of "guises" solves most of the problems for it; that said, I need to do more reading, so put me down as merely leaning Millian.

Science: scientific realism or scientific anti-realism?

Scientific realism. Because, you know. Duh.

Teletransporter (new material): survival or death?

Can I suggest the answer is somewhat subjective? Personally I would regard it as survival, but I'm very open towards difference of intuitions and I think that the disagreement is more to do with people having different values than to do with some (or all) people being wrong about an actual fact in the world.

Time: A-theory or B-theory?

B-theory is the one which holds all times to be equally real, and suggests that we move through time rather than time itself moving, right? Accept that one.

Trolley problem (five straight ahead, one on side track, turn requires switching, what ought one do?) 

switch or don't switch?

I would lean towards switching. I'm not entirely comfortable with it, but David Friedman's variation on Fat Man (in which both the Fat Man and yourself are required to does a fair job of convincing me that we should probably be willing not only to turn the trolley, but to push the fat man in its way.

Truth: correspondence, deflationary, or epistemic?

I read The Simple Truth and it sounded sensible. Then again, I haven't done a great deal of engagement with the views other than correspondence - certainly I could not explain what they are - so I'll have to just say I have insufficient engagement with the subject area.

Zombies: inconceivable, conceivable but not metaphysically possible, or metaphysically possible?

Again, especially insufficiently familiar, but leaning towards one of the not-metaphysically-possible positions.

Greed vs. Self-interest

A lot of people who attack mainstream economics will say it assumes that people are always greedy, and that this isn't the case, therefore it is based upon false premises. I feel like this is unfair - I wouldn't describe "economists believe everyone is always greedy" as a strawman, but it's an unfair way of putting it.

Economists tend to assume people are self-interested. I'm not certain how to cash out the difference between being "greedy" and being "self-interested", but I'm fairly certain there is one. For example, I would much rather eat a nice meal than be poked in the eye. Given a choice between the two, I would choose the meal. I don't think that makes me greedy, but it is definitely a self-interested choice.

Perhaps we might say that being "greedy" implies a certain lack of concern for others. There are people who I care about deeply, and I would say that their well-being contributes to my well-being. Hence, if I had to option to provide a benefit to my brother at minimal material or temporal cost to myself, I would be likely to provide this benefit. We can conceive of this as being self-interested, but it seems weird to describe it as greedy.

Alternatively, perhaps we think of greed as being overly concerned with material wealth, as compared to other valuable things. If someone were to pave over a beautiful garden in order to build houses, I can imagine them being described as a "greedy developer".

In any case, I don't think either of these words - at least as used in the most conventional sense - is really an appropriate way of describing the way economists conceive of self-interest. It's true that our models frequently exclude charitable spending and gifts to other agents, but if you want to call failing to give to charity greedy then (while I agree with you) you're going to have a hard time arguing that people aren't basically greedy, given the rather small size of charitable donations. (And also given that Effective Altruism is seen as radical and unusual. Since I heard of it, EA has always seemed rather obviously correct - at least, so long as one accepts moral realism - and yet, EA evangelism is not just a matter of explaining the basic ideas to people, you generally have to convince them over weeks and months. This strongly suggests to me that, when people donate to charity, the extent to which they help people is not generally at the forefront of their mind.)

Perhaps the best way of explaining the way most people understand the word "greedy" is that it should be viewed as relative to a socially agreed baseline. So it's "greedy" not to pay taxes, and moreover, "paying one's taxes" is defined relative to the intent rather than the letter of the law. (This "intent" can be very nebulous, of course - what is one person's "incentive to promote valuable business and job creation" is another person's "corporate loophole"). But since most people don't really give to charity, it's not greedy not to give - just so long as you do give when everyone is doing so (e.g. school non-uniform day, a leaving present for someone at the office, icebucket challenge).

This is not to say that the assumption that people act "rationally" in the economist's sense is entirely warranted: merely that to suggest it has too low a picture of humans is quite the wrong way to go about attacking it. A far better attack - one which, in my view, has a lot of truth to it - is that it overestimates people. People do not generally set out purposefully so as to best achieve their goals. Indeed, they make certain consistent and predictable errors. This is indeed something of a challenge to the axioms of neoclassical economics - although, with a better awareness of human psychology, it may well be possible to repair the faulty assumptions to make better predictions.

Rawls on Procedural Justice

From A Theory of Justice, page 76:

A distribution cannot be judged in isolation from the system of which it is the outcome or from what individuals have done in good faith in light of established expectations. If it is asked in the abstract whether one distribution of a given stock of things to definite individuals with known desires and preferences is better than another, then there is simply no answer.

In this passage, Rawls is actually talking about the importance of equality of opportunity, but it sounds a lot more like something out of Anarchy, State and Utopia. We frequently think of Rawls as "the minimax guy", and certainly that is the aspect of his principles of justice which has received the most attention, so it is quite interesting to see him giving so much weight to a conception of procedural justice - albeit a rather more demanding version of it than a Nozickian would advocate.

I remember, back when we were first studying Rawls, the lecturer would present us with two graphs like the ones below. He would ask us about which we thought was a better society. If I were to go back in time, I would be equipped with a pretty smart-arse response.

Step by step...

...gender equality progresses.

Kurdish defenders have victory in their sights. After exactly a month of fighting, they say they have driven Islamic State from most of the city.

But from a hilltop across the border in Turkey, it is clear there is still fighting going on, particularly in the north of the city. Small and heavy arms fire can be heard, as well as occasional explosions. There have also been several air strikes this afternoon by the US-led coalition.

One 32-year-old Kurdish militia commander, who leads the fighting in the east of the city, told me she hoped the city would be "fully liberated" very soon.

(from a BBC article on the war currently going on between ISIS and the Kurds).


Notice that little word in the final paragraph: "she". At almost any time before now, the idea of a woman leading an army (with certain rare and very charismatic exceptions) would either have been laughed at or would have called to the mind the Amazon stereotype. Instead, women of ability are able to lead armies, and to be taken seriously. Perhaps The Onion laughs at this kind of thing, but I view it as a genuine step towards genuine sexual equality.

Can Christians have compassion?

It has sometimes been pointed out that the desire of many on the left to blame high crime rates and other bad behaviour by poor people on the environment in which they grow up is rather at odds with a liberal conception of people as free and rational agents. It occurred to me today that this is an even greater problem for those who take the bible to be the word of God:

For since the creation of the world God’s invisible qualities—his eternal power and divine nature—have been clearly seen, being understood from what has been made, so that people are without excuse. (Romans 1:20)

The Christian believes that, with two exceptions (and one of them was also a deity) every person who has ever lived has sinned, and grievously so. Despite this ridiculously strong evidence that living without sinning is basically impossible given the human condition, people are still taken to be morally responsible for having sinned.

I can see two ways in which a Christian might push back against this, but both seem to have very severe problems. The first is to argue that going to hell for one's sin does not necessarily imply a moral judgement against one for having sinned; merely, that one is not absolutely pure and therefore cannot be with God who is himself absolutely pure. This is perhaps the easier bullet to bite, but it still means that Divine Command theories of morality are rendered incoherent. This is a serious problem, not only because many Christians would like to identify morality with God's law but also because one of the most popular arguments for God's existence is that it gives us a grounding for objective morality.

The other counter-argument would be that while we cannot realistically go without sinning, we can generally sin less than we actually do. But this makes it difficult to resist the argument that especially virtuous people. who sin but do so at rates for lower than other humans, ought to be (in a sense) justified by their own efforts. "Yes, it's true that I sinned, but it would have been nigh-impossible for me to have sinned less considering that I am, ultimately, only human." This flat-out contradicts crucial Christian doctrine:

Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me." (John 14:6)