Apparently in Scotland senior doctors are urging health professionals to consider (meant literally not just a synonym for approve) allowing the active euthanasia of severely disabled babies.

Well it’s about time. These aren’t people missing a limb or ‘merely’ severely retarded and deformed. They appear to be talking only about babies with horrible incurable conditions that will create years of pain and have a very low change of survival. Frankly as long as we are talking about these cases it really is a no brainer.

The situation these babies find themselves in is effectively that of an individual with a terminal illness who losses all mental facilities including speech and any understanding of the outside world and is doomed to suffer a year of excruciating pain before death. Given such a grim diagnosis I suspect that but for the influence of religious/cultural prohibitions nearly all of us would choose an early death. Moreover, unlike a grown individual the child does not yet have fully formed personality, goals, dreams, achievements, a lifetime of memories or a web of personal relations that (help) make us so desperate to hang on to life.

Of course the standard objections are heard from disabled rights groups

Simone Aspis of The British Council of Disabled People:

Euthanasia for disabled newborns tells society that being born disabled is a bad thing. If we introduced euthanasia for certain conditions, it would tell adults with those conditions that they are worth less than other members of society.

Wait this tells society that being born disabled is a bad thing? Ohh fuck, we couldn’t have people believing it would be better to be born without disabilities than with them. I mean then they might go out and do something horrible like trying to increase prenatal care or give women vitamins. Even if some people hold the ridiculous view that it isn’t worse to be born disabled I don’t think anyone is going to volunteer for the option of pervasive severe pain followed by an early death.

So let’s look at the second claim that this would tell society that adults with these conditions were worth less than other members of society. We can already see it deeply mistaken. We would be doing for the babies the same as we would do for ourselves. In fact it would be forcing these children to endure pointless suffering to assuage our moral sentiments that would show a disregard for the disabled.

But even when applied to less extreme situations, say aborting a child whom ultrasound shows to be missing limbs, this argument is simply fallacious. As Van Gogh and many others illustrate living an enjoyable life and being valued by society are very different concepts. Additionally someone’s worth to society just doesn’t have much to do with whether they deserve dignity, respect and decent treatment. Obviously everyone isn’t above average and some people are worth less to society than others but this has little to do with whether we think they ought to be denied equal treatment, denied basic human dignity or even if we would be friends with them.

Ultimately this argument proves far too much. If euthanasia for the severely disabled tells society that being disabled is a bad thing why don’t programs to end teenage pregnancy tell us being a teenage pregnancy is a bad thing? If this program would tell adults with these conditions that they were worth less than other members of society why don’t teenage pregnancy prevention programs tell adults born to teenage mothers they are worth less than other parts of society?

In addition to the standard arguments from the disabled community we also have the boilerplate concern about the role of doctors.

But the paper quoted John Wyatt, consultant neonatologist at University College Hospital, as saying: “Intentional killing is not part of medical care… once you introduce the possibility of intentional killing you change the fundamental nature of medicine. It becomes a subjective decision of whose life is worthwhile.”

This argument is not just wrong it is downright harmful. The fundamental nature of medicine is not about saving life it is about improving the quality of life. Every time a doctor treats acne, makes surgery a bit more complex to avoid leaving a scar, prescribes ADD or anti-anxiety medication, gives a woman who had a mastectomy an implant or administers painkillers they are improving quality of life at the expense of possible side effects. Making trade offs between life and quality of life IS the essence of medicine.

So yes when the patient cannot speak for themselves it is necessary to make a subjective decision about whether their life is worth living. We are doing it right now and it is infinitely better to face this fact than letting people suffer so we can pretend to avoid the question.

Ultimately I think we ought to go far beyond this proposal. I think we ought to mandate abortion for all fetuses discovered to have birth defects. By mandating abortion we would minimize the moral pain associated with making the decision and I don’t think there is any question that aborting a fetus is less bad than going and making someone disabled (say by poisoning babies). Once we’ve bit the bullet on abortion and agreed it isn’t murder we should be prepared to treat it as such. If people knew they could use birth control for a month and reduce their chance of birth defects a hundred fold they wouldn’t hesitate so how is aborting the defective fetuses any different? I might even favor euthanasia for severely retarded children or those with extreme physical deformities inflicting severe suffering even if non-terminal.

A couple days ago Ali and I were having a rehash of our standard argument about public statements and moral responsibility. In particular whether or not Larry Summers deserves blame or criticism for not being more careful about emphasizing that he wasn’t suggesting the utterly simplistic ‘women just can’t do it so we can ignore social issues’ position. Now having read his remarks I thought it was pretty damn clear he wasn’t advocating anything of the kind, he just wanted people to consider the possibility that biological differences play a substantial role. However, I agree it would have been better had he been even more careful. The question is whether this is the sort of thing which deserves blame or criticism.

Now certainly there is a principle that says one is morally responsible for foreseeable harm that results from your speech. If you’re giving a speech to an angry mob you know to be capable of violence and say ‘the world would be better if so and so was hanged’ then you bear responsibility for his death. However, we are less inclined to criticize someone for failing to make a helpful point or when the remark falls within a societally accepted zone. I will argue that Summers’ failure to make additional cautionary remarks is less bad than the normal behavior of most distinguished individuals that we would never think of criticizing. Thus by criticizing Summers without making it clear that the commonplace behavior we see all the time is even worse one gives the false impression that he is more blameworthy. Worse this criticism itself is harmful speech as it furthers the notion that the mere suggestion of biological effects is morally outrageous as it is only the content of Summers remarks that differentiates him from all these individuals who skate by without a second thought.

Implicitly I will assume that the moral responsibility one has for making or not making a remark depends only on the foreseeablity of the effects and the harmfulness of these effects. Keeping this in mind let us consider a college president (or any public figure) who publicly supported Bush in the last election (change this to Kerry if you are of the other political persuasion). Now I think the evidence that electing Bush would lead to harm was pretty damn clear (it was also pretty clear the first time too). Anyone unblinded by emotion could have seen the harms Bush had already inflicted upon the nation and thus should have known that supporting Bush would lead to delitorious results. Now while it is unclear to me whether Summers’ failure to be more careful lead to any significant harms but electing a worse president costs hundreds, and perhaps hundreds of thousands in Iraq their life. Yet even among those who dislike Bush few blame outspoken Bush supporters the way Summers is blamed even though if more distinguished individuals, particularly known conservatives, had urged us to vote against him he probably would not have won. Note that if you don’t like this example just substitute your favorite law or issue you think is obvious and clear and ask if your well-intentioned but mistaken opponents are blameworthy for being on the wrong side of the issue. If so why aren’t we hearing the sort of criticism of them we hear about Summers’?

I think an even better example are ministers and public officials who express a belief in christianity (or islam or judaism) Now of all the claims bandied about in public discourse those offered by the major organized religions are the most absurd. Each of these religions makes specific claims about miracles at times in the past, e.g., people rising from the dead. It is hard to think of a widespread belief that has stronger evidence against it. Yet if religion is false it seems quite evident that it imposes serious costs on society not to mention causing conflict and poor regulation. It’s my opinion that merely engaging in the practice of convincing people to believe and devote great energy to a crazy belief system that you should know is incorrect is itself more blameworthy than what Summers did (unless you have compelling reasons to think that deceiving the people is to their own benefit). Still since some are going to argue that organized religion has beneficial effects (I think they ignore the secular institutions that would arise to take their place) let’s focus on specific beliefs.

So consider any priest, minister or layperson who claims that religion forbids one from using birth control. The harm of this belief, particularly in Africa where religious aid often won’t distribute condoms, is blatant. Or consider the religious belief that abortion is murder. Once again the harm of outlawing or even restricting abortion and stem cell research is quite clear. There are a hundred other beliefs that are also easily seen to be harmful if false. Yet if these beliefs weren’t publicly supported by ministers or other laypeople almost no one would believe them. Since the falsity of religious belief is infinitely more apparent than the need for Summers to more carefully explain his point and the harms far greater anyone who publicly professes one of these beliefs is even more blameworthy than Summers.

Finally and most analogously consider the people who argue against biological explanations of performance differences. For instance the people who released the recent national academies of science report claiming to disprove biological effects. Now having read the literature it is equally absurd to hold the extreme view that it is all social without a biological component as it is to hold the extreme view that it is all biological without a social component. At the very least the hormone studies show that their is some indirect effect of biology on someone’s likelihood to succeed in math and science. Many of these biological differences are likely going to be unrelated to ability yet given our social structures affect the individuals inclination to enter and perform in math and science, for instance women’s greater risk aversion.

The extreme social view isn’t just a nice delusion, it negatively impacts our ability to make mathematics and science accessible for women. If we pretend there aren’t any differences between men and women we can’t fix how society responds to the irrelevant differences. For instance if women are biologically more inclined/better at learning one way and men another it is important to ensure that both ways are compatible with our teaching. Unlike the extreme biological view the extreme social view is actually held by educated individuals making academic policy making it at least as much of a threat. Thus if Summers is blameworthy for not making his rejection of the extreme biological theory even more clear in his speech then groups like the national academies are far more culpable for writing reports seeming to suggest it’s all social without even hinting that the extreme social view is in error.

In short I just don’t see how one can coherently call Summers’ remarks blameworthy and not call people’s mistaken opinions about far more influential subjects (war, famine, third world aid, contraception) even more blameworthy. Since we don’t blaming Summers for his remarks is misleading and, since the difference between Summers and these other individuals is merely what position he took, sends the message that you just can’t consider even partially biological explanations.

So today the execution of Morales in California was indefinitely postponed today when two doctors balked at actively participating in the execution. This situation was created after a judge ruled based on a study in the lancet, that the standard method of lethal injection may not render an inmate fully unconscious allowing them to suffer and thus may be cruel and unusual.

I have to say I approve of the decisions by the doctors involved. I tend to think the entire debate over doctor assisted suicide is just stupid if doctors have anything to do with executions. However, this issue is at least debatable.

What I don’t understand is why we are executing people with methods that have the slightest risk of causing pain. What is death not enough? Why must we be additionally cruel and make sure they die in an unpleasant fashion? It isn’t like their aren’t plenty of perfectly painless, even enjoyable ways to die. Why not end a killers life with an overdose of opiates? Or as the judge suggested an overdose of barbiturate (there is no good reason it needs to be given by a doctor or nurse but I suspect the judge’s ruling in this case was simply mandated by state law, i.e. it would be illegal for someone else to administer a controlled substance). Hell, given a choice between the current procedure and a large caliber precisely aimed gun to the head I would take the gun out of fear the barbiturate wouldn’t be enough.

I’ve never understood the societal need to inflict pointless pain but surely this case is just ridiculous. We are already killing them for their crime, is it to much to ask to do it in the most painless way we know how?

So a few weeks ago I published a really long post about the murky legal aspects of gay marriage. Unfortunately, despite the apparent inconsistency between past precedent and laws denying gays the right to marry it seems unlikely the court is going to grant gays the right to marry anytime soon. In fact from a political perspective it is likely that a decision in favor of gay marriage would cost the court a great deal of political capital that would be better used elsewhere. The real issue behind gay marriage is not some abstract legal right but the social acceptance of homosexuality and it is unclear if an unpopular court decision supporting gay marriage would advance this cause or provoke resentment and retard it. Ultimately, just as with civil rights, any real solution to this problem will need to come from the legislature and ultimately from society. While this solution is a long way off the form it will take is already crystalizing. As has happened in a number of other countries and a state or two the traditional franchise of marriage is going to be extended to homosexuals. However, this approach just repeats the mistakes of the past. It injects the government into the bedroom and the household and asks it to make moral judgments about what sort of relationships are good and which are not. The only difference is that gays would be in the approved category.

In a moment I will detail the problems with legal marriage but first let me outline the alternative so they can be compared. Rather than having the government pick out a certain sort of relationship, set the terms of that relationship and reserve certain privileges and benefits to the people in that relationship adults could confer whatever subset of those benefits they saw fit via contract (more or less see below). For instance anyone could sign papers granting another consenting adult joint parental rights to any children they have. This way for instance not only lesbians who wanted to raise a child together but a pair of spinster sisters could do the same. Of course there would still need to be a special underlying legal status for people who have chosen to legally treated as a single entity but it would be available to any type of relationships be it parent-child, brother-sister, or husband-wife. Most people of course would simply take a standard set of these legal relationships requiring no more paperwork than a marriage license does now but the same privileges would be available to anyone no matter what kind of relationship they were in. There are a few details that need to be dealt with (like preventing people from using these arrangements to arbitrarily transfer wealth tax free). I will offer some suggestions on the details in the extended entry below but first let me detail the benefits of this approach.

As I’ve already hinted at the basic problem with marriage is that it forces the government to select what sort of relationships are ‘worthy’ of the economic and legal benefits of marriage. If you think it is wrong to deny the benefits of marriage to gays just because a majority of people disapprove of that sort of relationship it would be hypocritical not to also support the same benefits to people in group marriages or other non-traditional relationships. In fact there seems to be no justifiable reason to grant these benefits only to people in sexual relationships. If one is unfortunate enough to remain single for your entire life why should the government add insult to injury and deny you these benefits if you choose to cohabitate with a friend or relative? If one suggests that these benefits aren’t really a big deal and single folks (say single sisters who live together) aren’t being screwed over then there is no harm in dissolving the legal institution of marriage, people can just live together without these minor advantages, and if these advantages do matter it seems wrong to deny them to the people who are unlucky enough to be single (not only do studies show marriage makes one more happy it lets one reduce many expenses).

Apart from the basic issues of fairness having the government pick out what relationships count as marriage inevitably entangles gets public policy entangled in an emotional mess. Though many people argue that marriage is about incentivizing two parent homes or other desirable child-rearing behavior neither the benefits or who they are granted too have little rational relation to these ends. Why for instance do we allow women over 50 to marry if it is about children? If it turned out that it was bad for children if their parents stayed in a failed relationship for financial reasons could you imagine a tax benefit for divorce? While many of the benefits offered by marriage are also good for child-rearing, and it would be foolish not to let parents receive them, it is clear that the notion of marriage is such a deeply emotional subject for most people that it can never be treated as just a tool for incentivizing behavior. Intrinsically people view the status of marriage as a type of approval and so long as the government decides what sort of relationships are to be approved of our social policy will be distorted by strong emotions and many people will be hurt by governmental disapproval.

Just like other tough moral, spiritual and personal issues it would be best if the government just stayed out of the debate. We all know that having the government decide which churches are acceptable would cause unnecessary acrimony and suffering. The situation is pretty much the same with marriage. It would be best if we could get the government completely out of the bedroom and leave the matter of deciding what is an acceptable marriage to the churches and the couples. Below I will outline some specifics about how we might accomplish such a thing.

Of course despite the eminent sensibility of such an approach it is about as politically viable as free abortions. I can see the political accusations already, “The secular liberals even want to take away your right to MARRY.” (more…)

Lately it seems I’ve been writing lots of conservative sounding posts so I figured it was time to brush up on my liberal credentials and write a pro-abortion piece. In fact such a very pro-abortion piece that I’m sure most liberals would try to disown me and instead label me as a fascist. So to head off this line of attack let me emphasize that I’m not advocating any government action at all in this post, that is a hard and complex issue. I’m only talking about people’s personal moral responsibility. Also nothing in this post is meant to disparage the disabled only to acknowledge that most of us (disabled people included) would very much prefer not to be disabled

So my controversial claim is that expecting women (and their partners) who discover their fetus suffers from a developmental disorder or other condition that will cause it to be seriously disabled#[ser] have a moral obligation to abort that child. In fact not only do I believe this but I think anyone who doesn’t think abortion is deeply wrong and agrees to a few other reasonable assumptions is required to hold this position.

Let me stress that there is no sarcasm involved, this is not a “Modest Proposal” style shock piece, I really do hold this position and find these arguments compelling. I realize that many people will be outraged at this suggestion and tempted to dismiss it out of hand. However, I urge you to read my entire post and try to identify where I go wrong. Especially in issues like this we need to make sure our emotions don’t run away with our brains.

Below I will offer a detailed argument which does not suppose that abortion is a morally neutral act. However, let me first explain the intuition behind this conclusion before people stop reading in outrage. Basically the idea is we don’t believe it is wrong not to procreate or abort just because this this choice prevents some people from ever existing. Just because abortion prevents children whose parents would have aborted them from existing doesn’t make it morally wrong. The fact that the disabled are an easily identifiable and somewhat socially cohesive doesn’t change the basic situation

Yet if abortion itself is not wrong then aborting the disabled should be morally equivalent to sorting your eggs for genetically healthy specimens before conceiving and since eggs are just cells this should be morally equivalent to providing pre-conception therapy to your eggs to save your child from being seriously disabled. Yet if your only chance to save your child from a serious disability was pre-conception therapy not only would it not be wrong it would be morally required. Hence it is actually morally required to abort the disabled. (more…)

So I’ve been listening to the Dali Lamma’s discussion with the dean of Stanford’s religious studies program today on the radio and like every time I hear the Dali Lamma I found myself very impressed. This particular conversation focused on non-violence and what the Dali Lamma interprets this to mean. If I understood the Dali Lamma correctly he basically defined non-violence to be acting so as to minimize violence. Apparently even wars could be undertaken in the name of non-violence so long as they truly were intended to avert more violence than they caused.

I wonder what all those hippies who view the Dali Lamma as the ultimate font of wisdom think. I bet when he said it was too early to tell if the Iraq war was a good idea yet he sent some liberals into fits.

The more I hear from the Dali Lamma the more I suspect he is a hard core utilitarian dressed up in fancy clothes. I’ve yet to hear him say anything Bentham wouldn’t heartily approve of, except perhaps the references to the spiritual (come to think of it what was Bentham’s theistic disposition?). The irony involved if this is true is amazing as many of the people who venerate him seem to do so as a reaction against cold calculating moralities like utilitarianism.