Effectiveness Enhancement and Motivational Enhancement

Hannah Maslen asks the question as to whether there is an important difference between the enhancement of effectiveness and the enhancement of motivation; see marathon mice and the will to work . In this posting I will examine Maslen’s question and will conclude there is. I will further conclude even if the artificial enhancement of effectiveness is unacceptable that the artificial enhancement of motivation may be acceptable.

In order to examine this question we must first examine what is meant by motivation. Intuitively motivation simply means how much effort we put in to achieving our goals. The greater the effort we put in, the greater our motivation. What do we mean by our motivation? Is motivation something we possess in much the same way as we might possess such things as strength or intelligence? Let us accept there are some means of enhancing our strength and intelligence which are acceptable; after all athletes enhance their strength through training and scholars their intelligence through learning. Let us also accept motivation is something we possess in much the same way as we possess strength or intelligence. Prima facie it follows there are some ways of enhancing our motivation which should be perfectly acceptable.

The above is of course too simplistic. For the sake of argument let us now assume there are some means enhancing strength and intelligence which are unacceptable such as artificial means. If this is so we might agree with Leonard Kass,

“Yet in those areas of human life in which excellence has until now been achieved only by discipline and effort, the attainment of those achievements by means of drugs, genetic engineering, or implanted devices looks to be “cheating” or “cheap.” We believe – or until only yesterday believed – that people should work hard for their achievements. “Nothing good comes easily.” See Beyond therapy: Biotechnology and the Pursuit of Human Improvement .

Basically it seems to me that Kass’ argument might be summarised as follows. He argues that if we obtain certain goods without any real determination that in so doing we devalue determination in general. In addition, for his argument to work he must believe the damage this does to our determination is not offset by the value of any goods obtained. For the moment let us accept this argument. Let us also assume it is possible to artificially enhance our motivation. It follows there is an important difference between the enhancement of effectiveness and the enhancement of motivation. Enhancing our effectiveness devalues our motivation whilst it is hard to see how enhancing our motivation could devalue motivation. More generally if something is worth enhancing then it must have some value and enhancing this something can only enhance this value. Of course if such an enhancement devalues other goods this devaluation might supply us with a reason not to proceed with the proposed enhancement. For instance Kass believes it would be wrong to enhance our intelligence or strength by artificial means because these enhancements would devalue and eventually damage our motivation. Let us accept that increased determination is a good thing. It follows from the above that it would not be wrong to artificially enhance our determination and hence our motivation provided this enhancement does not damage some other goods. In the case of enhancing our motivation what sort of other goods might we damage? Our determination to be determined? It seems it would be possible for Kass to endorse artificially enhancing our motivations whilst at the same time maintaining it would be wrong to artificially enhance more general goods such as our strength or intelligence and still remain consistent. Personally I doubt that Kass would make such an endorsement.

What sort of objection to the above might an objector such as Kass raise? He might suggest that artificially enhancing someone’s motivations would damage her authenticity as a person. What does it mean to be authentic? Intuitively an authentic person is one who is true to her self. An authentic person is someone who is not easily swayed by short term emotions or the views of others. I have argued in previous posts that a person is defined by what she cares about, what she takes pride in. It follows that anyone who is a person must care about or love something. I would suggest how authentic a person is depends on how she acts with regard to what she cares about or takes pride in. Enhancing someone’s motivation, her determination, does not change what she cares about. Moreover enhancing someone’s motivation increases her disposition to act with regard to what she cares about. It follows enhancing someone’s determination does not damage her authenticity. Accepting the above means it might even be argued enhancing someone’s motivation does not damage her authenticity and might possibly enhance it.

However my objector might respond by pointing out I have been treating our motivation in a purely instrumental way. He might proceed to suggest our motivations form part of who we are. He might then maintain accepting the above means that artificially enhancing our motivations might still damage our authenticity as a person. I am inclined to accept our motivations are part of who we are. Our motivations might have both intrinsic and instrumental value to us. Personally I hope I am a reasonably determined person and take some pride in my determination. I would argue if someone is proud of some personal attribute then she must care about that attribute and as a result that attribute helps define her as a person. If someone fails to act in a determined way when she cares about something she will be ashamed of herself. Let us accept that our motivations are not purely instrumental but have some intrinsic value for us. Let us further accept that some people care about their motivations and that this means these motivations help to form them as persons. It follows our motivations can be part of our authentic self. Does this acceptance mean we shouldn’t artificially enhance our motivation? People seek to change themselves by enhancing themselves by training or learning. I can see of no reason why people changing themselves by these means will render themselves in-authentic. Perhaps, as suggested above, we shouldn’t do this by artificial means because doing so might damage our motivation. However I can see no reason why someone shouldn’t change herself by artificially enhancing her motivation because doing so might damage her authenticity. In practice I have some remaining doubts but perhaps these might be based on some unjustified arrogance on my part.

Meaning and Happiness

In a recent posting in practical ethics Hannah Maslen considers happiness meaning and well-being. Let us accept that happiness and meaning in life are both part of well-being. There is usually a positive correlation between happiness and meaning. Usually happy people have a more meaningful life and vice versa. However some research by Roy Baumeister, Kathleen Vohs, Jennifer Aaker and Emily Garbinsky shows this correlation is not always positive (1). Maslen wonders if when this occasional incompatibility occurs whether we must make a decision about which of these two goods to pursue. In what follows I will consider this question. I will however use a slightly different approach to what is meant by meaning in life.

Before examining Maslen’s question I must consider what is meant by meaning in life. Firstly I must make it clear I am not going to consider what a meaningful life is from some objective viewpoint. I am going to consider what living a meaningful life actually means to the person who lives that life. According to the researchers’ results meaningfulness involves doing things that express and reflect the self and in particular doing positive things for others. This involvement can increase someone’s stress, worries, and anxiety. Secondly meaningfulness involves being a giver more than a taker. Lastly meaningfulness integrates past, present, and future, and sometimes meaningfulness means feeling bad. I agree with Maslen that these results rule out a purely hedonistic life as a meaningful life. Moreover these results seem to be incompatible with a meaningful life being based on desire fulfilment. For as Maslen points out stress, worry and anxiety are associated with frustrated desire, rather than desire fulfilment. It might be thought that a meaningful life is one that includes a number of objective items, items such as friendship and good health. Personally I believe such items may well contribute to a meaningful life but that they do not define it.

I now want to return to a common thread of this blog. I want to suggest that in order for someone to have a meaningful life he must ‘care about’ or love something. Indeed I would go as far as to suggest that for someone, whose life is totally devoid of any ‘caring about’, he has a life totally devoid of any meaning and as a result is not really a person at all. He is simply a wanton, see (2). In what follows I will treat the terms ‘caring about’ and ‘loving’ as interchangeable in much the same way as Harry Frankfurt does. Someone who ‘cares about’ or loves something identifies himself with what he cares about and makes himself vulnerable to losses and susceptible to benefits depending upon whether what he cares about flourishes or is harmed (3). The researchers’ results showed meaningfulness involved doing things that express and reflect the self. Caring about something means identifying with what is cared about. Identification involves doing things that express and reflect the self. Secondly the researchers’ results showed that meaningfulness can increase someone’s stress, worries and anxiety. Caring about something makes someone vulnerable and so can also increase his stress, worries and anxiety. Lastly these results show meaningfulness integrates past, present, and future. According to Frankfurt caring about involves consistency, steadiness of behaviour, and some degree of persistence (4). It follows caring about must integrates past, present, and future to some degree. In the light of the above it appears accepting that, meaning is imparted to someone’s life by what he cares about or loves concurs very well with the researchers’ results.

Let us accept that meaning in someone’s life is dependent on what he loves or cares about. If someone’s beloved flourishes then he is susceptible to the benefits of this flourishing. He is happy. It is important to be clear that someone’s beloved can refer to things as well as people. Someone’s beloved might for instance be a cause, his religion, or a place. If someone’s beloved is harmed then he is harmed. He is unhappy. At times caring about or meaning is incompatible with our ideas about being happy. Some positive psychologists such as Martin Seligman might disagree. Seligman would incorporate meaning into the meaning of happiness, see PERMA . In such cases happiness seems to mean well-being. Such a meaning seems at odds with our intuitive ideas of happiness and in what follows ‘happiness’ will refer to these intuitive ideas. Let us return to Maslen’s question, must we sometimes make a decision about whether we should pursue happiness or meaning? I will now argue the question is meaningless because if meaning depends on what we love or ‘care about’ we cannot make such a decision.

We cannot make such a decision because we cannot make a decision to love. Someone cannot simply decide to love someone or something. According to Frankfurt the will of a lover is not free. On the contrary he, because of the very nature of loving, is captivated by his beloved and his love. The will of the lover is rigorously constrained. Love is not a matter of choice (5). It follows if meaning depends on what we love that we cannot simply choose to have less meaning in our lives in order to be happier. This conclusion has important consequences for any pursuit of happiness. This pursuit is limited at least for our intuitive ideas of happiness. This limitation means that whilst we may of course seek to modify our life in order to be happier, that these modifications cannot be based on consciously altering or lessening the meaning in our lives. Of course I accept that what matters, what we love or what has meaning, may change over time but this change is not a matter of our own volition. I also accept even if we cannot simply will love we can nonetheless sometimes situate ourselves in situations in which love might grow.

1. Roy Baumeister, Kathleen Vohs, Jennifer Aaker & Emily Garbinsky, 2013, Some key differences between a happy life and a meaningful life, The Journal of Positive Psychology, 2013, volume 8(6)
2. Harry Frankfurt, 1999, Necessity, Volition, and Love. Cambridge University Press, page 114.
3. Harry Frankfurt, 1988, The Importance of What We Care About. Cambridge University Press, page 83.
4. Frankfurt, 1988, page 84.
5. Frankfurt, 1999, page 135.

Pharmacological Moral Enhancement

Joao Fabiano asks us to imagine that in the future humanity makes a major breakthrough, see Practical Ethics. He imagines that society develops a pill which rids our morality of all its faults. Without any side-effects, it vastly increases our ability to cooperate and to think rationally on moral issues, while also enhancing our empathy and our compassion for the whole of humanity. Such a pill would morally enhance us. Fabiano argues the use of such a pill would present us with grave dangers. In this posting I will consider Fabiano’s worries about pharmacological moral enhancement but with some slight modifications my comments might be applied to germline editing using CRISPR.

The pill Fabiano asks us to imagine has two functions. Firstly it enhances our cognitive abilities. Secondly it enhances our capacity for empathy. For the sake of argument I consider two pills, firstly one which enhances our cognitive abilities and secondly one which enhances our capacity for empathy. This separation means it would be possible to gain one of these kinds of enhancement even if the other posed dangers. I will consider the implications of using of each of these pills in turn.

Prima facie it might be assumed that increasing our powers of reason would increase our capacity for morality. If reason allows us to see others as much the same as ourselves then the domain of morality expands. It might be argued this has happened over time. In ancient civilisations such as that of the Greeks moral concern for the most part focussed on citizens of that state. Over time this focus broadened to include women, slaves and even animals. This seems to be the position adopted by Steven Pinker (1). However this ability to see others as much the same as ourselves does not automatically expand the domain of morality. Persson and Savulescu point out that reason and self-interest could tell you to rob and kill an injured stranger in the wilderness rather than help him or to abstain from returning a favour to someone you will not ever see again rather than return it at some cost to yourself (2). Moreover it might seem that a cognitively enhanced sociopath could do much more harm than one who had been un-enhanced. It might be suggested that if a tyrant such as Hitler or Mao had been cognitively enhanced that he could have inflicted even greater suffering. In the light of the above it might be thought I am not in favour of cognitive enhancement for moral reasons.

In fact if a pill became available, which simply cognitively enhanced us without any adverse side effects, I would be in favour of us taking such a pill for moral reasons. Firstly reason as pointed out by Hume reason alone does not give us any reason to act. If reason alone gives us no reason to act then cognitive enhancement will not alter someone’s ends. At this point an objector might point out even if cognitive enhancement does not alter someone’s ends it might enable an evil person achieve his evil ends more effectively. I accept my objectors point but would also point out cognitive enhancement should equally make it easier for a good person to achieve his good ends. In addition I would suggest that because there are more good people rather than evil people we should favour cognitive enhancement. However my objector might now suggest that certain people, such as Hitler or Mao, could cause even greater suffering if they were cognitively enhanced and that this suffering outweighs the more modest good most cognitively enhanced people would be capable of. She might then argue that because of this increased suffering which might be caused by a small minority of cognitively enhanced people we should not favour cognitive enhancement. In response I would doubt whether people such as Hitler or Mao could cause greater suffering provided they were cognitively enhanced. Moral monsters cannot cause great suffering alone. Let us accept my suggestion that most people are good, even if only to some modest degree. It follows if most people were cognitively enhanced that they would be less likely to aid moral monsters such as Hitler or Mao further their ends. It further follows we should favour cognitive enhancement. My second reason for favouring cognitive enhancement is that it is inevitable. Even if it is impossible to cognitively enhance us by pharmacological means we will nonetheless be enhanced by education. We will experience an ever expanding knowledge basis even if the speed at which we process this basis remains constant. It follows if pharmacological means of cognitive enhancement are adopted we are merely speeding up an inevitable process.

Let us consider the implications of using the second pill solely to enhance our capacity for empathy. Fabiano worries whilst such an enhancement might lead to an increase in our individual tendency towards cooperation between individuals it might also lead to an increase in competition between groups, this worry is shared by Paul Bloom (3). He argues that what is important about enhancing morality is increasing cooperation between groups. I accept Fabiano’s argument and find his worry plausible. Evolution designed us to live in small groups and enhancing our empathy might only lead to more social cooperation with people we know. Enhancing our empathy might not lead us to have any more moral concern for those separated by distance and time. It might not lead those of us in the more affluent parts of the world to think more about those of the third world or future generations, see (4). Let us assume our increased capacity for empathy is only for people we know. This increase means we might see the wants and needs of people we know assuming greater importance to us. This increased importance might lead us to exploit those people we don’t know to benefit those we do. For instance enhancing our capacity for empathy for those we know, existing people, might lead us to disregard the needs of future generations to serve the needs of the present one. In the light of the above it appears Fabiano’s worries are justified and that we should not encourage empathic enhancement for moral reasons.

If we should not encourage empathic enhancement for moral reasons should we only encourage cognitive enhancement for these purposes? Someone might suggest we should enhance our toleration of others. Indeed I would suggest in more connected, multi-racial, multi faith world the capacity for toleration is among most important moral capacities we can possess. Unfortunately at the moment there appears to be no prospect of simply enhancing our toleration by pharmacological means. In the light of the above does this mean we should only attempt to enhance our morality cognitively unless some means is found to enhance our toleration? I will now argue it does not. However even if it is impossible to directly enhance our toleration I would suggest any other type of moral enhancement should be judged by its indirect effects on our toleration.

Let us return to considering enhancing empathy and Fabiano’s worry that enhancing our empathy might lead to more group competition. Basically it might lead to less toleration. I only share Fabiano’s worry provided we only enhance our empathy. However if we can enhance our empathy it seems probable we can also enhance our cognition. It follows that in much the same way doctors use a drug cocktail to treat some diseases such as cancer, we might use a pharmacological cocktail to address our moral shortcomings. It might appear that provided we use a pharmacological cocktail to enhance both our empathy and our cognition that Fabiano’s worry might be misplaced. Let us accept that enhancing our empathy should lead to more social cooperation with people we know. Now it seems to me whether Fabiano’s worry is justified or not depends on what is meant by ‘people we know’. It is certainly justified if we only mean family and friends. It’s also justified if ‘people we know’ means people who share our particular tastes, feelings and prejudices. However ‘people we know’ could just mean the broader recognition of these people simply as people. That is they are capable of love, being hurt and are the sort of creatures that can decide their own future. It might appear that enhancing our cognition might change what we mean by ‘people we know’ from friends and family or people who share our tastes to people in the broader sense outlined above. However the above appearance might be false. It is possible even if we enhance both cognition and empathy that our enhanced empathy simply overwhelms our ability to act rationally. Whether enhanced empathy might overwhelm someone’s cognitive abilities is an empirical question and it should possible to design an experiment to answer this question. Provided it can be shown that enhanced empathy doesn’t overwhelm someone’s cognitive abilities and we adopt dual enhancement we have reason to believe Fabiano’s worry is unwarranted.

In conclusion I want to consider the enhancement of our empathy in more detail. In order to do so we must be clear about what is meant by empathy. Being able to feel empathy roughly means one has the capacity to understand and share the feelings of another. I have suggested above that the ability to feel empathy must initially have a broad basis. We must see others as being capable of love, being hurt and being the sort of creatures who can decide their own future. It follows if I care about someone in a purely empathic way I must care about what she cares about, rather than what I think might be in her best interests. Understanding other people is not always easy. Sometimes we mistake the feelings of another and substitute, what we believe they feel or even what we think they should feel, for their true feelings. We may do this because we are lazy. We simply don’t ask people how they feel. Or we may do this because we simply assume others feel the same way do. We suffer from epistemic arrogance. This substitution means we move from empathic concern to sympathy. It also means we leave the initial broad basis for empathy behind, see caring and empathy. If a pharmacological means became available which enhanced our understanding of others without leaving this initial broad basis I see no reason why such a means should not be adopted. Provided we retain this basis of empathic concern then I see no reason why enhancing our empathy should lead to more group conflict as envisioned by Fabiano.

1. Steven Pinker, 2011, The Better Angels of Our Nature, Allen Lane, page 656.
2. Ingar Persson & Julian Savulescu, UNFIT FOR THE FUTURE, Oxford University Press, page 107.
3. Paul Bloom, 2016, Against Empathy, Ecco
4. Michael Slote, 2007, The Ethics of Care and Empathy, Routledge, page 2

What do we mean by true self?

In this posting I want to examine what we mean by true self, indeed even wether the concept is a meaningful one. Buddhists and David Hume would suggest that true self is an illusion. Perhaps anti-vaxxers suggest otherwise? Their decisions seem to be based on the need to identify as a certain sort of person rather than the facts In an interesting piece posted in peasoup Joshua Knobe wonders whether the notion of a 'true self' really is best cashed out in terms of certain distinctive features of an agent's psychology. He suggests that our notion of a true self is a value-laden one and that we partly determine what lies within an agent's true self by making value-judgments of our own. In this posting I will firstly wonder whether the idea of a true self is even a meaningful one. I will conclude it is. This conclusion will open up the idea of a true self that can be cashed out in certain distinctive features of an agent's psychology. I will suggest these distinctive features are the agent’s pride and shame.

Let us examine Knobe’s position. Knobe asks us to consider someone,

“who is addicted to heroin but who desperately wants to kick the habit. He has a craving for another hit, but when he reflects, he rejects this craving and wishes he could get rid of it. Now ask yourself: Which part of this person constitutes his true self -- his craving for another hit or his desire to quit?”

Knobe suggests that intuitively we would link his true self with his desire to quit. He then asks us to consider an evangelical Christian called Mark

“He believes that homosexuality is morally wrong. In fact, Mark now leads a seminar in which he coaches homosexuals about techniques they can use to resist their attraction to people of the same-sex. However, Mark himself is attracted to other men. He openly acknowledges this to other people and discusses it as part of his own personal struggle.”

Knobe suggests in this case our intuitions are not so clear. Perhaps if someone is a born again Christian his intuitions would link Mark’s true self to his belief that homosexuality is wrong. Whilst someone of a more liberal nature would link Mark’s true self to his underlying sexual desires. The above leads Knobe to suggest that our idea of someone else’s true self is dependent on our values.

My first reaction to Knobe’s suggestion is to question whether such a concept of a true self is a useful one. Perhaps we should simply say we have a self and leave David Hume would suggest  that the whole idea of a self is an illusion. I would not go as far as that because everyone is different. Moreover everyone remains different even when we disregard their physical attributes. People are different because they have differing dispositions, abilities and personalities. If we define someone’s self by a set of non physical attributes such as, his dispositions, abilities and personality then he has a self. Let us accept that someone’s self is a meaningful concept, but is the idea of someone’s will meaningful? Many experiments have demonstrated that our decisions are partly determined by the situations we find ourselves in. For instance in a classic experiment Alice Isen and Paula Levin showed being made to feel good greatly influenced someone’s subsequent actions. In this experiment Isen and Levin showed that someone who dropped papers outside a phone booth was much more likely to be helped to pick them up if the person in the booth had just found a dime in the slot (1). Such experiments do not show we don’t have a will. However in the light of them someone might suggest our will is irrelevant when it comes to decision making. In response I would simply point out that not everyone makes the same decision in the same situation and that this difference in decision making is best explained by our differing dispositions, abilities and personalities, our self. The way in which our decisions are affected by our self is our will. I accept of course that many of the decisions, we think we consciously make, are made unconsciously and that sometimes our consciousness merely endorses these decisions. It follows that in many ways our will is not always under our conscious control. Let us accept our self and our will are as defined above.

 If we accept it makes sense to talk about someone’s self and his will does it also make sense to talk of his true self? I accept the idea of someone’s self can be cashed out in certain distinctive features of his psychology but are there any additional distinctive features of his psychology that mark out his true self? My initial reaction was that there are not. However on reflection it seems to me there might be. What then could be the distinctive features of someone’s psychology that mark out his true self? In what follows I will argue those distinctive features are his pride and shame. Prior to making my argument I must make it clear what I mean by pride and shame.

I will deal with shame first. David Velleman suggests shame is anxiety about social exclusion (2). I have argued that there are two types of shame . Type one is as suggested by Velleman. Type two shame is someone’s anxiety about harming the things he loves or values. I would further suggest that, with the exception of sociopaths, all people feel type two shame. When considering shame with regard to someone’s true self I am only interested in type two shame. Let us now consider pride. Pride might be very roughly defined as someone’s pleasure or satisfaction with his belief that he possesses some property which he values. Unlike shame I believe there is only one sort of pride. However there are deficient forms of pride as shown by Shakespeare’s Coriolanus, see damaging self love pride and shame. Firstly pride may be empty when someone’s pride is focussed on himself, rather than some of the attributes he possesses or values he holds. Secondly pride may be exclusive when a proud person is incapable of feeling any shame. I would class such forms of pride as deficient pride and when considering someone’s true self I only interested in non- deficient pride.

  will now suggest our true self is defined by a subset of our actions, those actions that cause us to feel pride or shame. It is sometimes suggested that someone’s true self is defined by the beliefs and values which he reflectively endorses. I accept someone’s true self is connected to his beliefs and values. However I do not believe someone’s beliefs and values are simply defined by his endorsement following some reflection. Someone might believe he will act in a certain way but when the time for action comes finds he cannot do so in that way. What he thought he believed or valued doesn’t give him reason to act. I would suggest that someone the beliefs and values which define his true self are determined by what he feels proud or ashamed of. Indeed someone might not be fully aware of his beliefs and values and can come to a better understanding of himself not by reflection, but by those of his actions of which he is proud or ashamed of. If the above is accepted then others can also make sense of his true self by those of his actions which he is proud or ashamed of. Additionally I would suggest that actions which make someone proud are actions he can defend even if sometimes his defence can sometimes only be mounted retrospectively. Similarly someone must be able to give some reason for his shame. An objector at this point might object that a retrospective defence is simply a justification. I will not pursue his point here.

 Let us return to Knobe’s two examples using the above definition. In the case of the heroin addict our intuitive ideas of someone’s true self and his true self coincide. Let us now consider Mark. Let us assume that even though Mark openly acknowledges he is attracted to other men, to other people and discusses it as part of his own personal struggle, he feels some shame about this fact. Let us also assume that Mark feels some pride about his coaching homosexuals in techniques they can use to resist their homosexual inclinations. Knobe suggests our intuitions about Mark’s true self depend upon whether we believe homosexuality is acceptable or not. I would suggest provided, we know what Mark is proud or ashamed of in his thoughts and actions concerning homosexuality, our intuitions about Mark’s true self do not depend on our beliefs about homosexuality. In order to see this let us consider someone who believes homosexuality is acceptable. Let us assume he accepts that Mark is ashamed about his feelings for other men and that he can account for his shame by referring to his beliefs and values. Let us further assume he also accepts that Mark is proud he coaches homosexuals in order to change their sexual inclinations and that he can defend this coaching by referring to his beliefs and values. I would suggest that such a person would find it difficult not to associate Mark’s true self with coaching of homosexuals rather than his desire for other men irrespective the person’s own values. It should also be possible to set up an experiment to test the validity of my suggestion.

I have argued the idea of someone’s true self is a meaningful concept. However not all meaningful concepts are useful ones. I will now use a real life example to tentatively suggest that someone’s true self might be a useful concept. I will use the example of MB, see General Medical Concuil's consent guidelines . MB was twenty-three years old and was thirty-three weeks pregnant. She visited her local health clinic twice and on each occasion was asked for a sample of blood. On both occasions she refused consent saying she was frightened of needles. At a later visit to the health clinic it was suspected that her baby was in a breech position and this was later confirmed by ultrasound.  Breech position carries the risk of prolapse. If prolapse occurs there is a risk that the baby’s umbilical cord might get entangled in the membranes after they have ruptured causing the baby’s blood supply to be obstructed during birth. This obstruction might cause death or brain damage to the baby due to lack of oxygen. The above was explained to MB and she was admitted to hospital where she consented to a caesarean section but she again refused to consent to a venepuncture to provide blood samples. However, when she was taken to operating theatre and the anaesthetist wished to insert a veneflon, MB refused consent and was returned to the ward. Later, when her GP visited her, she again consented to the caesarean section. However she again refused consent when taken to operating theatre. The Hospital trust applied to the courts and MB was found to be of unsound mind due to her ambivalence caused by her needle phobia and hence her refusal of consent was incompetent. In cases of ambivalence such as that of MB it makes sense to ask which decision represents the patient’s true self. If a patient can coherently defend his decision based on his beliefs and values then provided he has a true self his decision should be accepted. If however his ambivalence extends to his beliefs and values and these conflict it might be questioned if he really has a true self. In the case of MB her refusal of consent to a venepuncture was not a decision she could defend, it was not a decision that reflected her true self and as such was not a competent decision.

1. Alice Isen, Paula Levin, 1972, Effect of feeling good on helping: Cookies and kindness, Journal of Personality and Social Psychology, Vol 21(3), Mar, 384-388.
2. David Velleman, 2009, How We Get Along, Cambridge University Press, page 95.

Prisoners serving Life Sentences and Voluntary Euthanasia

In previous postings I have suggested that prisoners serving life sentences have a right to be assisted to commit suicide, see Prisoners serving Life Sentences. In this posting I will argue that this right should only apply to assisted suicide and should not extend to euthanasia. Before commencing my argument I will make some definitions I will use clear. Euthanasia means someone deliberately ends another’s life to end his suffering. Involuntary euthanasia means this is done when he does not consent. Non voluntary euthanasia means this is done when he is incapable of giving consent. Voluntary euthanasia means this is done with his consent. Assisted suicide means someone deliberately provides the means for another to end his own life. I will assume without any further argument that involuntary and non voluntary euthanasia are inapplicable to prisoners serving life sentences. In what follows I argue voluntary euthanasia should also be inapplicable to such prisoners.

Let us consider a prisoner serving a life sentence for some gruesome murder of an innocent person. Let us further assume this prisoner decides he wants to die. Why if he fully consents shouldn’t someone end his life? One reason might be that, unless the prisoner was suffering, doing so would not be a case of voluntary euthanasia. Moreover, unless the prisoner was suffering, it is not clear what would be the motive of whoever carried out the act. The motive could not be one of punishment for punishment should not depend on the wishes of the prisoner. However let us now assume our hypothetical prisoner is suffering. Why in these circumstances, provided the prisoner fully consents, shouldn’t someone end his life? One reason might be that the prisoner’s suffering could and should be relieved by other means. If his suffering is caused by poor penal conditions then these should be addressed. Voluntary euthanasia should never be used to tackle poor penal conditions; even if it tackles overcrowding! Let us now further assume that the prisoner’s suffering is not caused by poor penal conditions. Perhaps his suffering is caused by mental health problems. If a prisoner suffers from a physical illness such as diabetes then his suffering should be addressed by medical means. Similarly I would argue if a prisoner suffers from mental problems his suffering should be addressed by mental health experts. Voluntary euthanasia should not be used to address mental health problems. Lastly let us consider a scenario in which the prisoner’s suffering is not caused by penal conditions or any mental health problems. Perhaps he simply does not want to spend the rest of his days in prison or more unlikely perhaps he suffers from remorse because of the terrible crimes he committed. Surely if assisted suicide is permissible in such circumstances then so should voluntary euthanasia? I will now argue that voluntary euthanasia should also remain inapplicable even in these circumstances.

In my previous postings I have argued that a prisoner should retain some limited autonomy. Part of that limited autonomy is the right to commit suicide. As the state deprives a prisoner of the means to commit suicide it should provide him with these means in a controlled environment. The prisoner’s right to be assisted to commit suicide depends on his ability to make an autonomous decision. At this point an objector might point out voluntary euthanasia also involves an autonomous decision. She might proceed to argue, if I use a prisoner’s retention of limited autonomy to justify assisted suicide that, the same justification could apply to voluntary euthanasia.

I have two responses to my objector’s argument. Firstly I would suggest we have no need to kill someone provided he can be assisted to commit suicide. My objector might respond by suggesting that there is no real moral difference between killing and assisting someone to die. This is simply a variation of the acts and omissions problem and I will not deal with his suggestion here. My second response carries more weight. I would suggest we can never be completely certain whether someone’s decision is an autonomous one or not. I will then argue we can be more certain that someone has made an autonomous decision to commit suicide than when he gives informed consent to voluntary euthanasia. I will base my argument on the importance of what we care about when making autonomous decisions, see (1). Frankfurt argues autonomous decisions are decisions the agent cares about. I have suggested that autonomous decisions are decisions which are not discordant with what the agent cares about, see autonomous decisions . However I would agree with Frankfurt by suggesting an agent’s actions are better indicators of his autonomous decisions than the choices he makes or what he decides to do. The choices he makes and what he decides to do are only intentions. Sometimes when we come to act we find we cannot carry out our prior intentions because it was not clear to us what we really care about until we came to act. A prisoner giving informed consent to voluntary euthanasia is making a choice and deciding what would be best for him. His intentions are of course an indicator of an autonomous decision. However in the light of the above a prisoner’s actions in committing assisted suicide are a much better indicator of his autonomous decision.

1. Harry Frankfurt, 1988, The Importance of What We Care About. Cambridge University Press, page 84.

Is Toleration an Outdated Virtue?

It is sometimes argued that toleration is an outdated or incoherent virtue. One reason for given for this is John Horton’s example of a tolerant racist (1). In this posting I will argue his example does not give us any reason why we should not treat toleration as a virtue. In order to make my argument I must make clear what is meant by toleration and outline what is meant by a tolerant racist.

To be tolerant means someone accepting something he believes is bad or wrong and which she has the power to change. Toleration then has three elements. An example of a tolerant racist might be someone who accepts everyone has equal employment rights whilst believing certain racial groups should not have these rights, perhaps because he believes members of these groups are lazy, and has the power to deny members of these groups these rights in some limited circumstances. Such a person could be regarded as a tolerant racist. According to Magali Bessone if we accept the standard definition of toleration, outlined above, then “the more strongly racist a person is, the more virtuous he appears to be” (2). In essence the above means the stronger someone’s racist belief that these groups should not possess these rights then provided he does not act on these beliefs the more tolerant he appears to be. I will now argue this appearance is false because the example of the tolerant racist conflates the moral worth of tolerance with the amount of effort it takes someone to be tolerant.

At this point I want to introduce another example which I will call the reluctant truth teller. Let us assume someone finds it hard to tell the truth. He likes to embellish stories and exaggerate his exploits. Nonetheless this person forces himself to be truthful. Let us compare the reluctant truth teller with someone who finds it natural to be truthful. If we accept the logic of the tolerant racist then it would appear that the reluctant truth teller is morally more virtuous than the person who finds truth telling natural. I could proceed to construct an example of a reluctant just man and this would lead to an identical appearance. In general I would argue accepting the tolerant racist argument means accepting that in general someone who reluctantly accepts some virtue is morally more virtuous than someone who finds being virtuous in the same way natural. I would further argue accepting the tolerant racist argument means accepting the value of someone’s moral virtue depends on the amount of effort he has to make to act virtuously for all the virtues.

Why does acting virtuously have moral value? Several reasons might be advanced. It might for instance help society flourish or it might be aimed at some concept of the good. Whatever gives acting virtuously its moral value it does not seem to directly depend on the amount of effort someone makes. Increased effort aimed at evil ends certainly does not diminish the evil intended. I of course accept that extra effort aimed at achieving some virtuous end may make achieving that end easier but I do not accept this extra effort adds moral value to this end. Accepting the latter means accepting that, a racist who continues to tolerate other races, when he has the power to do otherwise, does not become more tolerant if his racism increases.

At this point someone might point out to me that the above argument depends on toleration being seen as a moral virtue. I accept his point. My objector might now suggest that toleration is a personal virtue in much the same way as courage is. He might further suggest if we accept that toleration is a personal virtue that the problems caused by the tolerant racist resurface. I believe toleration is a moral virtue but I am willing to accept that toleration may also be a personal virtue. However I am unwilling to accept even if toleration is regarded as a personal virtue that a racist, who tolerates other races whilst he has the power not to do so, increases his toleration if his racist beliefs increase. Let us accept that a brave or tolerant person usually flourishes better than he would have done had he not possessed these personal virtues. Let us accept that in general the value of a personal virtue is that it helps its possessor flourish better in life. It follows the value of toleration depends only on how tolerant someone is and not on how much effort it took him to be tolerant. In order to see why the above must be true let us consider an example. Let us consider two tolerant people. Let us also assume it is possible to measure tolerance to some degree, if this is not so the ideas connected to the tolerant racist example make no sense. The first tolerant person is extremely tolerant and toleration comes extremely easily to him. The second is only minimally tolerant and it takes him a great effort to achieve this minimal tolerance. If we allow that effort plays some part in the degree of toleration then it might be possible that both these persons possess the same degree of toleration. However it seems inconceivable provided all other things are equal that the person with only minimal toleration will flourish equally as well as the extremely tolerant person. A racist with only minimal toleration of other races will, all other things being equal, not flourish as well as a more tolerant person.

I have argued that toleration is not an outdated or incoherent virtue. I have argued that toleration helps someone flourish. However toleration not only benefits the tolerant person it benefits those tolerated. Helping others to flourish by toleration might help to some small degree to combat fundamentalism and so benefit society.  

1. John Horton, 1996, Toleration as a virtue, in D Heyd (editor), toleration: an elusive virtue, Princeton University Press, pages 28-43.
2. Magali Bessone, 2013, Will the Real Tolerant Racist Please Stand Up, Journal of Applied Philosophy, 30(3).

Gay Marriage 2

It might be suggested that the state has other reasons to promote marriage rather than just that of helping children flourish and I was wrong to concentrate on this sole reason in previous postings when I argued against gay marriage. It might be further suggested what gay couples want equality with heterosexual couples. However equality must be justified equality, for instance children don’t have equality with adults when it comes to voting. Nonetheless it seems reasonable to suggest what gay couples want is equal access to the benefits of marriage.

What then are the benefits of marriage? Firstly married couples offer each other mutual support. Secondly traditional marriage is meant to guarantee sexual exclusiveness. This exclusiveness is often more of an expectation than guarantee is practice. Thirdly marriage gives the partners in the marriage certain property rights and guarantees these rights after the death of one of the partners. Lastly a marriage helps in the rearing of children. It would appear there are four main reasons why people marry. As I have previously suggested only the last reason is a good reason why the state should support traditional marriage, it might appear my objector is justified in claiming my basis for the state supporting traditional marriage is at the best highly selective and at the worst prejudiced towards gay couples.

At this point I must make clear my previous position. I argued the state should recognise traditional marriage only because it helps children to flourish. I did not argue the state should recognise traditional marriage because of the additional benefits outlined above. Someone might raise two objections to the above. Firstly she might suggest that state should recognise traditional marriage because of these additional benefits. Secondly she might point out even if the purpose of the state in recognising traditional marriage is only to help children to flourish that a consequence of this recognition is that these benefits become available to married couples. She might then proceed to argue if the state prohibits gay couples from marrying these benefits are made unavailable to gay couples and as a result is guilty of unfair discrimination.

In response to my objector I would suggest the first two benefits of marriage as outlined above are questionable. Firstly is the mutual support a couple offers each other really enhanced because they are married? I would argue the best form of mutual support depends on love. Not however some form of sentimental love in which the lover’s interests continue to take precedence over those of her beloved. Mutual support requires someone taking the interests of her partner as her own. The form of love I’m concerned with as always in this blog is ‘caring about’. Frankfurt defines this form of love as follows,

“It is in the nature of a lover’s concern that he is invested in his beloved. That is, he is benefited when his beloved flourishes; and he suffers when it is harmed. Another way of putting it is that the lover identifies himself with what he loves. This consists of accepting the interests of his beloved as his own.” (1)

In addition I would agree with Frankfurt such love is not something we choose (2). We cannot simply choose to love someone. It follows if a couple simply choose to get married this does not automatically give them the best form of mutual support. It may of course in time lead to such support. It further follows if a couple choose to get married because they love each other they do not obtain the benefits of the best form of mutual support because they marry, they already possess this form. At this point my objector might point out there are less than ideal forms of mutual support. Forms based on self-interest. For instance in a traditional marriage a wife may support her husband in his job because it is in her interests to do so, his job supports her also. And a husband may support his wife’s staying at home looking after their children as it’s in his interests, she’s supporting his children. In response I would point out such mutual support depends on self-interest irrespective of whether the couple are married or not. In the light of the above it would appear mutual support depends on love or self-interest and that mutual support is not enhanced by marriage. I am also doubtful as to whether sexual exclusivity is a benefit of marriage. Perhaps marriage enhances sexual exclusivity but the divorce courts show it certainly doesn’t guarantee it. I will not pursue this point further.

The third benefit marriage is supposed to give its partners are certain property rights and guarantees of these rights after the death of one of the partners. These are real benefits and if gay couples are denied these benefits they are discriminated against. However in the UK and many other countries all these rights are made available by civil partnerships because the financial provisions in these mirror those in marriage. It follows the state if it prohibits gay marriage it does not deny gay couples any property rights or the guarantee of these rights after the death of one of the partners

I accept that married couples offer each other mutual support. But I have argued this mutual support is due to love or self-interest. It is not due to the fact they are married and as a result mutual support is not a benefit of marriage. I am also highly doubtful as to whether sexual exclusivity is a benefit of marriage. Marriage does give married couples some financial benefits but these benefits are available to gay couples through civil unions in countries in which these unions are available. It follows if the state prohibits gay marriage then in countries which permit civil unions the state does not deny gay couples equal access to the benefits of marriage by this prohibition. In my previous posting I argued that provided gay marriage does not harm children the state has no reason to prohibit gay marriage. In this posting I have examined whether, based on the first three benefits of marriage outlined above, the state has reasons to promote gay marriage. I have questioned whether these benefits in fact exist. It follows the state has no reasons to promote marriage based on the interests of married couples, gay or heterosexual.

I have argued that the only reason the state has to support marriage is the welfare of children. I have suggested that because the roles of husband and wife are now interchangeable the state has no reason to prohibit gay marriage, provided of course this does not harm children’s welfare. In some countries it is now possible for gay couples to adopt children, see list. It is also possible for a gay couple to have a child, by means of donor insemination or surrogacy involving IVF, which is genetically related to one of the partners. It follows if the state has reason to encourage traditional marriage because this helps children flourish it also has reason to support gay marriage. This reason can still be justified even if only a small number of gay couples wish to have children. At this point my objector might point out even if the roles of husband and wife are interchangeable the roles of mother and father are not, see for instance Virginia Ironsides. She might then suggest that because of this the children of gay couples do not flourish as well as those of heterosexual couples and as a result the state should not recognise gay marriage if this encourages gay couples to have children.

Basically my objector is arguing that because the children of gay couples do not flourish as well as the children of heterosexual couples that gay couples should not have children. She might suggest this is because gay relationships are unnatural relationships not suited to the rearing of children or the children of gay couples might be bullied at school. In response I would point out there it appears there is no evidence that the children of gay couples do not flourish as well as those of heterosexual couples. Indeed there is some evidence that when they are young they flourish just as well as the children of heterosexual couples and perhaps even better, see Goldberg and Smith. Moreover even if the children of gay couples do not flourish as well as those of heterosexual couples this does not imply gay couples should not have children. Children in deprived areas may well not flourish as well children born into more affluent areas but no one seriously suggests that people in deprived areas should not have children. It seems inevitable to me that some gay couples will have children. Let us assume that the children of both heterosexual and gay couples who stay together flourish better than the children of couples who split up. Let us also assume marriage helps couples who stay together. Lastly let us assume the state has a duty to help children flourish. It follows from the above the state should promote gay marriage even if the number of gay couples with children is low. I accept the above conclusion and as a result have changed my mind about the desirability of gay marriage.

1. Harry Frankfurt, 2006,Taking Ourselves Seriously, Stanford University Press, page 41.
2. Frankfurt, 1999, Necessity, Volition, and Love, Cambridge University Press. Page 135.