Wednesday, 15 November 2017

Ectogenesis and the Abortion Debate


Ectogenesis means the gestation of a foetus in an artificial environment outside the mother’s womb. Recent research with raising premature lambs in gestation bags means there is some possibility that ectogenesis might be feasible. Let us assume that ectogenesis becomes possible. It has been suggested that such a possibility might lead to the end of the debate about the permissibility of abortion, see bioedge. In this posting I will argue that whilst the realisation of this possibility might reframe the debate it will not end it.

One of the classic arguments for the permissibility of abortion is that of Judith Jarvis Thompson . Thompson asks us to imagine that someone wakes up to find herself in bed connected to a famous unconscious violinist suffering from a fatal kidney disease. Her thought experiment assumes that she is the only one with the right physiological features to save the violinist. Thompson assumes she has not consented to being connected to the violinist and that he will automatically recover in nine months. She suggests that it is morally permissible for her to demand to be disconnected from the violinist even if this leads to his premature death. She then argues by analogy that a pregnant mother has a right to an abortion. A woman has a right to be disconnected from her unborn child even though this will lead to the child dying. If ectogenesis becomes a possibility, then Thompson’s argument by analogy fails. In Thompson example it is not possible to disconnect the person connected to the violinist without the violinist dying. However, if ectogenesis becomes possible then it might be feasible for a mother to become disconnected from her unborn child without the child dying. The child is then gestated/incubated in an artificial womb.

It might appear that if ectogenesis becomes feasible then abortion will become unnecessary. Let us reimagine Thompson’s thought experiment. In this reimagined scenario someone is still connected to the violinist for nine months in order to save his life and at the end of this time she is disconnected. Unfortunately, the violinist’s illness has greatly weakened him meaning he needs care for the next fifteen years. Equally unfortunately because she are a close relation of the violinist it is suggested that she is the ideal person to carry out this caring. Someone in this scenario has two reasons for wanting not to be connected to the violinist. Firstly, she simply doesn’t want to be connected, secondly she wants be disconnected so she doesn’t have to care for the violinist later on even if this causes his death.

Let us further reimagine our thought experiment. The violinist’s doctors come along with some good news, they have discovered some new treatment which means it is unnecessary for someone to be connected for nine months. However, the violinist will be greatly weakened and still need care for the next fifteen years and that because of your close relationship you remain the best person to provide that care. You now have no reason to cause the violinist’s death because you wish to be disconnected but you still have some reason to cause his death because you don’t want to care for him for next fifteen. This scenario seems analogous to that of a pregnant women wanting an abortion if ectogenesis becomes feasible. She now has no reason to cause the foetus’ death because she can be disconnected, she might even never be connected in the first place, but she does have a reason this death because she doesn’t want to be a mother. It might be objected that I am not realistically representing the situation. My objector might suggest that others can care for the violinist, even if as not as well as a close relative, and that an unwanted baby can be cared by the state or adopted. I accept her objection. She might conclude that there is no need for abortion if ectogenesis becomes available and that the state provides childcare for abandoned children.

The soundness of my objector’s conclusion depends on two factors. Firstly, exactly how ectogenesis works and secondly the State’s willingness to finance ectogenesis and the extra childcare involved. Let us consider the process of ectogenesis. It seems conceivable that one day ectogenesis might be used by couples who conceive using IVF and that there might be no need for women to gestate the foetus involved in IVF at all, but these are not the women seeking abortions. The women seeking abortions are already carrying the foetus involved. Might the process in removing the foetus from a women’s womb be much more invasive than a simple abortion? If so might the women involved prefer an abortion? I will put this question to one side and deal with the importance of the preferences of a women carrying a foetus later. Let now consider the State’s obligations. The philosopher Rousseau sent all his five children to the Paris Foundling Hospital immediately upon birth. It might be argued that if a great many people acted in the same manner as Rousseau that the cost of ectogenesis together with that of childrearing might place too great a burden on the state. I find such an argument unpersuasive and in the era of safe contraception think it unlikely that the State would find the burden of financing ectogenesis and extra childcare excessively burdensome.
In spite of the above many people would feel uneasy about the ease with which Rousseau gave away his children. It might be possible for a potential mother to have a preference not to have a child and a preference not to abandon any child she had. Let us assume abortion ceases to be an option open to women due to ectgenesis and state childrearing. Let us consider a pregnant woman who would prefer not to be a mother and also prefer that if she did indeed become a mother not to abandon her child. In the above scenario she could not have an abortion and would find herself unable abandon the child she didn’t want. I would find her preference not to abandon her child commendable for two reasons. First, she displays a caring attitude towards her child. Secondly she has a sense of personal duty, she believes some duties shouldn’t be delegated to the state. She might believe she doesn’t have a duty to cause a child to exist but that if she does cause a child to exist then she has a duty to rear that child.

It is important to be clear about the relationship between her two preferences. Her primary preference is not to become a mother. If she cannot satisfy her primary preference, then she has a secondary preference not to abandon her child and become a mother. She doesn’t want to be in a position in which she satisfies her second preference. She has a mega preference that she should be able to satisfy her first preference rather than her second. Her position is analogous to that of a soldier. Most soldiers would prefer not go to war but if they must do so most would prefer to act courageously, they have a mega preference that there will be no need for them to act courageously in battle. If we can ask whether we should satisfy her mega preference means that the possibility of ectogenesis would not end the abortion debate, but merely reframe it.


Should we try to satisfy her mega preference? It might be argued that someone’s inability to abandon her child means that at a later period she might be glad she became a mother. It might then be further argued because she later affirms having the child she must also affirm the conditions necessary for that child to exist, she must become glad she was unable to have an abortion and that as a result we had no reason to satisfy her mega preference. This situation is analogous to Parfit’s fourteen-year-old girl who has a child and later in her life her love for that child means she must affirm her decision to become pregnant at fourteen was a good decision for her. For an excellent treatment of these issues can be found in Jay Wallace’s ‘The View from Here’ (1). I would feel uncomfortable in endorsing the fourteen-year-old’s decision as a good decision and likewise would feel uncomfortable in failing to endorse someone’s mega preference to have an abortion as a good for her because she might later come to love her child. I would suggest in cases such as these result in the feeling of a deep sense of ambivalence and do not give us reason to regard the fourteen-year-old girl’s decision as a good decision or the denial of abortion as justified. If we accept the above, then the possibility of ectogenesis and State childcare doesn’t give us reason to ban abortion. I don’t believe the idea of souls should play any part in determining the permissibility of abortion. I do believe it is permissible for a woman have an abortion before the foetus becomes conscious. However, if science can determine when consciousness emerges this might change the time at which abortions ceases to be permissible.


  1. See chapter 2 of, Jay Wallace, 2013, The View from Here; On Affirmation, Attachment, and the Limits of Regret, Oxford University Press.


Thursday, 19 October 2017

If a Lion could Speak

According to Wittgenstein, “if a lion could speak, we could not understand him.” (1) It is by no means clear what  Wittgenstein meant by this remark and I will suggest two possible explanations. Firstly, there might exist some languages which cannot be translated into any other. Secondly some minds might be so radically different from ours that the thoughts in those minds might be so radically different to our own that we couldn’t conceive them. It might appear that whilst the soundness of these propositions might be of academic interest it is of no practical importance. I would suggest that this appearance is mistaken. Suppose that some advanced AI, robots or even aliens could speak could we understand them? The answer to this question might help support or provide some evidence against Bostrom’s orthogonanlity thesis. Recently Facebook abandoned an experiment after two artificially intelligent programs appeared to be chatting to each other in a strange language only they understood, see the Independent . Stephen Hawking believes if we are ever contacted by aliens we should think very carefully before replying due to the dangers involved. I am extremely dubious about whether we will ever be contacted by aliens but the possibility exists as long as we are unsure of how life evolved in the universe. The first possible danger posed by our inability to communicate with aliens formed the subject matter of the 2016 film Arrival, might powerful minds with which we cannot communicate pose a threat to us? Besides the above possibility there also exists the possibility that alien minds might be so radically different from ours that they might consider us of no importance and even consider us as dangerous. This second possibility might also be posed by some advanced form of AI. On a more practical level if Wittgenstein is correct then Turing tests are pointless for we might be unable to converse with fully intelligent conscious entities.

Let us accept that language can be roughly defined as a system of communicating information. However, there is an important difference between language processors and language users. If language is simply a system of communication then ‘computer languages’ such as Java, C and Python are languages in much the same way as are English, Mandarin and Sign Languages used by the deaf. I would suggest that however fast a computer runs or however much information it can handle that if this is all it can do then it cannot be said to be a language user. What does it mean to be a language user? I would suggest that for some entity to be considered as a language user this entity must determine the use it puts language to.  At the present time computers, robots and AI don’t determine how the information they process is used and as a result aren’t language users. It follows that at the present time that any dangers posed by computers, robots or AI are due to our misuse or misunderstanding of them rather than some imagined purpose such entities might acquire. It might be objected by someone that accepting my suggestion means that because animals don’t determine the use the language they use that they also aren’t real language users. It would appear to follow that chimpanzees and clever crows which appear to communicate with us are really language processors in much the same way as computers rather than users. I would argue this objection is unsound. Animals might simply use language but the use of the language is put to, unlike the use of computers, is determined by the animals’ needs and wants. Accepting the above means accepting that certain animals are primitive language users. The rest of this posting will only be concerned with language used by language users as defined above.

 

Let us consider the possibility that we might be unable to understand the language of aliens or some advanced form of AI. It is possible that any AI, however advanced, must remain a language processor rather than a language user. Nonetheless because we are uncertain as to how we became language users the possibility of some advanced AI becoming a user cannot be completely ruled out. Let us now consider whether some language might be untranslatable into any other. By untranslatable I don’t mean some language which is difficult to translate but rather that some language is impossible to translate. Of course we may not capture all the nuances of some language in translation but is there any language that cannot translated at least to some degree? In order to answer this question, we must ask another what is meant by a language?  Let us accept that language is a system of communicating information among language users as defined above. Information about what? Information must include knowledge of things in the world shared by the language users. The world of language users must be a world of things. These things might include such things as, physical objects, descriptions of behaviour in the world and emotions among others. If any world was a completely undifferentiated one with no distinct things existing in it there could be no speech and no need for language users. Our original question might now be reframed. Is it possible for the users of one language to talk about a set of totally distinct things from the users of another language? This would only be possible if the world of one set of language users was totally separate from that of another set. This might be possible if language defines the world we live in, language could also help us make sense of the world we live in. Let us assume for the sake of argument that lions could talk. Would this talk define a lion’s world or help lions make sense of the world they live in? I would suggest language must touch the world rather than define it and that this world is shared by all of us to some degree. I don’t believe Wittgenstein would agree. It follows that if lions could talk they would talk about some things common to our world. For instance they might talk about being hot or cold, hunger or being content. It follows lions could speak that we should be able to understand them even if the translation proved to be difficult in practice and we couldn’t understand all the nuances of their language. However, would the same be true for some more fanciful language users such as advanced AI, robots or aliens? I would suggest the same argument can be applied and that all language users share the same universe to some degree and it is impossible for the users of one language to talk about a set of totally distinct things from the users of another language. Because language must touch the world any two sets of language users must talk about some of the same things. It follows we should be able to partly translate the language of any language users who share our world even if this might prove to be difficult in practice.

I have argued that we should be able to partly translate any language in our universe even if this might prove to be difficult in practice. This argument presumes that all language users share the same universe, share some common understandings. Lions and human beings all understand what is meant by trees, sleep and hunger but only humans understand what is meant by a galaxy. The above appears to suggest that there is a hierarchy of understanding and that some things can only be understood once a creature has understood some more basic things. The above also seems to suggest that there is a hierarchy of languages with simple ones only touching the more basic things in the world whilst more complex languages are able to touch a wider domain. In the light of the above it seems possible that aliens or some advanced AI might be able to talk about things we are unable to understand. Is it possible that our inability to fully understand the language of such entities might pose us with an existential threat?

Our failure to understand such entities means that we cannot completely discount the above possibility, however I will now suggest that we have some reasons to believe such a threat is unlikely to be posed to us by aliens. Language use is not simply a cognitive exercise. Any communication between entities that don’t have a will is not language use but language processing, language users must have a will. For something to have a will means it must care about something. If something cared about nothing, then it would have no basis on which to base decisions and all its decisions would be equally good meaning decisions could be made at random. The domain of our moral concern has expanded over time. Slavery is now unthinkable, women in the western world are considered of equal worth when compared to men and our moral concern extends to animals, all this is very different to ancient world. What has caused this increase in the domain of our moral concern? I would suggest this increase is due to an increase in our projective empathy. This increase is not simply driven by an increase in our ability to feel emotion. It is driven by our ability to see others as sharing with us some features of the world. Slaves can have a will even if the exercise of this will is restricted, animals can also feel restricted and pain. This ability is due our increase in our knowledge of the world rather than any increase in either cognitive ability or empathy. In the light of the above I would suggest that any aliens are unlikely to pose an existential threat to us. Language users must have a will. Having a will means caring about something. It seems probable that any aliens which might threaten us would have an advanced basis of knowledge, without such a basis it is difficult to see either how they would contact us or how they might threaten us. If some entity has an ability to care about and advanced knowledge basis, then it seems probable that it will have a wide domain of moral concern and that we would be included in that domain. I have argued above that if aliens ever contact we should be able to partly understand them. In the light of the above it seems that any failure on our part to fully understand possible aliens would not pose an existential threat to us.

Does the above apply to advanced AI or robots. If such entities don’t have a will then any threat posed by such entities would be due our failure to understand how such entities function or a failure to set them clear goals. The possibility exists that we might create some bio-hazard by failing to fully understand what we are doing. The threat posed by advanced AI or robots without a will is similar. However, provided we are extremely careful in how we set the goals of such entities this hazard can be minimised. I am extremely doubtful whether advanced AI or robots can acquire a will, nonetheless because we don’t fully understand how consciousness originated such a possibility cannot be completely ruled out. I have argued that it is unlikely that our inability to understand any possible aliens would pose an existential threat to us, however I would suggest any such failure to fully understand some advanced AI which is in the process of acquiring a will might pose such a threat. The threat might be due to an emerging primitive will being akin to that of a child. Perhaps the fact that some such emerging entity has a primitive will might mean it wouldn’t prefer the destruction of the whole world to the scratching of its metaphorical finger, but it might prefer the destruction of humanity rather than refraining from such scratching. It follows if the possibility exists that advanced AI or robots can acquire a will that we should take seriously the possibility that if this will starts happening that such emerging entities might well pose us with an existential threat. Any failure on our part to fully understand such entities would compound such a threat. Perhaps if such entities can fully acquire a will the threat will recede.

  1. Ludwig Wittgenstein, Philosophical Investigations, 1953, Blackwell, page 223
Afterthoughts
Assuming that we can understand a lion AT/Alien to some degree the question arises what sort of things might we understand. Goals, intentions or reasons? Perhaps even if we understand the goals and intentions of some advanced AI we might be unable to understand its reasons. But we don't understand all our reasons, reasons run out according to Wittgenstein.  The question becomes how many reasons we need to understand and how many can we do.

Thursday, 21 September 2017

What do We Mean by Work?


It is always important to be clear about what we are talking about when discussing philosophical questions. What we mean by work is important because it raises some interesting philosophical questions. For instance, John Danaher wonder whether work makes us happy, Tim Douglas wonders whether the future is workless (1), or perhaps robots will mean that in the future we will have no need to work. In this posting I want to consider what we mean when we discuss work.

The Cambridge online dictionary defines work as “an activity, such as a job, that a person uses physical or mental effort to do, usually for money.” Work seems tied to the idea of a job. In might appear that we could improve our definition of what we mean by work by considering what we mean by a job. Unfortunately, what we mean by a job, is like that of work, far from clear, moreover sometimes the definitions of work and a job seem to be intertwined. For these reasons I will restrict my discussion to what we mean by work. Let us consider an old fashioned couple, the husband works on a farm providing them with an income whilst his wife does the housework in their home. This example raises several interesting questions. Are both doing the same thing at some basic level? If they aren’t it would appear that there is a family of related definitions of what we mean by work.  Examples of members of such a family are easy to imagine, working for a wage, housework, schoolwork and someone working on improving her game or garden. Indeed it would seem perfectly natural for someone to say she is going to work in her garden. If we accept such a family of meanings do all members of this family have equal worth or does the value of work vary depending on which member of the family we are considering?

I want to reject the idea that the meaning of work is really a family of related meanings for two reasons. First, the apparent appearance of a family of different meanings might be an illusion. It seems entirely plausible that work might have only one meaning and that the appearance of a family of meanings is not due to any difference in meaning but rather to the different domains work is carried out in. Farmwork is not conceptually different from housework, the apparent difference is due to the different domains each is carried out in. Secondly let us assume that what we mean by work is a family of related meanings. If we accept the above, then it should be possible to say something about the relationship between family members. However, if we can say something meaningful about this relationship between family members then perhaps what we say could form the basis of a common definition for all forms of work.

Let us accept that there is something common to the meaning of work in different domains. Work is different from play. If considering what is meant by a job doesn’t help us to define work, then perhaps considering the differences between work and play might do so. Both are forms of work and most forms of play can be fun but play is never serious whilst all work is serious. What do I mean by serious? If someone plays at something she can simply stop playing at will because play isn’t serious. If someone works at something she can’t simply stop working for no reason because work is serious. Of course she might dislike work and be glad to stop working but work matters to her and she must have a reason to stop working. If we accept the above, then even if professional footballers are playing a game they are also working. Indeed, someone whose garden matters to her might be said to working in her garden.

Let us accept that work must matter to the worker. Accepting the above doesn’t mean the worker must like her work. Indeed, in some circumstances the worker might hate her job. I have suggested someone can simply stop playing and that stopping has no important consequences for her. The same is not true of work. Someone might well stop working at her dead end job but stopping has consequences for her that matter. Her work matters even if this is only for instrumental reasons, these reasons might simply be making a living or buying the things she values. For someone who loves her garden stopping gardening might mean the garden she loves becomes neglected. Work was defined by the Cambridge online dictionary as “an activity, such as a job, that a person uses physical or mental effort to do, usually for money.” In light of the above work might be better defined as an activity requiring physical or mental effort and that activity matters to the worker. Adopting the above definition would mean working for a wage, housework, schoolwork and playing professional sport could all be regarded as work in the same way and need not be regarded as a family of loosely connected definitions and any apparent differences could be due to the different domains the work is carried out in.

I have argued the definition of work above means that we don’t have to accept a family of loosely connected definitions. The definition I have adopted above depends on the idea that work matters, work is something we care about. Accepting this definition means we had workers before our modern ideas about workers, a Neanderthal hunter might be regarded as a worker. However, even if work might be defined one way we might care about work in two ways. First, someone might work in order to make a living or to obtain the things she desires. Work matters to her for instrumental reasons. Someone working solely to make a living would be a good example of the instrumental value of work. Secondly, someone might work at something because this something matters directly to her. Work has a kind of intrinsic value to her. Someone working in a garden she loves would be good example of such work. Work might matter for what it enables us to obtain or work might matter because we care about what we are working at. Someone working solely to make a living and someone working in a garden she loves are extreme examples and many forms of work might matter to someone because of both values. For instance, someone might drive a bus in order to make a living whilst also take pride in her driving abilities.

Let us accept that work might be defined as an activity requiring physical or mental effort that matters to the worker and that work might matter to the worker for two reasons or some combination of the two. What are the consequences of accepting the above? The first of these is that we must reject the idea that work is a family of loosely related definitions. Of course there are different kinds of work, the work of a banker is different to that of the cleaner in the bank. However, at a basic level both are undertaking some activity, requiring physical or mental effort, which matters to both of them. Of course the complexity of the activity and the domain in which the activity is carried out matter, but these considerations don’t affect this basic definition. Secondly if work must of necessity matter to someone, work isn’t play, then work must be of some value in her life. I argued above that work can have instrumental or intrinsic value, we can work for something or work at something. If someone works at something simply because it matters to her then work gives her life meaning. Moreover, the reason why it matters does not alter the fact that working at something gives someone’s life meaning. For instance, someone might work at providing relief to the starving because she believes it’s a good thing to do whilst someone else might work at studying quasars simply because she finds quasars interesting. Both of these persons work at something for different reasons, but for both of them their work has intrinsic value giving their lives meaning. Let us now consider someone who works for its instrumental value. If someone simply work for something, then this something permits her to pursue the things that matter in life to her, the things that give her life meaning. If someone works as a cleaner, then this might enable her to feed the family she loves. Lastly let us assume that work gives our lives meaning and that automation might destroy many jobs. What are the likely consequences of accepting these assumptions and how should we deal with them? Let us first consider those workers who work instrumentally to obtain the things that matter to them. Clearly some will be unable to make a living which might lead to social unrest. One solution to the above could be the introduction of some sort of universal basic income (UBI). I would suggest that in such circumstances even capitalism has an interest in introducing UBI as it is dependent on some sort of social cohesion. Unfortunately, even if automation does destroy jobs and a UBI is introduced this introduction by itself might be insufficient to maintain social cohesion. If people become bored and little matters to them then social cohesion might become eroded. Boredom in this situation wouldn’t be a minor matter but of major concern both to individuals and society. One way of dealing with this concern might be to refocus the way people work. Perhaps people should focus on working at rather than working for. Such a refocussing would accord better with stoic ideals. Someone’s ability to work at something is less dependent on her having a job. Nonetheless such a refocussing of the way we work is not straightforward as many people would need to be helped to change their focus from working for to working at. I have suggested in a previous posting that such a refocussing might be helped by a refocussing of our education system, see work, automation and happiness . The focus of education might be broadened from simply preparing people for work to helping them to lead a good life.  Such a shift might be aided by placing greater emphasis on the humanities. Once again such a change in emphasis would accord better with stoic ideals. It might be objected that I am adopting a somewhat elitist attitude. I accept this objection and offer two suggestions to combat such elitism. First, the focus of education might be broadened still further to enabling some people learn a craft. Crafts sometimes allow the craftsperson to enter a flow state giving her life some meaning. Secondly in ancient Greece the elite lead a life of leisure in which sport and the gymnasium were important. Perhaps sport participation should play a greater part in any society which finds its cohesion damaged by automation. I have suggested above that a professional footballer might be regarded as a worker if we accept the above definition an amateur footballer might be said to work at his game. Like UBI such participation would be expensive but these costs might be partly offset by health benefits.



  1. Tim Dunlop, Why the future is workless, New South Publishing.

Tuesday, 15 August 2017

Good Government, Democracy and Referendums




 

Government is an ongoing process. Any single referendum aimed at making a binding decision on some issue is not an ongoing process. Any such referendum is of course a process, but it is a process designed to bring about closure if the possibility of a further referendum is excluded. In this posting I will argue that accepting the result of some types of referendums, such as the Brexit one, is damaging to good government and is fundamentally undemocratic.

Democracy might be defined as the belief in freedom and equality among people. Democratic government might be defined as “a system of government in which all the people of a country can vote to elect their representatives.” (1) The two definitions are connected because if people aren’t free they can’t govern themselves. What does it mean to govern oneself? The ability to govern oneself is the ability to make decisions without being deceived or coerced and to enact those decisions. The ability to govern a state is much the same. It is the ability to decide which policies a state wishes to pursue together with the capability to enact them. The ability to govern of course applies to both dictatorships and democratic states. Democratic government takes place by its citizens determining its policies either directly, through such means as referendums, or by electing representatives. Personal government must of necessity be an ongoing process. Let us assume someone governs herself and that she decides at time t1 doing x is best thing for her to do. Let us next assume at time t2 and in a roughly similar situation she finds that she is unable to do anything other than x. I would suggest that at time t2 she is unable to fully govern himself. To be able to fully govern herself at t2 she must have the ability to revisit her past decisions and if necessary revise or change them. Accepting the above of course does not mean she must change her decision or even consider changing it. Moreover, any inability at t2 doesn’t need to be connected to any lack of further reflection on her part, she may be perfectly satisfied with her previous decision and feel no need for further reflection. However, even if she simply accepts some decision her acceptance cannot be forced onto her and she must retain the ongoing ability to accept or reject this decision. The same is also true of states. Governing a state requires that the state retains the continuing ability revise and if necessary change its own policies. Governing a state must of necessity be an ongoing process. States that don’t do so become lifeless and fossilised.

I now want to argue that the use of some sorts of referendums damage this ongoing process. It might be objected that provided the electorate in some referendum is not deceived or coerced that the result of the referendum can contribute to good government. I accept my objector’s position holds in some circumstances referendums can contribute to good government. Nonetheless I would argue that my objectors position doesn’t always hold in all circumstances. I will argue that use of some sort of democratic referendums to determine policy can damage good governance. Of course a democratic referendum might help to determine a policy. However, a democratic government must retain he ability to revise and if necessary change its own policies. If a referendum determines some government policies for the foreseeable future, then that government loses part of its ability to make and change some of its own policies in the future. The above holds even if the referendum in question was conducted democratically. In what follows I will consider referendums which determine some government policies for the foreseeable future rather than binding ones. No binding referendum binds forever, binding referendums only determine some policy for the foreseeable future. Referendums can express the will of the people but this expression isn’t the everlasting will of the people as everlasting will just doesn’t exist, people can, do and should be able to change their minds. Accepting he above means accepting that the use of a democratic referendum by any government, when the result of the referendum determines a policy for the foreseeable future, damages good government because good government is an ongoing process.

I have argued that referendums which determine government policy for the foreseeable future damage good government. It might be objected that I’m misrepresenting the point of referendums. The point of referendums is to shift the focus from elected government to a more direct form of governance. I accept my objector’s point. I accept that referendums can shift the focus from elected government to a more direct form of government. However, I will now argue that any referendum which is designed to determine long term policy damages good governance. How can direct government by the use of referendums possibly damage good governance? I am not suggesting all such referendums damage good governance. I am only suggesting that those referendums which determine some policy for the foreseeable future damage the ability of the electorate to govern themselves directly. Let us imagine a state which is governed directly by its electorate by the use of referendums. Let us assume that one of these referendums determines one of this states policies for the foreseeable future. I will now repeat my central argument as to why such a referendum damages good governance. Let us accept that government must be an ongoing process. This referendum damages this ongoing process. I have argued that someone’s ability to govern himself means she must have the retain ability to change his decision and that the same is true of voters. If voters in some referendum determine some policy for the foreseeable future, then they deprive themselves of the ability to decide on some policy at some future date. Even if referendums, which are designed to govern directly, are conducted democratically they can still damage good government and if they deprive the electorate of the ability to make further decisions on some matter are undemocratic. Both good government requires retaining the ability to react to changes in circumstances, any referendum which determines government policy for the foreseeable future destroys this ability to react. I suggested above that such referendums in spite of appearances are fundamentally undemocratic. Clearly any democratically conducted referendum which aims to elect a leader for life destroys democracy. I now want to argue that any referendum which takes place in a democracy with the aim of determining some policy for the foreseeable future damages that democracy. In a democracy the electorate must retain the ability to shape government policy. It might be objected that if the electorate have democratically determined some policy in a referendum that nothing can be more democratic than that. I would suggest soundness of this objection depends on how long such a referendum is meant to determine a state’s policy. Let us assume that a referendum determines some state’s policies for the foreseeable future. Such a referendum is undemocratic. Over time he electorate changes. Some electors die whilst others become enfranchised. It follows that the result of the referendum over time might come not represent the will of the majority of the electorate. The will of the majority might be ignored.

Let me once again make my position clear I’m not saying all referendums damage good governance or are undemocratic. Referendums which are advisory or determine short or perhaps even medium term policy need not damage a government’s ability to govern nor are they fundementally undemocratic. I am saying all referendums which determine long term policy or policy for the foreseeable future damage good governance and are undemocratic. I believe the Brexit referendum to be such a referendum. What conclusions can be drawn from the above? Firstly, referendums should never be used to determine long term policy. Secondly if referendums must be used to determine policy in the medium term they should not be decided by a simple majority of actual voters. At the very least referendums to determine medium term policies should require a majority among all those eligible to vote in order to be valid. A larger majority should mean that the result of the referendum would remain the democratic will of the electorate for a longer period.

  1. http://www.oxfordlearnersdictionaries.com/definition/english/democracy?q=democracy



Tuesday, 11 July 2017

Charlie Gard and Experimental Treatment for Children



Until recently I assumed without much reflection that it would be best if Charlie Gard was allowed to die peacefully. After some reflection I still believe this would be the most sensible option. However, after this reflection it seems to me that this case raises an important philosophical issue. What should form the basis of our decision making when deciding whether some experimental treatment might be appropriate for children. In this posting I will examine this issue. I have previously argued that autonomous adults with life threatening conditions have a right to try experimental treatments provided these treatments are privately financed, see wooler.scottus . I would argue that this right to try applies to all potential experimental treatments even when the chances of a cure are slim and possibilities of adverse side effects high. If the above is accepted, then it might appear to automatically follow that children’s parents have a right to try experimental treatment to combat their children’s life threatening conditions. I will argue this appearance is unsound and that the issues are more complicated when children are involved.

Let us accept a Millian account of autonomy is correct.  Let us accept that someone’s “own good, either physical or moral, is not a sufficient warrant” to preventing her from exercising her will provided this exercise does not harm to others. This acceptance implies that we must accept that autonomous adults have the right to try experimental treatments, subject to certain conditions, even when the results might be harmful. The same right does not extend to children. Parents must consider the physical, mental and moral good of their children. If parents fail to do so, then a court must decide what is in the child’s best interests. If we accept the above then it doesn’t mean children should never receive experimental treatment. However, it does mean the situation is more complicated than that in the case of adults.

It is generally accepted that parents should act in their children’s best interests and that if they fail the do a court has the right to intervene in order to protect these interests. Let us consider a case in which an experimental treatment becomes available to treat a gravely ill child. How should the child’s parents decide on whether she should undergo the treatment? Intuitively we might assume that they should decide whether the proposed treatment is in the child’s best interests. For any experimental treatment what is in the child’s best interests is a question of probability. Medical probabilities are complicated and parents and courts should usually take the advice of medical experts.

Does accepting the above mean parents should never accept any experimental treatment for a child who is gravely if this treatment is not recommended by the majority of medical experts and carries a low probability of success? Surely any treatment with a low probability of success cannot be in a child’s best interests. However, the above is not always true. In a few cases, experimental treatment might well be in a child’s best interests even if in the majority of cases it isn’t and in these cases might even be harmful. The philosophical issue I want to raise is on what basis should parents and courts use when deciding whether experimental treatment should be accepted. Most would suggest that the decision should be based on what is in the child’s best interests even if the probabilities attached to these interests are extremely hard to determine. I now want to argue such a suggestion is mistaken and that the decision should instead be based on the probability of whether any experimental treatment is likely to harm the child concerned.

Medical ethics is concerned with beneficence, non-maleficence and respect for patient autonomy. Usually parents or in some cases the courts decide whether experimental treatment is appropriate on the basis of what is in the child’s best interests. They apply the principle of beneficence. I appears that acting on the principle of beneficence excludes considerations of autonomy. I argued elsewhere that this assumption might not hold in the case of competent adults, see autonomy and beneficence . I have suggested above that in the case of a young child and experimental treatment that is sometimes impossible to ascertain what is in her best interests making it impossible to apply the principle of beneficence. Kant argued ought implies can. Let us accept Kant was right. It follows if we cannot ascertain what is in a child’s best interests that we ought not apply the principle of best interests. I would suggest that in this situation we should adopt the principle of non-maleficence. Adopting the principle of non-maleficence when considering the acceptability of using an experimental treatment for a child has two important consequences. First it means we need consider harm to the child. In the case of terminally ill children the harm of most concern must be the child’s suffering. Whether someone is suffering should be easier to determine than what is in her best interests. Secondly adopting the principle of non-maleficence brings respect for autonomy back into play. If the autonomous wishes of a sick child’s parents will not harm her then then these wishes matter.

What does accepting the above mean in practice? It might be objected that in practice it is just as difficult to act in a non-maleficent manner as it is to act beneficently. I would suggest such an objection carries little weight provided we ask and can answer three important questions concerning harm. First, we must ask whether the proposed treatment will cause any additional suffering to the child. Second, we must ask whether such treatment would extend the duration of her suffering. Thirdly, we must ask whether moving a child to receive such treatment will cause her further suffering. These questions remain difficult to answer. However, some further more practical questions might be asked to help us answer to answer the first three. I’m a philosopher and for this reason I will only tentatively outline some of these more practical questions. Is the child currently in pain? Will any experimental treatment lead to extra pain? Could any extra pain be controlled? Will the treatment cause nausea? These are clear cut questions and for this reason should be easier to answer than deciding if some treatment is in the child’s best interests. It follows that provided some experimental treatment will not cause a terminally ill child any further suffering, that from a non-maleficent basis, that there is no reason why that child should be denied such treatment provided it is privately financed. At this point I want to emphasise that I am only saying that experimental treatment should be acceptable according to the principle of non-maleficence, I’m not saying such a decision is a good decision.

What are the implications of the above in the case of Charlie Gard?  Should the wishes of his parents matter? When a court decides on what is in the welfare of a child the decision is based on what is in the child’s best interests. Accepting the above means that the wishes of Charlie Gard’s parents should play no part in the court’s decision. However, I have suggested that in cases such as that of Charlie Gard it is sometimes impossible to reach a decision based on best interests. Courts are concerned with practical matters and must make decisions. If a court cannot make a genuine decision based on beneficence then it might make a decision based on the futility of treatment in the belief that this equates with best interests. The two are not identical. Perhaps in these circumstances it would better not to fudge any decision and instead rely on the older principle of non-maleficence. It might even be argued that in these circumstances that a court deciding in a non-maleficent manner to limit a child’s suffering is also acting in a manner which might be loosely described as beneficent. I believe it would be more credible in these circumstances to simply admit acting on the principle of non-maleficence. If we accept the above, then certain questions need to be asked. Is Charlie suffering? Would any proposed experimental treatment cause him further suffering? Would moving him to receive any proposed experimental treatment cause him to suffer? Let us assume that Charlie is suffering then we must now ask whether any proposed experimental treatment likely to reduce or eliminate his suffering. If the answer is negative Charlie should be allowed to die peacefully. Let us assume Charlie isn’t suffering. It seems to me provided that the second and third questions above can be answered negatively that the wishes of his parents should matter and they should be free to seek experimental treatment provided it is privately funded. Accepting the above does not imply seeking such treatment is wise or desirable but only that it should be permissible.

In the light of the above discussion when dealing with difficult treatment options for seriously ill children we should ask the following questions when considering whether we should and if we should how to apply the principle of non-maleficence.
  1. Is it possible to ascertain what is in a child’s best interests? Not just what we want to believe is in the child’s best interests. If the answer is no we can move on to apply the principle of non-maleficence.
  2. Is the child suffering? If no we can move onto 4
  3. Can this suffering be relieved? If yes we can go onto 4.
  4. Will this proposed treatment cause further suffering which cannot be relieved. If no then such treatment is permissible according to the principle of non-maleficence even if others believe it to be futile



Wednesday, 7 June 2017

Autonomy and Beneficence


In this posting I want to investigate what we mean by autonomy and the relationship between autonomy and beneficence. I will firstly examine two different accounts of autonomy. In order to do so I will briefly outline the differences between a content neutral account of autonomy and a substantive one. I will then raise some difficulties with accepting a substantive account of autonomy. Next I will examine the relationship between a content neutral account of autonomy and acting beneficently. I will conclude that preference should be given to respecting autonomy over acting beneficently when these two values clash. I will then consider what specifically makes rape and slavery so wrong to support my conclusion. Lastly I will examine the implications of accepting this conclusion for the doctrine of informed consent, the age at which someone should be able to vote and the right of the disabled to make their own decisions.

John Stuart Mill defined the only way power can be rightfully exercised over another.

“The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” (1)

Mill’s definition can be used to provide a definition of a content neutral account of autonomy. An autonomous person should always be free to exercise his will freely, provided this exercise doesn’t harm others. Such a definition of autonomy might be classed as a primitive or basic account. In what follows a basic account of autonomy will refer to a Millian account It might be suggested that advances in technology and medicine mean that such a basic account is an outdated one. It might be further suggested that these advances mean a more substantial account of autonomy is required. A substantive account. A substantive account of autonomy places some constraints on what an autonomous person can autonomously choose even when his choices don’t harm others. For someone’s decision to be autonomous it must accord with certain accepted norms in addition to the norm of not harming others.

I now want to present two arguments against adopting a substantive account of autonomy. My first argument will suggest that adopting a substantive account of autonomy would mean that autonomy becomes a superfluous concept. Let us consider a substantive account of autonomy in which someone’s decisions are only accepted as autonomous ones provided they would be regarded as reasonable by most reasonable people. It might be objected it would be hard to define which people are reasonable and what such reasonable people might find to be reasonable. For the sake of argument let us ignore this objection. Why does autonomy matter? It matters because it differentiates between those decisions we should always respect and others. Let us accept that an autonomous choice should be a reasonable one which would be accepted by most reasonable people. In this situation it seems that to talk of respect for autonomy becomes mere rhetoric. In this situation the concept of autonomy is doing nothing useful. Someone wanting to know which decisions he must respect, by deciding if they are autonomous decisions must first know that which decisions would be accepted by all reasonable people. I would argue that this is all he needs to know in order to respect someone’s autonomy. In this situation we simply don’t need the concept of autonomy. I would suggest the same argument can be applied to any other norms which might be applied in any other substantive account of autonomy such as, someone’s best interests, acceptability to society or giving no offence to religious standards. It appears to follow that those who advocate the need for a more sophisticated account of autonomy, a substantive one, make the concept of autonomy a redundant one.

I have argued above that respecting someone’s autonomy cannot simply mean acting to further someone’s best interests because if we do so the idea of respecting autonomy seems to do no useful work. I might act in my dog’s best interests but this doesn’t mean I respect him or believe he is an autonomous dog. Caring about someone or someone doesn’t seem to be the same as respecting autonomy. What then is meant by respect? Respecting someone doesn’t simply mean saying nice things about him for if this was so there would seem to be no difference between respect and flattery. I would suggest respecting someone involves admiration and that admiration is linked to valuing. For instance, if I respect someone I might do so because I admire his honesty, determination or his ability to make good decisions. I can admire someone because he is a certain kind of person but what qualities do I admire and value if I admire someone simply as person? What is a person? Christine Korsgaard argues that a person is not identical to the human being the person supervenes on. She suggests that,

“When you deliberately decide what sort of effects you will bring about in the world, you are deliberately deciding what sort of cause you will be. And that means you are deciding who you are.” (2)

It would be difficult to call anyone who was unable to make any decisions a person. However, whilst the ability to make decisions is a necessary condition for personhood it isn’t a sufficient one. Some who makes all his decisions randomly or based on mere whims might be regarded as a wanton according to Frankfurt (3). To be a person someone must have the capacity to make decisions based on what he cares about or values. What does the above tell us about respecting someone simply as a person? It would seem that if respect involves admiration then respect for a person involves admiration for a creature which can make his own decisions based on what he cares about. I have suggested that respect, admiration and valuing are linked. I would now suggest that respecting a person requires accepting his decisions. If we don’t do so, our supposed admiration and valuing of him as the kind of creature who can make his own decisions based on what he values, becomes mere rhetoric.

A defender of a substantive account of autonomy might object to the above and argue that we can respect someone’s autonomy by respecting him as the sort of creature that can make some of his own decisions. He might proceed to argue we need only accept those of his decisions which don’t harm his best interests. He might suggest that by doing so we then are still respecting his autonomy, we are just according it less importance. I would reject such a suggestion and. will now present two arguments to support my rejection.

Firstly, let us assume that we can respect someone’s autonomy by only accepting those of his decisions which are in his best interests. It might then be argued that provided we do so we are still respecting him as a person. But if we do so are we respecting someone simply as a person or a particular kind of person? For instance, I can respect someone simply as a person whilst at the same time failing to respect him as a particular kind of person.  I believe for instance that he is a bad parent. It seems if we respect someone’s autonomy, by only accepting those of his decisions which are in his best interests, that we are respecting a particular kind of person. We are only respecting those persons who make good decisions. Alternatively, we might only respect someone when he makes good decisions. Does this matter? Let us assume we only respect the autonomy of those people who make good decisions and that we should adopt a beneficent attitude to those who don’t. I have argued above that what defines someone simply as a person is his ability to make his own decisions, to shape his life. It appears if we only respect the autonomy of people who make good decisions that we fail to recognise some people simply as persons. Next let us assume that we only respect someone’s autonomy when he makes what we regard as good decisions. If we do so I can employ the argument used above and question whether respect for autonomy really does any useful work. It follows if we respect peoples’ autonomy by only accepting those of their decisions which we think are in their best interests that either we won’t be respecting some people simply as persons or we are only respecting people as a part time persons.

I now want to argue that if we respect someone’s autonomy by only accepting those of his decisions which we believe to be in his best interests that we aren’t acting in a fully caring way. It might be objected that we are only acting in this way because we really do care about people. In response I would suggest that in this situation because we decide what is in someone’s best interests we might be accused of epistemic arrogance. However, let us lay this suggestion aside and assume that respecting someone’s autonomy in this way doesn’t mean we are exhibiting epistemic arrogance. I would still suggest that this form caring is a deficient form. I accept if we act in such a way we are acting sympathetically but I would argue we aren’t acting empathically. True empathic care means we must care about what someone cares about rather than simply what we believe to be in his best interests. Someone might suggest sympathetic caring is as good as empathic caring. I would reject such a suggestion. I can care about someone or something sympathetically simply because I want him to flourish. This is the way someone might care for a dog he loves. Empathic caring isn’t so simple. If I care about someone empathically I must care about what he cares about in addition to what I believe are in his best interests. Empathic caring is a more complicated way of caring than caring based on sympathy. However, because something is more complicated doesn’t automatically mean it is better. People don’t want to be cared for in the same way as dogs. But why, surely it’s good to be loved, cherished and beneficently cared for? People don’t want to be cared for in the same way as pets because they value being recognised as persons which requires recognising them as the kind of creatures who can decide their own future. It follows if we care about people as persons we must care about what they care about and this requires caring about them in an empathic way.

Even if the above is accepted an objector might argue that if we care about someone empathically that whilst we must always care about what he cares about, in some situations we should give priority to acting beneficently. This argument supposes a particular concept of beneficence. This concept holds that to act beneficently is to act in someone’s best interests. It also holds that to act beneficently towards someone doesn’t always means acting in what he perceives to be in his best interests. This means we must act in accordance with some accepted standard, perhaps a standard that most reasonable people would accept. But if we act beneficently in this way who are we acting beneficently towards? We are certainly acting beneficently to human beings but towards persons? We are acting as if someone can be a part time person. It might be objected that there can’t be such a thing as part time person. I find this objection unconvincing. Children can make some decisions for themselves whilst their parents make others in their best interests. Children might be regarded as part time persons. Nonetheless I would suggest that most adults don’t want to be part time persons being a person is central to them. Perhaps this is one reason why children want to grow up. Being a person is central to most people’s interests. Can we be said to be acting truly beneficently towards someone if we are prepared to ignore what he perceives to be central to his interests? I would suggest we can’t. If we accept the above, it follows that acting truly beneficently requires acting in accordance with someone’s perceived best interests and not what we perceive to be in his best interests. It further follows if we act in a way that serves someone’s best interests, as we see them, that we are acting in a caring way, however our caring even if well intentioned is an incomplete form of caring.

At this point a further objection might be raised. It might be suggested that I’m presenting a misleading view of substantive autonomy. A substantive account of autonomy might be better defined as an account that places some constraints on what an autonomous person can choose, even when his choices don’t harm others, in some limited circumstances but in all other circumstances we should respect his choices. My objector might agree that in the past a basic account of autonomy was sufficient to protect our freedoms. He might now suggest that technological progress and modern medicine mean we have a need for a more sophisticated account of autonomy and that a substantive account satisfies this need. I have questioned above whether any substantive account of autonomy is actually an account of autonomy. I would suggest that any such proposed account is in reality an account of how to balance respect and caring about someone. How to balance respecting autonomy and acting beneficently. My objector might suggest that it is perfectly legitimate to balance these two. In response I would argue that whilst someone might well have a legitimate aim of respecting autonomy and acting beneficently when these two values don’t clash that this clash. A clash of these values depends on a particular account of beneficence. To act beneficently according to this account is to act in someone’s best interests and this doesn’t always means acting in what he perceives to be in his best interests. I have argued above that acting in this way is a deficient form of beneficence and is an incomplete form.

I have argued that we should reject a substantive account of autonomy for two main reasons. Firstly, if we adopt a substantive account of autonomy this account makes itself redundant. Secondly, if we adopt such an account we are not acting in a truly beneficent or caring way. Accepting the above means we must always accept someone’s basic autonomous decisions. It also means we cannot ignore such decisions or coerce someone into changing such a decision. Accepting the above also means we must sometimes accept bad decisions. Autonomous decisions needn’t be good decisions. In such cases we should attempt to persuade the decision maker to change his decision when it is unwise, however if our persuasion fails we must be prepared to accept the decision.

I now want to consider what’s wrong with slavery. It might be argued that the wrongness of slavery is self-evident. Slaves are abused and cruelly treated. However, R M Hare (4) used a thought experiment to show this need not always apply. He imagined an island called Juba which was ruled by a benevolent elite for the good of all with no abuse or cruel punishments. He also imagined an island called Camaica on which everyone was free but all lived in abject poverty. He speculated that some free citizens of Camaica might prefer to be slaves on Juba. If we accept such a situation is possible, even if unlikely, and we believe slavery is wrong what reasons can we advance for this wrongness. What is wrong is that the slaves on Juba are not regarded as the kind of creatures who can determine their own future and this harms them because as I have argued above for any person the ability to determine his own future is central to his interests. However, I will now argue that the concept of autonomy violated is our basic concept of autonomy. Is it conceivable that the substantive autonomy of the slaves on Juba could be respected? A substantive account of autonomy might allow a slave’s decisions to be accepted as autonomous ones and respected provided they are in his best interests and any decision a slave makes which aren’t in his best interests aren’t regarded as autonomous ones. If we accept a substantive account of autonomy, then the autonomy of the slaves on Juba would be respected. The slaves on Juba would be treated as children or part time persons. Wasn’t colonialism a bit like this? Beneficent colonialism was a bit like Hare’s imaginary Juba and treated the people colonised as children or only part time persons.

Let us now explore the wrongness of rape using a thought experiment similar to that of Hare. Let us consider a gentle rapist and a compliant victim. The physical harms caused by such a gentle rape are minimal nonetheless the crime doesn’t seem to be a minor one to us. What reasons can be advanced for the seriousness of a psychically gentle rape? It might be pointed out that the harm lies not the violence inflicted but the threat of violence, the violation of bodily integrity or both of these harms. I accept these points. Let us consider the violation of bodily integrity first. The simple fact that the victim’s body was penetrated is irrelevant, this could occur during consensual intercourse. What matters was that her body was penetrated against her will and this involves failing to respect her autonomy. Let us now consider the threat of physical harm causing psychological. Let us assume the victim is aware that she will not be harmed provided she complies. She complies and is raped. She isn’t psychically harmed and because she complied moreover she had no reason to fear psychical harm so any psychological harm is not due to fear of being psychically harmed. In spite of this I would argue psychological harm occurs. It occurs because she isn’t seen as the kind of creature who has a right to decide what to do with her own body, she isn’t considered as a person, her basic autonomy isn’t respected.

If we accept a non-substantive or basic account of autonomy as the only meaningful account of autonomy what implications does this have for the doctrine of informed consent? Is the doctrine of informed consent based on respect for autonomy? If the doctrine of informed consent is based on a substantive account of autonomy, then I would suggest the doctrine isn’t actually based on respecting autonomy for the reasons given above. In this situation the doctrine of informed consent is concerned with balancing acting beneficently and respecting autonomy. The concern is to stop people making bad decisions rather than respecting autonomous ones. This balancing act assumes beneficent care means acting in someone’s best interests as seen from a particular vantage point, perhaps what most reasonable people would consider to be in someone’s best interests. I have argued above such a concept of acting beneficently is an incomplete concept and that true beneficence requires always accepting basic autonomous decisions. Autonomous decisions don’t have to be good decisions. However autonomous decisions are not made randomly or based on mere whims. Autonomous decisions are based on what we care about, based on what matters to them.

Accepting the above has important implications and I will now briefly examine three of these. We might divorce the doctrine of informed consent from respecting autonomy and simply say that the doctrine is concerned with furthering patients’ best. This would be an honest approach. However, if we do so when we ask patients for their consent are we really asking for consent or acquiescence? Alternatively, we might accept that the doctrine of informed consent is based on respect for basic autonomy. If we do so it seems to me that a patient can make an autonomous decision simply to trust his doctor’s advice, after all we trust lawyers, accountants and other professionals all the time. It also seems that the information needed to make a basic autonomous decision is less than that currently supplied when taking informed consent. This might have more to do with a fear of litigation rather than a misguided concept of autonomy, see montgomery and the information needed for informed consent . The information required for informed consent should be patient driven and be determined by how much information he needs and wants to make an autonomous decision. Secondly democracy depends on voters’ ability to make an autonomous decision. If we accept a basic concept of autonomy, then perhaps the voting aged should be lowered. Perhaps it should be lowered to the age needed to give sexual consent. Lastly the United Nations convention on the rights of persons with disabilities want more people with cognitive and psychosocial disabilities to make their own decisions, see United Nations . Let us accept that an autonomous person has the right to make his own decisions. It follows that how many people with cognitive and psychosocial disabilities should be able to make these decisions depends on the concept of autonomy employed. If as I have suggested a basic concept is employed then more disabled people should be able to make their own decisions as an autonomous decision is not the same as a good decision. The emphasis should be on helping such people make good decisions rather than making good decisions on their behalf.



  1. John Stuart Mill, 1974, On Liberty, Penguin, page 69
  2. Christine Korsgaard, 2009, Self-Constitution, Oxford University Press, page 1
  3. Harry Frankfurt, 1999, Necessity, Volition, and Love. Cambridge, page 114
  4. R. M. Hare, 1978, What is Wrong with Slavery, Philosophy and Public Affairs 8.
  5. Matthew Burch, 2017, Autonomy, Respect and the Rights of Persons with Disabilities in Crisis, Journal of Applied Philosophy, Vol 34(3) 

Tuesday, 2 May 2017

Widespread Moral Enhancement


In my last posting I examined whether we should morally bio-enhance psychopaths. I concluded that we should encourage such enhancement. Ingmar Persson and Julian Savulescu argue that there is a need for a much more widespread moral enhancement in order to counter the existential dangers our modern world poses (1). They argue that because our morality developed in small communities it is unsuitable for combatting these dangers. I accept that there is a need for such enhancement. In this posting I want to examine how widespread such enhancement needs to be in order to be effective and how such enhancement might be implemented.

Some might argue that if we change our society by becoming more tolerant then we will naturally morally enhance the members of society. If someone lives in a brutal society then she is more likely to act in a brutal manner, whilst if she lives in a tolerant society her toleration is likely to increase. Stephen Pinker argues that this is already be happening (2). I believe society can change people, enhance people, but that this change is extremely slow. The existential dangers we face are pressing and it seems likely that moral enhancement by creating a more tolerant society might be too slow to combat these dangers.

Persson and Savulescu favour moral bio-enhancement. According to them provided such enhancement is proven to be safe then,

“some children should be subjected to moral bio-enhancement, just as they are now subjected to traditional moral education.” (3)

What exactly do Persson and Savulescu mean by moral bio-enhancement? They argue that moral bio-enhancement should seek to increase our dispositions for altruism and justice They argue moral bio-enhancement should do so by making,

 “men in general more moral by bio-medical methods through making them more like the men who are more like women in respect of sympathy and aggression, but without the tendency to social forms of aggression.” (4)

Such bio-enhancement is aimed at changing our dispositions in respect to empathy or sympathy but does not seek to change our cognitive abilities. Let us accept that such enhancement is safe. I now want to examine two questions regarding this form of enhancement. First is it likely to be effective and secondly should such enhancement be mandatory or voluntary.

If we simply enhance our disposition for empathy is such an enhancement likely to combat the dangers facing us? Some have argued that enhancing someone’s empathy simply increases the degree of empathy she feels, but doesn’t expand the domain of her empathy. Paul Bloom questions the benefits of empathy by suggesting that increasing people’s empathy is more likely to increase tension between different groups rather than diminish it. (5) If we accept Bloom is correct then we have reason to believe moral bio-enhancement based solely on enhancing our capacity for empathy would not be very effective. However, I believe there are reasons why dual enhancement involving both our capacity for empathy and cognitive abilities might be more effective, see moral character enhancement . It seems possible that if we enhance our cognitive abilities whilst at the same enhancing our capacity for empathy that such dual enhancement might lead to a broadening of the domain of our moral concern. Bloom holds that it is useful to compare empathy with anger.

“Both are universal responses that emerge in childhood. Both are social, mainly geared toward other people, distinguishing them from emotions such as fear and disgust, which are often elicited by inanimate beings and experiences. Most of all, they are both moral, in that they connect to judgments of right and wrong.” (6)

Judgments are based on the way we view some situation. The way we view some situation depends to some degree on our cognitive abilities. It follows if judgments are similar in some way to empathy that empathy might also depend to some degree on our cognitive abilities. In the light of the above it might be sensible to also enhance our cognitive abilities if we are going to enhance our capacity for empathy.  In the light of the above I would suggest that provided it can be shown that cognitive enhancement enlarges the domain of our empathy that any moral bio-enhancement should be dual enhancement.

Let us accept that dual moral bio-enhancement is desirable and that the means of such enhancement are safe. In these circumstances should such enhancement be mandatory or voluntary? In my previous posting I argued that any moral bio-enhancement of psychopaths should be voluntary in order to respect their autonomy. I will now argue the same is true of more widespread moral bio-enhancement. It might be objected that the need to counter the threats posed by climate change and nuclear armageddon should trump respecting autonomy. Indeed, my objector might point out if we don’t deal with these existential threats there will be few people left whose autonomy we should respect. In response to my objector I would suggest that there is no need to make moral bio-enhancement mandatory in order to counter these threats. It has been assumed that such enhancement has been thoroughly tested and proved to be both safe and effective. In these circumstances it might appear that any decision about becoming morally bio-enhanced is simply a no brainer. Surely we all want to be good people? In response my objector might point out that vaccines have thoroughly tested and proved to be both safe and effective and in spite of this some people refuse to have their children vaccinated even though they desire that their children enjoy good health. She might then argue by analogy that much the same would apply to any moral bio-enhancement. I am prepared to accept that my objector is correct in her assessment that some people would not voluntarily morally bio-enhance themselves. However, I will now argue that her analogy is unsound. For any vaccination program to be effective a high percentage of the population need to be vaccinated. For moral bio-enhancement to be effective, in order to counter existential threats, I would suggest that only a majority of people need take such enhancement in a democracy. A majority is all that is needed to enact legislation to counter these threats. I would further suggest that provided moral bio-enhancement is proven to be safe and effective a majority of people would take it. It follows that even if a substantial minority refuse to take such enhancement that there is no need for such enhancement to be mandatory.

My objector now might raise a further objection. She might argue that cost of such enhancement might deter a majority of people from taking it. If the costs of any bio-enhancement are high then I am prepared to accept my objector’s objection, but I am doubtful whether in practice such costs would be high. If the majority of the population take such enhancement, then these large numbers should lower these costs. However, let us assume I am wrong and that the costs would be high. Let us accept that civilised society has duty to protect both itself and its citizens from anarchy and possible destruction. It follows if society faces anarchy and destruction due to these existential threats which could be avoided by moral bio-enhancement provided the costs of such enhancement were lower, that society should subsidise or freely provide moral bio-enhancement. In addition, such enhancement would carry further benefits for society. If someone is morally bio-enhanced, then it seems probable that she will be less likely to commit crime. More fancifully moral bio-enhancement might reduce the threat of terrorism. Reduced crime would be a saving for society. It follows that society has financial incentives to encourage moral bio-enhancement. In the light of the above it seems improbable that the cost of moral bio-enhancement is going to prevent the majority of people taking it provided it is safe.

In the above it has been assumed that moral bio-enhancement is safe. This assumption may be false because all drugs have some side effects. In these circumstances we would still be faced with existential threats and a morality which seems incapable of addressing these threats. In these circumstances there is a further alternative we might consider. Perhaps we might use algorithms to guide our decision making in response to these threats. It might be objected that the use of algorithms threatens our autonomy. I response I would argue whether this threat is meaningful depends on how we use any such algorithms. I am not suggesting we simply use algorithms to make these difficult decisions for us but rather to guide our decision making. I am suggesting that we might possibly use algorithms in assisting us in making moral decisions. Such assistance should be interactive and the algorithms in question might evolve in response to our interactions. I have dealt with algorithmic assisted moral decision making at greater length in a previous posting. Perhaps using algorithms in such a way does not threaten our autonomy.

  1. Ingmar Persson & Julian Savulescu, 2012, UNFIT FOR THE FUTURE, Oxford University Press.
  2. Stephen Pinker, 2011, The Better Angels of our Nature, Viking.
  3. Persson & Savulescu, page 113.
  4. Persson & Savelescu, page 112.
  5. Bloom, Paul. Against Empathy: The Case for Rational Compassion (pp. 207-208). Random House.
  6. Bloom, page 207.



Engaging with Robots

  In an interesting paper Sven Nyholm considers some of the implications of controlling robots. I use the idea of control to ask a different...