justice

Poem: The Band Plays On

R. Horton

Following a crescendo of violence,
an allegro jubilee of relief and release
brings us all a moment of respite
before resuming the rhythm of the rigour
and ardor of unflinching struggle.

And a young woman tells us we can
be the light if we dare, and her innocence
gives us new hope and a new cadence
for resolute strides to an unknown
future of heat, yes, but also illumination.

Still, this isn’t a cadenza, but a restrictive
repair, a scaffolding of democratic skills,
a dampening of fear and a regrouping
of willing collaborators marching forward
on the promise of hope and camaraderie.

And the band plays on, because the music
of justice has no coda, only refrains.

Everybody’s Talking About Bioethics Now #COVID19

R. Horton5 Comments
Photo by Gustavo Fring on Pexels.com

Since this pandemic got rolling, it seems everyone wants to talk about bioethics “trolley problem” quandaries like how to decide which of three dying patients gets the one ventilator on hand or whether it is okay to lock up healthy people to prevent the spread of a deadly virus. All the boring stuff suddenly got real and real fast, but maybe it’s not that interesting.

You should give the ventilators to the people with the best chance of surviving, right? I think that is how triage works. And, oh, was it all right to tell people to turn off their lights when bombers were flying overhead in the middle of the night? Sometimes even the rugged individualists have to work as a group. The problem is that some of our rugged individualists have never really been put in a position to make tough decisions, so they aren’t prepared.

And that gets us to the real ethical issues here. It is really unethical to be unprepared for emergencies. Experts in many fields have been warning of coming pandemics for at least 15 years. Even George. W. Bush, bless his tiny heart, knew he had to prepare for pandemics, and he at least took at stab at it. And the ever financially minded Barack Obama prepared for pandemics and even dealt with one on his watch. His didn’t get quite so out of hand, of course, and no one should have to tell you why.

So, the important ethical decisions were made years ago, and many of them had to do with the most attention-starved principle of bioethics, justice. The failure to prepare for a public health emergency affects everyone, as we now see, but too many people have always seen efforts to protect public health as efforts to protect “people not like me.” This isn’t always a sign of racism; sometimes it is just pure classism. Some people just don’t hate based on skin color, religion, sexuality, or any of that stuff. They hate poor people of all types.

This is also not a matter of choosing between the “economy” and the needs of working people. Preparing for a pandemic would have meant having mechanisms in place for extensive testing, tracing, and isolation that would have prevented the need to shut down almost all business activities. With proper preparation, the world would have suffered but could continue functioning.

And I guess a lot of Americans really were satisfied with their employer-provided health insurance that they are now losing, because it turns out their employers really never valued them as much as they assumed. It would seem that intelligent and hard working people should always be able to get healthcare, and that’s what we’ve been trying to tell you. You can be hardworking and intelligent and also poor, and maybe it is good that more people are learning this rather difficult lesson right now. Maybe it will help in the future.

But public health isn’t all about health insurance, though turning infected people away from a hospital because they can’t pay is certainly not a good way to protect the public from a pandemic. No, protecting the public health, which is really protecting national security (and global security) is about being able to deal with emergencies, which would require not selling off all the equipment you might need. Most homeowners have never used a fire extinguisher, but the ones who used them successfully were pretty happy they had invested in buying one and taken the time to learn how to use it.

So, yes, more than a decade ago, epidemiologists, virologists, climate scientists, public health experts, public health ethicists, and environmentalists were warning that the world was becoming much more hostile. How do we prepare to ensure our own long-term survival isn’t really as much fun as debating who gets the last ventilator, maybe, but it can save many more lives.

And maybe you’re saying there’s no point in going on about this now as it’s too late. What’s done is done, you’re saying, but this ain’t over, folks. One way or the other, COVID19 will be resolved, but other pandemics will follow along with drought, flooding, mass migrations, and a host of other public health crises that aren’t that hard to imagine if you only try. You may think I’m crazy, but I’m not the only one. Plenty of experts in relevant fields are already imagining the worst and best case scenarios. Maybe it’s time to listen to them.

Corporatocracy and Me

R. Horton

The East India Company was the first modern corporation,

And it is credited with introducing the world to markets that are free,

But it brought the free market enforced by the world’s largest standing army.

It was the beginning of colonialism, imperialism, and Corporatocracy.

The EIC introduced the world to spices, tea, and global slavery.

Some in the United States rebelled with a giant tea party,

It set off a revolution but didn’t bring down corporate rule,

The robber baron bosses soon controlled trade, news, and even schools.

We may think their practices went against the principles of enlightenment.

But the EIC employed such men as John Locke, JS Mill, and Jeremy Bentham.

So the first corporation took control of public attitudes and education.

Promulgating equality for all European, land-owning men.

While denying rights to all those considered less than human.

When the US tried to recognise non-white men with an amendment

Giving them equal protection from abuse and harassment,

The railroad said, “Hey, corporations are people, too,”

And the courts went along as they always do.

 

Well, what’s past is past, and now it’s all good.

We’ve grown used to the idea of corporate personhood.

Citizens United taught us money is speech

You have a voice, but Exxon’s has more reach.

And Monsanto, now Bayer, wants to feed the entire globe,

By controlling food, seeds, farming, drugs, and microbes.

You have no other choice than to just trust them,

As manufacturers lead us on a race to the bottom.

Apple computers are built in factories with suicide nets.

Because conditions are so bad workers prefer death.

Our clothes are made in sweatshops where workers burn.

We’ve no choice to buy them is all that we’ve learned.

In 2007, the financial sector destroyed the economy,

But workers bailed them out with hard-earned money.

Now we’ve cut funding for public education.

Replacing it with the public/private partnership.

Giving business control of science, arts, and research.

IF you want unbiased info, you’re left in the lurch.

But what about corporations great philanthropy?

Don’t They give developmental aid from sense of charity?

No, They buy up or steal resources and flood markets with free food,

Destroying the economy and local businesses for good.

You can scream about Trump or any other entity,

But corporations are your true enemy.

 

Nussbaum and Rand on the Politics of Love

R. Horton1 Comment

I’m currently reading Martha Nussbaum’s Political Emotions: Why Love Matters for Justice. Love is an important focus of the book, but it is certainly not the only emotion that Nussbaum considers important to a minimally decent society. Still, love (and its relevant associate, compassion) is an integral part of a stable and humane democratic society.

English: Photograph of Martha C. Nussbaum take...

Nussbaum suggests that it is entirely appropriate for governments to encourage the development of political emotions that are absolutely necessary for a functioning society. Of course, totalitarian, repressive regimes often rise to power on waves of extreme patriotism coupled with xenophobia and violent anger. This is a risk of the state cultivating emotions, but it is also likely that inappropriate emotions arise because we shirk our duty to cultivate the correct emotions. Who decides which emotions are correct? Why, we political liberals, of course. Nussbaum is more optimistic than I about the ability to create a state that will encourage the appropriate arts and literature to cultivate emotions that will engender empathy and promote democratic feeling. Still, we are obligated to make every effort to counter those who would work to destroy both compassion and democracy.

Nussbaum recognizes the potential for paradox in her claim, but she defends her position with depth and detail. The fact that I agree with both her goals and method make it quite easy for me to follow along and hope, against all odds, that is possible to create a more decent society than what I currently see around me, even if I feel we must go it alone without the full support of government.

Ayn Rand

But all this talk of love got me thinking of Ayn Rand, of course, as many things these days get me thinking of Ayn Rand. She said that we should be selfish and never sacrifice ourselves to others. In contrast, many of us have foolishly believed that to love someone was, in fact, to be willing to sacrifice ourselves for his or her well-being. On this point, I think Ayn Rand was able to explain herself quite clearly. When asked whether we shouldn’t be selfless in our romantic relationships, she said,

“When you are in love, it means that the person you love is of great personal, selfish importance to you and to your life. If you were selfless, it would have to mean that you derive no personal pleasure or happiness from the company and the existence of the person you love, and that you are motivated only by self-sacrificial pity for that person’s need of you.”

She makes a good point. We sacrifice for those we love because we value them so much that their loss is a personal loss to us, and their suffering is a suffering we share. We do not love out of duty; we love for the pleasure it brings us.

For Rand, altruistic concern for strangers entails a denial of self-satisfaction and an indenture to others. By living for the needs of others, we deny our responsibility to determine and seek our own needs. It does not occur to Rand, as it does to Nussbaum, that is possible to value other humans with a love that extends beyond our realm of personal contact. It is possible that I want to preserve the lives of strangers thousands of miles away because I value them, even if abstractly, to the point that their suffering causes me suffering.

I don’t want to live in a world where millions of people starve to death each year, and I do not believe they are starving because of the poor choices they have made. I believe they are starving because of structural economic violence against them. In many cases, the world’s resources have been stolen by brute force (did farmers and fishers in Africa foolishly give their land to oil companies?). Poverty, addiction, and disease are largely a result of violence against people who are not recognized as being fully human, fully deserving of respect.

We don’t have to accept this reality. As Nussbaum says, “We should surely not assume that the form emotions take in the corporate culture of the United States reveals a universal and timeless truth about how things must be.” No, we can work to ensure that our moral imagination can perceive other human beings as beings worthy of respect, dignity, and, yes, love. If we seek to respect ourselves, we must demand respect for all.

Love is possible.

Teaching Ethics to Greedy Bastards

R. Horton3 Comments

When a corporate executive, high-powered lawyer, or well-funded medical researcher is exposed for egregious unethical behavior, we often say it would have been a good idea for that person to have had a class in ethics with some follow-up training. We’d like to think that with the proper ethics training even the most heartless sociopath could be encouraged to at least follow some of the rules.

And if we can’t (note: we can’t) encourage bad people to be good people, what are ethicists worth? Well, our roles fall into several categories: 1. Providing ethical answers to dilemmas. 2. Offering ethical analysis of a particular problem. 3. Teaching ethical decision-making, which makes a good-faith assumption that the decision maker is sincere in wanting to be ethical. 4. Holding wrongdoers accountable for their behavior.

The first category is offered to clients who don’t want to take complete responsibility for their ethical decisions. Once a professional ethicist has offered an opinion on whether something is above board, an organization can say, proudly, “All our policies and procedures have been reviewed by someone with extensive training and expertise in ethics and found to be compliant with all ethical and legal codes.” Indeed, it can be a very good idea for an organization to get an outsider to review policies for possible ethical problems.

The second category is related, perhaps a subset of the first. When institutions encounter a particularly sticky issue, they might ask an ethicist to help them work through all the ethical considerations and explore how various ethical theories can help them solve the dilemma. Again, a useful role for the ethicist.

The third category involves training. Rather than giving answers to ethical questions, the ethicist can teach motivated individuals to analyze various conflicts on their own. Most people know how to think ethically, but they sometimes forget some of the considerations that professionals might find to be second nature.  Developing a more thorough approach to ethical approaches can benefit individuals and organization alike. It cannot, however, turn a bad person in to a good one. Evil people don’t lack ethical tools—they lack a conscience.

So, what do we do about the evil people? An important role for ethicists, in my considered and passionately held opinion, is to cry foul when individuals and institutions engage in egregious behavior. And when ethicists disagree on what is an egregious action, fervent debate erupts in the public sphere, benefitting the public and everyone involved, or so it should be. When ethicists sound the alarm that some behavior is abhorrent and shameful, a public chorus against such actions can at least ensure that the bad actors confront public scrutiny.

Think it doesn’t work? Remember in 2011 when executives at Transocean received bonuses for their safety record after the explosion in the Gulf of Mexico killed 11 and sent millions of gallons of oil streaming into the water? After public outcry, the executives thought better of keeping those bonuses and donated them to the Deepwater Horizon Memorial Fund. Social regulation pushes and pulls behavior through honor and shame. In responding to abhorrent behavior, Kwame Anthony Appiah says, “Shame, and sometimes even carefully calibrated ridicule, may be the tools we need. Not that appeals to morality—to justice, to human rights—are irrelevant.”

Most of us evaluate ethical theories in the following way: Knowing that I am an ethical person, which ethical theory best fits my behavior? Following this method, we can all justify our actions through theoretical ethics as we simply seek out the theories that validate our behavior. Given that we all have justification for our behavior, public outcry is not likely to immediately shake our perception of what is appropriate, and, indeed, the public rarely speaks as one voice. Further, the common view is often wrong, or so I judge it to be. Bertrand Russell once said, “In view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.” Indeed.

Many people, especially those in power, feel their behavior is beyond reproach. They seem to think they could not have gained power if they were not deserving of it. Public outcry and public discourse, can remind them that they are, in common with the rest of us, flawed and fallible human beings. What this means is that we must raise our voices, express what we find shameful and honorable, and join or create a conversation over morality, dignity, and justice. Only when we suppress our voices do we lose. Only our common humanity makes our salvation possible.

Update on Saylor White

R. Horton

After public pressure and eliminating all excuses for denial, Aetna has finally approved Saylor’s surgery, so he is at last getting treatment. His wife sent the following message to those who were concerned about him:

“Great news! Aetna APPROVED Saylor White‘s surgery with the original surgical team and hospital. They could not provide the services in-network so had to approve it. His doctors office is working to reschedule ASAP. Thank you to everyone who has been comfort and support to us during this trying time. Bless you all!”

While we are all relieved and thrilled he is getting treatment, there is no excuse for subjecting sick people to so much stress and indignity.

Notes on European Socialized Healthcare

R. Horton1 Comment

Yesterday, I posted a blog about three people who must rely on contributions from friends, admirers, and strangers to maintain the healthcare they need, and these three individuals are not unusual cases in the US. It is the argument of conservatives that universal healthcare coverage (or anything socialized) will deprive workers of their dignity. It is the pride of ownership and rewards for hard work that gives people self-respect and a feeling of accomplishment. Providing for yourself makes you a better person.

The majority of Europeans, where it is generally inconceivable that anyone would be forced to hold a fundraiser to pay medical bills, seem to disagree. Just as most Americans do not consider Social Security or public education to be a demeaning form of charity, most Europeans do not consider healthcare to be a demeaning government handout. Rather, healthcare is a burden shared by all to protect their common interests. The costs of advanced medical technologies and surgeries are out of range for all but the richest Americans. Medical emergencies can quickly run to the hundreds of thousands of dollars. A six-figure salary will not offset the costs.

Having to ask friends, family, admirers, and strangers to help pay your bills is demeaning, demoralizing, and degrading. The conservative vision of letting everyone pay their own way or debase themselves in their dying months, weeks, or days is appalling and unconscionable. I have my own objections to the Affordable Care Act, but trying to fix the problem is more honorable than ignoring the problem or, worse, declaring that the current crisis in healthcare is acceptable. We must demand solutions. If you are opposed to the solution on the table, bring your idea to the table.

Ignoring the problem is killing us. Unfortunately, we must also be humiliated before we can die penniless and ashamed.

Don’t force me to pay for your religious practice

R. Horton

Members of the Catholic Church have expressed outrage that the new health laws require them to provide contraception to women. This was weeks ago, but Catholics continue to double down on this position. They say the state has no right demanding that they violate their own religious beliefs.

This argument makes perfect sense. The government has no right telling private individuals how they should conduct their affairs. So long as they aren’t taking public money, serving the general public, or hiring non-Catholic employees, there should be no controversy at all.

But according to an article in Mother Jones:

Under Obama, Catholic religious charities alone have received more than $650 million, according to a spokeswoman from the US Department of Health and Human Services, where much of the funding comes from. The USCCB, which has been such a vocal critic of the Obama administration, has seen its share of federal grants from HHS jump from $71.8 million in the last three years of the Bush administration to $81.2 million during the first three years of Obama. In fiscal 2011 alone, the group received a record $31.4 million from the administration it believes is virulently anti-Catholic, according to HHS data.

Under the first amendment, the government must not establish a religion. Funding of faith-based charities avoids violating the first amendment by demanding that those charities do not use their services to promote their faith or discriminate against those of other faiths.

Requiring them to use public funds to offer public services without discriminating against non-Catholics is not an attack on religion. Permitting charities receiving public funds to discriminate against non-Catholics would be using my taxes to promote religious views I find reprehensible. I am amazed that conservatives, libertarians, and Tea Party members aren’t outraged at this use of taxpayer money. Surely conservatives believe we should trim the federal budget and protect religious liberty at the same time.

If Catholic Charities want to exclude contraception from their health plans and refuse to recognize the rights of same-sex marriages, they should immediately refuse all public funding, including federal, state, and local funds. If they refuse, the federal government should simply withhold the funds (courts have supported such actions in the past). Or, they can continue to receive taxpayer money and offer their services without discrimination.

Can justice be utilitarian?

R. Horton

I have always been fond of Utilitarianism and, quite frankly, impressed by the arguments of all the major Utilitarian writers. Criticisms of Utilitarianism also make sense, but they don’t seem consistent with the views of major Utilitarians. I suppose I most commonly hear Utilitarianism dismissed as a cruel philosophy that would accept sacrificing individuals so long as a larger number of people drew some advantage from the sacrifice.

This argument affects me strongly as I feel a society that is unjust to only one person is an unjust and unacceptable society. Yet, I still find myself in great admiration for Bentham, Mill, Hare, Singer, and others. What I admire about these Utilitarians is that they never ignored the plight of people (or even non-human animals) who were marginalized by society. It is precisely this inclusiveness of Utilitarianism that attracts me.

For example, in one of my bioethics classes, we had a discussion of how to respond to a pandemic. Some of my colleagues said that doctors must deal with the person in front of them with full attention. To toss this person aside, they said, would just be Utilitarian. They pronounced “Utilitarian” as if they were saying, “pure evil.” Utilitarianism seems heartless to them. Doctors making calculations as to what actions would benefit the most people. I object, however, and say that it seems more heartless to ignore the 10 people dying in the street than it does to step away from one hopeless case in the hospital. I am biased, but I happen to think the person in the hospital is likely to be more privileged than the people who are in the street, and I feel we should give priority to the poor and dispossessed.

I also noted that everyone, doctors and non-doctors, was obligated to help as many people as possible. In this way, no one should be left to die alone with no one showing concern for him or her. Utilitarians such as Peter Singer and Peter Unger make powerful arguments for devoting more attention to those dying of starvation in the world. They do not advocate, as you might expect from the criticisms leveled against them, ignoring the suffering of the poor so long as it benefits the rich. Rather, they suggest that everyone has an obligation to try to relieve the suffering of everyone else, with no one being left out of the mix. I realize things don’t happen this way, but ethicists attempt to describe how things ought to happen, not how things are likely to happen.

So, all this leaves my question about justice open. I want to say that everyone will be happier if we all live in a state that is perfectly just.* For this reason, we cannot ignore injustice inflicted on any one person. When I make this assertion, I’m taking the line that we should all follow a rule, and some will say that so-called “Rule Utilitarianism” is just another form of deontology. I think the two may be compatible. It may that I have misunderstood Utilitarianism. If that is the case, I think most Utilitarians have also misunderstood it.

*Yes, I know, we are not likely to agree on what is meant by “perfectly just.”

The High Cost of Occupation: The High Cost of Injustice

R. Horton

According to various reports, the Occupy Wall Street movement has cost cities upward of $10 million. As the protesters are angry at the diversion of public funds away from public services (I know people say no one knows what they want, but they are really quite clear about what they want), it might seem that this wasteful spending is only making things worse. The more cities spend on police, the less they can spend on libraries, public parks, infrastructure, and all the other things that make society work. We might ask whether military ordnance such as Tampa Police Department’s tank (no, armored rescue vehicle) is a good use of money, but policing protests takes a few pennies either way.

Somehow, it seems cities always have enough money to deploy an army to suppress a non-violent protest but not enough money for basic services. The cash tin for security is bottomless. But surely, even those in power would rather not have to spend all this money on security if it can be avoided. No one wants to have to live with barricades everywhere. And no one wants to live with the inconvenience of constant protests.

And that is the point. Protests are intended to create a situation that everyone would rather avoid. As Martin Luther King put it, “Nonviolent direct action seeks to create such a crisis and foster such a tension that a community which has constantly refused to negotiate is forced to confront the issue. It seeks so to dramatize the issue that it can no longer be ignored.” This is what this movement, and any other political movement, seeks to accomplish. It is obvious that $10 million is not enough to create a crisis for the current established order.

When the current order is threatened, it will of course blame the dissenters for a new sense of crisis and chaos. This blame is misplaced. It is a breakdown of order that provokes civil disobedience in the first place. Mass movements are made up of people who want a just and civil society. As John Rawls, another great American philosopher, said, “If legitimate civil disobedience seems to threaten civil peace, the responsibility falls not so much on those who protest as upon those whose abuse of authority and power justifies such opposition.”

Which brings us to the final point. The purpose of protests is to make the cost, financial and otherwise, of injustice greater than the price of justice.