A post by Francis Beckwith (“Thomson’s Defense of Abortion at Forty“), which takes a new look at Judith Jarvis Thomson’s “A Defense of Abortion (Philosophy & Public Affairs, 1971),” prompts me to recall my writings and warnings about abortion and other eugenic practices.
I begin with an excerpt of my first anti-abortion post, from August 2004, “I’ve Changed My Mind“:
As a libertarian — who believes that a legitimate function of the state is to protect humans from force — I can no longer condone the legality of abortion. For one thing, legal abortion is a step on the path to legal euthanasia….
Once life begins it is sophistry to say that abortion doesn’t amount to the taking of an innocent life. It is also sophistry to argue that abortion is “acceptable” until such-and-such a stage of fetal development. There is no clear dividing line between the onset of life and the onset of human-ness. They are indivisible.
The state shouldn’t be in the business of authorizing the deaths of innocent humans. The state should be in the business of protecting the lives of innocent humans — from conception to grave.
I have much more to say about eugenics. Please read on.
In “Next Stop, Legal Genocide?” (September 2004), I noted the spread of legal euthanasia in Europe, and said that
[l]ibertarians ought to be up in arms about euthanasia. Where are they on the issue? Buried deep in the Libertarian Party website [but not longer available] is one reference to euthanasia….
My vote for most anti-freedom political zealot goes to Pat Robertson. [Who] espouses [among other things] condemnation of euthanasia….
— Barry Rowe, Melbourne, Florida
And that’s all [there was and is] to be found on the website of the political party that claims to “hold that all individuals have the right to exercise sole dominion over their own lives….” No wonder I … [have] deep disrespect for the Libertarian Party as a exponent of libertarian ideals.
Later in the same month, in “It Can Happen Here: Eugenics, Abortion, Euthanasia, and Mental Screening,” I quoted at length from Sherwin B. Nuland’s “The Death of Hippocrates” (The New Republic, September 13, 2004):
The exhibition [on eugenics at the United States Holocaust Memorial Museum in Washington] details the influence of eugenics on determining Nazi policy from the time of the party’s assumption of power in 1933 until the end of World War II….Though some have thought of it as an applied science, eugenics is in fact more a philosophy than a science. Its proponents based their notions on genetics, having as their purpose the improvement of the breed. The word was defined exactly that way in 1911 in a book by the eminent American biometrician and zoologist Charles Davenport, director of the Eugenics Record Office at Cold Spring Harbor, New York (elected to the National Academy of Sciences in the following year), who called it “the science of the improvement of the human race by better breeding.”
Eugenicists believed that it is possible, and even a good idea, to attempt to enhance the quality of our species by regulating the reproduction of traits considered to be inheritable….
Looking back with the wisdom of hindsight, it seems so clear that eugenics had always been a dangerous notion, and that its adherents were either deluded or racist. But the fact is that such a realization was slow in coming, and appeared only after matters had gotten completely out of hand and the stage set on which horrendous events would take place [under Hitler’s rule]. Among the several reasons that medically trained students of eugenics allowed matters to turn so ugly was their failure to recognize a basic fact about the scientific enterprise, which is well known to historians and philosophers of the subject but continues to elude even some of the most sophisticated men and women who actually do the work….
The basic fact to which I refer is that neither medicine nor science itself derives its “truths” in the thoroughly detached atmosphere in which its practitioners would like to believe they work….
Today’s molecular biologists and geneticists have dipped a very powerful oar into the ongoing stream of debate about heredity versus environment. Every year — every month — we read about newly discovered genetic factors determining not only physical characteristics but those of morals and mind as well. Sometimes we are even told their precise locations on the DNA molecule. No one knows how much of this will hold up in the coming decades, but we can be sure that a significant proportion of it will be confirmed. Some authoritative scientific voices are telling us that we should take advantage of the new knowledge to fulfill our fantasies of improving ourselves and indeed our species….
This is genuinely terrifying stuff. Not since the first half of the twentieth century have prominent thinkers been so starry-eyed at the thought of controlling the future of our species, or at least that privileged portion of it that will have the financial, cultural, and other wherewithal to take advantage of the offer being presented to us….
Looking backward, we can now see the danger in state-enforced policies of improvement [through eugenics], but too many of us have yet to awaken to the equally dangerous reality of improvement that is self-determined. We are once again standing on the slope, from the top of which the future we may be wreaking is already visible. Now is the time to recognize the nature of human motivation — and the permanence of human frailty.
To which I could only add this:
Now, think about the “progressive” impulses that underlie abortion (especially selective abortion), involuntary euthanasia, and forced mental screening — all of them steps down a slippery slope toward state control of human destiny.
My “slippery slope” view found reinforcement in George Neumayr’s article, “The New Eugenics” (The American Spectator, July 13, 2005), which I quoted in “The Old Eugenics in a New Guise” (July 2005); for example:
EACH YEAR IN AMERICA fewer and fewer disabled infants are born. The reason is eugenic abortion. Doctors and their patients use prenatal technology to screen unborn children for disabilities, then they use that information to abort a high percentage of them. Without much scrutiny or debate, a eugenics designed to weed out the disabled has become commonplace….
The right to abort a disabled child, in other words, is approaching the status of a duty to abort a disabled child. Parents who abort their disabled children won’t be asked to justify their decision. Rather, it is the parents with disabled children who must justify themselves to a society that tacitly asks: Why did you bring into the world a child you knew was disabled or might become disabled?…
Andrew Imparato of AAPD [American Association of People with Disabilities] wonders how progressives got to this point. The new eugenics aimed at the disabled unborn tell the disabled who are alive, “disability is a fate worse than death,” he says. “What kind of message does this send to people living with spina bifida and other disabilities? It is not a progressive value to think that a disabled person is better off dead.”
Whereupon, my fairly measured tone became appropriately condemnatory:
In sum, the state is condoning and encouraging a resurgence of Hitlerian eugenics. And it’s not just happening to the unborn. As I wrote here, “think about the ‘progressive’ impulses that underlie abortion (especially selective abortion), involuntary euthanasia, and forced mental screening — all of them steps down a slippery slope toward state control of human destiny.”
Later in July 2005, in “The Left, Abortion, and Adolescence,” I pondered the source of the left’s attachment to abortion:
What I want to know is why [abortion] is of such great importance to the left. What is it about abortion (or the “right” to have one) that seizes the passions of the left? …
…The left is in an arrested state of adolescent rebellion: “Daddy” doesn’t want me to smoke, so I’m going to smoke; “Daddy” doesn’t want me to drink, so I’m going to drink; “Daddy” doesn’t want me to have sex, so I’m going to have sex. But, regardless of my behavior, I expect “Daddy” to give me an allowance, and birthday presents, and cell phones, and so on.
“Daddy,” in the case of abortion, is government, which had banned abortion in many places. If it’s banned, the left wants it. But the left — like an adolescent — also expects government to cough up money (others’ money, of course) to quench its material desires.
Persons of the left simply are simply unthinking, selfish adolescents who want what they want, regardless of the consequences for others. The left’s stance on abortion should be viewed as just one more adolescent tantrum in a vast repertoire of tantrums.
The gloves were off, and would stay off. Eugenicists are not to be taken lightly, even when they are lightweight leftists.
“Law, Liberty, and Abortion” (October 2005) focused on the constitutional and moral wrongness of Roe v. Wade:
Abortion was considered murder long before States began to legislate against it in the 19th century. The long-standing condemnation of abortion — even before quickening — is treated thoroughly in Marvin Olasky’s Abortion Rites: A Social History of Abortion in America. Olasky corrects the slanted version of American history upon which the U.S. Supreme Court relied in Roe v. Wade.
Because abortion was not a right at the time of the adoption of the Ninth Amendment, there is no unenumerated right to abortion in the Constitution. The majority in Roe v. Wade (1973) instead seized upon and broadened a previously manufactured “privacy right” in order to legalize abortion….
In effect, the Roe v. Wade majority acknowledged that abortion is not even an unenumerated right. It then manufactured from specified procedural rights enumerated in the Bill of Rights — rights which are totally unrelated to abortion — and from strained precedents involving “penumbras” and “emanations,” a general right to privacy in order to find a “privacy” right to abortion….
It is therefore unsurprising that the majority in Roe v. Wade could not decide whether the general privacy right is located in the Ninth Amendment or the Fourteenth Amendment. Neither amendment, of course, is the locus of a general privacy right because none is conferred by the Constitution, nor could the Constitution ever confer such a right, for it would interfere with such truly compelling state interests as the pursuit of justice. The majority simply chose to ignore that unspeakable consequence by conjuring a general right to privacy for the limited purpose of ratifying abortion.
The spuriousness of the majority’s conclusion is evident in its flinching from the logical end of its reasoning: abortion anywhere at anytime. Instead, the majority delivered this:
The privacy right involved, therefore, cannot be said to be absolute. . . . We, therefore, conclude that the right of personal privacy includes the abortion decision, but that this right is not unqualified and must be considered against important state interests in regulation.That is, the majority simply drew an arbitrary line between life and death — but in the wrong place. It is as if the majority understood, but wished not to acknowledge, the full implications of a general right to privacy. Such a general right could be deployed by unprincipled judges to decriminalize a variety of heinous acts.
Underlying the majority’s sophistry was its typically “liberal” reluctance to place responsibility where it belongs, in the hands of those persons who (in almost all cases) conceive through engaging voluntarily in an act, the potential consequences of which are well known….
Later in the same post, I refuted Judith Jarvis Thomson’s argument for abortion:
The self-defense argument — which is sometimes billed as a property rights argument for — goes like this: A fetus is an “uninvited guest” in or “invader” of its mother’s body, which is the mother’s property. The mother may therefore do with the fetus as she will.
But a fetus is neither an uninvited guest nor an invader. Rather, it is a life, and that life — by biological necessity — is its mother’s responsibility:
- Conception, in almost all cases, is the result of a consensual act of sexual intercourse….
- Conception is a known consequence of the act of sexual intercourse….
- Life indisputably begins at conception:
Surely the child is alive then [at the tying of the umbilical cord]. It cannot be the mere act of tying the cord that produced life. Then when did life begin? With respiration? That is only one added function. There was circulation previously, and the power of nervous action and motion. Why is not a fetus alive when it is diving and plunging in its mother’s womb? Simply because its lungs are not inflated? Out on such nonsense! One might as well say that a child born blind was not alive because it did not use its eyes. It is on the record, I believe that children have been born by the Caesarean section, after the death of the mother. If there was no vitality in the fetus previous to respiration, then why was it not dead, like the mother? There can be no doubt of it, there was vitality or life. Then if we acknowledge that the fetus had life, how can we say at what period of gestation that life commences? The period of quickening varies, and I do not see why a fetus is not quite as much alive just before it moves as just after. . . . [From O.C. Turner, “Criminal Abortion,” Boston Medical and Surgical Journal, Vol. 5 (April 21, 1870), pp. 299-300. Quoted by Marvin N. Olasky in Abortion Rites: A Social History of Abortion in America, Regnery Publishing, Inc., Washington, D.C. (1995), pp. 121-122.]
- A person who conceives therefore has incurred an implicit obligation to care for the life that flows from her consensual act.
- Given that the existence of a fetus cannot cause harm to anyone but its mother, the only valid route for terminating the life of a fetus would be a legal proceeding that culminates in a judicial determination that the continuation of the life of the fetus would cause grave physical harm or death to the mother.
A fetus, in sum, cannot be treated as “property,” to be disposed of willy-nilly. A libertarian who argues otherwise can do so only by regarding the fetus a sub-human implantation for with the mother bears no responsibility. Such a libertarian might as well argue for a right to keep slaves or a right to dispose of dependent children and parents through involuntary euthanasia. (For a brilliant demolition of an argument similar to Thomson’s, see Matt Walsh’s “I Am Afraid of This Indisputable Pro-Choice Argument.”)
When that realization strikes home, the next step may be an appeal to the viability of the fetus. The argument that a fetus is “inviable” — and therefore somehow undeserving of life — until it reaches a certain stage of development is a circular argument designed to favor abortion. A fetus (except in the case of a natural miscarriage) is viable from the moment of conception until birth as long as it is not aborted. It is abortion that makes a fetus inviable. Abortion therefore cannot be excused on the basis of presumed inviability.
Drawing an arbitrary line, say, three months after conception does not change the fact that a life is a life. And if that arbitrary line can be drawn, why not draw it at birth or just after birth or at any time during a child’s life? Remember, we are arguing here about libertarian principles, not legal niceties. If a child is a mother’s “property” — or if a mother always has a right to “defend” herself from an “unwanted guest” (in her womb or in her home) — why stop at abortion in the first trimester? (Actually, the law hasn’t stopped it there, which is a point that I’ll come to when I discuss the slippery slope down which we’re headed.)
As for the “privacy” argument,
If privacy were a general right, a murderer could claim immunity from prosecution as long as he commits murder in his own home, or better yet (for the murderer), as long as he murders his own children in his own home.
I am unable to avoid the conclusion that abortion is an anti-libertarian act of unjustified aggression against an innocent human being, an act that is undertaken for convenience and almost never for the sake of defending a mother’s life. Murder, too, is an act of convenience that is seldom justified by self-defense. Abortion, therefore, cannot be validated by mistaken appeals to self-defense, privacy, viability, and safety. Nor can abortion be validated (except legalistically) by a series of wrongly decided Supreme Court cases….
If libertarians are to be faithful to libertarian principles, they must oppose the law even when — especially when — it puts convenience above principle. As I wrote here (modified language in brackets):
You may like the outcomes in Griswold v. Connecticut, Roe v. Wade, and Lawrence v. Texas because [you just like them or because they comport with your half-baked notion of liberty]. But it should bother you that the Supreme Court can so blithely turn the law on its head to enact its own beliefs, on the pretext of finding rights in “penumbras, formed by emanations” of the Constitution. A Court that can do such things is a Court that can just as easily interpret the law so as to restrict liberty, all in the name of meeting a pressing social need — as it has in done in many instances.
Another facet of abortion that drew my attention is the putative link between “Abortion and Crime” (April 2010):
In several posts at my old blog, I examined the causes of crime and ways to combat it. Among other things, I debunked the proposition that more abortion means less crime. (See this post and follow the links therein.) Abortion, if it does anything, leads to more crime by women because it “frees” them from child-rearing:
Derived from Statistical Abstracts of the United States: Table HS-24. Federal and State Prisoners by Jurisdiction and Sex: 1925 to 2001; and Table 338. Prisoners Under Federal or State Jurisdiction by Sex.
Let us leave abortion, for now, and jump to “The Case against Genetic Engineering” (July 2007):
Slate’s William Saletan, writing at The New York Times, reviews Michael J. Sandel’s The Case against Perfection: Ethics in the Age of Genetic Engineering. I have not read Sandel’s book, nor do I plan to read it. My case against genetic engineering, to which I will come, may bear no resemblance to Sandel’s. But there’s no way of learning what Sandel’s case is, given Saletan’s rather glib criticism of Sandel’s book….
Saletan, in so many words, professes a tautology: The future will bring what it will bring, and whatever it brings will be the future. Saletan might as well write this: If murder is widely accepted in the future, murder will be acceptable in the future. I doubt very much that Saletan would endorse such a statement. I suspect, rather, that an effort to be clever at Sandel’s expense led Saletan down a moral blind alley of his own construction.
What is that moral blind alley? If it is not obvious to you, consider this passage from the entry for moral relativism at the Stanford Encyclopedia of Philosophy:
Metaethical Moral Relativism (MMR). The truth or falsity of moral judgments, or their justification, is not absolute or universal, but is relative to the traditions, convictions, or practices of a group of persons.The definition of MMR* points to Saletan’s error. He treats the same (or very much the same) group of persons as being a different group because of the passage of time. In other words, the future just “happens” — as if people cannot make judgments in the present about the consequences, for them, of pending or reversible decisions.
To come at it a different way, Saletan conflates what could be with what should be. There could be a market for genetic engineering, but should there be such a market? There are, after all, markets for murder, arson, and the fruits of theft (among other such things), but I doubt that Saletan would condone such markets.
The real issue, then, is whether to allow genetic engineering, in light of its consequences. Saletan finally approaches that question when he says that “self-engineering….seizes control of humanity so radically that humanity can no longer judge it.”…
Our present world, contra Saletan, is (relative to the brave new world of genetic engineering) one of freedom and responsibility. To use the example of a baby with Down syndrome (properly Down’s syndrome), parents who choose to abort such a baby (for that is what Saletan means) have every bit as much “freedom” to make that choice (under today’s abortion laws) and are just as responsible (morally) for their decision as they would be if they were to choose bioengineering instead. Genetic engineering simply introduces different “freedoms.”
Thus we come to the real issue, which is the wisdom (or not) of allowing genetic engineering in the first place. For, as we know from our experience with the regulatory-welfare state, once an undesirable practice gains the state’s approbation and encouragement it becomes the norm.
And that is the broad case against allowing genetic engineering: If it gains a government-approved foothold it will become the norm. It will result in foreseeable (and unforeseeable) changes in the human condition. It will cause most of us who are alive today to wish that it had never been allowed in the first place.
How so? Consider the specific case against genetic engineering:
- Following upon (but not supplanting) abortion, it would enable humans to retreat further from the acceptance of responsibility for the consequences of the procreative act. The prospective acceptance of responsibility for our actions is a restraining influence upon which civil society depends. That restraining influence has been lessened enough by such elitist initiatives as the legalization of abortion, leniency in the punishment of criminals, and permissiveness in the face of disruptive speech and behavior in public schools.
- It would reinforce the attitude — inherent in abortion — that humans are mere machines to be overhauled or junked at will. It would, in other words, take us another giant step down the slippery slope toward state-condoned (if not state-conducted) euthanasia.
- From there it would be an easy step for the state (controlled by “liberal” elites) to dictate who may have children, how many children they may have, the gender-mix of the children, the occupations those children may pursue, etc., etc., etc.
Yes, genetic engineering could have some positive consequences (e.g., reducing the number of children born with Down’s syndrome). But the prospect of such consequences should not eclipse the broad, fundamental, negative consequences for human dignity and liberty.
My bête noire, in matters of eugenics, is Peter Singer. I first discussed his abhorrent view in “Peter Singer’s Fallacy” (November 2004). Here are some key passages:
Peter Singer — the Ira W. DeCamp Professor of Bioethics at the University Center for Human Values of Princeton University… — says this about his ethical position:
…I approach each issue by seeking the solution that has the best consequences for all affected. By ‘best consequences’, I understand that which satisfies the most preferences, weighted in accordance with the strength of the preferences. Thus my ethical position is a form of preference-utilitarianism….
That is to say, Singer sets himself up as an omniscient arbiter and weigher of the preferences of billions of individual humans (and other animals), in the belief that he has a formula for determining “the greatest good of the greatest number.” That is a bankrupt formula, as I have written:
…It’s patently absurd to think of measuring individual degrees of happiness, let alone summing those measurements. Suppose the government takes from A (making him miserable) and gives to B (making him joyous). Does B’s joyousness cancel A’s misery? Only if you’re B or a politician who has earned B’s support by joining in the raid on A’s bank account.
Something like “the greatest good for the greatest number” can come about only in a representative democracy, where political bargaining about legitimate government functions leads to a compromise that’s satisfactory to most members of the body politic. An example would be an agreement to have a defense budget of a certain size and to authorize (or not) the use of the armed forces for a particular defensive objective….
There is much more to say about Singer. “Peter Singer’s Agenda” (December 2005) appeared in the aftermath of the tragic, state-ordered murder of Terry Schiavo, which Singer sought to exploit:
Peter Singer, euthanasia enthusiast, is piggy-backing on the Schiavo fiasco. This is from WorldNetDaily:
During the next 35 years, the traditional view of the sanctity of human life will collapse under pressure from scientific, technological, and demographic developments, says controversial bio-ethics professor Peter Singer.
“By 2040, it may be that only a rump of hard-core, know-nothing religious fundamentalists will defend the view that every human life, from conception to death, is sacrosanct,” says Princeton University’s defender of infanticide. “In retrospect, 2005 may be seen as the year in which that position (of the sanctity of life) became untenable,” he writes in the fall issue of Foreign Policy.
Singer sees 2005’s battle over the life of Terri Schiavo as a key to this changing ethic.
The year 2005 is also significant, at least in the United States, for ratcheting up the debate about the care of patients in a persistent vegetative state,” says Singer. “The long legal battle over the removal of Terri Schiavo’s feeding tube led President George W. Bush and the U.S. Congress to intervene, both seeking to keep her alive. Yet the American public surprised many pundits by refusing to support this intervention, and the case produced a surge in the number of people declaring they did not wish to be kept alive in a situation such as Schiavo’s.”…
Yes, people say that they don’t want to share Terri Schiavo’s fate. What many of them mean, of course, is that they don’t want their fate decided by a judge who is willing to take the word of a relative for whom one’s accelerated death would be convenient. Singer dishonestly seizes on reactions to the Schiavo fiasco as evidence that euthanasia will become acceptable in the United States.
Certainly, there are many persons who would prefer voluntary euthanasia to a fate like Terri Sciavo’s. But the line between voluntary and involuntary euthasia is too easily crossed, especially by persons who, like Singer, wish to play God. If there is a case to be made for voluntary euthanasia, Peter Singer is not the person to make it.
Singer gives away his Hitlerian game plan when he advocates killing the disabled up to 28 days after birth. Why not 28 years? Why not 98 years? Who decides — Peter Singer or an acolyte of Peter Singer? Would you trust your fate to the “moral” dictates of a person who thinks animals are as valuable as babies?
Would you trust your fate to the dictates of a person who so blithely dismisses religious morality? One does not have to be a believer to understand the intimate connection between religion and liberty, about which I have written here and here. Strident atheists of Singer’s ilk like to blame religion for the world’s woes. But the worst abuses of humanity in the 20th century arose from the irreligious and anti-religious regimes of Hitler, Stalin, and Mao.
Then, in September 2006, “Singer Said It“:
From an article at LifeSiteNews.com:
In a question and answer article published in the UK’s Independent today, controversial Princeton University Professor Peter Singer repeats his notorious stand on the killing of disabled newborns. Asked, “Would you kill a disabled baby?”, Singer responded, “Yes, if that was in the best interests of the baby and of the family as a whole.”…
“Many people find this shocking,” continued Singer, “yet they support a woman’s right to have an abortion.” Concluding his point, Singer said, “One point on which I agree with opponents of abortion is that, from the point of view of ethics rather than the law, there is no sharp distinction between the foetus and the newborn baby.”
Let us be clear: Singer admits that it is the people who don’t support a woman’s “right” to have an abortion who insist that there is no distinction between the fetus and the newborn — or the fetus and an old person whose death might be convenient to others. Given Singer’s endorsement of involuntary infanticide — abortion and the killing of “disabled” newborns (“disabled” as determined how and by whom?) — Singer accepts, by implication, the rightness of involuntary euthanasia.
In “Rationing and Health Care” (July 2009), I tackled Singer’s pretensions to omniscience in matters of life and death:
Peter Singer — utilitarian extraordinaire , spokesman for involuntary euthanasia, and advocate of infanticide — recently shared with millions of rapt readers his opinions about why and how health care must be rationed: “Why We Must Ration Health Care,” The New York Times Magazine, July 15, 2009. Given Singer’s penchant for playing God, the “we” of his title could be an imperial one, but — in this instance — it is an authoritarian one.
Singer is among the many “public intellectuals” (some of them Nobelists) who believe in an omniscient, infallible government, provided — of course — that it does things unto the rest of us the way that they (the “intellectuals”) would have them done. And, like most of those “intellectuals,” Singer is dead wrong in his assertions about how to “solve” the “health care problem,” because his underlying premises and “logic” are dead wrong.
I begin with Singer’s central thesis:
Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for….
The slipperiest of Singer’s facile statements is his characterization of what happens in free markets as “rationing,” thus lending back-handed legitimacy to true rationing, which is brute-force interference by government in what is really a personal responsibility: caring for one’s health. For it has somehow come to be common currency that “health care” is a “right,” something that government ought to do for us, instead of something that we ought to do for ourselves. (After all, we do live in an age of “positive rights,” which come at a high cost to everyone, including those who seek them.)
Most Americans are, however, enmeshed in a Catch-22 situation. They have less money to provide for themselves because it has been taken from them by government, to provide for others. But Singer deems the provision inadequate:
In the public sector, primarily Medicare, Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals.
Singer’s “solution” is to make things worse:
The case for explicit health care rationing in the United States starts with the difficulty of thinking of any other way in which we can continue to provide adequate health care to people on Medicaid and Medicare, let alone extend coverage to those who do not now have it.
How will outright rationing entice doctors and hospitals to provide services that they are now unwilling to provide? If doctors leave the medical profession, and new doctors enter at reduced rates, what would Singer do? Begin drafting students into medical schools? What about hospitals that refuse to conform? Would they be nationalized, along with their nurses, orderlies, etc.?
What a pretty picture: Soviet-style medicine here in the U.S. of A. Yet that it precisely where outright rationing will lead if the politburo in Washington sees a shrinking supply of doctors, hospitals, and other medical providers — as it will. Most politicians do not know how to do less. When they create a mess, their natural inclination is to do more of what they did to cause the mess in the first place….
Singer defends the bureaucrats, as long as they do it his way, of course. He begins with NICE:
…Britain’s National Institute for Health and Clinical Excellence…. generally known as NICE, is a government-financed but independently run organization set up to provide national guidance on promoting good health and treating illness…. NICE had set a general limit of £30,000, or about $49,000, on the cost of extending life for a year….
There’s no doubt that it’s tough — politically, emotionally and ethically — to make a decision that means that someone will die sooner than they would have if the decision had gone the other way….
As a first take, we might say that the good achieved by health care is the number of lives saved. But that is too crude. The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds. These are, of course, generic teenagers and generic 85-year-olds….
Health care does more than save lives: it also reduces pain and suffering. How can we compare saving a person’s life with, say, making it possible for someone who was confined to bed to return to an active life? We can elicit people’s values on that too. One common method is to describe medical conditions to people — let’s say being a quadriplegic — and tell them that they can choose between 10 years in that condition or some smaller number of years without it. If most would prefer, say, 10 years as a quadriplegic to 4 years of nondisabled life, but would choose 6 years of nondisabled life over 10 with quadriplegia, but have difficulty deciding between 5 years of nondisabled life or 10 years with quadriplegia, then they are, in effect, assessing life with quadriplegia as half as good as nondisabled life. (These are hypothetical figures, chosen to keep the math simple, and not based on any actual surveys.) If that judgment represents a rough average across the population, we might conclude that restoring to nondisabled life two people who would otherwise be quadriplegics is equivalent in value to saving the life of one person, provided the life expectancies of all involved are similar.
This is the basis of the quality-adjusted life-year, or QALY, a unit designed to enable us to compare the benefits achieved by different forms of health care. The QALY has been used by economists working in health care for more than 30 years to compare the cost-effectiveness of a wide variety of medical procedures and, in some countries, as part of the process of deciding which medical treatments will be paid for with public money. If a reformed U.S. health care system explicitly accepted rationing, as I have argued it should, QALYs could play a similar role in the U.S.
Here we have utilitarianism rampant on a field of fascism. Given that (in Singer’s mind) “we” must nationalize medicine (i.e., ration “health care”), “we” must do it right. To do it right, “we” must weigh human life on a scale of Singer’s devising, and not on the scale of our individual preferences. For Singer knows all! And government knows all, as long as it operates according Singer’s calculus of deservingness.
Singer, obviously, is a fan of “death panels.” They enable him (and his ilk) to indulge their fantasies of omniscience, at the expense of humanity.
My final post about Singer (to date) is only tangential to the subject of this post. I simply refer you to it: “Peter Presumes to Preach.” I do so because it is impossible for me not to share my loathing for the man’s “principles.”
I will close, appropriately, with “Invoking Hitler” (May 2010). The target of opportunity is a section of philosopher Jamie Whyte‘s Bad Thoughts – A Guide to Clear Thinking. Specifically, my post focused
on one of [Whyte’s logical errors], which is found under “Shut Up — You Sound Like Hitler” (pp. 46-9). Here’s the passage to which I object:
Anyone who advocates using recent advances in genetic engineering to avoid congenital defects in humans will pretty soon be accused of adopting Nazi ideas. Never mind the fact that the Nazi goals (such as racial purity) and genetic engineering techniques (such as genocide) were quite different from those now suggested.
Whyte seems to believe that policies should be judged by their intentions, not their consequences. Genetic engineering — which Whyte defines broadly — is acceptable to Whyte (and millions of others) — because its practitioners mean well. By that standard,
- abortion-on-demand is acceptable because abortion is a “right” that enables a woman (and, sometimes, her partner) to escape the consequences of a procreative act;
- judges may order the killing of (possibly) terminally ill persons who cannot communicate their own wishes; and
- it is all right to use genetic modification techniques to breed children who are “superior” in some respects.
I cannot find a moral distinction between such “benevolence” and Hitler’s goal of racial purity….
Whyte, in his eagerness to slay many dragons of illogic, sometimes stumbles on his own illogic. Not all invocations of Hitler are inapt, as Whyte seems to suggest. Genetic engineering, Whyte’s primary example, can be Hitlerian in its consequences, regardless of its proponents’ intentions.
I say “can be Hitlerian” because genetic engineering can also be beneficial. There is, for example, negative genetic engineering to cure and treat particular disorders.
I will continue to invoke Hitler where the invocation is apt, as it is in the cases of abortion, involuntary euthanasia, and the breeding of “superior” humans.
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For much more, browse the “Favorite Posts” page of this blog. See especially the section titled “Self-Ownership (abortion, euthanasia, marriage, and other aspects of the human condition.”