Thursday, May 07, 2009

Intention in Cardiff

I recently gave a talk on euthanasia to the studen Pro-Life Society in Cardiff University. This gave rise to a question from a graduate student, by email, as follows (in part). His questions are in blue, my replies in bold.

I agree that intent is vitally important but I think it only applies more broadly than to killing/not killing. With the example of the child slipping in the bath. Would it have not been wrong if the intent was primarily to gain the inheritance, with an undesirable side effect being the child dying? I think yes! You phrased this scenario as wanting to let the child drown so that you could claim the inheritance. But is there a difference between the two as I have worded them?

The point of the example is that the person looking after the child needs the child to die if he is to inherit the money. The death of the child is intended, therefore, as a means to inheriting. We intend means in exactly the same way as we intend ends.

You also gave the example of not jumping into the river to save your rival, because it would spoil your shoes. This was okay despite knowing that not jumping would cause his death because his death was not your primary intent even though it might be your desire. But on the other hand not jumping in because you desired his death was wrong.

I fail to see the difference. In both cases you have knowingly chosen not to act to save his life. The intension does not justify the end. If saving his life was right, then you have done wrong. Either you have valued shoes which are not sacred above a life which is. Or you have wished a man to die for your own benefit.

The 'end', saving ones shoes, does not really need to be justified: it is not wrong. I didn't say that it would be permissible not to jump in, out of concern for one's shoes, only that it would be possible. It would be wrong because it would infringe one's obligation of aid to someone in danger of death. It would not be wrong becuase the bystander intended the death - ex hypothesi he didn't.

If I intend to buy a cheap pair of shoes and as a result of that demand a child is forced to attempt to supply my 'need' in a sweatshop and as a result of industrial accidents/poor conditions dies am I then responsible?... given that I already know that children are dying in sweatshops.

I was not intending death but I still think the knowledge of the means makes me somewhat culpable. (I bought a £10 pair of shoes yesterday, and am feeling a bit guilty)

You may be complicit in a bad situation: in technical language, you might be involved in material cooperation with evil. But you don't intend the evil, which makes it less bad. Obviously it is worse if you are buying the shoes in order that the child dies.

So, can I turn off a machine, for the patients 'good', be that the prevention of suffering or etc. when I know this bring about immediate death? I can only be innocent if somehow I believe that their death will not be, 'bad'. Indeed that allowing the inevitable to hasten nearer is somehow 'good' and in their best interest, on balance, given the discomfort of being in a coma, having a feed tube in place, etc. If their death can then be described as good how can it be wrong to desire it for a patient. If it is not wrong to desire it. Why should it be wrong to act in the patients 'good' or best interest to allow it to happen. Not to make it happen but allow it to happen.

Another way of putting this is: the doctor stops the treatment when the treatment is no longer doing the patient any real good. I agree.

I think there is a clear difference between injecting potassium, which is fatal (and largely untraceable) and not giving antibiotics/more chemotherapy/IV food&fluids. In the first, you are taking the ending of a person's life into your own hands. In the second you are deciding not to artificially prolong their life.

In medicine we artificially prolong life all the time. This is not wrong, in many causes it is good. This is good but I don't think it is always good or an obligation.

I had not heard that the intent to allow a person to die being described as wrong before. I ... struggle to see how intent to kill and intent to allow to die can be the same thing.

..But I really struggle to see the deference between intent and the expected side effects and how one can then be said to be morally responsible for one and not the other.

Well, how do you express the difference? This has proved, in the philosophical literature, to be extremely hard. If it is ok to 'permit' death (while intending it) and wrong to 'kill' (while intending), it will be easy to find ways to bring about people's death by omission, and not by action. The morally important difference, as is recognised by the law, is what you intended. If you intended the injection to kill, you have murdered the victim. If you intended to cure, or ease pain, then the death was either an accident or a side effect.

You are responsible for forseen side effects, however, under the principle of proportionality.

...With end of life events I really struggle to see more than a semantic difference between the intent to prevent suffering, by stopping feeding which will cause death, and intending to allow death, by stopping feeding which will cause an end to suffering. The outcome and ultimate intention is the same. In both I am aware of the consequences of my actions and have to believe that the intent, to prevent unnecessary suffering, allow God to make decisions as to when the life will actually end and respect the life that is there by not actively killing them will be enough.

I'm not sure what distinction you are trying to draw here. It is wrong to intend death, by action or omission. It is permissible to act or omit to act with the intention of easing pain; if this shortens life that it will be permissible if that is a proportionate evil to the good you are trying to bring about. In other words if the patient is going to die soon anyway, and the suffering is very great, and the only drugs which will ease the pain will shorten the life, you can intend the easing of pain knowing that your actions will shorten the life. This is no more 'murder' than building a road on which you know people will die - despite the fact that in these cases we are talking about actions, not omissions.

Saturday, April 11, 2009

Discrimination in hiring: the Christian colleges in America

The American Philosophical Association is undergoing a rancourous debate about a proposal to prevent various Protestant universites from advertising in the APA's paper, 'Jobs for Philosophers'. The argument is that since these universities ask their staff to live in accord with Christian norms, which exclude sex outside marriage, they discriminate against homosexuals. This kind of argument is becoming common.

A very helpful response has been put together by Mark Murphy, a Catholic philosopher at Georgetown University. It is interesting to note the leading role taken by Catholics to defend the right of institutions to follow a practice that no Catholic institution, as far as I know, would dream of adopting. These Protestant colleges, moreover, would as cheerfully have excluded Catholics as homosexuals a generation ago. But that, as they say, is not the point.

Dr Murphy's letter can be seen in full here; here's an interesting extract on the nature of discrimination.

First, there are reasons to believe that these institutions are not engaging in discrimination based on sexual orientation. The policy lacks a definition of discrimination. We suggest that it is plausible that satisfaction of any of the following conditions is sufficient to constitute discrimination, but satisfaction of at least one of them is necessary: (a) intentional targeting for burdening of the protected class; (b) burdening that is motivated by animus against the protected class; (c) burdening of the protected class that is disproportionate and not adequately justified. But none of these is satisfied in the case of the sexual conduct requirements at these Christian colleges. (If there is an alternative understanding of 'discrimination' not here considered under which these schools do discriminate, we ask that the defenders of the original petition bring it forward and defend its acceptability.)

(a) Those with a particular sexual orientation are not targeted. Employment is conditioned on one’s willingness to refrain from sexual conduct outside of traditional marriage; it is compatible with the satisfaction of this condition that one be of any sexual orientation, and no particular sexual orientation would be sufficient to meet the condition.

(b) There is no institutional animus toward those who are homosexually oriented; or, to put it more guardedly, no evidence at all of institutional animus toward those homosexually oriented has been brought forward. The norms of sexual conduct of the institutions in question are broad, reaching to various sorts of sexual conduct, both homosexual and heterosexual, and appear to be generally enforced as written. (If defenders of the original petition have evidence that these institutions' policies are being enforced in a way that provides evidence of institutional animus, we urge that they put it forward.)

(c) What will generate most contention is whether there is unjustified disproportionate burdening. Defenders of these schools’ policies will note that adherence to their policies on sexual conduct is justified by the job description, which is to contribute to the living of a Christian life in a specific sort of educational community. This way of life does in fact place different burdens on people; no doubt those who are homosexually oriented are burdened in a way that those heterosexually oriented are not. But we think that it is important that in the context of US discrimination law, and even in the context of the APA’s own norms, there is some deference given to the religious character of the institution — that these are schools that adopt the requirements for the conduct of their communal life from what they take to be divine revelation, and it is explicitly allowed by the APA policy for schools to make adherence to the faith statements of these schools, statements that include moral claims about the ordering of individual lives and communities, a condition of employment. When we add to this the fact that one's adherence to a certain faith affects what one counts as a 'burden' and what personal and social meaning those burdens have, it is, at best, an extraordinarily contentious claim to hold that these schools discriminate in the sense of placing a disproportionate burden without adequate justification. To put it another way: for the APA to defend the claim that there is unjustifiable burdening, the APA will have to endorse officially a certain disputed view on the ethics of marriage and human sexuality, and commit itself to the falsity of any view, secular or religious, that disagrees.

The Pope on AIDS and condoms

My attention has been drawn to a very interesting article on Alligator online by Michael Webb, which goes into some detail about the research on the effectiveness of condoms. The Pope's claim that condoms 'make things worse' with the AIDS epidemic in Africa has overwhelming plausibility to those who have watched the failure of contraception to reduce so-called 'unwanted pregnancies', and, for that matter, ordinary sexually-transmitted diseases, in the West. If fire-hosing condoms at people doesn't reduce pregancies, it is not going to work with AIDS either. In fact we actually see an increase of pregnancies, and abortions, where contraceptives have been pushed at people; a similarly tragic consequence, one may infer, is likely to happen with AIDS. The fact that the advocates of condoms refuse to accept that this is happening, and insist the situation would be even worse without the condoms, just shows the blind attachment to ideology when you face ostracism and redundancy for dissent.

Why condoms might be counterproductive as preventers of pregnancies and AIDS is, intuitively, that promoting contraception promotes a culture of promiscuity, and the culture of promiscuity is actually not very friendly to putting those rubber things on just at the moment life is getting interesting. Webb, however, uncovers some very interesting research which not only supports the casual empiricism against condoms but gives a slightly different (though not conflicting) explanation, that of 'risk compensation'. When you make an activity safer, people performing the activity will take more risks with it: see 'The Pope was right' on the Cornell Society.

Everything we do is based on an assessment of benefit and risk. We have a certain appetite for risk (as they say in finance), and if something becomes safer, we'll tend to go for the extra benefits associated with taking on another slice of risk. This is really not controversial; the only question, in making things safer in any given situation, is whether the risk compensation will end up making the situation worse over all. It will depend on how much safer people are made to feel, and what the opportunities for greater risk-taking might be.

People in countries afflicted by AIDS are still willing to engage in promiscuous sex: hence AIDS continues to spread. Whatever the (perceived) risk they are running is, that is a level of risk they are happy to live with. If you give them condoms and they wear them 50% of the time, thinking that makes them 50% safer, they would rationally double their number of partners to get back up to the old level of risk. The reward of doing this, of course, is fantastic: twice as many partners! There may, of course, be other factors.

So much for the principle. But this is exactly what many researchers have found. Over to Michael Webb:

Dr Edward Green, Director of the AIDS Prevention Research Project at Harvard. “The best evidence we have”, he says, “supports the Pope’s comments. There is a consistent association shown by our best studies between greater availability and use of condoms and higher (not lower) HIV infection rates.” He told me:

In epidemics that are population wide, where most HIV is found in the general population, for whatever reason we can't get people to use condoms consistently, and when they use them at all, that seems to have the effect of disinhibiting people's behaviours so they end up taking greater sexual risks and cancelling whatever risk reduction they have gotten from the technology they're using.

Webb points out that the studies making this point are fairly limited in number: no surprise there, since this is not a conclusion the AIDS industry wants to hear. He also points out that there is agreement accross the debate that IF condoms were used 'consistently and correctly', and IF behaviour didn't change, then condoms would help with AIDS: true, but irrelevant.

More interstingly, Webb makes the odd conclusion that 'the Pope should not make claims that can be interpreted as being scientific.' This is odd because he adds that the Pope's remarks were interpreted as making a claim not supported by the evidence. But the body of Webb's article has shown that it is perfectly scientifically respectable to hold that view; it may not be the view of the WHO but there is plenty of evidence for it, and the WHO is not infallible.

A deeper reason for Webb's criticism of the Pope, however, is that the Pope's position is, or ought to be, really a matter of moral teaching: against promiscuity, and against contraception. Webb seems to think that if this was made clearer, criticism of the Pope would have less traction.

It is true that the Pope's position is driven by moral concerns, and the moral teaching of the Church. But it is because voicing this moral teaching has been condemned as tantamount to mass murder - as Jon Snow gently put it, the Pope is responsible for 'millions of deaths' - that it become necessary to look into the claims being made about the effectiveness of condoms.

Catholic reseachers and all people of good will can and must refute the lies which are used to justify crimes. The Nazi genocide was unjustifiable, but people were persuaded to go along with it on the basis of grotesque lies about the Jews. The Church has had to contend with 'black legends' in every age; the work of the Bollandists on Church history is an example of her response. It is true that even if they were successful, condoms would not be justified, but the Pope in concerned to influence opinion and policy, and the lies must be opposed.

The idea that Catholics should leave the 'facts' in the hands of their opponents to distort at will only has to be stated to be rejected.

Monday, January 19, 2009

Licit cooperation with evil

Here it is, in Poland (hat-tip to the Hermeneutic of Continuity).
The window can be opened from the outside. A person with a baby the parents are unable or unwilling to care for can pop the baby in and make themselves scarce. The baby will be scooped up by nuns on the other side and looked after. This is a modern version of a long-standing practice; in former times convents would sometimes have a wheel set horizontally into the wall like a dumb waiter: put the baby on the wheel, turn it so it goes inside, the baby is cared for and the parent or whoever remains anonymous.

Is it cooperation with evil? Of course: it is an extremely grave sin for a parent to abandon a child, even when the child's prospects are not too bad. The existence of these windows facilitates this abandonment, by ensuring that there will be no legal sanction against the abandoning parent. (Neglect and of course killing of children is illegal: normally abandonment would be at least neglect and probably killing.)

Furthermore, not only are these windows providing a specific mechanism for a person who wishes to commit this sin, but by making the sin easier and eliminating the legal risk they will certainly be making it more common, if only fractionally.

It is not wrong, however, to provide the window. The nuns' intention is conditional: that a person seriously considering abortion, infanticide or abandonment use the window instead, and perform a less serious sin with far less bad consequences for the baby. They do not intend that anyone abandon a child, any more than a person providing fire-extinguishers intends there to be a fire in which they might be used. Given that the provision of the window is a merely material, not formal (intended) cooperation with evil, it can be justified by reference to its consquences, including the possible scandal it might cause. Since the motivation of the nuns is clear enough, there is not likely to be scandal; nor does it seem likely that the existence of the windows will increase the number of times people abandon (or murder) their infants to the point where the scheme becomes the cause of greater harms than of good.

In this way it is a far clearer example of licit cooperation with evil than other putative examples, such as needle-exchange schemes for drug addicts, the provision of drugs themselves to adicts, or the distribution of condoms.