Tag: ethics

Things I Care Deeply About That Cannot Be Changed Through Law

My heart breaks over the knowledge that more than a million abortions occur annually in the US alone.  Yet I do not believe changes in the legality of the practice are the best way to improve the situation.

Let me state at the outset that the entire issue of the morality abortion comes down to one thing only, and that is whether or not one believes that a fetus is a human life, and at what point it becomes one.  I’ve never met someone who believes that killing an innocent child is moral.  Yet a great many people believe that abortion is moral.  This does not mean they are evil or unprincipled.  They believe that a fetus is not yet a human.  I do not attempt here or anywhere else to convince people otherwise.  I don’t pretend to have knowledge of some clear-cut point in the biological process when a fetus becomes a human.  I am only writing about why I, as someone who does believe a fetus from the earliest stages is a human life, do not believe that outlawing the practice of abortion is the best thing to advocate.

In other words I believe abortion is a tragic act, but not all tragedies are best reduced through law.

Government Failure

I am skeptical of the ability of governments to enforce laws in general, but especially those with which a huge part of the population disagrees.  Even laws most people agree on, like those against drunk driving, are enforced poorly and often with more hassle and harassment of innocents than actual curbing the activities of the perpetrators.  Anti-abortion laws do not seem to me a likely way to reduce the number of abortions significantly and they do seem likely to produce a great many other ill-effects.  Illegal abortions that pose a greater risk to the mother would boom, and entire black markets around them.  Attempts at enforcement would doubtless cost billions and open up a bevy of privacy violating medical and personal interventions affecting millions of people who were not even attempting to abort.

But there’s another thing.  For those who feel this is a deeply moral issue, the practical aspect is perhaps less important than the ethical one.  Many people believe that consumption of alcohol is immoral, yet even they will admit that the prohibition era did nothing to improve the moral fiber of individual Americans but had the opposite effect.  AA and rehab programs are far more effective at getting to the core of alcohol related problems.

So if I believe abortion to be a tragic ending of a beautiful human life, what kinds of activities do I think might reduce it?

Keep Innovating

Abortions in the US have dropped every year for some time now.  I suspect the main reason is myriad forms of birth control are better, cheaper, and more accessible.  No one wants to abort.  Those who do would prefer to not have gotten pregnant in the first place.  Where there is a need in a free market, there is an incentive to meet it.  Companies big and small have continued to produce more, better, and cheaper technologies for preventing unwanted pregnancies.  This will continue, and could happen even more if regulatory barriers were eliminated and markets freed more generally.

Open Up Markets in Adoption

Currently, those who want to adopt have to pay for it.  In this sense, there already is a market for children without parents.  The problem is it is illegal for the birth-parents to receive this money.  Pregnancy and labor is emotionally, mentally, and physically taxing.  It reduces ability to earn money and increases risk of health problems.  It’s a full-time job.  Yet women with unwanted pregnancies who don’t feel comfortable ending them have no real way to make up for this cost.  Carrying a baby to term and having another couple adopt puts tremendous cost on the birth mother.  Removing the laws against payment to birth mothers would dramatically reduce the number of abortions.  Getting government agencies and regulations out of the adoption market altogether would do more still.

Imagine the power of pro-life activists and philanthropists if they channeled their energy and resources away from protest signs at clinics and towards funds to pay pregnant women to carry to term and choose adoption?  Many organizations do as much as they legally can in this direction today, but the legal and moral resistance most people have to open markets severely constrain this option.

Care and Support

I would venture to guess most women who abort do not do so easily or impulsively.  Regardless of their beliefs on the morality of it, it’s a hard decision.  A woman faced with this decision is likely to be pushed away by loud yelling about the immorality of abortion or attempts to make it illegal.  It is impossible to advocate making abortion illegal without putting mothers with unwanted pregnancies on the defensive.  They feel condemned and hated, which is not a recipe to get someone to reconsider.  Even the suggestion of judgement will push people into secrecy, where they are likely to suffer more during the process.

Those who are deeply moved and saddened by the act of abortion would do better to come alongside those with unwanted pregnancies and help them in a nonjudgmental way.  Offer emotional, spiritual, and material help without being pushy or manipulative.  This works best with someone you have established some kind of relationship with, and on a one-on-one level.  Yet organizational efforts could do the same (and many do).

Many might call this moral suasion.  I suppose it is in a way, but it is very difficult to convince someone that their idea of morality is wrong by simply telling them so.  The thing is, you don’t even need to convince someone that something is immoral if you can show them a better way.  Show a course of action that is better for them even given their current moral beliefs.  If they have an environment that won’t judge but will support them every step of the way, even offering to help with parenting or to adopt the child, the chances of an abortion will decrease.

The Nirvana Fallacy

There are a great many horrible things in the world.  Murder, theft, sickness, poverty.  It’s easy to get righteous and proclaim support for laws and institutions that do not tolerate these things.  Such posturing is pretty empty though, because there is no system or law that can eliminate them.  The important question is not, “Which system is right?”, because we’d all choose perfection.  The important question is “Which of the possible systems is preferable?”  It is not enough to condemn the status quo compared to an imaginary world where none of the things you dislike occur.  When condemning the status quo it behooves us to ask, “Compared to what?”

I think a change in abortion laws is a distraction from better methods to reduce the practice.  Pro-life advocates, to the extent they outsource their energy to lobbying and politics, feel good enough about their efforts to slack in other, more practical ways that do more.  What happens if abortion is made illegal?  If the pattern follows similar policy battles the winning side will feel really good about themselves and probably do less of the more valuable kind of work.  Think of those who fight for government efforts to end poverty and the way it crowds out more effective private efforts.

The Takeaway

I don’t normally talk or write about abortion, but I think it’s an important example of how even things that some find fundamentally wrong are not always best met with the ham-handed approach of policy.  Our tendency to idolize law as a means for achieving our ends, no matter how moral they might be, is to our detriment.

Justice and Morality

It seems there’s a difference between justice and morality.  I’ve never quite come to a comfortable conclusion about the nature of the two concepts and their relationship, but it’s worth exploring.

Suppose you jump in someone else’s car parked in the valet entrance at a hotel and speed away to get your wife in for an emergency C-section.  You’ve saved the baby and possibly the mother.  It would be strange to call this immoral.  In fact, it might be very moral, even heroic.  But it also seems clear that the owner of the car has been wronged.  She was unable to make her meeting in time, some of her gas was used up, and maybe you even got a few dings in the door.  She has suffered an injustice.  So even though you acted morally, it’s possible you acted unjustly.

Let’s say you have a deep hatred for your neighbor.  One day an envious rage takes over so you pick up a rock and throw it at his new car, hoping to shatter the window.  You miss.  No one sees the action, and the rock rolls harmlessly into the weeds.  It seems likely you’ve acted immorally by trying to destroy his property.  But it would be odd to say any injustice was done.  Your neighbor hasn’t suffered a wit from your failed attempt at vandalism.

Justice is about living with other people, while morality is about living with yourself.  Justice is about right relation to others as measured against the mores of society, while morality is about right relation to right itself, as measured against your own beliefs.

Whether or not justice exists objectively or is entirely a social construct, it has an unmistakable universality.  The particulars, and the process of discovering and remedying injustice differ in each society, but the basic tenets are the same.  No society has ever praised or rewarded breaking a promise, stealing, or murder.  There are instances where such acts are called by other names or given a pass under special circumstances, but that’s just it; they always require justification.  The default human position is that coercion is bad, and social systems evolve to mitigate it.

What would justice demand from you in the car theft scenario?  The nice thing is, we don’t have to decide in the abstract.  Justice always takes place in a social context, and the process seems just as important as the outcome.  For productive cooperation, the systems that determine and deal with injustice are best when they are transparent, stable yet flexible, knowable in advance, and not applied preemptively.

Even though everyone may acknowledge that your theft of the car was unjust, if the process allows arbitrators to consider circumstances, they may let you off, or they may ask only that you pay the owner a small fee.  These contexts are rich, and the owner has a lot to consider as well.  Perhaps she hears your story and decides not to pursue any recompense.  Maybe she is really ticked and wants to, but realizes the social approbation she’ll get for doing so isn’t worth it, even though she would win her case.  Since justice exists only in a social context, and for the use and benefit of humans, even if it is violated, there needn’t be black and white, always-and-everywhere rules demanding uniform punishment.  Though a uniform and recognizable process is needed, uniform outcomes don’t seem to be.  This is why common law is so much more effective than legislation at maintaining peace.

Morality is trickier.  I might be using the term differently than most people in this post (I have often used it more loosely myself, many times on this blog…don’t hold it against me!), but I think morality is something that exists in all of our minds, whether or not it exists “out there” objectively.  We have a conscience.  We have beliefs about right and wrong that are distinct from our sense of justice.  That’s why nearly everyone would agree that you acted immorally in story number two, even though justice demands nothing of you.  Our sense of morality changes over time, and is very different from person to person.  Part of life’s journey is discovering it and constantly adapting to it.

I’ve known people who genuinely believed it was wrong to have a drop of alcohol.  Whether or not I agree, it was clear that if they did, they would feel a lot of guilt.  They would be violating what they know to be right.  Some of those same people’s views changed over time, to where years later they no longer thought it wrong to drink, and they could do it with a clear conscience.  Morality doesn’t seem to be about the acts themselves like justice does.  It seems to be about whether or not a person is violating their own sense of right.  Many spiritual traditions talk of being in unity with oneself, being of one mind, or having an undivided heart.

It’s easy to conflate justice and morality, in part because we deliberately do so with children.  It’s more convenient to wrap everything up into right and wrong, and train kids to do and don’t do based entirely on these words.  I don’t think it’s helpful for kids in the long run, but it requires less work, so most adults do it.  Kids are told to say hi when someone says hi to them for the same reasons they’re told not to take Johnny’s toys; because it’s the right thing to do.  Yet the first is not unjust and probably not immoral, while the second is definitely unjust and probably immoral.  Children are also trained to obey the law because it’s right to do so.

They’re not often told that justice demands an abstention from coercion, even if the law doesn’t, or that the law may ask them to do something they feel is deeply immoral.  This oversimplification and lumping everything into basic right/wrong categories has the potential to result in atrocity.  Those who allow the law to be a shortcut for justice or morality, for example, can find themselves rounding the neighbors up and sending them off to prison, or worse.

There’s more to be explored on this topic, but I’ll save it for another day.

UPDATE: Check out this post with a handy-dandy 2×2 matrix to visualize these concepts.

Private Charity Isn’t Enough

Originally posted here.

“The idea that churches can tackle national poverty, take care of those who are ill, and rebuild communities after natural disasters requires a spoonful of bad moral theology and a cup of dishonesty.” – Robert Parham

In this blog post, EthicsDaily.com editor and Executive Director of Baptist Center for Ethics Robert Parham claimed that churches and charities could never do enough to alleviate poverty. I agree.

Poverty will never be “tackled” because it is a relative term; a moving target. If you could describe the plight of America’s poor today to a poor person in another country, or an American 100 years ago, they would conclude that poverty had been eliminated. The standard of living among the poorest Americans today is incredible by world and historical standards. Yet we still wage the war on poverty, even in America. This is not a bad thing – helping the down and out can be wonderful. But when we aim at targets like the “end” of poverty, there is no end to what we can justify in order to reach this impossible goal. “The poor will always be with you.” The question is how best to reach them, spiritually and materially.

The second reason I agree with Parham’s claim is that, to the extent that poverty can be reduced, private charity alone is simply too small to do it. The incredible gains in social and material welfare of the poor in America have not primarily resulted from charity, churches or governments. They have resulted from (mostly) free-market economies.

If we look at poverty in a vacuum as Parham does and ask how private charity compares to government efforts, we could conclude that private efforts are too small. But if we look at government and private efforts combined compared to the power of the market, they would be dwarfed so as to make them hardly important in the big scheme. Charity is a targeted and short-term salve for the wounded; its value is far more in its spiritual nourishment and encouragement than any material progress it brings. A vibrant free-market is the only institution powerful enough to bring about the kind of dramatic increases in standard of living that most of us wish to see.

Public Choice

Jumping from the premise that private charity is not enough to the conclusion that government must do something places a blind, sometimes idolatrous faith in government that counters logic and experience. The incentive structure in government departments is to perpetuate and grow regardless of their effectiveness or the need for their services. There is no check on whether or not they are effective. In fact, the less effective a bureau of poverty relief is, the more they are rewarded with bigger budgets. If poverty is on the rise, and they will always claim it is so as to increase their importance, the last thing to do is cut the department of poverty relief!

Government programs are also subject to “capture” by interest groups and politicians. Scratch the surface of any government program and you will find that it is not the “general welfare” being promoted, but the welfare of a very small and politically connected group at the expense of the general welfare.

To examine private efforts and claim they cannot tackle a problem is only half the analysis needed. We must also examine government efforts and ask if they can tackle the same problem before we charge them to do it. The field of Public Choice Economics does just this, and you would be hard-pressed to find a case where the market is not providing something and getting government involved makes it better. If Christians have a duty to help the poor, they also have a duty to use their brains to discover ways that actually work. Intentions and actions are not enough, we need to understand how to be effective. This requires some knowledge of economic and political systems.

Wrong about Rights

The most damning and least supported claim in Parham’s article was that it is wrong for a Christian to value other people’s property rights:

“[L]ibertarian morality values property rights over human rights. For a Christian, that’s bad moral theology.”

I beg to differ. What Parham leaves unexplained is how human rights are to exist absent property rights. Private property is not some sacred dogma for its own sake; it is important because there is no other method of peacefully settling competing demands for limited resources. Such resources include food, water, shelter and other necessities of life. Common definitions or human rights include the right to be free from hunger. How can you have this right if you have no right to the very food you need to survive?

If Parham means by human rights the right to food, shelter, health care and other positive rights, this poses an incurable conundrum. Positive rights are a logical and practical impossibility. They cannot coexist with negative rights, or even with other positive rights.

A positive right is a right to something. A negative right is a right from something. A positive right obligates another person to take action. A negative right prohibits another person from taking action. A right to life, liberty or property is a negative right. You are free to live and act and justly acquire property, and no one can prohibit that so long as you are not violating their rights. A right to health care is a positive right. If you have the right to receive health care, someone else has an obligation to give it to you. If I am a doctor and you say you need my services, I am obligated to assist you in a world of positive rights. But what if at the same time I am hungry and need to eat rather than assist you in order to maintain good health? Our positive rights to health care cannot both be fulfilled, and in order for one of us to fulfill them we’d have to violate the other’s negative right to liberty and property.

Indeed, it is not possible to have any moral theology whatsoever without an acceptance of private property. One cannot give generously what one does not own, and one cannot help another by stealing from him.

Means and Ends

To sum up the argument, the author couldn’t imagine church and charity doing a task to his satisfaction, so his response was to ask men with guns to take money from people who presumably wouldn’t part with it voluntarily, and give it to causes he valued. Everything government does is backed by threat of force. Indeed, that is the only thing that distinguishes government from all other institutions. Let’s remove the intermediary agents (IRS, law enforcement) and revisit the argument with the author as the principal actor:

Churches and charities can’t or won’t do as much to help the poor as Parham wants, so he threatens, “donate or else.”

That’s clearly a barbaric and inhumane way to a more civilized and humane world. Yet voting for people, who will appoint people, who will hire people, who will send threatening to extort money to give to some bureaucrats to spend on social causes is no different in moral terms.

Appealing to Christian ethics is an odd tactic to justify a redistributive state.  Jesus made it pretty clear that the methods of the kingdom of God are service, sacrifice, grace and love. The means of all earthy kingdoms are brute force and the threat of it.

When the rich man refused to sell all his possessions and give the proceeds to the poor, Jesus did not send the disciples after him to extract a percentage on threat of imprisonment. He let him walk away. Christians are supposed to do the same.

First, Do No Harm

Last summer I had a trip to the emergency room that highlighted one of the perversities of the medical industry in the United States: Health practitioners are prevented from helping patients because of regulatory hurdles erected by the state at the behest of vested interests.

We were on vacation in a small town on the shore of Lake Michigan, and I experienced some intense stomach pains. When the pain persisted, I wondered if it might be my appendix and decided to hazard a trip to the ER to get it checked out. Fortunately, my appendix was fine and the pain subsided not long after I arrived at the hospital. Unfortunately, my experience in the ER was painful for other reasons.

I arrived late at night to a small but clean new building. There were only two other people in the ER waiting room and there were several nurses and hospital personnel on hand to take my information. I was in the system and seated in no time.

Then I waited for an hour and a half.

Given that effective pricing mechanisms are not available to the hospital, the long wait actually makes sense as a way to weed out the more frivolous ER visitors. Hospitals are required to see everyone who comes in, and virtually no one pays directly for their health services, so the incentive is to abuse the ER with visits of low importance. Making patients wait a long time is one of the only means available to the hospital for reducing low value visits. Indeed, one of the two patients there before me left during this time.

Finally I was admitted. A very energetic 30-something nurse took my vitals and inquired to the nature of my visit. I discussed my abdominal issues at length, and he looked very thoughtful and excited, like an engineer relishing the challenge of a puzzle he knows can be solved. He asked a slew of good questions, some of them unexpected to me. He looked pleased in a Sherlock Holmes kind of way.

Now I was excited. I could tell he had several ideas about my condition. He said, “Well, you have to wait for the doctor.” He paused and lowered his voice a bit, “but I can tell you that I don’t think you’re in serious trouble … I’ve got some really good ideas on what’s going on and what you can do about it. I’ve seen and experienced what I think you’re dealing with.”

This was great news! I’ve had on and off unexplained stomach issues for a number of years, so I was eager to hear his thoughts. I asked him to elaborate and he looked a little dismayed. “I’m not a doctor. It would be outside of my professional boundaries if I told you more. The doctor will be in soon.” Then he left.

I was irritated, but glad at least that he seemed so energized and full of ideas. I was hopeful he’d talk to the doctor—and the doc could share his thoughts. I waited.

I waited some more.

After 45 minutes, I wandered into the hall (revealing hospital gown and all) looking for signs of life. I rounded a corner and came to a room where six or seven nurses were hanging around chatting. I asked if the doctor had forgotten about me. They casually said he’d come soon and returned to their chit chat. I went back to the room. At this point the pain had subsided quite a bit, and after my vague conversation with the nurse, I was convinced I was not in danger. Still, I wanted his thoughts. The nurse poked his head in again, seeming to feel sorry for me and, showing signs of frustration said, “Sorry, the doctor will be here soon. Hang tight.”

I waited another 45 minutes. Nothing.

I was tired, feeling better and getting grumpy. I had no cell signal, and I knew my wife was worried. I wandered the hall one last time with no result, so I decided to leave.

As I drove back to the cottage, I couldn’t help thinking of the frustrated nurse who seemed to have some helpful information he was dying to share with me but couldn’t. Why couldn’t he? Because he’s not a state-licensed doctor, and state-licensed doctors have made sure they are the only ones allowed to provide certain information.

The public justification for medical licensing laws is that they protect patients from bad service. The idea that state bureaucracies are the best way to guarantee good service is laughable. Just visit the DMV. The laws do offer protection, but not to patients. They protect doctors’ economic interests from the competition of other health practitioners with less training who might offer services at lower cost. This is an ethical problem for the medical profession.

The famous medical creed, “First, do no harm,” means that doctors ought not intervene with a patient if the intervention might cause more harm than doing nothing. But what about legal intervention? Left alone, I would have happily paid the nurse for his insight into my discomfort. He would have happily offered it. The doctor’s cartel, far from doing nothing, intervened with the long, blunt arm of the law and prohibited this interaction from taking place. In doing so, they caused harm to me by denying me information that could prove valuable to my health. In this case, it was not an emergency, but it very well could have been. There are instances of medical services prohibited by regulations that cause severe illness or death.

In South Carolina, where I now live, a law was recently passed banning midwives from assisting in home births if the mother has previously had a C-section or is otherwise considered a “high-risk” birth. The nurses and doctors advocated this law. It reduces the growing competition from the more personal, convenient and far less expensive home birth practitioners. Of course you can’t reasonably make it illegal for so called high-risk mothers to have home births across the board, because sometimes it just happens. So the law only makes it illegal for a midwife to assist. The result has been an increase in unassisted high-risk home births and an increase in medical problems as a result.

In both cases, the doctors’ lobby violates the creed to do no harm. Rather than letting people follow their planned course of action, professional associations concerned with the economic interests of their members run to the state and demand intervention that prohibits voluntary exchanges and does harm to the patients.

Milton Friedman argued long ago against medical licensing because it raises the cost and reduces the accessibility of medical services. Not only is it a bad practice for these economic reasons, but it is unethical as well. If doctors have an ethical obligation not to interfere with a patient when it might do harm, they should start by opposing state licensing regimes that do just that.

Originally posted here.