Monthly Archives: January 2018

Institutions & Evil

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Dungeons & Dragons (D&D) introduced the alignment system to the gaming world. This system, though regarded by many players as restrictive and artificial, offered a degree of guidance on how to play good, evil, lawful, chaotic and neutral characters. This system has also proven useful in the real world, allowing gaming nerds like me to quickly categorize actions and people. This system is also rather useful for mapping the current political landscape of America.

A key component of any society is its institutions. In the United States these institutions include the systems that constitute the government such as Congress, the Environmental Protection Agency, the Supreme Court and the Federal Bureau of Investigation. These institutions are used to maintain (or impose, if you prefer) order. While it is tempting to mistake order for goodness, D&D makes a clear distinction between lawful and good—a distinction long recognized by philosophers. In the D&D alignment system, creatures can be lawful (as opposed to chaotic or neutral) but also evil at the same time. Good creatures can be chaotic or neutral; thus rejecting the constraints of law and order.  Evil creatures that are not lawful also have the option to be chaotic or neutral. While chaotic good and neutral good creatures will support (or at least not harm) good institutions of order and law, evil creatures that are not lawful are generally willing to harm evil institutions of order and law—as will be seen, they care not for order.

The alignment most vehemently opposed to order and institutions of order is chaotic evil. Chaotic Evil is defined this way:

A chaotic evil character does whatever his greed, hatred, and lust for destruction drive him to do. He is hot-tempered, vicious, arbitrarily violent, and unpredictable. If he is simply out for whatever he can get, he is ruthless and brutal. If he is committed to the spread of evil and chaos, he is even worse. Thankfully, his plans are haphazard, and any groups he joins or forms are poorly organized. Typically, chaotic evil people can be made to work together only by force, and their leader lasts only as long as he can thwart attempts to topple or assassinate him.

In the real world, chaotic evil types are generally involved with institutions from the outside and this is typically an adversarial role. For example, a person who is actively chaotic evil will tend to run afoul of law enforcement. Chaotic evil types can be useful to institutions—for example, terrorist groups find this sort of person useful as a suicide bomber or cannon fodder. If a chaotic evil person holds power in an institution, either or both will tend to fare poorly—such types tend to either destroy or be destroyed by the forces of order. Be they good or evil.

Neutral evil beings can operate within institutions far better than chaotic evil types. Neutral evil is defined this way

A neutral evil villain does whatever she can get away with. She is out for herself, pure and simple. She sheds no tears for those she kills, whether for profit, sport, or convenience. She has no love of order and holds no illusion that following laws, traditions, or codes would make her any better or more noble. On the other hand, she doesn’t have the restless nature or love of conflict that a chaotic evil villain has.

While chaotic evil types can be like wild beasts assailing order or beastly idiots within the china shop of society, neutral evil types tend to be like parasites within a host. While institutions sensibly regard neutral evil types as a dangerous enemy, neutral evil people often find institutions very useful as means to their own selfish ends. For example, a neutral evil person who secured a political office would use it to enrich themselves at the expense of the institution and the people they are supposed to serve. Sensible neutral evil types are careful to not kill their host—at least for as long as they need it. They can even seem to serve order by exposing or destroying other neutral evil people. But this is also from selfishness-they do not value order for its own sake, they merely dislike having competition.

As should be surmised from the name, lawful evil creatures favor institutions of order and law. D&D defines lawful evil this way:

 A lawful evil villain methodically takes what he wants within the limits of his code of conduct without regard for whom it hurts. He cares about tradition, loyalty, and order but not about freedom, dignity, or life. He plays by the rules but without mercy or compassion. He is comfortable in a hierarchy and would like to rule, but is willing to serve. He condemns others not according to their actions but according to race, religion, homeland, or social rank. He is loath to break laws or promises.

This reluctance comes partly from his nature and partly because he depends on order to protect himself from those who oppose him on moral grounds. Some lawful evil villains have particular taboos, such as not killing in cold blood (but having underlings do it) or not letting children come to harm (if it can be helped). They imagine that these compunctions put them above unprincipled villains.

In the real world, lawful evil people find happy homes in institutions. In some cases, they make up most of the leaders of the institution and rely on non-evil, but lawful, followers to implement their evil. In fiction, the Empire of Star Wars is a paradigm case of lawful evil. In the real world, Nazi Germany is often presented as a paradigm of lawful evil. While these examples are clear cases of evil, most governments tend to have strong lawful evil components. For example, the legal acceptance and state enforcement of slavery in the United States was a paradigm case of lawful evil.

Lawful evil people, as the description suggests, can appear to be good people—or at least to have virtues. For example, a lawful person in the real world might work for law enforcement and be a paradigm of loyalty, a respecter of tradition and a stickler for rules as they systematically oppress people of a certain ethnicity or religion within their society. They are a paragon of law, but not of goodness.

Both Plato and Kant were aware of this sort of problem—the danger of a person with only some of the virtues, or in Kant’s terms, lacking a good will. Plato warned of the clever rogue: “Did you never observe the narrow intelligence flashing from the keen eye of a clever rogue‑how eager he is, how clearly his paltry soul sees the way to his end; he is the reverse of blind, but his keen eye‑sight is forced into the service of evil, and he is mischievous in proportion to his cleverness?” Kant, in his Fundamental Principles of the Metaphysics of Morals, raises a similar point:

Moderation in the affections and passions, self-control, and calm deliberation are not only good in many respects, but even seem to constitute part of the intrinsic worth of the person; but they, are far from deserving to be called good without qualification, although they have been so unconditionally praised by the ancients. For without the principles of a good will, they may become extremely bad; and the coolness of a villain not only makes him far more dangerous, but also directly makes him more abominable in our eyes than he would have been without it.

The paragon of lawful evil is just this sort of person and the most dangerous villain of all, for they are not content with mere selfishness nor are they merely bringers of chaos. Rather they forge institutions of evil or corrupt existing institutions. This allows for systematic, large scale evil that is easily perceived by good—even by the lawful evil themselves.

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Medicaid Expansion & Hospital Closures

One aspect of Obamacare was the expansion of Medicaid in states that agreed to accept this expansion. Some states, such as my adopted state of Florida, declined the expansion. This provided researchers with an opportunity to study the effects of accepting or rejecting the expansion.

One study, conducted by <a href=”https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0976″>researchers at the University of Colorado Anschutz Medical Campus</a>, found that hospitals in states that expanded Medicaid were six times less likely to close than hospitals in states that declined the expansion. Hospitals in rural areas, which tend to rely more heavily on Medicaid and generally have less income relative to urban hospitals, were the hardest hit.

These results are hardly surprising. Hospitals are required by the <a href=”https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/”>1986 Emergency Medial Treatment and Labor Act</a>(EMTALA) “to ensure public access to emergency services regardless of ability to pay.” As such, unlike other businesses, they cannot turn away people who cannot pay for the services they provide. While Medicaid payments to hospitals are notoriously low, some payment is better than no payment. Because of this, hospitals in states that expanded Medicaid are less likely to need to provide unpaid services and this makes it more likely that they can remain profitable and stay open.

It is, of course, reasonable to consider alternative explanations. After all, mere correlation is not causation and it would be fallacious post hoc reasoning (to infer that because A happened after B, B must have caused A) to simply conclude that Medicaid is the cause. The states that expanded Medicaid might differ in other ways from states that did not—for example, they might have more robust economies or larger percentages of privately ensured patients. That said, the study does seem to support the connection between Medicaid and hospitals remaining open.

One moral and practical concern about hospital closings is that people who need care will be less able to receive it. While it would be hyperbole to claim that hospital closings would leave people in the area with no care, it does reduce their access to care. This is especially of concern in rural areas that already have few hospitals. While people can, of course, travel to get medical care, increased travel times would reduce the likelihood that people will seek care and would also impact outcomes. For example, rapid treatment is critical for stroke victims. Even if patients still have access to a local hospital, hospital closures will increase the time patients need to wait for treatment and this can have a negative impact on medical outcomes.

While health care does not operate within a free market of informed consumers and competitive prices, the closing of hospitals can result in increased costs for medical care. After all, the scarcer a commodity is, the more people tend to charge for it. Since medical care is already extremely expensive, an increase in costs would be even more of a burden on patients, especially those that are not affluent.

Because of the negative impact of not expanding Medicaid, states that have not expanded it should do so. This will decrease hospital closures and thus have a generally positive impact. From a moral standpoint, this would be the right thing to do—assuming that the state has an obligation to the well-being of its citizens.

One obvious counter to this view is to argue against such an obligation. This position is often taken by conservatives who favor limited government and oppose entitlements. There is also the obvious market-based argument here (although medical care is clearly not operating as a free market). The gist of this argument is that medical services are a business and that if a business cannot stay open on its own, then the state has no obligation to intervene. As such, Medicaid should not be expanded to address this problem: if the hospitals cannot stay open on their own, then the market should close them.

The easy and obvious reply to this is that, as noted above, the law requires hospitals to provide medical services even when patients cannot pay. By imposing this restriction, the state has taken a strong role in the market. Since the state imposes this requirement on hospitals, it seems reasonable that the state should take steps to offset this burden—in this case, by expanding Medicaid.

Alternatively, EMTALA could be repealed and hospitals could operate like other businesses in terms of being able to refuse services for those who cannot pay. In this case, there would not be a need to expand Medicaid to assist hospitals in remaining open—they would not lose money providing services to those who cannot pay. But, there would be a high cost in terms of sickness and death among those unable to afford medical care. There is also the possibility that even without the burden of EMTALA hospitals would still be more likely to close without a Medicaid expansion. After all, while hospitals would not be losing money on patients who cannot pay, they would also not have the financial benefit of the Medicaid expansion. As such, their closure rate would presumably be higher than hospitals in states that have expanded Medicaid.

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Dark Mirror’s USS Callister: A Star Trek Story

Jesse Plemons, right, in the “USS Callister” episode of ‘Black Mirror.’ Netflix

Having grown up on Star Trek and the Twilight Zone, I really enjoyed Black Mirror episode ‘USS Callister.’ Being a philosopher, I rather enjoyed reading various thought pieces on the work and decided to add my own tribble to the heap. If you have not seen the episode, there are obviously spoilers ahead.

Much like the brilliant Star Trek lampoon Galaxy Quest, ‘USS Callister’ begins with what appears to be a Trek clone overstuffed with overacting and delightful cheese. Captain Daly, a Kirk-like figure, leads his diverse and adoring crew in a battle against a Khan like villain (complete with a recreation of a scene from Star Trek II: The Wrath of Khan). Under the slice of cheese is a true horror: The USS Callister is within a virtual reality game controlled by Robert Daly and the other “players” are self-aware digital clones of his co-workers.

Daly has powers in the game comparable to Charlie X of Star Trek (including the ability to transform a victim’s face into a mask of unbroken flesh) and uses them to control the controls, forcing them to play the game with him. Since Daly’s coworkers treat him rather badly, it is initially tempting to feel some sympathy for him, but it is revealed that Daly cloned and spaced (putting out an airlock without a suit) the son of his boss. Daly also transforms cloned female co-workers into large alien bugs which horrifically retain their intelligence.

Daly seals his own fate when he digitally clones his newest co-worker, Nanette, and forces her to play the game. To make an excellent story short, digital Nanette leads the crew in a successful rebellion against Daly aided, unwittingly, by the original Nanette.

Jenna Scherer, of Rolling Stone, makes an excellent case that the episode is a criticism of the sort of toxic fandom that has spewed its hate at the fact that the captain’s chair has been increasingly available to people who are not straight, white males. I certainly agree that the episode does just that. However, I also contend that it is a Star Trek story, albeit crafted to avoid lawsuits from the corporate masters of Star Trek. I think this might be a point worth making since I see it as important to distinguish the episode’s criticism of toxic fandom from what seems to be a sincere commitment to the values of classic Star Trek. Making this case requires considering what it is to be a Star Trek story.

The easy and obvious (and legalistic) answer is that a Star Trek story is one that occurs within the Star Trek universe as defined by the corporation that owns the property. While legally sound, this is not satisfying from a philosophical standpoint. Setting aside the legal concerns, another easy way to define such a story is in terms of the setting—that is, a story in the Star Trek universe is thus a Star Trek story. That is also unsatisfying—merely having the Federation, Klingons and such does not seem to suffice—for there is more to a true Star Trek story than just the setting, props and inhabitants. There is the intangible “feel” of a Star Trek story as well as the values inherent to such a story. Since an entire book could be written about this, I am forced to stick with a few quick points that are especially relevant to ‘USS Callister.’

One underlying theme of Star Trek is the dual nature of humanity’s relation to technology. On the one hand, Star Trek is fundamentally optimistic about technology—warp technology allows starships to explore the galaxy and advances in technology have freed the Federation from economic oppression. On the other hand, Star Trek also explores the threat technology presents in terms of its potential for abuse. The Borg are, of course, the paradigm example of the dangerous side to technology. While ‘USS Callister’ might seem to be entirely on the dark side of technology, the ending is optimistic—the digital clones are fully people and, at the end, set out to have their own life in the vast universe of the game.

Star Trek, especially the original series, also placed an emphasis on rational problem solving and teamwork. The model was, of course, a strong captain leading a competent crew of decent people. While this is not unique to Star Trek, this model was carefully followed by the episode: as in many classic Star Trek episodes, crew members made essential contributions to the success of the plan—and, of course, the diversity of the crew is a key part of their strength.

Most importantly, Star Trek also advanced a set of moral principles, as exemplified by the rules and laws of the Federation and Star Fleet. In the episode “Captain Daly” speaks of the values of Space Fleet, but often uses them to justify inflicting worse horrors. For example, after defeating a co-worker he has cast as a villain, the “villain” begs Daly to kill him and thus free him. Daly cites the Space Fleet rules about not killing and instead has the “villain” locked in the brig—thus extending his torture. While it is tempting to see the episode as mocking the values of Star Trek by having a Kirk-like figure mouthing them while grotesquely violating their spirit, this is what contributes the most to making it a Star Trek story. Daly is not Kirk exposed. Daly is, rather, another example of a classic Star Trek villain type: a Star Fleet captain gone bad. In ‘The Omega Glory’ Captain Tracey, commander of the Exeter, violates the Federation’s Prime Directive and ends up committing mass murder and fighting Kirk in order to secure what he hopes is the secret to immortality. While Daly is obviously modeled on Kirk, he is most like Captain Tracey: someone who has professed his love for his ideals, but who abandons them for his own selfish desires when pushed into a crisis. Daly thus shows the irony of the toxic fan—they are acting in violation of the very principles they profess to embrace.

Digital Nanette and her fellows, in contrast, act in accord with the classic values of Star Trek—they act with courage and are willing to make great sacrifices for each other. Appropriately enough, at the end of the episode Nanette is the captain of the USS Callister—a position she has earned. While Daly and the toxic fans might fancy themselves captains, they are the villains. Which is, of course, also a feature of classic Trek: the moral lesson.

Upon their escape from Daly’s private game, the crew’s uniforms and the ship are upgraded to a modern style (like that of the new Star Trek movies). While it might be tempting to see this as a condemnation of classic Star Trek, it can be a metaphor of how the moral goodness of classic Trek is still relevant today, though it was clearly best to leave behind the miniskirts. So, it is reasonable to see ‘USS Callister’ as praising the good of Star Trek while, at the same time, criticizing toxic fandom.

 

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