Tag Archives: Ethics

Opioids, Heart Surgery & Ethics

While pharmaceutical companies and their stockholders have profited greatly from flooding America with opioids, this has come at a terrible cost to others. Showing that the idea of gateway drugs can prove true, there has proven to be a clear path from legal opioids to illegal opioids (such as heroin). As would be expected, the use of opioids can have a terrible impact on health. One example of this is endocarditis.

Endocarditis is, roughly speaking, an abscess on a heart valve. While not limited to drug users, it is not an uncommon consequence of injecting opioids. Since the abuse of opioids is increasing, it is no surprise that the number of drug users suffering from endocarditis has increased significantly.  As would be imagined, the treatment of endocarditis involves a very expensive surgery. As would also be imagined, many of the drug users getting this surgery are on Medicaid, so the taxpayers are footing the bill for this expensive treatment. To make matters worse, people typically return to using opioids after the surgery and this often results in the need for yet another expensive surgery, paid for by Medicaid. This does raise some serious moral concerns.

There is, of course, the very broad moral issue of whether Medicaid should exist. On the one hand, a compelling moral argument can be made that just as a nation provides military and police protection to citizens who cannot afford their own security forces or bodyguards, a nation should fund medical care for those who cannot afford it on their own. On the other hand, a moral argument can be made that a nation has no obligation to provide such support and that citizens should be left to fend for themselves in regards to health care. Naturally enough, if the nation is under no obligation to provide Medicaid in general, then it is under no obligation to cover the cost of the surgery in question. On this view, there is no need to consider the matter further.

However, it does seem worth granting for the sake of argument that the state should provide Medicaid and then consider the ethics of paying for endocarditis surgery for opioid addicts. Especially when they are likely to continue the behavior that resulted in the need for surgery. It is to this discussion that I now turn.

While it certainly appears harsh to argue against paying for addict’s heart surgery, a solid moral case can be made in favor of this position. The easiest and most obvious way to do this is on utilitarian grounds.

As noted above, the surgery for endocarditis is very expensive. As such, it uses financial and medical resources that could be used elsewhere. It seems likely that a great deal of good could be done with those resources that exceed the good created by replacing the heart valve of an addict. This argument can be strengthened by including the fact that addicts often return to the very behavior that resulted in endocarditis, thus creating the need for repeating the costly surgery. From a utilitarian perspective, it would be morally better to use those resources to treat patients who are far less likely to willfully engage in behavior that will require them to be treated yet again. This is because the resources that would be consumed treating and retreating a person who keeps inflicting harm on themselves could be used to treat many people, thus doing greater good for the greater number. Though harsh and seemingly merciless, this approach seems justifiable on grounds similar to the moral justification for triage.

Another approach, which is even harsher, is to focus on the fact that the addicts inflicting endocarditis on themselves and often doing so repeatedly. This provides the basis for two arguments against public funding of their treatment.

One argument can be built around the idea that there is not a moral obligation to help people when their harm is self-inflicted. To use an analogy, if a person insists on setting fire to their house and it burns down, no one has a moral responsibility to pay to have their house rebuilt. Since the addict’s woes are self-inflicted, there is no moral obligation on the part of others to pay for their surgery and forcing people to do so (by using public money) would be like forcing others to pay to rebuild the burned house.

One way to counter this is to point out that a significant percentage (probably most) health issues are self-inflicted by a lack of positive behavior (such as exercise and a good diet) and an abundance of negative behavior (such as smoking, drinking, or having unprotected sex). As such, if this principle is applied to addicts in regards to Medicaid, it must be applied to all cases of self-inflicted harms. While some might take this as a refutation of this view, others might accept this as quite reasonable.

Another argument can be built around the notion that while there could be an obligation to help people, this obligation has clear limits. In this case, if a person is treated and then knowingly returns to the same behavior that inflicted the harm, then there is no obligation to keep treating the person. In the case of the drug addict, it could be accepted that the first surgery should be covered and that they should be educated on what will happen if they persist in their harmful behavior. If they then persist in that behavior and need the surgery again, then public money should not be used. To use an analogy, if a child swings their ice cream cone around playing like it is a light sabre and is surprised when the scoops are flung to the ground, then it would reasonable for the parents to buy the child another cone. If the child then swings the new cone around again and the scoops hit the floor, then the child can be justly denied another cone.

An obvious counter is to contend that addicts are addicted and hence cannot be blamed for returning to the same behavior that caused the harm. That is, they are not morally responsible for what they are doing to themselves because they cannot do otherwise. This does have some appeal, but would seem to enable the justification of requiring addicts to undergo treatment for their addiction and to agree to monitoring of their behavior. They should be free to refuse this (which, ironically, assumes they are capable of free choice), but this should result in their being denied a second surgery if their behavior results in the same harm. Holding people accountable does seem to be cruel, but the alternative is unfair to other citizens. It would be like requiring them to keep rebuilding houses for a person who persists in setting fires in their house and refuses to have sprinklers installed.

These arguments can be countered by arguing that there is an obligation to provide such care regardless of how many times an addict returns to the behavior that caused the need for the surgery. One approach would be to build an analogy based on how the state repeatedly bails out big businesses every time they burn down the economy. Another approach would be to appeal to the value of human life and contend that it must be preserved regardless of the cost and regardless of the reason why there is a need for the medical care. This approach could be noble or, perhaps, foolish.

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Medicine & Markets

As a point of ideology, many conservatives advocate the broad application of free market principles. One key part of this ideology is the opposition of regulation, at least regulation that does not favor businesses. Since health care is regarded as a business in the United States, there is an interesting question in regards to the extent that health care pricing should be regulated by the state.

Because of the high cost of health care in the United States, there have been proposals to place limits on the cost of health care services. Some areas have implemented such proposals, but there is a general lack of such regulations on pricing. Those who oppose such regulations often contend that pricing should be set by free competition between health care providers and that consumers of health care should be savvy shoppers. The idea is that savvy health care shoppers will take their business to providers that offer better services or lower costs, which will force the competition to lower costs or improve quality.

There are various problems with the idea of savvy health care shoppers. The first is the challenge consumers face in finding the prices that health care providers charge. While it can be difficult to predict what services a consumer might need, health care providers often have a range of prices depending on who is paying for the services. For example, insurance companies negotiate prices with providers and these differ from what consumers without insurance would pay. Health care providers, although they always have a database of billing codes and costs, are generally reluctant to provide this information. This makes savvy shopping difficult.

A second problem is that health care consumers typically lack the medical knowledge to make informed decisions about health care. While a person might have some challenge in sorting out what sort of phone or laptop they should buy, sorting out what sort of medical care they might really need is typically beyond the skill of most people. That is why people go to medical professionals. As such, being a savvy shopper is rather difficult.

A third problem is that it is something of a mistake to describe a health care consumer as a consumer; it is usually more apt to call them a patient. While this might seem to be a mere difference in labels, the difference between consumer and patient is significant.

A rather important difference is that a patient is typically in duress—they are injured or ill and thus not in a very good state to engage in savvy shopping practices. While an informed rational consumer will be looking for the best deal, a suffering patient is concerned primarily with getting better. As people say to not go grocery shopping on an empty stomach, it would be best to not shop for health care when one is not healthy—but that is exactly when one needs health care. There are also the more extreme cases. For example, a person who is badly injured in a car crash is not going to be shopping in a savvy manner for emergency rooms as they are being transported in the ambulance.

It can be countered that there are cases in which a person can engage in savvy shopping, such as elective surgeries and non-emergencies. This is a reasonable point—a person who is not in dire need can take the time to shop around and be a savvy consumer. However, this does not apply to cases in which a person is sick or injured enough to impeded such savvy shopping.

Another important difference between consumer and patient is that the consumer often has a reasonable choice between buying a good or service and doing without. In contrast, patients usually have a real need for the good or service and doing without would be a real hardship or even fatal. When one must buy the good or service and the provider knows this, it makes it much harder to be a savvy shopper. This also provides a segue into the matter of regulating prices.

While free market pricing can work when consumers can easily do without the good or service, it runs into obvious problems for the consumer when the goods or services are necessities. To the degree that the patient cannot do without the health care goods or services, the patient is at the mercy of the provider. So, while a person can easily elect to do without the latest iPhone if they cannot afford it, it is much more difficult for a person to do without their chemotherapy or AIDS medication. True, a consumer could do without liposuction or breast implants, but such elective surgery differs from non-elective treatments.

The stock counter to such concerns is that if a consumer finds the price of a good or service too high, they can go to a lower priced competitor. Assuming, of course, that there is real competition. In the case of health care, the opportunity to find a lower priced competitor can be problematic. A patient might not have the time to shop around on the way to an emergency room. In many places, there is not any local competition with lower prices. As such, this free market advice is not very helpful.

In the case of pharmaceuticals, patients often find that there is no competition. When a company has a patent on a medication, the United States’ government uses its coercive power to enforce that patent, ensuring that the company retains a monopoly on that medication. Because of this, a patient who needs the medication has two basic choices: do without or pay the price. There is no free market competition, so without regulation on the part of the state, the company can decide to charge whatever is desired—subject to the cost of bad press, of course.

This monopoly system does create something of a quandary for a principled proponent of the free market. On the one hand, without such patents a free market of drugs would make it irrational for for-profit companies to invest in costly research. This is because as soon as the drug was developed, the competition would just duplicate it and can sell it cheaper because they would not need to recoup the cost of development. A solution, which would not be very free market, would be to have the state fund the expensive research and then provide the results to companies who would then compete without monopolies for consumer dollars. Another “solution” would be to let the market remain free and hope that medications would somehow be developed.

On the other hand, if the state stepped in to regulate prices as part of the agreement for using its coercive power to protect the monopoly, then there would also be no free market competition. But, the state could see to it that the companies charged prices that allowed profits while not gouging patients.

My own view, as might be suspected, is that since patients are essentially a coerced market when it comes to health care and medication, the state should act to regulate prices. In the case of pharmaceutical companies, this should be part of the bargain with the state that allows them to maintain their monopolies. After all, if taxpayer dollars are to be used to protect monopolies, then they should get something in return—and this something should be reasonably priced medication. In the case of health care providers, while they do not usually have a monopoly, they do have a coerced market. Just as the state justly steps in to prevent price gouging during large scale natural disasters, it can justly do so in regards to personal disasters—that is, injury and illness.

I am certainly sensitive of the desire of health care providers and pharmaceutical companies to make a profit and, as such, I would certainly advocate that the regulations on pricing leave them a reasonable margin of profit. While it might be objected that a reasonable margin of profit it hard to define, my reply is that if price gouging can be recognized in other areas, it can (and is) be recognized in the realm of medicine.

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Trump Supporters as Moral Heroes

While Trump claimed that he would help the forgotten people of America, his rural and small town supporters will most likely be harmed by the implementation of his agenda. Trump also ran hard on repealing Obamacare and engaging in what some would characterize as trade wars. If the administration makes good on these promises, many of his supporters will be harmed. Some have gone as far as asserting that Trump’s presidency will prove to be a disaster for the white working class.

Since these are factual claims, they can be countered by evidence to the contrary and it is worth considering that the predictions of woe might prove to be in error. That is, the Trump administration will lead the working class and forgotten people to a new age of prosperity, health and wellbeing. While not logically impossible, this does seem unlikely. As such, the most reasonable bet is that the Trump administration will prove to be good for Trump and his fellow economic elites but not so good for everyone else.

After Trump won, a cottage industry of writing articles explaining why people supported him when doing so seemed contrary to their interests. It is, of course, tempting to liberal intellectuals to explain this support in terms of such things as racism. It is also tempting to think that people were willfully ignorant of Trump’s long history of misdeeds (such as how students were exploited by Trump University), that many of his supporters were pathologically delusional in believing that he would truly act in their interests or that they were simply stupid. I will, however, advance a different account, that the Trump supporters who will be hurt by Trump and the other Republicans are moral heroes.

While there are many ways to be a moral hero, one standard way is for a person to willingly suffer harm for the sake of the good of others. The stock philosophy 101 example is, of course, the soldier who throws themselves upon a grenade to save their fellows. This is often presented in utilitarian terms: the willing suffering of the few is outweighed by the good this generates for the many. If the Trump supporters knew they would be hurt by his policies, but believed that their suffering would make America great again, then they could be regarded as moral heroes for their sacrifice. If, however, they thought they would benefit from Trump’s policies and got it wrong, then they would not be moral heroes, but merely have been acting from self-interest.

While a noble sacrifice for the good of the many would be heroic, it does not seem that Trump’s policies will be good for the many Americans. Rather, it seems that Trump and his fellow Republicans will be crafting policies that benefit the rich at the expense of the many. For example, his tax plan will be amazing for the rich but harmful to those who are not well off. As such, without an assumption of ignorance, those who supported Trump and will be harmed by his policies cannot be considered moral heroes. At least in the context of utilitarianism. However, there are other moral theories and one of these might make them moral heroes.

Trump, like most people, does not seem to operate based on a considered moral theory. This is no more surprising than the fact that most people do not operate based on considering theories in physics, biology, medicine or engineering. However, these theories still apply to what people do and it is reasonable to consider what sort of moral theory Trump and his fellows would fit into.

The way Trump has treated contractors, students at Trump University, women and others indicates that Trump operates from selfishness. This would suggest that the most likely moral theory to apply to Trump would be ethical egoism. This is the view that a person should act to maximize value for themselves. Alternatively, that each person should act entirely in their own interest. This is in contrast with altruistic ethics, which include the view that each person should not always act solely in their own self-interest, but should consider others.

Ethical egoism seems to fit many Republicans and hence it is no surprise that the frat-bro Republican philosopher Paul Ryan has embraced the ethical egoism of Ayn Rand. To be fair, after John Oliver critiqued Rand, Ryan did assert that he does not embrace her objectivism. However, consideration of Rand’s policies show that they are consistent with the ethics of Rand as expressed in her view that selfishness is a virtue.

While Trump would seem to fit within ethical egoism, this moral theory would make the Trump supporters who will be hurt by Trump chumps and not heroes. After all, a moral hero in ethical egoism would be a person who acts to maximize their self-interest. This will typically be at the expense of others. A moral hero of an ethical egoist would not back Trump if they believed that doing so would be contrary to their interests and would not maximize value for them. However, there is still a chance for moral heroism.

While Trump certainly has the selfishness part of ethical egoism down, classical ethical egoism enjoins everyone to maximize their self-interest. In the ideal laid out by Adam Smith, this would result in competition that is supposed to benefit everyone by the magic of the invisible hand of the market.

It is true that Trump, Ryan and their ilk are presenting polices that do not just benefit themselves. Many of these polices do benefit others, but it is a select group of others, namely the economic elites. While this could be explained in terms of ethical egoism, that Trump and Ryan are doing the right thing because benefiting these elites benefits them (Ryan, for example, enjoys the financial backing of these elites and this enables him to get re-elected) there is also an alternative. This could be called “ethical oligarchism.” This is the moral view that people should act to maximize value (or in the interest of) the oligarchs. This can, of course, be a nationalistic ethics—that people of a country should act in the interest of their oligarchs. It could also be a general view that transcends borders—that everyone should act in according with the interests of the oligarchs of the world.

On this view, the Trump supporters who will harmed by Trump’s policies are moral heroes—they have sacrificed their own good for the good of the oligarchs.

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The State & Health Care

One way to argue that the state is obligated to provide health care (in some manner) to its citizens is to draw an analogy to the obligation of the state to defend its citizens from “enemies foreign and domestic.” While thinkers disagree about the obligations of the state, almost everyone except the anarchists hold that the state is required to provide military defense against foreign threats and police against domestic threats. This seems to be at least reasonable, though it can be debated. So, just as the United States is obligated to defend its citizens from the Taliban, it is also obligated to defend them against tuberculous.

Another approach is to forgo the analogy and argue that the basis of the obligation to provide military defense and police services also extends to providing health care. The general principle at hand is that the state is obligated to protect its citizens. Since anthrax and heart failure can kill a person just as dead as a bullet or a bomb, then the state would seem to be obligated to provide medical protection in addition to police and military protection. Otherwise, the citizens are left unguarded from a massive threat and the state would fail in its duty as a protector. While these lines of reasoning are appealing, they can certainly be countered. This could be done by arguing that there are relevant differences between providing health care and providing armed defenses.

One way to do this is to argue that the state is only obligated to protect its citizens from threats presented by humans and not from other threats to life and health, such as disease, accidents or congenital defects. So, the state is under no obligation to protect citizens from the ravages of Alzheimer’s. But, if ISIS or criminals developed a weapon that inflicted Alzheimer’s on citizens, then the state would be obligated to protect the citizens.

On the face of it, this seems odd. After all, from the standpoint of the victim it does not seem to matter whether their Alzheimer’s is “natural” or inflicted—the effect on them is the same. What seems to matter is the harm being inflicted on the citizen. To use an obvious analogy, it would be like the police being willing to stop a human from trying to kill another human, but shrugging and walking away if they see a wild animal tearing apart a human. As such, it does not matter whether the cause is a human or, for example, a virus—the state’s obligation to protect citizens would still apply.

Another approach is to argue that while the state is obligated to protect its citizens, it is only obligated to provide a certain type of defense. The psychology behind this approach can be made clear by the rhetoric those who favor strong state funding for the military and police while being against state funding for medical care. The military is spoken of in terms of its importance in “degrading and destroying” the enemy and the police are spoken of in terms of their role in imposing “law and order.” These are very aggressive roles and very manly. One can swagger while speaking about funding submarines, torpedoes, bullets and missiles.

In contrast, the rhetoric against state funding of health care speaks of “the nanny state” and how providing such support will make people “weak” and “dependent.” This is caring rather than clubbing, curing rather than killing. One cannot swagger about while speaking about funding preventative care and wellness initiatives.

What lies behind this psychology and rhetoric is the principle that the state’s role in protecting its citizens is one of force and violence, not one of caring and curing. This does provide a potential relevant difference; but the challenge is showing that this difference warrants providing armed defense while precluding providing medical care.

One way to argue against it is to use an analogy to a family. Family members are generally obligated to protect one another, but if it were claimed that this obligation was limited only to using force and not with caring for family members, then this would be rightfully regarded as absurd.

Another approach is to embrace the military and police metaphors. Just as the state should thrust its force against enemies within and without, it should use its medical might to crush foes that are literally within—within the citizens. So, the state could wage war on viruses, disease and such and thus make it more manly and less nanny. This should have some rhetorical appeal to those who love military and police spending but loath funding healthcare. Also to those who are motivated by phallic metaphors.

As far as the argument that health care should not be provided by the state because it will make people dependent and weak, the obvious reply is that providing military and police protection would have the same impact. As such, if the dependency argument works against health care, it would also work against having state military and police. If people should go it on their own in regards to health care, then they should do the same when it comes to their armed defense. If private health coverage would suffice, then citizens should just arm themselves and provide their own defense and policing. This, obviously enough, would be a return to the anarchy of the state of nature and that seems rather problematic. If accepting military and police protection from the state does not make citizens weak and dependent, then the same should also hold true for accepting health care from the state.

As a final point, an easy way to counter the obligation argument for state health care is to argue that the state is not obligated to provide military and police protection to the citizens. Rather, the military and the military, it could be argued, exists to protect and advance the interests of the elites. Since the elites have excellent health care thanks to their wealth and power, there is no need for the state to provide it to them. Other than the elites in government, like Paul Ryan and Trump, who get their health care from the state, of course. On this view, support for using public money for the military and police and not health care makes perfect sense.

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Social Media & Shaming

While shaming was weaponized long ago as a means of punishment, social media has transformed it into a weapon of reversed mass destruction. Rather than a single weapon destroying masses, it is the social media masses that are destroying one person at a time. Perhaps the best known example of this is the destruction of Justine Sacco, the woman who tweeted “Going to Africa. Hope I don’t get AIDS. Just kidding. I’m white!” While Sacco is currently the best known victim of such shaming, the practice has become a common one and the list of casualties increases each day.

While it is tempting to issue a blanket condemnation of shaming, this would be a mistake. While shaming is abused, it can be a morally acceptable form of punishment. However, this requires that it be used properly and justly.

As with any form of punishment, shaming should only be used when the target has done wrong. Unlike with actual civil and criminal laws, there is not a codified set of rules specifying what actions are wrong in a way that warrant shaming. As with most social interactions, people are guided by vague norms, intuitions, traditions and feelings. As such, the practice of shaming can be rather chaotic. That said, it is certainly possible to consider situations rationally and assess whether they are shame worthy or not—though disputes are inevitable. Working out such guideless would be analogous to developing a hybrid between laws and etiquette and would presumably require at least a small book, which is far beyond the scope of this short essay. However, I do have some recommendations.

In the United States criminal justice system, there is a presumption of innocence on the part of the defendant. This is based on the ideal that it is better to allow the guilty to go free than to punish the innocent. The same sort of presumption should be extended to those who are accused of engaging in shame worthy actions. I would even suggest a specific sort of presumption, namely a presumption of error. This is to begin the consideration by assuming the accused acted from error rather than malice.

One common type of error that leads to excessive shaming is when a person attempts to be funny, but fails to do so because of a lack of skill. Sacco’s infamous tweet seems to be an example of this sort of error. A skilled comedian could have created a piece of satire using the same basic idea and directed attention to the issue of race in the context of AIDS. Because of a lack of comedic skill, Sacco’s tweet came across as racist—although all the evidence seems to clearly show that this is not what she intended. Another type of error is that of ignorance—a person has no malicious intent, but errs by not knowing something rather important. For example, a person trying to be funny might appear racist because they are unaware of the social norms governing who has the right to use which terms of race. The obvious example, is a white person imitating a black comedian’s use of the n-word without realizing that the word is essentially off limit to white comedians.

If a person is reasonably judged worthy of shaming, the next concern is how and to what extent the person should be shamed and the objective of the shaming. Since shaming is a punishment, the usual moral considerations about punishment apply.

One reason to punish by shaming is deterrence—so the shamed will not engage in shameful activity again and that others will be less inclined to behave in similar ways. Another reason is retribution—to “balance the books” by harming the shamed in return for the harm they did. While retribution strikes me as morally problematic (at best), both deterrence and retribution should be limited by the principle of proportionality. That is, the punishment should be comparable in severity to the harm done. If the punishment is excessive, then it creates a new harm that would require punishment and this punishment would need to be proportional or there would need to be another punishment and so on to infinity. As such, even if retribution is embraced, it can only be justified when it matches the harm inflicted.

Unfortunately, in social media shaming the punishment tends to be excessive. In fact, the punishments for such offenses can exceed those imposed for serious civil or criminal violations of the law. For example, Sacco’s failed attempt at humor cost her job and wrecked her life. One reason that the punishment can be excessive is that people are often insulated from consequences of their acts of punishment, and hence they are freed to be harsher than they would be in person. That said, shamers are sometimes themselves shamed for shaming, thus creating a vicious circle. Another reason for the excesses of punishment is the scope of social media. A person’s shame can be broadcast to the entire world and the entire world can get in on punishing the person, thus inflicting excessive harm. This also helps explain why people who are shamed are often fired—their employers fear the wrath of the social media mob and will fire a person to protect themselves.

Another, and what I think is the best, reason to punish is redemption. Such punishment aims to inform the person that their action is unacceptable, to give them a chance to atone for their misdeed and to allow them a chance to be accepted back into the social fold. This approach does have some limits. The person must be subject to feeling shame or vulnerable to the consequences of being shamed. A person who is shameless (or at least without shame in the matter at hand) will be rather resistant to attempts to appeal to their sense of shame. A person who can suffer little or no ill-consequences from being shamed will also not be corrected by shaming. Donald Trump is often presented as an example of a person who is either shameless or able to effectively avoid the negative consequences of being shamed (or both).

Punishing for the purpose of redemption does put a limit on the punishment that should be inflicted. After all, excessive punishment is unlikely to teach a person a moral lesson about how they should act (but it can teach a practical lesson). Also, excessive punishment can do so much damage that a person cannot effectively make it back into the social fold. Such redemptive shaming should be severe enough to send the intended message, but moderate enough that the person can achieve redemption. What is often forgotten about redemptive punishment is the important role of society—redemption is not merely about the wrongdoer redeeming themselves, but other people accepting this redemption. Those who engage in social media shaming all too often rush to punish and then move on to the next transgressor. In doing so, they fail in their obligations to those they have punished, which includes offering an opportunity for redemption.

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The Swarm (film)

Anyone who has played RTS games such as Blizzard’s Starcraft knows the basics of swarm warfare: you build a vast swarm of cheap units and hurl them against the enemy’s smaller force of more expensive units. The plan is that although the swarm will be decimated, the enemy will be exterminated. The same tactic was the basis of the classic tabletop game Ogre—it pitted a lone intelligent super tank against a large force of human infantry and armor. And, of course, the real world features numerous examples of swarm warfare—some successful for those using the swarm tactic (ants taking out a larger foe), some disastrous (massed infantry attacks on machineguns).

The latest approach to swarm tactics is to build a swarm of drones and deploy them against the enemy. While such drones will tend to be airborne units, they could also be ground or sea machines. In terms of their attacks, there are many options. The drones could be large enough to be equipped with weapons, such as small caliber guns, that would allow them to engage and return to reload for future battles. Some might be equipped with melee weapons, poisons, or biological weapons. The drones could also be suicide machines—small missiles intended to damage the enemy by destroying themselves.

While the development of military drone swarms will no doubt fall within the usual high cost of developing new weapon technology, the drones themselves can be relatively cheap. After all, they will tend to be much smaller and simpler than existing weapons such as aircraft, ships and ground vehicles. The main cost will most likely be in developing the software to make the drones operate effectively in a swarm; but after that it will be just a matter of mass producing the hardware.

If effective software and cost-effective hardware can be developed, one of the main advantages of the battle swarm will be its low cost. While such low-cost warfare might be problematic for defense contractors who have grown accustomed to massive contracts for big ticket items, it would certainly be appealing to those who are concerned about costs and reducing government spending. After all, if low cost drones could replace expensive units, defenses expenses could be significantly reduced. The savings could be used for other programs or allow for tax cuts. Or perhaps they will just build billions of dollars of drones.

Low cost units, if effective, can also confer a significant attrition advantage. If, for example, thousands of dollars of drones can take down millions of dollars of aircraft, then the side with the drones stands a decent chance of winning. If hundreds of dollars of drones can take down millions of dollars of aircraft, then the situation is even better for the side with the drones.

The low cost does raise some concerns, though. Once the drone controlling software makes its way out into the world (via the inevitable hack, theft, or sale), then everyone will be using swarms. This will recreate the IED and suicide bomber situation, only at an exponential increase. Instead of IEDs in the road, they will be flying around cities, looking for targets. Instead of a few suicide bombers with vests, there will be swarms of drones loaded with explosives. Since Uber comparisons are now mandatory, the swarm will be the Uber of death.

This does raise moral concerns about the development of the drone software and technology; but the easy and obvious reply is that there is nothing new about this situation: every weapon ever developed eventually makes the rounds. As such, the usual ethics of weapon development applies here, with due emphasis on the possibility of providing another cheap and effective way to destroy and kill.

One short term advantage of the first swarms is that they will be facing weapons designed primarily to engage small numbers of high value targets. For example, air defense systems now consist mainly of expensive missiles designed to destroy very expensive aircraft. Firing a standard anti-aircraft missile into a swarm will destroy some of the drones (assuming the missile detonates), but enough of the swarm will probably survive the attack for it to remain effective. It is also likely that the weapons used to defend against the drones will cost far more than the drones, which ties back into the cost advantage.

This advantage of the drones would be quickly lost if effective anti-swarm weapons are developed. Not surprisingly, gamers have already worked out effective responses to swarms. In D&D/Pathfinder players generally loath swarms for the same reason that ill-prepared militaries will loath drone swarms: while the individual swarm members are easy to kill, it is all but impossible to kill enough of them with standard weapons. In the game, players respond to swarms with area of effect attacks, such as fireballs (or running away). These sorts of attacks can consume the entire swarm and either eliminate it or reduce its numbers so it is no longer a threat. While the real world has an unfortunate lack of wizards, the same basic idea will work against drone swarms: cheap weapons that do moderate damage over a large area. One likely weapon is a battery of large, automatic shotguns that would fill the sky with pellets or flechettes. Missiles could also be designed that act like claymore mines in the sky, spraying ball bearings in almost all directions.  And, obviously enough, swarms will be countered by swarms.

The drones would also be subject to electronic warfare—if they are being remotely controlled, this connection could be disrupted. Autonomous drones would be far less vulnerable, but they would still need to coordinate with each other to remain a swarm and this coordination could be targeted.

The practical challenge would be to make the defenses cheap enough to make them cost effective. Then again, countries that are happy to burn money for expensive weapon systems, such as the United States, would not need to worry about the costs. In fact, defense contractors will be lobbying hard for expensive swarm and anti-swarm systems.

The swarms also inherit the existing moral concerns about non-swarm drones, be they controlled directly by humans or deployed as autonomous killing machines. The ethical problems of swarms controlled by a human operator would be the same as the ethical problems of a single drone controlled by a human, the difference in numbers would not seem to make a moral difference. For example, if drone assassination with a single drone is wrong (or right), then drone assassination with a swarm would also be wrong (or right).

Likewise, an autonomous swarm is not morally different from a single autonomous unit in terms of the ethics of the situation.  For example, if deploying a single autonomous killbot is wrong (or right), then deploying an autonomous killbot swarm is wrong (or right).  That said, perhaps there is a greater chance that an autonomous killbot swarm will develop a rogue hive mind and turn against us. Or perhaps not. In any case, Will Rodgers will be proven right once again: “You can’t say that civilization don’t advance, however, for in every war they kill you in a new way.”


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Gaming & Groping II: Obligations

In my previous essay, I discussed some possible motivations for groping in VR games, which is now a thing. The focus of what follows is on the matter of protecting gamers from such harassment on the new frontiers of gaming.

Since virtual groping is a paradigm of a first world problem, it might be objected that addressing it is a waste of time. After all, the objection can be made that resources that might be expended on combating virtual groping should be spent on addressing real groping After all, a real grope is far worse than a virtual grope—and virtual gropes can be avoided by simply remaining outside of the virtual worlds.

This sort of objection does have some merit. After all, it is sensible to address problems in order of their seriousness. To use an analogy, if a car is skidding out of control at the same time an awful song comes on the radio, then the driver should focus on getting the car back under control and not waste time on the radio.  Unless, of course, it is “The Most Unwanted Song.”

The reasonable reply to this objection is that this is not a situation where it is one or the other, but not both. While time spent addressing virtual groping is time not spent on addressing real groping, addressing virtual groping does not preclude addressing real groping. Also, pushing this sort of objection can easily lead into absurdity: for anything a person is doing, there is almost certainly something else they could be doing that would have better moral consequences. For example, a person who spends time and money watching a movie could use that time and money to address a real problem, such as crime or drug addiction. But, as so often been argued, this would impose unreasonable expectations on people and would ultimately create more harm than good. As such, while I accept that real groping is worse than virtual groping, I am not failing morally by taking time to address the virtual rather than the real in this essay.

It could also be objected that there is no legitimate reason to be worried about virtual groping on the obvious grounds that it is virtual rather than real. After all, when people play video games, they routinely engage in virtual violence against each other—yet this is not seen as a special problem (although virtual violence does have its critics). Put roughly, if it is fine to shoot another player in a game (virtual killing) it should be equally fine to grope another player in a game. Neither the killing nor groping are real and hence should not be taken seriously.

This objection does have some merit, but can be countered by considering an analogy to sports. When people are competing in boxing or martial arts, they hit each other and this is accepted because it is the purpose of the sport. However, it is not acceptable for a competitor to start pawing away at their opponent’s groin in a sexual manner (and not just because of the no hitting below the belt rules of boxing). Punching is part of the sport, groping is not. The same holds for video games. If a person is playing a combat video game that pits players against each other, the expectation is that they will be subject to virtual violence. They know this and consent to it by playing, just as boxers know they will be punched and consent to it. But, unless the players know and consent to playing a groping game, using the game mechanics to virtually grope other players would not be acceptable—they did not agree to that game.

Another counter is that while the virtual groping is not as bad as real groping, it can still harm the target of the groping. To use an analogy, being verbally abused over game chat is not as bad as having a person physically present engaging in such abuse, but it is still unpleasant for the target. Virtual groping is a form of non-verbal harassment, intended to get a negative reaction from the target and to make the gaming experience unpleasant. There is also the fact that being the victim of such harassment can rob a player of the enjoyment of the game—which is the point of playing. While it is not as bad as groping a player in a real-world game (which would be sexual assault), it has an analogous effect on the player’s experience.

It could be replied that a player should just be tough and put up with the abuse. This reply lacks merit and is analogous to saying that people should just put up with being assaulted robbed or spit on. It is the reply of an abuser who wants to continue the abuse while shifting blame onto the target.

While players are in the wrong when they engage in virtual groping, there is the question of what gaming companies should do to protect their customers from such harassment. They do have a practical reason to address this concern—players will tend to avoid games where they are subject to harassment and abuse, thus costing the gaming company money. They also have a moral obligation, analogous to the obligation of those in the real world who host an event. For example, a casino that allowed players to grope others with impunity would be failing in its obligation to its customers; the same would seem to hold for a gaming company operating a VR game.

Companies do already operate various forms of reporting, although their enforcement tends to vary. Blizzard, for example, has policies about how players should treat each other in World of Warcraft. This same approach can and certainly will be applied to VR games that allow a broader range of harassment, such as virtual groping.

Because of factors such as controller limitations, most video games do not have the mechanics that would allow much in the way of groping—although some players do work very hard trying to make that happen. While non-VR video games could certainly support things like glove style controllers that would allow groping, VR games are far more likely to support controllers that would allow players to engage in virtual groping behavior (something that has, as noted above, already occurred).

Eliminating such controller options would help prevent VR groping, but at the cost of taking away a rather interesting and useful aspect of VR controller systems. As such, this is not a very viable option. A better approach would be to put in the software limits on how players can interact with the virtual bodies of other players. While some might suggest a punitive system for when one player’s virtual hands (or groin) contacting another player’s virtual naught bits, the obvious problem is that wily gamers would exploit this. For example, if a virtual hand contacting a virtual groin caused the character damage or filed an automatic report, then some players would be trying their best to get their virtual groins in contact with other players’ virtual hands. As such, this would be a bad idea.

A better, but less than ideal system, would be to have a personal space zone around each player’s VR body to keep other players at a distance. The challenge would be working this effectively into the game mechanics, especially for such things as hand-to-hand combat. It might also be possible to have the software recognize and prevent harassing behavior. So, for example, a player could virtually punch another player, but not make grabbing motions on the target’s groin.

It should be noted that these concerns are about contexts in which players do not want to be groped; I have no moral objection to VR applications that allow consensual groping—which, I infer, will be very popular.


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Wells Fargo & Financial Crimes

The venerable Wells Fargo bank made the news in 2016 for financial misdeeds on a massive scale. Employees of the company, in an effort to meet the quotas set by management, had created numerous accounts without the permission of the clients. In response over 5,300 lower level employees were fired. Initially, CEO John Stumpf and former head of retail banking Carrie Tolstedt were to keep their rather sizable compensation for leading the company to a great financial “success” based on this fraud. However, backlash from the public and the shareholders has resulted in Stumpf and Carrie losing some of their financial compensation.

As would be expected, there are currently no plans for criminal charges of the sort that could result in jail time. This is consistent with how financial misdeeds by the elites are typically handled: some fines and, at worst, some forfeiture of ill-gotten gains. While I do not generally agree with Trump, he is not wrong when he points out that the system is rigged in favor of the elites and against the common people. The fact that Trump is one of the elite and has used the system quite effectively does not prove him wrong (that would be fallacious reasoning); rather he himself serves as more evidence for the rigging. Those who loath Hillary Clinton can also add their own favorite examples.

It is instructive to compare the punishment for other misdeeds to those imposed on Wells Fargo. Shoplifting is usually seem as a fairly minor crime,  but a person who shoplifts property with a combined value of less than $300 can pay a fine up to $1000 or be sentenced to up to a year in jail. Shoplifting property with a combined value over $300 is a felony and can result in a sentence between one and ten years in jail. While Wells Fargo did not seem to directly steal money (that is, it did not simply empty accounts into its own coffers), it did rob people through the use of fees and other charges that arose from the creation of these unauthorized accounts.

While there are clearly differences between the direct theft of shoplifting and the indirect robbery of imposing charges on unauthorized accounts, there seems to be little moral distinction: after all, both are means of robbing someone of their rightful property.  Because of this, there would appear to be a need to revise the penalties so that they are properly proportional.

One option is to bring the punishment for major financial misdeeds in line with the punishment for shoplifting. This would involve changing the fine for financial misdeeds from being a fraction of the profits (or damages) of the misdeeds to a multiple of the profits (perhaps three or more times greater). It could be argued that such a harsh penalty could financial ruin an elite who lacked adequate assets to pay for their misdeed; however, the exact same argument can be advanced for poor shoplifters.

Another option is to bring the punishments for shoplifting in line with the punishments for the financial elites. This would change the fine for shoplifting from likely being in excess of the value of what was stolen to a fraction of what was stolen (if that). The obvious objection to this proposal is that if shoplifters knew that their punishment would be to pay a fraction of the value they had stolen, then this punishment would have no deterrent value. Shoplifting would be, in effect, shopping at a significant discount. It is thus hardly shocking that the financial elite are generally not deterred by the present system of punishment—they come out way ahead if they do not get caught and can still do very well even if they are caught.

It could be objected that the financial elite would be deterred on the grounds that they would still be better off using legal means to profit. That way they would keep 100% of their gain rather than a fraction. The easy and obvious reply is that this deterrent value is contingent on the elite believing that the legal approach would be more profitable than the illegal approach (with due consideration to the chance of getting caught and fined). Since the punishment is often a fraction of the gain and the potential gain from misdeeds can be huge, this approach to punishment has far less deterrent value than a punishment in which the punished comes out at a loss rather than a gain.

It is also interesting to compare the punishment for identity theft and fraud with the punishment of Wells Fargo. Conviction of identity theft can result in a sentence of one to seven years. Fraud charges also have sentences that range from one to ten years and beyond. While some do emphasize that Wells Fargo was not engaged in traditional identity theft was morally similar. As an example of traditional identity theft, a thief steals a person’s identity and gets a credit card under that name to use for their own gain. What Wells Fargo did was open accounts in people’s names without their permission so that the company could profit from this misuse of their identity. As such, the company was stealing from these people and doing them the same sorts of harms inflicted by individuals engaging in identity theft.

From a moral standpoint, those involved in these actions should face the same criminal charges and potential punishments that individuals acting on their own would face. This is morally required for consistency. Obviously enough, the laws are not consistent—the misdeeds of the elite and corporations are so often punished lightly or not at all. This is nothing new—the history of law is also the history of its unfair application. The injustice of justice, one might say.  However, this approach is problematic.

Looked at from a certain moral perspective, the degree to which I am obligated to accept punishment for my misdeeds is proportional to the consistency and fairness of the system of justice. If others are able to walk away from the consequences of their misdeeds or enjoy light punishments for misdeeds that would result in harsh penalties for me, then I have little moral reason to willingly accept any punishments that might be inflicted on me. Naturally, the state has the power to inflict its punishments whether I accept them or not, but it seems important to a system of justice that the citizens accept the moral legitimacy of the punishment.

To use an analogy, imagine a professor who ran their class like the justice system is run. If an elite student cheated and got an initial grade of 100, they might be punished by having the grade docked to an 80 if caught. In contrast, the common students would be failed and sent before the academic misconduct board for such a misdeed. The common students who cheated would be right to rebel against this system and refuse to accept such punishments—though they did wrong, justice without consistency is but a mockery of real justice.

In light of this discussion, Wells Fargo is yet another shining example of the inherent injustice and inequality in the legal system. If we wish to have a just system of justice, these disparities must be addressed. These disparities also warrant moral disobedience in the face of punishment. Why should, morally, a shoplifter accept a fine that vastly exceeds what they stole when a financial elite can pay but a fraction of their theft and profit well from their misdeeds?


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Philosophers (including me) on the Ethics of Voting

I, and other philosophers, were recently interviewed by Quartz about the ethics of voting. The article is short, but an interesting read. I am, of course biased.

Here is the link:

Ethicists say voting with your heart, without a care about the consequences, is actually immoral

Antibiotics & the Cost of Agriculture

Modern agriculture does deserve considerable praise for the good that it does. Food is plentiful, relatively cheap and easy to acquire. Instead of having to struggle with raising crops and livestock or hunting and gathering, I can simply drive to the supermarket and stock up with the food I need to not die. However, as with all things, there is a price.

The modern agricultural complex is now highly centralized and industrialized, which does have its advantages and disadvantages. There are also the harms of specific, chosen practices aimed at maximizing profits. While there are many ways to maximize profits, two common ones are to pay the lowest wages possible (which the agricultural industry does—and not just to the migrant laborers, but to the ranchers and farmers) and to shift the costs to others. I will look, briefly, at one area of cost shifting: the widespread use of antibiotics in meat production.

While most people think of antibiotics as a means of treating diseases, food animals are now routinely given antibiotics when they are healthy. One reason for this is to prevent infections: factory farming techniques, as might be imagined, vastly increase the chances of a disease spreading like wildfire among an animal population. Antibiotics, it is claimed, can help reduce the risk of bacterial infections (antibiotics are useless against viruses, of course). A second reason is that antibiotics increase the growth rate of healthy animals, allowing them to pack on more meat in less time—and time is money. These uses allow the industry to continue factory farming and maintain high productivity—which initially seems laudable. The problem is, however, that this use of antibiotics comes with a high price that is paid for by everyone else.

Eric Schlosser wrote “A Safer Food Future, Now”, which appeared in the May 2016 issue of Consumer Reports. In this article, he notes that this practice has contributed significantly to the rise of antibiotic resistant bacteria. Each year, about two million Americans are infected with resistant strains and about 20,000 die. The healthcare cost is about $20 billion. To be fair, the agricultural industry is not the only contributor to this problem: improper use of antibiotics in humans has also added to this problem. That said, the agricultural use of antibiotics accounts for about 75% of all antibiotic usage in the United States, thus converting the factory farms into for resistant bacteria.

The harmful consequences of this antibiotic use have been known for years and there have, not surprisingly, been attempts to address this through legislation. It should, however, come as little surprise that our elected leaders have failed to take action. One likely explanation is that the lobbying on the part of the relevant corporations has been successful in preventing action. After all these is a strong incentive on the part of industry to keep antibiotics in use: this increases profits by enabling factory farming and the faster growth of animals. That said, it could be contended that the lawmakers are ignorant of the harms, doubt there are harms from antibiotics or honestly believe that the harms arising from their use are outweighed by the benefits to society. That is, the lawmakers have credible reasons other than straight up political bribery (or “lobbying” as it is known in polite company). This is a factual matter, albeit one that is difficult to settle: no professional politician who has been swayed by lobbying will attribute her decision to any but the purist of motivations.

This matter is certainly one of ethical concern and, like most large scale ethical matters that involves competing interests, is one that seems best approached by utilitarian considerations. On the side of using the antibiotics, there is the increased productivity (and profits) of the factory farming system of producing food. This allows more and cheaper food to be provided to the population, which can be regarded as pluses. The main reasons to not use the antibiotics, as noted above, are that they contribute to the creation of antibiotic resistant strains that sicken and kill many people (vastly more Americans than are killed by terrorism). This inflicts considerable costs on the sickened and those who are killed as well as those who care about them. There are also the monetary costs in the health care system (although the increased revenue can be tagged as a plus for health care providers). In addition to these costs, there are also other social and economic costs, such as lost hours of work. As this indicates, the cost (illness, death, etc.) of the use of the antibiotics is shifted: the industry does not pay these costs, they are paid by everyone else.

Using a utilitarian calculation requires weighing the cost to the general population against the profits of the industry and the claimed benefits to the general population. Put roughly, the moral question is whether the improved profits and greater food production outweigh the illness, deaths and costs suffered by the public. The people in the government seem to believe that the answer is “yes.”

If the United States were in a food crisis in which the absence of the increased productivity afforded by antibiotics would cause more suffering and death than their presence, then their use would be morally acceptable. However, this does not seem to be the case—while banning this sort of antibiotic use would decrease productivity (and impact profits), the harm of doing this would seem to be vastly exceeded by the reduction in illness, deaths and health care costs. However, if an objective assessment of the matter showed that the ban on antibiotics would not create more benefits than harms, then it would be reasonable and morally acceptable to continue to use them. This is partially a matter of value (in terms of how the harms and benefits are weighted) and partially an objective matter (in terms of monetary and health costs). I am inclined to agree that the general harm of using the antibiotics exceeds the general benefits, but I could be convinced otherwise by objective data.


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