More untimely stuff about disability

I don’t understand Nussbaum’s point in the first paragraph you’ve included. Rawls absolutely argues that a full scheme of health care be available to everyone in society. From the restatement: “[health care] falls under the general means necessary to underwrite [fair equality of opportunity] and our capacity to take advantage of our basic rights and liberties, and thus to be normal and fully cooperating members of society over a complete life” (174)

And this is certainly not the only justification given for health care in Rawls’s work. In the more concrete stages of his though, he suggests that universal health care is a necessary feature of a property-owning democracy, and indeed required for any decent liberal society.

Is Nussbaum’s misrepresentation of Rawls’s thought just the result of a careless/uncharitable reading? Or does she have something else in mind I’m not picking up?

now he knows more about the Beatles’ oeuvre than most of the people in this room. His interest in Star Wars and Galaxy Quest has given him an appreciation of science fiction, just as his fascination with Harry Potter has led him to ask questions about innocence and guilt. He is learning a foreign language, having mastered the “est-ce que tu” question form in French and being able to charm young women at the cheese counters of French supermarkets by saying “je voudrais du fromage de chèvre, s’il vous plait.” I confess that neither of us has the least interest in chatting about the latest Woody Allen movie; but perhaps Professor Singer will be interested to learn that Jamie and I have had a running conversation over the past five years about the film Babe, which introduced Jamie not only to the question of whether it is right to eat animals but also to the fact that there are various theories out there as to why humans eat some animals and not others.

Michael, it sounds as though you’re arguing here that not all people with Down’s Syndrome are what Singer (or most of us, anyway) would call severely cognitively impaired rather than against the claim that “it is less wrong, all other things being equal, to kill someone with severe cognitive impairments than to kill you or me.”

Also, what if Singer had set the bar lower and instead of “to play the guitar, to develop an appreciation of science fiction, to learn a foreign language, to chat with us about the latest Woody Allen movie, or to be a respectable athlete, basketballer or tennis player” had said “to use language at all, to play a sport at any level, to watch a movie or distinguish between music and noise”?

I know you’ve written a lot about this, probably on CT as well, so feel free just to refer me somewhere else.

While I’m basically on your side on the substantive issues, the “historically contingent” move, which non-philosophers routinely make against moral philosophers (like me) always seems passive-agressive. If you agree with him about squirrels, what does adding that the agreement is historically contingent add? Perhaps recognition of our own fallibility, and hence the possibility that you are both wrong? But then, why not just say that? Sure, we are fallible, and all our judgments should be a little bit tentative in recognition of that fact. More urgently, we should try to figure out which of our moral intuitions is false, and, better, figure out what to replace them with. Observing that maybe, one day, people will disagree with us about squirrels..well, so what? The issue is, what will their reasons be, and if you can say something about those, you should say them right now, so we can think about them. Those reasons might force us to give up our intuitions right now (or they might not, because they might not be very good reasons).

I’m bemused that McMahan was uncomfortable recognising the extent to which his view relies on intuitions at the bedrock — in fact in your account it sounds as if he was fairly upfront about it. Most of us use some version of reflective equilibrium as our basic method in moral philosophy, and while we think it gets use further than just asserting intuitions, we do see intuitions (that is, reflective judgments) as key resources, and the method of reflective equilibrium is designed to launder them. Sociologists point out that our intuitions are shaped in part by our own social and cultural position; that is right, and that is a reason for lamenting the fact that analytical philosophers (like literature professors) are not a very socially or culturally heterogenous bunch, and to draw others into a process of wide reflective equilibrium. I doubt that McMahan disagrees with this. But as Matt says, none of this implies that morality is intuition all the way down, any more than the fact that all observations are theory dependent implies that science (or worse, the world) is intuition all the way down. There are facts, and we have limited resources for getting at them because we are epistemically imperfect, and we have to do the best we can, by offering, imagining, and scrutinising reasons. Sometimes people can get too attached to positions they hold, and this makes them less responsive to reasons than they should be (never happens to you or me, of course), but it is the person, not the method, that is at fault.

This paper by Jeremy Waldron is long and inconclusive, but well worth reading:

http://weblaw.usc.edu/academics/assets/docs/waldron.pdf

I actually don’t have a problem with assigning moral worth based on “humanness” – after all, all species that are a product of natural selection are strongly programmed to favour their own over others, and it could hardly be otherwise.

I’d also suggest that while the principle of “all human beings have the same moral worth” is a workable one, that generally seems to produce good results, the principle of “all life has the same moral worth” is simply impossible, as clearly nobody can claim that destroying a bacteria responsible for a nasty disease is morally equivalent to killing a human being. I don’t have a good answer as to how we should determine the moral worth of non-human lifeforms and the morality of killing such lifeforms, but degree to which pain and fear is experienced seems intuitely important, and certainly I feel uncomfortable consuming animal products where there’s some reason to believe that insufficient attempt was made to minimise pain and fear among the animals providing the products. But I’m not entirely sure what a rational argument justifying this position would look like, given that we don’t apply it among born humans: it’s no less immoral to kill a human who is physically incapable of suffering pain and fear than one who is. But many of us (myself included) do accept it’s less immoral to kill a developing human foetus than any born human – even a born human who is known to be incapable of experiencing pain or fear. But I wonder what I would feel about a human foetus growing in an artificial womb…

I saw a young man hunched over a computer game, and then I noticed you leaning over his shoulder. “Hey,” I thought, “that’s Jamie Bérubé!”

It was a little bit of a thrill, spotting a celebrity out in public.

Let me also add that I greatly appreciated your response to McMahan. It helped clarify for me why the sessions with Singer and McMahan seemed not just nauseating but sterile. It seemed like no one said anything new and nobody altered anyone’s opinion; the time was wasted, unproductive. Some of the people at the conference may have hoped that they could demonstrate “deep moral facts” to Singer and McMahan. I think that must have been why they were invited. I’m cynical enough to think that most people reason from their conclusions to their premises. No one is going to change Singer’s mind by pointing out a flaw in his logic, nor is Singer going to demonstrate to you that Jamie is comparatively less human than a philosophy professor. Incompatible premises can battle it out in politics and poetry, but in philosophy they just talk past each other. I thought you added an important political note by describing the history of moral status claims, and Prof. Kittay reached toward poetry towards the end in describing her relationship with her daughter.

“Why not judge on reproductive fitness? It is a nice clean measure of moral worth that is rooted deep in biology and history.

Ack! No no no no no no no. Down that road lies the conviction that three generations of imbeciles are enough. I ain’t a-goin’ there.”

To be clear, I was being sarcastic with that suggestion, and I think you were with the response but internet nuance can be tough. ;)

I guess I don’t understand why intuition about cognitive ability or not works but intuition about intrinsic human worth doesn’t. I know you can’t be expected to answer since you don’t buy into the cognitive ability question as controlling. But I remain mystified.

“Jeff, I think the reason you haven’t yet heard a cogent argument against your position is that you won’t accept a pragmatist argument as cogent. But let me give it a try. I’m not going to rely on concepts like ‘intrinsic human worth,’ but I can try to learn a little from history. And let’s imagine that we might have learned—very slowly, very gradually, because as a species we’re really not very bright about such things—that every attempt to banish some humans from the category of rights-bearing beings, every attempt to lop off some members of the human family, has had vicious and catastrophic results. ”

Why not extend this argument to the unborn? The moral acceptability of abortion is, Thomson notwithstanding, dependant upon the claim that the fetuses being aborted aren’t people (there might be a couple cases where that isn’t quite true, but to rely on those would exclude the vast majority of currently legal results).

And notice, you can’t use the dependency argument here, since the severely mentally handicapped are also dependent. You can’t use the “they aren’t really people” argument because you just said that all such arguments need to be thrown out. And you can’t say that, pragmatically, legalized abortion serves interests of “society” or the “community” better because whose interests count is precisely at issue here.

“I knew that writing a chapter about the ethics of selective abortion w/r/t fetuses with disabilities would alienate at least half my potential readership, so I decided to shoot for three-quarters instead.”

These are the words of a controversialist who relishes polemic. Who needs a search for truth when the cut and thrust of a fine wit is so ready to hand? Whatever merits the deep intuitions of a philosophical hipster may be, they certainly do not include humility.

Or you could point out that empathy and a willingness to learn are cognitive capacities, essential for learning and rock-bottom necessities to ground moral agency. Since you’ve got the self-restraint not to pound in the obvious, unlike me.

If you’re simply talking about cognitive ability, you don’t need to go back as far as foetuses – even newborn human babies don’t have significant cognitive ability compared to fully able adult humans, and presumably even compared to fully able adults of various other species. But very few would claim that it was less immoral to kill a human baby than even the most cognitively developed adult chimpanzee. Here our natural instincts as a species come into play: our genes are programmed to value the human baby more, because the sorts of genes that control our instinctual moral reasoning are significantly more likely to have copies inside the baby vs the chimp*, and we also possess genes that make us naturally protective towards babies, because if we didn’t care for and protect them uniquely human genes wouldn’t survive at all.
Given that our genes are so programmed to protect humans other other species, and we can’t avoid being products of our genes, any moral philosophy that doesn’t treat humans as a special case is surely likely to lead to conclusions that the vast majority of humans simply couldn’t bring themselves to accept.

* For any random gene it may well be the case that it has a better chance of being reproduced by the chimp, simply because adult chimps have ~99% of our genes and can definitely reproduce, whereas human babies have only slightly more of our genes, and are at significant risk of not surviving long enough to reproduce. But for the sorts of genes that do control our instinctual preference for human babies over chimps, this logic is quite different, as such genes are largely uniquely human, and chimps probably don’t carry them at all. In an each-gene-for-itself world, this is what matters. As yes I’m probably using gene when I should be using allele.

Really great post, Michael, thanks.

“I’m just not buying the utilitarian calculus at all, no matter where Singer sets the bar. The fact that he underestimated the potential of some people […] is in itself, for me, reason enough to resist any moral calculus that involves a performance criterion for being human.”

I tend to think Harry is completely correct in his comments. Perhaps one way of phrasing it is this: A lot of moral philosophers will see their job as the first-order one of trying to find the truth of the matter, and putting forward arguments and reasons that support why they think what they do. But it’s a different project – a second-order one – to allow facts about human uncertainty and epistemic fallibility to enter into our calculations. The argument “McMahan is a pretty clever guy, so he knows more than me, so I should hold his view” probably has some force in one sense, but it’s not an argument philosophers are likely to accept for their purposes. Equally, “Singer made a bad mistake, so other people with the same views are probably making mistakes too” possibly has force in one sense, but it’s not an argument philosophers are likely to accept for their purposes.

If philosophers were doing the latter project, they would do more history, sociology and so on, in order to judge just how “historically contingent” their views were. But that’s not their project. Of course, that makes things more complex when you try and work out just how much relevance moral philosophy does have for the choices we have to make here and now. I take it that this question is where all of the non-ideal theory comes in, and matters here are going to need a greater sense of our own fallibility and so on (which, obviously, isn’t the same as ignoring philosophical arguments, but perhaps just qualifying them to a greater extent).

But it is important to seperate out two different projects here, and not charge people with doing something wrong for not pursuing the project you thought they were.

Oh, and a final point: One reason why “our moral intuitions will be different in 1000 years” doesn’t hold much weight even for the latter kind of project is that they could change in the other direction. Perhaps we’ll find in 1000 years that we’re less tolerant of disabled people: I doubt this possibility changes your views on the matter, so why should the reverse possibility change McMahan’s?

“One of Nussbaum’s arguments about surrogacy, fyi, was that guardians of adults with cognitive disabilities should be entrusted with voting on behalf of those people if they can’t vote on their own, because otherwise people with significant cognitive disabilities will be stripped of one of the important features of citizenship.”

Why wouldn’t they be able to vote on their own?

Surely, the “deep moral fact” here is that McMathan knows that there are bound to be people in his audience who have sons, brothers, sisters, etc who have Downs’ Syndrome, but there are not any people in his audience who have family members who are squirrels. The defining property of what counts as human is that they can have particular kinds of relationships with other humans (defined from some arbitrary paradigm case if you must), and family and kinship relations are a) an important kind of the relevant relationships, b) factually, a large part of the reason why we care (in the sense of attribute moral value to) about some mammals and not others. I suspect McMathan would say that there was nothing intrinsically worse about shooting a squirrel that happened to be a beloved family pet, but I bet he’d be surprised how few takers he got.

How would guardians voting for the disabled pair up with parents getting extra votes for their [minor] children? Apart from the fact that the latter suggestion would sell the USA to those ‘Quiverful’ nutters…

Excellent post, and some interesting comments (especially from Harry B).

But I don’t really understand what method it is that you think Singer and McMahan are using, and shouldn’t be. They’re reasoning about what we ought to do. Like all reasoners, they need places to start – we could call these starting places ‘intuitions’, but that obscures the various differences between them (they include exemplary stories, familiar imagery, more or less educated emotions and perceptual capacities, learned principles, pious hopes, etc.). Singer’s typical method is to reason his way through this thicket by discovering, and trying to remove, tensions between the different ways these different starting-places point. For instance: we think that like cases ought to be treated alike, and we don’t think that distance is a relevant difference, but we do think – incoherently – that we are blameworthy for not pulling a drowning child out of a nearby pond, but not blameworthy for not sending some money to UNICEF, which would also save a child’s life (lots of lives, in fact). We should therefore, if we’re to act rationally, send some (lots of) money to UNICEF. This is a consistency argument, not an attempt at a Cartesian deduction of the fundamental truths of ethics.

One might well argue that Singer takes too little account of some of these starting-places in his reasoning. But there isn’t, so far as I can see, an alternative, ‘intuitions all the way down’ method of not doing the reasoning. That just leaves us stuck in the thicket.

I want to suggest that your problems with Singer and McMahan are substantive disagreements about the capacities of (e.g.) people with Down syndrome and about the moral significance of human responses to one another (including those of us with Down etc.), not issues about method at all. The foundationalism/anti-foundationalism debate is just beside the point.

Lex — I agree that parents shouldn’t automatically get to vote as many times as they have children plus one, but it is not unprogressive to think that children’s interests should be represented in government policy somehow. There are better and worse ways of doing this depending on the circumstances, and in some circumstances giving parents extra votes might be the best — or least bad — way.

Now, my good man, please tell me where you disagree with my argument about abortion and disability. Where precisely am I cool instead of correct?

To the degree that I can actually discern a coherent argument, it seems that the answer you pose to ethical and policy questions generally considered to be formidable is “all of the above.”

I remain unpersuaded that there are transcendent moral virtues to be advanced by compelling such parents to bear children with disabilities. For that reason I have insisted that it is more consistent with the principles of democracy for people like me to persuade prospective parents and genetics counselors not to think of amniocentesis as part of a search-and-destroy mission, and to persuade them that many people with disabilities, even those disabilities detectable in utero (like Down syndrome), are capable of living lives that not only bring joy and wonder to those around them but are fulfilling and fascinating to the people living them as well. But I will not argue that some forms of childbirth should be made mandatory, nor will I demand that prospective parents be barred from obtaining genetic information about the fetus if they desire such information.

Society is to endorse and economically underwrite the entire spectrum of personal, religious, and “intuitive” choices made by its members regarding the conception and rearing of disabled children. From this non-decision, some wise democratic consensus will magically arise.

It would be amusing to apply this “method” of inclusive policy making to such issues as polygamy, indentured servitude, slavery, and paid harvesting of human organs. What splendid pluralistic outcomes we could enjoy if we would allow a thousand flowers of choice to bloom.

“he’s pretty good at exposing some of our cherished moral axioms as simply moral intuitions. ”

I don’t understand what this means. What is the functional difference between a moral axiom and a moral intuition that you believe? It sounds like you are saying that he is really good at exposing ‘A’ as ‘A’.

If it’s intuitions all the way down, then in my opinion religiously-based intuitions are just as reasonable as any others. So on “who counts as human?”, I’m happy with the imago dei view. (“Man, being made in the image of God, has inalienable dignity, and should be loved, cherished, and respected, from conception until natural death.”)

Or, to pose it as a question: is there any sense in which intuitions can be “public reasons”, or are they inherently private reasons (even if very broadly shared)?

Berube:

1) Did McMahan ever cite Down children as examples of human beings with “severe and profound cognitive impairments”? I’ll bet you dollars to donuts he didn’t, because they’re well above the threshold of cognitive capacity he requires for personhood, rights, etc. If so, your references to them in connection with him are a red herring.

2) Would you have been content with your “pragmatist” argument in other cases, e.g. facing the Holocaust? “I’m not certain that it’s impermissible to slaughter Jews, but given human fallibility you Nazis can’t be certain that it’s permissible. So the safe course is not to slaughter them.” Wouldn’t you have wanted a somewhat more, ah, robust argument than that? And mightn’t we then want to know how far that more robust argument extends?

This is why I don’t find Nussbaum’s critique of Rawls convincing (if I understand it): As Rawls designs the original position, parties to the contract need to consider that, yes, they may indeed show up in the society as disabled, even profoundly. This consideration will certainly inform the basic structure they are willing to approve.

Apparently if I try to use my full name my comment goes in to moderation. But, anyway, the “matt” in #5 is me, who normally comments here, and the “matt” in #50 is someone else who I wish would use a different name in recognition of an internet tradition and all so that we’re not confused. That I might agree with him here (though I’m not sure) makes the confusion more possible.

I suspect that some people commenting in this thread have read Rawls, Nussbaum, Walzer, and Singer while others have not but really like the sound of their own voice.

Call me crazy, if you must.

Forget discussing the latest (probably awful Woody Allen movie), how about becoming homecoming king?
Here’s one for Singer:

Best, Lawrence

SamChevre: I think that’s a really good question, but am not willing to answer it on this thread (because a) I want to think more carefully about my response and b) weaving an answer into this discussion i beyond my limited cognitive capacity). I’ll ponder it a bit and see if I have something useful to say.

Michael: Singer in

… the principle of equality is not based on any actual equality which all people share. I have argued that the only defensible basis for the principle of equality is equal consideration of interests, and I have also suggested that the most important human interests — like the interest in avoiding pain, in developing one’s abilities, in satisfying basic needs for food and shelter, in enjoying warm personal relationships, in being free to pursue one’s projects without interference, and many others — are not affected by differences in intelligence.

I am still confused as to what Singer said in contradiction.

Our resources are limited. That is why parents discriminate among their own children. The musically talented child will receive the advanced piano lessons. The natural athlete will receive the expensive running shoes. Society’s resources are also limited, thus utilitarian schools of social philosophy try to align ethics with economics.

Sweeping away everything we have learned about rationing resources among individuals to clear the path for “intuitive” thinking about treating the disabled puts us into uncharted territory. What is the intuitively correct level of investment in a disabled child? If one discards utility, the answer is infinite, because there is no limit to the enhancement of an individual’s abilities through careful and costly nurture.

HH, perhaps our “intuitive” thinking is generally good enough because it has been shaped by millions of years of natural selection?

After all, our intuitive thinking towards disabled individuals isn’t to “do everything possible to help them succeed”, but rather to acknowledge that by relatively minor sacrifices on our own part, we can significantly improve their lives. And we are rewarded for this: for most humans it makes us feel good when we help the less advantaged. It’s obviously a successful evolutionary strategy.
I would argue that if it were otherwise, then the vast majority of all humans would strongly feel that significantly disabled people should, for instance, be left to die and would probably feel satisfaction – a warm inner glow even – at seeing society rid of such a drain on its resources. In such a world any sort of legal or moral framework that gave disabled people the same rights as the rest of us would never even get off the ground, no matter how well it might be logically supportable.

I accept BTW that our intuitions are shaped by the culture of the day as well as our evolutionary past, but I think there are limits to how much cultural expectations can control the degree to which we feel good when helping others. Does anyone know of any good scientific studies of nature vs nuture behind moral intuitions?

One is here, on earth, surrounded by craziness and people trying, in the midst of it, to lead human lives, lives with the humanity left in.

This is a splendid glimpse of the artistic perspective on life. The glorious circularity of being more human by showing greater instinctive humanity is the perpetual motion engine that powers the magical humanistic faith. (Trust the Force, Luke!)

The ancient Aztecs determined that their “humanity” required ripping the beating heart out of a sacrificial victim to assure that the sun would maintain its vital transit across the sky. This was the perfectly natural and widely accepted consequence of people trusting their intuitions.

I think we can do better.

HH, of course we can do better than just accepting our intuitions. But I think it would be folly to completely ignore them, especially in areas where they have obviously been helpful in maintaining our survival for the last several hundred thousand years. Of course many humans intuitions are wrong largely because we live in such a different world to the one we evolved in, or because there was insufficient evolutonary pressure for correct intuitions to form (e.g. intuitions about the fundamental laws of physics or chemistry are usually wrong), but our “moral world” isn’t that much different today than 200,000 years ago, and it’s usually only in areas where it is different (e.g. our technological capacity to keep humans alive) that intuitions become problematic.

NPOV (#s 66 & 68) has preempted me in some ways, although I think in others we are likely to disagree. In trying to understand where “intuitive commitments” come from we need to think in evolutionary terms – both as literal biological evolution and in the evolution of social structures. As a matter of biological evolution, we have developed emotions and intuitions that lead us to sacrifice short-term self interest in favor of the interests of our children and other close relatives. This makes us no different from many other species. Where we are different is that, as a matter of social evolution, we have built on this platform to extend the suppression of short-term self-interest to favor other members of our local society who are not biologically related to us.

As societies develop and mutually beneficial interactions among strangers become the norm, the scope of the suppression of self-interest extends to include people very different from ourselves. In a pre-modern society, any stranger is fair game for robbery. Societies that have been successful in building very large social orders are those that have scaffolded an ability to suppress self-interest in favor of strangers onto the evolved ability to suppress self-interest in favor of family members. The extension at first is virtually never to all humanity. Instead it is to larger groups that can be analogized to the family – the church, the tribe, the nation, the language group, the race. If a society can’t do this, it can’t grow. So the societies that all of us belong to are able to do it. And they do it by inculcating children with the “value” of suppressing short-term self-interest in favor of a larger group. It has nothing to do with morality and everything to do with evolutionary success.

The extension of this suppression of self-interest in favor of others is conceptualized as “rights.” We say that people “have rights” when what we mean is that certain things are prohibited even though, in a world of unbridled self-interest, those things might be done to them. And we hypothesize that these rights “are” (or perhaps “should be”) co-extensive with all of humanity. Then we argue further about the proper borders of these rights – are chimpanzees in or out? Are people in a persistent vegetative state in or out? -without ever recognizing that the entire rights concept has no foundation. It is merely a construct that posits that an evolutionarily created rule of behavior has non-historical and non-evolutionary content.

Michael,

Great post, as usual. My thoughts are here:

http://www.medhumanities.org/2008/10/on-values-disab.html

If you do manage to read all the way down, you’ll note I don’t think we need face a choice between devotion to moral principles and moral intutitonism. There are variants of moral thinking, including one I am partial to (moral particularism) that simultaneously rejects generalism or principlism in morals but maintains that morality is not reducible to intuitions.