Friday, October 19, 2012

The Duty to Extend the “Biological Warranty Period” (Part 4)

For the past few months (see here, here and here) I've been reflecting on the link between the following moral principle (from Singer) and practical aspiration:
Duty to Aid: If it is in our power to prevent something very bad from happening, without thereby sacrificing anything else morally significant, we ought, morally, to do it.

Practical Aspiration: decelerating the human rate of molecular and cellular decline (i.e. slowing the rate of biological aging).

The principle is of course Singer's famous moral principle invoked in 1972 to raise greater awareness about global poverty. So how can this principle be employed to get to the practical prescription I believe is imperative for addressing the health challenges of today's aging populations? To see the connection, a great deal of empirical and theoretical work must be done. In this post I will focus on the theoretical work that must be done.

I will focus on what I take the limitations of Singer's principle to be, limitations which make it unlikely that the principle will be of much help in tackling global poverty or any other issue that is more complex than the issue of saving a drowning child from a pond.

As originally stated, Singer's duty to aid only tracks two important variables:

(a) the magnitude of the harm in question (e.g. lack of food, shelter and medicine).

(b) the cost of intervening to prevent that harm.

So what is ignored? I believe there are (at least) two other important variables that must also be considered:

(c) the probability that intervening will result in the prevention of harm.

(d) the magnitude of the benefits of preventing the harm in question.

(a third variable is the probability that the harm of non-intervention will be realized, but I won't complicate matters further by addressing that point here)

These two further variables come into sharper focus when we attend to the realities of disadvantage, and combating disadvantage, in the real world.

As originally stated, Singer's duty to aid is an impotent moral principle for guiding moral action in the real world because it assumes that the relevant harms in question (i.e. suffering and death from poverty and lack of medicine) can be prevented with 100% certainty and it provides insufficient details concerning the relevant benefits (i.e. prevention of suffering and death from lack of food and/or medicine permanently?, for 2 days? for 20 years?). His famous example of a child drowning in a pond example clearly illustrates this. Let me expand upon that example.

Singer asks us to imagine you are walking by a pond and notice that a child is drowning in that pond. You could save the child's life if you jumped into the pond (thus making the modest sacrifice of getting your clothes wet). But notice that in this scenario there is a 100% certainty that intervention will result in success. Furthermore, because it is a child drowning, it is also the case that "preventing the child from drowning" will result in "adding 60-70 years of additional life". And these two factors thus make the intuitive force of the duty to aid the drowning child very stringent.

However, when Singer moves to the example of helping the poor in distant lands, he insists that the probability of preventing suffering and death from lack of food, shelter and medicine is also a certainty with little regard for the magnitude of the benefits of intervention (beyond saying "it prevents suffering and death"). Here is a very telling passage which illustrates this first point:

From the moral point of view, the development of the world into a "global village" has made an important, though still unrecognized, difference to our moral situation. Expert observers and supervisors, sent out by famine relief organizations or permanently stationed in famine-prone areas, can direct our aid to a refugee in Bengal almost as effectively as we could get it to someone in our own block. There would seem, therefore, to be no possible justification for discriminating on geographical grounds. (232)

In the 40 years since Singer wrote that statement we now know that the story of humanitarian aid is, at best, a mixed story of both failures and successes. Effectively combating global poverty has proved to be much more challenging and complex than Singer presupposed in 1972 (see this article). The expert observers and famine relief organisations did not always pursue policies that helped (in the long term) the poor. Indeed, sometimes they made, despite good intentions, the situation even worse.

And this is related to the second issue Singer's principle and example obscure. By characterizing the goal of intervention as "preventing suffering and death" one presumes Singer means permanently preventing (i.e. eliminating) the suffering and death of lack of food, shelter and medicine. And thus his claim that it is just as easy to help a refugee in Bengal as it is a poor neighbour down the street is obviously false. Assuming the neighbour down the street lives in a society with access to clean drinking water, security (e.g. effective police force), a strong economy, etc. the odds that providing some food to them will, in the long run, prevent them suffering and dying from poverty are much higher than the odds facing the person who lives in a less developed country that is plagued by infectious disease, lacks basic sanitation, is prone to civil war and conflict, etc.

Singer deliberately limits his principle to refer only to "the prevention of harm", rather than suggest the duty requires us to benefit others (see p. 238). He wants to avoid suggesting that others are morally required to benefit others as that could would lead to a principle of max utility that would enslave everyone to work for the greatest happiness of the greatest number. Singer's principle only instructs us to prevent avoidable suffering and death, in a world devoid of those harms you are morally free to do as you wish. But by avoiding the proposed benefits of intervention Singer's principle becomes untenable for very few harms can be permanently eradicated, even in the richest of countries.

The point of giving to humanitarian aid is not just to "prevent suffering and death", more details must be given. What if, for example, the intervention only prevents suffering and death for 5 days? Or 5 weeks? Or just 5 months or 5 years? Shouldn't this matter to the stringency of the duty to aid? Singer's moral principle, as stated, obscures such considerations by defining the benefit of intervention in such vague terms.

How could we improve Singer's principle, so that it could function at the operational level of the real world where there are pervasive forms of suffering and death, where interventions can range from low probability to high probability of success, and the magnitude of the benefits of intervention can range from short-term (prevent suffering and death for a few weeks or months) to the long-term (prevent suffering and death for the foreseeable future).

To see the relevance of these issues consider again Singer's simple example of the drowning child. Rather than the simple case where the probability of saving the child is 100%, imagine a case where there is only a probability of success. So you are walking between 2 ponds, and each pond contains a drowning child. In one pond, the child has just fallen in and will drown in the next few minutes unless you (the only person around) save her. If you act quickly you can make it to her in time and save her life 100% guaranteed. In the other pond is a drowning boy who, you can infer, has been drowning for a few minutes already and has now stopped moving. If you act quickly you may be able to revive him before he dies. However, because he is unconscious already, there is only a 50% chance that you can save his life.

What do you do? Singer's original principle does not help us in this case because the principle only applies in the cases where the possibility of aiding is 100%. In the case I have now described, I suspect most people believe the duty to aid should be influenced by the probability of success. With the numbers presented in my case, most probably feel that we would be morally obligated to rescue the child with the 100% survival probability. This guarantees at least one child will live, and that is better, all else being equal, than doing an act with a 50/50 chance of saving 1 life.

If we alter that example slightly further now, so that there is only the 1 pond and the only child drowning is the child with a 50/50 of surviving, do we feel the duty to aid is significant enough to warrant the action of getting one's shoes and pants wet? Yes. Why? Because the probable prevention of suffering and death is something we are obligated to pursue when the sacrifice involves nothing of moral importance.

From these kinds of examples we can generate the following "rule of thumb": the greater the chances are that we can prevent serious harm, the more stringent the duty to aid is.

It is important that this point be made for those who wish to invoke a Singer-like argument to tackle poverty. Suppose a critic says that global poverty is just inevitable. Singer might respond, as he does, by saying "Poverty can be eliminated, and helping the poor in distant lands is just like helping the poor in one's own country". The critic might respond that this is a real stretch of the truth. Many of the poor living in distant lands face problems the poor in our own country do not face, such as infectious disease, lack of sanitation, the "resource curse", etc. So the critic is sceptical about the likelihood that any action they could undertake, either as an individual or collectively as whole society, will prevent poverty. As stated, Singer's principle assumes the chances of success must be 100%, but in the real world there are very few guarantees of anything. A principle that takes the probability of success seriously is more likely to lead to sage moral decision making.

Let us now imagine some scenarios that illustrate the importance of also considering the magnitude of the benefits of aiding others. Imagine there are two ponds, each with a drowning child. You only have time to save only one child. If you save the first child then it is reasonable to expect that they can live an additional 60+ years of life. But the child drowning in the other pond suffers a rare and incurable heart disorder they just contracted earlier that week. You recognize the child from a news story you watched that very morning. This disorder impairs the proper functioning of their heart, so each day there is a 50% chance the child will suffer a fatal heart attack and not live to see another day. If you save this child from drowning there is a 50% chance they will die tomorrow from the heart attack, a 50% chance they would die the following day if they survive, and so on until their luck runs out. So while you can prevent this child drowning and dying today, it is a certainty that they will suffer and die from another cause within the next days. Who do you save? Should the magnitude of the benefits factor into your deliberations? Are they morally relevant?

As stated, Singer's moral principle does not treat such considerations as morally relevant. All that matters is that you save a child from drowning. And when extended to the context of global poverty, all that matters is you prevent people suffering and dying from poverty. But in real life the magnitude of the benefits of interventions do matter. Consider the case of poverty. Suppose that, when Singer was writing in 1972, there existed two international aid agencies you could donate money to to aid the poor in other countries. The two agencies took different approaches to poverty. Agency A focused on shipping food and clothes to this poor country, so with you donation enough food could be shipped to feed 100 people for 6 months. Agency B takes a different approach. Instead of spending charitable donations on food they buy modern agriculture equipment, build wells and schools so that the poor can become self-sufficient and escape poverty. With your donation enough equipment and education could be provided to feed 100 people for the rest of their lives. Both agencies fulfill the criteria detailed in Singer's principle- they both prevent suffering and death. But the magnitude of the benefits are very different. Charity B eliminates poverty for 100 people, while agency A simply postpones the problems for a couple of months. You have to decide which agency to donate your money to. Should the magnitude of the benefits of aiding matter? Yes. How can the duty to aid be modified to track such a consideration?

Ok, so bringing all these points together, here is what I propose we do:

Singer's original duty to aid: If it is in our power to prevent something very bad from happening, without thereby sacrificing anything else morally significant, we ought, morally, to do it.

To make this principle sensitive to the probability that intervention will be successful, we need to add the proviso : All else being equal, the greater the likelihood that we can prevent something very bad from happening, without thereby sacrificing anything else morally significant, the greater the moral duty to do it.

And to make this principle sensitive to the magnitude of the benefits of intervention, we need to add: All else being equal, the greater the likelihood that we can prevent something very bad from happening, without thereby sacrificing anything else morally significant, the greater the moral duty to do it. Furthermore, the greater the benefits of preventing something very bad from happening, the greater the moral duty to do it.

This principle can be a useful moral compass for tackling the dilemmas that arise in a world with limited resources and pervasive suffering, disease and death. More to follow on moving from this principle to tackling the rate of biological aging.