Main

November 14, 2009

To get started...

To start us off easy, I'll direct your attention to some provocative blog posts.

Via Deliberate Agrarian, this gem:

Currently, myself and many of my friends are on varying forms of state aid [...]

With this in mind, I've compiled a simple list of rules (or perhaps, "guidelines") to help minimize the embarrassment and discomfort of taking public assistance.


1. Don't be dirty. Present yourself in as hygenically-perfect a condition as possible. [...]
2. Don't be clean. But remember, you are poor. You shouldn't be able to afford things like shampoo, or fresh laundry, etc. [...]
3. Never engage in any luxury activity at all, ever. Remember, you are currently taking public aid, which means of course that you must never, ever, find any way to enjoy your life that costs any amount of money at all. [...]
3a. In addition to money-costing activities, also remember that free activities that you might enjoy are also forbidden. [...]
4. Never possess any item which could be construed as you spending money. [...]
4a. To maintain the personal moral indignation of the taxpayer to our situations, it is acceptable to on occasion breach rule #4 in limited fashion. This allows the taxpayer to continue with their prejudices, which is crucial for our status quo. [...]
5. Only purchase things deemed appropriate by the surrounding consumers. [...]
6. Maintain an acceptable number of children. [...]


Rick Saenz suggests that this reaction to the recipients of public assistance is due to the replacement of "community mechanisms which once ministered to people in need" by bureacratic public aid programs, and I agree. If we institutionalize our charity into public assistance programs, do we obscure the connection between giver and givee behind an overly abstracted system of taxation and government aid? And does this obscuring mean that we're too eager to demonize the recipients of government handouts at the same time that we feel less inclined to engage in personal, ad-hoc charitable activity because "there's welfare for those people"?

The right-wingers would agree with me, I think, but they would say that the solution is simply to cut taxes and end public aid, relying instead on private charity. I'm not a right winger because I think too many of us are like little Lloyd Blankfeins, convinced that whatever greedy and selfish habits they've adopted are entirely sufficient to discharge whatever obligations they may have to others. The virtue of public assistance programs is that it makes helping others a legal obligation, and not merely a moral one, which people find too easy to rationalize away.

May 14, 2008

Heroes at home

We hear people throwing around the word "hero" a lot these days, mostly in reference to our soldiers fighting in Iraq. Heroes these soldiers may be, but let's also recognize some other heroes serving our country, even if they aren't lauded by the Hugh Hewitts and Rush Limbaughs of the world. Heroes like the military lawyers and judges who aren't playing along with the system of kangaroo courts set up by the Bush administration to try convict prisoners at Guantanamo:

The Supreme Court, then, is hardly the only thing standing between the president and kangaroo convictions at Guantanamo. The truth is that the best thing the commissions have going for them right now are the lawyers and judges in uniform who have, albeit reluctantly, refused to play along. If they'd been out on the battlefield, they'd have killed any detainee they met as an enemy. But they're not willing to see them killed in the wake of a sham trial. That's not because they value the lives of terrorists over the lives of Americans or because they value legal formalism over the exigencies of war. It's because they come out of a long military tradition of legal integrity and independence. And much as it must pain them, this precludes them from being yes men for the Bush administration at the expense of the rule of law.

January 30, 2008

Blind pigeon

A brilliant essay on caring for a blind pigeon.

July 26, 2007

Lost bird

"Lost: tame bird. Will not bite! Cannot defend itself from dogs or cats. Please call for reward."

Flyers with this announcement went up on almost every lightpost and street sign in my neighborhood last week, accompanied by a black-and-white photo of a small bird with a longish beak. Unfortunately, I haven't seen the bird, and that makes me sad.

The silver lining in this lost-bird story is that people are capable of missing their pet bird. In fact, I wouldn't be surprised if the person who went to all the trouble to post all those reward flyers actually loved that little bird. People can be self-absorbed and destructive, but they can also be loving -- and it's probably a good thing to remind ourselves of this every once in a while.

So I thought about love as I walked home. I started thinking about those of us who are so convinced of the non-equivalence, moral and otherwise, of people and birds that they would interpret this love for a missing bird as evidence that people sometimes misplace their emotions, or (more generously) that people have such a surplus capacity for love that they can afford to squander it on a being that isn't somehow intrinsically worthy of it. These people might say that humans alone can validate another person's love and can sometimes compel it, but a mere bird can only be the indifferent target of irrational emotion.

Surely you know people that think like this. You might even think this way yourself. After all, it does make instinctive sense to think of human beings as special in many ways, including perhaps their "appropriateness" as objects of our love.

But how can we know enough to be sure of this? If we can be confident about anything in the world, I think that we can be most confident about our ignorance. Religions, it seems to me, exist because at some level we're aware that we have no idea what the hell we're all doing here, or why, or what the point of it all is. Religions exist because we humans feel profoundly uncomfortable with this ignorance, and we mostly prefer faith -- just a belief in something we're not logically or empirically compelled to believe in -- to raw blubbering ignorance. We're uncomfortable not knowing what happens to us after we die, so we make up a story and believe in it rather than live with uncomfortable ignorance. We don't know why we're here, so we put our faith in a religious story that tells us why we're here and what we're supposed to be doing.

I'm not arguing against faith. I'm just saying that I think the ideas and stories we have faith in, that we believe without compulsion, are things we create and are not given to us by God. No, scratch that. I'm saying that even if there's a God that has given us anything, it's too difficult to distinguish which of our many yearnings and wishes and beliefs are God-given and which are conjured up by ignorant people just like ourselves. We have to remember that although faith may be a good thing, it's definitely not knowledge.

So what does this have to do with a lost bird? Even if many of you would agree with me that faith isn't knowledge and that we're ignorant about a lot of things, I'm surprised how many of us will act as if they know that loving a bird is a slightly foolish thing to do. But if it's a noble thing to love another person, why is it foolish to love a bird? Or to put the same thing a different way, if loving a bird is foolish, then aren't we just as foolish when we love each other?

It seems to me that in the dark of our ignorance, we could be a bit more generous than that. As far as I know, love is a wonderful thing, and it doesn't have to be hoarded up as if it were in danger of running out. Moreover, birds are wonderful too, and there's no evidence that we squander our love if we give some of it to a bird. So for all you humans-are-the-only-worthy-beings people out there, you can put a cork in it.

I don't believe you.

October 29, 2006

In the ICU, and thinking about Huckleberry

I'm in the ICU this month. It's a great place (the only place?) to learn what I need to be a competent ER physician -- but it's no less draining for knowing that.

The medical ICU is a joyless place. It's a place where very sick people stay, usually at the end of their lives, to absorb all the high-tech medicine that we can possibly throw at them, in order to live a few more weeks than they would have otherwise. Yes, there are important exceptions, where we save a patient's life in the ICU and he or she leaves to spend time with their families and go for walks on sunny days in their favorite park -- but this is still an exception.

Add to this the horrendous hours, which makes it impossible or at least very difficult for residents to get to know each other as anything other than tired, overworked, cogs in a machine. Throw in the intern's inevitable lack of knowledge and gross inefficiency, and it shouldn't be surprising that there's not much joy for them in the ICU. Speaking for myself at least, there isn't.

My brother just lost his cat, Huckleberry. He was the greatest cat. Friendly, intelligent, and always hungry! He had some klnd of cancer that deformed his jaw, and he had to have it taken off. For a cat who loved to eat, that must have been a particularly large loss. My brother, because he loved this cat, did the best thing for him in the end, and had him "put down" by the vet. Huck, RIP.

If Huckleberry had been a person, he would almost surely have been laid up in the ICU for the last few weeks of his life. He'd have been unconscious, with a feeding tube down his throat to substitute for the eating he'd loved before the cancer. The people "caring" for him would have been overworked and unfamiliar with him as anything other than a reason for more chores. They'd have been more concerned with writing down all the numbers that the machines hooked to his body were spewing out 24 hours a day than with "caring" for him in any sense that could have mattered.

I'm not saying that we should euthanize people. I'm saying that the end of Huckleberry's long life was probably better, being my brother's cat, than it would have been as a human being.

***

Here's a poem I've posted before that means more to me now that I'm spending so many hours in the ICU.

Three Elegaic Poems
Wendell Berry

I
Let him escape hospital and doctor
the manners and odors of strange places
the dispassionate skill of experts

Let him go free of tubes and needles
public corridors, the surgical white
of life dwindled to poor pain

Foreseeing the possibility of life without
possibility of joy, let him give it up.

Let him die in one of the old rooms
of his living, no stranger near him.

Let him go in peace out of the bodies
of his life --
flesh and marriage and household.

From the wide vision of his own windows
Let him go out of sight; and the final

time and light of his life's place be
last seen before his eyes' slow
opening in the earth.

Let him go like one familiar with the way
into the wooded and tracked and
furrowed hill, his body.

II
I stand at the cistern in front of the old barn
in the darkness, in the dead of winter,
the night strangely warm, the wind blowing,
rattling an unlatched door.
I draw the cold water up out of the ground, and drink.

At the house the light is still waiting.
An old man I've loved all my life is dying
In his bed there. He is going
slowly down from himself.
In final obedience to his life, he follows
his body out of our knowing.
Only his hands, quiet on the sheet, keep
a painful resemblance to what they no longer are.

III
He goes free of the earth.
The sun of his last day sets
clear in the sweetness of his liberty.

The earth recovers from his dying,
the hallow of his life remaining
in all his death leaves.

Radiances know him. Grown lighter
than breath, he is set free
in our remembering. Grown brighter

than vision, he grows dark
into the life of the hill
that holds his peace.

He's hidden among all that is,
and cannot be lost.

August 30, 2006

Europe's Christian roots?

I read Without Roots alongside Kwame Anthony Appiah's Cosmopolitanism because they seemed to exemplify two common responses to the problem of cultural intolerance and violence. Appiah's book describes the familiar liberal response: we can avoid violence by recognizing that most differences between people aren't as serious as they seem, and by treating the differences that remain as irrelevant to the practical problem of living together. The book by Pera and Ratzinger promised to argue for some version of the cultural conservative's response: stable toleration requires that we all recognize some fundamental "moral essence" of humanity; the Christian tradition of Europe recognizes this moral essence; therefore the foundations of a stable, nonviolent society must somehow embrace our Judeo-Christian roots.

I'm not very sympathetic to the accretions of right-wing opinion that cling to the religious traditionalists like barnacles, but on one point at least, they're more effective than the liberals. The conservatives say that there are moral values that we must recognize as universal and superior to all others. Otherwise, our efforts at peaceful toleration will allow hideous evil to flourish. Toleration based on relativism rather than on absolute moral standards cannot recognize the evil of regimes like Mao's or Stalin's.

Liberals, of course, recognize that murder can't be tolerated, much less genocide. The problem is that liberal arguments aren't usually very good at explaining why. A morally crippled person, reading Kwame Anthony Appiah's arguments, might easily fail to see why a society or regime like Stalin's ought to be one of the "losers" when it conflicts with a regime or society that prohibits torturing political opponents in gulags. Appiah certainly doesn't give compelling reasons; he simply says that there will be winners and losers when irreconcilable values conflict, and that the losers won't be happy about it. The closest Appiah comes to actually giving a reason is when he says that some values (like not hurting others) are actually shared almost universally; the defenders of Hitler are not very numerous. But even if this is empirically true, Appiah can't give a reason why it's a good thing that this is true.

The problem that most liberals face, no matter how morally upstanding they may be, is that reasoned arguments are the most subtle and difficult means of distinguishing good from evil. I don't know whether there's a philosophical consensus about whether it's even possible to reason about the concepts of good and evil without resorting to non-rational discourse, such as the language of faith. But one thing's for sure: it's much, much easier to talk about good and evil in the language of faith and religion than it is to talk about these things using rational arguments. That's why most people who aren't moral philosophers in fact look to things other than reason when they make judgments about morality. Something's evil because the Bible or the Koran or their priest or their mother says it is, or beause it just is, period. No reasoned arguments necessary (or possible?).

This is why the conservatives are more effective than most liberals, at least on this question. Joseph Ratzinger can explicitly appeal to faith in order to say "this, my friends, is evil." Appiah perhaps ought to do this too, but his attachment to reason and fear of un-reason lead him to make hand-wavy gestures at the point when he wants to argue that some things just shouldn't be tolerated.

Ok, so on that much I think Without Roots is a better book than Appiah's, because it's more straightforward and honest. But what about the rest?

Pera and Ratzinger: Saving the world by invading Iraq and outlawing gay marriage

Joseph Ratzinger is, of course, the Pope, but he wrote these materials when he was merely one of the most influential thinkers high up in the hierarchy of the Catholic Church. Pera is an Italian politician, and one of the most interesting things about this book is to see how Ratzinger keeps his distance from politics, preferring to discuss ideas and issues in the abstract or in historical terms, while Pera is more willing to apply these ideas to practical policies. This dynamic is fascinating. Ratzinger alone is very measured, interesting, and even compelling. One can't help but admire his historical knowledge, and his tone is scholarly and pleasant. It's easy to simply think along with Ratzinger, but when you read Pera's contributions, you can no longer be a curious spectator. With Pera, you have to declare yourself as an ally or an enemy. And since Ratzinger nowhere says that he disagrees with Pera and often claims to agree with him, you realize that if ideas have consequences you'd better be either for Ratzinger or against him.

Here's what Ratzinger says: the history of Europe is a long, slow process of moving religion out of the public sphere -- Ratzinger wants to bring it back. The initial moves of this long process were good ones. In the Western Roman Empire, temporal power was divided from spiritual power, with the former resting with kings and the latter resting with the Pope. This was good because human pride makes absolute power too dangerous. It's not clear where along the road to the modern secular state Ratzinger thinks Europe ran off the tracks, but he certainly thinks it has done so by now. Today, Ratzinger says, Europe's "broad Christian consensus" is threatened. The modern European state has succumbed to a "hollow" belief in technology and progress as a secular substitute for spiritual values. Totalitarianism and dictatorship remain a real threat because the relativism that permitted the regimes of Stalin and Hitler is stronger than ever.

The proper response to this sorry trajectory is to ensure that any future European Constitution protects fundamental human rights as "values that take precedence over the jurisdiction of any state." Modern abominations such as cloning, "trafficking in organs for transplants," and gay marriage would be stopped in their tracks.

I'm sympathetic to Ratzinger's worries about an unbounded faith in technological progress. And he's surely right that without some absolute moral values that limit the permissible uses of new technologies, we will again have to confront massive horrors of the sort that we saw in the 20th century. I'm thinking here about, you know, mass genocide and nuclear annihilation. That's why it's so lame to end, as too many conservative screeds against secularism do, by trotting out organ transplants and gay marriage as the sort of horrors that should motivate us to change essential aspects of modern state power. Unless you're a believer in a very particular interpretation of a very particular bit of religious scripture, the threat of gay marriage is not going to chill you to the core.

It only gets worse when you read Marcello Pera's pieces. As a practicing Italian politician sympathetic to Ratzinger's views, Pera allows himself greater license to talk about specific political controversies. The war in Iraq is the best example. Pera praises the Bush Doctrine generally as a shining example of what a leader with moral convictions can do, and he praises the invasion of Iraq specifically as something Bush and the U.S., but not the hollow and hopelessly secular European states, had the courage to do. If it's true that Ratzinger's brand of moral absolutism would be reliably translated by politicians like Pera into policies like George W. Bush's, then I know where I stand. I'm against it, full stop.

Kwame Anthony Appiah's liberalism leads him to belittle people's cultural and religious convictions, but Pera and Ratzinger's religious convictions lead them to all but explictly reject toleration. We can believe in whatever we want, so long as we submit to the authority of leaders espousing the Christian (and specifically Catholic) religion. What else can Ratzinger mean when he chooses such a particular "evil" as gay marriage to condemn? It would be fine if, like Appiah but without Appiah's hemming and hawing, Ratzinger had espoused absolute moral values that could at least pretend to be universal.

Reading both of these books, I get the sense that any solution to the toleration problem is a fine balance between Appiah's toleration and Ratzinger and Pera's convictions. But I'm not optimistic that any one author or theorist will get it right. If we manage to achieve it in practice, it's going to be because both sides check each other's excesses.

August 22, 2006

Cosmopolitanism's limits

Last winter when I was in Hyde Park to interview for a residency spot, I stopped in at 57th Street Books and found two books on the front table. One was Kwame Anthony Appiah's Cosmopolitanism: Ethics in a World of Strangers. The other was by Italian politician Marcello Pera and Joseph Ratzinger (now Pope Benedict XVI), entitled Without Roots: The West, Relativism, Christianity, Islam.

I thought it would be fun to read them together. One offered "cosmopolitanism" as an antidote to the inevitable conflicts that arise in a globalized "world of strangers." The other saw a threat to "tolerance and civility among peoples of diverse convictions" in Europe's "apostasy toward . . . the spiritual roots of European civilization" as George Weigel's preface puts it. Nonviolent coexistence demands some degree of toleration, and toleration seems to demand that we embrace some kind of relativism. Could one really argue for a renewed commitment to religious values on the grounds that this apparent absolutism is more conducive to toleration than some form of relativism? This post addresses Appiah's book; I'lll talk about Pera and Ratzinger separately.

Anthony Appiah: Virginia Postrel on steroids

I admit that the comparison might not be entirely fair, but for the sake of brevity I'm going to call Kwame Anthony Appiah the thinking man's Virginia Postrel (or perhaps Thomas Friedman, if you prefer).

Appiah argues that we can't be cosmopolitans until we give substantial weight to our shared humanity, relative to the weight we give to our shared identity with our co-religionists, countrymen, or ethnic group. The "golden rule of cosmopolitanism" according to Appiah is something like the Roman playwright Terence's "I am human; nothing human is alien to me." When it comes to culture, we ought to recognize the empirical reality that there is no such thing as cultural purity. Every culture has been "contaminated" by others, whether by trade, migration, or Hollywood movies. "We do not need, have never needed, settled community, a homogenous system of values, in order to have a home. Cultural purity is an oxymoron."

This does not mean that there are no differences among peoples. In fact, the threat of cutural imperialism shouldn't be overstated, because even when the same television show is seen worldwide, different peoples have different reactions to it. Even when Coke is marketed around the world, local people often prefer local beverages when they're available. "And whatever loss of difference there has been, [people] are constantly inventing new forms of difference: new hairstyles, new slang, even, from time to time, new religions."

But if homogenization isn't a problem, why do so many people think that it is? According to Appiah, it's because they don't like change. "So why do people in [the world's villages] sometimes feel that their identity is threatened? Because the world, their world, is changing, and some of them don't like it."

Well, duh. It isn't that people don't like change per se; they don't like change that threatens their identity. The problem with all of this breezy talk about sources of conflict that, illusory or not, lead people to kill each other in mass numbers, is the same problem that Postrel and Friedman have also failed to solve. Appiah never takes the proper measure of the non-cosmopolitan's objections to our modern circumstances. You can see this when he equates threats to a person's identity with a mere distaste for change in general. These are clearly problems of a different order of magnitude. We can't conjure away the problem Postrel-style by describing millions of people who feel the need to kill or be killed in a war against modernity as merely stubborn.

Appiah also sets up an all-too common straw man to represent those who argue that elements of our tradition should be preserved. He speaks as if all these people simply want to foreclose choice, and force everyone to be small farmers. For instance (p. 103-4):

Above all, relationships are changing. When my father was young, a man in a village would farm some land that a chief had granted him, and his [family] would work it with him. If extra hands were needed in the harvest season, he would pay the migrant workers who came from the north. . . . Nowadays, everything has changed. Cocoa prices have not kept pace with the cost of living. Gas prices have made the trasportation of the crop more expensive. And there are new possibilities for the young in the towns, in other parts of the country, and in other parts of the world. Once, perhaps, you could have commanded your nephews and nieces to stay. Now they have the right to leave; in any case, you many not make enough to feed and clothe and educate them all. So the time of the successful farming family has gone; and those who were settled in that way of life are as sad to see it go as some of the American family farmers whose lands are being accumulated by giant agribusinesses. We can sympathize with them. But we cannot force their children to stay in the name of protecting their authentic culture; and we cannot afford to subsidize indefinitely thousands of distinct islands of homogeneity that no longer make economic sense.

This is simply modern superstition thoughtlessly repeated. The economy (conceived of as a natural "force" for which we are not responsible) has made it impossible to pursue a way of life that has sustained many generations of people. Despite the economic impossibility of pursuing the old ways of life, the abandonment of these old ways and the adoption of the modern ways is glorified as a "choice" that young people freely make. Appiah doesn't recognize the contradiction, perhaps because he's so eager to condemn those who would "force" their children to remain on the farm as enemies of free choice. But who are these people? We here a lot from Anthony Appiah and Virginia Postrel about these family-farming tyrants, but we're never told who they are. It's just assumed that they exist. But I haven't met one, or read their articles or books, or seen any of the draconian stay-on-the-farm laws that they're trying to pass.

I suspect that, if we were really more concerned about "freedom" than about defending modernity as such, we'd be willing to acknowledge that much of what young people do when they leave the family farm is done because there isn't any other real choice to make. Economic realities, to the extent that they make the family farm unprofitable, make moving to the cities a necessity and not a choice. Appiah (and Friedman) can argue that the family farm doesn't make economic sense, but they can't have it both ways and simultaneously claim that the abandonment of the farms is a glorious example of personal freedom.

The fact is that the modern economic realities that are condemning family farms in favor of global agribusiness are not natural events. We subsidize global agribusiness, not family farms. Much less do we subsidize "thousands of distinct islands of homogeneity," whatever that might mean.

Appiah does discuss more serious sources of conflict than changing hairstyles and new slang. He points out that the conflict in the United States between people who favor and who oppose legal abortion is not a conflict over fundamentally incompatible values. Instead, it's a conflict over how the shared values of life and freedom ought to be applied in a particular case. The conflict between observant Muslims and observant Jews wouldn't be as fierce if they didn't both share similar beliefs about the importance of Jerusalem. The resistance to British colonization of Ghana was fiercest among the most Westernized Ghanaians, who shared with the British the values of nationalism and self-determination.

Appiah comes close to acknowledging that when people disagree like this, reason will often fail. These differences don't arise because people aren't being reasonable. There are going to be winners and losers, and the losers will be very angry, and they may respond with violence. But I suspect that to just say this and stop would be to admit the defeat of cosmopolitanism, and Appiah is unwilling to do this explicitly. Instead, he turns quickly away from a discussion of winners and losers to a discussion of habit. He acknowledges the limits of reason: "I have learned in a life of university teaching and research that even the cleverest [why not simply "most intelligent"?] people are not easily shifted by reason alone. . . " The point of conversation and cultural interchange isn't to arrive at a consensus about values. "...[I]t's enough that it helps people get used to one another." End of chapter.

Sure, living with someone different teaches us about them and makes them less unfamiliar. But if Appiah wants to suggest also that it makes us more tolerant of them, he leaves it as merely a suggestion. Who wants to kill Iraqi Sunnis? Iraqi Shiites, not Alabama Baptists. Who routinely killed Irish Catholics? Irish Protestants, not Buddists in Japan. Will cosmopolitan cultural interchange lead to a safer and less violent "world of strangers?" Appiah doesn't argue convincingly that it will.

January 23, 2006

Taking risks for $73 million

This article, apart from its interesting discussion of the windfall profits that the Iraq war has bestowed on some pretty sleazy people, contains the following gem of a paragraph:

"The American economic system rewards those who take great risks with commensurate benefits," Mr. Rubin said of Mr. Brooks's stock sales and compensation [$73.3 million in 2004]. "The compensation Mr. Brooks received is directly attributable to the risk he undertook in aiding the capitalization of DHB and achieving extraordinary results for the company."

This is certainly the knee-jerk thing to say, but let's actually ask ourselves: do successful entrepreneurs "deserve" the piles and piles of money that they make because they "take risks?" Is it right that our economic system should reward "risk" so handsomely?

These are question that'll get me branded as a socialist kook. But before I go ahead and ask anyway, let's get at least one thing straight. The absence of any moral entitlement to such huge amounts of wealth wouldn't, by itself, be a sufficient reason to abandon our current economic system. Even if our super-rich don't deserve what they get, we could easily decide that any alternatives to our current system are less desirable than the status quo. Maybe they're all too impractical, or too risky, or just too dull and boring.

But it does seem a little strange that investing your money in a business that becomes successful somehow entitles you to such huge financial rewards. For one thing, this investment activity isn't anywhere near as "risky" as many other risks people take but which don't offer equivalent financial rewards. A soldier risks his life to defend his country, but our economic system doesn't reward him. A worker on a crab fishing boat risks his fingers, and sometimes his life, to do his job, but he'll never make $73 million a year catching crabs. If a mother goes without health insurance so she can provide for her children, her risks won't ever be rewarded with a financial windfall.

The risks that many entrepreneurs take are valuable, but are they so much more valuable than these other kinds of risks? They're certainly not more altruistic. The entrepreneur risks his money because he wants to get rich (he's 'incentivized'). These other kinds of risk-takers do it for the sake of someone else, or they do it because they don't have too many other options. From a moral perspective, it seems weird that the entrepreneur among all these people should deserve to take home so much more bacon than everyone else.

So what does it say about our economic system when its biggest winners don't always seem to be the most worthy? One thing I think it says is that "dessert" "desert" in a moral sense is actually pretty irrelevant. Some rich CEOs are fine people; others are complete jerks. None of that matters, one way or the other, for economic success. A capitalist economy just doesn't care.

Maybe that's a good thing. Non-capitalist economic systems that have tried to explicitly reward the most moral people have had to wrestle with the tough question of who's the most deserving. In practice, that usually ended up being the guy who ran the army or controlled the most effective assassins. I don't think it's easy for human beings to consciously decide who 'deserves' to have the most money, and the downside risks of even trying it are huge.

But let's cut the crap: next time some office-supply store owner starts feeding you the line about entrepreneurs "deserving" so much money because of the "risks" they've taken, think about the guys getting shot at in Iraq. We let the entrepreneurs keep their $73 million not because it's the most 'moral' thing to do, but because it'd be too dangerous to try to reallocate the money to the people who really deserve it.

Taxes are not, despite zealous protestations to the contrary, a reallocation. Only progressive taxation can even pretend to be, and none of that (in the U.S. at least) ever rearranges the hierarchy of financial winners and losers. Taxes simply allow for the state to pay for common expenses, and while we can argue about what these expenses should be, no one but a kook would say that they don't exist.

January 16, 2006

Writing about Wendell Berry

One of the best things about writing a paper on Wendell Berry, which I'm doing now, is having to read Berry closely. It's really a joy.

Perhaps the biggest rhetorical strength of Berry's essays are also their biggest rhetorical weakness: they're very poetic (or impressionistic,or allegorical). They're not particularly analytical or explicit. On the one hand, this makes them very inspiring for someone like me who reads Berry sympathetically. On the other hand, someone who isn't inclined to give Berry the benefit of the doubt is likely to dismiss his work as devoid of solid argument and evidence.

What I'm finding, as I work on my paper about Berry's relationship to the political philosophy called liberalism, is that a close, analytical reading makes his essays really sparkle. There is really a lot of solid argument in them, but those arguments are delivered poetically, which means the reader has to contribute a lot of himself if he's going to see what the argument is.

For example, I think Berry makes a powerful argument that the modern way of seeing the world makes it very difficult to take responsibility for our actions, and because of this it's dangerous. Of course, what exactly this "modern worldview" is takes some teasing out. Think of the uncritical enthusiasm for technology, the myth that pursuit of self-interest benefits the community, and the belief that the future will be better than the past. The modern worldview has historically led us to denegrate the merely local. It has encouraged hyperspecialization over generalization. And these two things -- globalization and hyperspecialization -- prevent us from even knowing the effects of what we do, let alone taking responsibility for them.

It's a profound critique of the way we aspire to live, that I think is largely correct. Puzzling through all of this is really, really fun.

October 22, 2005

Police state?

Sometimes I think the definition of a "police state" just means a country where the government is just a little bit more intrusive than ours. The beauty of this definition is that the USA can never -- by definition -- be a police state.

The New York Times reports that internet access providers are being required to "upgrade" their systems so that the government can monitor online communications:


If law enforcement officials obtain a court order to monitor the Internet communications of someone at a university, the current approach is to work quietly with campus officials to single out specific sites and install the equipment needed to carry out the surveillance. This low-tech approach has worked well in the past, officials at several campuses said.

But the federal law would apply a high-tech approach, enabling law enforcement to monitor communications at campuses from remote locations at the turn of a switch.

It would require universities to re-engineer their networks so that every Net access point would send all communications not directly onto the Internet, but first to a network operations center where the data packets could be stitched together into a single package for delivery to law enforcement, university officials said.

I'd like to know a bit more about what this turning of switches means. The article makes it sound like every packet of internet data will be routinely sent to a government "network operations center" and that we'll have to trust the government not to turn any switches until it obtains a court order. If that's true, will there be any way to monitor the government's behavior? Will anyone be able to tell when the government is listening in?

This sounds like a setup for abuse. If all it takes to intercept emails is a "turn of a switch," I'll bet a dollar to a donut that the government won't always bother with the court order. The best we can hope for is that we can catch them when they cheat.

October 13, 2005

Stop trusting Bush about "enemy combatants"

Let's quickly tick off some recent instances where our trust in George W. Bush may have been misplaced. We trusted Bush to take homeland security seriously, and he gave us Michael Brown. We trusted Bush when he told us that Iraq was an imminent threat because of its WMDs, but there were no WMDs. Bush is now asking us to trust him about Harriet Miers, and for good reason, many of us aren't. Why, then, should we continue to trust him about Guantanamo?

Former Solicitor General Seth Waxman gave a lecture at the law school this week. He discussed the role of the judicial branch in the "Global War on Terrorism" (which he helpfully informed us is often abbreviated "GWOT") and suggested that the country might be better off if the courts changed their approach. Along the way, he read a chilling transcript from a hearing for a prisoner in Guantanamo that should make us all question the deference we've been willing to give to George W. Bush.

Continue reading "Stop trusting Bush about "enemy combatants"" »

October 02, 2005

Health care priorities

Health care resources, as we all know, are scarce. How has our country chosen to distribute these resources?

In Michigan, family medicine is "dying" as medical students are lured away from primary care.

More than a quarter of Michigan's 12,700 primary care physicians are at retirement age, according to a recent report from the Michigan State Medical Society. At the same time, today's medical students are being lured to specialty fields that promise better pay, more manageable hours and the chance to work with flashy new technologies and treatments. (Via Kevin, M.D.)

At the same time in California, EM physicians are finding it harder and harder to find specialists who will care for their patients:

Hospitals are paying $600 million a year to ensure that on-call physicians are available - and still some communities are having problems finding specialists," Emerson said.

Kivela said that if a patient shows up at the emergency room with a broken jaw and has no insurance, the emergency room physician has a dreadful task of finding an oral surgeon willing to come in and take the case.

"I'll have to call eight or 10 different doctors," he said. "I'll spend two hours making these calls while a bed is taken up in the emergency room while sick patients wait." (Via Symtym.)

This may be absurd, but it's not chaotic. We have a system that draws money and talent away from the most cost-effective fields of primary care and into the less cost-effective specialties, while this same system also makes it more and more difficult for a patient to gain access to those specialists. It's no wonder that our country performs so poorly on virtually all measures of public health like life expectancy and infant mortality.

Of course, we haven't gotten here by accident. We've chosen to endure these piss-poor public health results because we don't want to disturb our unquestioned ability to provide the world's best high-tech medical care to those patients who can afford to pay for it themselves.

We've chosen to lower medicaid and medicare payments to primary care physicians because we're both unwilling to bear the tax burdens of these redistributive public health programs, and we prefer to spend what tax revenue we do collect on the development of high-tech medical treatments. These high-tech solutions are favored by the private sector because they're a lot more lucrative than low-tech primary care. We've chosen to funnel our finite amount of health care resources into the pockets of pharmaceutical companies, medical device manufacturers, hospitals, and specialist physicians who primarily treat the wealthy self-insured. This has been at the expense of cost-effective primary care and low-income chronically ill patients.

Is this a good thing? Some of us think not. More of us -- at least to the extent that our policies reflect our democratic preferences -- think it is.

September 25, 2005

Take some risks

Jonathan Kozol says: stick your neck out!

What I tell these young people is, the world is not as dangerous as the older generation would like you to believe. Anyone I know who has ever taken a risk and lost a job has ended up getting a better one two years later. The ones I pity are the ones who never stick out their neck for something they believe, never know the taste of moral struggle, and never have the thrill of victory.

September 20, 2005

For shame! (updated)

NEW YORK -- A doctor's group critical of drug companies is protesting its exclusion from the American Academy of Family Physicians' (AAFP) annual Scientific Assembly—a major event for pharma marketers.
Come on, is exclusion really necessary? Well, maybe it is if the event is less a "scientific assembly" than it is an opportunity for pharmaceutical firms to ply doctors with gifts rather than persuade them with scientific evidence. (Via Matthew Holt.)

EDIT: GruntDoc links to Dr. RW, who links to the No Free Lunch website. Apparently the AAFP has changed its mind. Good for them.

The best part of this story?

No Free Lunch has accepted the AAFP’s invitation and plans to be present at the session which opens September 28 at the Moscone Center. Attendees are encouraged to visit The No Free Lunch booth, #1613, immediately adjacent to that of the California Table Grape Commission.

Open dialogue about the pharmaceutical industry's influence on physicians may not be, but it's reassuring to know that table grapes are definitely "within the character and purpose of the Scientific Assembly."

Here's the AAFP's press release.

January 18, 2005

Governor or physician?

Thomas Mayo at HealthLawProf Blog raises questions about whether a physician, who also happens to be a Governor, violates medical ethics by signing an inmate's death warrant.

The Kentucky Board of Medical Licensure says that Gov. Ernie Fletcher, who is a physician, did not violate medical ethics when he authorized the execution of an inmate on the state's death row, despite the AMAs prohibition of physicians from participating in executions. "The committee, which examined the issue at the request of four death-penalty opponents, said Fletcher was acting as governor, not as a doctor, when he signed a Nov. 8 death warrant for Thomas Clyde Bowling."

After reading Mayo's post and looking at the information he links to, I think the Board got it right. Yes, we should worry when docs avoid their ethical responsibilities by trying to remove their "physician" hats at convenient times. But we should also avoid falling into the trap of defining the person by their profession. The AMA's code of medical ethics doesn't completely define the ethical obligations of every human being who happens to have chosen the profession of medicine.

Ernie Fletcher may be a physician, but he's also pursuing another profession. If Fletcher had refused to sign the death warrant, would he have been violating his ethical responsibilities to Kentucky's citizens as Governor? Those obligations come from Kentucky law and the promises he may have made to the citizenry before he was elected, and have nothing to do with medical ethics. It's crucial that a person be able to set aside his role as a physician, because otherwise he might find it difficult to do anything else in his life ethically.

I knew an emergency doc once who also served as a reserve police officer. He couldn't have done that job well if the code of medical ethics had attached to his person 24/7. Conversely, he couldn't have been an ethical physician if he was bound to treat patients with the ethics of a cop.