The Ethics of ‘Opt-out, Presumed-Consent’ Organ Donation

By Keith Tidman

According to current data, in the United States alone, some 107,000 people are now awaiting a life-saving organ transplant. Many times that number are of course in similar dire need worldwide, a situation found exasperating by many physicians, organ-donation activists, and patients and their families.

The trouble is that there’s a yawning lag between the number of organs donated in the United States and the number needed. The result is that by some estimates 22 Americans die every day, totaling 8,000 a year, while they desperately wait for a transplant that isn’t available in time.

 

It’s both a national and global challenge to balance the parallel exigencies — medical, social, and ethical — of recycling cadaveric kidneys, lungs, livers, pancreas, hearts, and other tissues in order to extend the lives of those with poorly functioning organs of their own, and more calamitously with end-stage organ failure.

 

The situation is made worse by the following discrepancy: Whereas 95% of adult Americans say they support organ donation upon a donor’s brain death, only slightly more than half actually register. Deeds don’t match bold proclamations. The resulting bottom line is there were only 14,000 donors in 2021, well shy of need. Again, the same worldwide, but in many cases much worse and fraught.

 

Yet, at the same time, there’s the following encouraging ratio, which points to the benefits of deceased-donor programs and should spur action: The organs garnered from one donor can astoundingly save eight lives.

 

Might the remedy for the gaping lag between need and availability therefore be to switch the model of cadaveric organ donation: from the opt-in, or expressed-consent, program to an op-out, or presumed-consent, program? There are several ways that America, and other opt-in countries, would benefit from this shift in organ-donation models.

 

One is that among the many nations having experienced an opt-out program — from Spain, Belgium, Japan, and Croatia to Columbia, Norway, Chile, and Singapore, among many others — presumed-consent rates in some cases reach over 90%.

 

Here’s just one instance of such extraordinary success: Whereas Germany, with an opt-in system, hovers around a low 12% consent rate, its neighbour, Austria, with an opt-out system, boasts a 99% presumed-consent rate.

 

An alternative approach that, however, raises new ethical issues might be for more countries to incentivise their citizens to register as organ donors, and stay on national registers for a minimum number of years. The incentive would be to move them up the queue as organ recipients, should they need a transplant in the future. Registered donors might spike, while patients’ needs have a better hope of getting met.

 

Some ethical, medical, and legal circles acknowledge there’s conceivably a strong version and a weak version of presumed-consent (opt-out) organ recovery. The strong variant excludes the donor’s family from hampering the donation process. The weak variant of presumed consent, meanwhile, requires the go-ahead of the donor’s family, if the family can be found, before organs may be recovered. How well all that works in practice is unclear.

 

Meanwhile, whereas people might believe that donating cadaveric organs to ailing people is an ethically admissible act, indeed of great benefit to communities, they might well draw the ethical line at donation somehow being mandated by society.

Another issue raised by some bioethicists concerns whether the organs of a brain-dead person are kept artificially functional, this to maximize the odds of successful recovery and donation. Doing so affects both the expressed-consent and presumed-consent models of donation, sometimes requiring to keep organs animate.

 

An ethical benefit of the opt-out model is that it still honours the principles of agency and self-determination, as core values, while protecting the rights of objectors to donation. That is, if some people wish to decline donating their cadaveric organs — perhaps because of religion (albeit many religions approve organ donation), personal philosophy, notions of what makes a ‘whole person’ even in death, or simple qualms — those individuals can freely choose not to donate organs.

 

In line with these principles, it’s imperative that each person be allowed to retain autonomy over his or her organs and body, balancing perceived goals around saving lives and the actions required to reach those goals. Decision-making authority continues to rest primarily in the hands of the individual.

 

From a utilitarian standpoint, an opt-out organ-donation program entailing presumed consent provides society with the greatest good for the greatest number of people — the classic utilitarian formula. Yet, the formula needs to account for the expectation that some people, who never wished for their cadeveric organs to be donated, simply never got around to opting out — which may be the entry point for family intervention in the case of the weak version of presumed consent.

 

From a consequentialist standpoint, there are many patients, with lives hanging by a precariously thinning thread, whose wellbeing is greatly improved (life giving) by repurposing valuable, essential organs through cadaveric organ transplantation. This consequentialist calculation points to the care needed to reassure the community that every medical effort is of course still made to save prospective, dying donors.

 

From the standpoint of altruism, the calculus is generally the same whether a person, in an opt-in country, in fact does register to donate their organs; or whether a person, in an opt-out country, chooses to leave intact their status of presumed consent. In either scenario, informed permission — expressed or presumed — to recover organs is granted and many more lives saved.

 

For reasons such as those laid out here, in my assessment the balance of the life-saving medical, pragmatic (supply-side efficiency), and ethical imperatives means that countries like the United States ought to switch from the opt-in, expressed-consent standard of cadaveric organ donation to the opt-out, presumed-consent standard.

 

In Praise of Monarchy

by Thomas Scarborough

It stands to reason, that hereditary monarchy ran into trouble in modernity. 

Following the Age of Reason and the Scientific Revolution, things increasingly had to be measured and controlled. People’s lives were less and less the province of natural and personal influences—until, in the 20th century, Theodor Adorno famously wrote, ‘Reason itself appears insane as the world acquires systematic totality.’

In time, our lives became easier to predict, more manageable, and more secure—which is to say, a self-imposed causality increasingly prevailed. It meant, wrote Thomas Huxley, ‘the extension of the province of what we call matter and causation’. Ultimately, we came to control—in a sense—the weather (climate control), the abundance of nature (global streams of goods), even the sun (artificial lighting), and so much more. 

However, while this brought many improvements to our comfort and well-being, it often represented a loss of accident and freedom in our lives. We lost something of the essence of life: the smell of the rain, the wind in our hair, the chill of the evening, or the soil under our feet. Susan Sontag wrote, ‘All the conditions of modern life ... conjoin to dull our sensory faculties.’

This drive towards predictability and control included political systems. Hereditary monarchs, who were often fickle, volatile, unpredictable—and too often, simply dangerous—were increasingly reined in or replaced by more regular and predictable dispensations. Republicanism in particular gained in favour, in the sense of ‘a scientific approach to politics and governance’. 

This shift meant, at the same time, that as humanity emerged from pre-modernity, hereditary monarchy generally left behind it a period in which it was vainglorious, out of touch, and abusive. People’s lives, too, were no longer ruled by monarchical colonists' prerogatives. While previously, social and material cultures were repressed or destroyed, causing grief and trauma to this day, hereditary monarchy has now, by and large, disavowed such supremacy. 

I pause this post now to turn my attention to you, the reader. Without saying as much, you and I have—if indeed it is agreed—developed the argument that the character of hereditary monarchy has been shaped by the era and intellectual climate in which it existed. Therefore, our attitude towards monarchy, and the desirability of monarchy itself, has to do with historical eras—most immediately, pre-modernity, modernity, and postmodernity. 

We may now ask, how does hereditary monarchy relate to postmodernity—a period which many would estimate to have begun around the 1960s? 

All over the world, things have changed. Our transitions to modernity, then to postmodernity, mean that we no longer greatly value, as we once did, what Friedrich Nietzsche called ‘glittering mirages’—called metanarratives now. We are deeply suspicious, today, of monolithic philosophies, ideologies, and systems. We have gained in experience, too. We have now seen that even republicanism is subject to confusion, impotence, capture, and war. 

In postmodernity, hereditary monarchy may represent five things which we generally prefer over the preceding modernity: 

• That human fate is bound up always with the uncertainty and ambiguity of personality and personal destiny. The ‘humanity’ which we find in systems, both good and bad, will not be worked out of them. Hereditary monarchy reminds us that our fate is bound up with personal factors, and our own designs and expectations continually confounded. 
• Hereditary monarchy reminds us that government itself cannot ultimately be reduced to reason and rules, and that systematic control is elusive. Monarchy, in an important sense, now represents accident and freedom, rather than the regimentation and subjection it once did. 
• We are reminded, through hereditary monarchy, that government is not a mere administrative function, but can only be properly viewed where we include personal meaning. It is not all of it about rational, scientific, or even efficient control, but often it comes down to the mystery of semiotic codes: a smile, a gesture, a cup of tea, or a set of brooches. 
• Hereditary monarchy, contrary to what once was the case, withers metanarratives and ideologies, which have been so destructive to humanity in the past. It shows us that there is no novum ordo, no social optimism, no Omega Point. Instead, we have people, with limited lifetimes, and limited capabilities. 
• With individuals being the focus of hereditary monarchy, we are reminded, in fact on a daily basis, that monarchies are fallible—perhaps moreso than we may recognise it in the entirety of a republican order. Rather than representing autocracy, as once was the case, hereditary monarchy reminds us of the necessity of checks and balances. 

The Virus Stats that Cost Everyone a Lot

By Martin Cohen

This is a post about statistics. Not that I’m actually a great mathematician, let alone a statistician, but I do at least appreciate that the power of numbers to influence debates. And a debate in particular where statistics have been thrown around since the beginning of the Covid one. 

So, travel with me back nearly two years to the origins, and take a second look at some key metrics that have been tossed about ever since. One problematic measure has been the “Case Fatality Rate”. This was officially put by the United Nations at just under 1%, making Covid a very deadly virus.

The bit we can agree on is the definition. The CFR is the number of deaths from Covid divided by the number of “confirmed cases”.

The problem is that deciding who actually died “from Covid” is very murky. A typical report is that 95% of people dying from Covid have other co-morbidities. This means that they may actually have died from these rather than from Covid. The issue is exacerbated when you see that the typical age of someone dying “from Covid” is pretty much the age at which anyone dies.

So the numerator part of this crucial figure is HIGHLY debatable - and the denominator part, the number of cases is too. For starters, one problem is that what you, me and Joe Public understand as “a confirmed case” is someone who has symptoms and goes to hospital and is tested and found to have the virus. That would all make sense. But in fact, a case is simply someone who has the virus. And again, it is agreed that the great majority of people who encounter the virus never have any symptoms. These people are often not counted. This is why the number of cases a country has depends essentially on how much testing the government chooses to do.

To make matters worse, it depends on the criteria used for the test. The benchmark test, the so called PCR (polymerase chain reaction ) test, considered “the gold standard” for detecting Covid. The test amplifies genetic matter from the virus in cycles; the more cycles used, the greater the amount of virus, or viral load, found in the sample. Crucial to the test, then, is how many cycles are used -and that, perhaps surprisingly, is not a medical decision but a political one. In Europe, for example, The European Centre for Disease Prevention and Control does not recommend a specific maximum amplification cycle threshold for PCR tests. However, it does recommend that if the values are high, e.g. > 35, “repeated testing should be considered”. In other words, it recognises the results are unsafe.

Yet that decision on the number of cycles is not even communicated when a “positive test” is returned. As Angela Rasmussen, a virologist at Columbia University in New York told the New York Times, “It’s just kind of mind-blowing to me that people are not recording the C.T. values from all these tests — that they’re just returning a positive or a negative.”

Ultimately, there is no standard cycle threshold value that is agreed upon internationally. The U.S. Food and Drug Administration currently gives laboratory manufacturers autonomy in determining how many cycles are needed to determine whether a sample is positive or negative.

How accurate the test is matters, because everyone admitted to hospital, for whatever reason - maybe they had a heart attack - is routinely tested for Covid. If they are considered positive, and later on die, they will be counted as a Covid fatality, as “dying within 21 days of a positive test”.

So that’s three rather big question-marks lurking in the Covid data. But the next one, I think, is worse. This statistic purports to show vaccines save people from the worst effects of the disease.

It’s the statistic that led the CDC in the US to say:

“COVID-19 vaccines are highly effective at preventing severe COVID-19 and death.”

And you can read that in all the papers, in all the fact-checkers, and so you “might” think it must be true. However, statisticians at Queen Mary College in London, looked at the UK data (which is representative of other countries too) and concluded:

"Official mortality data for England suggest systematic miscategorisation of vaccine status and uncertain effectiveness of C19 vaccination”

They noticed that the official statistics showed that, following vaccination, the UNVACCINATED died. The so’-called healthy vaccine' effect. A less cheery explanation was that vaccines might actually be killing people - but if the deaths occurred within 21 days, as most side-effects do - being classified as deaths of “unvaccinated”.

This is a possibility, and adverse effects databases like the European EudraVigilance database and US VAERs ones currently report alarmingly high numbers, in apparently compelling detail – however the miscategorisation does not need to mean that vaccines are killing a lot of elderly people. Rather, fragile people are prioritised for vaccination, and thus skew the figures. However, by grouping vulnerable people together statistically to be vaxed and then … calling this group the unvaccinated, the authorities have very conveniently created an apparently miraculous positive effect for vaccines. That it is not really there is indicated that the positive effect is not only for Covid but for ALL CAUSE mortality!

This is known. Yet far from accepting the statistics mislead, governments and drug companies surmise that the treatments may have unexpected general positive effects.

In reality, the statistical anomaly is large because in countries like the UK, the NHS Guidelines explicitly state that the most critically ill people are the ones who must be prioritised for vaccination in each age group.

Let me try to sum it all up in three sentences! Vaccine data shows most of the advantage from the jab in the first few months. Because Covid vaccination programs prioritise very ill people, a significant number of whom die in the following 21 days - not from the vax necessarily, just because they were, well, vulnerable. Whatever the reason, again under the official guidelines, these deaths are classed as "unvaccinated", creating the “bad news” for the unvax and the amazing, parallel, health boost for the vaxed.

So there you have it. Some examples of how duff statistics, not anything more secretive let alone worrying, created a Ten Trillion Dollar “pandemic” that never was.

Do We Have Free Will?

by Jeremy Dyer *

Seneccio, by Paul Klee, 1922

The psychiatrist and philosopher Viktor Frankl wrote: ‘Psychoanalysis unmasks neurosis, and behaviourism demythologizes neurosis.’ This article was inspired by his thoughts in his 1978 book, The Unheard Cry for Meaning.

Psychological therapy—the classic ‘talking cure’—assumes the mechanics of unconscious motivation: childhood trauma and conditioning, subconscious conflicts and neuroses. These mechanics simply have to be unpacked, understood and exposed for an automatic cure. And in many cases, this works.

Behavioural therapy—classic ‘fake it till you make it’—assumes that functional behavior can overrule internal ills. Thus exercising at the gym cures depression. And in many cases, this also works! Additionally, it reveals that much uncovering ‘subconscious motivation’ is merely a waste of time.

Thus a blend—enter Cognitive Behavioural Therapy (CBT)—is ideal, right?

Wrong.

Both views, psychoanalytic and behavioural, are reductionist. They assume that we are a type of machine that can be broken down into parts, understood, and then rebuilt in a better way. Not all problems are due to childhood trauma, nor is behaviour modification the solution to all ills. We are far more than a complex machine, much more than advanced rats.

Both of the above, depersonalising, reductionist views of the individual—‘imprintings’ in the mindware—have logical solutions. Any particular lens of diagnosis implies the cure from that viewpoint.

But people are not entirely the slave of their history and upbringing - they can think and act for themselves, against the flow if they so decide. In defying our ‘programming’, in fact, we become uniquely alive. We are not all sheeple; predictable and controllable, like good soldiers and office workers.

No. The history of the world consists of the outliers, those who have broken the mould. Thrown off the conditioning, and rebelled. All progress depends on the ‘unreasonable man’, the playwright and political activist George Bernard Shaw famously said; the one who breaks the mould, comes up with their own original ideas like Spartacus, Mahatma Gandhi, Virginia Woolf, Mao Zedung, Rosa Parks, Salvador Dali—people who think and act for themselves. History records many, hero and villain alike.

Viktor Frankl held that the true purpose of psychological intervention is to create a new meaning of life. What he decidedly means is the process of examining the meaning of one’s life and, intrinsically, how to come to terms with one’s difficulties. This method is not limited to a certified expert, but can be anyone or anything which truly inspires and motivates one, be it spiritually or financially. Change is the goal, to move past ‘stuckness’.

Frankl wrote, “Many people in good jobs are successful but want to kill themselves.” One university survey of students who had attempted suicide and also ‘found life meaningless’ revealed that the majority of these students were engaged socially, performing well academically, and on good terms with their family.

The desire for meaning, the awareness of the pain of living, is not a psychological dysfunction but a part of who we fundamentally are. In other words, to feel despair is entirely rational. It is the painful personal condition itself that we must engage, to become our authentic, unique self. The only solution to the experienced horror of a meaningless life is to try to make sense of it with full engagement. The exact same process that is force-fed the addict in rehab. Confronting the horror of ones existence.

We have ‘agency’ and volition, self-observation, meta-cognition, the will to act… Will to meaning is the universal, teleological survival-drive that is built into us all. If this dies, we die.

Everyone is bored with the media-driven, ideological clones. Be who you are, become more who you truly are: fascinatingly unique.



* Jeremy Dyer is a psychologist and artist.

Are ‘Ideas’ the Bulwark of Democracy?

Caricature of Alexis de Tocqueville by Honoré Daumier (1849).

By Keith Tidman

Recently, Joe Biden asserted that ‘democracy doesn’t happen by accident. We have to defend it, fight for it, strengthen it, renew it’. And so, America’s president, along with leaders from over a hundred other similarly minded democratic countries, held the first of two summits, to tackle the ‘greatest threats faced by democracies today’.

Other thought leaders have weighed in, even calling democracy ‘fragile’. But is democracy really on its heels? I don’t think so; democracy is stouter than it’s given credit for, able to fend off prodigious threats. And here, in my view, are some reasons why.

First, let’s briefly turn to America’s founding fathers: James Madison famously said that ‘If men were angels, no government would be necessary’. A true-enough maxim, which led to establishing the United States’ particular form of national governance: a democratic republic. With ‘inalienable’, natural rights.

Many aspects of democracy helped to define the constitutional and moral character of Madison’s new nation. But few factors rise to the level of unencumbered ideas. 

Ideas compose the pillar that binds together democracies, standing alongside those other worthy pillars: voting rights, free and fair elections, rule of law, human-rights advocacy, free press, power vested in people, self-determination, religious choice, peaceful protest, individual agency, freedom of assembly, petition of the government, and protection of minority voices, among others. 

Ideas are the pillar that keeps democracy resilient and rooted, on which its norms are based. They constitute a gateway to progress. Democracy allows for the unhindered flow of different social and political philosophies, in intellectual competition. Ideas flourish or wither by virtue of their content and persuasion. Democracy allows its citizens to choose which ideas frame the standards of society through debate and the willingness to subject ideas to inspection and criticism. Litmus tests of ideas’ rigour. Debate thereby inspires policy, which in turn inspires social change.

Sure, democracy can be messy and noisy. Yet, democracies do not, and should not, fear ideas as a result. The fear of ideas is debilitating and more deleterious than the content of ideas, even in the presence of disinformation aimed to cleave society. Countenancing opposing, even hard-to-swallow points of view ought to be how the seeds of policy sprout. Tolerance in competition, while sieving out the most antithetical to the ideals of society, helps to lubricate the political positions of true leaders.

Democracy makes sure that ideas are not just a matter for the academy, but for everyone. A notion that heeds Thomas Jefferson’s observation that ‘Government is the strongest of which every man feels himself a part’. Inclusivity is thus paramount; exclusivity aims to trivialize the force-multiplying power of common, shared interests, and in the process risks polarizing.

Admittedly, these days our airwaves and social media are rife with hand-wringing over the crisis or outrage of the moment. There’s plenty of self-righteousness. On the domestic front, people stormed the Capitol building just over a year ago, unsuccessfully attempting to interrupt the peaceful handover of presidential power. Extremists of various ideological vintage shadow the nation. Yet, it’s easy to forget that the nation has been immersed in such roiling politics and social hostilities earlier in its history. There’s a familiarity. All the while, powerful foreign antagonists challenge America’s role as the beacon of democracy. The leaders of authoritarian, ultranationalistic regimes delight in poking their thumb into America’s and Europe’s eye.

Lessons of what not to do come from these authoritarian regimes. Their first rule is not to brook objection to viewpoints prescribed by the monopolistic leader. Opinions that run counter to regimes’ authorised ‘truth’ — shades of Orwell’s 1984 — threaten authoritarians’ survival. They race to erase history, to control the narrative. Insecurities simmer. If the chestnut ‘existential crisis’ applies anywhere, it’s there — in autocrats’ insecurities — to be exploited. Yet, they’re aware that ‘People rarely take to the streets demanding autocracy’, as recently pointed out by the former Danish prime minister, Anders Fogh Rasmussen. Contrarianism menaces the authoritarians’ laser focus on power and control: their imposition of will.

The free flow of ideas is democracy’s nursery of innovation. The constructive exchange of opinions is essential for testing hypotheses, to determine which ideas are refutable or confirmable, and thus discarded or kept. Ideas are commanding; they are democracy’s bulwark against the paternalism and disingenuousness of hollowed-out constitutional rights, which have been autocracies’ fraudulent claim to mirror democracies’ bills of rights.

All this leads to the cautionary words of the nineteenth-century political philosopher and statesman Alexis de Tocqueville: 

‘…that men may reach a point where they look at every new theory as a danger, every innovation as a toilsome trouble, every social advance as a first step toward revolution, and that they may absolutely refuse to move at all’.

Democracy thus far has resisted the affliction of which de Tocqueville counseled. It is the emboldened churn of ideas, as spurs to vision, experimentation, innovation, and constructive criticism, that have enabled democracy to maintain its firm footing. A point that might, therefore, inform the second global summit on democracy now slated for year's end is how this power of enlightened ideas underscores the untruth of democracy’s supposed fragility. 

Picture Post #71 Melting Away

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'Because things don’t appear to be the known thing; they aren’t what they seemed to be

neither will they become what they might appear to become.'

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Posted by Martin Cohen

Photo by Luca Bravo, via Unsplash  

Luca Bravo, this month's photographer, is an Italian web developer whose portfolio of photographs is, he says, inspired by ‘silent hills, foggy mounts and cold lakes’. However, most of his photographs are of cityscapes because he is also interested in what he describes as ‘the complex simplicity of patterns and urban architecture’. Many of these images are of modern buildings, and many are striking – visually impressive. They use a limited palette of colours and feature geometrical extravagances created in steel and concrete. 

But I liked this photograph best. It is of a rather modest building - only captured in a clever way. As our rubric for Picture Posts has it: here is something that isn't quite what it seems to be… 

The Meaning of 2022

2019. The Karoo Semi-Desert. Photo by Thomas Scarborough.

by Chengde Chen *

 

When the face mask is off

A Christmas smile appears 

But you know it is a forced one

With much fearfulness underneath 

The plague persists with craziness 

Bones piling up mountain high

Global warming knocks on the door

Proving it has been too late to stop

The conflict between the superpowers 

Increasingly lead to a world war

Which probably let nuclear power

Decide our joys and sorrows

Three kinds of doom come together

As if to make sure there is no escape

But it is this that gives 2022 meaning –

To test human resilience to the full!

* Chengde Chen: author of Five Themes of Today; The Thought-read Revolution, etc. chengde.chen@hotmail.com

Can Thought Experiments Solve Ethical Dilemmas?

In ethics, the appeal to expand the “moral circle” typically requires moving from consideration of yourself to that of all of nature.

By Keith Tidman

What, in ethical terms, do we owe others, especially when lives are at stake? This is the crux of the ‘Drowning Child’ thought experiment posed by the contemporary philosopher, Peter Singer.

Singer illustrates the question to his students in this way:

You are walking to class when you spot a child drowning in a campus pond. You know nothing of the child’s life; and there is no personal affiliation. The pond is shallow, so it would be easy to wade in and rescue her. You would not endanger yourself, or anyone else, by going into the water and pulling the child out.

But, he adds, there are two catches. One is that your clothes will become saturated, caked in mud, and possibly ruined. The other is that taking the time to go back to your dorm to dry off and change clothes will mean missing the class you were crossing the campus for.

Singer then asks his students, ‘Do you have an obligation to rescue the child?’

The students, without exception and as one might expect, think that they do. The circumstances seem simple. Including that events are just yards away. The students, unprompted, recognise their direct responsibility to save the flailing child. The students’ moral, and even pragmatic, calculus is that the life of the child outweighs the possibility of ruined clothes and a missed class. And, for that matter, possibly the sheer ‘nuisance’ of it all. To the students, there is no ambiguity; the moral obligation is obvious; the costs, even to the cash-strapped students, are trivial.

The students’ answer to the hypothetical about saving a drowning child, as framed above, is straightforward — a one-off situation, perhaps, whose altruistic consequences end upon saving the drowning child who is then safe with family. But ought the situation be so narrowly prescribed? After all, as the stakes are raised, the moral issues, including the range of consequences, arguably become more ambiguous, nuanced, and soul-searching.

At this point, let’s pivot away from Singer’s students and toward the rest of us more generally. In pivoting, let’s also switch situations.

Suppose you are walking on the grounds of a ritzy hotel, to celebrate your fiftieth anniversary in a lavish rented ballroom, where many guests gleefully await you. Because of the once-in-a-lifetime situation, you’re wearing an expensive suit, have a wallet filled with several one-hundred-dollar bills, and are wearing a family legacy watch that you rarely wear.

Plainly, the stakes, at least in terms of potential material sacrifices, are much higher than in the first scenario.

If, then, you spot a child drowning in the hotel’s shallow pond nearby, would you wade in and save the child? Even if the expensive suit will be ruined, the paper money will fall apart from saturation, the family antique watch will not be repairable, and the long-planned event will have to be canceled, disappointing the many guests who expectantly flew in at significant expense?

 

The answer to ‘Do you have an obligation to rescue the child?’ is probably still a resounding yes — at least, let’s hope, for most of us. The moral calculus arguably doesn’t change, even if what materially is at risk for you and others does intensify. Sure, there may be momentary hesitation because of the costlier circumstances. Self-interests may marginally intrude, perhaps causing a pause to see if someone else might jump in instead. But hesitation is likely quickly set aside as altruistic and humanitarian instincts kick in.

To ratchet up the circumstances further, Singer turns to a child starving in an impoverished village, in a faraway country whose resources are insufficient to sustain its population, many of whom live in wretched conditions. Taking moral action to give that child a chance to survive, through a donation, would still be within most people’s finances in the developed world, including the person about to celebrate his anniversary. However, there are two obvious catches: one is that the child is far off, in an unfamiliar land; the other is that remoteness makes it easier to avert eyes and ears, in an effort at psychological detachment.

We might further equivocate based on other grounds, as we search for differentiators that may morally justify not donating to save the starving child abroad, after all. Platitudinous rationales might enter our thinking, such as the presence of local government corruption, the excessive administrative costs of charities, or the bigger, systemic problem of over-population needing to be solved first. Intended to trick and assuage our consciences, and repress urges to help.

Strapped for money and consumed by tuition debt, Singer’s students likely won’t be able to afford donating much, if anything, toward the welfare of the faraway starving child. Circumstances matter, like the inaccessibility; there’s therefore seemingly less of a moral imperative. However, the wealthier individual celebrating his anniversary arguably has a commensurately higher moral obligation to donate, despite the remoteness. A donation equal, let’s say, to the expense of the suit, money, and watch that would be ruined in saving the child in the hotel pond.

So, ought we donate? Would we donate? Even if there might appear to be a gnawing conflict between the morality of altruism and the hard-to-ignore sense of ostensible pointlessness in light of the systemic conditions in the country that perpetuate widespread childhood starvation? Under those circumstances, how might we calculate ‘effective altruism’, combining the empathy felt and the odds of meaningful utilitarian outcomes?

After all, what we ought to do and how we act based on what’s morally right not infrequently diverge. Even when we are confronted with stark images on television, social media, and newspapers of the distended stomachs of toddlers, with flies hovering around their eyes.

For most people, the cost of a donation to save the starving child far away is reasonable and socially just. But the concept of social justice might seem nebulous as we hurry on in the clamour of our daily lives. We don’t necessarily equate, in our minds, saving the drowning child with saving the starving child; moral dissonance might influence choices.

To summarise, Singer presented the ethical calculus in all these situations this way: ‘If it is within our power to prevent something bad from happening, without sacrificing anything of comparable moral importance, we ought, morally, to do it’. Including saving the life of a stranger to avoid a child’s preventable death.

For someone like the financially comfortable anniversary celebrator — if not for the financially struggling college students, who would nevertheless feel morally responsible for saving the child drowning on campus — there’s an equally direct line of responsibility in donating to support the starving child far away. Both situations entail moral imperatives in their own fashion, though again circumstances matter.

The important core of these ethical expectations is the idea of ‘cosmopolitanism’: simply, to value everyone equally, as citizens of the world. Idealistic, yes; but in the context of personal moral responsibility, there’s an obligation to the welfare of others, even strangers, and to treat human life reverentially. Humanitarianism and the ‘common good’ writ large, we suppose.

To this critical point, Singer directs us to the political theorist William Lecky, who wrote of an ‘expanding circle of concern’. It is a circle that starts with the individual and family, and then widens to encompass ‘a class, then a nation, then a coalition of nations, then all humanity’. A circle that is a reflection of our rapid globalisation.

Perhaps, the ‘Drowning Child’ thought experiment exposes divides between how we hypothesize about doing right and actually doing right, and the ambiguity surrounding the consistency of moral decision-making.

Mathematical Meditations

by Thomas Scarborough

I shall call this post an exploration—a survey. Is mathematics, as Galileo Galilei described it, ‘the language in which God has written the universe’? Are the numerical features of the world, in the words of the authors of the Collins Dictionary of Philosophy, Godfrey Vesey and Paul Foulkes, ‘free from the inaccuracies we meet in other fields'? Many would say yes—however, there are things which give us pause for thought.

• Sometimes reality may be too complex for our mathematics to apply. It is impossible to calculate in advance something as simple as the trail of a snail on a wall. Stephen Hawking noted, 'Even if we do achieve a complete unified theory, we shall not be able to make detailed predictions in any but the simplest situations.' If we do try to do so, therefore, we abuse mathematics—or perhaps we should say, in many contexts, mathematics fails. 

• Our measurement of the world may be inadequate to the task—in varying degrees. I take a ruler, and draw a line precisely 100 mm in length. But now I notice the grain of the paper, that my pencil mark is indistinct, and that the ruler's notches are crude. In many cases, mathematics is not the finest fit with the reality we deal with. In some cases, no fit at all. I measure the position of a particle, only to find that theoretical physicist Werner Heisenberg was right: I have lost its velocity. 

• The cosmologist Rodney Holder notes that, with regard to numbers—all numbers—'a finite number of decimal places constitutes an error'. Owners of early Sinclair calculators, such as myself, viewed the propagation of errors in these devices with astonishment. While calculators are now much refined, the problem is still there, and always will be. This error, writes Holder, 'propagates so rapidly that prediction is impossible'. 

• In 1931, the mathematician Kurt Gödel presented his incompleteness theorems. Numbers systems, he showed, have limits of provability. We cannot unite what is provable with what is true—given that what this really means is, in the words of Natalie Wolchover, ‘ill-understood’. A better known consequence of this is that no program can find all the viruses on one’s computer. Consider also that no system in itself can prove one’s own veracity. 

• Then, it is we ourselves who decide what makes up each unit of mathematics. A unit may be one atom, one litre of water, or one summer. But it is not that simple. Albert Einstein noted that a unit 'singles out a complex from nature'. Units may represent clouds with noses, ants which fall off a wall, names which start with a 'J', and so on. How suitable are our units, in each case, for manipulation with mathematics?

• Worst of all, there are always things which lie beyond our equations. Whenever we scope a system, in the words of philosophy professor Simon Blackburn, there is 'the selection of particular facts as the essential ones'. We must first define a system’s boundaries. We must choose what it will include and what not.  This is practically impossible, for the reason that, in the words of Thomas Berry, an Earth historian, 'nothing is completely itself without everything else'. 

• I shall add, myself, a 'post-Gödelian' theorem. Any and every mathematical equation assumes that it represents totality. In the simple equation x + y = z, there is nothing beyond z. As human beings, we can see that many things lie outside z, but if the equation could speak, it would know nothing of it. z revolts against the world, because the equation assumes a unitary result, which treats itself as the whole.
  

Certainly, we can calculate things with such stunning accuracy today that we can send a probe to land on a distant planet’s moon (Titan), to send back moving pictures. We have done even more wonderful things since, with ever increasing precision. Yet still the equations occupy their own totality. Everything else is banished. At what cost?

Picture Post #70: Civilisation!

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'Because things don’t appear to be the known thing; they aren’t what they seemed to be

neither will they become what they might appear to become.'

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Posted by Tessa den Uyl

Rooftop Madrid. 2021. 

The last two picture posts did regard a certain idea of decay, and as a threesome, this picture might enhance that subtle fascination that surrounds those layered surfaces.

The abstract has often been criticized as either easy art or difficult thinking. Even when we became used to abstract ideas and turned them into what is called: rational thinking. Do we not mostly accept what is convenient in some way or other, no matter how illusory things are, and all the rest we prefer to discard? 

We overlap thoughts with actions and emotions; overlapping is our strength and our misery. Continuous overlapping sketches the picture we live in, and so, rather unawares, we shake a cocktail that we define as ‘our life’. 

What we can apprehend simply by viewing even trash, so complicated by its nature for refuse(d), and often wished unseen, is that everything traces into something else, and transforms. 

Symbolically, when we look at ourselves, we might find a trashy landscape far worse than this rooftop. Although the terror of seeing the veritable junkyard from within also shows the many forgotten things that we touched and related to during our life. And we’re all that, not just a part. 

The picture we prefer to see cannot match the reality we imagine. How real can we truly be?