Competing Claims and Separate Persons

I've previously argued that consequentialist moral theories respect the "separateness of persons" when they recognize individual persons as being of distinct intrinsic value, rather than seeing them as mere means to the single token value of aggregate welfare. (This entails more fine-grained non-instrumental desires, and associated emotions like regret, but doesn't ultimately affect what actions are the right ones to perform.) So I was interested to come across a different conception of the separateness of persons in Michael Otsuka's 'Prioritarianism and the Separateness of Persons'.  According to Otsuka, a theory respects the separateness of persons when it is sensitive to "competing claims" and so treats "non-identity" cases differently:

It is morally relevant that there are distinct persons with competing claims to receive benefits. Such competing claims ground moral complaints on the part of those who would be worse off, relative to others, and the case for giving benefits to people with such complaints is stronger than it otherwise would be in analogous [intra-personal or non-identity] cases in which the prioritarian value of distributing goods in one way rather than another is equally great, yet such complaints are lacking. (371-2)

Consequences in Time

M. Oreste Fiocco has a curious paper, 'Consequentialism and the World in Time', forthcoming in Ratio.  It contains a number of arguments that strike me as very confused.

One central argument may be characterized as follows:
(1) Consequentialism is committed to "temporal homogeneity" (i.e. Eternalism)
(2) The truth or falsity of consequentialism is non-contingent
(3) Temporal homogeneity is contingent
So, Consequentialism is false.

Parfit on Aggregation and Iteration

People often claim that a large harm to one person is more important to prevent than a very great number of smaller harms to different people.  But this "anti-aggregative" view (that we ought to prevent the one great harm rather than the many smaller ones that quantitatively outweigh it) is indefensible for the straightforward reason that repeated iterations of such a choice would make everyone worse off.  As Parfit explains in 'Justifiability to Each Person' (p.385):

[W]e might claim that
    (1) we ought to give one person one more year of life rather than lengthening any number of other people’s lives by only one minute.
And we might claim that
    (2) we ought to save one person from a whole year of pain rather than saving any number of others from one minute of the same pain.
These lesser benefits, we might say, fall below the triviality threshold.

These claims, though plausible, are false. A year contains about half a million minutes. Suppose that we are a community of just over a million people, each of whom we could benefit once in the way described by (1). Each of these acts would give one person half a million more minutes of life rather than giving one more minute to each of the million others. Since these effects would be equally distributed, these acts would be worse for everyone. If we always acted in this way, everyone would lose one year of life. Suppose next that we could benefit each person once in the way described by (2). Each of these acts would save one person from half a million minutes of pain rather than saving a million other people from one such minute. As before, these acts would be worse for everyone. If we always acted in this way, everyone would have one more year of pain.

Lives Can't be Saved

As I've written before:

We talk a lot about 'saving lives', but we shouldn't -- it's really quite misleading. At best, we may save a few decades of someone's life. Death is never banished; merely postponed. "Reducing" the number of deaths in the world is not a coherent goal: we know there will be exactly one for each life, and there's no changing that (modulo immortality research). What we really mean here is that we aim to extend life. It's worth being clear on this, since not all life-extensions are equal, but a rhetorical focus on 'death' [or 'life-saving'] occludes this fact.

It's an obvious point, but one that seems unjustly neglected in the bioethics literature.  It seems very common for bioethicists to want to balance the two goals of (1) saving the most lives and (2) maximizing life-years (see, e.g., Kerstein & Bognar).  But "saving the most lives" is not, strictly speaking, a coherent goal (especially when contrasted with the goal of extending people's lives as much as possible); talking this way gives an unwarranted rhetorical glow to what actually amounts to simply distributing life-years across a greater number of people.  And I don't see any good reason to take that as an ultimate goal.

Unreliable Philosophy?

Jason Brennan's 'Scepticism about Philosophy' raises a very interesting challenge, arguing that "[w]idespread disagreement shows that pursuing philosophy is not a reliable method of discovering true answers to philosophical questions."

I want to explore three ways of responding to the challenge (I should flag that these extend beyond the scope of Jason's paper, and so should be taken as "semi-related thoughts" rather than "objections").  We may question (1) whether there is any better alternative to doing philosophy as best we can -- however unreliable that may be; (2) the extent to which "discovering true answers" is an important goal of philosophy; and (3) whether "philosophy" in general is the relevant reference class for assessing reliability, or whether we should instead be assessing a range of more fine-grained methods.

Treatment, Prevention, and Bad Bioethics

Macklin and Cowan's (2012) 'Given financial constraints, it would be unethical to divert antiretroviral drugs from treatment to prevention' makes for a very frustrating read.  They heavily cite a very good 2009 paper by Brock & Wikler, 'Ethical Challenges In Long-Term Funding For HIV/AIDS', which argues that various grounds people might appeal to for favouring treatment over (more efficient) prevention don't actually support that conclusion upon further reflection.  It's good stuff -- I'll summarize some of it below.  Macklin & Cowan, however, simply reiterate the previously-discussed principles and assert without argument that these favour treatment over prevention (in many cases completely neglecting to mention, let alone refute, the powerful objections previously raised by B&W).  It's quite extraordinary.

Philosophers' Carnival: New Directions

After eight years (!), I'm stepping down from running the Philosophers' Carnival.  Fortunately, Tristan Haze of Sprachlogik has volunteered to take over the reins, and I gather that he has plans to revive the carnival and get it out of its recent slump.  So, my thanks to Tristan.  And for any old fans of the carnival: keep an eye out for improvements to come!

QALYs, DALYs, and Complete Lives

Persad et al's 'Principles for allocation of scarce medical interventions'* offers interesting criticisms of existing theories of just allocation, and proposes a new account that they call "the complete lives system".  I recommend checking out the whole paper, here I'm just going to explore one strain of it.

By way of background: "QALYs", or Quality-Adjusted Life Years, are self-explanatory.  "DALYs", or Disability-Adjusted Life Years, sound like they should be the same thing but (confusingly) also build in an instrumental component, discounting the "unproductive" years of the very young and elderly in favour of the (young-ish) working-age population.