Lessons from the Pandemic

It's generally recognized that our (American) response to the Covid-19 pandemic was disastrous. But I think far fewer appreciate the full scale of the disaster, or the most significant causal levers by which the worst effects could have been avoided.  (Yes, Trump was bad.  But his public health disinformation and politicization of masking -- while obviously bad -- may prove relatively trivial compared to the mammoth failings of our public health institutions and medical establishment.)  Much of the pandemic's harm could have been mitigated had our institutions been properly guided by the most basic norms of cost-benefit analysis.  Consider:

Epistemic Calibration Bias and Blame-Aversion

People typically treat having an importantly false belief as much more problematic than failing to have an importantly true belief.  They're more concerned about being over-confident than being under-confident in their credences.  But why?  Is such an epistemic asymmetry warranted?

I'm dubious.  The ideal is to be epistemically well-calibrated: to have just the degree of confidence in an important proposition that is warranted by your evidence, such that in the long run exactly X% of your "X% confident" beliefs turn out to be true -- no more and no less.  Moreover, it seems to me that we should be equally concerned about miscalibration in either direction.  If we are underconfident (or withhold judgment entirely) when our evidence strongly supports some important truth, that's just as bad, epistemically speaking, as being correspondingly overconfident.

Philosopher Spotlight: Eden Lin

I'm delighted that Eden Lin agreed to contribute the following post to my "philosopher spotlight" series.  Enjoy!

* * *

Most of my work has focused on the normative ethics of well-being or welfare, which investigates (i) what counts as a life that is going well or badly for the individual whose life it is, (ii) what determines how well or badly someone’s life is going, and (iii) what things are good or bad for individuals in the most basic way.

2020 in review

[Past annual reviews: 2019 & '18, 2017, 2016, 2015, 2014, 2013, 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, and 2004.]

Off the blog: In contrast to many families, our childcare situation actually improved in 2020 (!), so I was able to be much more productive than in the previous couple of years:

* Completed my little Parfit book for Cambridge University Press' Elements in Ethics series.

* 'The Right Wrong-Makers' -- probably my best paper yet -- accepted for publication in PPR.

* Co-authored a Washington Post op-ed (on pandemic research ethics) with Peter Singer.

* Expanded the above into a short-but-sweet open-access paper in Research Ethics.

* Contributed to another co-authored paper (highlights here) exploring the prospects for controlled voluntary infection as a pandemic policy tool.

* 'Deontic Pluralism and the Right Amount of Good' appeared in print.

Blog posts:

Academia

* Beneficent Retirement and Academic Successorships - exploring Smilansky's suggestion that "for a great many people, the best professional action that they can currently take is to leave their profession." Argues for time-limited tenure and other policies to encourage more & shorter academic careers.  Are there any non-selfish reasons to oppose this?

* Academic pay cuts vs job cuts -- in a forced-choice situation, we should much prefer the former. We should even prefer pay cuts for established professors over more common measures like hiring freezes.

* What if authors could respond to referee comments? - could help relieve the systemic overburdening of journals, as a confused report just means the review process will start all over again somewhere new.

* What Should Editors Ask of Referees? - suggestions for improving peer review.

Ethical & Political Theory

* A New Paradox of Deontology - why the shift to agent-neutral deontology doesn't help. (Improved version posted to PEA Soup.)

* Moral Theory and Motivational Contingency - How, if at all, would your motivations change in response to changes in your normative- or meta-ethical beliefs? 

* Nefsky on Tiny Chances and Tiny Differences - I refute some bad arguments for thinking that consequentialism has any kind of "inefficacy problem".

* When is Inefficacy Objectionable? - after addressing three prominent arguments, I conclude: "none of these arguments appear to have any potential to establish that consequentialism is collectively self-defeating. They're complete non-starters. If I'm right about this, then the current literature on this topic would appear to be deeply confused."

* Emergence and Individual Impact - explains why Sinnott-Armstrong's famous arguments in defense of "joyguzzling" rests on an incoherent assumption.

* Who's responsible for offset harms? - working through some puzzles about moral offsetting.

* No Utility Cascades - a simple refutation of a recent Analysis paper.

* Monotonicity and Inadvisable Oughts - Sometimes you ought to do a specific thing that's of a general kind, but you ought not to do that general thing (because you'd actually do it in the wrong specific way). (Responding to contrary arguments from Daniel Muñoz & Jack Spencer).

* Vulcan Interests and Moral Status - affect is required for non-zero welfare, but one may possess moral status even while one's welfare is stuck at zero.

* Hedonism, Egoism, and Implausible Restrictions - Why I think hedonism and egoism are completely bonkers, poorly-motivated views.

* Political Beliefs, Uncertainty, and the Expected Value of Paralysis - uncertainty is no reason to suspend belief (undermining Jason Brennan's latest argument against voting).

* Adams' Critique of Global Consequentialism - a good objection, though his follow-through is off-track.

Posts on the Ethics of Controlled Voluntary Infection

* Highlights from my coauthored paper on deliberate infection (summarizes and links to major points from the following posts).

* Pandemic moral failures: how conventional morality kills.

* When is CVI worthwhile?

* Three Neglected Advantages of Controlled Infection

* Combining Experimental Vaccines + Variolation - this policy could have stopped the early pandemic in its tracks, with minimal risk.

Other Applied / Pandemic Ethics

* Lives are the Wrong Measure - many issues in ethics are subject to reasonable dispute, but this isn't one of them.  Counting all deaths as equal is simply idiotic.  This post refutes a contrary argument that rests upon a kind of probabilistic bias.

* Innocuous vs Unjust Systemic Discrimination - disparate outcomes needn't be unjust. Common objections to QALYs rest on a very basic failure to appreciate this: "If men end up worse off when everything is counted as it ought to be, that does not make correctly counting things sexist against men. And so it goes, of course, for the elderly and (detrimentally) disabled."

* Against Conventional Moral 'Decency': There's actually nothing "decent" about blindly prioritizing quantity over quality of life.

* Against 'prudish' research ethics - A striking analogy between prostitution and so-called "exploitative" medical research.

* The Optimal Use of Sub-optimal Vaccines - NYT "experts" cannot imagine how to incentivize people to remain in socially valuable medical trials.

* Against Bad Government (pandemic edition) - I'm shocked by how incompetent and harmful our local government's response has been.

* Scale and Symmetry in Covid Debates - on the importance of comparative assessments when every available option involves grave costs.  Plus a quick illustration of how immense the indirect harms from the pandemic could be.

* Legality is No Excuse - it's possible to exercise one's legal rights in ways that are morally wrong, obvs.

* Where Best to Give - now easier to know than ever before!

Other

* What Makes Your Papers Worth Reading?  I offer my answers there.  I look forward to others contributing to my Philosopher Spotlight Series soon (I've some exciting guest posts lined up for the new year -- feel free to shoot me an email if you're interested in joining in!). 

* VR Recommendations for Oculus Quest - and at just $300, I'd strongly recommend the latest headset to anyone interested in the technology -- after surviving 2020, you deserve a treat.

Happy New Year!

Scale and Symmetry in Covid Debates

One curious feature of some public debate about Covid policy is when people object to a disliked policy proposal by appealing to a consideration that counts at least as much against the alternative.  Here I'll just highlight a couple of especially striking examples of this: scale and unknown risks.

(1) Scale:  Back when people were debating whether society's response might end up being worse than the disease, it wasn't unusual to see health boosters emphasize the sheer scale of the health costs that would be incurred along the path to herd immunity through natural infection.  "Even a fatality rate of just 0.01% for younger adults would translate into thousands of deaths across that population."  That kind of thing.

Which invites the obvious response: Yes, the scale of a pandemic makes the policy stakes really high!  For example, if you lower everyone's quality of life by an average of 1/3 for a year, that translates into more than 100 million life-years of equivalent value lost in the US alone (cf. estimated health gains of a few million life-years from covid prevention measures).

New Paper on Pandemic Ethics

'The Ethics of Deliberate Exposure to SARS-CoV-2 to Induce Immunity', forthcoming in the Journal of Applied Philosophy, by Robert Streiffer, David Killoren, and myself.

Abstract:

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale DEI would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future.

Quick summary of the harm-reduction potential of DEI:

VR recommendations (for Oculus Quest 1 & 2)

I expect plenty of people will be waking up to a new Oculus Quest 2 tomorrow, so figure it could be helpful to share some recommendations, as a long-time fan of virtual reality...

Combining Experimental Vaccines + Variolation

Current estimates suggest that the US will end up with around 500k Covid deaths (itself but a tiny fraction of the total harm done), with eventual herd immunity reached half via vaccination and half via natural infection.  I expect we could've done much better via variolation (low-dose viral inoculation), for reasons I've previously discussed.  But I've recently learned that an even better option was available -- though it's not one that I've seen anyone suggest before.

NY Mag reports that "We Had the COVID-19 Vaccine the Whole Time" (well, since February).  Many now wonder: Would it have been prudent to distribute the experimental vaccine, at least to high-exposure or high-risk individuals, even before it was proven safe and effective?  Quite possibly.  After all, the risks from an untested vaccine of this sort are much lower than the risks from COVID-19 for many individuals.  The main potential downside would be the "moral hazard" of vaccinated individuals behaving more recklessly and spreading COVID if the vaccine turned out to be either (i) ineffective, or (ii) effective only at suppressing symptoms but not viral transmission.

But this risk could in turn be avoided by a combination policy of vaccination followed by variolation (with quarantine).  If the vaccine fails, variolation acts as a "fail-safe" to provide natural immunity (while minimizing unwitting community transmission, in stark contrast to all our uncontrolled infections).  And if the vaccine worked (as turns out to actually be the case) then the risks from variolation are further minimized.  Given even a moderate chance of vaccine effectiveness, the expected value of variolation is significantly bolstered (due to reduced risk).

Against Bad Government [Pandemic Edition]

Libertarians like to rail against "Big Government", but that often comes off as needlessly ideological and indiscriminate.  Governments are capable of doing good things, after all, and it's worth supporting them when they do.  (Granted, there are more sweeping arguments for why, say, a market-based economy is a better idea than communist central-planning, no matter how "good" the communist leaders might be.  But attacks against "big government" tend to have a wider target than just this.)

So I prefer to stake a claim against bad government.  When governments do bad things, it's the badness, not the mere fact of intervention, that I'm opposed to.  Framing it this way may help to make for a more receptive audience, too: few liberals are impressed by sweeping complaints about "big government", but nobody could deny that particular policies might be bad.  And from there we might even be able to identify systematic reasons why certain governments, at certain times, could be expected to generally do more harm than good, and hence why we might reasonably prefer that they had less power over us (at least if we're not able to remedy the deeper problem).

Adams' Critique of Global Consequentialism

From p.479 of 'Motive Utilitarianism':

The moral point of view—the point of view from which moral judgments are made—cannot safely be defined as a point of view in which the test of utility is applied directly to all objects of moral evaluation. For it is doubtful that the most useful motives, and the most useful sort of conscience, are related to the most useful acts in the way that the motives, and especially the kind of conscience, regarded as right must be related to the acts regarded as right in anything that is to count as a morality. And therefore it is doubtful that direct application of the test of utility to everything results in a system that counts as a morality.

How must the right motives be related to the right acts?  Plausibly through a principle that links normative and motivating reasons: an agent acts from the "right reasons" when their motivating reasons are the very normative reasons that make the act worth doing.  Something along those lines.