February 28, 2007

I have to wonder

What do my libertarian friends think of this?

Twelve-year-old Deamonte Driver died of a toothache Sunday.

A routine, $80 tooth extraction might have saved him.

If his mother had been insured.

If his family had not lost its Medicaid.

If Medicaid dentists weren't so hard to find.

If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth.

By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.


Now, I'm inclined to call this an act of violence. In denying Driver medical care, we as a society are responsible for his death.

But let's bracket that question since, as Andrew Bailey correctly pointed out, defining violence is hard. Let's look instead at a principle of Peter Singer's:

If we can prevent something very bad from happening by doing X, and if we can do X without sacrificing something of comparable moral worth, then doing X is morally required.

In particular,

If we can prevent (or substantially reduce the incidence of) the death of poor people from preventable diseases by paying a progressive tax into a single-payer health care system, and our freedom from taxation is not of comparable moral worth with the death of poor people from preventable diseases, then paying a progressive tax into a single-payer health care system is morally required.

This isn't a particularly utilitarian principle. Indeed, I have trouble understanding what it would be for the general principle to be false; what else could it be for X to be of less comparable worth than Y except for the sacrifice of X for the sake of Y to be morally required?

But I suppose libertarians want to reject the conclusion the more specific principle implies. How does this rejection go? The specific principle is an instance of the general principle, and I've already suggested the general principle is as analytic a truth as one could hope for. Then there's an empirical premiss, concerning the effectiveness of single-payer health care systems in improving public health, which I take to be extremely well-supported. The only other option is to claim that not paying into a progressive income tax is of higher moral comparable worth than the lives of poor people, which seems to be radically incompatible with any baseline notion -- whether Kantian, Aristotelean, or mainstream Christian -- of the intrinsic worth of every individual, a la Nozick.

Is the libertarian seriously going to claim that property is of greater intrinsic worth than life?

8 comments:

Drew said...

Libertarians just don't think that way. They think in clear moral absolutes, but their morality doesn't burden them with obligations. Libertarian morality exists only to hamper government.

It's not a question of comparable moral worth of people and property. A single-payer healthcare system is unacceptable because it would require government to collect mandatory taxes from individuals by force. That's wrong. End of discussion.

Noumena said...

For a certain class of libertarians (Ayn Rand, Mark Poyar), that's certainly true. But there are more philosophically rigorous libertarians, including Robert Nozick and my friend and colleague Andrew Bailey (who commented on my post on libertarians the other day). Those are the ones I'm more interested in arguing with -- after all, they're the ones who might actually concede a point against them.

Andrew Bailey said...

Suppose this is true:

"If we can prevent (or substantially reduce the incidence of) the death of poor people from preventable diseases by paying a progressive tax into a single-payer health care system, and our freedom from taxation is not of comparable moral worth with the death of poor people from preventable diseases, then paying a progressive tax into a single-payer health care system is morally required."

The libertarian is free to grant all this without inconsistency. The fortunate may have unique moral obligations to subsidize the health care of others, say. But this does not entail the permissibility of the state-sponsored *taking* of this money, however. This is where the libertarian must demur.

It may be morally obligatory for S to give money toward end X, but still morally impermissible for some distinct S' to require (with force, say) S to give money toward X.

Do you disagree?

Drew said...

Ok, I'm way out of practice with the whole philosophy thing, and I would have been out of my league even in my prime. So maybe I'm missing something obvious, but it really looks to me like Andrew's answer is exactly the same as the one I predicted.

Andrew Bailey said...

Not quite. You write: "They think in clear moral absolutes, but their morality doesn't burden them with obligations. Libertarian morality exists only to hamper government."
Let me be the token libertarian here and note that I, at least, deny this. Constraints on permissible government actions aren't the only moral principles I recognize. I acknowledge, for example, the existence of duties to do all sorts of nice things for other people; it's just that the vast majority of these duties are not permissibly encoded in or enforced by law.

Noumena said...

What's the (read: your) principle for distinguishing moral requirements that can and cannot be `permissibly encoded in or enforced by law'? Kant has one early in the Metaphysics of morals, though I can't recall what it is off the top of my head and I'm feeling too lazy to go downstairs and check.

Andrew Bailey said...

I favor a demarcation having something to do with coercion... Everyone has a duty to refrain from acts of initial violence, and this is a (the) duty which is permissibly enforced or encoded in law. =)

I'm still curious whether you agree with me that not all moral requirements are permissibly enforced or encoded in law. Are there *any* acts morality requires of us such that others cannot (while acting morally) force us to perform them?

Noumena said...

If we take pluralism seriously, as I think we should, then we need a demarcation between the full extent of the ethical and the legal because of the gap between the (one) political and (several) comprehensive conceptions.

Here's the way Kant distinguishes the two differences at the end of the introduction to The metaphysics of morals: ``Ethical lawgiving (even if the duties might be external) is that which cannot be external; juridical lawgiving is that which can also be external.'' (6:220) Annoyingly, his only examples are of ethical lawgivings, so it's hard to get clear just what he means by this principle.

But that's the sort of thing I'm looking for.