On radicalism:I do not count professions of it for very much, nor do I demand specific policy proposals. My claim was that the programme offered in Stubborn Attachments is inherently conservative, due to the combination of (a) zero discounting and (b) our ignorance about the distant future. I see the message of the book as: we cannot know how to do the good we ought to do, so the best we can do is keep things (roughly) as they are.
(As an aside, I note that Tyler is—or at any rate,was—clearly worried about this problem himself: he devotes chapter 6 to addressing it. There he points out that uncertainty needn’t paralyze us, because, for example, if we have the opportunity to avert nuclear disaster, his theory tells us to take it. Which is something along the lines of the exception proving the rule.)
On replaceability: If Tyler argued for the conclusion that one human life constitutes a replacement for another, I would happily crown him a radical. He could then go on to use replaceability to make policy suggestions, such as that of spending less on medical care for the elderly—or, because he really should have generalized the point: for anyone, old or young, who, for whatever reason, has relatively few years remaining to them. (Age is a red herring here: Tyler ought to urge spending less on a procedure adding one year to a 20 year-old’s life than a procedure adding two years to a 90 year-old’s.)
But Tyler cannot quite bring himself to assert that we ought value human lives at replacement cost, let alone argue for it. In his response to me, as in his book, he hedges: “different lives are either commensurable or they are not, again as I discuss in the book.” He then goes on to grab neither horn of the dilemma, but to proclaim we cannot make social policy decisions unless we assume they are. And we must make those decisions, “whether we like it or not.”
The relevant passage inStubborn Attachments hedges in exactly the same way as Tyler’s comment: “[I]t is unlikely that measures of replacement cost are the correct way to value a human life. Still, replaceability should not be completely irrelevant to how we think about the value of a life.” (p.86) Tyler wants to say that one human life does not replace another, but our public policy should act (more) as though it did. When we start talking like this, we know it’s time to summon up the ghost of philosophy.
Tyler challenges me: if we don’t compare the value of human lives, how can we possibly decide how much medical care the government should provide? I respond: There are many ways! Philosophy teaches that such a comparison is but one way to make a decision. Since this isn’t an essay in systematic philosophy, I won’t aim for coverage of the field, but instead focus on one plausible contender: the concept of bounded obligation.
Let me illustrate it in an arena more familiar to me than healthcare, namely education. Undergraduates in my classes sometimes ask me to read drafts of papers in advance. I refuse, because, among other reasons, it would be too time-consuming. But I will allow a student to send me a one-page outline, and then meet with her to discuss it. I have determined that this is how much I owe, and not more.
I acknowledge that any given student’s philosophical understanding might be improved if I were to devote all my time and energy to that project; and I view that understanding as having an intrinsic, incomparable value; and yet I think I have reason to withhold some of my time and energy. I foreseeably forgo bringing about some quantum of philosophical improvement—and not because I foresee greater improvements on other fronts! I don’t view myself as “trading” the help I refuse to give one student for the help I go on to give another.
Instead, I understand myself as having an obligation to each one, an obligation that extends so far (reading outlines) and no further (not reading drafts). I am not saying it is easy to figure out what I owe—the process has been one of trial and error, and it continues to evolve over time. (I used to read drafts!) I am simply reporting, first personally, that I do not find myself stymied by the demand to make intelligent, well-grounded decisions about how much educational care to provide, even given my refusal to make invidious comparisons about the comparative value of my students’ minds.
I don’t see why we shouldn’t, when deliberating over the analogous problem in the healthcare arena, ask ourselves, “How much medical care do we owe each person?” I would like Tyler to explain what prevents us from putting the question that way, thereby avoiding the need to ask ourselves “how much is a human life worth?”
A final note: the above argument about replaceability suggests that we should spend less on those with fewer upcoming years because their lives are worth less. This is not the same thing as saying that we should spend less on them because that promotes economic growth. For instance, it could be the case that the knowledge that they will be taken care of in their later years prompts people to take more risks and contribute more to the economy. This is an empirical question and Tyler does not address it in his book. His argument for reducing care to the elderly relies on a philosophical claim about the value of human life, rather what would have to be empirical claims about what would promote economic growth. And so my original challenge, which overlaps with Joshua’s, stands: show us how valuing economic growth drives radicalism!