Dying for a donation

The most outstanding feature of organ markets is that most people hate the idea. This is a curiosity deserving a second glance. There are organ shortages almost everywhere, with people dying on waiting lists hourly. To sentence them to death based on a cursory throb of disgust is not just uncivilised but murderous.

First I should get some technical details out of the way. An organ market can involve buying from living donors, or selling rights to organs after death, or both. Organs needn’t go to the rich preferentially; like any treatment, that depends on the healthcare system. The supply of organs available won’t decrease – if free donations dropped as a result of sales, the price would rise until either enough people sold organs or relatives and friends felt morally obliged to donate them anyway. A regulated market needn’t lead to an increase in stolen Chinese organ imports. It would lower the price here, making smuggling less worthwhile, while stopping Australians going on desperate holidays to seek organs in the under-regulated Third World.

That they ‘commodify the human body’ is the main objection to organ markets. They certainly do that, but why is commodification terrible? Well, a commodity is generally an object subordinated to the goal of making money. Treating other humans in that way leads to abominable actions. Slavery and organ theft are examples of human commodification that rightly repulse us. This doesn’t generalise however. The horror in these examples is that people are being made miserable because they don’t want to be sold. This is a completely different scenario to people voluntarily commodifying themselves.

After all, if commodifying people is inherently wrong, why allow paid labour? Renting out a portion of your time, mind and body to a company or government is surely commodification in the same vein. Or is selling body parts just too much commodification? It doesn’t seem so to me – you can lose more of your most personal possession, your limited lifespan, working than you would selling a kidney. Regardless of how we personally answer that question, there is no reason for the public to decide where the line on commodification should be drawn rather than the people choosing to be involved.

Perhaps anyone who wants to commodify themselves must necessarily be insane and unable to make good choices. To decide that somebody with an alternative idea must not be of sound mind is a big step. The fact that someone disagrees with your opinions, especially ones without arguments behind them, hardly proves they are insane. To all of those who use their gut reaction of disgust to produce policy, Alex Tabarrok asks, “Is it not repugnant that some people are willing to let others die so that their stomachs won’t become queasy at the thought that someone, somewhere is selling a kidney?”

But can people in desperate poverty be considered to be making free choices? Many say no. So, is the choice between starving and selling one’s kidney really a choice? Yes; an easy one. One of the options is awful. To forbid organ selling is to take away the better choice. If we choose to provide an even better option to the person that would be great – but it is no solution to the problem of poverty to take away what choices the poor do have absent outside help.

A related argument is that even with better choices, poor people will be so desperate as to be irrational. However even if we accept that poor people are irrational, for anyone desperate enough to become irrational, selling an organ is probably a great idea. Given the ubiquitous human aversion to being cut up, poor people are more likely to underestimate the merit of that cash source. Should we intervene there?

Another argument regarding poverty is that organ markets are highly unegalitarian; they’re another way to exploit the poor. However, there are two inequalities involved in this market. People have differing amounts of money, and people have differing numbers of functioning organs. Which of these inequalities is worse for those with less? The most pressing egalitarian action would be to redistribute the organs more fairly. By happy coincidence the most effective way to do this is to simultaneously redistribute wealth as well. If poor people sell organs, all the better; the money is redistributed to them as organs are also redistributed to those with least.

The alternative to a market is ‘altruism’. If a brother needs an organ to live, how can you refuse? Unlike the disconnected poor person who benefits from an extra option, this family member loses their previous option of keeping both their organs and their family relationships. The latter are effectively held to ransom. This system leaves the patient with the stress of traipsing around making such awkward requests. Instead of loving support, they get to watch the family politics as everyone tries not to be left with the responsibility, everyone hiding their relief when their blood type is incompatible. Often people offer an organ, then ask the transplant team to judge them a poor match. This gets them off the hook, but leaves the ill person in a cruel cycle of hope and despair. It’s analogous to telling cancer patients ‘come for chemo on Tuesday’, then refusing them any every week till they die. If the patient is fortunate enough to find a donor, there is potentially the stifling lifelong obligation to them. People have refused organs over this. The troubling emotional dynamics surrounding ‘donation’ led Thomas. E Starzl, a great transplant surgeon, to stop doing live transplants.

My favourite argument against organ markets is ‘it will create a distopic world where an underclass exists to replace body parts of the rich’. This is flawed in a multitude of ways. Most people would be in neither category. It would create as much of a split as ‘people who make donuts’ vs. ‘people who eat donuts’. The exchange of money makes the parties more equal in the transaction than if one is the unfortunate victim of a request they cannot refuse. Individual people can’t be used as organ factories. Number of organs is a hopeless basis for discrimination, due to the effort involved in actually finding out which organs somebody has.

‘Altruistic giving’ is more coercive than a market, unnecessarily cruel to the patient, the donor and their family and friends, and leaves thousands to die on waiting lists. Organ markets can save lives without us having to sacrifice morality and should join the ranks of life insurance and money lending; markets we once thought unthinkable.

Originally published in Woroni. 

Don’t change your mind, just change your brain

The best way to dull hearts and win minds is with a scalpel.

Give up your outdated faith in the pen over the sword! With medical training and a sufficiently sharp but manoeuvrable object of your choice, you can change anyone’s mind on the most contentious of moral questions. All you need to make someone utilitarian is a nick to the Ventromedial Pre­frontal Cortex (VMPC), a part of the brain related to emotion.

When pondering whether you should kill an innocent child to save twenty strangers, eat your pets when they die, or approve of infertile siblings making love in private if they like, utilitar­ians are the people who say “do whatever, so long as the outcome maximises overall happiness.” Others think outcomes aren’t everything; some actions are just wrong. According to research, people with VMPC damage are far more likely to make utilitar­ian choices.

It turns out most people have conflicting urges: to act for the greater good or to obey rules they feel strongly about. This is the result of our brains being composed of interacting parts with different functions. The VMPC processes emotion, so in normal people it’s thought to compete with the parts of the brain that engage in moral rea­soning and see the greatest good for the greatest number as ideal. If the VMPC is damaged, the ra­tional, calculating sections are left unimpeded to dispassionate­ly assess the most compassionate course of action.

This presents practical oppor­tunities. We can never bring the world in line with our moral ide­als while we all have conflicting ones. The best way to get us all on the same moral page is to make everyone utilitarian. It is surely easier to sever the touchy feely moral centres of people’s brains than to teach them the value of utilitarianism. Also it will be for the common good; once we are all utilitarian we will act with everyone’s net benefit more in mind. Partial lo­botomies for the moralistic are probably much cheaper than policing all the behaviours such people tend to disapprove of.

You may think this still doesn’t make it a good thing. The real beauty is that after the procedure you would be fine with it. If we went the other way, everyone would end up saying 'you shouldn't alter other people's brains, even if it does solve the world's problems. It's naughty and unnatural. Hmph.'

Unfortunately, VMPC dam­age also seems to dampen social emotions such as guilt and com­passion. The surgery makes utili­tarian reasoning easier, but so too complete immorality, mean­ing it might not be the answer for everyone just yet.

Some think the most impor­tant implications of the research are actually those for moral phi­losophy. The researchers suggest it shows humans are unfit to make utilitarian judgements. You don’t need to be a brain surgeon to figure that out though. Count the number of dollars you spend on unnecessary amusements each year in full knowledge peo­ple starving due to poverty.

In the past we could tell moral questions were prompting action in emotional parts of the brain, but it wasn’t clear whether the activity was influencing the deci­sion or just the result of it. If the latter, VMPC damage shouldn’t have changed actions. It does - so while non-utilitarianism is a fine theoretical position, it is seemingly practiced for egoistic reasons.

Can this insight into cognition settle the centuries of philosophical debate and show utilitarianism is a bad position? No. Why base your actions on what you feel like doing, dis­counting all other outcomes? All it says about utilitarianism is that it doesn’t come easily to the hu­man mind.

This research is just another bit of evidence that moral reasoning is guided by evolution and brain design, not some transcendental truth in the sky. It may still be useful of course, like other skills our mind provides us with, like a capacity to value things, a prefer­ence for being alive, and the abil­ity to tell pleasure from pain.

Next time you are in a mor­ally fraught argument, consider what Ghandi said: “Victory at­tained by violence is tantamount to a defeat, for it is momentary’” He’s right; genetic modification would be more long-lasting. Un­til this is available though, why not try something persuasive like a scalpel to the forehead?

....
Originally published in Woroni

Some half-serious, half-formed thoughts on existing and so on

So I've been banging my head against a wall (metaphorically, almost not) for about a week and a half (or years on and off) about the apparent meaninglessness of anything and the difficulty of finding anything to do that is mildly satisfying next to the absurdity of existing. This is what I've come to:

On lack of inherant meaning in anything:

- Whether there is value inherent in the universe or not (by the way there's not) doesn't matter (nothing does! lol. But that's not my point). Value that you choose to place on something is as legitimate as that which 'God' or anything else does. It would be impossible for a God or anything else to allocate value to things in any more legitimate a way. If they did, and you disagreed with them, why would their values have precedence? To give them precedence would be a value judgement. There is no better possibility than what we've got (similar to how there is no better version of free will than determinism).

- Really it's not that bad. You have the freedom (yay) to value what you think should be valued. If there were some fundamental ones one had to stick by, I'd probably whinge heaps more about that (and anyway, if not comfy with it you can probably find some place to live where some government will be willing to choose values for you - such as Australia it seems)

- It is objectively better to value things, and to value things that other people's values aren't mutually exclusive with. 'Better' is defined in terms of the value placed on stuff (yours and others') - if you value things more, there will be more value. So it will be better. If you value killing people etc. you will impinge on their (probably less messed up) experience of value quite considerably, so it will very likely not be better. In the end the goodness of anything is a practical question of whether the values of the individuals involved are fulfilled. Potential for this depends on them having values, and them not being contradictory.

Note: there is a difference between indifference and not valuing things. You can just indifferently value whatever comes along, without caring what it is (though there are still other people's fixed values to watch out for). This can kind of work.

- You probably get on alright having your own values - knowingly chosen/based on biological and environmental effects - for things like wallpaper and lunch. Just do it for everything else (I don't like AIDS because it doesn't go with my sofa).

On how to behave when the absurdity of existing at all is just so crazy that anything else seems incredibly unsatisfying in comparison:

- Violence? Tried it this arvo for a bit. Distracting, yes. Fun, hell yes. Incredibly satisfying? Not really. A viable source of income? Possibly, but would have to find richer people to mug :)

- If you really feel like hurting yourself just to feel something, physical violence is probably not the best bet. Before it hurts enough you will damage yourself, which isn't useful. Try psychological torment ;D Some good bits of emotion can be had from just thinking about this kind of thing...satisfaction from the horror of dissatisfaction...mmm it's even pleasingly recursive (I like recursion and I don't care if God does). I had some other ideas, but I edited them out, as I feel bad about depressing people, ironically enough.

-Seek satisfaction from the absurdity of existing, without doing anything about it? Just think about it and see how amazed you can be. I suspect not enough to seem appropriate, but what's appropriate?

- Try to be nice and save the world and stuff? As mentioned earlier, I think this is the inevitable conclusion I must come to, regardless of the source of it's preferability. However I'm slightly inclined not to. On further introspection, I think this is merely because I just don't want to follow all the people who are lefties or righties or whatever because they haven't thought about any of this and are just engaging in smugness about their smugness about what they blindly assume is right. It's just kind of lonely - I feel like a hipocrite and an outsider to their sentiments, which makes me angry, which makes me more right wing. This is a bad reason, and anything is going to be lonely, with or without other people to misunderstand me. So this one isn't written off - in fact I think it is still going to be the inevitable conclusion.

- Something that hasn't been done before? Hard to find and once you've done it, it's been done. Also, it is unlikely to be terribly satisfying. Things that are particularly satisfying have probably been done. The best candidate for 'something that hasn't been done and might be satisfying' is something horrendously idealistic and difficult, like saving the world (from whatever, it's irrelevant here). Which solves the problem in the last point, because when smug people with the same end goal as me talk to me I can at least say I want to save the world because it would be 'kind of post-modern'. This will at least make it clear to them if we probably can't relate to each other, and they will go away.

- Hang around and think more about it? I am probably stupid enough to be wrong about how I'm even looking at these problems. Almost cerainly in fact - to my knowledge, nobody exists who isn't impressively stupid. This is one of the more interesting things to read/think about anyway.

- Wait until one day I give up caring about whether things matter inherently or not, and be back to square one...until I stop caring about that...fuck...

- Be relieved that as a the kind of complicated biological and social thing you are, you have a good few pre-programmed preferences for things. You could chuck them all out the window, on the basis that they are arbitrary upshots of evolution. However so are you, and they are the arbitrary upshots you like, and you probably won't find much satisfaction in not having them particularly. Also it's hard to do properly and you probably can't keep it up for that long ('...it is inevitable to be drawn back into human drama...').

So there. I think I'll go for a combination while I look for other things to think.

Is outdoing monkeys while imagining free will the only way you can feel like a man?

Why does it bother people that we might be pretty similar to other monkeys (i.e. with better vocabularies, worse feet etc but no glorious fundamental difference)? Similarly what's so scary about everything being mechanistic, free will not existing, and everything being meaningless apart from the values that we make up?

If we are fundamentally similar to other animals it has no effect whatsoever on the experience of humanity that we cherish. It has always been that way, and works fine. We know what being human is like, so if monkeys are similar that should only change our ideas of what being a monkey is like. What being a monkey is like is not usually considered a pressing issue in society, so why care? Why does our societal self-worth rest on being heaps better than monkeys?

Similarly with the other possibilities listed above, if they are true, obviously they always have been and everything we enjoy is possible in their presence. It isn't like as soon as you stop believing in free will you will turn into a robot. If it's the case, you already are one, and everything you've ever loved and dreamed of has arisen from that. It's not some strange new reality.

Perhaps practically these things seem to hold different probabilities for the future to other beliefs? e.g. the universe being purely mechanistic might make Heaven seem unlikely. But you could still have a mechanistic God and Heaven and soul (it's not nearly as impossible as non-mechanistic ones). It's not the end of the world.

Or is it actually hard to hold one's own values, for instance, without the delusion that they are somehow fundamentally valuable?

God is irrelevant

Philosophically that is. Psychologically he fulfils an important role - to distance us from philosophy.

In no way would the existence of a God alter the important properties of the universe. Most of the problems a God supposedly solves are merely shifted to the other side of him - a step further away from humans, where we can comfortably ignore them.

Some solutions God doesn't really provide (presumably all thought of before by various philosophers, but I don't know which ones, and it's irrelevant, so please excuse the plagiarism) :

Creator of the universe: An obvious one. Where did God come from then? If he's existed forever then so could a universe. If you think something as complex as a universe couldn't come from nothing, how complex would God have to be to be able to make universes?

Source of morality: Where does God get his moral principles from? If he invents them himself they are just as arbitrary a set of restrictions on behaviour as any other (such as an atheist's morals are feared to be by the religious). Why follow them? If they are inherent in the universe, related to other people, or a matter of choice then God isn't needed.

Morality is a set of value judgements. If God and I both have a set of value judgements (a moral code), to say that God's takes precedence is a value judgement in itself. Who judges? God? Why?

Provider of free will: For reasons discussed in the previous post, Free will isn't a concept (unless you mean determinism), God can't have - or give humans - free will which isn't deterministic. The absence of God's 'free will' is even more apparent if he must be good all the time (unless he invents his own changeable moral code as he goes, but is that the kind of morality God should subscribe to? Well yes, if he does! But there's still the old problem of free will not existing - he can't escape).

If he's all powerful as well, then he just ends up as another natural law - one that makes good things always happen. Anyone who's been alive can tell you there's fairly solid empirical evidence against such a law existing, but my point isn't to draw attention to the problem of evil so much as to point out that natural laws are nothing new.

The final picture? A God who may well exist*. But who cares? Yeah, if he's all powerful perhaps you should follow his moral laws just to stop him smiting you, but that's politics, not metaphysics.

*except perhaps for the whole problem of evil bit - but goodness is hard to define, so let's give him a break on that one for a moment

Free will isn't a concept (unless you mean determinism)

Imagine something happens. For instance you make a decision. There are three possibilities for this occurence:

1. It could be related purely to other factors (determinism)
2. It could be not related to other factors (randomness)
3. It could be a combination of these (a mixture of determinism and randomness)

None of these are free will (as commonly understood). So where does the concept of free will fit in? How could an occurence escape from being in one of these categories? Clearly it can't. So there is no possibility of a concept of free will that is in opposition to determinism, let alone a chance of it existing in reality.

But you feel like you have free will (whatever that is - just don't think about it), don't you? Or to put it another way, you feel like your actions are neither determined nor random. You choose them.

And that is precisely why they are determined. They are determined by you. And you already exist to the finest detail at the time you are making the decision. If you made choices (or some element of them) not controlled by your personality, experience, thoughts and anything else that comes under the heading of ‘the state of your brain as a result of genetics and your prior environments’, they would be random, which still isn’t free will (not to mention being a less personal and less appealing model, if that's how you choose your beliefs).

You might argue that you can choose what to think and how to feel , and how heavily to let those things influence you, when making a decision. That doesn't alter the situation however. Those are then choices too, and your decisions for them would presumably have to be made based on other thoughts and feelings , which you would presumably choose, and so on. The point at which free will should have occurred would just be shifted back indefinitely. Again you just have a long chain of cause and effect.

The closest thing you can have to free will is for your actions to be determined purely by the state of your brain. Free will is determinism.