Abortion Rights and Medicare for All (Daily Dose for May 22nd 2019)
Medicare Supplement News | May 27 - 2019
https://www.youtube.com/watch?v=zB7mYvXiamU
6 thoughts on “Abortion Rights and Medicare for All (Daily Dose for May 22nd 2019)”
I’m very glad that you’re getting this content out there, but I don’t think that the Thomson argument fits very well with being a lefty (social democrat or socialist). This is because as leties we believe in substantial duties to aid others which can outweigh a lot of concerns of personal autonomy when the stakes are high enough. You may recall that Thomson appeals to some very right-libertarian intuitions about Henry Fonda not having a duty of justice to save someone’s life by walking across the room and putting his hand on her fevered brow. Here is an argument as to why lefties should reject Thomson’s conclusion that one doesn’t have a duty of justice to stay connected to the violinist, and ipso facto her conclusion that we don’t have duties to remain pregnant for 9 months if our moral reasons to preserve the lives of fetuses are just as strong as those to preserve typical human adults, which is that lefties should accept the following premises: (P1) If one can prevent enormous harm to someone else at much smaller cost to oneself, then (all else held equal) one has a duty of justice to prevent that harm. (P2) Staying connected to the violinist for 9 months rather than unhooking would prevent enormous harm to the violinist at much smaller cost to oneself. Therefore (C) All else held equal, one has a duty of justice to stay connected to the violinist. Similarly (P2′) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then gestating a fetus for 9 months prevents enormous harm to the fetus at much smaller cost to oneself. Therefore (from P1 and P2′) (C’) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then, all else held equal, one has a duty of justice to gestate a fetus for 9 months. Moreover, since I think it’s fair to say that (P3) If one has a duty of justice to do X, then all else held equal the state or other relevant actors may coerce one into doing X, we can infer from P3, C, and C’: (C2) All else held equal, the state or other relevant actors may coerce one into staying connected to the violinist for 9 months, and (C2′) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then, all else held equal, the state or other relevant actors may coerce us into gestating a fetus for 9 months. I actually accept C2 and C2′ but I reject the consequent of C2′ because I reject its antecedent – but I thus think that our not having the kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults is absolutely crucial to the principled moral case against state / community restrictions on abortion.
I disagree with (P1) at least in the sense of a legally enforceable duty where the smaller cost to oneself infringes on bodily autonomy. G.A. Cohen’s “Eyeball Lottery” case is pretty compelling to me. Of course, as leftists we think that personal autonomy understood in terms of property rights sometimes has to take a back seat to justice, but I think that bodily autonomy is much more basic than even rights to personal property (in the sense of the personal vs. private property distinction). In fact, that distinction–property rights vs. bodily autonomy–is a good way to cash out where we part ways with libertarians. George Kateb’s line about Robert Nozick comes to mind: “I find it impossible to conceive of us as having nerve endings in every dollar of our estate.”
Also, I think you’re slightly misremembering JJT. As I recall, she says that Henry Fonda *does* have an obligation to walk across the room to place his hand on the fevered brow. (He just doesn’t have an obligation to fly across the country to do so.)
*+Ben BurgisI thought you might say that :). Before explaining why I don’t think that that is ultimately a defensible position, just to clarify about JJT on Fonda: she holds that he has some kind of obligation to save the life when the cost of doing so is trivial, but not an obligation that corresponds to a “right” the violation of which would be unjust and the sort of thing that the state can interfere with: “But suppose he isn’t on the West Coast. Suppose he has only to walk across the room, place a hand briefly on my brow–and lo, my life is saved. Then surely he ought to do it-it would be indecent to refuse. Is it to be said, “Ah, well, it follows that in this case she has a right to the touch of his hand on her brow, and so it would be an injustice in him to refuse”? So that I have a right to it when it is easy for him to provide it, though no right when it’s hard? It’s rather a shocking idea that anyone’s rights should fade away and disappear as it gets harder and harder to accord them to him.
…So my own view is that even though you ought to let the violinist use your kidneys for the one hour he needs, we should not conclude that he has a right to do so–we should say that if you refuse, you are, like the boy who owns all the chocolates and will give none away, self-centered and callous, indecent in fact, but not unjust” (1971: 61)
The reason I think an unrestricted version of P1 is true is that I don’t think that what counts as one’s physical body has the sort of moral relevance it would have to have for a restriction of it to be defensible. All it is to be part of my physical body is for something to be in the relevant way part of the structural and metabolic processes of the organism that I currently occupy. Suppose that some time in the future a billionaire has several thousand bodies into which his brain could be very easily transplanted and re-transplanted (or if you like this is after we’ve all already uploaded our consciousnesses into silicon media and the billionaire has several thousand silicon bodies into which his consciousness can be easily transferred). Now there is a young child dying of a rare condition that needs a single cell from the finger of one of the billionaire’s 1,000 bodies, the extraction of which he would not even notice even if he were to transplant / upload into that body. Now we ask the billionaire for permission to extract the cell and, being the sort of billionaire he is, he refuses. May we extract the cell from the body of the billionaire without his permission when it is a body into which he has never even transplanted his brain? You’d better believe, it, every bit as much as we can confiscate a few of his dollars or yacht (cf. Unger Living High and Letting Die 1996) or other property to save someone’s life . OK, now suppose that the billionaire had once transplanted or uploaded his brain into that body for a few seconds but has now left it and plans never to return to it. Can he now correctly say to us “haha! If I hadn’t occupied the body you could take a cell from its finger, but I was once in it for a few seconds, so now you can’t have the cell and your precious child will die! Hahahaha!”? Of course not. What if he had occupied the body for several years? Surely that changes nothing. Now what if *gasp!* he currently occupies the body? Does that mean we can’t extract the cell he won’t notice to save the child’s life? Of course not. Why on earth should it matter that he currently occupies this physical thing to whether we can impose a virtually non-existent cost on him by taking something from it to save a child’s life? (In some discussions one can make this kind of point more directly by considering the need to take one hair on someone’s head against her will to save a child’s life; I just wanted the rest of it to illustrate how implausible it is to invest enormous moral significance regarding that fact that we occupy an organism concerning whether others can impose very small costs on us by doing things to that organism against our will if we refuse to do our duty and use that organism to help others at relatively trivial costs to ourselves).
Especially in light of the reality of disability and adaptation to disability, It isn’t clear to me how directly Cohen’s eye lottery case challenges an unrestricted version of P1 since it isn’t clear to me that taking one of my eyes and giving it to someone currently blind prevents enormous harm to her at vastly smaller cost to me. What might come closer to a direct challenge would be John Harris’s (1975) “The Survival Lottery” organ lottery case, where everyone is entered into an organ lottery and a few are chosen at random to be painlessly killed and have their organs used to save the lives of 5 other individuals dying of organ failure. This gets into what I mean in P1 about preventing serious harm at much smaller cost to oneself. If one isn’t an act consequentialist I think that one can adopt a version of P1 according to which giving up one’s life to save 5 isn’t in the relevant sense an instance of preventing enormous harm to others at relatively trivial cost to oneself – the sort of thing this weak version of the principle would be after would be things like being required to give up all of our luxury money to save one or more children from dying of poverty-related causes (see e.g. Unger 1996). But I think that being hooked up to a violinist for 9 months (during which you can do other things, even if you bear analogues of the physical burden of pregnancy) is a relatively very small cost like giving up all of one’s luxury money in relation to saving the life of a child, in a way that giving up one’s life to save the lives of 5 others is not a relevantly relatively very small cost. As such, if early fetuses actually were such that we had the same kinds of moral reasons to preserve their lives as we do to preserve the lives of children and typical human adults, gestating them for 9 months would similarly be, like staying hooked up to the violinist for 9 months to save him and unlike giving up one’s life to save 5 others, be an instance of incurring a relevantly relatively very small cost in order to prevent enormously greater harms to others. (If, on the other hand, we should be act consequentialists, Harris’s organ lottery would not in practice have sufficient further negative effects, then I think that we just have to accept that the organ lottery would in principle be justified, although I suspect that actually trying to institute it would probably have further effects that would do more harm than good, in which case it wouldn’t really be justified in practice)
+H.S. Ross This is a great comment. Seriously, the kind of thing you always hope for (and rarely get) when reading the comments on these things. Off the top of my head, I’d say that the billionaire-with-many-bodies case is an interesting gray area between bodily autonomy (which libertarians think of as “self-ownership” though I’d resist conceptualizing as a form of property) and ownership of “external property.” I take your point about the eyeball lottery–while being down to one eye and thus having depth perception problems, etc., is a whole lot better than having *no* working eyes, it might not count as a “small cost.” On the other hand, forced blood donation to help people who would die without it still strikes me as unacceptably invasive even though it really is a very small cost. In any case, though, the billionaire example is really good. I’m going to have to think more about it.
+Ben Burgis Thanks! Just for the record I am 100% down with taking someone’s blood or bone marrow against their will if it is clearly the only way to save a child’s life and the child, the potential donor who is refusing to donate, and I (along with all necessary medical equipment) are all trapped on a desert island and I don’t have to worry about any bad future social effects. (And I will continue to be 100% down with this even if I stop far short of going all the way over to act conseqeuntialism and endorsing forced organ donation that kills one to save the lives of five in such a desert island scenario, on the basis of the version of P1 that I think all non-consequentialists should still accept).
For the argument “when does a fetus/baby have intrinsic worth?”, I like to use an analogy of a glass jar and pile of sand in a glass factory that will be turned into a glass jar in 20 weeks time. Both have potential to hold water but only one has the capacity to hold water which is the same with sentience and consciousness, of course because a person has bodily autonomy as shown in the paper you mention ( Judith Jarvis Thomson isn’t ok with very late abortions being legal ) an abortion can never be judged the same as murder even if avoiding killing sentient beings is our goal. We can determine an actual baby than can survive outside a host different to a fetut, let a lone a completely mindless and brainless blog of cells , there’s a whole spectrum .
I’m very glad that you’re getting this content out there, but I don’t think that the Thomson argument fits very well with being a lefty (social democrat or socialist). This is because as leties we believe in substantial duties to aid others which can outweigh a lot of concerns of personal autonomy when the stakes are high enough. You may recall that Thomson appeals to some very right-libertarian intuitions about Henry Fonda not having a duty of justice to save someone’s life by walking across the room and putting his hand on her fevered brow. Here is an argument as to why lefties should reject Thomson’s conclusion that one doesn’t have a duty of justice to stay connected to the violinist, and ipso facto her conclusion that we don’t have duties to remain pregnant for 9 months if our moral reasons to preserve the lives of fetuses are just as strong as those to preserve typical human adults, which is that lefties should accept the following premises: (P1) If one can prevent enormous harm to someone else at much smaller cost to oneself, then (all else held equal) one has a duty of justice to prevent that harm. (P2) Staying connected to the violinist for 9 months rather than unhooking would prevent enormous harm to the violinist at much smaller cost to oneself. Therefore (C) All else held equal, one has a duty of justice to stay connected to the violinist. Similarly (P2′) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then gestating a fetus for 9 months prevents enormous harm to the fetus at much smaller cost to oneself. Therefore (from P1 and P2′) (C’) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then, all else held equal, one has a duty of justice to gestate a fetus for 9 months. Moreover, since I think it’s fair to say that (P3) If one has a duty of justice to do X, then all else held equal the state or other relevant actors may coerce one into doing X, we can infer from P3, C, and C’: (C2) All else held equal, the state or other relevant actors may coerce one into staying connected to the violinist for 9 months, and (C2′) If we have the same kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults, then, all else held equal, the state or other relevant actors may coerce us into gestating a fetus for 9 months. I actually accept C2 and C2′ but I reject the consequent of C2′ because I reject its antecedent – but I thus think that our not having the kind of general moral reasons to preserve the lives of early fetuses as we have to preserve the lives of typical human adults is absolutely crucial to the principled moral case against state / community restrictions on abortion.
I disagree with (P1) at least in the sense of a legally enforceable duty where the smaller cost to oneself infringes on bodily autonomy. G.A. Cohen’s “Eyeball Lottery” case is pretty compelling to me. Of course, as leftists we think that personal autonomy understood in terms of property rights sometimes has to take a back seat to justice, but I think that bodily autonomy is much more basic than even rights to personal property (in the sense of the personal vs. private property distinction). In fact, that distinction–property rights vs. bodily autonomy–is a good way to cash out where we part ways with libertarians. George Kateb’s line about Robert Nozick comes to mind: “I find it impossible to conceive of us as having nerve endings in every dollar of our estate.”
Also, I think you’re slightly misremembering JJT. As I recall, she says that Henry Fonda *does* have an obligation to walk across the room to place his hand on the fevered brow. (He just doesn’t have an obligation to fly across the country to do so.)
*+Ben BurgisI thought you might say that :). Before explaining why I don’t think that that is ultimately a defensible position, just to clarify about JJT on Fonda: she holds that he has some kind of obligation to save the life when the cost of doing so is trivial, but not an obligation that corresponds to a “right” the violation of which would be unjust and the sort of thing that the state can interfere with: “But suppose he isn’t on the West Coast. Suppose he has only to walk across the room, place a hand briefly on my brow–and lo, my life is saved. Then surely he ought to do it-it would be indecent to refuse. Is it to be said, “Ah, well, it follows that in this case she has a right to the touch of his hand on her brow, and so it would be an injustice in him to refuse”? So that I have a right to it when it is easy for him to provide it, though no right when it’s hard? It’s rather a shocking idea that anyone’s rights should fade away and disappear as it gets harder and harder to accord them to him.
…So my own view is that even though you ought to let the violinist use your kidneys for the one hour he needs, we should not conclude that he has a right to do so–we should say that if you refuse, you are, like the boy who owns all the chocolates and will give none away, self-centered and callous, indecent in fact, but not unjust” (1971: 61)
The reason I think an unrestricted version of P1 is true is that I don’t think that what counts as one’s physical body has the sort of moral relevance it would have to have for a restriction of it to be defensible. All it is to be part of my physical body is for something to be in the relevant way part of the structural and metabolic processes of the organism that I currently occupy. Suppose that some time in the future a billionaire has several thousand bodies into which his brain could be very easily transplanted and re-transplanted (or if you like this is after we’ve all already uploaded our consciousnesses into silicon media and the billionaire has several thousand silicon bodies into which his consciousness can be easily transferred). Now there is a young child dying of a rare condition that needs a single cell from the finger of one of the billionaire’s 1,000 bodies, the extraction of which he would not even notice even if he were to transplant / upload into that body. Now we ask the billionaire for permission to extract the cell and, being the sort of billionaire he is, he refuses. May we extract the cell from the body of the billionaire without his permission when it is a body into which he has never even transplanted his brain? You’d better believe, it, every bit as much as we can confiscate a few of his dollars or yacht (cf. Unger Living High and Letting Die 1996) or other property to save someone’s life . OK, now suppose that the billionaire had once transplanted or uploaded his brain into that body for a few seconds but has now left it and plans never to return to it. Can he now correctly say to us “haha! If I hadn’t occupied the body you could take a cell from its finger, but I was once in it for a few seconds, so now you can’t have the cell and your precious child will die! Hahahaha!”? Of course not. What if he had occupied the body for several years? Surely that changes nothing. Now what if *gasp!* he currently occupies the body? Does that mean we can’t extract the cell he won’t notice to save the child’s life? Of course not. Why on earth should it matter that he currently occupies this physical thing to whether we can impose a virtually non-existent cost on him by taking something from it to save a child’s life? (In some discussions one can make this kind of point more directly by considering the need to take one hair on someone’s head against her will to save a child’s life; I just wanted the rest of it to illustrate how implausible it is to invest enormous moral significance regarding that fact that we occupy an organism concerning whether others can impose very small costs on us by doing things to that organism against our will if we refuse to do our duty and use that organism to help others at relatively trivial costs to ourselves).
Especially in light of the reality of disability and adaptation to disability, It isn’t clear to me how directly Cohen’s eye lottery case challenges an unrestricted version of P1 since it isn’t clear to me that taking one of my eyes and giving it to someone currently blind prevents enormous harm to her at vastly smaller cost to me. What might come closer to a direct challenge would be John Harris’s (1975) “The Survival Lottery” organ lottery case, where everyone is entered into an organ lottery and a few are chosen at random to be painlessly killed and have their organs used to save the lives of 5 other individuals dying of organ failure. This gets into what I mean in P1 about preventing serious harm at much smaller cost to oneself. If one isn’t an act consequentialist I think that one can adopt a version of P1 according to which giving up one’s life to save 5 isn’t in the relevant sense an instance of preventing enormous harm to others at relatively trivial cost to oneself – the sort of thing this weak version of the principle would be after would be things like being required to give up all of our luxury money to save one or more children from dying of poverty-related causes (see e.g. Unger 1996). But I think that being hooked up to a violinist for 9 months (during which you can do other things, even if you bear analogues of the physical burden of pregnancy) is a relatively very small cost like giving up all of one’s luxury money in relation to saving the life of a child, in a way that giving up one’s life to save the lives of 5 others is not a relevantly relatively very small cost. As such, if early fetuses actually were such that we had the same kinds of moral reasons to preserve their lives as we do to preserve the lives of children and typical human adults, gestating them for 9 months would similarly be, like staying hooked up to the violinist for 9 months to save him and unlike giving up one’s life to save 5 others, be an instance of incurring a relevantly relatively very small cost in order to prevent enormously greater harms to others. (If, on the other hand, we should be act consequentialists, Harris’s organ lottery would not in practice have sufficient further negative effects, then I think that we just have to accept that the organ lottery would in principle be justified, although I suspect that actually trying to institute it would probably have further effects that would do more harm than good, in which case it wouldn’t really be justified in practice)
+H.S. Ross This is a great comment. Seriously, the kind of thing you always hope for (and rarely get) when reading the comments on these things. Off the top of my head, I’d say that the billionaire-with-many-bodies case is an interesting gray area between bodily autonomy (which libertarians think of as “self-ownership” though I’d resist conceptualizing as a form of property) and ownership of “external property.” I take your point about the eyeball lottery–while being down to one eye and thus having depth perception problems, etc., is a whole lot better than having *no* working eyes, it might not count as a “small cost.” On the other hand, forced blood donation to help people who would die without it still strikes me as unacceptably invasive even though it really is a very small cost. In any case, though, the billionaire example is really good. I’m going to have to think more about it.
+Ben Burgis Thanks! Just for the record I am 100% down with taking someone’s blood or bone marrow against their will if it is clearly the only way to save a child’s life and the child, the potential donor who is refusing to donate, and I (along with all necessary medical equipment) are all trapped on a desert island and I don’t have to worry about any bad future social effects. (And I will continue to be 100% down with this even if I stop far short of going all the way over to act conseqeuntialism and endorsing forced organ donation that kills one to save the lives of five in such a desert island scenario, on the basis of the version of P1 that I think all non-consequentialists should still accept).
For the argument “when does a fetus/baby have intrinsic worth?”, I like to use an analogy of a glass jar and pile of sand in a glass factory that will be turned into a glass jar in 20 weeks time. Both have potential to hold water but only one has the capacity to hold water which is the same with sentience and consciousness, of course because a person has bodily autonomy as shown in the paper you mention ( Judith Jarvis Thomson isn’t ok with very late abortions being legal ) an abortion can never be judged the same as murder even if avoiding killing sentient beings is our goal. We can determine an actual baby than can survive outside a host different to a fetut, let a lone a completely mindless and brainless blog of cells , there’s a whole spectrum .