ELEPHANT TO PLATT, KENNETH, ALL:
I will turn to other species shortly in an attempt to meet Kenneth's
concerns head on with a suggestion about the moral value of persons. But
first: some bald statements just cry out for a good old-fashioned
philosophical counter-example! Such as:
> PLATT:
> I see no moral difference between saving the patient or killing the
> germ. They are both sides of the same coin.
ELEPHANT:
Three examples throw doubt on this claim.
1. We often require the Germ to live, in a laboratory, in order to extract
information with which to save the patient(s). This is not entirely besides
the point, because it does mean that saving patients and killing germs are
not the same thing. You will now qualify your claim and say that saving
patients and killing germs *in patients* is the same thing. My other two
points address this.
2. Geriatric palliative care. You can argue that the 'disease' in question
is just Old Age, but in fact the old tend to die of perfectly identifiable
disease processes, and that includes germs, cancers etc. It's generally
agreed that we should try to save the patient, but it is also agreed that
saving the patient does not equate with doing everything you can under all
circumstances to keep biological processes continuing at the expense of all
'Quality of Life'. 'Saving the patient' turns out to be a complex concept,
because being a human being is not just being a functioning heart, or even a
pattern of brain-waves (anticipating the ecg point). It turns out that
'human being' is, surprise surprise, a Moral Concept. Being a 'person' is
more than being having functioning internal organs. For this reason, a
doctor does not save the human being by treating their body as if he has the
right to do whatever he damm well pleases with it, in the name of fighting
off all those germs. There is a duty of care, but there is also a duty of
respect. When the respect is removed, you are dehumanising the patient, and
that is the very opposite of 'saving' the patient. Doctors who continue
trying to kill off every germ beyond the point were the patient himself
would wished to have lived are not 'saving the patient'. They are
completely dehumanising and discounting the patient, and treating the body
instead.
3. Imagine a disease which medical science can triumph over, but only very,
very slowly. You can think of this in terms of a race to develop a cure,
while the victim lies prone in his bed and suffers, ventilors keeping him
alive, for fully fourty years. In the end we discover the cure and he
walks. This same situation exists if we think of ourselves as always
having had the cure, but a cure which is a very, very slow one. Like
antibiotic treatments for tuberculosis only fourty times worse. Now in this
case the imperative to save the biological life of the patient and the
imperative to kill the germ are the same. But is the patient just his
biological life? No. In which case, it looks as if the imperative to kill
the germ equates to the imperative to keep the poor victim alive and in
great pain throughout the majority of his life: is that 'saving the
patient'? It rather looks like the opposite to me. It looks like treating
the patient as a medical experiment, treating him less respectfully that you
would your dog. 'Cure a success: patient tried to kill himself'. Certainly
it is not giving 'Quality of Life' to anyone but the successful doctors.
I think all these examples show that 'saving the patient' and 'killing the
germ' are not as near the same as makes no difference. There is a
difference, and it has to do with the difference between 'saving the
patient' and preserving a biological pattern. It is only biological
patterns which germs attack - officious doctors can do violence to more
valuable patterns: and my name for those higher patterns is 'the patient'.
That's why doctors owe their (oath of) allegiance to the life of the
patient, and not to the death of germs.
One way of ensuring that Doctors treat the patient and not the disease is to
take out something called a 'living will'. The other is to educate doctors
into a respect for persons. But luckily, most doctors are already well
ahead of Platt on this one.
I suspect that a lot of Kenneth Van Oost's concerns have to do with this
moral importance of the 'person' - he may correct me on this. Besides the
approach to germs, 2 more of Kenneth's points seem to have something to with
this. First, there is the worry that valuing 'intellect' means devaluing
persons who don't have 'intellect' the way Prisig does - Lila comes to mind.
Kenneth was accusing (Platt's account of) MOQ of being right wing, but he
didn't mean free market! He meant 'Social Darwinist' or worse: the idea
that some human beings are just more valuable than others, and that their
interests should always triumph. I think that's a point we need to think
about, because it sure doesn't look like morality the way most people
understand it. It looks like might is right. The way to address it is to
point out that the meaning of 'intellect' is being stretched in quite alot
of directions here. There's no denying that Prisig is an intellectual and
that Lila isn't. But it isn't true to say that Lila has no intellect:
anybody who can conceptualize has intellect. Well now, what is it that
constitutes the higher level: intellectualism or intellect? There's a big
difference. If intellectualism is the higher level, then Lila is grouped
with other beings that have social value as their highest level of value,
like, say, termites. But if intellect is the higher level of value, not
intellectualism, it turns out that Lila is a morally valuable as Prisig is.
She is on the same level. This is the way it out to turn out, in my veiw.
Perhaps, indeed, the moral value of 'persons' or 'intellects', does a lot to
address Kenneths concerns about MOQ and other species in the animal Kingdom
too. Because in point of fact we treat cats and dogs as conceptualizers: as
intellects. We rely on them to recognise different human beings as
different, and this requires that they have, in effect, a concept of you. A
dog responds to his owner's command, but not to the same command given by a
stranger. Perhaps we have first hand experience of a dogs 'personhood' that
goes further. These are beings with an interior world. They are
intellects. That, I think, is what gives them the value they trully have,
and it is what separates them from germs.
I'm really quite chuffed about this idea for reading the "intellectual"
level as the level of "intellect" rather than as the level of
"intellectualism", because it seems to me that it addresses quite alot of
the concerns I've had about the level. It seems to me that Prisig treats
this higher level as a kind of political program - the sort of political
progam that can be a protagonist in world history, for example. But
intellectualism just can't be that sort of program, I have argued, because
intellectuals can (and in fact do) hold an infinite number of opinions about
what is best, intellectually speaking. In contrast, placing value on
'intellects' seems to underpin a comparatively clear political and moral
program: respect for persons - treating the human person as the highest good
in medicine, law, sexual relations et al. There is even a familiar ring to
this moral imperative: do not treat persons as if they were means only,
treat them as ends in themselves.
I guess the "intellectualism" interpretation would treat persons as being,
ultimately, only means to the continuation of thought. That does seem
cart-before-horse. Perhaps some remarks about the pragmatic unity
intellectual theory and personal practice are needful? Later.
Kenneth, I have found your posting inspiring. Platt and I may now argue
about whether or not my suggestion might resemble what Prisig means. But
I'm tempted to say straightaway: Prisigian or not, this looks like a very
High Quality veiw. Shall we call it 'true' then?
ttfn
Puzzled Elephant
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