Wednesday, September 08, 2021

The Lunatic Approach to Public Ethics

 Parker Crutchfield, professor of medical ethics at WMU, has given some thought to the question of how we can better arrive at cooperative solutions to pandemics, and after some deliberation has come up with an answer: drug people.

My research in bioethics focuses on questions like how to induce those who are noncooperative to get on board with doing what’s best for the public good. To me, it seems the problem of coronavirus defectors could be solved by moral enhancement: like receiving a vaccine to beef up your immune system, people could take a substance to boost their cooperative, pro-social behavior. Could a psychoactive pill be the solution to the pandemic?

The answer to this question, my dear readers, is No.

Crutchfield's idea is that if you drug people with oxytocin or psilocybin, this can make them more 'cooperative': "Then, perhaps, the people who choose to go maskless or flout social distancing guidelines would better understand that everyone, including them, is better off when they contribute, and rationalize that the best thing to do is cooperate."

I notice throughout that it never occurs to Crutchfield that cooperation is a two-way street. It never occurs to him, for instance, that someone might say that he is the one who needs psilocybin so that he will learn to cooperate with people who have objections to his preferred medical policies. In reality, we know from other medical campaigns more or less what works to increase participation in things like vaccinations: make it free, make it locally accessible, bring it to those who need it rather than expect them to come to you, have doctors sit down with people who are hesitant to clarify any concerns they might have, get feedback from people to find the conditions under which they would be willing to take it and adapt accordingly, don't lecture, be patient, have a clear and stable source of information for any questions people might have. The number of people who reject things like vaccination and masking as a matter of pure principle are very few; if you are getting a large amount of resistance, you can be quite sure that the reason is that either you are being very confusing (so they are defaulting to what they know better about), or you are making it very difficult for them (so they are refusing to make the effort you keep demanding), or you are being a jerk to them (so they are digging in their heels in response, since nothing makes people so stubborn as being provoked and attacked). Cooperation is something you and other people do together; it's not making other people comply with your preferences. But everything Crutchfield talks about is concerned with getting people to comply, not with getting people to cooperate

Crutchfield does consider two possible objections someone might make to his proposal:

(1) We don't have drugs that are effective enough yet. He concedes this, which seems to be a bit of problem for his plan. Granted, Crutchfield is primarily talking about what might be done in future pandemics, but, first, it's not clear that any such drugs would ever properly do what he wants; second, it is not clear that a drug that does what he wants would not have seriously bad side effects; third, it's not clear whether widespread distribution would actually be feasible. None of these things are clear because the drugs don't exist, and we don't know exactly what they would be or how they would work.

(2) People who are unwilling to get vaccines are perhaps not going to sign up to be drugged into compliance. Never fear, Crutchfield has a solution to this:

As some have argued, a solution would be to make moral enhancement compulsory or administer it secretly, perhaps via the water supply.

I sometimes wonder if you need to be certified as a horrible and villainous person in order to be a bioethicist. It does seem to be a field that collects a lot of people who tend to advocate villainy.

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