Sunday, April 30, 2006

Voluntarism and Tax Breaks


The following post is an opinion article I wrote for Newsday (a NY newspaper) in May 2005. The commissioning editor invited me to write an opinion piece on an issue that was getting a lot of local attention in NY at the time- tax breaks for volunteer emergency personnel. In the aftermath of 9/11 New Yorkers, perhaps more than anyone else, appreciated the value of the brave contributions emergency personnel make to society. But in this article I tried to temper such sentiments with some reflections on the meaning of voluntarism and by placing the issue within the larger context of societal fairness.

Cheers,
Colin

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Rewards, yes, but tax breaks, no
[published in Newsday, May 1st 2005]

By Colin Farrelly

Emergency personnel provide an essential public service, and many risk the ultimate sacrifice — their own safety. In the aftermath of 9/11, gratitude for the heroism and dedication of these workers has inspired support for tax relief for volunteer firefighters and ambulance workers around the United States.

Legislation is now being proposed in Rockland County, for example, that would allow such volunteer workers to shop tax-free. “Any kind of incentive you can give the volunteers is a good thing,” the bill’s sponsor has said.

For Long Island, in 2004 Gov. George Pataki signed into law legislation that increased the property exemption benefit on the homes of eligible Suffolk fire and ambulance volunteers. They are permitted a 10- percent exemption on the assessed value of a home, rather than the previous cap of $3,000. Yet, in February, the Harborfields Central School Board decided not to grant the tax exemption to volunteer firefighters in the fire departments of Greenlawn and Centerport. The board wrote that it appreciates the service of the volunteers, but that the exemption would result in $52,271 “that would have to be borne by others in the community.”

Given the different stance that localities have taken on this issue, it is worthwhile to consider the question: Are tax breaks for volunteer emergency workers appropriate and fair? A proponent of tax relief might argue: "These volunteers make enormous sacrifices- they literally risk their lives- and giving them a tax break is a way of expressing our public gratitude for their sacrifices." No one would argue that these volunteers aren’t making a substantial contribution. But are tax breaks an appropriate form of recognition?

We admire volunteer firefighters and emergency workers because their actions go over and above a citizen’s call of duty. Some kind of public recognition is no doubt required. But monetary compensation, in the form of tax breaks, is arguably inappropriate and potentially unfair. The satisfaction of contributing without pay is part of the reason this work is rewarding for many volunteers. To offer what is effectively a salary is to reduce the most admirable characteristic of humans (benevolence) to the impoverished measure of value that already consumes society- money. The more significant the tax break is for such volunteer work the less it can plausibly be described as "volunteer" and the less prestige in the community this work will have.

Perhaps more important, the problem with granting such tax breaks is that such policies could potentially exacerbate existing injustices. The Harborfields school board clearly is concerned with this question: How will localities make up the loss in public revenue? This leads to more questions: Will extra tax-burdens be placed on citizens? If so, will this be done in a fair manner so the extra burden does not fall on those who already suffer economic hardships? If taxes will not be raised, then what will localities be willing to cut in order to offset the loss of public revenue?

It is one thing to say you support tax relief for volunteer emergency workers, but it is hypocritical to do so if you are not willing to subsidize such tax breaks out of your own pocket. To be fair across the board, tax breaks for volunteers must be made in conjunction with higher taxes on the more affluent, so that the rewards for volunteers do not also inflict unfair burdens on the vulnerable.

There are, of course, other possible arguments that are used to support tax breaks for volunteer emergency workers. Some make a pragmatic case that such tax breaks could help bolster lagging recruitment efforts. It would cost far more, this argument goes, if the locality is forced to replace the volunteer organizations with a paid force. The Greenlawn fire chief estimates, for example, that it would cost taxpayers $1.2 million to $1.4 million for one engine with five firefighters and one ambulance with two EMS workers, far more than the $52,271 tax break.

Faced with the choice between creating incentives to bolster volunteers or incurring the costs of a paid force, one might reasonably claim that tax breaks for volunteers are necessary. But that doesn’t necessarily make them fair. Why don’t we also give tax breaks to other dedicated volunteers who make admirable sacrifices that benefit our communities, such as literacy volunteers ? Fairness requires us to treat like cases alike, so is it fair to give tax breaks only for certain kinds of volunteer contributions and not others?

Fairness also requires us to consider the moral general question of why it is that localities face such a dilemma in the first place. When tax breaks are expected for voluntary sacrifice in service of the community, and the assumption is that a monetary reward is the only sign of sincere gratitude for civic contributions, one has to wonder whether there is a larger, more pressing, problem that we have failed to diagnose and address.

Wednesday, April 26, 2006

The Genetic Revolution: A Snapshot


Back in September 2005 I signed up for a Google Alerts on the topic "Gene Therapy". Google Alerts “are email updates of the latest relevant Google results (web, news, etc.) based on your choice of query or topic”. So I receive an email notifying me of the internet link for any news story posted on the topic “Gene Therapy”. Compiling 8 months of Google Alerts provided me with a fascinating glimpse of the momentum of the genetic revolution. I received *hundreds* (after 200 I gave up counting!) of updates on various news reports. But the quantity of stories and reports is not the most interesting part of this tale. What is truly fascinating is the *variety* of news stories, each of which bring to the fore a different dimension of these incredible innovations and the challenges we face. Let me try to bring this snapshot of the genetic revolution to life by highlighting some of the different components of the story of gene therapy (as told by 8 months of Google Alerts!).

One part of this picture is the story of the noble search for ways to prevent or cure genetic disease. This story in the connected.telegraph is the story about a "germline" genetic therapy for metabolic diseases, a story that raises ethical concerns about germline interventions and human rights. There is also this press release which reports that a clinical trial has resumed, despite some setbacks, into a treatment of X-linked severe combined Immuno-deficiency (X-SCID), an inherited genetic disease. There is also this story which reports that University of Florida scientists used a healthy human gene to prevent blindness in mice with a form of an incurable eye disease that strikes boys. And finally, today's Google Alerts bring this story about a long-term animal study which suggests that SCID Gene Therapy itself causes cancer in about a third of cases. Four different stories highlighting the successes and setbacks in the struggle to mitigate genetic disadvantage.

During the Winter Olympics in February there were stories like this, this, and this. Stories which highlight the concern that professional athletes might engage in gene doping. February also brought the report about Hashmukh Patel, a 62-year-old retired semiconductor engineer from Silicon Valley. Hashmukh suffers from late-stage cancer of the esophagus and travels to Beijing for a Chinese gene therapy drug called Gendicine ( the world's first commercially approved gene therapy drug).

The Google Alert's snapshot also brings to the fore the issue of funding biomedical research. This snapshot reveals a mixture of public and private funding. So there is the story about a 2 million Euro grant from the Dutch governmental organization Senter to fund an innovative therapeutic that promotes nerve regeneration. There is also this report about a contract between Cobra Biomanufacturing Plc. and the Australian company Replikun Biotech. A deal aimed at supporting the development of an innovative gene therapy method. And finally there is the story of actor Michael J. Fox's grant of $4.2 million to a University of Pittsburgh Medical Center affiliate called Rheo Gene Inc. The grant funds the development of gene therapy for Parkinson's disease (Fox has Parkinson's).

I conclude my story of the Google Alert's snapshot with the update I received today- this report, which is the final quarter results for Oncolytics Biotech Inc. Under the heading "General Risk Factors" is the following sage insight:

"Prospects for biotechnology companies in the research and development stage should generally be regarded as speculative. It is not possible to predict, based upon studies in animals, or early studies in humans, whether a new therapeutic will ultimately prove to be safe and effective in humans, or whether necessary and sufficient data can be developed through the clinical trial process to support a successful product application and approval."

The Google Alerts for just the past 8 months gives us a glimpse of the complex myriad of ethical, social and legal issues raised by the new genetics. The stories linked above are just a brief snapshot of the larger story that is unfolding around us with rapid speed. The story of our search for solutions to the arbitrary and often tragic consequences of the natural lottery of life is one of both successes and setbacks. But it is also an incredible story of human ingenuity and determination. And perhaps that is the biggest story revealed in the snapshot provided by Google Alerts.

Cheers,
Colin

Tuesday, April 25, 2006

What is Political Theory?


Political theorists are concerned with how we ought, collectively, to live together. The job of the political theorist is to bring some precision to fundamental (yet contested) political concepts- like freedom, equality, democracy and justice. Ideas are powerful things, they exert great influence on the real world and help determine the fate of the lives of billions of people. So the political theorist’s job is an important job. A diverse range of social, economic and political arrangements can (and have been) defended by reference to abstract political values. And the theorist helps equip us with the analytical tools necessary to differentiate between legitimate functions of government and the arbitrary use of power.

Suppose a political theorist puts forth a new theory, or advances a nuanced spin on an existing theory. By what standards should we evaluate such a theory? In other words, what are the criteria by which we measure success and failure in political theory? What makes good theories “good”, and lousy theories “lousy”?

It is not surprising that political theorists of different stripes will give different answers to these questions. Liberals will likely emphasize criteria they believe are important to a defensible political theory (e.g. the promotion of toleration and autonomy), while socialists want a theory that recognizes the exploitative nature of capitalism. Feminists believe a theory must be equipped to deal with patriarchy and multiculturalists want a theory that addresses cultural inequality and difference. With so many theorists functioning with different specific ideas of what makes for good political theory, it is not surprising that students often find it difficult to know what they are expected to do in a political theory class (when it comes to writing an essay and critically assessing these debates).

I suspect everyone who has taught a course in political theory frequently encounters the following kind of comment when students begin debating rival normative theories: “Isn’t it all just a matter of opinion? There are no right or wrong answers!”. To this remark an instructor will no doubt invoke his/her well rehearsed response, which goes something like this- “Some theories are backed by reasoned arguments and sound premises, while others might be based on mistaken or misguided premises. Our job is to figure out which positions can withstand rigorous critical analysis and which cannot”. But such manoeuvring simply side-steps the important question: What makes for “good argument” or “sound premises” when one is talking about a normative discipline like political theory? Great question! And like all great questions it is difficult (yet fun!) to try to answer. To answer this question I think one needs to provide a few more specifics about what political theory actually is.

I think the best characterisation of political theory is that advanced by John Dunn (1990) in ‘Reconceiving the Content and Character of Modern Political Community’. Dunn claims (p. 193) that "the purpose of political theory is to diagnose practical predicaments and to show us how best to confront them". Doing this, he adds, requires us to develop the following three distinct skills.

1. Ascertaining how we got to where we are and understanding why things are this way.
2. Deliberating about the kind of world we want to have.
3. Judging how far, and through what actions, and at what risk, we can realistically hope to move this world as it now stands towards the way we might excusably wish it to be. (Dunn, 1990, p. 193)

The three skills identified by Dunn require a political theory to be well grounded in terms of both the normative and empirical assumptions and arguments it relies upon. The first skill requires a good comprehension of the empirical realities of the world. What are the social, political and economic histories of our societies? Telling this story is useful for understanding the current predicaments of one’s society. It might help us to understand why concerns of racial or gender inequality arise, or concerns about environmentalism, healthcare and welfare reform. Knowing something about the history of the culture, people, political institutions, economy, etc. of the society in question is important for being able to both diagnose its current ills and make a realistic prescription for remedying these predicaments.

Knowing one’s past is important for deliberating about what is feasible for one’s future. Thus the first skill relates to the second and third skills noted by Dunn. The third skill requires a political theory to be somewhat pragmatic in terms of confronting the range of options realistically open to us as we aspire for a more just and desirable social arrangement. If a political theory is not adequately grounded in reality it risks being discarded as mere “pie in the sky”. And this raises important questions about the second skill. As Dunn notes, this second skill is less explicit in its demands for imaginative self-discipline. If this second skill is not tempered by the first and third skills I believe we risk jeopardizing the value of political theory/philosophy.

Keeping Dunn's three skills in mind are helpful when constructing and assessing political theories. A good deal of the disagreement among contemporary political theorists stems from differing opinions concerning what constitutes a "healthy exercise" of these different skills.

Cheers,
Colin

Sunday, April 23, 2006

Libertarianism and Rectification


This is my first post (of what I hope will be many) on libertarianism. I myself am not a libertarian but I really do enjoy debating with libertarians. I am fortunate to have had two excellent colleagues who are libertarians. Before coming to Waterloo I taught at Manchester University with Hillel Steiner (a left-libertarian). And here at Waterloo I have Jan Narveson (a right-libertarian) just down the hallway in the philosophy department. I have profited immensely from the many discussions and debates I have had with them over the years.

By seriously entertaining the arguments of my theoretical opponents I open my mind to new considerations that I would have failed to seriously entertain if I only discussed issues of justice with like-minded scholars (NOTE: such openness also guards against “group polarization”, a topic I will blog about at a future time). Furthermore, as a professor one is constantly exposed to diverse viewpoints in the classroom (from the left, right and everything in-between!) and I have never viewed the classroom as a venue for me to “indoctrinate” students with my own viewpoints. In fact, my classroom experiences actually play a formative role in my own intellectual development. So I try to create an atmosphere of openness and invite students to engage in civil debate with me as well as their peers. I find this helps me fine-tune my own moral and political sensibilities.

I would like to briefly outline one line of argument I have been recently developing against libertarianism. The thrust of this criticism stems from a larger beef I have with theories of justice that function at the level of “ideal theory” but I won’t get into that (at least not yet! :)). There are of course many variants of libertarianism, each of which is subject to different kinds of concerns and objections. Here I wish to raise a challenge for libertarians of a particular ilk- those who support Robert Nozick’s “entitlement theory of justice". This account of justice maintains that “whatever arises from a just situation by just steps is itself just (Nozick, 1974: 151). An important (though much neglected) component of Nozick’s theory is the principle of rectification. To make a long story short, the principle of rectification maintains that victims of injustice are sufficiently compensated if they are no worse off (having received compensation) than they would have been had the injustice not taken place (what Gregory Kavka (1982) calls the No Net Harm Criterion). If one takes the principle of rectification seriously (as good libertarians ought to!), then I believe this will lead libertarians to endorse conclusions that will not sit well with them.

It is useful to begin by distinguishing between intragenerational rectification and intergenerational rectification. The former refers to compensation for victims who are alive to collect rectification awards while the latter encompasses all injustices and, in theory, ensures that the present distribution of entitlements be that which would have obtained had only the principles in acquisition and justice in transfer been observed throughout history (Robert Litan, 1977: 234). Both types of rectification pose formidable challenges to libertarians.

Libertarians who champion the entitlement theory of justice, in the “here and now”, face a dilemma. If they believe that the distant injustices of the past have not been rectified then they should advocate, as Nozick himself does, a stringent prioritarian principle (like Rawls’s difference principle) rather than complain that the current welfare state is an unjust violation of their property rights. So good libertarians should join the fight with egalitarians (at least for the foreseeable future) rather than raising principled objections to redistributive taxation (in the current, non-ideal setting). I suspect this conclusion will be unpalatable to many libertarians thus lending support to the hypothesis that they are not seriously committed to the principles of entitlement. In which case one could be forgiven for thinking that some libertarians use Nozick simply as a façade to mask the fact that they are simply making a self-interested (rather than principled) argument for lower taxation.

On the other hand, if libertarians believe that the requirements of intergenerational rectification have been satisfied, then intragenerational rectification for (what THEY [not me!] see as) the victims of the existing welfare state (i.e. the rich) will require compensation the extraction of which will mandate an extensive (rather than minimal) state. And this conclusion will strike most of us (including, I suspect, some libertarians) as calamitous. Let me expand on this second horn of the libertarian dilemma.

Suppose one believes that the requirements of the No Net Harm Criterion has in fact been satisfied (how one could actually determine this I profess not to know!). Suppose further that we had knowledge of the exact date when intergenerational rectification had been satisfied. That date was 20 years ago. In such a scenario we could characterise the history of this society as having the following three stages:

Stage #1: Colonialism/ Slavery, etc... This stage was one where severe and frequent violations of the principles of initial acquisition and just transfers occurred. These transgressions were not rectified for centuries and thus issues of intergenerational rectification arose.

Stage #2: (Just) Welfare (or Compensatory) State: This stage was one where redistributive taxation occurred and eventually compensated the ancestors of the victims of past injustices for the atrocities that occurred during Stage #1.

Stage #3: (Unjust) Welfare State for the past 20 years: The past 20 years has been a situation where redistributive taxation has been imposed on the affluent members of society but such redistribution is not warranted by the No Net Harm Criterion. So for the past 20 years the affluent members of society have been “forced to work” for the benefit of others and this is a severe infringement of their right to self-ownership. This injustice has gone on for twenty years and this generates a claim to intragenerational rectification.

*If* the history of one’s society looked something like this, then (and only then) could one make sense of why, in the “here and now”, libertarians object to redistributive taxation. Libertarians believe that such taxation is analogous to forced labour as it violates the self-ownership of tax payers who are forced, under threat of coercion, to pay for universal education, healthcare, and the other social provisions of the welfare state. According to the No Net Harm Criterion, justice requires us to compensate the victims of the welfare state so that they receive the distribution of holdings *that would have* obtained had the injustice (i.e. redistributive taxation for 20 years) not taken place.

In the case of intragenerational rectification (unlike intergenerational rectification) it will be much easier to identify who has profited and who has been harmed by the welfare state. The problem for the libertarian will be extracting this compensation from those who have profited from the injustice of the welfare state. It is not simply enough to eliminate redistributive taxation itself (though that will be seen as a necessary measure). Eliminating redistributive taxation would simply prevent future state-sanctioned violations of self-ownership from occurring but it will not redress the injustices of the past. So the affluent (and their descendants), in the “here and now”, can demand compensation from those who reaped the benefits of universal education, universal healthcare and the other social provisions of the welfare state (and did not pay an equal share of the costs of these provisions). The consequences of the principle of rectification, in this kind of scenario, would be deeply troubling. It would lead to exploiting the most vulnerable members of our society. Recipients of welfare would be expected to repay their debt to the affluent. Those who received medical treatment funded through universal healthcare would be expected to repay their debt to the affluent, etc…. If these individuals cannot afford to repay their debt, why not make them the servants of the affluent? If taxation truly is analogous to forced labour, as Nozick suggests, then the rich have already served 20 years as the indentured servants of the poor. It seems only fair that, if the poor cannot repay the rich, that they sacrifice some of their own time to help compensate for the time the affluent spent working for the poor. This would help us to compensate the affluent for their lost time.

No doubt many libertarians will want to resist the conclusion that rectification could legitimize slavery. But given the fact that they often invoke such language when they oppose redistributive taxation, it is not self-evident how they could avoid such conclusions if society actually decided to implement the libertarian account of distributive justice. Far from legitimizing the “minimal state”, the entitlement theory of justice, when applied to non-ideal societies, will either inspire an egalitarian redistributive state (to rectify intergenerational injustice) or a draconian libertarian state that seeks to extract compensation from the most vulnerable members of our society. Either conclusion is one that should raise serious concerns for libertarians who invoke the principles of entitlement.

I can anticipate a few possible responses libertarians might make to my challenge. But I won’t pursue those here as I have gone on for long enough for just one blog entry! But I hope libertarians think the question of what their theory prescribes in non-ideal theory (rather than the idyllic Lockean state of nature) is a question worth taking seriously.

Cheers,
Colin

FORUM 2006 (webcast)



As a brief follow-up to my previous post on “Our Enhanced Future”, I encourage readers to visit the James Martin Institute’s (Oxford University) webcast for FORUM 2006: Tomorrow’s People- the Challenges of Technologies for Life Extension and Enhancement. The Forum is an example of what the future holds for academic conferences as the viewer can experience the conference as if they were actually there! There is also a discussion board on the various topics. This webcast will be of interest to my students who took my “Genetics and Justice” seminar this year as we examined a number of these issues (e.g. extending the health span, cognitive enhancements, etc.). Of particular note are the presentations by the Oxford philosophers Nick Bostrom and Julian Savulescu. Bostrom and Savulescu are both first-rate philosophers who are on the cutting edge of these new and exciting debates. So I highly recommend checking out this webcast!

Cheers,
Colin

Friday, April 21, 2006

Our Enhanced Future











We live in fascinating times. Recent advances in genetics and genomics open the door not only to new therapies (e.g. gene therapy) but also to the possibility of new radical enhancing technologies. Consider, for example, advances that have been made with genetically enhancing mice. Harvard University has created a genetically modified mouse called the Arnold Schwarzenegger mouse and Princeton University has created the Doggie mouse (a mouse with enhanced memory, named after the child doctor on the show Doggie Howser MD). This is fascinating stuff! What are we to make of the possibility of radical human enhancements? Is this something to be embraced or feared? Like most things in life, the answer is complicated and thus we should be cautious before rushing to judgement.

There are great potentials (e.g. extending the human health span, improving our cognitive capabilities, etc.) but there are also serious concerns (e.g. safety) that must be addressed. Let me briefly address two concerns that people typically raise when one talks about new human enhancements- safety and equality. To help address these two concerns I think it is useful to first consider how we view them when it comes to *existing* enhancing interventions. So consider the following imaginary (though typical) day of your average university student- lets call him Bob.

9:00 am Bob wakes up and the first thing he does is drink a few cups of coffee. Coffee has caffeine, which is a stimulant and is the world's most popular drug. Caffeine offsets the effects of sleep deprivation (Bob likes to party hard!) and aids Bob’s concentration.

10:00am After the jolt from his coffee Bob goes off to university. He reads, goes to lectures, writes papers, etc… By exposing himself to these educative influences alterations occur in his brain- learning makes the nerve cells more efficient and powerful.

6:00 pm. Bob goes to the gym, he lifts weights and goes for a run. These physical activities promote his bone density, boost his immune system, and reduce the chances of depression.

The important question now is: would any of us think we should prohibit Bob from pursuing these enhancing interventions? I think we’d all agree that there is no reason to prohibit Bob from pursuing and enjoying these enhancements. But it is important to realise that we are willing to let Bob pursue these enhancements even though some have RISKS and the provision of some is UNEQUAL.

Drinking lots of coffee can increase our risk of heart attack (though now there is reason to believe this might be genetic). When it comes to caffeine, we all agree that an overtly risk-adverse position to this mood-enhancing intervention is untenable. If the bar is set too high for safety we wouldn’t be able to do anything (especially things we find enjoyable). However, people are often ready to discard these reasonable standards for safety when one raises the question of regulating new human enhancements (like genetic enhancements). The philosopher will point out our need to be consistent in terms of the values we believe should inform human enhancements (both existing and future interventions). Pointing out that there is a *theoretical risk* with radical enhancements, for example, is not a compelling reason to ban them (if it was, then we should ban coffee). There are risks with many existing enhancing interventions: vaccinations (which boost our immune system) have some risk of harm, there are risks of injury with running and exercising, laser eye surgery has risks, etc.

I think two factors are worth mentioning in the context of possible radical human enhancements. Firstly, there is risk of harm in the status quo. Aging increases our risk of disease and, eventually, it kills us. Secondly, the level of acceptable risk should be determined, in part, by the magnitude of the benefits such interventions might confer. If we are willing to tolerate some minimal level of risk for something as trivial as the jolt from caffeine, should we not be willing to tolerate a proportionate level of risk for an intervention that could confer much greater benefits?

So it is important to realise that the choice is not between the status quo- with no risk of harm- and the enhanced future -with risk of harm. The question is really one of responsibly managing the harms (and risks of harm) we currently face and those we might face in the genetically enhanced future.

The second important issue that arises with respect to the prospect of radical human enhancements is equality. We permit Bob to enjoy the enhancing benefits of education even though these benefits are not equally accessible to everyone (in our society or the world). To get into university you have to have high grades and (in most cases) the money to pay for this. Determining what equality requires in the post-genetic revolutionary context is a fascinating question. I won’t try to tackle it here (at least for now). But it is something I am investing a lot of my energies into and have written a few articles on already (see my research page- linked from my home page). I will post some further thoughts on this issue later but for now I think it is worth noting that the current situation is not one of “genetic equality”, it is one of “genetic inequality”. So like the issue of risk, the status quo is not something we should celebrate in terms of the value of equality. The important question, for me, is how would the least advantaged fare in a situation where we permit enhancing technologies (even if they are unequally available) versus other possible scenarios (e.g. prohibition). That’s tough to answer. But rather than subvert scientific research in enhancements I am more in favour of pursuing *socio-economic justice*. So if egalitarians are looking for a fight to wage I believe that is the one we should wage, rather than raising principled objections to enhancing technologies.

Cheers,
Colin

Thursday, April 20, 2006

Responsible Risk Management




Risk of harm is omnipresent. One could address the issue of risk by focusing on obvious issues like the threat of terrorism, crime, global warming, hurricanes, etc. but let me approach the topic from a different angle. I wish to recount two separate stories that were reported in the media awhile back but have remained vivid in my mind whenever I think about the issue of risk management and responsible governance.


The first story is the sad story of a man who was decapitated by a malfunctioning elevator. CNN reported this story a few years back and I kept it on file because I found it interesting. The story is here

The story notes that elevators and escalators kill about 30 and injure about 17,100 people each year in the United States. I'd like to think my interest in such stories is not based on some subconscious morbid interest in human suffering but rather an interest in how pervasive (and sometimes unimaginable) risk of harm is and how complex the challenges of mitigating such risks can be. When one hears a story like the elevator tragedy (or a story about a child abduction, threat of terrorism, etc.) one can't help but feel that more should be done to mitigate the particular risk in question. But the reality is that there are an infinite number of risks that we are susceptible to, and thus we face tough and complex decisions when the reality is we can't eliminate *all* risk of harm. How do we prioritise the efforts to mitigate different kinds of risk? And whose responsibility is it to protect us from different types of risk?

The second story I would like to recount is from 2 years ago. It was a nice summer evening and I was watching the Canadian national news when two stories were reported (independently) one after the other. The first story was about a woman from Ontario who was paralyzed by West Nile virus and was suing the Ontario government for not doing enough to protect citizens. The second story was about protestors in a Western province who were protesting the government's decision to spray fields in an attempt to guard against the dangers of West Nile virus. The irony! The government can't seem to win- your damned if you do and damned if you don't.

These kinds of concerns (and the ones brought more vividly to the fore by 9/11 and hurricane Katrina) show that any humane society must take a responsible approach to the prevention of harm (and risk of harm). I have been led to these concerns by my work on genetics where genetic diseases can vary widely in terms of their risk of harm, prevalence and severity of disadvantage. These considerations ought to impact how stringent we believe the duty to mitigate genetic disadvantage is. But keeping the discussion more general for now, I think the following four considerations are central questions that any responsible approach to risk management must address and consider:

1. How probable is the risk of harm? The greater the probability of harm (all else being equal) the greater the case for intervention.

2. How severe and pervasive is the disadvantage in question? The greater the harm (all else being equal) the greater the case for intervention.

3. What is the likelihood that intervention will have the desirable effect (i.e. prevent or reduce the risk of harm)? The greater the likelihood that intervention will make a difference (all else being equal) the greater the case for intervention.

4. What is the cost of intervention? The cheaper the cost of intervention (all else being equal) the greater the case for intervention.

Thinking about these considerations in the context of environmental policy, the war on terror, healthcare, crime prevention, etc. will help ensure that we take a responsible approach to risk management. These considerations highlight the importance of getting the input of experts with specialised knowledge. But responsible risk management does not prescribe autocratic rule by knowledge elites. Nor does it lead us to embrace a crude or simplistic cost-benefit analysis (CBA). I like the purposeful approach taken by CBA but I think we need to embrace a more nuanced version of it if we are to make it a component of an attractive normative theory. How do we do this? One way would be to incorporate a democratic mechanism in the cost/benefit metric. Rather than simply positing a monetary value to everything we could permit informed citizens to play a role in terms of ranking the importance of various goods (e.g. better education vs. better healthcare vs. greater economic stability vs. safer streets, etc.). So one way of fostering a responsible approach to risk management is to foster democratic accountability and reflective deliberation (in addition to accumulating reliable facts).

At a minimum an informed and reflective citizenry must appreciate how enormous the task of minimizing risk is. Such a citizenry will not demand the government make protection from risk X or Y a top priority simply because they read a story about someone suffering from X, or witness a gripping amateur video showing someone being harmed by Y. An informed and reflective citizenry (and government) should ensure that other considerations (like the 4 points highlighted above) are part of the public debate.

And responsible journalists should ensure that the stories they report to the public are balanced and placed in an appropriate context. So the quality of the media is *vital* to ensuring responsible risk management. The sad reality is that many citizens are more afraid of being harmed by terrorists when the reality is that the greatest threat to their health is often themselves (e.g. their diet, lack of exercise, etc.). Reporting on how we are losing the war against obesity [update: kudos to the Guardian for reporting this] might not make for exciting news reports but it would serve a very useful societal function.

Finally, responsible risk management must also recognise that a division of labour is required. Certain responsibilities fall to the government in terms of enforcing formal regulations (e.g. covering food preparation) and policies/law (e.g. criminal law, etc.), but some responsibility should (and must) fall to us as individuals. As individuals we can do many things to reduce our own health risks- wear seatbelts, quit smoking, limit the intake of alcohol, exercise, eat well, etc. So the next time you feel inclined to slam the government for not doing enough to protect your safety ask yourself if you yourself are doing enough to protect yourself. Would you "re-elect" yourself as your own personal "Health Minister"? If not, put pressure on yourself to be more proactive about promoting your health!

Cheers,Colin

Tuesday, April 18, 2006

O Brave New Brain...


I am currently swamped with exam marking at the moment (why is the weather always beautiful when I have grading to do?). But I have started reading a new book- Nancy Andreasen’s Brave New Brain (Oxford, 2001). I’m only on chapter 3 but it is a fascinating book and topic. I was motivated to read it by my own neglect of the issue of mental illness (which has important consequences for my research on genetics and justice). In addition to the fight to combat the debilitating effects of single-gene disorders like cystic fibrosis and multifactorial diseases like cancer and heart disease, humans are also susceptible to a variety of mental illnesses. And the efforts to prevent and treat such illnesses warrant serious concern and attention. Andreasen notes that mental illnesses are among the most common diseases: schizophrenia affects 1% of the population; manic-depression another 1%; major depression 10-20% and Alzheimer’s 15% of senior citizens. In addition to the hardships mental illness imposes on the victims and their families, such illnesses also have important economical costs. Andreasen provides a table of the top 10 causes of disability in the world and their cost in DALYs (disability-adjusted life years). At the top of the list is unipolar major depression (cost of 42, 972 DALYs); other top mental illnesses include manic-depressive illness (cost of 13, 189 DALYs) and schizophrenia (cost of 12, 542 DALYs). Compare these costs with those imposed by war (13, 134) and violence (12, 955) and you get a sense of how enormous the costs of mental illness are on every society.

Why am I reading this book and trying to learn more about the brain and mental illness? Well, it addresses my concerns with GELS- the legal, ethical and social implications of the genetic revolution. Advances in mapping the human brain go hand-in-hand with the advances made with mapping the human genome. As Andreasen puts it “Once mind and molecule meet, prevention is possible. Improvements in treatment are certain” (7). Like our physical health, our mental health is influenced by a variety of factors- both biological and environmental. The Canadian Mental Health Association has a helpful webpage that contains a number of “Mental Fitness Tips”. In the hustle and bustle of everyday life it is easy to forget about promoting our mental fitness. Not surprisingly, looking after your physical health overlaps to a large degree with caring for your mental health. The site has a number of useful tips, so take a look at the list here: http://www.cmha.ca/bins/content_page.asp?cid=2-267-353&lang=1

By learning more about the brain, and the movement towards a biomedical and neurobiological model of the brain, I hope to get a broader appreciation of what the impact of the genetic revolution might be on human wellbeing. I’ll be posting a lot more on GELS issues in the future, but for now, back to marking!
Cheers,
Colin

Monday, April 17, 2006

First Post

Greetings!

Welcome to my new weblog. After following the phenomenon of blogging for the past 3 years or so I have finally (though cautiously!) decided to jump in with both feet and start this blog. The title is inspired by the philosopher Immanuel Kant’s 1784 essay “An Answer to the Question: What is Enlightenment?” For Kant enlightenment is our emergence from our self-imposed immaturity. He claims:

Immaturity is the inability to use one's understanding without guidance from another. This immaturity is self-imposed when its cause lies not in lack of understanding, but in lack of resolve and courage to use it without guidance from another. "Have courage to use your own Reason!"--that is the motto of enlightenment.

This quote nicely summarises the spirit of this blog (and my life), hence why I have called it “In Search of Enlightenment”. Of course by having such a grand title I run the danger of building up false hopes that I will deliver more than I actually intend to (or could) deliver. So let me be upfront from the start about my hopes and aspirations for this blog. I hope to run an intelligent and reflective blog that addresses a variety topical issues (especially in politics and philosophy). And I hope to do so in a way that does not undermine the other various commitments I have (e.g. work, family, etc.). A few weekly blogs should permit me to run an interesting blog and still meet the other commitments I have (he says naively :)…). Furthermore, I hope this blog will actually help me in my research. I intend to blog on topics related to my academic work, as well as issues that should be of interest to the more general public. So please keep an eye on this site. Once I figure a few more things out (I really a novice when it comes to this technology) I hope to get things rolling....

Cheers,
Colin