Thursday, April 08, 2021

New Paper on Cancer and Aging

My Opinion article titled "50 Years of the “War on Cancer”:  Lessons for Public Health and Geroscience" has been accepted for publication in the science journal GeroScience (journal of the American Aging Association) published by Springer.  The abstract:

The year 2021 marks the 50th anniversary of the National Cancer Act of 1971 and President Richard Nixon’s declaration of a “war on cancer”.  In 1971 cancer was the second leading cause of death in the US, and today it is still the second leading cause of death with an estimated 606,520 Americans dying of cancer in the year 2020.  The half a century campaign to eliminate cancer reveals at least two important public health lessons that must be heeded for the next 50 years of the war against the disease- (1) recognising the limits of behaviour control and (2) recognising the significance of rate (of aging) control. These two lessons result in a somewhat paradoxical conclusion in that we must have both humility and ambition in our attitudes towards future preventative medicine for the world’s aging populations.  Geroscience must become an integral part of public health if serious headway is to be made preventing not only cancer, but most of the other chronic conditions of late life.



Wednesday, March 24, 2021

Asking the Right Questions is More Important than Answering the Wrong Questions

Having spent more than half of my life studying the flight of humanity I would sum up the insights of most everything I have learned in following statement:  it is far more important to figure out what the right questions to ask are vs trying to figure out the answers to the wrong questions.

Some examples, at both the personal and public policy level:

Limited/Misplaced Questions       

How can I live a happy life?       

Why vote?

What are the proximate causes of disease?    

What causes conflict and war in the world?   

How can we maximize GDP?          

What duties/rules should I follow?   

What are the most important moral values?    

What should I do?                             

Better Questions

How can I live a life of meaning and purpose?

Why do anything?

What causes health?

What causes compromise and peace?

How can we flourish as a society?

What kind of person should I be?

What constitutes a reasonable balance among competing moral claims?   

What should I believe?  



Tuesday, March 23, 2021

Book Chapter ""Positive Biology" and Well-Ordered Science" now available

My latest book chapter titled “"Positive Biology" and Well-Ordered Science” has just been published in the edited book Measuring Well-Being: Interdisciplinary Perspectives from the Social Sciences and the Humanities by Oxford University Press.

The full book is available to download for free under “open access” for anyone interested in learning about interdisciplinary perspectives on wellbeing from the social sciences and humanities.

I think people may find this a timely read as we have hit the one year anniversary of the pandemic lock-downs. For over a year the focus of science, the media and public policy has been on pathology and minimizing the spread of one particular virus. If there is to be a future worth striving for, it is imperative that the public discourse, focus and policy decision-making turn to the broader concern of how to ensure human beings flourish.

The abstract of my chapter is below.

ABSTRACT: Going back to the Ancient Greeks (e.g. Plato and Aristotle), philosophers have long asked profound questions such as “What is knowledge?” and “What is the good life?”. Such questions compel us to engage in a deeper level of introspection and examination than most of us are typically accustomed to in our daily lives. The philosophical question contemplated in this chapter is: “What constitutes ‘well-ordered science’?” Invoking a virtue epistemological construal of knowledge as “success from ability” (Greco, 2010), I argue that the study of pathology must be supplemented by the study of the determinates of exemplary positive phenotypes (e.g. healthy aging and happiness). This requires transcending the limitations of what I call “negative biology”, and treating “positive biology” as an integral element of well-ordered science in the 21st century. Positive biology can help bring to the fore the importance of understanding the evolutionary and life history of our species, thus helping to provide the intellectual frameworks needed to inspire the development of novel and feasible interventions to improve human health.



Saturday, March 20, 2021

25 Years of Academic Publishing: Some Reflections

25 years ago this year I began my PhD studies in the Department of Philosophy at the University of Bristol.  It was also the first year I entered the world of academic publishing, having submitted my first paper to an academic journal (and having them swiftly reject it!)  I thought I would offer some reflections on the past 25 year journey of academic publishing, limiting my focus in this blog post to publishing in academic journals.

I preface my comments by noting that the life of an academic is a privileged and blessed life.  I am so fortunate to have the opportunity to make a living from the life of an engaged mind.  But it is also true that a life engaged in the world of academic publishing has it’s share of anguish and anxiety, especially for early career scholars struggling to earn a living and get some employment stability.  And this blog post was written with aspiring scholars/junior colleagues in mind. They might profit from hearing some of the experiences I have had on the “ups” and “downs” of journal publications.      

While a graduate student I was desperate to get some of my work published and starting sending things out to journals.  In hindsight this was premature.  For the first two years the 2-3 articles I had submitted were based on graduate work in my MA studies.  It was decent work for my courses and MA thesis, but not publishable research.  All were rejected. 

During my first year of the PhD program living in the UK I remember watching old re-runs of The Waltons, and identifying with John Boy and his struggles to get published as a writer.  In my first year of the PhD program I saw the episode where John Boy gets his first publication, after enduring many rejections and disappointments.  I found it an inspiring tale, and saw myself as an academic version of John Boy (i.e. a nerd’s nerd!).  The first two years of publication rejections seemed like a decade to me.

While a first year doctoral student I also purchased a copy of the book (pictured above) Guidebook for Publishing Philosophy.  I read every page of that book multiple times, going over the acceptance rate of the journals, the average time to acceptance/rejection and the circulation numbers of different journals.  It was only in the second year of writing my PhD thesis that my ideas developed more fully into something that was publishable.  And I started submitting parts of the PhD thesis to journals, now with success!  I was very fortunate in that I did have 3 papers (here, here and here) from my PhD dissertation accepted for publication before my PhD defence in year 3 of the program (1999). 

So when I first went into the job market in 1999 the fact that I had publications in hand really helped as the UK had a Research Assessment Exercise coming up in the next year or two and departments were looking for adding scholars with publications in hand that could help with their rankings.  But even with those publications I took two fixed lectureship positions before landing a permanent position at Manchester University.

My own personal triumphs and stresses of journal publication have evolved and changed over the years.  Prior to my first permanent appointment, and then tenure and eventually promotion to full professor, there were pressing careerist factors that weighed very heavily on my mind.  “Publish or perish!” was certainly a mantra that I internalized early on as I wasn’t coming from a top ranked university or program.  I knew that publishing was the only way to make some kind of name for myself in the discipline and (hopefully) land permanent employment.

 Reflecting back on 25 years of persisting through the process of article writing, then submitting and waiting, then re-submitting, revising, etc. I think it is accurate to say it is not an easy process (at least for me!).   Nor should it be.  Unlike a blog post, where anyone can write and then hit “publish”, an academic journal has gatekeepers and stringent criteria for publication.  Most submissions to a journal do not meet the criteria for publication.  Even the top scholars in the world have their work rejected.  One of the things that successful academics must learn to do well is to live with constant rejections of their journal submissions.  This isn’t always easy to do!  But some things (like one’s attitude and perception of the process) can help make it more palatable. 

For me, given my personality, I have found that to persist and flourish with academic publishing I had to consciously cultivate a kind of paradoxical mindset.  On the one hand, I needed to believe in myself, to have the confidence that my ideas and what I have written is worthy of being shared with others in a published journal format.  We all have some self-doubt, and no paper addresses all the relevant literature/ possible objections, etc.  But you have to make the judgement call as to when your ideas have been developed to a level when submitting to a journal is appropriate.  Self-confidence and a willingness to risk rejection are needed. 

So on the one hand ego (coupled with self-preservation and curiosity) plays a factor in getting you to submit things for publication in the first place.  And yet, ironically, ego can also prevent you from submitting, or at least to better publication venues.  If your ultimate goal is to avoid any journal rejections then there is foolproof strategy for achieving that- never submit an article for publication!   You need some ego to motivate you into the publishing game, but not too much ego.  I take some pride in being able to say that I have had my work rejected by some of the best journals in the world.  For without that attitude I never would have submitted my work to the journals that eventually did publish my work.     

Maintaining a sense of humility, with no sense of entitlement to have your work published in any particular journal, is also critical.  At the same time you need to have the confidence, competence and perseverance to write, revise, revise again, go through editor desk rejections, split referee rejections, R&R rejections, etc.  The narrative you tell yourself about your rejections is perhaps the most critical aspect of this process.  You want to avoid characterizing yourself as a “victim” of unfair editorial or referee reviews.  Conversely, you should be aware of the fact that a lot of luck and happenstance can come into play in the decision-making process.  For some journals your paper might not be a good fit.  What one editor considers “a timely and significant topic” the editor of a related journal considers “unoriginal and trivial”.  One referee might have sympathy with the methodological premises of your argument(s) and yet another is ideologically opposed to your method or conclusions.  What one assessor judges to be a “clear “ “original” and “interesting” contribution another assessor judges to be “unclear” “commonplace” and “unimaginable”. This is simply the way the journal gods blow.  Try not to get too frustrated by this process.  It is what it is.

Even now, over 20 years later, a journal rejection typically stings for a day or two.  But then I move on and “let it go”, determined to improve the work and submit it to the journal that will also choose it as its home destination.

It is always good for junior scholars to seek out advice from different types and ranks of scholars.  My own views are probably something of an outlier view.  In my writing I prioritize what I WANT to write, with only secondary or tertiary consideration for the discipline, let alone journals, it eventually gets published in.  This has its careerist risks, which fortunately for me haven’t been an obstacle to my career progression.  But for most disciplines you write for a specific sub-field and the few journals that publish in that field. In such a case you may want to give some thought to which topics are “most relevant” “trendy”, etc. to increase your odds of success.  I myself prefer to try pave a new direction or tackle neglected issues vs address what happens to be trendy and current in a field.  But my interests and motivations are a bit out of the norm.

Persisting in academic publishing teaches one resilience, patience, persistence, humility and it can also adversely impact one’s emotional wellbeing and even mental health. The stakes are high, one’s career and familial financial security often relies on success in publishing (especially in the early stages of a career).   Like most things in life, there are good aspects but also negative aspects.  Keep your eyes open to both of them, self-awareness and insight are important. 

A common mistake I often make is to be too forward-looking in my attitude towards publications.  When I first started my career, and a paper was accepted by a journal I really took time to appreciate that good news and bask in the sense of achievement for a while.  Unfortunately now I am typically too focused on the next project that I sometimes forget to stop to smell the roses.  It is important to be present to the feelings of gratitude and achievement, they help sustain a scholar through the rejections and revisions.

My career ended up going in different directions from what I initially anticipated when obsessing with the Guidebook for Publishing Philosophy as a graduate student 25 years ago.  But the book served me very well, showing me how important it is to do your research in advance, know which journals are a good fit and how long they take to review and what their prestige in a field is like.

Putting these rambling reflections together, I can distill 5 general bits of advice:

#1.  Don’t ever have a sense of entitlement about publications- no journal owes you a publication.  You hope that slaving away on a paper for months, even years, eventually results in a journal publication.  It doesn’t always.  But hopefully it does more times than not.    

#2.  Don’t take journal rejection personally.  Rejections can sting, especially when split referee reports or after revise and resubmits.  But understand this is part of the publication game.  Lick your wounds and let it go.  Holding on to bitterness and resentment about the process will cause you to have persistent negative emotional experiences with publishing and, eventually, you may stop submitting work to avoid those negative experiences.  

#3.  Have humility:  critical feedback from editors and referees typically improves your work and is an important part of the process of developing as a scholar.  Sometimes the negative reports are the most important kinds of feedback you get.  Unlike your colleagues, friends or the like-minded scholars in your network, an anonymous referee might challenge premises or assumptions in your work that should be challenged.  Judiciously responding to their concerns can make you a better scholar.

#4.  Be present with gratitude and a genuine sense of accomplishment when publication success does come your way. 

#5.  Be sure to have other hobbies and interests:  don’t make publishing the only focus of your life.  Of course it is an important aspect of one’s career, even calling, but be sure to live a well balanced life.  You need to be proactive in caring for yourself physically and mentally. 

25 years ago I started down the path of trying to get my academic research published.  The first two years did not yield any results, but I am happy to report that over the remaining 23 years I have had my work published in the following (30+) journals:

 Public Health Ethics

Law and Philosophy

Philosophy of the Social Sciences

British Medical Journal

Journal of Political Science Education

University of Toronto Law Journal

Journal of Value Inquiry

Ratio Juris: An International Journal ofJurisprudence and Philosophy of Law

Politics (twice)

Journal of Applied Philosophy

American Journal of Bioethics (twice)

Bioethics (twice)

Res Publica: A Journal of Legal and SocialPhilosophy

Journal of Medical Ethics (twice)

Kennedy Institute of Ethics Journal

Political Studies

Cambridge Quarterly of Healthcare Ethics (twice)

Political Studies Review (twice)

European Journal of Political Theory

Canadian Journal of Law and Jurisprudence

Canadian Philosophical Review

Canadian Journal of Political Science


Annals of the New York Academy of Sciences

Preventative Medicine (twice)

The Ethics Forum

Social Philosophy and Policy

QJM: An International Journal of Medicine

Journal of the Royal Society of Medicine

Journals of Gerontology: Biological Sciences  (twice)

Rejuvenation Research (thrice)

Nature’s EMBO Reports (twice)

Public Affairs Quarterly


Journal of Medicine and Philosophy

Politics and Life Sciences


All the best on your journey through the world of academic publishing!



Tuesday, March 02, 2021

The 4 Factors that Influence my Academic Research Projects


The world has many:

 (A) pressing societal problems. 

These societal problems fall into one of two categories: 

(A1) short-term societal problems (e.g. problems that could be resolved in the next decade or two).

Whereas other societal problems are pressing:

(A2) over the long-term (over the next century+). 

The world also has many (B) puzzling and intriguing predicaments, the solution to which will require depth, imagination and innovation in one’s critical thinking skills.   

Some societal issues are a combination of both (A) and (B), and still others are neither (A) nor (B), but makeup category (C)- issues that are not particularly pressing societal problems, nor issues that are particularly intriguing or perplexing.  

And as an educator and scholar interested in thinking about the origins, persistence and potential solution to different types of societal problems I try to always give serious consideration to the issue of deciding on which problems to focus my limited time, limited skills and limited energy on.

 My thought process has changed over my 20+ year academic career, and I take a different attitude towards different things I cover (e.g. a topic I might just address in 1 or 2 journal publications vs a more substantive engagement with in terms of a dozen journal articles over a decade and/or in a book). 

On the whole I think the following 4 factors loom large in my thought process.

(1) I look for problems that I think truly have a significant impact, both in terms of their scope (e.g. global vs just local) and the stakes involved (e.g. human health, happiness or wealth) and the duration of their significance (e.g. over the long run vs just the short-term).

(2) I also tend to pick problems that, while important, are typically ignored or neglected.  I am most intrigued by big problems that are not commonly perceived to be big problems.  That fact itself raises a host of interesting issues to consider.

(3) I am of course constrained by my own field of expertise, intellectual suppositions, biases, etc.  This means there are a long list of pressing issues it is better to let others tackle because they do have the requisite expertise.  But I also try to revise, update and expand my own expertise, when I feel it is important for me to dig deeper into an issue.  But at the same time I recognize that there are some significant problems I am not well positioned to address.

(4) there are also some intangibles at play- like my own intellectual curiosity and interest.  Some societal problems don’t really raise significant philosophical or ethical concerns.   It might sound somewhat perverse, but a big part of my attraction to theorizing about many of the issues I tackle is that doing so is, well,  fun!  They are issues that present a significant intellectual challenge to me because they require “outside the box” thinking, or the integration of empirical knowledge and normative theory, etc.  Some topics just really fascinate me, and motivation is key when it comes to academic research.  If you are not motivated to research a topic, no matter how important it is, you aren’t likely to do a deep dive into it, let alone sustain a research project over many years.  Having said this, (4) is closely aligned with (1).  I find it fun to tackle things that are important.  I don't see my research as a source of self-indulgence, but it does add meaning and purpose to my life which is why my passion for it still burns brightly after 20+ years.   

So distilling this down to a more concise description, my academic research interests are driven by:

(1)  Issues that I believe are pressing and important.

(2)  Issues that are somewhat marginalized within my discipline or policy making or at the societal level.

(3)  Issues that happen to fall “on my radar” (given my interests) and within my expertise.

(4)  Issues that engage and interest me.




Friday, February 19, 2021

History of Infectious Diseases (Part 1): "Typhoid" Mary and Polio

Next year I will be teaching a new seminar course titled “The Politics of Pandemics” which will cover the ethical, social and legal implications of trying to mitigate the public health risks posed by the 1400+
infectious organisms that cause disease in humans. 

 The scope of the course will be pretty expansive, covering both historical and contemporary endemics and pandemics ranging from the  bubonic plague, cholera, dysentery, semolina, typhoid fever, the 1918 influenza pandemic, polio, dysentery, Ebola, HIV/AIDS, the 2003 SARS outbreak and culminating with an extensive focus on the COVID-19 pandemic.

 At the moment I am digging deep into research on the infectious diseases that were rampant in the first half of the twentieth century in the United States.  It is proving to be a fascinating (albeit rather depressing) read, and it is amazing how this history is so quickly forgotten.  People living in developed countries often take for granted the extremely low levels of early-life mortality we commonly enjoy now.  But this reality is a true outlier from the circumstances which persisted throughout human history prior to the public health advances of the 20th century. 

I want to share two fascinating stories from this time period here.  The first is the story of “Typhoid Mary”, who was Mary Mallon from Ireland.  Mary emigrated to the US as a teen in 1884.  She worked as a cook and was an asymptomatic healthy carrier of Salmonella typhi.  Mary is often attributed as being the main cause of a typhoid outbreak in New York in the early 1900s. 

The story of how Mary Mallon was identified as the first “super spreader” reads like a detective novel. Immunization against Salmonella typhi was not developed until 1911, and it took over 30 more years for antibiotic treatment to become available.  And poor Mary Mallon spent a total of 26 years in forced quarantine.  More details about her are available here.

The other inspiring, but also tragic, historical example I wish to draw attention to comes from the polio outbreaks in the 1940s.  Polio is a disabling and potentially life threatening infectious disease caused by the virus poliovirus.  It can infect a person’s spinal cord, causing paralysis.  The CDC estimates that, in the early 1950s, before polio vaccines were available, polio outbreaks in the US caused more than 15 000 cases of paralysis each year.  President Franklin D Roosevelt was diagnosed with polio in 1921, at the age of 39. Because of widespread vaccine use, the United States has been polio free since 1979. 

Before vaccines, the “iron lung” was often used to keep patients alive if the virus’s action paralyzed muscle groups in the chest.  Paul Alexander is one the last “iron lung” survivors.  And this video details his journey through life living in the iron lung for nearly 70 years!  

When you consider how prevalent the extrinsic health risks of our environment are, it is amazing that humans have the lengthy life expectancy we enjoy today (over age 72).  The advancements of science and public health are miraculous achievements of human ingenuity, but they are not equally enjoyed by all in the world today.  These are achievements that each new generation must have gratitude for, and a desire to contribute towards to help us further improve the prospects of global health.  



Friday, February 12, 2021

National Post Article on Aging and COVID

I rarely do media interviews.  My attitude towards them is three-fold:

(1) I only agree to do them when they are on my areas of actual expertise (meaning I have published extensively on the topic and/or taught on the issue for many years) vs a topical issue that I might have some random or half-baked thoughts on I could share with someone willing to listen to me (my blog is the more appropriate venue for such reflections).  

(2) the media can be an effective venue to help disseminate important and specialized knowledge/insights to the general public vs a strategy to be utilized to boost one's name recognition/ professional prestige/ or ego. 

(3) I really dislike presenting "sound bites" and having to summarize complex arguments and insights in one or two sentences (though I acknowledge there are important reasons for doing so.... the reality often is TLDNR = one's perspective is never heard)

My recent article in Journals of Gerontology: Biological Sciences was covered by the National Post in this article.  Tom Blackwell is an excellent reporter, who also interviewed me for a piece back in 2012., so I really enjoyed doing an interview with him for the article.

A few samples from the news item last week:

“The COVID-19 pandemic is a highly fatal pandemic largely because of population aging,” notes Farrelly, a Queen’s University professor who has a new journal paper on the topic. “Our success in delaying death in late life made us vulnerable to COVID-19 mortality.”

....More intriguingly, and hopefully, Farrelly and others say the pandemic is a compelling reason to double down on a fascinating new domain of medical research. Its goal, rather than finding cures for individual diseases, is to treat the aging process itself.

....So how soon before a drug arrives that brings, not immortality exactly, but a longer “healthspan”?

Austad believes it ‘s coming within 10 years. Zhavoronkov is also optimistic, saying the last decade has seen remarkable progress, “more discoveries in aging medicine than in the entire human history.”

It feels personal to Farrelly, a political-studies professor who monitors geriatric science. His mother died in the midst of the pandemic after years of battling cancer, unable to see family in the last three months of her life because of COVID protocols. But he’s hopeful.

“I believe it will happen in my kids’ lifetime,” said Farrelly. “They won’t age like my mother did.”



"The Duty to Aid" and the Pandemic

7 years ago I published my article "Empirical Ethics and the Duty to Extend the "Biological Warranty Period" in the journal Social Philosophy and Policy (reprinted in Biologically Modified Justice).  In that article I examine extending Singer's principle of preventing bad occurrences (what I call the "duty to aid") to the predicament of aging and preventing late life morbidity and mortality.  

My goal in doing so was to draw attention to the reality that biological aging itself possesses the most significant public health threat to the world's aging populations (something that is still true today, even with the current pandemic).  

I think it is fair to say that the topic of aging, and its health implications and the science of biogerontology, are all pretty much non-existent topics and concerns in philosophical debates about ethics and political philosophy.  I have tried my best to redress this situation within the discipline for well over a decade now, but there is significant inertia coming from many fronts.  And then along came the pandemic of 2020, which I thought might help open the discipline's eyes to the biological realities of today's aging populations.        

The arrival of the COVID-19 pandemic in early 2020 posed a real challenge for the discipline as philosophers scrambled to figure out what morality and justice requires with respect to this pandemic.  The vast majority of COVID-19 fatalities are among older persons (in the US over 80% of COVID-19 deaths occur among persons age 65 and older), and yet many of the strictest public health measures proposed to limit the spread of the virus (such as closing schools, stay-at-home orders, banning travel, etc.) have imposed significant health and economic burdens on the whole population, but especially the young (age 20 and younger) who face minimal health risks from the virus itself.  

The discipline's neglect of real-world empirical insights- such as the prevalence of other causes of preventative deaths worldwide, the reality of multi-morbidity in late life, and the fact that there is a biological limit to the human lifespan- has resulted (IMHO) with distorted moral analyses of this pandemic.  I have seen commentators invoking general appeals to "saving lives at all costs", as if, prior to this pandemic, no one in the world ever died from preventable causes of death!  Such commentators do not seem aware of the fact that there are nearly 10 million cancer deaths each year1.6 million diabetes deaths per year, 1.35 million deaths each year from traffic accidents, 400 000 deaths per year from malaria, 700 000 deaths from HIV, and 800 000 people commit suicide each year.  These total more than 7 times the number of COVID-19 deaths in 2020.  Our response to this pandemic must be placed in the context of these other realities vs being treated in isolation from them.  

Now if one had their head buried in the sand about these other global problems, which are ALL causes of death for people much younger than COVID-19, and then in 2020 when one took their head out of the sand and read the headlines about COVID-19 they could easily form the false impression that it was the leading, or perhaps even only, pressing cause of death for humans.  This "perception of reality" distortion will thus lead to a distorted moral analysis of the moral landscape as the former will be consumed by a concern to only prevent COVID-19 mortality.  

So if we don't want to tackle the issue of pandemic ethics from this "head in the sand prior to 2020 perspective", where might we begin?  I believe the analysis of the duty to aid I advanced in my 2014 article is a good starting point.  It advances an "operational level" analysis of the duty to aid, one which rejects ageism but also takes seriously key empirical concerns that many have ignored in our public health response to this pandemic.

When it comes to aging and longevity I have noticed two polarized extreme positions, and I believe both are morally objectionable (but the "default" setting for many people's moral intuitions).  The first extreme attitude is the one I have faced for 15 years of my research on these topics- the ageist view that there is no moral duty to extend (healthy) life because (a) there are too many people in the world already, OR (b) in a world with early and mid-life mortality we shouldn't give any attention to tackling late life morbidity or mortality, OR (c) extending life would mean less jobs for younger people OR (d) aging is "natural" OR (e) people live too long already, etc. (there are more versions but these are the most common ones I encounter).  

Until the year 2020 (a)-(e) were the most prevalent attitudes I would hear from students and other academics.  

But since the outbreak of the pandemic in 2020 the pendulum has swung in the opposite direction, but so far it has gone to the extreme end.  Now it is not uncommon to hear people say "We should do everything possible to save lives!", even if this means indefinite stay-at-home orders for healthy people, cancelling school for children, violating basic individual rights and freedoms (including the right to protest), massive unemployment, increased risks of obesity, mental illness, delays in screening and other medical appointments, increases in suicides, more drug addictions, and potential economic ruin from unmanageable government debt. 

Witnessing the train wreck of the public health response to this pandemic, coupled by the emotive and mostly ill-informed public discussion and debate on this topic on social media and print media/TV has really driven home to me how important the "intellectual virtues" are, like paying attention to the relevant details, exercising the detective's virtues, and having intellectual humility.  

Below I reproduce a few paragraphs from my 2014 article, that seem more relevant than ever given this pandemic.  It tries to steer us to the mean between the ageist view which disregards the moral equality of all and the fanatical commitment to save lives regardless of the prospects of success, or costs/burdens doing so imposes on others.  During the pandemic governments have struggled to find this mean between the COVID-deniers and the strict lock-down enthusiasts.  The details of the argument in that paper make the case for this judicious middle ground approach:  

Return again to Singer’s example of the drowning child. Instead of the young child drowning in a pond, let us now imagine that it is 60 years into the future from Singer’s imagined drowning example. The child is now a 65 year-old adult, in fact she is a grandmother, and has returned to the very same pond where she almost drowned 60 years earlier. She has brought her grandson with her, to enjoy a picnic lunch and explore the pond. While chasing tadpoles with her grandson in the pond, the grandmother slips on a rock and hits her head. She now lays unconscious at the bottom of the shallow pond that nearly took her life 60 years earlier. You are walking by the pond and hear the grandsons’ pleas for someone to help his grandmother (he is not strong enough to rescue her). What do you do?

I shall assume that most readers share my conviction that we should aid the drowning grandmother. Furthermore, I believe the stringency of the duty to aid in this example is very pressing, and of equal strength to the imperative to help her when she was a child. The urgency to prevent suffering and death does not dissipate, or even severely diminish, simply because the grandmother is now older than she was 60 years earlier. She still deserves to be treated as a moral equal to other persons, her chronological age does not erode this status as an equal. She, like all of us, has interests, aspirations and goals that are worthy of respect and consideration. Thus we ought, if it is within our power to prevent something bad from happening without sacrificing something of comparable moral importance, to aid her.

This modified version of Singer’s drowning example illustrates the point that the age of the person in need of assistance by itself has no ethical relevance in the drowning example. The person who saves drowning children, but is unmoved to aid drowning grandparents, acts unethically. Their actions are “ageist”. Robert Butler, the first director of the NIH’s National Institutes of Aging, coined the term ‘‘ageism’’ in 1969,16 which means a systematic stereotyping of, and discrimination against, people because they are old. Ageism violates the humanist conviction that all persons’ interests matter, and they matter equally. The age of a person in need, just like the nationality of those in need, has no ethical significance.

However, it is important to note that, at the operational level of implementing DA in practice, the age of those in need of assistance can be relevant as age often functions as a proxy for estimating the “expected utility” (or benefits) of an intervention and this can be a relevant consideration when the resources available to aid those in need are insufficient to redress all preventable suffering and death in the world.

Recall that modified DA ("DA" means the "duty to aid") has the stipulation the greater the benefits of preventing something very bad from happening, all else being equal, the greater the moral duty to prevent the bad in question. But all else is not necessarily equal, and this reality means that the duty to aid cannot be simply partitioned into serially ordered duties, with the duty to save children having lexical priority over the duty to prevent suffering, disease and death late in life. We must attend to both kinds of harm, and the stringency of the duty to prevent the risks associated with premature death should depend upon the considerations which modified DA stipulates (e.g., the probability that non-intervention will result in harm, the probability that intervention be successful, the cost of intervention, and the magnitude of the benefits of intervention).