The Eutyphro Problem I

I was involved in a most interesting e-mail exchange for the better part of November and December of last year. It all started with a claim about the notorious Eutyphro problem for so-called 'divine command theory'. The claim, poffered by Chris Morris, was that the traditional Eutyphro dilemma is not a dilemma if one makes a distinction between what is 'right' and what is 'good'.

Let me explain. Divine command theory (aka 'theological voluntarism') is the view that one ought to do something if and only if God commands it. More precise, an action is right if and only if God commands it. There is an old dialogue written by Plato entitled Eutyphro in which that old scoundrel Socrates has a discussion with young Eutyphro on the street. Eutyphro is on his way to the courts to denounce his father. In the course of the 'discussion' (for it really is a monologue where Eutyphro's contributions are restricted to utterances such as "Indeed!", "Pray go on...", "I see....", etc.) Socrates asks Eutyphro "Are acts pious because the Gods command them, or do the Gods command these actions because they are pious?" The dialogue does not really give an answer, but later philosophers have taken this question to be the kiss of death for divine command theory (DCT).

The reason is that this question can be reformulated as an inescapable dilemma for DCT-ers: "Is an action right because God commands it, or does God command it because it is right". If it is the case that an action is right simply because God commands it, it seems that God could have commanded just about everything and it would be 'right'. Thus, if God had said 'go and kill all Canaans, rape their women and butcher their children' this would be right. But how could this be right? Murder, rape and infanticide are wrong and it seems, they are wrong necessarily. DCT cannot explain why these are wrong necessarily. Alternatively, if God commands us not to commit murder etc., because these actions are wrong it seems that God is irrelevant for the determination of what is wrong. Murder is wrong and God's commands do not add anything. In short, it seemed DCT is not a plausible theory of what is 'right'.

However, this is too fast. A DCT-er could argue that one ought to distinguish between the 'right' and the 'good', between 'duty' and 'value'. Then DCT can be salvaged from this dilemma. For God is such that he 'tracks' the good, what is valuable, and bases his commands on that. So God commands us not to commit murder and his command makes it our duty not to commit murder. However, the reason that God issues this command -- and issues it necessarily -- is that there is a connection between this command and what is good or valuable. (I am trying to avoid saying that the connection between the command and what is good is a consequentialist one. That is, it need not be the case that God commands us not to commit murder because such actions have the best feasible consequences. As long as there is some relation which makes it the case that God could not command us murder, rape, plunder and what have you...).

This seems correct -- at least to me, but I took a lot of flak trying to defend this view to others.

However, thus stated and defended, the Eutyphro problem (for it no longer is a dilemma) does point to a different problem for the DCT-er. A DCT-er has to have some story as to how God's commands can make and action right. What is it about God's commands (as opposed to mine for example) that make murder wrong? In other words, DCT can be defended against the Eutyphro problem, if it can be shown that God has moral authority. What could this authority be and how can you show that God (were he to exist) has it.

One final remark: this discussion is germane, not just for the assessment of a rather arcane view in moral philosophy that only a bunch of crazed, uncritical fundamentalist believers endorse. Similar problems arise for any alleged authority. For example, why ought one to do as the government commands? Why are the decisions of democratic bodies (e.g., a well-functioning parliament) legitimate? Why ought one to accept what experts (e.g., teachers) tell us to accept? Finally, note that there is a similar problem for you: why should you do what you decided to do?

I will come back to this later I hope...

In the mean time, check out the stuff here...

Australia wins the Ashes again...

I like sports. Not as much as I like other things, such as philosophy, wine, movies or my new study (oh, it is so great to have a room all to yourself!), but I do like sports. I also like a strange sport: cricket. I used to watch the BBC broadcast the test matches of the West Indies against England. I particularly like the disappointed comments of the Brittish commentators when Curtly Ambrose produced another lightening strike that took an English wicket for 0...

In general, I like it when the poms (i.e., English) get beated at anything, but probably nothing more than when they are beaten at cricket -- that most English of all sports.

So you can imagine my joy when Australia (Ozzie-ozzie-ozzie! Oy-oy-oy!) beat the winging Poms fair and squarely in a best of five by winning all five test matches within three to four days. And Shane Warne, Wunderkind par excellence, most talented of all slow bowlers I have seen, with a life style that fits the glossies very well, took most wickets before retiring from the game. With more than 700 (SEVEN HUNDRED) test wikets to his name... Oh what a joy.


http://www.youtube.com/watch?v=IzLt6b4cwoo

The market for healthcare

There was an interesting discussion over on politics@aqute where comparisons were made between the costs of US healthcare and those of most European countries. (In case you wonder, you ought to get sick in Western-Europe: same care, only much cheaper...). At that point questions were raised about the efficiencies and inefficiencies of the 'market for healthcare'.

Here I would simply want to raise a theoretical point. Why should you think that a market for healthcare could ever be efficient? Here are some considerations why not:

First, there is no single commodity 'healthcare', but a very mixed bunch of goods and services.

Secondly, because of this, you can expect that the 'market' for certain services, is more like an oligopoly or even a monopoly. Think of certain drugs -- even generic ones -- where only a few companies or just one, manufactures them We all know from econ 101 that monopolies and oligopolies are not efficient.

Third, the demand for many of the goods and services under the heading of healthcare is extremely inelastic, perhaps even lexical. When you are confronted with potentially deadly or debilitating afflictions, you are willing to part with lots and lots of disposable income to get cured. Personally, I would fork over €1000 with equal ease as I would pay €1 for a medicine if it is going to save my life.

Fourth, lots of 'healthcare' is not best described as 'goods and services', but exactly as the name suggests: as care. For example, there are 20-odd regimes and methods to deal with secondary diabetes. Doctors spend lots of time with their patients to figure out what suits them best. My sister, a family physician in the Netherworld, told me the following story. She had a male patient in his mid-50s who was diagnosed with diabetes. After explaining the options available, the man told her that he preferred inoculating insulin himself on a daily basis. This involves among other things, day-to-day monitoring of one's own sugar-levels and recording them. After a week, the patient visited her, as agreed before to report on his experiences. It turned out that he had not monitored his sugar-levels at all. Now, IF diabetes treatment were just some service, the obvious conclusion would be that the man apparently does not want the self-inoculating treatment after all and you would suggest a different approach. But for healthcare professionals, here is where the real work starts. For the thing to do now is to figure out why this patient is not monitoring his sugar levels and fine-tuning the treatment given the results of this investigation. In other words, what is required from the healthcare professional now is an attitude of caring for his patient -- not an attitude of a commercial service provider, like a banker or an accountant. Since the nature of the goods to be provided consist of such a large measure of 'care', which is a "commodity' radically different in kind from other goods and services, it seems to me likely to be expected that the 'market' of care functions is radically different way than that of, say, legal advice or financial consultancy. (Nancy Folbre is an economist at the University of Massachussets who has done some work into this aspect of healthcare if I remember correctly).

Finally, the level of knowledge and expertise required to make informed consumer decisions in healthcare is in some case not realistic. My physician offered to prescribe one of two anti-allergy tablets: loratadine or the other stuff (I forgot the name). Both have advantages and disadvantages. How can I know which one to ask for? Also, my physician will perhaps know of some general known side-effects and the overall effectiveness of both drugs, but she does not know about the cost of these things. Nor does she know what works best for me. How is one to make rational, informed consumer decisions in such a situation? More, precise, in situations of asymmetry of information, an efficient price and allocation are unlikely to occur.

Given all these factors, I doubt that an efficient market in healthcare is even theoretically possible and I am not surprised that neither the private sector, nor the public sector are particularly good at organizing 'healthcare' in efficient ways.