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Russian Dolls

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Incentive structures are created within other incentive structures, and at the outermost edge is only the initial distribution of the capability for force.



Should fast food restaurants be allowed to sell food without posting calorie content? To market unhealthy food to children?

Should garbage cans be labeled “Landfill”?

Should manufacturers be allowed to sell caffeinated alcoholic beverages? To whom should alcoholic beverages be sold?

Should prostitution be legal? Drugs? Weapons? Nukes? Divorce?

What should the age of contractual capacity be? The age of sexual consent?

What should be the consequences of a breach of contract?

Are taxes the same as stealing?

A System of Incentives

The field of law & economics recognizes that a system of law is a system of incentives. We adjust human welfare by adjusting the incentive structures in which humans operate.

Any incentive structure, including but not limited to a legal system, helps people predict how they will be treated, and thus how to plan their actions. Any incentive structure will do, more or less, for this purpose. But some individuals will always be treated sub-optimally by any incentive structure. The only certainty is that some will live in misery – there is always plenty of misery to go around. But who should be miserable, and how miserable, and why?

By creating or adjusting incentive structures, planners assume that they know what is best for human flourishing. Creating and adjusting incentive structures is an inherently epistemically ungenerous activity. This, I think, is the main problem with Bryan Caplan’s take on behavioral economics, which I’ve previously summarized thus:

Bryan Caplan thinks that the solution [to the problem of men not wanting to work] is to not have soup kitchens. That is, to make everybody so miserable that they HAVE to work, or else.

Caplan (and his coauthor) “know” that it’s better for people to live as close to a “productive,” middle-class existence as possible; so they argue we should adjust the incentive structure to give the poor fewer choices so that they are forced to make the “right” choice.

The search for a just, ethically defensible incentive structure requires an attempt to get outside of any single individual or group’s notion of what is best – to do what’s best for everyone, not just the would-be incentivizer and his cronies.

The Russian Doll Problem

In some sense, incentive structures compete with each other (e.g., capitalism v. communism). But even competing incentive structures exist within a wider incentive structure. The governments of countries may be seen as competing incentive structures, existing within the wider incentive structure of the world. Organized crime and government are competing systems of incentive, and operate within the wider incentive structure of the natural world. This is true even if the background incentive structure is merely “might makes right” – which is probably the only possible top-level, ultimate incentive structure.

Creating and adjusting incentive structures is at best hubris, at worst tyranny.

Some (libertarians, the religious, and advocates of democracy, for example) ignore this problem by assuming a privileged status for some kind of incentive structure.

Privileged Incentive Structure: God Said So

Some of the most successful religions worldwide have a built-in legal system and/or incentive structure. For this reason, some religions function very well as technologies that promote trade. Sharia in Islam, Gemora in Judaism, and Canon law in Christianity are the most well-known examples.

Religions are not written texts. As my rather religious Jewish boyfriend puts it, the written text (e.g. Mishnah) is like a constitution – but a government is not its constitution. The United States has a tiny little constitution, but the system of incentives is largely given by the enormous system of courts and police that interpret and enforce the written text.

Adherents of these religions get around the Russian dolls problem of incentive structures by assuming a privileged status for their enshrined incentive structure on the basis that this incentive structure was ordained by God.

Privileged Incentive Structure: The Market Said So

Libertarians attribute a privileged status to the “free market.” However, a market exists within a context of a wider incentive structure (the initial distribution, human nature, scarcity). Markets are not ever really “free” – there must be a wider incentive structure to contain the market, even if this incentive structure is merely “might makes right.”

Privileged Incentive Structure: The People Said So

A novel solution to the Russian Dolls problem of incentive structures is: let the participants choose their own incentive structure. Various forms of democracy claim to embody this solution.

Ultimately, this is no more than creating a market to determine the rules for the market. “One person-one vote” is, ultimately, as arbitrary as “one dollar, one vote” (or “one bullet, one vote,” for that matter). Why is a person the proper unit of democracy? Why adults and not children? Why present people and not future people? What about the rights of those in the minority position on anything? Why is it fair for a majority to impose its will on a minority? Democracy is, at best, a caricature of consent.

Prior to garnering fame as an authoritarian parenting enthusiast, law and economics scholar Amy Chua wrote a book (World on Fire: How Exporting Free Market Democracy Breeds Ethnic Hatred and Global Instability) explaining some of the problems with “democracy-as-privileged-incentive-structure” – especially when combined with a purportedly free market. In the real world, economic advantage tends to not be spread equally among people – or randomly. Advantages, whether intellectual or material, tend to be clustered within identifiable groups of people, and these groups tend to attempt to manipulate the system of incentives to increase this clustering (that is, to promote inequality). Unfortunately, the red-in-tooth-and-claw nature of the background incentive structure is frequently revealed when “market-dominant minorities” are punished for their inequality-promoting success in often gruesome ways by the (ethnic) majority.

Is the “free market” right, in this case? Should market-dominant minorities, racial or otherwise, own and keep an ever-growing majority share of the world’s property? Or is “democracy” right? Should the majority be able to punish the market-dominant few? The conflict, rarely acknowledged, demonstrates that neither is an inherently good incentive structure.

The nature of our universe prevents an ethically sound incentive structure from existing.

It’s the initial distribution all the way down.


Misery, or suffering, might be defined as that of which there is negative scarcity. Not only is there an abundance, but there is an abundance and its consumption is not optional. I think it is more humane to think of economics in terms of a system for the distribution of misery, rather than the distribution of scarce, utility-promoting goods and services.

Written by Sister Y

March 8, 2011 at 9:00 pm

Child Support for Unwanted Children is Wrong

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See my related essay: What is Special about Genetic Paternity?

Generally, before the government can take a person’s life, liberty, or property, the person must be afforded due process – a neutral, fair process by which the appropriateness of taking the person’s life, freedom, or property can be verified.

Indeed, it is a general moral principle that it is generally wrong to take away someone’s life, or property, or freedom – you have to have a really good reason.

Sometimes, the reason is that the person agreed to forfeit property. This is why we enforce contracts.

Sometimes, it is “fair” to take away someone’s life, or freedom, or property, if the person has done something that society sees as morally reprehensible. This is the principle underlying the criminal justice system.

Governments can even justifiably take property when a person has not done anything wrong, and has not agreed to give it up, as is the case with income taxation. The justification is slipperier here, but at least there are genuine moral justifications for taxation, even if their correctness is debatable.

But there is no moral justification for forcing a person to pay child support for a child he did not wish to conceive.

In most of the world, for most of its history, men have had reproductive rights, and women have not. In modern Western society, women have reproductive rights, and men do not. But “karma is a bitch” is not a moral argument.

It is wrong to force a woman to have a child when she does not want to have it. Simply consenting to sex does not, in our culture, entail consent to reproduction, nor should it. A sexless world is a miserable world; restrictions on reproductive rights are restrictions on one of the most pleasurable activities humans have access to.

Similarly, it is wrong to force a woman to have an abortion if she does not want one. The bodily invasiveness of pregnancy, and of abortion, should indeed mean that birth and abortion are under the exclusive control of the womb-owner.

But it does not follow that a man should have to pay child support for children he does not wish to conceive. In our society, if a man gets unlucky – a condom breaks, his girlfriend was lying to him about using birth control, his girlfriend was lying to him about not trying to get pregnant, etc. – and unwittingly functions as a sperm donor, he is completely at the mercy of his female sex partner.

Having an unwanted child is a personal and financial disaster. Child support laws should not encourage women to inflict this tragedy upon others.

Memento mori, as Chip says.


“Don’t breed or buy while foster kids die”

On an unrelated note, I had a question about what I meant by my “don’t breed or buy while foster kids die” spiel. “Breed” is obvious; by “buy,” I mean utilizing expensive reproductive technologies such as in vitro fertilization (IVF) and surrogacy. It is as immoral to participate in such processes as a sperm or egg donor, or as a surrogate, as it is to participate as a prospective parent.

Written by Sister Y

May 26, 2010 at 9:00 pm

No Death With Dignity for Potential Breeders

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From The Guardian:

The Italian government has been plunged into a constitutional crisis over the fate of a 38-year-old woman who has been in a coma for the past 17 years. Eluana Englaro was left in a vegetative state after a car crash in 1992. After a decade-long court battle, doctors reduced her nutrition on Friday in preparation for removing her feeding tubes, which her father claims would be in accordance with her wishes.

But in an extraordinary turn of events, the country’s prime minister, Silvio Berlusconi, after consultation with the Vatican, has issued an emergency decree stating that food and water cannot be suspended for any patient depending upon them, reversing the earlier court ruling. On issuing the emergency decree, Berlusconi declared: “This is murder. I would be failing to rescue her. I’m not a Pontius Pilate.”

Justifying his campaign to save Englaro’s life, the prime minister added that, physically at least, she was “in the condition to have babies”, a remark described by La Stampa newspaper as “shocking”. Giorgio Napolitano, Italy’s president, has refused to sign the decree, but if it is ratified by the Italian parliament doctors may be obliged to resume the feeding of Eluana early this week. [Emphasis mine.]

Christ. Really? (Thanks nil.)

Written by Sister Y

February 9, 2009 at 1:04 am

The Drug Prohibition and the Right to Suicide

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Back in 1997, in The Atlantic, Ezekiel Emanuel wrote:

Rational people should be able to end their own lives; suicide should remain decriminalized. But to say that is a far cry from saying that people have a right to have others, namely physicians and pharmacists, help them to end their lives. The ability to commit suicide is what Isaiah Berlin called a “negative liberty” — a liberty to keep others from interfering with the individual. The right to euthanasia is a positive liberty — a liberty to have others help to realize an individual’s goal. The justifications for negative liberties are widely accepted, and the Bill of Rights is essentially a list of negative liberties; positive liberties are affirmed only when necessary to ensure robust participation in public affairs and to preserve essential opportunities. It is hard to see how granting a right to PAS and euthanasia is necessary to either of those goals.

In any case, the number of dying patients who have unremitting pain or who want to die and are physically incapable of killing themselves is very small — a few thousand of the 2.3 million Americans who die each year.

There is a right to suicide, claims Dr. Emanuel – a right not to be interfered with. Of course, in practical terms, Dr. Emanuel is terribly mistaken, even in his conception of the right to suicide as a negative right: the state regularly and predictably interferes with individuals attempting to commit suicide. Pro-forced-life U. S. Supreme Court Justice Antonin Scalia has stated, in his concurring opinion in Cruzan v. Director, Missouri Department of Health, that

It has always been lawful not only for the State, but even for private citizens, to interfere with bodily integrity to prevent a felony. That general rule has of course been applied to suicide. At common law, even a private person’s use of force to prevent suicide was privileged. It is not even reasonable, much less required by the Constitution, to maintain that, although the State has the right to prevent a person from slashing his wrists, it does not have the power to apply physical force to prevent him from doing so, nor the power, should he succeed, to apply, coercively if necessary, medical measures to stop the flow of blood. The state-run hospital, I am certain, is not liable under 42 U.S.C. 1983 for violation of constitutional rights, nor the private hospital liable under general tort law, if, in a State where suicide is unlawful, it pumps out the stomach of a person who has intentionally taken an overdose of barbiturates, despite that person’s wishes to the contrary. [Citations omitted.]

Justice Scalia unfortunately states the policy of our country: it is decidedly one of interfering, using as drastic and invasive means as possible, with an individual’s decision to commit suicide.

Even if we did live in the fairy land that Dr. Emanuel apparently hails from, in which there exists a “negative right” to suicide, there is still the problem of means. Dr. Emanuel says that there is no need for “assisted suicide,” because one can perfectly well off oneself, and one has no right to have another person assist one in the act. However, again Dr. Emanuel ignores the sad reality that all would-be suicides face: the only means to commit suicide that are reliable and comfortable enough so as to not be objectionably cruel are in the exclusive hands of doctors. With barbiturates under the strict control of doctors, the “right to suicide” doesn’t mean much.

As long as there is a drug prohibition, there will be a moral need for “assisted suicide.” Remove the drug prohibition – at least, the prohibition on barbiturates – and there will no longer be a moral need for “assisted suicide,” at least for able-bodied people.

Dr. Emanuel assures us that “the number of dying patients who have unremitting pain or who want to die and are physically incapable of killing themselves is very small.” I wonder what he means by “physically incapable” of killing oneself. Unable (or unwilling) to shoot oneself in the head with a shotgun? To slash one’s artery with a knife? To hang oneself? Is the “right” to do one of these things – and potentially be dragged back to life if one fails to die – really all the “right” that is morally called for?

Like many forced life advocates, Dr. Emanuel offers a comforting vision of an imaginary world, to distract us from having real compassion for suffering people in the real world.

Tragically, Dr. Emanuel is the Chair of the Department of Bioethics at the National Institutes of Health.

Edit: In summary, my problem is this: there is a general drug prohibition on sleeping pills that are lethal at high doses, and there are policy reasons for that, however misguided. In addition, there are good reasons why a person should not have the right to expect another person – here, a doctor – to assist him in committing suicide. But when you put these two sensible-sounding propositions together (drug prohibition and no right to assistance), they no longer make ethical sense. One of them has to give.

Written by Sister Y

December 16, 2008 at 5:07 am

Oregon’s Law

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Oregon’s Death With Dignity Act succeeds in many ways. The Act respects patient autonomy, from its definition of “capable” to mean that

in the opinion of a court or in the opinion of the patient’s attending physician or consulting physician, psychiatrist or psychologist, a patient has the ability to make and communicate health care decisions to health care providers, including communication through persons familiar with the patient’s manner of communicating if those persons are available.

to the way it allows patients to decide for themselves whether to notify family members and when – even if – to self-administer the lethal prescription, once requested. (Some people who request suicide assistance don’t use it until months or years after it has been provided.)

Oregon’s law is wrong, however, in limiting access to death to those with terminal illnesses. Although this flawed version is certainly the only version of the law that would have had a chance of being enacted, the fact remains that it is wrong.

First, restricting access to comfortable means of death to those with a terminal illness is actually demeaning to people with terminal illnesses. The idea that human dignity somehow requires that one be able to walk and talk and control one’s bodily functions is demeaning and wrong, as Felicia Ackerman (see Readings) and disability advocates point out. A terminally ill person must decide for him or herself whether to request suicide assistance; it is not the right decision for everyone. But what possible justification could there be for limiting this right to terminally ill people, except that their lives are somehow less valuable than those lives that will (probably) continue on for many years? The designation “Death With Dignity Act,” of course, hints at the demeaning implication of the limit: some deaths are dignified, other are not. The state will decide for you whether you are undignified enough to be allowed to die peacefully. (The Oregon law does not allow assisted suicide to be provided to non-terminally-ill disabled or merely old people, but the implications of the restriction to terminally ill people are clear enough.)

Second, the Oregon law’s restriction against suicide assistance to non-terminally-ill people is wrong because suicide is an important right for everyone, not merely the terminally ill. In fact, if anything, the right is more important for those who are not terminally ill, because their time of suffering will most likely be much longer than those who will die soon naturally. And, as pointed out by Velleman, terminally ill people are much more likely to be harmed by having the option to die than healthy people are, because they are more likely to be dependent on the care of others and therefore to feel themselves to be a burden. A more sensible restriction might be to allow suicide assistance only to non-terminally-ill people! I am not, of course, in favor of this restriction, but it makes more philosophical sense than Oregon’s law, which makes political sense, if anything.

Meanwhile, Switzerland recently extended suicide rights to those with incurable mental illnesses. Jacob Appel, writing in the Hasting Center Report, explains the basic ethical issues:

Another set of objections are from those who support a basic right to assisted suicide in certain situations, such as those of terminal disease, but do not wish to extend it to cases of severe and incurable mental illness. This resistance may be inevitable, considering the increased emphasis that contemporary psychiatry places on suicide prevention, but the principles favoring legal assisted suicide lead logically to the extension of these rights to some mentally ill patients.

At the core of the argument supporting assisted suicide are the twin goals of maximizing individual autonomy and minimizing human suffering. Patients, advocates believe, should be able to control the decision of when to end their own lives, and they should be able to avoid unwanted distress, both physical and psychological. While these two principles might explain why a victim of amyotrophic lateral sclerosis or cancer would choose assisted suicide, they apply equally well in many cases of purely psychological disease: a victim of repeated bouts of severe depression, particularly in cases where treatment has consistently proven ineffective, rationally might prefer dignified death over future suffering. [Hastings Cent Rep. 2007;37(3):21-23. Via Medscape. Emphasis mine.]

Written by Sister Y

June 24, 2008 at 3:40 am

Costs of Coercive Suicide Prevention (and an outline of an alternative)

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One of the themes of my project thus far has been to point out that coercive suicide prevention practices do nothing to prevent or decrease actual suffering, and often increase suffering by forcing people who genuinely want to die to stay alive. Coercive suicide prevention, far from reducing suffering, serves the socially negative purpose of masking suffering, so that the true level of suffering is less apparent.

My hypothesis, which I plan to flesh out in greater detail in the coming weeks, is that if the same public funds that are currently spent toward coercive suicide prevention were instead spent on reducing acute suffering in suicidal people though non-coercive means, both suffering and suicide would be reduced.

I am currently in the stage of collecting data on how much money is spent on coercive suicide prevention.

Preliminary data: In the state of Georgia, a 2005 study showed that $40 million was spent in 2002 alone on hospitalization and emergency room treatment of suicides and suicide attempters. 900 people completed suicide that year, 2800 were hospitalized, and 5400 visited emergency rooms for intentionally self-inflicted injuries. Assuming that completed suicide attempts are proportional to attempted suicides and self-inflicted injuries, we can calculate a per-completed-suicide cost in Georgia of about $44,000 (which is not the cost of treating a successful suicide, but rather the average medical expense for suicide treatment per completed suicide). Assuming nationwide costs mirror Georgia’s, that would give a national expenditure of around $44,000 times 32,595 suicides for 2002, which comes out to $1.4 billion for the country.

The Washington State Department of Health gives a higher figure – $4 billion for medical treatment of suicides nationally – though I can’t immediately trace the source.

Of course, these estimates leave out many other hard-to-measure costs of coercive suicide prevention, including police response, the cost of the government maintaining lists of formerly suicidal gun buyers (as in California), and costs associated with preventing would-be suicides from accessing lethal drugs.

Now imagine what things would be like if even a fraction of this money were spent on genuinely trying to reduce the suffering of suicidal people (and even non-suicidal people, for that matter). My proposal, as I now see it, would involve

  • ceasing automatic interference with suicide attempters, and publicizing this policy, to destroy the dangerous “fantasy of rescue” that might cause many people who do not genuinely want to die to make a suicide attempt
  • setting up a procedure for medically assisted suicide (prescribing a lethal dose of, say, barbiturates to a competent adult requester)
  • which procedure could have a waiting period, like gun purchases or marriage or divorce, and even require multiple requests
  • requesters, to be competent, must understand the nature of death and be able to articulate a non-delusional reason for wanting to die
  • a diagnosis of Major Depressive Disorder would not suffice to render someone incompetent to request suicide assistance
  • upon requesting suicide assistance – and, ideally, even if suicide assistance is not requested – some of that aforementioned money could be deployed to provide help with any problems identified by the suicide requester
  • any assistance (counseling, social worker consultation, housing assistance, bankruptcy assistance, etc.) must be offered without conditioning the eventual suicide assistance on the requester accepting the assistance

It must be recognized that coercive suicide prevention is harmful, in that it increases suffering while masking the suffering experienced by the population. And, despite drops in suicide associated with reduction in gun ownership, a high percentage of suicides are ultimately unpreventable through coercive means, as noted in a 2005 UK study tracking the increase and success rate of suicide by hanging (the lethality is around 70%). Hanging requires no special equipment – the study noted successful hangings conducted with belts, sheets, shoelaces, tights, bra straps, shirts, shower curtains, and pajama trousers – and has a 70% rate of lethality, even when the suicide is not fully suspended. (Of course, of the 30% who fail, how many will be subjected to the treatment suffered by the unidentified patient in the Annals of Neurology article?)

But we must consider whether, if there were a comfortable medical option widely available, many of those gun suicides, hanging suicides, and cutting suicides might opt to request it, instead – and, ultimately, many of them might get help solving the problem they originally thought suicide was the only answer to. For many people, of course, it would mean, not rescue from suicide, but a less horrible death – which, I would argue, is a good thing in itself.

For those suicides who really want to be rescued, my proposal serves to provide genuine, 100% certain rescue – before the suicide attempt is even made. And for those who have considered all options and only desire a comfortable death, my proposal would not humiliate or coerce them into accepting questionable “treatment” to which they have not consented, but would provide a way for them to end their lives with minimal harm to themselves or others.

Written by Sister Y

June 14, 2008 at 10:44 pm