Moral dilemmas in life

There are many moral dilemmas in life. Almost each day we have to resolve some but most of them have become routine, and we don’t see them any longer. Other moral dilemmas give us sleepless nights. Happily they are rare.

Some moral dilemmas ask “only” for the right decisions. I put the word only in quotation marks, for often there is no right solution. The trolley problem, which I have discussed in several blogs, is a philosophical example. Other dilemmas costs us money, when we want to resolve them, and just that may be the problem. Here is such a case. I had to think of it when I read a newspaper article this morning.

First the philosophical description: John is suffering from a serious illness, although he will not die of it. Maybe he can become 100 years old! But since he is 20 now, it can mean yet 80 years of severe pain and awful treatments. Say that his suffering is 100 on a scale from 0-100. Happily there is a medicine that relieves his disease a bit, but there is one problem: It will make that another person – say his brother – will also suffer for the rest of his life, say on level 90. Moreover, John’s suffering will only diminish to this same level 90. Will we do this? Probably not.

Then a clever researcher develops a new medicine. It will cure John, but it is very, very expensive. The insurance doesn’t want to pay it and John cannot pay it. Happily the country is governed by the Radical Leftist Environment Party, which succeeded to make the people of this country the happiest in the world. It wants to keep it so, and since already the whole state budget is spent on happiness and health, it wants to introduce an extra tax. There is one problem: The level of suffering of every inhabitant of the country is 0 on the scale just mentioned (with the exception of John, of course) and it will raise to 1 because of this “John’s Recovery Tax”. But nobody will notice the rise, and the parliament agrees to the new tax. Although the Stand Alone Liberals vote against the bill on principle, in their hearts they think that it was the right decision. And so John gets his medicine and his level of suffering goes down to the general level of 1 (for he had to pay his share in the new tax as well).

That’s what I was thinking about after I had read the newspaper article this morning. It was about a boy who suffers from a metabolic disease that is so rare that the pharmaceutical industry doesn’t want to invest money in the development of a new medicine. Also his insurance company and the state don’t want to do it. So the boy and his parents stand alone and can only hope that they can gather enough money by crowdfunding for further research that may help the boy. Nevertheless, the problem could easily be solved by the state by spending a little part of the public health budget or of the research stimulation fund on developing a medicine. For it is better that many (the taxpayers) suffer a very little bit (and nobody will notice it) than that one suffers a lot.

But alas, my story doesn’t end here. Soon after the John’s Recovery Tax Bill had passed the parliament, there were general elections. Since many people thought now that they could become even happier yet by standing alone, the Stand Alone Liberals were the big winners and could form the new government. One month later it became known that Ann was ill of a different disease, which also would bring a life-long suffering to her, although she, too, could become 100 years old with her disease. Etc. But who would notice it if the national level of sufferance would raise to 2? Nobody. So the Radical Leftist Environment Party, now in opposition, put forward an “Ann’s Recovery Tax Act”. However, the Stand Alone Liberals rejected the bill, not only with the argument that it is better to stand alone, but also because, as they argued, there are 6,000 rare diseases. Maybe they can all be cured, but if the government would have to pay it, things will go out of hand and in the end everybody will noticeably suffer: Each new case would bring the national level of sufferance one point higher. So the government did nothing and Ann had to stand alone and from then on everybody with a rare illness. Only John was lucky, for the new government respected the decision of the old parliament to support him. The Radical Leftist Environment Party realized that 6,000 rare diseases is quite a lot, indeed, and it proposed to create an aid fund for a minimum support for every patient, on condition that the national level of sufferance would not surpass 5, but the government rejected this proposal, too.

So the problem is this: How much suffering is acceptable for a population that wouldn’t suffer if it would ignore the suffering of the unhappy few? You cannot bear the burden of whole world but this doesn’t imply that you don’t need to do nothing when others suffer, certainly not if you don’t notice that you bear a burden. What someone can bear and wants to bear is his or her responsibility, but this should not mean that everybody must stand alone and care only about the own problems and solutions (as seems to be the policy in some countries). Merry Christmas!

Sources

I wrote most of this blog without consulting any literature, but it leans heavily on what I remembered from Derek Parfit’s work (google for him!) and from Stijn Bruers, Morele Illusies. Antwerpen, Houtekiet 2017 (any Dutch reader of this blog should read this book!). See also Larry Temkin.