04 December 2017
Organ Transplantation: Who should go to the end of the line?
November 27, 2017
The shortage of organs for transplantation results in some people having to be at the end of the line. For some organs, this will result in their dying for lack of an organ. In response, some people have discussed whether people who have destroyed their organs or have unhealthy lifestyles should get lower priority. They might have destroyed their organs via the use of alcohol, drugs, or cigarettes.
Among the organs that are successfully transplanted are heart, intestine, kidney, liver, lungs, pancreas, and thymus. There are also transplanted tissues such as bones, corneas, heart valves, nerves, skin, tendons, and veins. A single donor can save eight lives, for example, by giving a heart, liver, pancreas, etc. The donors can be living or dead. On some accounts, they are alive if the donor is merely brain dead.
The Department of Health and Human Services reports that in 2016, 116,000 people were on the waiting list for an organ and the list is getting longer. Each year, 7,300 people die waiting for an organ (roughly 20 a day).
The group that oversees organ distribution, United Network for Organ Sharing (UNOS), recommends that organ transplants be distributed based on who most needs the organ, who would most benefit from it, and who has been waiting the longest to receive it.
UNOS’ criteria are mistaken. First, by not allowing the donor or his family to sell or otherwise determine who gets the organ, the recommendation tramples on people’s property rights. The National Organ Transplant Act of 1984 made it illegal to for dying people or their families to sell human organs and bone marrow. Unsurprisingly, the act did not make it illegal for doctors to sell transplant-related services. Perhaps the congressional delegation that passed the act was brain dead.
Second, by not solely focusing on who would benefit the most from receiving an organ, the criteria fail to be efficient. Such a focus would put people in the line based on the number and quality of years they would get from a new organ. Instead, the system favors fairness over people’s rights and doing the most good.
Philosophers John Harris and Benjamin Smart separately discuss whether those with unhealthy lifestyles should go to the end of the line. The fairness argument is that people who destroyed their organs have reduced the number of organs available to the public. As a result, they should go to the back of the line. In other words, because the unhealthy have lessened the public’s supply of organs, they should get lower priority when it comes to tapping into the supply.
One problem with this is that organs are not communal goods. It is not as if organs are like coal on government land that the government owns and may distribute as it sees fit. If the concern is about depletion of resources, then it is unclear why the penalty for depletion of resources should be limited to those who have depleted the supply of organs. Criminals and welfare recipients deplete people’s resources. It is unclear why they shouldn’t go to the end of the line because they depleted the pool of medical and other resources just as the unhealthy depleted the pool of organs. More than one in five Americans (and one in three New Yorkers) is on medical welfare (Medicaid and CHIP). The welfare recipients likely don’t pay their fair share of their children’s education costs or the cost of fire, military, and police protection, the cost of the roads, and so on. If people who deplete resources should go to the end of the line, then criminals and welfare recipients should join them.
A second problem with sending the unhealthy to the end of line is that harm is imposed by individuals, not groups. If we are going to put unhealthy individuals at the end of the line, we should allow them to buy their way out of it, perhaps by purchasing organs from the third world or, perhaps, merely paying for people’s transplant surgeries.
If we are going to put groups, rather than individuals, at the end of the line for depleting the supply of transplant organs, we should also do so for groups who don’t give their fair share to the organ pool. In the U.S., Blacks are 29% of the transplant-organ waiting list, but donate only 16% of the organs (by deceased donors). Asians are 8% of the waiting list, but donate only 3% of organs. If we’re prioritizing people by how their group depletes resources, blacks and Asians should join the unhealthy, criminals, and welfare recipients at the back of the line.
Also, as philosopher Stephen Wilkinson points out, some people with unhealthy lifestyles sometimes benefit others by increasing the supply of transplant organs or increasing the overall amount of all medical resources. The former might include people who engage in dangerous sports (for example, motor sports) and whose organs are donated after an accident. The latter might include smokers. As a group, they save the government money by dying before they require expensive medical treatment that accompanies old age.
If the pool of organs were increased by allowing people to sell them, there would be less of a need to prioritize people. The best way to do this is to create a market in organs. This would ensure that many more people would donate organs, especially families of people who died or who are brain-dead. This would also be more respectful because people own their organs and thus have a right to sell them just as people who own cars have a right to sell them.
Putting the unhealthy at the end of the line depends on there being a communal pool of organs. There’s no such pool. If there were, criminals, welfare recipients, and some minorities should join the unhealthy at the back of the line.
15 November 2017
The Ruling Class versus Trump
November 12, 2017
The ruling class has gone to war against Donald Trump. The Bush presidents, Hillary Clinton, Barack Obama, establishment media, Wall Street, deep state, and leading Hollywood lights have denounced him in hysterical terms. He’s driven members of the Republican establishment (consider, for example, retiring senators Jeff Flake and Bob Corker) onto the fainting couch. While the drama queens make for entertaining TV, it is clear that Trump, for all of his many flaws, is an adult trying to correct the ruling class’ childish policies and corruption.
Exhibit A is the ruling class’ endless wars. The Bush interventionists and their Democratic co-conspirators have us mired in unnecessary wars in Iraq and Afghanistan. This stupidity is interspersed with Obama’s and Clinton’s unconstitutional wars in Libya, Serbia, and Syria. None of these wars generated as much outrage as does Trump. Congress ran and hid when it became clear that the second Iraq war was based on a mistake, if not a lie. Incredibly, the ruling class learned nothing from the Vietnam War.
Jeb Bush, Hillary Clinton, and other establishment candidates made it clear that if elected, they’d get us into still more wars. Yet we hear the rich and connected lecturing us on how these were the candidates we should have chosen. These wars cost more than a trillion dollars, thousands of lives, and tens of thousands of casualties. They’ve resulted in Iran’s tightening control of the Middle East, ISIS’s rise, and the Taliban’s widening control in Afghanistan. Trump hasn’t ended our involvement in these messes, but at least he hasn’t started new wars.
Exhibit B is immigration. No one seriously thinks that it was good for this country to flood it with tens of millions of unskilled and uneducated illegal aliens and their anchor-baby children. Studies indicate that unskilled immigrants are more likely to receive welfare, use more welfare (per household), have more children out of wedlock (at least Hispanic immigrants do), and likely have lower IQs than Americans who were already here. Even fewer think that the flood was good for the poorest Americans.
Even if one did think the flood was good for the country, no one seriously thinks it would have been better than taking in skilled, educated, and wealthy immigrants as do other nations. For example, no one can seriously argue that, on average, this country would be better off with an illegal alien from Mexico who is illiterate in Spanish rather than a Japanese neurosurgeon, Irish physicist, or Turkish engineer. The flood of immigration (roughly 1.4 million in 2015) has resulted in 43 million immigrants being here. This doesn’t count their American-born children. On one controversial estimate, one quarter of Mexico is here.
Did anyone beside Trump ask Americans whether they wanted to drastically change the country by flooding it with tens of millions of immigrants and want to continue to do so? Judging from the overwhelming opposition that arose when the ruling class tried to slide amnesty through, the American people want this to stop. Yet, the ruling class of both parties cry out in pain when Trump suggests that Americans should decide who gets to be a citizen rather than it being decided by who sneaks in the dark of night.
The diversity immigration lottery is a monument to how vapid the ruling class is. It manages to admit immigrants who lack skills, money, and family connections. Instead, they come from countries that normally do not send a lot of immigrants. This policy is so divorced from American interests that it is a testament to the need for adult supervision over the ruling class.
Exhibit C is rampant corruption. It is uncontroversial that Barack Obama’s administration had no respect for the law and no one was held accountable. The administration broke the law by ignoring Obamacare rules, giving unauthorized bailouts to insurance companies, performing illegal mass surveillance using captured internet data and then lying about it to Congress, amnestying thousands of DACA children without Congressional authorization, and on and on. The ruling class gave a pass to the attorney general (Eric Holder) when he was clearly in contempt of Congress and the IRS when it targeted conservative groups in the run up to the election. To this day, the IRS’s Lois Lerner has not been convicted of a crime and has retired with a government pension.
Similarly, no adult seriously believes that Hillary Clinton and her aides did not violate the law when she was grossly negligent in handling of classified emails and when her aides destroyed evidence covered by a subpoena. The fact that the FBI cut sweetheart deals with her and her aides and then rewrote the statute to give her a pass shows how deep the corruption runs. In the IRS and Clinton-email cases, many of the central players pled the Fifth. No one wonders why.
It stinks to high hell that Russian interests gave the Clintons and their foundation millions in the Uranium One deal. The recent revelation that the Democratic Party was in the tank for Hillary Clinton just adds to the stench.
Moral corruption was front and center when career politicians like John McCain stabbed his voters in the back when it came time to act on Obamacare and building a wall, matters that were at the heart of their campaigns.
There has also been no progress, and I mean none, on the debt, which is now larger than the economy. The same is true for the ungodly tax code, exploding entitlement programs, and the gutting of the Constitution.
None of these outrages bothered the Bushes, Clintons, John Kerry, John McCain, National Public Radio, The New York Times, retired military leaders, Wall Street, etc. etc. Decades of pushing disastrous wars and foolish immigration policies and tolerating rampant corruption is fine if done by the right people. Call people out on twitter, however, and we need fainting couches. The ruling class has earned our contempt.
01 November 2017
The Case for Sex Discrimination in Academia
October 30, 2017
The academic world is very busy trying to hire women and minorities. A good illustration of this is what is going on in philosophy.
Philosophers are putting an enormous amount of resources into increasing the number of women in the profession. Women are favored in hiring in philosophy. There are philosophy summer programs open to women and minorities, but not white males, that help them prepare for graduate school. There are quotas for keynote speakers, women-only scholarships, and close attention paid to the percentage of women in the profession. Much of this is also true in other fields such as those in science, technology, engineering, and math (STEM).
Whatever justifies the state paying for universities also justifies merit-based hiring. This is because more of the good things that universities bring about (for example, education or research) will come about if universities hire the best person for the job. The case for producing more of these good things is especially compelling at state universities given that the state makes taxpayers pay professors’ salaries and overhead.
In philosophy, merit-based hiring favors discrimination in favor of men. Male philosophers produce more research than do female philosophers. This is true in general and in the top journals in the field. This is probably not the result of discrimination by the reviewers (the field’s gatekeepers) because the greater the degree of anonymous review, the greater the disparity. The publication difference is consistent with the clear majority of the most influential philosophers being men.
The case for discrimination rests in part on the failure of studies to show that women are better researchers in other ways or better teachers. Male professors get better teaching evaluations, although some researchers do not think this is due to their being better in the classroom. Women do more service (for example, committee work), but, generally, universities do not think service is as important as research and teaching.
The result fits into a general pattern. For example, while female medical professors acquire federal funding at similar rate to male professors, they publish less and their publications have less impact. In science, generally, women publish less.
This case for discrimination should not be surprising. There are a number of cases when gender or race discrimination for limited state positions is appealing. Currently, there is a shortage of physicians. 25% of female physicians in the U.S. do not work full-time. Discounting female applications by the likelihood they leave the field would decrease this shortage. Another instance of this is discounting minority applications to medical school. The cost of medical error is high and there is good reason to believe that black and Hispanic doctors, specifically those who strongly benefit from affirmative action, commit more errors and more serious errors.
Perhaps female philosophers are less productive because they are more likely than men to work part-time rather than full-time in philosophy. While there is no data in support of this, it is true in other fields (for example, physicians and veterinarians). In the absence of evidence that fewer female philosophers work full-time or that when they do work full-time they work fewer hours, this is not a reason to discriminate against them.
One objector might claim that research, even at elite universities, is not important and, hence, universities should not discriminate on the basis of research. If this were true, then the way in which professors are hired, promoted, and paid is largely mistaken. This objection succeeds, then, only by throwing out what faculty currently look at when hiring and promoting philosophers.
A second objector might focus on the cost of sex discrimination. She might argue that women in philosophy are particularly valuable because they provide role models, reduce stereotypes, improve group decision-making, make the workplace less homogenous, and provide other benefits (for example, more investment into women’s education). Even if this were true, though, it is unclear that these benefits outweigh the cost in research productivity. In the absence of knowledge of the balance of these benefits and costs, discriminating against women is reasonable. The same is true for not discriminating.
A third objection is that women’s lesser productivity in philosophy is due to injustice. Perhaps unequal and unfair demands on mothers or workplace hostility explains the difference. The problem with this objection is that, if true, it might justify changing the workplace. It is less clear that it justifies giving women positions for which they are, on average, less meritorious. If one NFL running back is better than a second, most people (including the owner, coaches, players, and fans) think the first should be hired over the second even if injustice caused the second to be worse. It is unclear why it is more important to choose the best running back than the best philosopher.
A fourth objection is that merit-based hiring should be done on an application-by-application basis. The objector argues that an employer should not favor someone merely because he is a man. This objection does not succeed if a person’s sex helps us predict how well someone will perform. Based on what we know about research production in philosophy, medicine, and STEM and what we know about career choices and performance elsewhere, it is reasonable to believe that sex adds to what we know about an applicant’s likely performance in the future.
Universities regularly use other rough predictive information such as how elite the school was from which an applicant graduated, how well she does when interviewed, and number and quality of publications. There should not be a much higher bar for sex-based predictive factors than other predictive factors. Also, this objection will not work for affirmative-action proponents because they support taking sex and race into account.
In philosophy and likely much of the academic world, state universities should either not discriminate or, if they must discriminate, they should favor men.