31 August 2009

Does it work for you?

"Of course, Behaviourism 'works'. So does torture. Give me a no-nonsense, down-to-earth behaviourist, a few drugs, and simple electrical appliances, and in six months I will have him reciting the Athanasian Creed in public."
W.H. Auden


In the latest round of debate about enhanced interrogation techniques, we are once again subjected to the completely irrelevant debate as to whether EIT (a.k.a. torture) "works." As Auden observed, of course it does.

As the so-called Cheney memos show, and even the Washington Post reported, high value detainees such as Khalid Sheikh Muhammed provided a great deal of actionable intelligence after being subjected to waterboarding and other such techniques.

Unfortunately, too many (mostly on the political right) repeat this triumphantly, as if the end truly does justify the means. That's dangerous ground to tread upon. It is also, it would seem, an accepted line of reasoning on the other side, though. Why else continue the now utterly absurd denials?

From a purely moral perspective, the question of whether or not EITs work, by itself, has absolutely no bearing on whether they should be used. There are two questions which are relevant, it seems to me, assuming there is already general agreement that torture, per se, is immoral.

First, we must decide whether we consider EITs such as those used on a handful of terrorists, including KSM, meet our definition of torture. Whether or not they worked does not answer this question. If they are not torture, we might still object, but not based upon our moral opposition to torture.

Second, we must recognize that the most difficult moral decisions often involve not a single moral choice, but a requirement to balance competing moral imperatives. It is legitimate to disagree on the proper balance, but that is not the debate I've been hearing.

Those who triumphantly point to the results of EIT sessions are not really celebrating the breaking of wills or spilling of secrets, I don't think (or at least I don't hope.) The reason they seem so cheered by these successes is that the information gleaned resulted in saving American lives.

That (saving lives) is the competing moral imperative which enables them to believe these methods (again, if we assume them to be torture) are acceptable to practice under certain circumstances. The responsibility to protect innocent lives, they reason, outweighs the prohibition on torture.

It would seem then, that by continuing to deny the effectiveness of EITs, those opposed to their use are tacitly accepting the moral calculus by which the other side justifies their use.

But both sides avoid the debate.

30 August 2009

About those town halls...

The White House and Democrats in Congress chose a curious strategy in response to the sometimes raucous town hall meetings. They attacked the American people.

Naturally, the mainstream media picked up on the theme. What was more disturbing is how many conservatives have offered their concern about the “lack of civility,” or some such thing. They would rather see a reasoned debate, they say; a polite airing of questions and answers.

There are a few problems with that. It is not the voters showing up to town hall meetings who tried to shut down debate. It was the clearly stated intention of President Obama and the Congressional leadership to ram a health care bill through without even debating it among themselves, much less soliciting input from their constituents. It is more than a little bit disingenuous to pretend now that it is they who are being deprived of an opportunity to fairly present their views. We know Obama’s view: “I won.” So shut up and do what I say.

Unfortunately for the Democrats, it really doesn’t work that way, and it never has. You can shut out the minority party if you want to, but you can’t just ignore the people, or expect them to go along with you every time just because they went along with you once.

President Kennedy once said, “Those who make peaceful revolution impossible will make violent revolution inevitable.”

By extension, I would say that those who attempt to eliminate all debate make vocal crowds at their town hall meetings inevitable. And they have no right to complain.

Beyond that, although I have not attended one myself, even in the televised highlights intended to show how out of hand the town halls have become, they really don’t look terribly unruly to me. And if you saw Rep. Sheila Jackson Lee answering her cell phone while a constituent asked a question, I think you’d have a hard time arguing she felt at all intimidated by her subjects. When the crowds roar, it seems mostly to be in approval of a taxpayer’s statement, or in loud disapproval of an elected official’s words. How else is a room full of people to participate?

Town halls are not a forum for debate, and they are not a forum for elected officials to lecture. Congressmen can lecture all they want the rest of the year. At town hall meetings, they need to listen.

20 August 2009

There are worse things than being broke

So, President Obama is going to make “an emotional and moral appeal?” I’m sure it will include many anecdotes about the struggles of various people trying to get insurance, or pay their medical bills. Isn’t it long past time to stop using sad stories to sell abhorrent policies? Because you know what? If your aim is to eliminate all the sad stories, you will never be done “reforming.”

Just to keep in the spirit of things, I have a health care “sad story,” but it’s one I don’t think he can use.

A little over five years ago, my son was diagnosed with brain cancer. He underwent a ten hour, microscope-guided brain surgery. He received six weeks of total brain and spine radiation, followed by 10 months of very intensive chemotherapy. After all of that, his cancer returned. He underwent another surgery, more radiation, a form of chemotherapy that could only be described as savage, and a bone marrow transplant. That did not work either. So he began another, somewhat more experimental therapy that his body simply could not tolerate. We traveled to other cities and states, got him into another clinical trial, and even tried many other, unconventional therapies.

During his five year battle, my son received at least 50 MRI scans, countless physical exams, many gallons of blood transfusions, at least three extended stays in ICU, a couple of near-death experiences, at least seven minor surgeries, and daily handfuls of prescription drugs for many, many months.

Also during this time, I changed jobs twice, and insurance companies four times. We paid our full, annual “out-of-pocket maximum” at least six times in five years. Not everything was covered fully, and we had to pay for a lot of of things in cash, despite being fully insured. I also took several months of unpaid leave from work. The total cost of his care was many hundreds of thousands of dollars, with tens of thousands of that out-of-pocket.

And I would gladly pay it all, and more, again. I would gladly sell everything I own, declare bankruptcy, and spend the rest of my days in debtor’s prison if it meant curing my son’s terrible illness.

But that was never, as it turns out, one of our options. You see, although treatments have become more successful over the years, the sad truth is that there is still no cure for cancer. Despite the best doctors and the best care in the world; despite many treatments and tests our young president’s “experts” might well have deemed “unnecessary,” my son died earlier this year.

In retrospect, I suppose you could say that all of his treatments were “unnecessary.” After all, none of them worked.

Only we don’t live our lives in retrospect; we don’t decide what is necessary, or even what is best, based solely on some oddsmaker’s calculation of the chance of success. As Americans, we expect to make our own free choices on how to spend our money, and how to live our lives. And some choose to honor the sanctity of life, rather than some ephemeral, materialistic notion of the “quality of life.”

My son chose to live his life fighting until the end, never giving up simply because the odds against him were too great, or the treatments too debilitating. Just because he lost his battle does not mean it wasn’t worth fighting - but that is exactly the sort of calculation that Obama seeks to mandate – not to preserve “dignity,” but solely to save money.

There are broader consequences to decisions to deny care. The incurable, seeking “unnecessary” hope for a cure, serve also to advance medical science by testing new therapies. But in Obamaworld, if the “unnecessary” is not worth paying for, not worth trying, how will it never become the cure?

I am pretty sure Mr. Obama will not use my sad story in one of his speeches. There is not much in my story to sell his idea of “reform.” His reform wouldn’t have helped my son. His reform won’t cure cancer. But that is not why I reject his plan. I don’t expect the President of the United States to cure cancer (although I suspect many of his supporters believe that he could.)

I reject his plan, and the philosophy behind it, because it does not celebrate freedom, does not encourage innovation, does not honor the individual judgment of medical professionals or their patients, and, in the end, because of its singular dedication to saving material resources, it is profoundly anti-human.

You may say his plan would have “saved” me some of the money I paid out over the years, and I have no doubt that is true.

But that’s savings I can do without. There are worse things than being broke.