April 22, 2014

Why is slavery wrong?

A question was posted by b_b on hubski.com recently under the title “An interesting question.”  In the post, the question was expressed:

“I think it's not really going out on a limb to say that the overwhelming majority of reasonable people oppose slavery in this day and age. But, the question made me realize that I'm not sure I'd ever been asked why slavery is bad, but rather, I've always taken it as axiomatic that slavery is morally abhorrent.”

I think it would be fair to paraphrase the question simply as:

     Why is slavery wrong?

I arrived late to the discussion (as usual) and only left a passing remark.  It really is an interesting question though, and quite worth a serious look.  Let’s start with a nice succinct definition of slavery – or at least of the sense in which I will use the term here.

     Slavery is the legitimized institutional practice of holding human beings as property, without recognized rights or legal standing of their own.

While perhaps not perfect, this definition does two immediately useful things.  First, it shears off any muddy arguments about softer forms of influence or coercion.  If the laws of your society recognize that you are an autonomous human being that cannot be legally owned by someone else, then you are not a slave.  Second, it limits our discussion to what a society recognizes as legitimate – and excludes conditions that authorities would punish were they brought to light.  A person locked in some sociopath’s basement may be no better off than a slave, but that person is only a slave so long as his or her condition goes undiscovered.

The first answer I would propose to the question, the introspective one, is entirely uninspiring and unsympathetic.

     I believe slavery is wrong because, as a child, my parents, teachers, and the television taught me it is wrong.

Nasty and banal as this answer sounds, it is not trivial.  I am well aware that if I had been born into an English family in Barbados in the 18th century, a west African family at about the same time, or a Roman family at any point in Rome’s history, I would have almost certainly had a different set of moral standards.  It might be nice to think that my humane instincts would have forced me to find slavery abhorrent, but the plain fact is that most of the people in the groups I have just mentioned accepted it as a legitimate, acceptable institution.  It is important to understand that when we get asked important moral questions we naturally tend to regurgitate the values that our environment has imparted to us.  We want these values to be absolute, but in fact they rarely are.  In case you’re getting nervous already, I do not intend to advocate a moral relativist position regarding slavery.  Systems of social organization have consequences, so it is incorrect to say they are all equal – that one is no better than any other.  All I am saying is that it’s fruitless to congratulate ourselves for absorbing values we were almost certain to absorb.

One line of examination we could pursue, while not really a moral assessment, is to consider slavery from a Darwinian perspective.  By this I don’t mean to cast the slaves themselves as losers in an evolutionary struggle, but rather to ask whether or not slavery does some fatal damage to a society which supports it.  After all, if the institution of slavery couldn’t pass such a Darwinian test, one would have as close to an absolute reason for discarding it as one can expect to get out of nature.  Imagine, as a thought experiment, a society with a moral system that didn’t censure theft or murder in any way.  It is immediately obvious that such a society would not flourish, its members being constantly preoccupied with the security of their property and persons.  Sadly, the historical record shows that slave holding societies have often flourished – provided, of course, that one does not consider the welfare of the slaves themselves to matter in the assessment.  Rome prospered and endured for hundreds of years, as did many other slave holding societies.  The only society that I am aware of that collapsed because it supported slavery was the French colony of Saint-Domingue – which, following a successful slave rebellion, was renamed Haiti.  Again, this is by no means an argument that slavery is good – it is only an argument that slavery is not abhorred by nature.  Nature, it has often been observed, is not noted for compassion.

Again skipping over moral arguments, there is at least one good practical argument against the institution of slavery in modern times.  It has simply been rendered unprofitable by technology.  One big diesel-powered harvester can do the work of dozens, maybe hundreds, of agricultural slaves.  Further, the diesel-powered harvester does not plot to kill the farmer as it lies quietly in its shed at night.  House slaves have been replaced by many labor-saving gadgets run by cheap electric motors.  Why would one want slaves to beat the rugs when one could buy a Hoover – or even a robotic Roomba?  Even in poor societies, the worst of the heavy lifting is now done by uncomplaining mechanical servants.  While human sex trafficking does not meet my technical definition of slavery, it is notable that it accounts for a large fraction of the truly forced labor still performed in the world.  This is one of the few areas that has not been adequately mechanized – though I have no doubt that the Japanese robotics industry is trying.

Asking why anything is wrong, of course, is to ask a moral question.  Even allowing that human beings are very plastic in the kind of things they can consider good or evil, it is still true that some moral systems are innately more stable than others.  Moral systems that are internally coherent are more stable than moral systems that are riddled with contradictions.  It is important to consider that the great majority of people alive today believe, more-or-less deeply, in either some notion of freedom or some notion of equality.  They believe in these ideals not merely as abstractions, but as real conditions, however vaguely understood, that they desire for themselves.  Tolerating the institution of slavery threatens to make either of these ideals incoherent.  Freedom, in the simple sense of being free to act according to one’s own desires, is utterly nullified by slavery.  The essence of slavery is to be the property of someone else – an instrument rather than an autonomous human being.  Equality, too, is made ridiculous by the institution of slavery.  Even the sense of equality that the left and right can generally agree on – equality before the law – is rendered empty when one group of people are not even considered legal persons.

When neither the ideals of freedom nor equality are very general in a society, slavery is not so morally objectionable.  Most people, throughout history, have accepted the particular niches that their circumstances made for them.  The circumstances of a slave were a bit worse than average – but without a vague but powerful idea that everyone should, on the one hand, be free, or, on the other hand, be equal, the fate of the slave was just that – fate. Roman slaves, it should be pointed out, where not recognizable by race or ethnicity.  The Romans didn’t need the notion that someone was inherently less than a person to justify depriving that unlucky individual of autonomy.  It was only after the Enlightenment ideals of freedom and equality became widespread that would-be slaveholders needed a racial inferiority argument to avoid the troublesome moral incoherence.  Such an argument is adequately sustainable when the slaves are field hands – whom the slave holder only interacted with remotely – but rather fell apart with house slaves – whose humanity the slave holder could not help but constantly observe.  If one could not sustain the idea that slaves were not persons, then one had to reject the idea that personhood carried with it any rights.

While I think that the twin ideals of freedom and equality are largely incompatible with each other, neither is compatible with slavery.  You can only not think slavery is abhorrent if you are capable of thinking in some pre-Enlightenment way, or if you are bereft of moral sentiment altogether.

April 11, 2014

An anonymous death

These events were recounted to me by my wife, a county social worker.  For obvious reasons, I cannot use any real names, either of the persons or the specific institutions involved.  To avoid talking and thinking about a real person as an abstraction – which is precisely the sad circumstance I would like to decry – I will call the subject of this story Charlie.

Charlie was an old man in poor health.  A retired auto worker, he was not a rich man – but he was not a poor man either.  Charlie was, among many other things he may have been in his life, a Medicare recipient.  A little more than a month ago he went to his local hospital with an acute shortness of breath.  The diagnosis was a collapsed lung.

A collapsed lung is a serious condition but, in itself, it is by no means a death sentence.  In Charlie’s case the lung required periodic drainage, among other things, but given attention and reasonable care his prospects for recovery were good.  Charlie was in his seventies and had various other medical problems, but nothing about his state of health was immediately terminal.  He might have been expected to live some number of years with whatever quality of life he could manage for himself – the same sort of expectations you or I might have as living, breathing human beings.

I can only imagine that forty or fifty years ago Charlie could have expected a moderately long hospital stay, during which he would have rested, had his condition attended to at intervals by nurses in small white hats, and by the end of which he would have probably gotten better.  He would not have expected to have been bankrupted in the process – Medicare or no Medicare.  Things have changed.  In the last forty years we have invented new techniques and new diagnostic equipment, but you cannot stay in a hospital for weeks or days anymore unless you happen to be very very rich or very very comatose.  Thus, after a relatively short interlude of adequate care, Charlie was gently booted out the door.

Until very recently, a hospital that could no longer profitably treat a Medicare recipient’s serious but unresolved condition passed him or her on to the second line of defense – a long term care facility, usually a nursing home.  There, Medicare would pay the person’s expenses for the first 30 days.  This was not enough for everyone, but it was something.  It might have gotten Charlie over the hump.  A funny thing has happened lately though – a little bureaucratic fine point with enormous consequences – as the result of the passing of the Affordable Care Act.  Medicare still covers the thirty days of long term care if a person is admitted to a hospital in the normal way.  However, Medicare doesn’t cover this long term care if you are admitted for observation instead of being admitted normally.  Medicare now also pays a hospital more if it admits a patient for observation than would be paid if the patient were admitted normally.  In medical terms, there is no distinction between the two kinds of admission.  Patients get the same care in the hospital regardless of their admission status.  It is purely a bureaucratic distinction, channeling a person in one direction or another.  Hospitals are businesses and their administrators know a deal when they see one.  Charlie was admitted for observation – so no long term care for him.

Charlie was instead ushered gently to the third line of defense – home healthcare.  One cannot send a person home while they are still seriously ill, not without the promise that a home healthcare worker will come around from time to time to try to finish the work that the hospital didn’t do.  Charlie was given a choice of home healthcare providers, and he picked one he had experience with from a prior illness.  Unfortunately, the provider Charlie picked was not the one the Federal authorities preferred.  Again, hospitals get reimbursed for referring patients to a particular provider, and not to others.  A little competition might be nice to keep home healthcare agencies on their toes, but it is bureaucratically easier for both the hospital and the government to only deal with one.  Thus, somewhere in the bowels of the hospitals administrative apparatus Charlie’s unprofitable and inefficient request got shuffled to the bottom of someone’s in-box.  Charlie sat at home – wheezing and waiting.

Finally some concerned bystander to Charlie’s suffering contacted my wife – the last line of defense.  County social workers have rather limited resources to work with.  In general, they investigate – then wheedle, cajole, and bluff more powerful institutions into producing better outcomes.  My wife sorted out what had happened, and extracted a promise from someone at the hospital to complete the unprofitable paperwork to set up services with the provider Charlie wanted.  My wife is not empowered to hold a gun to anybody’s head, nor does she want to be.

In the end, no paperwork was sent – and no one came.  Four days after the hospital promised to resolve the issue, Charlie’s collapsed lung filled to capacity with fluid.  He died of a heart attack, brought on by the accumulated strain, while sitting on his toilet.  A dignified death under the watchful eye of the caring institutions of his society.

We may bicker and haggle about who ought to be doing what – about whether this public policy or that one is the more moral or humane.  Perhaps, as individual human beings, we should spend a little less time trying to be maximally high-minded and a little more time being at least minimally decent.  Everyone involved in this process got a good outcome – except for Charlie.  The people at the hospital didn’t lose any money doing things they couldn’t bill for, and neither did they suffer the embarrassment of having a patient expire on their premises.  The Federal government was a financial winner too, saving money which it will no doubt spend – in its nearly infinite compassion – on someone else the anonymous bureaucrats decide to bestow it on.  The system functioned as designed.  It did everything perfectly – except deliver healthcare.  And let’s not kid ourselves that Charlie’s miserable fate was the product of peculiar circumstances that, you understand, just happen now and then.  Charlie died as the result of policies that people put in place.  Policies that remain in place.  Whether those policies were the result of malice, incompetence, or mere indifference makes very little difference to the outcome.  Any way you look at it – a man is dead.