There is no easier way to feel generous than to give away other people’s money. Furthermore, electors often judge the generosity of politicians by how much tangible benefit at others’ expense they are prepared to offer them. There is thus an inherent tendency in a democracy—though it is not quite an inevitability—for politicians to outbid each other in this type of generosity. And once such benefits have been received, they can be withdrawn only with the exercise of political courage: not the first quality of politicians in modern democracies.
Two proposals in America, supposedly the bastion of sturdy individualism, recently caught my attention. The first was that opioid addicts should be offered the antidote to overdose at public expense. The second was that male-to-female transsexuals should be offered uterus transplants when they become technically feasible, also at public expense.
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The argument for the first is that, by giving addicts the antidote for use when necessary, the number of deaths by overdose, running in America at an annual number of the deaths from the Korean and Vietnam wars combined, would decline. Lives would be saved thereby.
There is obvious force in this argument, though precisely how many lives would be saved, and at what expense, remains to be seen. Trials of such a policy usually exaggerate the benefits once it is institutionalised; routine dulls the edge of enthusiasm.
But objections to the idea also come soon to mind. People who are prepared to spend money regularly on illicit opioids are surely able to afford for themselves occasional doses of the antidote at small cost to themselves; and if they do not value their own safety enough to pay for it in this fashion, why should anyone else do so?
Against this might be urged the fact that they are suffering from an illness, namely opioid dependence, that prevents them from making rational decisions about their own welfare. This, however, is an argument with potentially very illiberal consequences, for it places addicts in the position of minors for whom others must take decisions. If opioid addicts cannot decide to pay to save their own lives, there surely cannot be any ethical objection to placing them under preventive detention and treating them as complete wards of the state.
The fact is, however, that opioid dependence is not an illness like any other, and it does not destroy a person’s ability to make decisions for himself, though no doubt it encourages him for a long time to take the line of least resistance.
A second possible objection to the free distribution of the antidote is that it might encourage carelessness among opioid addicts. Why take care if the antidote is always to hand? The end result might, paradoxically, be an increase rather than a decrease in deaths from overdose. Whether this objection is valid, however, is a purely empirical question: it would depend upon experience of universal distribution. My guess is that, overall, such distribution would save lives.
If this were so, to maintain opposition to the free distribution of the antidote would appear to be to accept avoidable death for merely philosophical or ideological reasons. The person who opposes the ever-increasing role of government as shepherd or sheepdog of the population or flock is thus put in a false position of denying someone or some group of people a benefit, in this case freedom from death from overdose. He would be a monster of callousness.
The freedom that many people now cherish above all is the freedom from the consequences of their own actions, while other people are only too eager to take on the role of guardian and protector of the weak and supposedly incapacitated—which is to say, a large proportion of the population. Through taxation, I may be my brother’s keeper; but I am not even my own keeper.
A recent paper in the American Medical Association’s journal of ethics suggests that third parties should in effect be forced through insurance premiums or taxes to pay for uterus transplants for men who want to be women and desire to have children, or simply to feel more completely female.
The argument goes more or less as follows. Uterine transplants can be successful in women, who subsequently go on to have children. If such transplants were to be denied to transsexual women on the grounds that they were transsexual, it would be a case of unjust discrimination. Furthermore, a sense of personal fulfilment is beneficial for health, and health is a precondition of many, indeed most, other desirable things. Therefore, denial of such transplants to transsexual women (men who want to be women) would be to deny them fulfilment and thus health: and to deny people health is unethical.
To ask such people to pay for their own uterine transplants would be unjust and discriminatory. A uterine transplant costs about $100,000, and only a small proportion of people could afford such a sum from their own pockets. To confine such transplants to those who could pay for it themselves would therefore be to make health and happiness a privilege rather than a right, and further increase inequality in society.
But are we not all born equal, with the same rights? What applies to Jews applies to transsexuals who want a uterus transplant: Hath not a transsexual eyes? Hath not a transsexual hands, organs, dimensions, senses, affections, passions? Fed with the same food, hurt with the same weapons, subject to the same diseases … And if a woman can have a subsidised uterus transplant, why not a transsexual man (or is it woman)?
As with so many discussions these days, one feels a sense of gloom even as one enters into them. Propositions that even a few years before would have seemed so outré that no one would have thought them worth refuting become almost unchallengeable orthodoxies in a matter of a few years, if not of months; it requires courage to dispute them, at least if one has a position in an institution or organisation to protect. A subliminal fear—which sometimes is not even subliminal—stalks intellectual life. One does not so much disagree as pronounce heresies. For the moment, luckily, burning at the stake is only metaphorical.
Let us try to imagine the next orthodoxy. One could run a sweepstake on this. Let us suppose that I have drawn the ticket saying “Incest”.
What is there that can be said against incest? The taboo against it is completely irrational. What is wrong with sexual love between brother and sister, or between brothers for that matter? Or between parents or grandparents and children or grandchildren? If the possibility of genetic defect of any offspring be urged against it, one can point to genetic and intrauterine testing to avoid such defect, to say nothing of the wide variety of means of preventing conception now available.
Mutual consent would, of course, be a requirement, but no doubt some bureaucratic procedure could be instituted to ensure it. There remains the question of the age of consent, but this should not really be much of a problem, for if children can decide to take puberty blockers (by definition before puberty), surely they can decide on consent to sexual relations with their grandparents, say, a year or two after puberty?
Love, we are told, is love. By what right, then, does the state, or any other authority, deny some humans the expression of their form of love, all the more so when their form of love does no harm?
No doubt incestuous liaison will be frowned upon at first: but the problem is not with incest, it is with the social attitude to incest. It is that which ought to change, as well as the law. Remove the taboo, and all would be well. As to the wisdom of men down the ages, it hardly counts as an argument. Such wisdom, after all, is as often wrong as it is right. And look at the Pharaohs: they enjoyed incest and ruled for centuries if not millennia …
These days, one is obliged often to argue against evident absurdities. If you argue against them, however, you confer dignity upon them; but if you don’t, they go by default. I have more and more sympathy with Karl Kraus, the Viennese satirist who wrote millions of words, when he was asked what he thought of Hitler. When it comes to Hitler, he said, I can’t think of anything to say. Hitler was beneath criticism.
Under his pen-name Theodore Dalrymple, Anthony Daniels recently published the collection Neither Trumpets Nor Violins, co-written with Samuel Hux and Kenneth Francis (New English Review Press), The Wheelchair and Other Stories (Mirabeau) and These Spindrift Pages, a collection of literary observations and reflections (Mirabeau)