Tag Archives | Therapeutic State

Plato and Voltaire on Vaccination

Voltaire on vaccination is right here. The Plato angle is a bit more complicated.

In Plato’s Laches, the question arises as to the relationship of courage (and by extension, virtue generally) to risk. On the one hand, the courageous person is supposed to be admirable, and so would not take foolish risks; thus being guided by wisdom seems built into the notion of courage. On the other hand, the riskier an action is, the more courage it takes to do it; the wiser you are, the better able you are to reduce your risks, making courage more useful to the less wise. So does greater risk correlate with more courage or less courage?


Plato’s solution, as I read the dialogue, is to distinguish two kinds of wisdom (or expertise): technical expertise, which involves knowing how to reduce one’s risks, and ethical expertise, which involves knowing which risks are worth taking. Plato goes on to illustrate the distinction by asking whether physicians, by being experts on health and disease, are thereby experts on what is worth hoping for and worth fearing (given that health is worth hoping for and disease worth fearing). Plato’s answer (again, as I read him) is that while being a physician makes you an expert on what will cure you, it does not make an expert on whether you are better off being cured or at what cost.

Plato’s distinction is one that is being lost in the current debate about vaccination, as the two kinds of expertise are being persistently conflated. One of the issues under debate is what the benefits and risks of vaccination actually are, in terms of quantified probabilities; that is a medical issue. A different issue under debate is whether, for any given probability assessment of benefits and risks, the benefits are worth the risks; that is not a medical issue, and having medical or other scientific training gives one no special insight into it.

I’m not offering this distinction as a magic bullet to resolve the political dispute. It’s not as though one type of issue falls within the jurisdiction of the law and the other doesn’t; legal expertise doesn’t automatically carry with it either medical or technical expertise, but on the other hand, applying the law will often require taking a stand on both.

As far as the political issue itself goes, I think a consistent libertarian can forcibly quarantine a Typhoid Mary, but forcibly vaccinating on the basis of a possible future risk of measles is too attenuated, and opens the door to all sorts of regulations to prevent behaviour that poses a slight risk to others (like banning Mein Kampf because people who read it might become Nazis). But of course my position requires taking positions on both the medical and the ethical issues. In any case, the point of this post is not to take a side on the vaccination debate, but just to distinguish two issues that keep getting run together.

Legs Broken, Crutches Distributed

One of the benefits of Obamacare, apparently – as you’ll learn from this piece, if you can make it past “people like you and I” – is that it enables this:

Tufts Medical Center in Massachusetts – along with their physician group and a company which owns and operates two hospitals in the region – has acted on this provision of the law and received $88.5 million in federal funds to create the state’s first member owned and controlled health insurance plan.

This “first” claim is quite false, of course. Massachusetts, like most states in the u.s., once had many member-owned, member-controlled health-insurance plans – until the government drove them out of business. Now the government is apparently attempting to run a top-down simulation of what it formerly destroyed. One thinks of Marie Antoinette playing shepherdess.

Hell Is For Children

The New York State report found students as young as nine years old subjected to sudden, painful, repeated electric shocks for ‘refusing to follow staff directions’, ‘failing to maintain a neat appearance’, “stopping work for more than ten seconds”, “getting out of seat”, “interrupting others”, “nagging”, ‘swearing’, ‘whispering’ and ‘slouching in chair’, and ‘‘moving conversation away from staff”. …

“These devices are much stronger than police stun guns (1-4 milliamps),” says Gregory Miller, former teacher at JRC. … In McCollins’ case, school staff used the powerfully painful electric shock device (45 – 91 milliamps, at 66 volts) on McCollins over the course of seven hours for not taking off his coat in class. After his “therapy” was over, McCollins was admitted to a nearby children’s hospital ….


Cordial and Sanguine, Part 18

My BHL post on Ron Paul’s healthcare answer is receiving favourable comment from both Andrew Sullivan and the National Review, and less favourable comment from Matt Yglesias. (CHT Matt Zwolinski.) I posted the following comment at Yglesias’s blog:

This response is pretty drastically missing my point. Suppose there are two possible ways of helping a patient, one much more effective than the other. The better way, A, is forbidden by law; the question is then asked whether the inferior way should be mandated by law. The libertarian (or at least the good libertarian) says: “no, don’t mandate B; instead, stop forbidding A.” That hardly counts as saying the patient should die; on the contrary, the libertarian thinks (rightly or wrongly) that the patient is less likely to die if the government stops forbidding A.

Shock Treatment

Now what the conservative generally says is “don’t mandate B, but don’t stop forbidding A either.” So I think it would be fair to charge the conservative with being willing to let people die. But that’s just a different position.

Part of the problem here is that non-libertarians tend to treat “let’s do something about X” and “let’s have a government program for X” as equivalent, and so tend to hear anyone who rejects the latter as rejecting the former. By contrast, libertarians generally think of governmental solutions as the least effective ones, and so for them treating “let’s do something about X” as equivalent to “let’s have a government program for X” would be like treating “let’s do something about X” as equivalent to “let’s sacrifice some babies to the moon god in order to address X.”

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