Tuesday, July 15, 2014

From the Frequent Responses file

Every time I teach medical ethics, I get at least one paper asking "why don't we experiment on prisoners, instead of poor, defenseless animals." I have added an entry to my canned response files for this one. I post it here in hopes that I can dissuade as many people as possible from this stupid, but inexplicably popular, idea.

 Ever since the Nuremberg war trials again Nazi doctors, experiments on humans without their consent has been considered a war crime. This has been adapted by most countries, including the US, as a part of law. If you want to experiment on prisoners, you need to explain how it can possibly be consensual.

You might think that US prisons are different than prisoner of war camps, because the people there are guilty of things like murder, assault and rape. But this is not what is going on in most prisons. In 2006, 49.3% of state prisoners were in jail for nonviolent offenses. For federal prisons, that number is 90.7%. (See wikipedia, end of the fourth paragraph down.) The drug war is largely responsible for this. In 2004, the majority of (55%) prisoners in federal prison were there for drug offenses. The same year in state prisons, 22% of the prisoners were there for drug offenses. (See here.)

For profit prisons also play a role here, because they lobby for tougher sentencing laws to increase their business, and hence their profit. (See here and here. In the most extreme case, a for builder of for-profit juvenile detention facilities in Pennsylvania bribed two federal judges to send innocent kids to their juvenile prisons. The judges in the case received 28 and 17 years in prison. The developers of the prisons who paid the bribes received 18 months and 12 to 18 months.

You said, "They had rights when they were not committing crimes and knowingly killing and raping people. If they want rights they shouldve thought about that before taking away someone else." But most rights specified in the US consitition do not go away if you have committed a crime. In fact, many of them only make sense after a person has been accused of a crime. The right to a fair trial, the right to see the evidence presented against you and the right to be free of cruel and unusual punishment are all rights that you get after you enter the justice system.

It is also worth looking at what happens when people do experiment on prisoners. The most notorious cases of this are the Nazi war crimes, but this has happened in US prisons as well. In 1906 Dr. Richard P Strong began experiments infecting prisoners in the Philippines, which was then a US possession, with cholera. Thirteen prisoners died when they were accidentally infected with bubonic plague. Six years later Strong conducted lethal experiments where prisoners were put on a diet without vitamin B1 in order to induce beriberi. They were given cigars as compensation. For more information, see this article, called "They were cheap and available" on the history of experimentation on prisoners. The article was originally published in the British Medical Journal, but the full article was posted on a web page run by health case activists.

Saturday, July 12, 2014


On my run I was thinking about the idea that every intention carries with it a microduty to fulfill that intention. (A microduty would be like a prima facie duty, but smaller.)

I got to thinking about that because I was thinking about situations where one desires at one time to avoid a future outcome but the outcome is one which, in the future, you would have actually be fine with if it occurs. This isn't as weird as it sounds. Think of a couple who are considering having an open relationship. One reason they might not want to is the fear that if they had an open relationship, they would fall in love with other people, break up with each other, and live happily with their new partners.

Or here's a more common one: a person gets a diagnosis of Alzheimer's and decides that when they reach a certain level of mental decline, they will no longer want life-extending treatment. But actually when they reach that level of mental decline, they are quite happy. They watch TV shows whose plots they can't follow and a nice lady brings them ice cream. This version isn't quite like the open relationship scenario, in that the person isn't absolutely sure they would like the outcome they are trying to avoid, but the basic idea is the same.

The book What Sorts of People Should There Be features several similar scenarios that play out at the level of human evolution. We can imagine a future where people live as clone pods, a hundred or so genetically identical individuals who only are concerned with the interest of the pod as a whole. We might want now to avoid this outcome, even if we would have no problem with it were it to happen.

My basic thought, while running along, was that we can make sense of our conflicting intuitions in these situations if we imagine that forming the intent at the earlier time creates a little duty. I can't spell out the rest of the thinking yet. And in any case, I'm a consequentialist, not a deontologist, so I shouldn't be trying to rescue these intuitions anyway.