Morality, Health, and Science

In our last discussion of morality and science, an interesting argument was raised in the comments (by rbd and then in more detail by Ben Finney), concerning an analogy between morality and health. Sam Harris has also brought it up. It’s worth responding to because it (1) sounds convincing at first glance, and (2) has exactly the same flaw that the morality-as-science argument has. That’s what a good analogy should do!

If I can paraphrase, the argument is something like this: “You say that morality isn’t part of science because you don’t know what a `unit of well-being’ is — it’s not something that could in principle be measured by doing an experiment. But one could just as easily say that you don’t know what a `unit of health’ is, and therefore medicine isn’t part of science. The lack of some simple measurable quantity is a simplistic attack against a sophisticated problem.”

This gets right to the point. Because, in fact, I don’t know what a “unit of health” is, which is why medicine is not — solely — part of science.

Let me explain what I mean. Obviously we use science all the time when it comes to medicine. Similarly, we should be very ready to use science when it comes to morality — it’s an indispensable part of the endeavor. But in both cases there is a crucial component that lies outside the realm of science.

Here’s how we do medicine, in a cartoonishly simplified version that is nevertheless good enough for our present purposes. First, we decide what we mean by “healthy.” Then, we use science to try to bring it about.

That first step is not science, no matter how much science might be involved in the definition. Various measurable quantities certainly belong to the realm of science — height, weight, pulse, blood pressure, lifespan, time in the 40-yard dash, etc. But what we decide to label “healthy” is irreducibly a human judgment, not an empirical measurable. Some people might think that extreme thinness is part of being healthy, while others might prefer a more robust physique. Some people might define health as the state that maximizes life expectancy, while others might put more emphasis on quality of life even at the expense of total years. It matters not a whit what people actually think, of course — even if everyone in the world agreed on what “healthy” meant, it would still be a judgment rather than an empirical measurement. If one contrarian person came up with a different definition, they wouldn’t be “right” or “wrong” in the conventional scientific sense. There is no experiment we could do to answer the question one way or another.

In the real world, we more or less agree on what constitutes health, so the non-empirical status of this choice isn’t treated as a crucially important philosophical problem. (At least, until you start reading the literature on disability studies, and you realize that what you thought was obvious maybe is not.) We agree on what health is, and we set out to achieve it, and that second part is very much science.

Morality is exactly the same way, although with somewhat less unanimity in the first step. We agree (or not) on what morality is, and once we do the process of achieving it is very much a scientific issue, in the broad-but-perfectly-valid definition of “science” as “an understanding of how the world works based on empirical data.” Once again, it doesn’t matter whether we agree or not, because that first step is a decision we human beings make, not something we measure out there in the world.

While both health and morality are human choices rather than empirically measurable quantities, they certainly aren’t random choices. Human beings aren’t blank slates; we have preferences. Most of us would prefer to live longer and be free of aches and pains; these preferences feed into how we choose to define “health.” Likewise for morality. But “we broadly agree on X” is not, and never will be, the same statement as “X is a scientific truth.” Understanding our preferences, turning vague impulses into precise statements, constructing logical frameworks based on them — that’s what the philosophy of medicine/morality is all about.

The case of morality is actually much more difficult than the case of health, because most interesting moral questions involve tradeoffs between the interests of different people, not only the state of one individual. So even if we could do experiments to establish a unique map between mental states and human well-being, we wouldn’t really be any closer to reducing morality to science. All very fun to think about, though.

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36 Responses to Morality, Health, and Science

  1. mazeRunner says:

    I’m first??

    Sean, wouldnt you agree that though the upper bound for health may be very subjective a lower bound could very well be objectively defined as atleast being un-ill or as being alive? Couldnt we say the same about human well-being and say the lowerbound on well being is not being in real pain while leaving the upper bound open?

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  2. Sean says:

    That’s still mixing up “agreement” with “empirical fact.” If I defined being dead as the state of greatest health, you might think I was crazy, but you couldn’t do an experiment to prove me wrong.

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  3. Ray says:

    If I understand your argument correctly, you’re saying that the part of morality/medicine that is unscientific is the precise definition of terms like “health”/”well-being”. In other words, the only moral argument that is not resolvable via science is the argument over semantics. Of course, we could take this even further and start arguing over the definition of “force,” thereby declaring that physics is not a science.

    Perhaps the mark of what is and isn’t a science is that in science we feel no compunction about saying that semantic disagreements are not “real” disagreements.

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  4. Cody says:

    Is it wrong to think biology is another example of science performed on ill defined premises? (Albeit far less ill-defined than medicine or morality; i.e., we still don’t have a great definition of what life is.)

    I think this is a general trend in human history: we can see a vague pattern to a natural phenomena, but it takes a very long time to develop the observational tools, pattern matching (math?), as well as the language of what we want to talk about, before we can make real progress. As a result, we move these areas of knowledge first from myth to philosophy and finally to science. But the increasing complexity of the fields (physicists have it lucky) means it takes much longer to assimilate them into the formal eyes of scientific investigation. Maybe we are approaching a time when science should be saying more about morality than philosophy?

    Additionally, if we accept the premise that questions concerning morality cannot be answered by science, what methodology is left to answer them? Has any methodology contributed to our body of objective truth other than science? It seems all real progress in objective truth is due entirely through the essentially scientific process of looking at reality very carefully to determine what is and is not true. Observing decaying corpses does clearly contradict the word health, as any reasonable person would define it, likewise we might say that any reasonable definition of morality will exclude much of what is passed as moral behavior today.

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  5. Thomas Larsson says:

    “If I defined being dead as the state of greatest health, you might think I was crazy, but you couldn’t do an experiment to prove me wrong.”

    Henrietta Lacks died of cervix cancer in 1951, but her cells (only her cancer cells) are immortal – the HeLa line. Is being immortal the state of greatest health?

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  6. David George says:

    You give a definition of “science” as “understanding” (which boils down to great faith), and a description of “morality” as a kind of undefined human choice. And presumably the choice is between undefinable terms, “good” and “evil”. But more precision, in the form of future direction, is possible here if you say the choice is between “a good way to go” and “an evil way to go”. And that may be more accurate considering the function, or purpose, of asking a “moral” question: the purpose is to figure out which way to go – to determine a future path. Which is not far distant from a similar purpose of science, except that once the future path is determined, the science is supposed to predict how to – what – get “there”?

    So, given the definition of science as “an understanding of how the world works based on empirical data”, there must also be a scientific purpose associated with the understanding, and that would be prediction, right? So a scientist seeks understanding in order to make a prediction – to tell the future, being here a generic multipurpose “future” – so “science” is a generic multipurpose predictive tool.

    There seem to be two complementary purposes at work, first the work of determining the future path, then the work of determining how to get there. But these are not exactly complementary, neither are they exact. If there is no end to the future path, there is no “there” to get to. And if no specific future target is set, how does science work to get to it?

    At the same time, we are told that the scientists are – not 100%, but not far off – certain, or agreed (after all, it is a “law” of thermodynamics) that the universe is headed for a maximum entropic state in which no work gets done, etc. – so what is the ultimate use of doing homework, moral or scientific? In other words, there is this one-off injection of Big Bang “energy”, and it is all downhill from there. Big Freeze, Big Rip, or other esoteric oblivion, is the future to which all paths lead.

    So immediately there is a loss of purpose, both moral and scientific, except as temporary playthings to while away the time.

    Fortunately, science does not understand these crucial aspects of how the world works: the universe is not necessarily doomed to Big Rip, Big Freeze, etc. Some aspects of evolution – the most crucial, the beginning and the end – are not understood. The problem is that, having no institutional sense of what is “good” or “evil”, the scientists may not understand that their “realistic certainty” (less than 100% but not far off) is taking the place, in the minds of interested “lay people”, of the “unrealistic certainty” of the former moral arbiters of church and state. People believe the amoral pronouncements of the scientists! (After all, science does pretty well elsewhere.) And understanding is not helped when for example the Big Bang idea is accepted and promoted as orthodox dogma and all caveats are hidden in mathematical obscurity.

    It seems to me that something needs to be added to this debate, so here it is: there is the possibility of a principle, founded in both “science” and “morality” which may bring them into a more complementary arrangement, and that is a harmonic principle. The word “harmony” is an interesting one because it has both scientific and moral connotations. It appears to be not very important in the scientific understanding of how the world works (possibly due to an imperfect model of matter), but is it not a “fact” that atomic orbitals or energy levels are harmonic at their roots? That is, the principal quantum number is a whole number (and its multiples). If the fundamental orbital is assigned a frequency, the next atomic orbitals are harmonics of this fundamental frequency. Of course there is more to it than that simple beginning.

    What does “harmonic” mean? The root sense is that of “fitting”. In other words, “harmonic” is “what fits”. (Slip that into Darwin and you may find that survival of the fittest is more accurately survival of what fits.) Does institutional science consider that an electron orbital is an orbital that fits? In other words (putting aside the question of what an electron is for the moment), that the (currently unknown to science) physical reason that an electron exists at a certain orbital radius is that it fits there?

    In the moral sense, the root sense of the word “harmony” is the same as the root sense of the word “good”, and also of the word “justice”. In other words, “good” is what fits – so, what is a fit way to go, a way that fits? And in the sense of justice, let the punishment fit the crime. Etc.

    These complementary senses suggest to me that there is scope for institutional science to explore a harmonic principle in natural systems, rather than concentrating on symmetry and symmetry breaking. Systems which evolve by joining together according to a harmonic principle (tempered with ever-present chaotic potential) are not the same as systems which evolve randomly according to a spontaneous symmetry-breaking principle. And the debaters may find that the purpose of the universe is to grow (to create new systems out of existing systems); and in order to grow it finds harmony (systems that fit), and the best we can do if the universe is time-infinite is to hone our sense of harmony, since as systems evolve into ever-increasing complexity the harmonies required to sustain them are also more complex. Which makes a more interesting plaything on the road to Big Bang oblivion – degrees of harmony or degrees of broken symmetry? It seems to me the symmetry path is itself approaching a nonsensical oblivion, evolving into a glass bead colliding game. And in this vein, perfect symmetry would be perfect entropy, would it not? I think that is what Penrose is getting at when he questions the initial conditions of the Big Bang idea: the universe seems to evolve from maximum entropy to maximum entropy (ignoring topological defects along the way).

    In short, following the path suggested by an as yet unrecognized, unelucidated harmonic principle you may eventually find a common basis both for “science” and “morality”, or even a scientific basis for morality.

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  7. Tom says:

    mazeRunner: The subjective, squishy part in defining what “health”/”morality” is not in deciding upon semantics, but in deciding upon one’s GOAL, ie what the end state you hope to bring about actually is.

    Once you have a clearly articulated goal in terms of measurable parameters, the science is straightfoward. This applies to so many endeavors that it’s almost shocking that it has to be said and is considered controversial.

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  8. Shecky R. says:

    It’s often been said that medicine is as much an art as a science (and I agree with that), and Sean has put a more empirical spin on the notion. Those who medically used leeches to bleed people 2 centuries ago no doubt thought it was good scientific practice; 2 centuries from now many current medical practices will likely similarly be seen as primitive and wrong-headed.

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  9. psmith says:

    Oh dear, oh dear, how to respond to this statement
    Morality is exactly the same way, although with somewhat less unanimity in the first step. We agree (or not) on what morality is, and once we do the process of achieving it is very much a scientific issue“?

    Science is the path to achieving moral behaviour? How will we do it? Gene therapy, selective breeding, psychotic drugs or perhaps culling imperfect members of the species? Or how about creating a morality implant that rewards moral choices and punishes immoral behaviour? Have you just invented a new branch of scientific inquiry?

    This reads like one of those clever spoof questions my prof delighted in. If you tried to answer the question in good faith you had already failed.

    More seriously though, a productive, happy social order achieved through active moral consensus must be the ‘holy grail’ of society that we are a very long way from achieving. Society has been struggling towards this goal for for more years than have been recorded. Now, with a breath taking insouciance, you blithely declare this is a problem that can be solved by science. Please elaborate.

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  10. Mark H. says:

    If I’m reading this right, this is another restatement of the is-ought problem in the realm of physical health. For example, it is an empirical fact that Patient X has a BMI that is significantly lower than the mean of the surrounding population. What is not an empirical fact is whether she is at a healthy weight while everyone else is overweight, or whether the surrounding population is healthy and she is unhealthily underweight. This conclusion depends not just on physical parameters, but on social consensus. I think I could stand to lose a few pounds, whereas my Indian neighbors tell me I need to eat more.

    Another example (based on Sean’s link to the Disability article at wikipedia): it is an empirical fact that a deaf person does not successfully receive and interpret audio signals for whatever reason. Whether this is a problem to be fixed depends on whether the person lost their hearing through injury or disease, was born deaf, or was born deaf to deaf parents in a deaf community.

    As Tom (#7) stated, determination of the goal (what ought to be) is the unscientific question.

    psmith: That is exactly the opposite of what Sean is saying.

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  11. Sven says:

    Bravo, David George! Your comment is very thought provoking.

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  12. David George says:

    Sven – Thank you! (Sobs) There is more! Even some high school math. But it would take a long time to set out. Meanwhile here and now, a short incremental note on how universal evolution may work: the “spacetime-energy complex”, which I understand as the necessity to set up parallel entities “spacetime” and “energy” and then integrate them because it isn’t possible to deal with one (energy) without using the other (spacetime), may be evidence of a redundancy. That is, it may be that spacetime = energy. I think Einstein gets close to this when he tells us that the gravitational field minus the field leaves nothing. Now apply this to the Big Bang scenario: when the film is set to run backwards, the mechanics make a big assumption, namely that all the energy we now see is present all the way back to the wee fractions of a second following the “beginning”, and it is all crammed into this tiny tiny space, at which point GR collapses and “quantum effects” are supposed to take over.

    But what if the assumption is wrong? So at the “beginning” all there is, is spacetime, i.e. motion, or expanding space. Then you have to ask, what causes the space to expand? It must be some influence. Now here you make a leap and say, whatever it is, it must be present not only at the edge of the expanding spatial “field” but everywhere within the field as well. And if the action of this influence is to “expand space”, then everywhere within the field the influence is attempting to expand space. Except there is no room to expand: all space is already occupied. Aha! The field, even expanding at its full potential (say at c) at its outer edge, is pressurized everywhere else! And to absorb this pressure, the space inside the expanding sphere begins to rotate. And following some as yet uncalculated maneuvers, you end up with a great number of tiny rotating spheres (neutrons) characterized by internal pressure of space trying to expand outwardly, and external pressure of space trying to expand inwardly, with the result being a permanently “sealed” rotating space. As the field expands, after a little while the external field is slighly depleted and the rotating sphere separates into proton and electron, with an intermediate field between them. And so the pressurized field creates matter. And it does this in cycles. In the region of the initially created matter, space doesn’t expand – it even contracts somewhat, so the matter particles gravitate toward each other. This is cyclical matter creation.

    Now, if we seek the energy source, where is it? In the Big Bang scenario, it is a single “creation moment” that lies in the past. And the microwave background is “leftover” radiation from the plasma at the “surface of last scattering”. But what if the “creation moment”, a.k.a. the energy source, is in the future? And the microwave background is radiation from a plasma following matter creation at the outer edge of the universe, receding at a constant rate (very close to c). And it never ends, although the cycles take longer and longer. In this vein, I notice that no one has rebutted Penrose’s “Gaussian” rebuttal of the “Gaussian” rebuttal: the circle families may be real. What if these circle families (and the “acceleration” phenomenon) represent matter creation cycles in a single, singular, uni-verse? And you might have an explanation for “dark energy”; and “dark matter” may be simply large scale rotating space. And so on. (There is more! They have everything backwards! But I don’t know whether this is the place to put it.) Anyway, thank you for reading.

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  13. JakeR says:

    Your conflation of health with morality is unfortunate because we can argue morality all day and get nowhere: Is abortion moral? What if it saves the life of the mother and ensures the safety of all future pregnancies that would otherwise become impossible? But what if the mother is an irresponsible Octomom? And so on. Pick your favorite issue and divorce it from all other considerations, something Harris failed to do.

    Health, however, can be quantified in a simple way, as was done by one Marvin E. Mundel under a contract for the US Indian Health Service sometime prior to 1978. It is the “community standard of health” (whatever that may be, usually identified by public health officials and specific for the population in question) and its unit is “a member of the population returned to the community standard of health,” or, as Mundell put it in that case, “a healthied Indian.” I worked on a similar system under Mundell’s tutelage, and it is remarkably simple to implement, yet it has the flexibility to rise along with a rising community standard of health.

    As for the Deaf/deaf, deafness is the community standard, with those opting for cochlear implants and the like as outliers. Presumably the recipient of a cochlear implant would be part of a separate community with varying degrees of successful treatment, and as the process improved, so would the community standard of health.

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  14. rbd says:

    Well, this seems to have been either a big misunderstanding or an argument about the meaning of the word “science”. Because Sam acknowledges that the first step, of setting the goal of morality, is not determined by science and also that the study of morality will be more akin to medicine than, say, physics. Whether medicine is a “true” science or not is a different story.

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  15. rbd says:

    I think if Sam would just call it science-based morality, instead of science of morality, everybody would be much happier.

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  16. spyder says:

    This is all very much like a platypus to Kant. Or perhaps it could use a little Husserl…

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  17. Hernanie Nacino says:

    We cannot separate each of them (Science % Morality), they are co-equal and interelated to each other although, they have owned meaning, in reality they both looking for truth…

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  18. Sean says:

    rbd– Excellent! I wanted to agree all along. Of course, he could have just said that he agreed, since I’ve said in every post I’ve made on the subject that we need to start with some moral premise from outside science, and then science will help us achieve the corresponding goal.

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  19. Peter Ozzie Jones says:

    I enjoy both the science and the off-science topics, have `the’ book, watch the vids etc.
    Just wondering if the proponents of the morality discussion would ever ask Sean what the 96% of this universe is made of, what gives rise to mass etc or even what is the mass of 1Kgm. Seems to me there is a softness on both sides of this debate?

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  20. Somite says:

    As a veterinarian I laughed a little over this blogpost. My patients have no concept of health except for the parameters I measure and my determination of their health. This demonstrates that health, at least in veterinary medicine is a reasonable objective measure.

    Ask any physician (I’m married to one) and they’ll tell you how sometimes the idea of “health” of some of their patients interferes with treatment and best possible outcome that expertise dictates.

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  21. Kevin says:

    Seems to me that you’re claiming that science is only descriptive, not prescriptive. I think that might be a pretty narrow view of science.
    In medicine, for example, we can describe the mean blood pressure of the population, correlate blood pressure ranges with health status, and define those blood pressures that place people at risk for long-term health damage (kidney disease, stroke, etc.). But science ALSO tells you what to do about it. Reduce your blood pressure and those problems are ameliorated. We call that “evidence-based medicine”. If it had turned out that extremely high blood pressure was protective or benign, EBM would have breathed a sigh of relief and gone on to other things.
    So, science can be both descriptive and prescriptive.
    In some areas, maybe not so much. We can describe how to build an atom bomb, but can’t prescribe how to use it (which would be “not at all” if we had any faculty of reason whatsoever).
    But it certainly seems that a false dichotomy is being invoked.

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  22. Nick says:

    Sean is arguing against a view that Harris doesn’t hold. Namely, that science can tell us that “well-being” should be valued. This has been clear since the beginning. I’ve never understood all the confusion.

    Sean: “That’s still mixing up “agreement” with “empirical fact.” If I defined being dead as the state of greatest health, you might think I was crazy, but you couldn’t do an experiment to prove me wrong.”

    No experiment would be necessary (or possible) because you would literally be talking nonsense. And on this point Cody (comment 4) seems to make a good point that the problem Sean is drawing attention to is not limited to medicine and a normative morality. If I defined “biology” differently from how biologists do I wouldn’t be empirically mistaken about anything, I would just have a different “irreducibly human judgment”.

    All in all, I don’t see the problem with Sam’s view. Basically, the well-being of conscious creatures is by and large the “subject matter”, if you will, of morality/value. The experience of those creatures is arising out of the way the universe is, altogether. It would seem to follow that there are facts about what should be valued and what should not.

    I think it is absolutely defensible that the well-being of conscious creatures is by and large the concern of systems of morality and value. And I think that when it comes to “well-being”, there is a there there. We can speak sensibly about it, just like we can speak sensibly about what a living thing is.

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  23. Geoff says:

    I think this is basically a problem of definitions. If I were to say that my version of astronomy is chiefly the study of garden gnomes, would I be wrong? Is it a philosophical claim that astronomy is the study of things in space? If you were to say that all of the sciences have to make some sort of philosophical justification at their most basic levels, then yes, you would have to say the same thing about a science of morality. If you wanted to say that those “philosophical” claims are intrinsic to their respective sciences, and that, while you can’t make someone value astronomy as the study of space objects, their simply isn’t another way to define astronomy, I think you could make the same case for a science of morality. In other words, whether or not it’s “outside” of science to say what science is, it’s the same case for all sciences.

    However I think Sam would say that we are simply not obliged to listen to those who would claim their ridiculous version of astronomy over everyone else’s. And we are similarly not obliged to listen to those who would say that morality is chiefly about something that isn’t well-being. People who would claim that just aren’t making sense. What other coherent case could be made for morality that didn’t involve well-being at some level?

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  24. Nick says:

    Excellently said Geoff! Thanks.

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  25. Joey Frantz says:

    I think there’s some confusion here over the role of definitions in the foundations of a science.

    If we are going to have a field that studies the universe on a broad scale, we should give it a name to go with it, and /that name should not have connotations already attached to it/. There’s nothing denotationally wrong with calling the study of the cosmos-at-large “sexual brouhaha” (“I’m a professor of sexual brouhaha at Princeton University” “Hubble’s influence on sexual brouhaha was immense” etc). But there is something connotationally wrong with it: it takes the connotations of a familiar phrase and attaches them to something that does not warrant such connotations.

    The same is going on if you just say “well we’ll just name the study of happiness ‘morality.'” The speaker is trying to take the connotations of vernacular moral discourse and affix them to a field that /already exists/. We already have research that studies happiness: it’s called positive psychology. Harris just wants to moralize empirical research.

    This is eqiuvocation. Science should be built from rational argument, not equivocation.

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  26. Joey Frantz says:

    I think there’s also some confusion over the importance of scientists making prescriptions. The mere fact that scientists often base prescriptions on their scientific research, or those of others, does not mean that science discovers what we should do. Science discovers facts; scientists themselves may make recommendations on the basis of those facts, but those recommendations are not the facts themselves.

    For example, scientists might discover that moderate drinking increases IQ. They might, on this basis, recommend that people generally drink moderately. However, the recommendation is not the discovery itself.

    Similarly, scientists might discover that being a secularist makes you happier and, on this basis, recommend that people become secularists. The recommendation is not the same thing as discovery, however.

    For this reason, it is simply NOT true that science is already in the business of discovering should’s. Should’s are often propped up on is’s, but the should’s are not science; only the is’s are.

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  27. Ben Finney says:

    That first step is not science, no matter how much science might be involved in the definition.

    Yes. That statement is true of every science, though. Some axiomatic judgement is made on what to measure, what to value, what to describe.

    The frustrating thing is that you think this somehow contradicts anything in Sam Harris’s book. He says, many times, that science is inextricably “in the values business”, by which he means exactly the point you’re making here.

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  28. Joey Frantz says:

    Ben–

    It does, actually, contradict something in Harris’s book, because it is not true of every science in the same sense. The abstraction of health is tied in with human preferences in a way that other abstractions, like gravity, are not, provided that “health” is understood to mean “what is good for a person’s functioning.” Sam Harris is free to devote his life to maximizing the “well-being” (whatever the hell he means by that) of beings-at-large, but it is not a fact of the universe-at-large that people should act that way.

    So we have value-laden abstractions, like health and morality, and we have scientifically useful abstractions, like intelligence or gravity. This is a relevant distinction that undercuts Harris’s thesis, because it means that his moral realist stance is not a scientific one. The desire to be healthy and the desire to make people happy are values, not accurate truth-claims.

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  29. Sean says:

    I have no interest whatsoever in disagreeing with Sam Harris just for the sake of disagreeing. From my first post on the matter, I tried to make clear that I think science is very important to the elucidation of a comprehensive theory of morality, once we agreed on some non-scientific moral premises from the outset. If he agrees, nobody would be happier than me. (But I do wonder why he would write articles entitled “how you can derive an ought from an is.”)

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  30. Ben Finney says:

    If morality is not-a-science in the same way as medicine is not-a-science, I think that’s a perversion of the term “science”. The things you’ve said about medicine don’t disqualify medicine from being a scientific subject, and they don’t disqualify morality from being a scientific subject.

    Since it seems we disagree on definitions, there isn’t much further to do.

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  31. mazeRunner says:

    Hmmm, looking at these posts methinks Sam should probably have argued for both health and morality being more sciencey than are ususally made out to be instead of trying to analogize morality past the science barrier with health. Now it seems health too is in the same boat as morality.

    @Joey in 25, maybe. But if you’re a consequentialist, there’s nothing much outside of “positive psychology” or something very close, in morality braodly speaking. Also its not all psychology, there are real things such as not being tortured to death which may ultimately act through “psychological effects” such as absence-of-pain.

    @Joey again in 26, oh come on man, you dont seriously mean that. You’re quibbling here.

    But again at the risk of appearing exasperatingly repetitive, couldnt it be argued that health defined as Sean is trying to would defeat the purpose of the whole exercise, since no sane being would define health as death, no matter however fuzzy it might otherwise be held to be? Didnt Sam already say we shouldnt take such definitions seriously any more than we take the asylum dweller’s definition of anything seriously?

    Moreover is health purely a statement of preference? Isnt it supposed to track something about the beings’ state of existence in reality? Like what of an unconscious/opinion-deprived being’s health? If I say my computer is in bad repair, it is in bad repair, irrespective of what opinions my computer may hold about health. Ditto for terminal babies. Isnt that objective enough? Maybe health is the wrong word for this, I dunno.

    Couldnt we make similar arguments about morality and say when we’re being serious i.e concerning ourselves with a normative set of beings, without taking seriously the likes of madmen’s, babies’ opinions, that certain things are empirically good and certain things are empirically bad, with the givens being such beings’ existential conditions especially their biological/psychological make-up and useful definitions of good and bad? Wouldnt that be as practically scientific as it gets in say biology wrt how we define life?

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  32. Stu says:

    Sean,

    How is picking a ‘first principle’ of health or morality different than say picking a first principle of Geometry? Like parallel lines never cross (which if I understand Geometry, isn’t provable as true without using the Geometry that arises from taking it as true in the first place). Is that statement just as outside of science as ‘living without infection’ is to health, or ‘living without mental abuse’ is to morality?

    It seems like it is to me, but I think I’m being to simplistic with it.

    thx.

    -Stu

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  33. Sean says:

    Stu– geometry isn’t science! It’s math, which always starts from some set of axioms and goes from there. It doesn’t matter whether the axioms are “true.” Science attempts to describe reality, so it cares very much about which premises are true, and the way it makes decisions about that is by doing experiment. In morality we also need to start from premises, but those premises can’t be tested by doing experiments.

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  34. Lovei says:

    A bit of topic but as a clinician, I applaude at a physicist aware that disability is a far more tricky concept most would think. I also sight at a physician not aware that her own perception of good treatment may differ from the perception of some of her patient, and that it is patient’s aims that should have priority. These old ways of thinking are long to kill… maybe because it is not a matter of science, as Sean emphazised.

    To put some flesh on the bones, consider a 95 y old patient at high risk of fall. Good practice, according to some physicians, would be to use contention. If what matters above all is longer life, this is definitly the good practice -many patients will agree and even ask for it. Some others will prefer taking the risk to fall, despite this is very dangerous for them (their muscles and bones usualy can’t take it -see the statistics of mortality, it’s freaking).

    According to the present laws and ethical codes, physicians need to check whether the patient fully understand the consequences, but then must also respect patient decision even if it’s not confortable for them -of course no clinician like when a patient fall then dies or lose his remaining autonomy.

    Last word from a very old man, dead now, who had lived long in but managed to escape from a country leaded by a dictator. He was still was very lucid at the time he faced this question for himself -the tests proved it. He said: Miss doctor, when security is everywhere, freedom is nowhere.

    Sometime even the most old-style physician has no choice but to hear her patient. ;-)

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  35. ollie says:

    I don’t know how many people remember “Fuzzy Set Theory” but it appears that being healthy falls into that category.

    But yes that is an interesting question: what does being healthy mean? Example: I had knee surgery this July to cut away torn cartilage (3 places, it turned out) yet prior to that (when I knew I’d be getting surgery), I was able to walk for 3-6 miles at a time; I was just on heavy doses of NSAIDS.

    I suppose that one problem is that when one attempts to assign a metric to something like health, one necessarily uses a projection map of some sort and thereby loses information.

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  36. P says:

    The more I read or hear the views of Sam Harris, Christopher Hitchens and Richard Dawkins the more I realize how out of depth they are regarding what Science really is. Dawkins at least deserves some respect but definitely not the other two. It is really a wonder to me how Harris and Hitchens have captured so much undeserved public attention.

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