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.

36 Comments

36 thoughts on “Morality, Health, and Science”

  1. 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.

  2. 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.

  3. 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.

  4. 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.”)

  5. 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.

  6. 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?

  7. 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

  8. 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.

  9. 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. 😉

  10. 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.

  11. 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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