Healthcare and the Limits of Reason

I'm sure that in the groves of academe they are shaking their heads over the outpouring of opposition to the president's health plans.

After all, it's pretty clear that we can't go on as we are. Someone is going to have to formulate a rational national policy on end-of-life care and regulate the offerings of insurance companies. Better leave it to the experts in medical ethics.

I had an epiphany on all this a few years ago when I read Sam Harris's The End of Faith. After roundly critiquing religious faith for a few chapters he began to develop his own ideas. It was strong on meditation and "rational ethics."

Well. There is a problem with that, Sam old chap. By the time you have got to a rational ethics you have already made the serious decisions. Let's illustrate the point with abortion.

Some people think that the laws on abortion should turn on the question of the beginning of life. And life, the activists say, begins at conception.

Other people, including the Supreme Court at one time, believe that the question turns on viability. At what point can the fetus live outside the womb? Obviously, this allows for early-term abortions, since a fetus in the first few months of pregnancy cannot survive outside the womb.

Still other people argue that a woman has a right to control her own body. On this view, it is clear that abortion is permitted up to, and perhaps including, live natural birth.

Some advanced thinkers are proposing a return to infanticide; someone will have the power to determine if a born-alive infant shall continue to live.

Then you could say that, as in the days of the patriarchy, the father has absolute power over the lives of the people in his household.

Now, it seems to me that you can build a rational ethics out of any of these approaches to the question of taking young life. What matters is your defining value about when it is permissible to take human life.

And that, of course, follows the traditional view of logic and reasoning. You start with certain premisses, and you then argue, using the rules of logic and reason, to prove certain conclusions.

So the experts in the liberal academy are missing the point. They are taking their view of human life as an incontestable premiss. But, of course, it is precisely their assumption that is in question.

The work of Zeke Emanuel, for instance, assumes that we should take a utilitarian view of human life. We should focus health care resources on productive people in the middle of life and less at the beginning of life and the end of life.

But that conflicts with the natural instinct of women, which is to care for the people they love, especially babies, and even including their ageing mothers.

The question is: who is right? The rational experts or the loving women?

I'm inclined to go with the women. Obviously, the obsessive care of loved ones is one of the great forces in the story of life--particularly mammalian life.

Rational speculations have their place. But I think that we need to be careful how far we extend it. There is a limit to the utility of reason.