ELEPHANT TO PLATT, KENNETH, ALL:

I will turn to other species shortly in an attempt to meet Kenneth's concerns 
head on with a suggestion about the moral value of persons.  But first: some 
bald statements just cry out for a good old-fashioned philosophical 
counter-example!  Such as:

> PLATT:
> I see no moral difference between saving the patient or killing the 
> germ. They are both sides of the same coin.

ELEPHANT:
Three examples throw doubt on this claim.

1.  We often require the Germ to live, in a laboratory, in order to extract 
information with which to save the patient(s).  This is not entirely besides 
the point, because it does mean that saving patients and killing germs are 
not the same thing.  You will now qualify your claim and say that saving 
patients and killing germs *in patients* is the same thing.  My other two 
points address this.

2.  Geriatric palliative care.  You can argue that the 'disease' in question 
is just Old Age, but in fact the old tend to die of perfectly identifiable 
disease processes, and that includes germs, cancers etc.  It's generally 
agreed that we should try to save the patient, but it is also agreed that 
saving the patient does not equate with doing everything you can under all 
circumstances to keep biological processes continuing at the expense of all 
'Quality of Life'.  'Saving the patient' turns out to be a complex concept, 
because being a human being is not just being a functioning heart, or even a 
pattern of brain-waves (anticipating the ecg point).  It turns out that 
'human being' is, surprise surprise, a Moral Concept.  Being a 'person' is 
more than being having functioning internal organs.  For this reason, a 
doctor does not save the human being by treating their body as if he has the 
right to do whatever he damm well pleases with it, in the name of fighting 
off all those germs.  There is a duty of care, but there is also a duty of 
respect.  When the respect is removed, you are dehumanising the patient, and 
that is the very opposite of 'saving' the patient.  Doctors who continue 
trying to kill off every germ beyond the point were the patient himself would 
wished to have lived are not 'saving the patient'.  They are completely 
dehumanising and discounting the patient, and treating the body instead.


3.  Imagine a disease which medical science can triumph over, but only very, 
very slowly.  You can think of this in terms of a race to develop a cure, 
while the victim lies prone in his bed and suffers, ventilors keeping him 
alive, for fully fourty years.  In the end we discover the cure and he walks. 
   This same situation exists if we think of ourselves as always having had 
the cure, but a cure which is a very, very slow one.  Like antibiotic 
treatments for tuberculosis only fourty times worse.  Now in this case the 
imperative to save the biological life of the patient and the imperative to 
kill the germ are the same.  But is the patient just his biological life?  
No.  In which case, it looks as if the imperative to kill the germ equates to 
the imperative to keep the poor victim alive and in great pain throughout the 
majority of his life: is that 'saving the patient'?  It rather looks like the 
opposite to me.  It looks like treating the patient as a medical experiment, 
treating him less respectfully that you would your dog. 'Cure a success: 
patient tried to kill himself'.  Certainly it is not giving 'Quality of Life' 
to anyone but the successful doctors. 

I think all these examples show that 'saving the patient' and 'killing the 
germ' are not as near the same as makes no difference.  There is a 
difference, and it has to do with the difference between 'saving the patient' 
and preserving a biological pattern.  It is only biological patterns which 
germs attack - officious doctors can do violence to more valuable patterns: 
and my name for those higher patterns is 'the patient'.  That's why doctors 
owe their (oath of) allegiance to the life of the patient, and not to the 
death of germs.

One way of ensuring that Doctors treat the patient and not the disease is to 
take out something called a 'living will'.  The other is to educate doctors 
into a respect for persons.  But luckily, most doctors are already well ahead 
of Platt on this one.


I suspect that a lot of Kenneth Van Oost's concerns have to do with this 
moral importance of the 'person' - he may correct me on this.  Besides the 
approach to germs, 2 more of Kenneth's points seem to have something to with 
this.  First, there is the worry that valuing 'intellect' means devaluing 
persons who don't have 'intellect' the way Prisig does - Lila comes to mind.  
Kenneth was accusing (Platt's account of) MOQ of being right wing, but he 
didn't mean free market!  He meant 'Social Darwinist' or worse: the idea that 
some human beings are just more valuable than others, and that their 
interests should always triumph.  I think that's a point we need to think 
about, because it sure doesn't look like morality the way most people 
understand it.  It looks like might is right.  The way to address it is to 
point out that the meaning of 'intellect' is being stretched in quite alot of 
directions here.  There's no denying that Prisig is an intellectual and that 
Lila isn't.  But it isn't true to say that Lila has no intellect: anybody who 
can conceptualize has intellect.  Well now, what is it that constitutes the 
higher level: intellectualism or intellect?  There's a big difference.  If 
intellectualism is the higher level, then Lila is grouped with other beings 
that have social value as their highest level of value, like, say, termites.  
But if intellect is the higher level of value, not intellectualism, it turns 
out that Lila is a morally valuable as Prisig is.  She is on the same level.  
This is the way it out to turn out, in my veiw.  

Perhaps, indeed, the moral value of 'persons' or 'intellects', does a lot to 
address Kenneths concerns about MOQ and other species in the animal Kingdom 
too.  Because in point of fact we treat cats and dogs as conceptualizers: as 
intellects.  We rely on them to recognise different human beings as 
different, and this requires that they have, in effect, a concept of you.  A 
dog responds to his owner's command, but not to the same command given by a 
stranger.  Perhaps we have first hand experience of a dogs 'personhood' that 
goes further.  These are beings with an interior world.  They are intellects. 
 That, I think, is what gives them the value they trully have, and it is what 
separates them from germs.

I'm really quite chuffed about this idea for reading the "intellectual" level 
as the level of "intellect" rather than as the level of "intellectualism", 
because it seems to me that it addresses quite alot of the concerns I've had 
about the level.  It seems to me that Prisig treats this higher level as a 
kind of political program - the sort of political progam that can be a 
protagonist in world history, for example.  But intellectualism just can't be 
that sort of program, I have argued, because intellectuals can (and in fact 
do) hold an infinite number of opinions about what is best, intellectually 
speaking.  In contrast, placing value on 'intellects' seems to underpin a 
comparatively clear political and moral program: respect for persons - 
treating the human person as the highest good in medicine, law, sexual 
relations et al.  There is even a familiar ring to this moral imperative: do 
not treat persons as if they were means only, treat them as ends in 
themselves.

I guess the "intellectualism" interpretation would treat persons as being, 
ultimately, only means to the continuation of thought.  That does seem 
cart-before-horse.  Perhaps some remarks about the pragmatic unity 
intellectual theory and personal practice are needful?  Later.



Kenneth, I have found your posting inspiring.  Platt and I may now argue 
about whether or not my suggestion might resemble what Prisig means.  But I'm 
tempted to say straightaway: Prisigian or not, this looks like a very High 
Quality veiw. Shall we call it 'true' then?


ttfn

Puzzled Elephant





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