The Religion of the Good, Part 2

A recent New Yorker profile of the philosopher Derek Parfit mentioned that the late Bernard Williams once dismissed the ideal of a universally compelling moral code as (I paraphrase) "something you use on the men who come to take you away." Indeed, implied in the "problem of evil" is the conviction (or fantasy perhaps) that if we could only find the right combination for the great moral mystery vault, the ponderous door of error would swing open, releasing a radiance that would burn away the scales from the eyes of the benighted.

I imagine that some religious believers have a similar feeling that if they could only depict or praise God rightly, his existence and glory would be as plain to everyone else as they are to them. The holy grail of thought is the proposition (or grand scheme of propositions) that is as self-evident as 2 + 2 = 4 but as transcendent and as life-changing as the existence of God. That is the constructed idea(l) that we imagine would stop the bad men in their tracks and bring them to their knees. If God does not exist, then it will be necessary to invent (it)--this is the project that is at least implicit in non-relativistic philosophy. As Wallace Stevens wrote, "One day they will get it right at the Sorbonne."

I once read a review by Helen Vendler in which she claimed that the role of the critic is not only (or even primarily) to explain or to justify, but also to celebrate. Similarly, I think that for anyone who reflects seriously about the moral life, explanation and justification go only so far, beyond which point one can only aspire to praise and embody one's views. The barbarians who burn down the monastery are unfazed by the crucifix; likewise, no secular moral system achieves the potency of a talisman. To accept this is also to accept a troubling existential diversity in human nature--other people see the great questions in the same way that I do, except when they don't do so at all. Perhaps the Tower of Babel is the central metaphor for humanity, making us the most atypical species. There is a strain in philosophy that seeks to tear down the tower in favor of a second Garden of Eden, done rightly this time.

The problem is that many men (most of them, alas, have been men) have been sure that they beheld the Truth, and terrible things have been done in the name of Truth. The point is to religiously (in the generic sense) embrace a system of meaning while avoiding clinical or moral insanity. Just as Satanism may be an internally consistent religion, so may there be functioning philosophies of evil (National Socialism, al Qaeda, etc.). We denounce them not because they have no justification (they do have their internal justifications), but because we find them pernicious and repugnant. Our grounds for doing so may be ultimately contingent on the creatures that we evolved to be, but that is the best we can do--we can never escape history by inventing ourselves de novo. By and large, we also happen contingently to find the blues and golds of sea, sky, and sun to be gratifying, and we can only be grateful that we do so. The truth is not given in any simplistic way, but there is also no truth that does not derive, in some fantastically complicated way and filtered through many generations of human consciousness, from our origin.

The Religion of the Good

A couple of weeks ago, in the New York Times philosophy feature "The Stone," Joel Marks confessed his loss of faith in objective morality:

"I thought I was a secularist because I conceived of right and wrong as standing on their own two feet, without prop or crutch from God. We should do the right thing because it is the right thing to do, period. But this was a God too. It was the Godless God of secular morality, which commanded without commander--whose ways were thus even more mysterious than the God I did not believe in, who at least had the intelligible motive of rewarding us for what He wanted us to do." (Italics in original).

Marks goes on to claim that even if we withdraw the quasi-theistic vehemence of our confidence in objective morality, and thus acknowledge the mere contingency of our beliefs, this needn't change our actual practice. We continue to believe what we believe and have the right to advocate our views in accord or in competition with others, but according to Marks, we can never claim that the views of others are wrong, only that they lead to different consequences. Such advocacy would seem able to achieve moral consistency, and not full justification. For instance, Marks notes animal welfare as one of his central preoccupations. Alluding to the basic moral tenet that avoidable suffering is wrong, one may educate others about animals' lives in factory farms, but not add the emotional force of moral disapprobation (which, Marks maintains, may provoke resistance or resentment as much as anything).

I think that this is wrong and that it mistakes human moral development. At a certain level we embrace certain traditions, rituals, and moral standards not because we pretend to ultimate moral justification of them, but because the alternative is chaos. We raise our children to believe that certain behaviors are not merely different from what we happen to do--they are wrong. We watch football rather than soccer by virtue of mere geographic contingency; while we may prefer football, we recognize that this is likely due to acculturation and habituation. But when we say that it is not right to abuse animals, we assert that this true everywhere and for everyone.

Secular morality does therefore partake of the emotional conviction of religious faith, but this reflects its fervor, not its groundlessness, and hence is a mark of strength and not weakness. The "God" of secular morality is an impersonal ideal that we collectively construct, not a personal interlocutor that we discover. There are, of course, many versions of this "God" just as there are many versions of the God of the Christian church (and obviously Islam and Judaism). But I think there can therefore be a fundamental secular referent of the term "Godless," which denotes not merely he who lacks faith in the supernatural, but he who is unable or unwilling to shape his behavior according to moral ideals and/or the suffering of others (conduct which we may designate as psychopathic or evil).

Near the beginning of Terence Malick's "The Tree of Life," the narrator comments that there are those who live in a "state of nature" and those who live in a "state of grace." We live in a "state of nature" insofar as we merely gratify our impulses, even if to the detriment of others, or complacently embrace our (evolutionarily) contingent dispositions. And there is a secular version of the "state of grace" whereby we believe ourselves to be free to (collaboratively) fashion a moral ideal.

The "religion" of secular ethics is prey to the same pathologies as conventional religion, i.e. propensities to rigidity, dogma, self-righteousness, hypocrisy, and exclusion. But it is also offers the same potential for affiliation and transcendence (if not, granted, the same degree of narrative interest or life-after-death consolation). I consider myself agnostic because I do not find any of the world's supernatural deities to be existentially compelling, but my attachment to, say, the Golden Rule (among other moral precepts) does have, as Joel Marks rightly argues, a good deal of faith to it. But inasmuch as there can really be no doubt as to whether the Golden Rule exists, this my attitude could be said to involve love more than belief.

Doctor Death

"Will you tell us when to live, will you tell us when to die?"

Cat Stevens

The execution of Albert G. Brown, Jr. in California has been delayed not only because of legal concerns, but also due to dwindling supplies of sodium thiopental. In my eight years of doing ECT we often had to switch back and forth between methohexital and thiopental (both barbiturates) because for whatever reason national supplies recurrently ran short. Why I wonder?

I remember that the morning of Timothy McVeigh's execution some years ago was an ECT day, and incredibly, the anesthesiologist involved (not one I usually worked with fortunately) commented before the patient was asleep that pre-ECT drugs and lethal injection drugs are similar (big differences: ECT involves supplemental oxygen and therapeutic effect; execution, not so much). When it comes to surgical types, the stereotypes are generally true.

The article mentions, to morbid and comic effect, the assurances of the spokesperson of California's Department of Corrections that adequate thiopental was available "to stop Mr. Brown's heart." Absurdly, the drug's maker then objected that its product was not "indicated for capital punishment."

Capital punishment is ultimate faith in the power of the state, which makes the conservative case for it puzzling. Execution is misguided for the same reason that suicide is misguided--in both cases death's finality overlooks the perennial possibility of human errors of judgment, whether of culpability or of the value of one's own life.

In any case, making execution into a quasi-medical procedure is a mockery. If we will celebrate death and its deterrent effect, let us haul out the gallows and the guillotine.

Science Run Amok

Every art and every inquiry, and similarly every action and pursuit, is thought to aim at some good; and for this reason the good has rightly been declared to be that at which all things aim.

Aristotle (trans. W. D. Ross)

Over at Edge, Sam Harris writes on science as it may apply to morality. He raises many compelling issues, but his piece exemplifies the grievous attempt to extend the relentless rigor of science beyond its rightful purview. If nothing else, the article is worth reading for its sheer effrontery (leave aside the moral debates of three thousand years, it's really rather simple!).

Harris argues that the force of science may be brought to bear on the problem of morality in three respects, not only anthropologically (documentation of actual ethical practices), but also as regards the ends of morality (which he stipulates as the well-being of conscious creatures), and surprisingly the art of persuasion, that is, bringing the benighted into the orbit of the empirically right-thinking.

His method is to claim that since the methods of science (i.e. evidence, consistency, parsimony) depend on consensus, and morality depends on consensus, then they are parallel endeavors; that is, normative moral phenomena--the ways one should live--are objectively true or false in the fashion that physical states of affairs are true or false. In other words, one may dissent from scientific methods (appealing, presumably, to revelation or intuition) just as one may opt out of moral claims, but to do so, Harris implies, is to place oneself beyond the pale. He also draws an analogy with economics, suggesting that just as goods and services may (theoretically) be generated and distributed in an objectively optimal manner, so is there a neutral calculus of human well-being.

The problem is that one may recognize many modes of human well-being without falling into the mire of moral relativism. To be sure, we are not entirely adrift in ambiguity. It is uncontroversial, for instance, to suggest that the citizens of Switzerland are better off in absolute terms than those of North Korea, just as it is safe to say that Bach is superior to Kate Perry. However, these are extremes, and most moral distinctions are more subtle. Are Americans better or worse off on average than Germans? Is Bach superior to Schubert?

The real problem for Harris appears to be what to do with the outliers, that is, those unreconstructed folks who fall in with creationism, or those societies that do things like execute adulterers. But the problem is that those with whom we disagree do not generally object to human well-being; they merely assess it differently. Those who oppose abortion or even stem-cell research believe that a society in which post-conception Homo sapiens are not disposed of is, on the whole, a desirable one. Muslim societies that discriminate against women or execute adulterers believe that they do so for the average benefit of all. Even Hitler believed that he was adding to the sum total of moral goodness (of the human beings who mattered to him). Can the methods of science, as opposed to moral consensus, really prove otherwise?

If so, there would presumably be some foolproof method, as yet undiscovered, of ascertaining comparative well-being. Are Californians better off than New Yorkers? How about men and women? Doctors and lawyers? The very notion is absurd.

Unsurprisingly, given the ambit of this blog, the matter may be best approached through the lens of psychopathology. In the various realms of fact, of morality, and of aesthetics, there are those with whom we merely disagree and those who are indeed beyond the pale. For instance, the evidence supporting the human contributions to global warming is strong, such that those to disbelieve are suspect and perhaps perverse, but nothing more. However, those who hold that the moon landing was faked or that Barack Obama was born in Kenya are, properly speaking, delusional in the sense of the cultural fringe.

Similarly, Auschwitz and North Korea are examples of psychopathy and megalomania, respectively, both of which may be held to be forms of moral delusion. In contrast, those who object to abortion or secularism are those with alternative moral views. Except in jest, there is no such thing as aesthetic delusion, although it seems to be ubiquitous.

The problem with applying the authority of science to moral and aesthetic realms is twofold. First, the external world exists independently of us, and is has certain characteristics and laws that we come to understand more or less accurately. Science is supreme here--no other technique for fathoming external reality comes close. However, ethics and art are not external to us--they are generated by us, and are found after the fact to be more or less admired or salutary. In science consensus as to method is the means to an end, but in matters of morality and art it is consensus through and through.

The second problem is that science leads inexorably to technology; understanding here implies the power to control and manipulate. And unfortunately the history of trying to engineer consensus in morality and art where it does not naturally exist is not propitious. For when we apply technological methods not to external reality but to human reality (ourselves), strange things start to happen. Yes, human beings and societies have a material reality that is subject to science, but that reality also supersedes and frames the very undertaking of science. Ethics and art are not technical problems to be solved but perennially unfolding realities to be experienced. The moralist and the artist are gardeners, not machinists.

Piscivores

"...until everything

was rainbow, rainbow, rainbow!

And I let the fish go."

Elizabeth Bishop, from "The Fish"

There is a book out that purports to demonstrate that fish feel real pain, which is not a mind-boggling surprise. At Salon Linda Kernohan discusses her vegetarian vicissitudes, including occasional ambivalence about fish, experiences that are pretty similar to my 18 years of meat-avoidance. The main difference is that I never aspired to veganism--it always struck me as too fanatical and puritanical and, ironically, as a kind of denial of the intricate web that we cannot help sharing with other creatures.

To live is to do damage, even if it is to the insects trodden unawares underfoot. There is also the fact we all benefit, as eventual patients, from animal-related medical experimentation. We affect animals by doing anything that emits carbon. It is disingenuous to suppose that in any aspect of our lives we do no harm. That is no argument, of course, to abandon harm-reduction.

I think vegetarianism turned me off on pure philosophy forever. Let me explain. When I first encountered Peter Singer's Animal Liberation in my early 20's, his arguments seemed so prodigious, and ultimately so irrefutable, that I was converted and remain so to this day. However, it didn't take long to realize that not only friends and family, but the vast majority of the human race, remain unmoved by such arguments. I am hard-pressed to think of any other routinely accepted behavior that has such little ethical justification. (Friends and family remain non-vegetarian, which I fully accept of course, and I do not foist my diet upon my children).

The only competitor to meat-eating as mainstream ethical violation may be the blithe acceptance of vast swaths of absolute poverty by prosperous first world citizens, of which I am every bit as guilty if not more so than the next person, so my ethical achievement, such as it is, is selective. Interestingly, Peter Singer has written passionately and prolifically about that issue too. At any rate, these examples convinced me of the relatively small role that justified reasons play in human conduct. So much the worse for philosophy, which always sends me back to religion, literature, and psychology, that is, to the constellation of contingent human needs, among which formal ethics constitutes only a minor part.

Kernohan's vegetarian experience is interesting in a couple of respects. She mentions not missing meat, so it's not as if her day-to-day life is some kind of triumph of self-denial. I recall enjoying meat twenty or more years ago, but it does not feel like a privation. Like her, I eat fish rarely, maybe once every month or two, and it's hard to say why. Maybe it is knowingly wicked self-indulgence (vice on a very small scale indeed).

Kernohan also raises the intriguing issue of depression and vegetarianism, in this case wondering whether subtle dietary deficits could affect mood in ways we don't yet fully understand. However, while she acknowledges other factors that of course may be related to depression, I wonder if she has it backwards. That is, could a depressive tendency and a certain moral and emotional squeamishness predispose to vegetarianism? Who knows, maybe not only vegetarianism, but political liberalism as well, could for some be outgrowths of Melanie Klein's depressive position, a morbid intolerance of suffering? As Nietzsche wondered, if one is virtuous at all, is one virtuous from a position of strength or from one of weakness?

Means and Ends

"Faith" is a fine invention
When Gentlemen can see --
But Microscopes are prudent
In an Emergency.

Emily Dickinson


Psychology Today had an interesting post by Norman N. Holland, Ph. D., who specializes in psychology and the arts, suggesting that psychology belongs more to the humanities than to the sciences. I find the suggestion at least somewhat persuasive, but not necessarily for the reasons he advances.

Holland points out that knowledge cumulates in the sciences, but not in the humanities. Postmodern quibbles aside, we can say that contemporary physics involves an objectively more true understanding of reality than, say, 17th century physics. But contemporary literature or philosophy represents no objective advance over the work of Milton or Spinoza (indeed, some might say quite the opposite). Science progresses, while the humanities are a neverending conversation about meaning and value.

So far so good, but Holland then claims that scientific research in psychology is not in fact amassing real knowledge, because empirical studies now necessarily involve such minute areas of focus, with such tightly controlled variables, that they do not contribute to a meaningful overall theory of mind (he doesn't use this example, but he might have alluded to the fact that despite thousands of studies carried out over decades, we seem no closer to a scientific understanding of consciousness than we ever were). That is, we have oceans of data, but they do not cohere into real understanding, and psychologists can carry out thousands more experiments, focused on increasingly miniscule areas of brain function, without changing this fact.

I don't find this argument convincing for a couple of reasons. In all the sciences, whether particle physics or marine biology, researchers must focus on narrow areas of interest with rigid variables; the second-order task of science is to combine these over time into a broader understanding. It just takes a long time. And when it comes to the brain, which arguably is the single most complex phenomenon in the known universe, it could be expected to take a much longer time. The fact that many trivial tenure-supporting studies are done, and no grand unified theory of the mind has yet emerged, does not mean that progress is not being made.

I would maintain that, beyond the cumulation of knowledge or the lack thereof, there is a more crucial distinction between the sciences and the humanities, and that is the difference between means and ends. Science is the domain of how things are, and the humanities is the domain of how things ought to be, that is, what and how we ought to value. Via technology, science also concerns itself with how things may be materially modified, but neither science nor technology can ultimately contribute much to the question of how things should best be appreciated, and whether in fact they ought to be modified.

The humanities obviously don't "decide" such questions conclusively or universally; they entail a fluid, continually changing dialogue in the form of historical, philosophical, and aesthetic inquiries. Every science and technology has its corresponding humanistic dimensions involving the proper places of fact and engineering within human experience. The difference with biology, and particularly psychology, is that the focus of study is human identity itself, not an object out in the world.

So the point is not that real factual understanding of the brain is not occurring, or that we will not eventually have massive potential to modify the brain even in subtle ways. The point is that consciousness is inherently a dynamic entity, and one engaged in essential value discrimination, on its own and in relation to other minds. The latter is the humanistic endeavor, and when it comes to the mind regarding itself, the stakes are highest of all. One can imagine a future neuroscientist describing and cataloguing an individual mind in all of its exhaustive attributes and propensities; but the subject may always respond, "Okay, that's what I am today, but I want to be...something else tomorrow, yet I'm not sure what." That is where the humanities, as opposed to science, come into play.

Hippocrates and the Hangman

"Many that live deserve death. And some that die deserve life. Can you give it to them? Then be not too eager to deal out death in the name of justice, fearing for your own safety. Even the wise cannot see all ends."

Gandalf, The Fellowship of the Ring

Granted, when it comes to the question of capital punishment, those on death row tend in their character to be more like Gollum (for whom Frodo desires death in this Tolkien quote) than like Socrates faced with the hemlock in Jacques-Louis David's famous painting. And it is noteworthy as regards the quote that contemporary America endeavors to give (deserved) life to those fated to die every bit as aggressively as it seeks to give (deserved) death to those otherwise fated to live after committing heinous crimes. In this respect capital punishment is a grim mirror image of the out-of-control medical-industrial complex. Even the wise...

This came to mind after a recent local story in which the Supreme Court of North Carolina decided (4-3!) that the state medical board cannot in fact discipline physicians who participate in executions (i.e. by monitoring vital signs to insure that the inmate is "not suffering"). Death sentences, which had been on hold for a couple of years because of this question, can presumably start up again.

It took me years to decide where I came down on the question of the death penalty. I used to be for it, as I've always had a healthy respect for evil as a real force in the world, and as Tolkien wrote, in terms of abstract justice there are people who have done things so awful that they deserve to die. However, in an odd parallel to the question of the possible rationality of suicide, I think that the absoluteness of death precludes, in practice, the ethically justifiable intentional taking of life for any reason but direct and obvious self-defense (any society-wide deterrent effect of capital punishment is debated, and is definitely not direct and obvious).

Capital punishment, like suicide, is a declaration that this particular person's life cannot be considered worth living; in an execution the state effectively commits suicide on another's behalf, conflating vengeance and penance. In this sense it is richly ironic that those on death row are not permitted to commit suicide, and indeed may not be considered "competent" for execution if they are suicidal. Both execution and suicide are acts of dreadful certainty: "By the permanence of this act I affirm that I (or we, the state) cannot possibly be mistaken, that things could never come to be different, whether through additional evidence or altered perception." Playing God, indeed, although to do so with someone else's life is rather different, isn't it, than to do so with one's own?

What physician would want the job of monitoring an execution? I suppose it could be a deeply ethical act, inasmuch as the about-to-be-executed are, by definition, those who have had every human right stripped from them--except for the right to freedom from inflicted physical agony. Another irony, as Atul Gawande's recent New Yorker article painfully described, is the regular use of long-term solitary confinement, which arguably inflicts emotional distress far more horrific than the physical pain someone could undergo during lethal injection. What is the difference? Well, there are media and family representatives observing an execution, but in a solitary cell, not so much. Very discreet.

I always come back to Oliver Cromwell's (paraphrased) admonition, "I beseech you, in the bowels of Christ, consider that you may be mistaken." Suicide means blinding oneself to the possibility of the ultimate error. Execution leaves this possibility open, but removes the option of ever rectifying it. Eventually the civilized world will view capital punishment much in the way it views slavery, as beyond the pale (much of the world does already actually, we just haven't joined it yet).

The Green Night

"O beware, my lord, of jealousy! It is the green-eyed monster, which doth mock the meat it feeds on."

Othello


As Natalie Angier points out in her interesting NYT article on the neurobiology of vice, envy and jealousy are distinct emotions, the latter referring chiefly to possessions potentially lost, the former pertaining to either goods or broader states of being never attained. But we easily recognize them as stemming from the common root of a resentful scarcity of the self. For anyone who has experienced them--and I presume we all have at one time or another--it is hard to say which is more unpleasant, forever gazing up at a desired peak--or falling from it once there. Most of us experience envy or jealousy trivially or transiently; some unfortunate folks make them into a pastime.

Envy apparently has an ancient association with green, perhaps because it was recognized as a kind of moral malady (yellow or greenish skin has long and rightfully been seen as a marker of illness). As Angier notes, envy is a peculiarly ungratifying sort of vice, except when it can be "successfully" discharged as schadenfreude. I think we tend to view the deeply envious as more pathetic than vicious, but all the same it is not a state of mind--advertising as it does the envier's incapacity and ingratitude--that inspires admiration. Envy seems a distinctly spiritual and existential sort of ailment.

The article's least illuminating aspect, actually, is its description of neuroimaging experiments (eventually to be assembled in the Annals of Tautology) designed to show that schadenfreude relates to an area of the brain (the ventral striatum) associated with dopamine and pleasurable experience. We need scanners to tell us this? Do they mean to say that envy, like every other experience, comes from the brain and not from an ethereal soul?

In the psychotherapy literature, envy is advanced as one reason why narcissism is so hard to treat. The narcissist has trouble being healed by a therapist because he envies what the therapist presumably has, i.e. relative well-being and peace of mind. Envy and resentment threaten to undercut the very person trying to help him. This is a distortion of the healthy "idealizing transference" (admiration, basically) that tends to occur in therapy. One admires someone who is seen to occupy a high position that one might conceivably reach as well; one envies the high position that seems unattainable. I suppose the challenge of psychotherapy is to make the unattainable seem attainable, but by constructive self-development rather than by resentful attacks on others. And some find it helpful to regularly practice gratitude as an antidote to envy.

Sociologically we would seem to be the envious species par excellence. The resentment of the technologically and economically backward Muslim world has been blamed, rightly or wrongly, for 9/11 and Al Qaeda. And as capitalism has threaten to careen out of control in recent decades, our keeping-up-with-the-Joneses status anxiety, i.e. envy, has been widely cited. Buying the McMansion, the late model car, the newest Ipod: all are preventive measures for envy, but like a colonoscopy (how's that for a metaphor?) these acts buy tranquillity only for a while. Envy is an evolutionary treadmill of the mind; at some point one just has to jump off.

Everyone a "Philosopher"

First (the Dodo) marked out a race-course, in a sort of circle ('the exact shape doesn't matter,' it said) and then all the party were placed along the course, here and there. There was no 'One, two, three, and away,' but they began running when they liked, and left off when they liked, so that it was not easy to know when the race was over. However, when they had been running half an hour or so, and were quite dry again, the Dodo suddenly called out 'The race is over!' and they all crowded round it, panting, and aking, 'But who has won?'

This question the Dodo could not answer without a great deal of thought, and it sat for along time with one finger pressed upon its forehead (the position in which you usually see Shakespeare, in the pictures of him), while the rest waited in silence. At last the Dodo said, 'everybody has won, and all must have prizes."

Lewis Carroll

Courtesy of Arts and Letters Daily, I found a compellingly spot-on take on contemporary moral relativism by Anthony Daniels at New Criterion (for such a profound issue, his analysis is remarkably brief and easy to read). Basically, his thesis is that moral relativism results when we grow too impatient for absolute and irrefutable philosophical justifications for ethics and morality. When no secular version of the Ten Commandments is unanimously forthcoming, the automatic fallback position is, "Well, then everything is relative."

It is a kind of black and white thinking: if ethical guidelines do not club us over the head with irrresistible force, then they must be wispy and dispensable. We crave an ethical absolute that, outside of religious strictures, is no longer available. It's a bit like violating a diet one is on and then deciding, "Well, what the hell, I may as well eat everything in sight."

Why is relativism increasingly a problem? Daniels has some interesting answers. One is the relative decline, in global terms, of Western political and cultural influence as compared to Asia (and, as I would add, Islam--could it be that some Westerners, viewing the fanaticism that characterizes a small but highly visible fraction of Muslim culture, implicitly decide that maybe relativism isn't so bad by comparison?). Second, the broadly decried emphasis upon individualism and consumption for several decades now has coarsened moral considerations.

But third, and interestingly, he suggests that, well, increasingly educated populations are less satisfied with the kinds of simplistic (but potentially useful) moral doctrines that prevailed in centuries past (think the Ten Commandments, the Golden Rule). That is, the average man on the street is much better than his ancestors at sophristy, that is, bending philosophical arguments to suit his own inclinations. He has just enough knowledge to be dangerous.

The problem is that as many philosophers of course have argued, ethics broadly considered draws on far more than the working out of logical syllogisms in some university library. It depends on evolutionary psychology, which hasn't much changed we can assume. But is also rests on the cultural consensus of shared tradition and decorum, on a kind of moral common sense that we increasingly seem to have lost. As individuals and as a culture, we have become clever enough to question and undermine communal common sense--but as my son teaches me anew every day, it's a lot easier to take things apart than to put them together.

I see an interesting correlate here with psychiatric diagnosis. Some seem to think that if mental disorders aren't as structured and as clearly laid out as, say, the periodic table of the elements, then they don't exist, or are merely social constructions. But there are levels of cultural common sense, the sense of ethics and the sense of illness, both of them falling under the wide rubric of the sense of the proper way to live. The common theme here is the tolerance, or lack thereof, for ambiguity, which is the natural habitat of ethics, law, and medicine.

The question is how much whole cultures can live with ambiguity. Socrates died because he was accused of blurring the clear black and white signposts that were "the gods." Those signposts served useful purposes, but they were also used to bludgeon people to death (just ask the Grand Inquisitor). But did Socrates have a substitute that whole cultures can live with? Can people live amid infinite shades of gray, without going blind or starting to hallucinate?

What is the good life anyway? Supposedly W. H. Auden said or wrote somewhere, and I paraphrase, "The purpose of my life is to help other people. What they themselves are good for I have no idea."

'Tis the Season

Hamlet: Denmark is a prison.

Rosencrantz: Then is the world one.

Hamlet: A goodly one, in which there are many confines, wards, and dungeons, Denmark being one o' the worst.

Rosencrantz: We think not so, my lord.

Hamlet: Why, then 'tis none to you, for there is nothing either good or bad, but thinking makes it so. To me it is a prison.

Over the weekend I finished reading philosopher Susan Neiman's Moral Clarity: A Guide for Grown-up Idealists. If you're looking for a last-minute gift for the amateur ethicist or preoccupied moralist on your list, and I'm sure you are, I recommend it. It has me feeling all Christmasy (?).

In an era of divisive political polarization it is difficult to convey the sense of an ethics that stems neither from self-interested identity nor from might-makes-right "realism," and Neiman makes as a good a case for Enlightenment values as one could for the general reader, I think. This is not meant to be a review (Simon Blackburn's for the New York Times is here), but the following notions stood out for me (what is the written equivalent of a sound bite?). In Neiman's view:

1. The Left, resigned to identity politics and the postmodern view of ethics as mere "discourse of power," has ceded useful distinctions of value and morality to the Right.

2. The problem is that the Bush administration, while draped in the garb of Enlightenment values, instead pursued policies based on naked self-interest, whether personal or national (often rationalized as "realism").

3. In other words, the Left has risked being amoral and relativist, while the Right has risked hypocrisy. Both tendencies support the complacent status quo.

4. In the recent political climate idealism in general and the Enlightenment in particular have gained reputations of being naive, imperialistic, and simplistic, when they needn't be any of these things. There is a fruitful middle ground between being grimly, resignedly realistic and being pie-in-the-sky naive.

5. The growing influence of evolutionary psychology, while it can shed light on why we have moral impulses at all, cannot be allowed to determine the limits of ethical possibility. After all, the whole point of ethics is not (or at least not merely) description, but rather prescription; we can, even if only with great difficulty and in minute increments, decide to be other than what we, contingently through natural selection, are.

6. Religious believers have no monopoly on ethics; it cannot be the case that "If God is dead, then anything is possible." A valid ethical system must be universalizable, not depending on what any one individual, clan, or nation feels to be a divine command.

7. One of the hardest questions in philosophy is "Why be ethical?" That is, why be ethical in the really reflective sense, rather than just comporting oneself based on self-interest and fear of punishment? After all, a fair number of people (and probably only a relatively small number of them psychopaths) more or less behave themselves in life not because of any deep ethical commitments that they could justify or even articulate, but simply because they don't want to step on any toes or stir up any trouble.

In philosophy (or maybe just in philosophy graduate departments and amateur philosophers like myself) there is the perennial dream of some ethical justification that will open the eyes of the immoralist to the error of his ways. But Neiman, seemingly granting that if such universal and theoretical justification were possible it probably would have been found by now, likens being moral to growing up. I like this metaphor a lot. The egoist who asks why be moral (at all) is much like the teenager (implicitly) asking why one should, in fact, grow up (in the sense, I suppose, of being generally responsible for oneself).

Being moral has several things in common with growing up. Human beings are probably evolutionarily constituted to do both, although with sufficient discretion it is quite possible to get by in life, and at times even to be externally very successful, without doing so. Both are exceedingly difficult to define, but we feel we know them when we see them. Both states are reached not through simplistic or black-and-white theoretical roadmaps, but by complex practices comprising both individual will and social consensus.

They are also alike in that they are never all-or-nothing; everyone struggles against lapses of self-interest or immaturity. Neither sainthood nor purity is reasonable or even desirable. The ethical person and the grown-up can remember and understand well the egoist and the teenager, but not vice versa--the latter cannot really comprehend what they are missing. If you seriously ask for a theoretical justification for being an ethical or a grown-up person, then you're not one (yet).

For some of us the holiday season is not primarily about God or even family time, but rather, if we're lucky, about idealism, both global and personal ("Peace on Earth" and--New Years resolutions). Christmas, appropriately for its ancient pagan origin around the winter solstice, is based on the conviction that no matter how things are now (good or bad), they can get (even) better.

The comparison between ethics and maturity brought to mind, perversely I guess if not for my line or work, another question for which philosophy has long struggled to find adequate answer: Why is suicide a bad idea? Almost everyone agrees that it is, but why? That cheery topic prompted the Hamlet quote above, but my thoughts on it will have to wait until next post.

Thou Shall Return Phone Calls

Before dismounting from my high horse, I will add a ninth rule for psychiatrists (but stopping short of an Old Testamentish ten):

9. Return phone calls. One of the most common complaints I hear from patients about their previous psychiatrist(s) is the failure to return phone calls--and not merely to do so in a timely manner, but rather to do so at all. I can't imagine doing this, any more than I can imagine just not showing up for work. I understand that, except for those private docs able to bill (and collect!) for phone calls, these interruptions of the work day seem to represent unpaid work. But it seems to me that just like the office space and furniture, time spent on phone calls should just be considered a cost of doing business, part of overhead. Of course, there are occasional patients who abuse the right or privilege to reach their doctor by phone, but those cases can be dealt with individually. Sometimes I think that if one wanted to do well in a private practice, a willingness simply to return calls promptly and politely would put one ahead of the game.

Okay, that's it.

Rules for Psychiatrists

Not long ago the NYT reproduced some "rules for doctors" devised by Dr. Rob in his blog "Musings of a Distractible Mind." They are worth reading, and I pondered what some rules for psychiatrists might be; at the risk of being presumptuous, I offer some off-the-cuff thoughts:

1. Even for "med management," take the time (it needn't take long) to get a sense of the patient's unique life story--its stages, its successes and failures, its hopes and goals. Doing so will help him or her to feel more understood, and it should help make the interaction more interesting to you (if it doesn't, this may be a hint that you're in the wrong specialty). I think of this as a mini-biography, distinct from diagnostic formulation.

2. Given the still very ambiguous state of psychiatric diagnosis, spend less time on hair-splitting (bipolar II vs. bipolar NOS?) and more time on what has pragmatically been helpful for the patient over time.

3. Regarding patients who seem rather annoying or downright detestable, in addition to trying to figure out how much this implies about the patient as opposed to the psychiatrist, actively try to find something to like about the patient. If you can't find anything at all, someone else probably ought to be treating him or her.

4. Be alert and don't be naive, but also don't assume you are a mind-reader as regards suspicions of "med-seeking," functional complaints, or whatever. Studies suggest that no one group of people, including psychiatrists, is better at detecting lies than any other. Take the patient's reports at face value until you have uncontrovertible evidence not to.

5. Be on the lookout for "psychopharmacological Calvinism." Substance abuse is real, and it can of course be iatrogenic, but it is also the case that benzodiazepines and stimulants are uniquely helpful for substantial numbers of patients. "Med seeking" is actually a misnomer; if you knew a particular medication to be helpful for your symptoms, wouldn't you "seek" it as well?

6. If the patient can't afford the medication, you're wasting everyone's time.

7. Take side effects seriously. Use every opportunity you can to reduce numbers of medications and dosages--but some people really do seem to need five drugs.

8. Regarding psychiatry's ability to intervene significantly in disorders over time, the discipline is still where medicine and surgery were perhaps a century ago. While the patient must have hope, beware of overconfidence and excessive expectations (particularly since these days the patient often comes in with the latter already). Diagnosis, prognosis, management, solidarity, comfort: these should be possible, even when treatment and potential for recovery are quite limited.

Okay, soapbox complete. I'm open to subtractions and additions.