Sunday, April 16, 2017

Principle of Beneficence

To many philosophers, beneficence and nonmaleficence are almost synonymous with morality. In ordinary language, the term beneficence (or sometimes called benevolence) indicates an obligation to "advance the most important interests of others and remove harms;" that is, to perform acts of mercy, kindness and/or charity. Exercising beneficence can consist in either providing a person(s) with something good, preventing something bad, or the undoing of something already bad. It is usually construed as a teleological principle calling upon us to increase pleasure and reduce pain in others. In order to perform an act of beneficence you must expend something on behalf of another person, usually time, energy or resources. The principle of nonmaleficence (or, the harm principle) refers to the moral obligation not to unjustifiably harm others. Before we can make much sense of these fundamental principles, it is essential that we examine the two concepts that are a part of their common conceptual framework: that is, the concepts of interests and harms.

As Joel Feinberg has suggested, interests are "anything we have a stake in." Obviously human interests can be of greater or lesser value. In fact, philosophers often distinguish between interests that are mere wants (or desires) and needs (or essentials). Harms consist in the invasion of an interest, which suggests that harms can also be evaluated as greater or lesser. Although I may want a new electric guitar, to add to my collection, it’s not really a need. Why? Because I am not really harmed very much if I do not get one! On the other hand, if I was a professional guitar player and my only guitar was stolen, I’d need to get another one. Why? Because, everyone has a substantial interest in earning enough money to meet their needs, and a guitar player cannot make a living without a guitar. Admittedly, there is a certain degree of malleability involved in drawing the line between wants and interests, but we really do all share a common set of needs. As Bernard Gert has argued, generally speaking, we all have a major interest in staying alive; being relatively free of physical and psychological pain, and being relatively free of disability. Conversely, we all agree that death, pain, disability and loss of pleasure are harms, and that all rational persons seek to avoid these harms, unless they have a good reason not to avoid them. The moral principles of beneficence and nonmaleficence require a relatively clear philosophical distinction between wants and needs.

The principle of beneficence implies that assisting others in securing their most important interests (needs) and removing harms is good. It is also nice to help secure their less important interests (wants), but generally speaking, we are not morally required to help others secure mere wants. So I don’t have a moral obligation to wash your car this weekend as an act of beneficence, but if you show up at my house hungry, I’ll gladly feed you! But it probably won’t be "surf and turf."

If some interests are greater than others, then obviously, some harms are greater than others. Rational human beings naturally seek to avoid suffering major harms by risking lesser and/or improbable harms. For example, I got the flu shot this year. It hurt for a couple of days. It took about a half hour of my day that I could have spent reading or playing guitar. But it was a rational decision. Why? Who wants to be sick for two weeks? An irrational person, however, often risks high probability major harms, for reasons that most rational people do not find particularly convincing. Suppose I know that I get the flu every year but I refuse to get the shot because I’m afraid of needles. Is that a good reason? Is it irrational? Is it irrational for a person to knowingly have unprotected sex with a person infected with the AIDS virus? Hint: Does it make sense to risk contracting a deadly, highly contagious disease in order to experience a few seconds of intense pleasure?

So all human beings take risks in order to realize their most important interests and avoid major harms. Rational persons take into account the magnitude of the interests at stake and the probabilities of suffering harm. Irrational persons have unprotected sex with strangers and risk contracting a life-threatening disease, in order to experience a rather intense experience of pleasure for a few seconds. It’s easy to talk about needs and wants in the

abstract, but the fact of the matter is that we do not always know what our own interests are, nor do we necessarily know how to attain them. If we do not always know what’s in our own best interests or how to attain those interests, we know even less about the interests of others and even less about how to attain those interests.

Now, what does all this say about beneficence? Given the fact that we are often confronted by individuals who find themselves in need, (or at least they believe that we are in need), how much of my time, effort, or resources am I morally required to risk (or sacrifice) in order to fulfill those needs? Are there times when I might be morally required to impoverish myself (and my family) in order to fulfill the needs of others? Suppose that I meet a street person downtown, and discover that he/she is desperately in need of expensive dental work. Let’s say a root canal. Am I morally required to provide it, even if it means taking out a loan? Am I a bad person if I do not help out? So what are the limits of beneficence?

As it turns out, this issue is enormously complex. Some philosophers follow Kant and differentiate between perfect duties and imperfect duties. Perfect duties are duties that are absolutely morally binding and require one specific action in order to be fulfilled. For example, I have a perfect duty not to unjustly kill other human beings. It requires one specific course of action: NOT killing another person without a good reason. Imperfect duties are also absolutely binding, but their fulfillment is subject to our own individual circumstances and choices. Hence, in the case of the homeless person with a toothache, I might fulfill the requirements of beneficence by referring that person to an appropriate governmental agency; or, in the very least I might decide to buy him a bottle of Tylenol. If I were a successful dentist, I could choose to provide those services as an act of personal charity, or refer him to a friend that does pro bono dental work. But is it immoral to do absolutely nothing?

Once you discover that this homeless person has dental problems, it dawns on you that others might have that same problem. Are you morally required to canvass the city looking for others in need of dental work? What do you do if you discover that there are fifty homeless persons with serious dental problems? Does knowledge of needy persons, automatically require beneficence? How much of your personal time, energy, and resources are you morally required to expend? If you cannot help everyone, how should you decide who to help? How would you decide? Would it be unfair to help some and not help others? And finally, what if someone has a life-threatening tooth infection but they refuse your offer of assistance? In other words, does the exercise of beneficence require other principles such as utility, justice, and liberty?

There’s also a coterie of other well-known problems associated with beneficence: most notably its tendency to generate unanticipated consequences. Here’s a basic question for you. If you are in need and if you have a choice between: A. Expend your own time, energy, or resources to meet that need; or B. Expend a benefactor’s time, effort, or resources. Would you choose A. or B.? When Hurricane Katrina struck the gulf coast, armies of beneficent volunteers flocked to Louisiana to help with the cleanup. If your property was damaged and would you rather pay an unemployed person from Louisiana to help clean up, or get a bunch of beneficent high school students to do it for free? What would you choose? Duh…Let me guess.

It is a well known fact that at least some acts of beneficence foster habitual dependency upon benefactors. When offered assistance human beings, naturally, reallocate their own time, energy and resources. That is inevitable when your act of beneficence saves someone time, energy, or resources. But you may not agree with their reallocation. They may choose to spend their savings on more cigarettes, alcohol, or lottery or tickets. At least some persons on Food Stamps buy unhealthy foods: pop, snacks, and foods high in saturated fats. On the other hand, they might also donate their savings to their church or another charity rather than stave off future dependency.

Human beings form habits. Once we accept the assistance of a benefactor, we reorder our lives and form new habits. Let’s face it! Unemployment can be habit forming, especially if you are unskilled: so can watching television and hanging out with your unemployed friends. In short, sometimes we need an incentive to work, and sometimes beneficence undermines those incentives. On the other side of the equation, there are some highly beneficent individuals that expend an extraordinary amount of their time, energy, and resources doing charitable work. Sometimes charitable work can interfere with other obligations toward one’s own family and work. Is it really good to spend all of your time at the food kitchen when your children need help with their schoolwork? Sometimes when you expend your time, effort, and resources in pursuit of beneficence, at some later point in time, you may find yourself unable to meet your own needs. Therefore, beneficence can at least sometimes, contribute to future dependency and reliance on benefactors.

There is also a cluster of problems associated with knowing exactly what to do in order to exercise beneficence. Are you really helping an alcoholic if you give him money? Does unwittingly contributing money to an inefficient charity really constitute beneficence? How much research effort should I expend before contribute to any given charitable organization? Similarly, how well should I know the person that I’m attempting to help?

In general we tend to exercise beneficence toward our relatives and friends much more often than we exercise it toward strangers. We’re all egoists at heart. Hence, we all are more likely to spend our time, energy, and

resources padding the wants and desires our relatives and friends, than we are likely to expend our time, effort, and resources in meeting the needs of strangers. Therefore, it’s pretty difficult to acculturate beneficence toward strangers, especially when they live on the other side of the world and do not look like us or act like us. Unfortunately, some of the neediest persons on earth live on the other side of the world in places where it is extremely difficult and expensive to provide assistance. So sometimes, beneficence conflicts with utility.

Nevertheless, we still teach our children to be more beneficent toward strangers. Indeed, that’s why the major religious traditions teach us to "love thy neighbor." But are there limits to what we can realistically expect out of acculturation? Even if we could manufacture a society of generous benefactors, would that necessarily, be a good society? Do we really want to live in a society of dependents supported by benefactors? Does the mere presence of benefactors spawn more and more potential beneficiaries? If so, is the elimination of poverty by encouraging beneficence a viable long-term strategy for the elimination of poverty.

The libertarian view on beneficence is fairly clear cut. Since we are all owners of our time, energy, and resources, it’s up to us individually to decide how we allocate those things. Ownership trumps everything. I own my body, which sometimes provides me with an advantage in the pursuit of my interests, and sometimes it provides a disadvantage. Sometimes my interests do not match up very well with my natural advantages. Even though I’m only 5’9’’ I suppose I could have pursued a career in the NBA, even though I’ve never exhibited one ounce of natural ability in that area. I have some natural talent for playing music, but I’m not anywhere near as talented as most professional musicians. If I had chosen to spend my life in pursuit of playing guitar, rather than teaching college, I would be competing under a decided natural disadvantage, and consequently, I would probably be unable to meet my own needs, let alone the needs of my family.

It is important to acknowledge that libertarians have an optimistic view of human nature. All of us are endowed with natural advantages. It’s up to us to choose to compete in areas where nature has given us a leg up. In short, poverty can be often traced back to bad decision-making: failure to discover, develop, and cash in on our natural endowment. Unfortunately, some of us have natural talents, but choose not to develop those talents. But again, it’s your life.

It is also true that some of us are also saddled with profound disabilities that prevent us from cultivating our abilities. At least some of these persons will be dependent upon beneficiaries for their entire life, such as some quadriplegics, and persons with profound brain damage. (Human being in comas may or may not be persons.)

There will always be a few persons that really need our help, primarily children and persons suffering chronic disease. Libertarians, like everyone else, are willing to donate their time, energy, and resources in order to advance their most important interests. The main difference between libertarians and everyone else is that they are more likely to exercise beneficence more efficiently, and try to help out only those who really need help. They are also profoundly averse governmentally-funded beneficence, which is notoriously inefficient and less likely to serve those who are truly in need.

So libertarians are free to discuss beneficence with one another and make suggestions to one another as to which individuals need help and how to help them. They can choose to form or participate in collective acts of charity. For example, we might decide to pool our resources and form a charitable organization to provide dental care to the needy. On the other hand, you might decide to give to a college or university, hoping to reduce future dependency.

Again, libertarians have a lot faith in human nature. Although we are programmed by selfish genes, human beings are also biologically programmed to experience feelings of sympathy toward other that are in need. Therefore, as individuals most of us are both selfish and fairly beneficent. But we are not unmitigated altruists either. We do feel good when we help out others. Libertarians also acknowledge that there is a darker side to human nature. We can’t deny the indisputable fact that many individuals simply do not need our assistance and that many charities are bogus and/or inefficient. That’s why it’s never a good idea to give to charities that contact you over the phone or over the Internet. Some of them might be worthwhile, but you have no easy way of knowing which ones are legitimate. I think morality calls upon us to exercise beneficence toward individual persons that we know something about, and that we ought to support charities that we know something about. We should also be mindful that charities target different beneficiaries. The Special Olympics, Make a Wish Foundation, and the International Red Cross all try to do good things for different populations. Even if these charities were equally efficient (which is not the case), it would not be easy to decide which one to support. But if you choose to spend your time, energy, or resources in the service of persons (or non-persons) that are not in need or if you choose to support inefficient or bogus charities, you can do that too.

Every year I give a modest sum to my Alma Mater the University of Kentucky, because I know that it does a lot of good by providing educational opportunities. It’s probably not as efficient as a private university, but I am confident that it is pretty efficient. But in the end, the fact is I own my money. I also donate old clothes to several

charitable organizations, but honestly I don’t really do it out of beneficence. I’m mostly interested in getting rid of unwanted garments that don’t fit any more. I don’t pat myself on the back, or brag about it. I don’t deduct that stuff from our income taxes.

Human beings form a wide variety of organizations to serve a wide variety of purposes. We often pool our resources and form beneficent organizations. Local, state, and federal governments also provide beneficent assistance via Medicare, Medicaid, and Food Stamp programs. Local governments provide, things like free health clinics, etc. Libertarians believe that, in general, private individuals and organizations are more efficient providers of beneficence. Most governmental attempts at providing beneficence are wrought with inefficiency and fraud. The most salient reason for this inefficiency is that governments spend other people’s money and therefore are less likely to demand efficiency. Private charities are also inefficient, but are less likely to be inefficient for very long. When the inefficacy of private organizations is exposed, benefactors naturally withdraw their money and invest in other charities. When was the last time you withdrew your tax dollars? Governmental inefficiency is well documented. Look no further than FEMA’s less than beneficent response to Hurricane Katrina or the government’s less than beneficent efforts to rebuild Iraq. Libertarians do not argue that government ought to steer completely clear of charity. Government can certainly help the rest of us by exposing deceptive and/or inefficient charities and by prosecuting fraudulent charities.

So the libertarian vision of beneficence is that American society is better of with a wide variety of privately beneficent organizations that compete with one another for our donations, rather than one single governmentally supported monopoly, like FEMA or even the Red Cross. In fact, when we pay taxes to support these governmentally funded organizations, we often mistakenly believe that we’ve fulfilled our moral obligation toward those in need. But all we’ve really done is perpetuate these notoriously inefficient monopolies that waste tax money. And unfortunately, there is also another unanticipated consequence. The more we rely on government to serve the needy, the less inclined we are to contribute to private charities. The higher the tax rate, the less disposable money we have to invest in pursuit of our own self interest and the interests of others. In other words, governmental beneficence not only wastes money, but it also has the unanticipated consequence of undermining private beneficence. But then again, let’s not assume that beneficence is a worthwhile social virtue. It may be the case that, over the long run, it causes more harm than good.

Finally, and perhaps most controversially, sometimes the best thing we can do for others is pad our own interests. What do you think would do more good for New Orleans? A. Spending a week sleeping in a tent, eating bologna sandwiches, drinking bottled water, and volunteering to clean up debris from the streets: or, B. spending a week staying in expensive hotels, eating in restaurants, gambling, drinking in bars, attending concerts, and buying souvenirs? I think many ideal altruists have a rather distorted view of economic activity. Most economists would agree that the best thing we can do for New Orleans is come down and spend our hard earned money in support the local businesses. In short, self-motivated acts can generate a lot good for others. So go to New Orleans and buy lobster tails, and perform an act of beneficence toward local fishermen.
 

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