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I'm just had my tooth out on the NHS. A few years ago, I had a… - Sally's Journal
August 8th, 2006
12:38 pm


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I'm just had my tooth out on the NHS. A few years ago, I had a giant neck abcess saved by the NHS too. I'm a big fan of the welfare state. It does wonderful things that makes peoples lives better - it feeds the hungry, heals the sick, houses the homeless, and generally helps out those in need.

It is however, very expensive. And the more civilised we get, the more of a burden we take on looking after those who cannot look after themselves. We do not allow unwanted babies to be left outside the village to be eaten by wolves - we bring them up. We spend money and time on looking after people who cannot look after themselves, on making devices that enpower people who lack limbs, eyes, etc.

It has been hypothisised (when hanging around abortiondebate mainly) that you can't discriminate against someone who doesn't exist yet. I'm not convinced by this (if you passed a law saying that in 300 years time women would no longer have the vote I think it still discriminates against women even though those women arn't around to be hurt) but it does seem that you cannot worry about what is in the interests of non-existant individuals - only classes of people.

So are we breeding dumb? By supporting the sick and the needy, by having a structure that allows people to survive who wouldn't survive for two minutes in a tougher world, is the only thing we acheive to guarentee we have even more sick and needy next generation, because we have beaten natural selection?

Which lead me to conclude that you could, if you were that sort of evil society, extract Darwin's price for people who fail to cope. We, the welfare state, will give you everything it is in our power to give you to make you happy and healthy, well and looked after. But the price we extract for it is sterilization. If we don't think you could survive in a society without excessive support, we make sure you don't pass on your genes, to lower the chances that we just get even more people we have to support. If you would have died without our society, you can't breed.

This is

A way of improving the human race
Fine so long as it applies to everyone except me
A good way to manage limited medical resources, if such resources were limited
Being cruel to be kind

Aiding weak people* so they survive and breed when in previous times they would not

Is good
Will lower the stadards of the human race
Is kind
Puts society under such a burden it cannot reach its full potential
Is a key part of being human

Under this scheme I would be steralised because of my life so far

Probably Not

I think it all falls down because we're not aiming to perfect one thing. Someone who is unable to walk may well be a great mathematician. Someone who costs the state thousands of pounds in health and social care when young may grow up to pay the state hundreds of thousands of pounds of taxes. And I think we are blessed in that we are rich, and we are morally obliged to care for all we can afford to care for. But if we couldn't afford to care for everyone I think a policy of caring for the people we had but not letting them breed seems to minimise a lot of hurt. Except that too is bollocks, because although there's some corrolation between parents and children there's no direct link - perfectly healthy people have ill babies, and disabled people have healthy babies.

Hmm. On the bright side, this has distracted me from the fact my tooth hurts.

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[User Picture]
Date:August 8th, 2006 12:17 pm (UTC)
Your scheme would need to distinguish passing from chronic issues. For example, appendicitis requires hospitaliation and stops you working for a bit, but goes away if you apply welfare to it and so I would assume that wouldn't fall into your remit (or at least, not until near the end of the queue). On the other hand, it is a good example of something that you'd prolly die from without society intervening with the appropriate health divisions, far more so than for example being deaf.
[User Picture]
Date:August 8th, 2006 12:27 pm (UTC)
I think the whole scheme is fundamentally broken. But it's confusing.

For example, imagine if there was a head-exploding gene, and all with the gene would have their heads explode on their 16th birthday, unless a magic plaster was applied to them at some point before then. The magic plaster is, conveniently and hypothetically, incredably cheap to produce (but requires some exciting skills and technology).

So head exploding is a passing issue that requires less than 10p worth of magic plaster to cure. It looks like it shouldn't fall into the remit of mad eugenics. But if we allow all the head exploders to breed, maybe in a few generations time far more people will have the head exploding gene than they "ought" to, in some survival-of-the-fittist sort of sense. And _then_ if society falls and people can no longer make magic plasters, suddenly everyone dies.

Is this a problem?
[User Picture]
Date:August 8th, 2006 12:27 pm (UTC)

If we don't think you could survive in a society without excessive support

Of course, we can't know for sure without running the experiment.

Also there are lots of non-genetic reasons you might need societal support to survive. So the proposed scheme would involve maiming lots of people with no benefit to society.

[User Picture]
Date:August 8th, 2006 12:32 pm (UTC)
It could also be argued that having a society is what defines a human, and that it was the creation of such a society and the protection offered, and then subsequently the creation of leisure time which allowed more space for innovation, that allowed the species to flourish in the first place.
Therefore people who dont have the drive to look after each other may be less fit if dumped back on the savannah (which seems to be the kind of 'civilisation falls' model you are guarding against)
Date:August 8th, 2006 12:31 pm (UTC)
There's also the point that 'fitness' in Dawinism isn't an absolute quality - but is relative to the current circumstances. A phenotype that may be a liability in some circumstances can be an advantage in others. I would therefore expect variability in a population to be a better guarantor of long term survival than its apparent health in its current circumstances. Perhaps then, saving even the apparently most useless is a viable evolutionary strategy - to keep breeding from a big a variety of human beings as we can and to keep our gene pool as varied as we can - even if some of the resulting phenotypes seem apparently to be less useful than others in the short term.
[User Picture]
Date:August 8th, 2006 03:23 pm (UTC)
I remember reading an article about some Dutch researchers who were studying populations of tits (no giggling there at the back) and identified two quite distinct behaviour patterns. Some tits were very bold and pushy, and others were very timid and nervous. It turned out that during times of dearth, the pushy tits did better (as measured in survival rates, I think), because they were willing to take more risks to get food, but during times of plenty survival rates were much higher amongst the paranoid tits, because the pushy ones got eaten by cats a lot.

Actually, that may be the wrong way round because my memory is rotten, but the observations neatly illustrated wryelle's point about varying circumstances, and the population of the two behaviour patterns was largely stable over time.
[User Picture]
Date:August 8th, 2006 12:35 pm (UTC)
Various other flaws, not necessarily exhaustive:

Where people are 'weak' and need welfare because of poverty, it is not necessarily due to their genes, but due to the economic structure of society. Poverty is passed down generations - but again that is a societal choice to make that so. In egalitarian Scandinavia, the children of the bottom 20% are far more likely to make it out of the bottom 20% than in the inegalitarian USA (or the UK) - the "American dream" of rags to riches is a myth, or at least a statistical improbability.

Most of the evidence shows that expenditure on health promotes economic growth, as it increases the productivity of the labour force.

The argument assumes that the only value of human beings is economic value. That if someone costs more to care for than they put into the economy through their work, then they have negative value. I shouldn't need to go into why this is wrong.

The argument that not allowing the 'weak' to breed (where we have restricted the definition of 'weak' to those who we are confident are weak because of their genes rather than anything else) 'minimises hurt' fails to account for the hurt of sterilisation, of not being able to have children. If you were to consider a strict cost-benefit analysis (ignoring the moral equation), you would have to calculate the increased probability of someone's children requiring care, times the cost of the care, versus the hurt caused by sterilisation. How to measure the latter? Well if we consider the amount that people with fertility problems are willing to spend to be able to have children, this would seem to be very high. It seems far from clear that your cost-benefit analysis would come out positive.

It's wrong and an offence to basic human dignity.
[User Picture]
Date:August 8th, 2006 12:37 pm (UTC)
I think that the whole state-of-the-gene-pool problem (should it actually be one) is one that's best dealt with by sticking our heads in the sand and hoping it will go away. As in: I don't think it's going to be urgent in the next few decades (or even centuries), currently we've got no better way of dealing with the problem than using rather crude and jackbooted solutions that look likely to do far more harm than good, and out knowledge of genetics has a long long way to go. Ultimately if there's a really big problem germline GM seems like a more humane solution, albeit one with problems of its own.

This all assumes, of course, than in a few centuries from now we haven't destroyed civilisation with WMD or a global environmental catastrophe, or all been replaced by superintellegent robots.
[User Picture]
Date:August 8th, 2006 12:38 pm (UTC)
I think you have to take into account that we value genetic traits other than the ability to survive long enough to procreate. Possibly from a purely utilitarian one would have to make a decision about whether it was worth passing on the disease prone genes to preserve the ones you liked so maybe you should add into the scheme fctors to take into account the cost of treating the congenital flaw and the talent of the person who might be sterilised. For instance you wouldn't want to sterilise a leading acedemic just because he had chronic asthma that was relatively cheap to treat.

I'm more concerned about the impact of culture upon demographics. Upper/middle class intelligent left wing women don't breed, or at least don't breed as much as the rest of the population. I've got a niggling concern that because intelligent people have better things to do than gestate and care for babies in a few hundred years the human race will be reduced to Heat magazine reading morons whose ancesters couldn't grasp the concept of taking a pill at the same time every day. This gives me the urge to have a huge family to try to tip the balance a bit the other way.
[User Picture]
Date:August 8th, 2006 12:49 pm (UTC)
Yes, that is a more interesting problem, and one that worries me. I worry sometimes if the world is built so that it is a paradox, and one can choose to be right-and-dead* or wrong-and-alive. That is, maybe it is just a fact that the very traits I love and admire won't survive and breed in our world. But that seems unlikely, else they wouldn't be here now.

I wonder what I would choose if I was presented with a straightforward choice between right-and-dead and wrong-and-alive too. But I try not to think about it.

*Where for "right" read "believer in the same things as me" ;-)
[User Picture]
Date:August 8th, 2006 12:44 pm (UTC)
There would have to be a sensible definition of "excessive" under such circumstances. For instance, a person who is unable to walk, but still does work, pays tax, contributes to NI, etc. is probably just fine. What if they need a PA? What if they can do a bit of inconsequential part time work, but not full time? I dunno...

I think looking after all the sick and needy, no matter how needy, is a lovely, morally sound and kind idea. But also a somewhat impractical one in some respects. We end up with an ageing, unhealthy population that takes more than it contributes and demands and demands and demands.

I suppose ultimately, society is more burdened by people who could (physically) work but won't/don't because they're too lazy/too underqualified/too fussy about what work is "good enough" for them even though they're not good enough for the work. Perhaps we should sterilise stupid lazy healthy people instead of hard-working sick/disabled people?
[User Picture]
Date:August 11th, 2006 02:24 pm (UTC)
That's an interesting concept. A sterilisation penalty for people in good health who fail to find a job after or who claim over a certain amount of money in unemployment benefits without appropriate justification.
[User Picture]
Date:August 8th, 2006 12:48 pm (UTC)
I absolutely agree with where it breaks down. I mean-- okay, posit James, who has an absolutely brilliant businessman's mind and would have made zillions of dollars and paid zillions in taxes to the state-- except that he suffers from post-traumatic stress disorder and a head injury sustained in wartime (where he got eight medals for courage, ingenuity, and service to others above and beyond the call of duty), with the result that he is unable to work, and is just barely supported by his wife, Hannah, who is a brilliant experimental poet who will eventually be credited with naming the post-postmodern literary movement something other than "post-postmodernism," for which she should also get a medal, but that doesn't exactly rake in the dollars, does it?

Okay, so do we want James and Hannah to perpetuate their genes in our society? I would say so. But are James and Hannah going to be able to afford emergency medical bills? I would say not.

This is obviously an extreme example, but it's just an illustration of the point that there isn't necessarily any correlation between whether people can support themselves and whether they should breed. Darwinism works because it doesn't select for anything but ability to survive on your own, against all comers-- survival of the fittest really means "survival of those who are fittest to survive" but human society values many things besides "who would win in a fight? Who would live through the winter?"
[User Picture]
Date:August 8th, 2006 04:19 pm (UTC)
Well put.
[User Picture]
Date:August 8th, 2006 12:57 pm (UTC)
1. How about, can't discriminate against people who don't exist at all? So, if you let someone be born, that's normally good (for them, for their parents, etc), and possibly bad (if their life turn out shit *enough*); but if they're not born that's neutral.

2. Should we care for people, whose existance doesn't directly help perpetuate the species? I think so. Some people's highest goal is to preserve the race, and it's important to me, but so are good lives for all people (human or, in theory, not) individually.

3. Certainly society tends to stymie natural selection. But I think not that much. It happens slowly with long lifetimes anyway. And we still will tend to evolve, just in different directions: immunities to aids; to cancer; desire for children; etc are an positive adaptions to reproduction more or less.

4. I'm not sure if breeding ourselves is inherently bad. But has several major problems:
(i) Simply not giving people fairly simple medical care is a crude and not very effective form. We might get a bit better at avoiding disease, but then half of people have bred already.
(ii) It's horrendously prone to abuse. Some evil people have an obviously warped idea of what to breed out of the human race. Our view may well be as warped (though may or may not be better than chance), or become so.
(iii) It's risky. You need diversity, and who knows what gene with an obvious defect mightn't have a subtle but crucial benefit?
[User Picture]
Date:August 8th, 2006 12:58 pm (UTC)
Hmm. How, I wonder, does the cost of looking after the sterilised weakling in old age balance against what could have been paid for (either directly or via taxes) by his potentially healthy offspring?
[User Picture]
Date:August 8th, 2006 01:07 pm (UTC)
Gosh, I'm suprised that I'm the only one who definitely would have been sterilised. I would die in a matter of days without my medicine and almost have done on many an occasion growing up (but medicine is much better at preventing that now). On the other hand, it is largely modern society that means that I *require* my medicine, so who can tell?

This now puts me in a position where I feel as though I ought to justify my existence (cf Red Dwarf's Inquisitor). Well, with the help of the medicine that I have (which, admittedly, I currently get for less than it costs), I am much fitter and an awful lot tougher than most people, can physically fight (good in a dog eat dog world, eh?), contribute more than average by taxes, managed at least as good educational results as most of my peers (who are largely Oxbridge) and generally contribute lots to society. I haven't taken a sick day in the entire of my graduate working life - true, other people would have done under the circumstances, but I'm much harder than they are.

It is my belief that having to overcome extremely demanding physical imperfections moulds a person into being a really tough cookie who is very determined and a high achiever. To me, those are good personality traits, though I'm not sure how much of them you'd pass from one generation to another - probably some through nurture.
[User Picture]
Date:August 8th, 2006 01:08 pm (UTC)
Pragmatic reasoning asside I am of the opinion that:

a) It is wrong to deny medical and social aid to the needy outside a triage situation. I don't try to justify this, I take it as an axiom.

b) The whole is greater than the sum of its parts. Ignoring that head-exploders might be multi-bilionaire wealth-producing geniuses, a few of them might be a good laugh down the pub, you can't put a value on what that adds to society.
[User Picture]
Date:August 8th, 2006 01:10 pm (UTC)
Under this scheme, I wouldn't exist.

So, uh. No.
Date:August 8th, 2006 01:13 pm (UTC)
I have a counterpoint. Modern society is driven by progress, and medicine drives huge amounts of progress. By providing "free" medicine and treatments under the NHS, you drive scientific research, and also cause money to flow.

Of course, the real solution is to develop genetic screening, and ensure future generations aren't born with disadvantageous genes, like "weak heart", "short life", "stupidity", "religion" and "vegetarianism". The legislature to allow this needs to be put in place, and soon, or there'll be chaos when science fact catches up with science fiction.
[User Picture]
Date:August 8th, 2006 01:35 pm (UTC)
Tosh. ( 8-) ) Look after the people who need looking after. (Because the thing you're not considering up there is: value to whom? Value to the premie's parents, or value to the State, or value to the ICU staff?)

And then think about persuading them voluntarily not to have children, by making other lifestyles less demanding and more rewarding.

It's not as if we need everyone to be working forty hours a week; food production is almost entirely automated, and everyone would be better off if all tax lawyers, advertisers and professional sports players were sent on permanent golfing retirement now.

We don't know what we're maximising, but happiness seems as good a candidate as any. You don't make people happy through forced sterilisation; you make some of them very unhappy indeed. (And if we can't afford to look after the children we're not going to be able to make the "happy and healthy and wealthy" benefits very overwhelming; they'll turn into "be sterilised if you want subsistence support" once they're applied to enough of the population. Cf the one-child policy in China, which started out by giving extra benefits to only children, and rapidly turned into penalising children with siblings instead.)
[User Picture]
Date:August 8th, 2006 02:04 pm (UTC)
It's a hard one to call - in some ways yes, we're weakening the race because of all those who wouldn't have survived to breed due to weakness or genetic problem are able to do so (I had meningitis at 18 months so I'm probably one of them). However, who's to say that people born with disabilities (or the genetics to cause them in later life) don't actually have something positive to contribute to the human race in other ways? To some extent any disability that is severe enough to prevent a person reaching puberty is likely to edit itself out of the gene pool even with medical help, so those that allow survival (including a lot of recessives) may have some potential purpose in the future. We're all allegedly descended from people who were capable of resisting the Black Death, and it's quite possible that some other pandemic will perform similar genetic selection before the medical establishment can stop it.

I think the key is diversity - if we end up with a monoculture then it's far more likely that we'll all be wiped out by some catastrophe. There are reasons why fair-skinned blond people are native to Scandinavia and black-haired dark-skinned people are native to the hot, sunny regions of the planet, it's basically because they're best equipped to survive the climate and natural selection has helped that. In some ways, the mixing of the races and cultures now that global travel is easier is helping to provide even more diversity and it may be that at some point in the future the best-off people on the planet are those who can point to a very mixed heritage.

Of course, one thing that is potentially worrying is the number of intelligent people (say for example, IQ over 120) who choose not to have children and so remove themselves from the gene pool. Heredity plays at least some part in intelligence, so as a country we're sliding down the scale at the moment. Perhaps it should ber a requirement for anyone with a degree to have to donate sperm or eggs to a central bank for improvement of the race?

[User Picture]
Date:August 8th, 2006 02:34 pm (UTC)
We appear to be having that flamewar further up the page already :-)
(Deleted comment)
[User Picture]
Date:August 8th, 2006 02:48 pm (UTC)
Firstly, as a minor point, doing something that affects someone who will never exist seems morally distinct from doing something that affects someone who merely doesn't exist yet. While setting a time bomb with a 200-year fuse is clearly wrong, it doesn't feel like a useful analogy.

Whatever one thinks about the abortion debate, a putative person obviously has no right to exist before egg and sperm meet. Whether or not they should exist is a question for the parents, and for society.

If someone's disabled, we should help them. If they want to have children, we should help them have children. Where things get messy is the case of someone who needs specialist help from society in order to live, and who wants our help in having a child who is very likely to inherit the condition.

At risk of outrage from the PC lobby, being disabled is a bad thing. Society would be better off with fewer disabled people; given the choice between having a disabled child and a non-disabled child, people would prefer the latter.

The problem is the public perception of what constitutes a disability, and the perceived severity of disabilities. Some things are so obviously disadvantageous and serious that it seems reasonable to me that we avoid children being born with the condition, where possible. Provided we can avoid then going down the slippery eugenic path towards reducing diversity and stigmatising minor medical conditions.

I'm happy for us to go a little way in this direction, but I'd stop way short of what's unacceptable, lest the taboids carry us forward uncontrollably. And I don't think I'd let the state override the wishes of parents who were happy to have a child they knew would likely be disabled.
Date:August 8th, 2006 10:19 pm (UTC)
At risk of outrage from the PC lobby, being disabled is a bad thing. Society would be better off with fewer disabled people; given the choice between having a disabled child and a non-disabled child, people would prefer the latter.

I agree - it's a bad thing in the sense that, all other things being equal, it is better having a non-disabled person than a disabled person.

However, a problem here is that the choice isn't between non-disabled and disabled, but between having a disabled person and not having one at all (as other people obviously aren't going to have more children to make up). So given that birth rates are already declining in developed countries, it could be rather a bad thing to significantly reduce the birth rate further.

Indeed, this could make things worse for the welfare state - athough we might reduce the number of people needing support slightly through natural selection, that might be countered by a far fewer number of workers having to support an increasing elderly population.
[User Picture]
Date:August 8th, 2006 02:51 pm (UTC)

Perhaps a re-reading of Bruce Sterling's heavy Weather will help: there's a sub-plot, a clique of eugenicists who treasure each and every strain of resistant AIDS for it's value in killing off people to stupid to follow basic sexual health precautions. Or too unlucky to avoid being born where the necessary education and rights for women exist, although that isn't stated so openly. And yes, they despise the weak and the diseased.

Their problem, and ours, is the ability to judge: a just and meritocratic society with an effective welfare state that gave *everyone* a pathway out of poverty could and should examine sterilisation for the indigent and the criminal. Likewise, a society of educated people with an open culture of measured political debate could and should be able to ask everyone whether they really do choose to pass those genes on. But we do not live in such a society; and, given the sterilisations and medical experiments that happened right up into the 1970s in the Nordic countries, I'm not sure that they do either.

And do we really know what we're doing? You're all educated enough to know about sickle-cell anaemia and malaria resistance. What about dyslexia, and the secondary maxima on the IQ histogram, way out there in Einstein territory?

Still, lack of complete information is a weak excuse and the Eugenics argument is real enough; some genes are a curse to those who are forced to inherit them, and the 'only in a triage situation' argument doesn't cut it. That has the hollow sound of someone who's only capable of making hard choices when confronted with the immediate prospect of death: I bet they'd vote Republican if they could, and let their grandchildren pay off all the government borrowing that finances today's juicy tax cuts - and put off the hard choices that face a polity that spends more than it earns.

Genetic issues have an even longer latency than fiscal irresponsibility: grandchildren don't vote and great-great grandchildren with polluted seawater up to their knees and an average IQ of 85 don't exist today and don't seem to matter. They are not 'real' in any sense that we can empathise with sufficiently to do anything for them - or at least, nothing that would involve sacrifices today. Certainly not 'real' enough that we'd put their imaginary interests ahead of someone who demands the right to breed today while knowing that their children will be unhealthy, dependant on drugs, and equally likely to curse the next generation in turn. And the more that bad genes propagate through the population, the more they meet up in even worse combinations - what would you like to go with with that asthma? - it's not just a numbers game with exponential growth, it's probability matrix with unknown dysergies.

Perhaps today's reading list is Neil Asher's Cowl, a work set in the deeply dystopian future where our posthuman descendants despise our generation for breeding stronger bugs and weaker humans. Their societies emerged from the ruins of a bankrupt civilisation decimated by disease and they are, through brutal necessity, pitilessly Darwinian and unashamedly fascist: a suitable epitaph to a democratic society that was absurdly generous in granting entitlements and empowerments to all who could be heard, but did not extend its notions of rights and justice to future generations.

[User Picture]
Date:August 8th, 2006 03:50 pm (UTC)
The eugenics debate tends to confuse social Darwinism with true Darwinism.

From a pure survival point of view a species is fit to survive if it can keep reproducing. It doesn't matter in the slightest whether an individual is weak or strong, if it produces offspring it has "won" in evolutionary terms: a "weak" group that keeps on breeding is fit for survival.

Indeed, the human tendency to protect the weak may have evolutionary advantages. Maximising the number of potential breeders increases your chances of survival, and genetic randomisation means that not all the offspring of the weak will themselves be weak.
Date:August 8th, 2006 04:51 pm (UTC)
one thing lots seem to assume is that if someone has a medical problem - that they'd get the snip. but how i read it is that if you needed the state to fix you, you'd get the snip. that's (to me) a big difference.

so econimicaly successful people who have medical problems just pay for it, and the same for their children.

there's a corrolory to that (no - i can't spell): things we value as a society should be rewarded. we already reward plumbers and stock analysts.. but if it's good for humanity to have neo-modern poets, hand in hand with the medical policy should go a policy of funding or otherwise rewarding the poets, the artists, and others who are "valuable".
[User Picture]
Date:August 8th, 2006 04:55 pm (UTC)
I'm kind of hitting this arguement from the other direction - the only way I can have children is with medical aid. Although it is uncertain, it may well be that any daughters I manage to have will have the same problem as me. Thus, in chosing to take a medical route to have children I will be adding shitty genes to the gene pool. Its something that has been worrying A and I.

Although, with the recent tests, it looks like a moot point anyway...
(Deleted comment)
(Deleted comment)
[User Picture]
Date:August 8th, 2006 06:54 pm (UTC)
passed a law saying that in 300 years time women would no longer have the vote

I, personally, think it's terrible that so many women are suffering these days. Join the campaign to end womens' suffrage!

Date:August 8th, 2006 07:00 pm (UTC)
I think it all falls down because we're not aiming to perfect one thing

You're half way there. We're not aiming to perfect one thing - and we are not aiming to perfect for one time (or do you think that next century's problems will be the same as this?). One of the strengths of humanity is adaptability - and what is considered useful now is not the same as what is useful for hunter-gatherers and who knows what the future will bring. I therefore think that diversity is a positive boon as it leads to insurance against future pressures.
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