Saving Humans by Numbers: Part 4 – The Veil of Ignorance

Dr Jussi Suikkanen

File:Ripple effect on water.jpg

This series of blog-posts is investigating who we should save in a simple case in which we can either save one person or five people from drowning, other things being equal. Intuitively, in this case you should save the group of five in the same way as you should always save as many people you can. In the previous two posts, I have gone through John Taurek’s argument to the conclusion that this isn’t right.

According to Taurek, we can’t justify our choice of saving the greater number to the single person who is about to die. The individuals in the group can offer the best justification for why the group should be saved: each one of them will die unless the group gets saved. The crux of the argument is that the single person who is about to drown can say exactly the same thing. Unless he gets saved, he dies too. This means that the demands of the single person and each one of the people in the group for being saved are equally strong and no individual has a strong claim for being saved. There is no group entity how has to suffer from death five times as much as the single person. For this reason, both the single person and the individuals in the group have an equal claim for being saved. As a result, it is permissible to save either the single person or the group, but you are not required to save the greater number. According to Taurek, this leads to the conclusion that we should flip a coin.

Note how radical consequences this argument has. Imagine that you have a set amount of drugs to administer. Imagine that there are two groups with two different medical conditions. One of these conditions is such that you need to give much more of the drug for people who suffer from it. If you give the drugs to group A, you’ll give 100 people 10 more quality-adjusted life years each. If you give the drug to group B, you’ll give only 20 people 10 more quality-adjusted life years each. Intuitively, you would want to give the drug to the larger group where it ends up giving people more quality life, but if Taurek is right you should flip a coin between these groups too. You could not justify favouring the bigger group to the members of the smaller group. If this were right, a maximally efficient health-care system would not be just.

Today I want to argue that Taurek reasoned in the right way but he drew the wrong conclusions from his argument. When you think about whom you should save in the basic case, it is exactly right to think about what you can justify to the individuals in question.  And, I think it is also right that when we think what can be justified to individuals in this kind of cases we need to compare what kind of burdens individuals come to bear as a result of our choices. The justifiable way of acting is the one that doesn’t unnecessarily burden any single individual.

The problem is that Taurek is wrong to focus just on the individual case. Instead, we should think about what kind of consequences general policies have for different individuals and whether these policies can be justified for everyone personally. This means that we must compare two different life-saving policies: the saving greater number policy and the coin flip policy. In the long term of course if the coin is fair, adopting the coin flip policy will kill three times more people than the saving the greater number policy (in the basic 1 vs. 5 situations we been considering).

The utilitarians will at this point automatically think that this just shows that the saving the greater number, but I think Taurek is right in insisting that utilitarianism overlooks what happens to individuals. Instead, when we think about which one of these principles we should adopt together, at that point we don’t know which ones of us the possible adoption of these principles will come to affect and how. We don’t know who will be saved because of them and who won’t. So, when we decide which one of these principles we should accept, we are all behind what John Rawls called the ‘veil of ignorance’. We know the consequences of the alternative policies in general, but not the impact on us as particular individuals.

If we think of the two possible principles in this way, both the saving the greater number principle and the coin flip principle will end up causing burdens to as individuals. The acceptance of the saving the greater principle gives us all a 17% chance of dying in a future life-saving incident where we turn out to be in one of the boats. The coin flip principle in contrast gives us only a 50% chance of dying in such incidents when we don’t know which boat we will be in. In this way, Taurek’s coin flip principle causes us all an unnecessary burden – a higher risk of death – if we don’t just think of what happens in one individual case. For this reason, the adoption of that principle can’t be justified to us. As a consequence, the saving the greater number principle is the only principle that we can be expected to accept, which is really why you should save the greater number in the life-saving cases. Principles that permit acting in any other way can’t be justified to us as individuals because they all make us more likely to die which is a burden in itself.

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