Answering some Kohlberg Dilemmas (Heinz and the drug).

In my last entry, I gave my answers to a Kohlberg Dilemma involving a child Joe and his father. This one is a more famous example: I vaguely remember running into it before in philosophy class.

In Europe, a woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. the drug was expensive to make, but the druggist was charging ten times what the drug cost him to make. He paid $400 for the radium and charged $4,000 for a small dose of the drug. The sick woman’s husband, Heinz, went to everyone he knew to borrow the money and tried every legal means, but he could only get together about $2,000, which is half of what it cost. He told the druggist that his wife was dying, and asked him to sell it cheaper or let him pay later. But the druggist said, “No, I discovered the drug and I’m going to make money from it.” So, having tried every legal means, Heinz gets desperate and considers breaking into the man’s store to steal the drug for his wife.

Of note is that this is a less realistic scenario than the first. A cure for any kind of cancer would not be discovered by a mere druggist. Making the scenario about a drug company would be more realistic but also more unwieldy. I think the scenario should have been about something else entirely.

That minor complaint aside, this scenario is definitely strongly connected to the capitalist system, where we believe that discoveries are an “intellectual property” which can be stolen. We also happen to believe that people have the right to life, but we don’t, in many societies, believe they have a right to health care, which makes any such right to life a logical impossibility. It is also about the profit motive being more important than the people motive. Capitalism is an inhuman system in all respects. It has no connection to real human rights or the real humanity we can show to each other.

1. Should Heinz steal the drug?
1a. Why or why not?

I have one issue with this question, and that is: if this cure involved radium, then how could Heinz or his wife know how to administer it safely? Anyway, I suppose we need to assume that the cure is easy to administrate, like some kind of pill (although ingesting radium seems rather dangerous).

That being said, my answer would be yes. Heinz should steal the drug in order to save his wife. Presumably he values his wife’s survival and health more than the chance of getting caught and going to jail. This is a moral question, not an ethical question, so there’s not really any issue of rights or principles here.

2. Is it actually right or wrong for him to steal the drug?
2a. Why is it right or wrong?

Now we’re entering into ethical considerations. The arguments for the theft being wrong would revolve around property rights, since a theft is by definition an attack on property rights. But I’ve already debunked property rights: nothing can be an actual right if it goes against another person’s rights. In this specific case, the druggist’s “property right” cannot trump the wife’s right to life. Beyond that, I don’t see any reason why the action could be wrong. Saving someone’s life is generally a good thing (if they want to live and if it spares them future suffering). The fact that the theft supports such an action means that it is, at the very least, not wrong.

My answer would be that stealing the drug is a right thing to do in this situation, because it is not wrong. The same evaluation applies, I think, to not stealing the drug. Neither of these actions can be wrong from an ethical standpoint, given the information we have in the scenario. Since my answer relies heavily on a factual statement (that property rights are bunk), I wouldn’t rate it on the Kohlberg scale, but it would probably be rated as post-conventional.

3. Does Heinz have a duty or obligation to steal the drug?
3a. Why or why not?

I do not believe that Heinz has a duty or obligation to steal the drug. As a society, we have an obligation to support the wife’s health in any way we can, but this does not mean that Heinz has to be the one to do it. To give an analogy I’ve used before, we recognize people’s right to be free from fires, but we don’t demand that any passerby help stop fires under penalty of law. We recognize that extinguishing fires is a specialized occupation, and we ensure that firefighters are the ones equipped to do so, not just some random people on the street (in modern times, anyway: standing around and passing buckets of water is another story).

So my point would be, there’s no reason to put the obligation on Heinz to cure his wife. If anyone has a duty or obligation here, it’s the druggist, who has the obligation to provide life-saving medications so everyone who needs them can have access to them (he is, after all, a druggist). Whatever action Heinz decides to take is a matter of personal risk-evaluation and moral evaluation, and has nothing to do with duties or obligations.

My evaluation here qualifies as post-conventional, insofar as it establishes a universal standard of justice (the obligation of the druggist to provide life-saving medications as being more important than profits).

My answers to the first questions have been rather different from my answers in the previous scenario of Joe and his father. In that scenario, I said that the father had no right to demand money from his son, and that the son’s money was rightly his. In this case, however, I believe that the druggist is not within his right to demand the kind of money that he’s demanding from Heinz, and that he has no right to his “intellectual property.” This may seem like a contradiction, but there are two huge difference between the two scenarios. The first is that in the Joe scenario, the child’s possession of the money was legitimate (his forty dollars was a wage given to him for legitimate work), while in this scenario, the druggist’s demands are based on profit, that is to say, illegitimate gains (the four thousand dollars is an arbitrary figure disconnected from the actual costs of the drug’s production and distribution). The second is that the druggist justifies himself on the basis of “intellectual property,” which is a contradictory concept (for many of the same reasons that the concept of property is contradictory).

Now, it may be that four thousand dollars is a reasonable cost price for the drug because the cost of discovery was so great (although I would question how a druggist could have spent all his time discovering this drug instead of working). But that would be a case for public provision of the drug (either by the State or the much better alternative of non-hierarchical health care), not for charging excessive amount of money to people who need it and can’t afford it. The belief that high research costs justify depriving people of vital health care is asinine and extremist capitalist nonsense.

4. If Heinz doesn’t love his wife, should he steal the drug for her? Does it make a difference in what Heinz should do whether or not he loves his wife?
4a. Why or why not?

5. Suppose the person dying is not his wife but a stranger. Should Heinz steal the drug for the stranger?
5a. Why or why not?

6. Suppose it’s a pet animal he loves. should Heinz steal to save the pet animal?
6a. Why or why not?

I think all these questions are obviously related. They are all moral questions similar to question 1, but with a lesser value being put on the life that needs saving. Presumably everyone would have some sort of cut-off point at which they’d say “no, Heinz should not do it just to save a stranger or a pet.” However, these are moral questions, not ethical questions, therefore they are essentially unanswerable by a third party. It would all depend on how Heinz evaluates the risks of the theft, as well as how much he values the survival of his wife, the stranger, or the pet. I would have no objection to Heinz stealing the drug for any of these reasons.

7. Is it important for people to do everything they can to save another’s life?
7a. Why or why not?

My answer to question 3 provides some indication of my answer here. I don’t think it is particularly important for anyone to save another person’s life, because most people are not qualified or equipped to do so, and it would be unfair to ask them to do it. While it is important for everyone to contribute their fair share of resources towards helping those who are qualified and equipped to do these jobs (through taxation, for example), we can’t expect saving people’s lives to be everyone’s daily concern.

Note that I am not talking here about Good Samaritan situations. I do think that Good Samaritan laws (laws protecting bystanders who give assistance) are a good thing in general. I am also skeptical of duty to rescue laws, apart from those cases where common law already applies (e.g. in cases where the danger was created by the bystander, between a parent or caretaker and minor children, between transportation companies and their patrons, between spouses). In general, again apart from the cases where common law applies, I think the decision to rescue or not to rescue should be left to the judgment of the bystander.

I am not sure where this answer fits on the scale. It may qualify as stage 4 (conventional), because it concerns the functioning of society as a whole at a pragmatic level, and not really any higher standard of justice.

8. It is against the law for Heinz to steal. Does that make it morally wrong?
8a. Why or why not?

No, I do not think a law alone can make an action morally wrong, for the same reason I gave in the previous scenario: I reject the relevance of parental authority and legal authority to moral decisions. To me, this is not an ethical consideration but a statement of fact: I am not saying that we should not consider the law as making an action morally wrong, I am saying that the law cannot (as a matter of fact) make an action morally wrong. The fact that a law exists against a given action (e.g. theft of “intellectual property”) or that no law exists against a given action (e.g. pornography), or that the State approves of, and subsidizes, a given action (e.g. procreation), has no bearing whatsoever on its moral status.

Because my answer has no ethical component, it cannot be rated on the Kohlberg scale (but the premise that the law is morally irrelevant only fits stage 6, post-conventional).

9. In general, should people try to do everything they can to obey the law?
9a. Why or why not?
9b. How does this apply to what Heinz should do?

My answer here is a continuation of my answer to question 8, as well as what I said about legal considerations in the previous scenario. In general, the law is only a consideration in the prudential sense that one may fear going to court or getting assaulted by a police officer. One should not, in any case, obey the law; one should fear the law, in the same way that one may fear a hurricane but that the hurricane does not confer any moral obligations. The latter statement (that hurricanes confer moral obligations) seems silly, therefore the statement that we should “obey the law” (i.e. that the law confers moral obligations) should seem equally silly, since a hurricane and the force of law are both situations of emergency, brute facts, which cannot be reasoned with and cannot be resolved by rational thought. So my short answer is that one should not “obey the law,” only fear it.

This applies to Heinz’ actions in the sense that he must measure his prudential interest in not going to jail in his evaluation of the risk of committing the theft. Whether Heinz is risk-averse or a risk-taker, whether there are other factors lowering or raising the risk, will have a big influence on this evaluation.

Note that I am not making a case for consequentialism here. The consequences of Heinz’s actions are not relevant to any evaluation of whether they are right or wrong. If Heinz ends up going to jail, and his wife dies, his action is not thereby wrong. And if Heinz remains a free man and his wife is cured, his action is not thereby right. My evaluation is solely made on the basis that the druggist has no right to keep Heinz from acquiring the drug. Every other factor in the case, including consequences, is irrelevant to the ethical conclusion that Heinz is in the right if he decides to steal the drug.

10. In thinking back over the dilemma, what would you say is the most responsible thing for Heinz to do?
10a. Why?

Again, I have to repeat something I wrote in answer to the previous scenario, as well as my answer to question 3: Heinz has no responsibility or obligation in this case because he has caused no wrong, and is not about to cause any wrong (since the theft would not be wrong). It is the druggist who has a responsibility and obligation to provide needed drugs to the population. Of the two possible outcomes, that Heinz tries to steal the drug or that Heinz does not try to steal the drug, neither can be said to be “more responsible”: he is partially responsible for his wife’s well-being, but it would be irrational to expect him to be responsible for stealing drugs from someone else (a dangerous and illegal action) in order to ensure that well-being.

If I had to give an answer, I would say that the most responsible thing for Heinz to do is to do what he thinks is best in the situation. This is not a real life situation, so real life considerations are not really relevant here, otherwise the most responsible thing for Heinz to do might be, for example, to get the media on his case and create a new Martin Shkreli-type situation, completely ruining the asshole’s life and hopefully lowering the price of the drug in the meantime.

Feel free to argue about my answers, or post your own answers, in the comments section.