A brief case for evidence-based medicine

Few people would openly admit that they prefer irrational treatments and doctors.  But most people do in fact advocate irrational health practices – using pseudonyms for “irrational” as “holistic,” “alternative,” “homeopathic” and the deadly “natural.”

Medicine requires reason

The human body operates according to certain causal principles. If we wish to make a change in our health, we must understand some of those causal principles and act according to our understanding. To act without a rational basis is to disconnect our goals from their achievement. Irrationality does not guarantee failure — it just means that success, to the extent that it happens, will be due to other factors that our goals.

The study of human health is especially difficult

In the field of health, especially rigorous rationality is necessary for at least five reasons:

  1. The human body will solve, or at least try to solve most problems on its own. This makes establishing causality due external factors quite difficult and introduces biases such as the placebo effect and the regression fallacy.
  2. The body is very complex! Because it evolved over billions of years, the causal relationships in the body are extremely complex and interdependent.
  3. For example, even if we know that the body has too little of a certain substance, taking that substance may: a: not do anything b: cause the body to produce even less of the substance or c: cause an unpredictable side effect. On the other hand, if the body has too much of something, then the solution may be to a: consume less of that substance b: consume more of that substance or c: the consumption has no relationship at all to the level of that substance.
  4. It can be difficult to measure the extent to which medical problems are solved. While some things can be measured, many things, such as pain levels are very difficult to quantify.
  5. It is difficult to isolate causal factors in human beings since changes in health take time to develop and we can’t control every factor during an experiment or dissect human subjects when it is over.
  6. Humans tend to be irrational when it comes to their own mortality! We fear death, leading us to irrational over or under spending on health as well as being especially vulnerable to all the logical fallacies.

In medicine, rationality requires quality science research

There is a name for the field that applies rigor to the discovery of facts about nature: science. Science has been so successful in improving the state of human knowledge that many irrational, anti-scientific quacks have begun to use the term “scientific” to describe anti-scientific practices and ideas. In response to this, the medical community has come up with a term which identifiers the distinguishing aspect of rationality: “evidence based medicine.” This phrase is a necessary redundancy that identifies the essential characteristic of science: that it is based on sensory evidence. The alternative to non-evidence based science is not science at all, but emotionalism – “I feel it is true, so it must be.”

In the last hundred years, we have discovered certain practices for ensuring the conclusions of our medical experiments are valid. We know experimentally that observing these practices leads to more accurate conclusions. Let me emphasize that: the truth of medical claims is strongly correlated with the degree to which experiments follow accepted scientific standards. There are a number of objective scales for measuring the quality of an experiment.

Five characteristics of quality medical studies

  1. The experiment and its results are fully described in enough detail to reproduce and compare the results
  2. There is a randomized control group
  3. The selection of control subjects is double blind
  4. The methods of randomization and blinding are accurately described and appropriate
  5. There is a description of withdrawals and dropouts.

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Addendum: How to judge health claims

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The one minute case for jury nullification

This is Swampyank's copy of "The Jury&quo...
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The role of a jury is to apply the law to the facts

A trial ought to be, a fact-finding process, conducted in order to determine whether pre-existing legal principles are applicable to a specific case.  It should not be a religious, philosophical, or political discourse – that is, the rules by which guilt or responsibility is determined must be known beforehand.  It is not up to the judge or jury to determine what the law ought to be, only to apply it to the established facts.  If the law was determined rather than applied at trial, it would be impossible for anyone to obey it.  Furthermore, a just legal system should be uniform – people must have assurance that outcomes will not depend on the particular judge and juror they stand before.

We have a personal moral responsibility to treat other men with justice 

However, while it is not the job of the juror to determine whether the law is just, it is his moral responsibility to treat other men justly.  Someone who is hired to be a repo agent may not have a contractual obligation to determine whether the collateral he collects is for debts which are legitimately are in default, but he has a moral obligation to refuse his assignments if he suspects that he’s seizing legitimate property.  If he refuses assignments based on tenuous grounds, he may justly be fired, but if he has some certainty that he’s seizing legitimate property, he becomes as much a thief as his employer.  Likewise with the juror.

A law based on invalid principles is inherently unjust

One criticism of jury nullification is that a jury is not neither qualified to judge the law nor does it have any legitimacy in doing so.  And this is certainly true as a matter of law.  A juror who disagrees with the practical implementation of the moral principles behind a law ought to defer to the established process.  He can always exercise his disagreement and try to effect change in his role as a private citizen.

But, the situation is different when a juror disagrees with the moral principles behind a law.  A law based on incorrect moral principles is unjust regardless of the facts of the case.  The conviction of anyone based on such as law is necessarily an act of aggression.  Any participation in the process, even solely in the function of determining the facts, is an immoral act.  No judge can honestly ask a juror to breach his integrity, or blame him for refusing to do so.    Everyone, regardless of his role, has a personal moral obligation to treat others justly and refrain from willingly participating in injustice.

Jurors should refuse to enforce unjust laws

What should  a juror do if he objects to the morality of a law?  He should refuse to serve if he believes that the principles of a law are inherently unjust.  By doing so, he does not undermine the legal process, since another juror can be substituted, nor does he violate his own integrity.  A juror exceeds his role if he refuses to convict because he thinks that the punishment for an action is too harsh, but he acts properly if he refuses to serve because he does not believe the act being prosecuted to constitute an act of coercion at all.

If the court is unable to find enough jurors who accept the morality of the law, it has two choices:  either require the charges to be dropped, or offer the dissenting jurors to serve anyway.  If they do so, they cannot be blamed for acquitting the defendant based on their judgment of the law, in addition to their judgment of the facts. If laws are consistent with the basic moral principles of citizens, it should not be difficult to find sufficient jurors.

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The One Minute Case For Usury

There is no objective criteria for what rate of interests is “usury”

Usury originally meant the practice of charging interest on loans.  Sometime during Medieval times, the charging interest as such became politically acceptable and the term change to mean charging excessive interest rates.  However, there is no objective definition of what a “fair” interest rate is beyond the rate agreed to by the parties involved, so an attack on usury is an attack on interest rates as such.  There is no such thing as a single “just” interest rate because interest rates in a free market move towards an equilibrium determined by the time-preferences of individual debtors and lenders.

Traders have the right to trade by any terms they wish

The borrower of a loan voluntary enters into a contract. As long as the contract is voluntary, it is immoral for any third party to use coercion to prevent voluntary agreements.

Interest is essential to the investment process

Charging interest is essential to guiding the investment process, which cannot be sustained by charity even it were forthcoming due to the economic calculation problem.  Interest rates are required to direct investments to their most productive use.  Interest-driven investment is essential to economic growth, and therefore to the very existence of industrial civilization. If charging interest were outlawed, industrial societies would quickly collapse due to the inability to efficiently allocate savings.

“Loan sharking” is caused by government failure

Loan-sharking (charging high interest rates backed up by the threat of violence) reflects the fact that the loans are being given to creditors with a high risk of default. The need for violence is due to the failure of governments to see this fact, or to adequately enforce the loan contracts (such as with overly lax bankruptcy laws), rather than any immorality inherent in moneylenders.

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The one minute case against “special interests” as the cause of corruption in politics

It is often said that  “special interests” are to blame for economic problems and corruption. But “special interests” are only a symptom, not the cause of the disease.

Pressure groups are inherent in a mixed economy

In a populist democracy with a mixed economy, every group that participates in the political system is a “special interest”, with the incentive and the power to use the political system to extract benefits for its members at the at the expense of everyone else. Corporations, unions, disease-awareness organizations, “minority” groups, and anyone who organizes around a common cause has the power believes that their fate or cause is more legitimate, important, and “special” than that of everyone else.

In a mixed economy, the state functions as a redistribution mechanism

The welfare and regulatory systems are the primary means to coercively redistribute property and confer monopoly benefits to various groups. In a mixed economy, everyone is constantly on the defensive against organized groups extracting benefits from him, and on the offensive attempting to use the coercive power of the state to extract benefits from others. Interventionism creates a vicious cycle hardly unique to corporations: first a lobby tries to extract special privileges from some politically neutral group, the group hires lobbyists to defend itself, and ends up using the influence it has gained to extract privileges at the expense of another neutral group, which must defend itself in turn.

“Special interests” are a consequence of the coercive power of government 

The existence of “special interests” is just a symptom of the disease: the growth of government power to a degree that allows those in power to violate our rights and steal our property for the benefits of their constituents. Populist “maverick” politicians who claim that they will “fight special interests” and “change the culture in Washington” are just attempting to subvert the power of the state to favor their particular constituency. Campaign finance regulations are just monopoly privileges created by the political élite to hide corruption from the public and make it more difficult for those without political connections and money to get elected and in order to defend themselves or join in the looting.

The solution to special interests is to remove to interventionist power of the state

The only solution to the problems caused by interventionism is to end interventionism – to separate government and economy. Take away the power of the government, and you will remove both the incentive and the power of the “special interests.” As long as governments try to control people and businesses with laws that go beyond the protection of property rights, the “special interests” will have the incentive to control governments.

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The One Minute Case For Philosophy

What is philosophy?

Philosophy is the field that looks at the most basic, universal questions about existence. While other sciences study certain aspects of things, or certain types of things, philosophy is concerned with the most abstract questions about existence and man’s role in it. Philosophy asks questions such as: How can we know what is true? What is our purpose in life? How should we act? How should we organize society?

Philosophy is inescapable

Why are you reading this? Do you want to learn something? Why value learning? Is it because you value knowledge or because you want to have a successful career? Why should those things matter to you? Is it because your parents said so, because you enjoy something, or because society needs it? Is your own happiness or obligation to others more important to you? How should you decide? If I tell you that something is good for me, does that also mean that it is good for you? Is the good the same for everyone or different because of culture or nationality or personality? Is something is true, is it true forever, or only for today? Are people good or bad? Are you? Why are some people more successful than others? Is happiness a matter of luck? What is a good life? How should you pick your friends? Can anyone know any of these things, with certainty, in the same way that we know that 1+1=2?

All these questions are answered by philosophy. You may never have thought about philosophy until today, but all conscious human action depends on a certain view of existence. All actions assume a certain view of existence, causality, and values. We have no choice about whether we have a philosophy. We can only choose what philosophy to adopt. We can subconsciously, passively, and uncritically accept the philosophy we are exposed to or, we can consciously, actively, critically, examine the ideas around us and accept them because they are true, not because we happened to live in a particular time and place.

Philosophy is the science of universal principles

Philosophy asks: what can we know and how can we know it? We re-examine the world as if discovering it for the first time and accept only that which we can prove to be true.

Why is this important? You might say that you know what is real because I can see and touch it. But not all knowledge is perceptual. If I tell you about an abstract idea, such as justice, how do you know if it is true? Because you feel it is true? Because others tell you it is true? Because you see it is true? But what can you point at to show what justice is? And can you be sure that something that is true to you is also true for everyone else and at all times?

The point of treating thinking as a science is to arrive at firm principles. You can live without an explicit philosophy if you live a primitive life and hunt animals in the jungle. But if you want to build an airplane to fly you across the world, you need a formal science of physics and engineering. And to live a successful life as a civilized human being and create a better future than the past, you need an integrated, scientific view of existence provided by philosophy. Philosophy has the power to make abstract concepts such as justice as clear as the things we can see and touch.

History is philosophy in action

The politics, culture, and economy of any society are formed by the ideas of the people who live in it. If most people believe that it is impossible for them to live without using violence against each other, than their society will be poor and violent. If people believe that whatever their ancestors practiced and believed is good enough for them, then they will continue to live just like their ancestors.

A few hundred years ago, most of the world believed that history was just an account of one ruling regime being replaced with another. If anyone believed in a better time, it was in the past, when great empires had existed and fallen. Today, people had a very different view of history. We believe in progress, in continuous improvement, in fundamental change in society and economy. These ideas have power: during the last 200 years, the world population increased from under 1 billion to over 7. Why did this happen? The world has embraced the technological and economic progress made possible by Western philosophy. A rational philosophy can offer a unifying explanation of man and his universe and a guide for people and societies to achieve values and peacefully coexist.


World human population (est.) 10,000 BC–2000 AD.

World human population (est.) 10,000 BC–2000 AD.

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The One Minute Case for Rational Self-Interest

Ayn Rand’s philosophy of Objectivism proposes a radical new theory of ethics: an objective, scientific theory of rational self-interest.  How does Ayn Rand justify her theory?

What is a moral code?

Morality is a code of rules or principles to guide one’s actions. Before deciding which principles man should live by, any moral theory must first explain why it is needed at all. Is it an arbitrary invention, or does it have some basis in reality? Is it universally true or different for every person? According to Objectivism, morality is objective: it is derived from our nature of human beings.

Life is the standard of value

All living entities must satisfy certain requirements (food, shelter, air, etc.) to remain alive. This is what sets life apart from inanimate matter. Life is a continual process of self-generated, goal-directed action. Only living things face the possibility of death and therefore the need to achieve values to remain alive. Only for living things can something be good or bad. The fact that life is conditional is the basis of values.

Values are automatic for non-volitional beings

The values needed for life are specific to the nature of each being: fish need water and worms; man needs food, clothes and shelter. Animals have claws, fangs, fur, and other traits to allow them survive in nature. These are their means of survival. For non-human animals, values are automatic: their instinct tells them that they must act in a certain way (hunt, run, reproduce) in order to remain alive. Animals neither need nor are capable of morals because they act according to instinct. Their instinct tells them that they must act in a certain way (hunt, run, reproduce) in order to remain alive.

For humans, our conscious, rational mind is our primary tool of survival

Human beings live by using our mind as the primary tool of survival. We pursue long-term goals to achieve the values needed for our life. Imagine a human being trying to live without choosing his values, like any animal: he would act on whatever he felt like doing from moment to moment. He would experience the drives to eat, reproduce, fight, and fear. But humans have urges, not instincts — it is up to our minds to decide how to achieve values. For a human being in nature, living without long-term goals is suicide.

Ethics provides a framework for long-term goal achievement

To consistently act towards long-term values, we need a consistent set of principles for living: a moral code. We need to recognize the facts relevant to our nature as human beings and live according to them over a lifetime. To recognize and act in accordance with reality is rationality. Morality is a means to an end — the end being life. If you want to live, then you must be rational.   The purpose of morality is to fulfill and enjoy one’s own life.

Rationality is the primary virtue 

The Objectivist ethics recognizes rationality as the primary virtue for man and productive achievement as his central purpose. To remain alive, we must focus on the facts and act accordingly. The choice to think and act rationally is the basis of virtue and life, and the choice to evade reality and abandon reason is the basis of evil. The primary virtue, from which all other virtues derive, is rationality, and the proper beneficiary of values is oneself.

Happiness is man’s highest moral purpose

According to Objectivism, each person should act to achieve the values required for his own life, neither sacrificing himself to others nor sacrificing others to himself. Productive achievement is the central purpose of life, which integrates all his other values. Virtues such as productivity, independence, honesty, integrity, and justice are aspects of rationality: living according to the requirements of life as a human being. Happiness is the result of successfully achieving values, and man’s highest moral purpose.

 

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A One Minute Guide to Political Identification

Political perspectives can roughly be grouped into three historical camps: Conservatism, (classical) Liberalism, and Marxism.

The essential difference between these schools is in their solution to the problem of human values. Liberals see individuals as rational, self-interested, and autonomous beings who can best resolve their conflicting material and spiritual values through voluntary cooperation. This means advocating a free market with a free marketplace of ideas (i.e. a pluralistic society) being its essential corollary.

Conservatism and Marxism also sees the individual as self-interested, but therefore as fundamentally irrational, corrupt, and unable to resolve conflicting values independently. Conservatives believe that individual desire is inherently corrupting and therefore advocate centralized guidance and control of spiritual values, and prohibition of material goods which might lead to spiritual corruption. Marxists believe that the pursuit of material goods is inherently violent and conflicting, and the essential controls must be of material pursuits. Marxists belittle ideas as irrelevant and advocate control of self-interested motivates through centralized social structures such as compulsory state-run schools. Conservatives are explicitly opposed to the marketplace of ideas, while Marxists explicitly view ideas as irrelevant, but in practice ruthlessly suppress dissent when it conflicts with their policy goals.

Since man is an integrated being, both Conservatives and Marxists end up advocating the same policies in the downward spiral to prevent the perverse consequences of the controls they instrument. Unchecked, they both lead to tyranny.
It should be noted that these are only tendencies and the vast majority of people are some combination of these three perspectives.  Judging intellectuals means evaluating the particular combination of these perspectives. Furthermore, these perspectives are not primaries, but derivates of a basic perspective of human nature. This means that political views rarely change directly, but rather filter up through changes in a person’s basic view of human nature.

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The One Minute Case Against Healthcare Reform

What does the government mean by healthcare reform?

When the Obama administration talks about healthcare reform what they are really talking about is using the coercive power of the government 1) to force healthcare providers to provide services at lower costs 2) to force individuals to choose the least expensive healthcare and 3) to force people who are not receiving those services (aka taxpayers) to pay for them.

Does everyone have a right to healthcare?

Not in the colloquial sense. Everyone does have a right to healthcare, but not in the sense that the administration uses it. The right to healthcare means that man had the right to take the actions necessary (e.g. working) in order to earn money and spend that money as he sees fit – in this case, on his healthcare. It does NOT mean that other people (or the government) must provide him with healthcare.
Thus, we see that the administrations proposed actions will secure the supposed “right” of everyone to have healthcare paid for by other people by undermining the actual, moral, right of individuals to choose, and pay for, their own healthcare goods/services.
“The end does not justify the means. No one’s “rights” can be secured by the violation of the rights of others.”
“The Cashing-In: The Student Rebellion” Capitalism: The Unknown Ideal, 256.

Should the government use force against its own citizens?

No. The purpose of the government is to protect the private property of its citizens against other citizens (the police) and against foreigners (the army). Any further expansion of the governments power beyond this mandate is not only immoral, but unconstitutional. The simple fact that some group of people chosen by the government (in this case, those without healthcare) would benefit from the governments use of force does not create a moral right to use force. This precept is DeToqueville’s “Tyranny of the Majority” in a practical sense, and is exactly what the Founding Fathers intended to protect us against by founding the USA as a republic backed by a bill of rights, instead of as a direct democracy.

Why is the government’s initiation of force immoral, if the goal is to benefit the “public good”?

“Just as no individual has the right to initiate force against anyone, neither does any group of men, in any private or public capacity. It is immoral to initiate force against any individual for any reason. This includes the initiation of force for “the public good.” The “public” is merely a collection of individuals, each possessing the same rights, and each being an end in himself. Any attempt to benefit the “public good” is an immoral attempt to provide a benefit to one group of individuals at the expense of another. In a free society, no individual benefits at the expense of another: men exchange the values they create in voluntary trade to mutual gain. The rule of law in a free society has just one purpose: to protect the rights of the individual.”
The One Minute Case for Capitalism: HeroicLife

Regardless, can the government lower prices of healthcare services?

Prices are determined by the marginal value of a good/service, not a government edict. If the government forces providers to set the price of a good/service below its cost, providers will no longer provide the good/service. If the government forces providers to lower prices, but not to lower them below cost, the government will be redistributing the profits of the HC provider to the HC consumer – thereby starving the R&D engine of modern medicine of its much needed fuel, capital.

Well then, how can the prices of healthcare be lowered?

The price of HC, like any other good/service, can only be lowered through increased productivity and innovation. Productivity in the production of healthcare goods comes directly from the concerted rational effort of those companies who stand to profit from that productivity – big pharma, providers, payers, etc. Stripping away the reward for their productive achievements – profit – severely dampers the incentives for the companies who provide HC goods/services to continue improving productivity and driving innovation. Thus, the only way to properly incentivize lower HC costs is by allowing entrepreneurs and businessmen alike the freedom to fully profit from the risky investments they make in healthcare innovation and productivity improvements.

What will be the direct results of the governments actions?

First, on taxation. The increased taxes proposed to finance healthcare reform, especially those on the rich (who create most of the value in the USA) will serve to disincentivize productivity and innovation.
Second, on providing healthcare. The proximate result of the governments proposal will be rationing, in its purest sense put forward by Ayn Rand in a letter to a friend “[Rationing means] to distribute [goods and services] in a certain particular manner–by the decision of an absolute authority, with the recipients having no choice about what they receive.”
Rationing, it must be made clear, is not the same as the distribution mechanism that occurs in a free market – where the price of a good determines how it is distributed – primarily because in a free market distribution decisions are made by individuals volitional choices, whereas in a rationed market distribution decisions are made by government edict. The government’s actions, in this case, will effectively eliminate some (if not all) of the choices you have in determining the way in which you receive healthcare.

What, then are the real drivers of our health care problems?

Primarily, that no free market currently exists in healthcare. Massive amounts of regulation by the FDA and other government bodies result in dramatic increases in the cost of medicine. Using Big Pharma as an example, the government has two quantifiable impacts. Directly, the cost of developing a drug in compliance with FDA processes costs roughly ~$1 billion per drug, money that would otherwise be used to fund further innovation or be passed on to consumers in the form of lower prices. Indirectly, the extended time it takes for the FDA approval process (roughly 10 years from patent application to market introduction) cuts the effective life of a pharmaceutical patent in half – stripping the PharmaCo of half of its potential profitability. (Barrons, June 2, 2003 Editorial Commentary: Gary Hull: Patent Piracy.)

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The One Minute Case against the Existence of God

A religion is an organized system of belief, most often assuming the existence of a higher power such as a supernatural almighty deity or an ultimate truth, first designed to enlighten humanity on the act of creation and produce specific prophecies that will come true if certain requirements are met. This case argues that supernatural deities do not exist, which entails the fact that all major religions are false and outdated phenomena outstripped by science, serving little other use than hampering additional scientific progress.

The cosmological argument

Some religious individuals argue that whatever begins to exist has a cause and since nothing causes itself, there has to be a First Cause, namely God. There are several objections to this argument, some of them being as following;

  • What caused the First Cause? By making use of the cosmological argument one presupposes that an uncaused effect exists, enabling it to cause a chain of effects without being caused itself. Seeing that the argument is reliant upon the premise that all effects have a cause it is in consequence invalid.
  • The First Cause is by no means equal to a deity. Even though the origin of the universe remains scientifically unexplained, it doesn’t justify supernatural religious claims.

The Teleological argument [Intelligent Design]

This argument states that some phenomena are too complex, or too apparently purposeful, to have occurred randomly. Therefore, these phenomena must have been designed by an intelligent or purposeful being (God).

– Who designed the designer? If an intelligent designer only is able to design irreducibly complex units, then an even more intelligent designer is necessary to design the original designer. This entails an infinite chain of designers. To counter this counter-argument some individuals make use of the cosmological argument. However, as explained above, this argument fails because it omits why a designer can be undersigned while the universe cannot.

William Paley’s watchmaker analogy makes use of this argument, and is to this date one of the most famous teleological arguments. He argues that there are structures which cannot function unless all substructures are present. By asserting that each substructure constitutes no benefit alone, evolutionary theory is unable to explain the substructures presence. Since the substructures presence cannot be explained, the whole structures presence cannot be explained either. Counter-arguments are as following:

  • There is a probability that all substructures came into existence simultaneously.
  • Substructures may have changed in function. A gradual replacement by several advantageous substructures’ function can lead to the evolution of structures claimed to be irreducibly complex.

The omnipotence paradox

Most, if not all, monotheistic religions claim the existence of an omnipotent God. This argument leaves the concept of omnipotence as a mere paradox unable to exist in a logical universe. If a deity is in fact omnipotent, then he is able to create a rock he himself cannot lift. Since he cannot lift the rock he just created he is not omnipotent.

Argument from free will

All monotheistic religions claim their god to be omniscient, and at the same time claim to have been given free will by the very same god. These two concepts are incompatible. Here is why: An omniscient being knows everything, including the future will of his supposed free willed- designees. Since the will is already known, it cannot be free at the same time.

Other[inductive] arguments state that a complete being (God) must also be dead or non-existing in order to be fully complete. Furthermore, some conclude that since most theistic religions eventually were regarded as untrue, all theistic religions are most likely to be untrue. Stephen F. Roberts formulated this beautifully by saying:
“I contend that we are both atheists. I just believe in one fewer god than you do. When you understand why you dismiss all the other possible gods, you will understand why I dismiss yours.”

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The One Minute Case for Designer Babies

The term “designer baby” is a derogative term for the use of reproductive and genetic technologies to accomplish an optimal recombination of the parents’ genes. This case argues that the voluntary use of genetic technologies, as well as prenatal screening and abortion is both moral and desirable. It does not address the morality of abortion (defended in this case) or the safety of particular technologies – an important consideration, but not a fundamental issue.

Parents ought to want healthy children

While there are many valid motivations to become a parent, in choosing to create a human being, parents assume a moral obligation to provide for and educate their children to become independent, mature adults. Beyond the legal obligation of providing minimum care, to the extent that parents love and value their children (and there is no reason to have children otherwise), parents ought to strive to maximize their child’s ability to become fully functional adult human beings – physically, spiritually, socially, romantically, etc. This means providing both appropriate education, and taking care of their physical needs.

Health can be objectively defined in relation to the requirements of human life

It is possible to make judgments about which mental and physical states are objectively superior in relation to other states. For example, a broken leg, a bout of flu, or a headache are undesirable because they prevent one from accomplishing a whole range of actions which are required for human life. We recognize this when we use technology (medicine) to help people overcome and heal from their injuries and illnesses. The same applies to genetic physical and mental deformities, which adversely impact one’s ability to accomplish his values. If someone suffers from clinical depression or schizophrenia, we offer them drugs that improve their ability to use reason to deal with reality and achieve the values they desire. If healthy, successful, productive human life is a value, then it is moral to use all available technology to maximize human potential to achieve the values they desire.

Biotechnology adds new tools to an ancient arsenal of genetic techniques for better offspring

If health is desirable and can be objectively defined, then parents ought to choose to have healthy children. They do this in a variety of means: Genetically, humans instinctively seek mates likely to produce healthy offspring – this is the basis of selective sexual attraction based on physical traits. Consciously, parents choose partners who share their child-rearing values. They also take measures to prevent child defects, such as abstaining from drugs during pregnancy and choosing to have children earlier in their life. Genetic counseling and prenatal screening are just two new tools for enhancing an ancient process.

The Gattaca objection confuses the potential for the actual

The Gattaca objection to screening undesirable traits is that people with undesirable traits have made many valuable contributions, and are capable of living fully productive lives. Supporters often give examples of great scientists like Albert Einstein or Stephen Hawkins with genetic or developmental abnormalities, or of people with serious impairments such as Down Syndrome who nevertheless hold jobs and assume most of the functions of normal adults.

This objection confuses between the seen and the unseen. What we see is that many people with undesirable traits are unusually successful, either in relation the average person, or to people with their symptoms. What we don’t see are all the people who failed to achieve their values because of their symptoms. If their genotype or embryo had been eliminated before birth, the unhealthy people would not exist, but an equal number of healthy people would. Unless the undesirable symptom itself contributed to their success, the percentage of unusually successful healthy people would be far higher than the number of extraordinarily successful unhealthy people. Certainly, healthy people would have a better chance at a normal life than someone with a chronic syndrome such as Down Syndrome, Tay-Sachs, or Spina bifida.

Genetic diversity is valuable – but only if it is used to enhance human life, not impair it

The “neurodiversity” movement opposes genetic screening on the grounds that atypical neurological development should be recognized and respected. The movement has a valid point insofar as neurodiversity has played a critical part in the development of human civilization. If every human being had exactly the same intelligence and developed in the same way, we would have no great scientists, artists, intellectuals, or entrepreneurs.

Unfortunately, the neurodiversity advocates only support “diversity” when it is due to ignorance, not conscious choice. They support a baby being born with Autism, Parkinson’s disease, dyslexia, or other disorders because the parents had no choice in the matter, but they oppose giving the parents the power to choose to have a child which is healthier than he would “naturally” be. If most parents could consciously choose what traits to give their children, they might prefer more intelligence, curiosity, a longer life, or stronger muscles. These are also varieties of genetic diversity.

Objections to genetic counseling and gene engineering are ultimately objections to technology

Few parents would choose to have their children be born blind, deaf, retarded, or crippled. Yet this is precisely what the “diversity” advocates want: to prevent parents from being able to improve on the “natural” forms of biodiversity.  Traits due to  sexual selection, random genetic mutation, and embryonic variation are acceptable to them, but traits due to conscious human choice are not.

Genetic screening via sexual selection has been practiced since the dawn of life itself.  No one suggests that we should pick a mate entirely at random, so the objection to genetic screening and engineering is due to the element of technology. Their objections are not to “designer babies” as such, but to the use of technology to improve the lives of human beings. They apply equally to a child whose genes are altered after birth, or to an adult. The logical conclusion of this neo-luddism is the opposition of all man-made improvements to human life as “unnatural.”

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