Meritocracy, Medicine, and the Case Against Perfection: A Conversation with Michael Sandel

December 20, 2021

Information

December 15, 2021

Michael J. Sandel, PhD

Anne T. and Robert M. Bass Professor of Government, Harvard University

Political Philosopher

Author

ID7310

To CiteDCA Citation Guide

00:00So good evening everyone and welcome
00:04to our Evening conference in the
00:07program for Biomedical Ethics at Yale.
00:10My name is Sarah Hall and I am one of
00:12the associate directors of the program,
00:14along with Jack Hughes and we're joined
00:17by our program director, Mark Mercurio,
00:20and we have the honor tonight of welcoming
00:24Professor Michael Sandel from Harvard.
00:27Michael Sandel teaches political
00:29philosophy at Harvard University.
00:32And actually I took his class
00:33when I was an undergraduate,
00:36and that's how I got bitten by the
00:38philosophy bug and and ended up here.
00:41Now almost 20 years later,
00:43just before I,
00:44I go further into his introduction.
00:46I just want to sort of cover
00:48some housekeeping about how
00:50tonight's program is going to work,
00:52although I think most people probably
00:54already know how how we roll.
00:57But tonight, Professor Sandel
00:59will be speaking on the order of.
01:02Maybe 20 minutes,
01:03maybe a little bit longer,
01:04but not quite as long as our
01:06typical discussions run because
01:08you wanted to leave more time for
01:10discussion in Q&A during that time,
01:12if you you should feel free to
01:14submit any questions you might have
01:16in the Q&A section and we will get
01:19to them afterwards after he speaks,
01:21Mark Mercurio will give a short
01:23response and then we're going to
01:25open it up to questions which I
01:27will moderate along with Mark if it
01:30gets particularly spirited, which.
01:32Which we hope it will and and
01:35and that'll be that we do have a
01:38hard stop at 6:30 as you know,
01:40and so even if you have the
01:43most brilliant burning question,
01:44if it comes in at 6:29 and and we
01:47still are working on another question.
01:49And unfortunately we'll just have
01:50to table that for another time.
01:52But I encourage you to submit
01:54questions early and often.
01:56Will try to get to as much as we can,
01:58and we are very,
01:59very excited to have to hear what
02:02Professor Sandel. Have to say tonight.
02:04So without further ado I will
02:07introduce him formally so again,
02:09Michael Sandel teaches political
02:11philosophy at Harvard University.
02:13His books on justice,
02:15democracy,
02:15ethics and biotechnology and markets have
02:18been translated into more than 30 languages.
02:21He has been described as the world's
02:23most influential living philosopher.
02:25His latest book, The Tyranny of Merit.
02:27What's become of the common good,
02:29was named a best book of the
02:31year by the Guardian Bloomberg,
02:32New Statesman.
02:33The Times literary supplement excuse
02:36me in Paris and New Weekly in Beijing.
02:40His previous books include the
02:41case against Perfection,
02:42Ethics in the age of Genetic Engineering,
02:45his legendary course.
02:46Justice was the first Harvard course
02:48to be made freely available online and
02:50has been viewed by 10s of millions of people.
02:53And again was the brilliant course
02:55that I took and made me fall in
02:58love with philosophy,
02:59his BBC series,
03:00the global philosopher explores
03:02the ethical issues lying behind
03:03the headlines with participants
03:05from around the world.
03:06Sandel has been a visiting
03:08professor at the Solon and
03:09delivered the tenor lectures on human
03:11values at Oxford in the US Sandel has
03:14served on the President's Council
03:15on bioethics and is a member of the
03:18American Academy of Arts and Sciences,
03:19and without further ado I present to you
03:22Professor Michael Sandel. Take it away.
03:25Well, thank you Sarah.
03:26Thanks so much and what a thrill it
03:29is to be introduced by you, Sarah,
03:31hearkening as you hearken back to the time
03:34when you took my my course on trustis
03:37as an undergraduate and thanks also to
03:40mark for for a hosting and convening us.
03:44When Mark and I first talked about
03:47what we might discuss this evening,
03:50we came up with the idea of
03:53speaking about my recent book,
03:56that Tyranny of Merit,
03:58but also an earlier book which echoes some
04:02of the OR anticipate some of the themes.
04:06The book Sarah just now mentioned,
04:08called the case against perfection.
04:10Ethics in the age of genetic engineering.
04:14Now these are two very different books.
04:17The tyranny of merit is about what's
04:20gone wrong with meritocracy these days.
04:23Whereas the case against perfection.
04:26Is an argument against the use of
04:30genetic engineering for enhancement
04:32rather than for medical purposes,
04:35but there is a theme that connects
04:39them and so in these opening remarks,
04:41I'd like to bring out that theme.
04:43See if I can make sense of it.
04:46Then I'll be keen to hear what you think.
04:50So first the tyranny of merit,
04:53which is the recent book on the face of it,
04:57to speak of the tyranny of merit,
04:58is paradoxical.
05:00We normally think of merit as a good thing.
05:04Merritt understood as.
05:06Appointing people to jobs and social
05:09roles based on their being well qualified
05:12for them who could be against that?
05:14If I need surgery performed,
05:17I want a well qualified surgeon
05:19to perform it.
05:20That's merit, and that's certainly a
05:23laudable and necessary form of merit.
05:27So how does merit become a tyranny?
05:31Becomes a tyranny when it turns
05:34into a system of meritocracy.
05:37Now anything that has ocracy
05:39at the end of it?
05:42Aristocracy democracy meritocracy
05:44refers to a system of rule.
05:49And when merit becomes the system of rule,
05:52as in a meritocracy,
05:54it becomes a way.
05:57Of allocating income and wealth,
06:00power and opportunity,
06:02honor,
06:02and social esteem on the basis of
06:06what people are thought to deserve
06:08and the basis of what people are
06:11thought to have earned for themselves.
06:14Now, meritocracy.
06:15So I'd like to argue has a dark side.
06:21The dark side is connected to the harsh
06:24ethic of success that it generates,
06:28but let me explain.
06:30Let's begin by stepping back and having
06:34a look at our present civic condition.
06:39In recent decades.
06:40The divide between winners
06:43and losers has been deepening,
06:46poisoning our politics, setting us apart.
06:50This has partly to do with widening
06:54inequalities of income and wealth,
06:56but it's not only that.
06:59It has also to do this divide with
07:03the changing attitudes toward
07:05success that have accompanied the
07:08widening inequalities.
07:10Those who have landed on top during
07:13these recent decades of globalization,
07:16those who have landed on top have
07:18come to believe that their success
07:21is their own doing.
07:23The measure of their merit,
07:25and that they therefore deserve
07:27the full bounty that the
07:29market bascos upon them.
07:31And by implication,
07:33to think that those who struggle those left
07:37behind must deserve their fate as well.
07:42This way of thinking about success.
07:45Reflect a seemingly attractive ideal.
07:50The ideal of meritocracy.
07:52The principle that says if chances are equal.
07:56The winners deserve their winnings.
07:59That's the key.
08:01Meritocracy is a theory.
08:03It's a principle of deserving Ness.
08:08Now, in practice of course.
08:11Chances are not truly equal.
08:14Well, you see this if we look
08:18at university admissions at Ivy
08:20League universities for example,
08:23there are more undergraduates.
08:26Who come from the top 1%?
08:30Then there are undergraduates who come
08:32from families in the entire bottom half.
08:35Of the country combined,
08:37bottom half of the income scale so clearly.
08:42We don't live up to the
08:46meritocratic principles we profess.
08:49But it's not only that even if
08:52we had a perfect meritocracy,
08:54even if we could fix the
08:58inequality of chances.
08:59Still, meritocracy would have a dark side.
09:03The dark side is that meritocracy
09:07is corrosive, but the common good.
09:10The reason it's corrosive of
09:12the common good is connected to
09:14the attitudes towards success.
09:16I mentioned a moment ago.
09:19Meritocracy.
09:22Even if chances were equal.
09:25Would encourage the winners to believe
09:29their success was their undoing.
09:33Meritocracy induces.
09:34Kind of meritocratic hubris
09:38among the winners.
09:40And humiliation among those left behind.
09:44The hubris among the winners consists
09:47in the idea I burned it on my own,
09:50and therefore I deserve it.
09:53But this hubris forgets
09:56the luck and good fortune.
10:00That help us on our way,
10:02it forgets our indebtedness.
10:04To those who make our achievements possible.
10:09Family teachers community country.
10:11The times in which we live.
10:15Now. It also.
10:18Has and here's how it becomes
10:22corrosive of the common good.
10:25It leads the successful
10:28to look down on those.
10:31Less fortunate than themselves.
10:34And this matters for politics.
10:37Think about our political
10:39moment in recent years.
10:41One of the most potent sources of the
10:45populist backlash against a leaps.
10:47Is the sense among many working
10:50people that elites look down on them?
10:54It's a legitimate complaint.
10:57Because even as globalization brought
11:01deepening inequality and stagnant wages.
11:05Its proponents offered.
11:07Working people, some bracing advice.
11:11If you want to compete in win in
11:13the global economy, they said.
11:14Go to college.
11:16What you earn will depend on what you learn.
11:20You can make it if you try.
11:22These were the meritocratic
11:24mantras in the book.
11:26I called them the rhetoric of rising.
11:30But these elites failed to see the
11:33insult implicit in their advice.
11:36The insult was this.
11:38If you didn't go to college,
11:41and if you're struggling in the new economy,
11:44your failure must be your fault.
11:48So it's no wonder that many working
11:51people turned against meritocratic elite.
11:57So what should we do in the book?
11:59I suggest rethinking 3
12:01aspects of our civic life.
12:04The role of higher education,
12:07the dignity of work in
12:10the meaning of success.
12:12We have made and universities
12:14have accepted the role.
12:16We've turned universities into
12:18arbiters of opportunity in a
12:21market driven meritocratic society.
12:24We've turned them into sorting
12:27machines for opportunity.
12:30But there's a problem with this.
12:32One of the problems is.
12:35Those of us who spend our days
12:37in the company, the credentialed.
12:39Can easily forget it, simple fact.
12:43Most people don't have.
12:46A four year college degree.
12:49In fact, nearly 2/3 of Americans do not.
12:54So it's folly to create an economy.
12:57That sets us a necessary condition
13:00of dignified work in a decent life.
13:04A college degree that most people don't have.
13:09Encouraging people.
13:11To go to college is a good thing.
13:14Broadening access for that,
13:16who those who can't afford it is even better.
13:19But this is not a solution to the
13:23inequalities brought about by globalization.
13:26So, broadly speaking,
13:27we should shift our public discourse.
13:30We should focus less.
13:32But arming people for meritocratic
13:36competition and focus more.
13:38On making life better for those
13:41who may lack a diploma.
13:44But who nonetheless contribute in
13:46important ways to the common good?
13:49Through the work they do the
13:51families they raised,
13:52the communities they serve.
13:54This means renewing the dignity
13:56of work and putting it,
13:59putting it at the center of our politics.
14:04We also so we we need to reconceive
14:09the role of the of the dignity of work.
14:13One prompt to doing so
14:15comes from our experience.
14:17During the pandemic the pandemic
14:20highlighted inequalities that pre existed,
14:23the pandemic, the most vivid being
14:25the divide between those of us who
14:29could work from home and those of us
14:31who are either lost their jobs or
14:33who in order to perform their jobs,
14:35had to expose themselves.
14:37The risks on behalf of the rest of us.
14:41But we did.
14:42I think there was a kind of turning during
14:46the pandemic and opportunity and opening.
14:50Because those of us able to work from
14:53home couldn't help but notice how deeply
14:56we depend on workers we often overlook.
15:00I'm thinking not only of those who
15:03worked mightily in the hospitals
15:06to care for COVID patients,
15:09I'm thinking also of delivery workers,
15:12warehouse workers, grocery store clerks,
15:15home health care providers,
15:17child care workers.
15:18These are not the best. Paid.
15:21Or most honored workers in our society.
15:26And yet,
15:27during the pandemic we began calling them.
15:30Essential workers nobody in the midst
15:34of the pandemic was referring to hedge
15:37fund managers as essential workers,
15:39so this could be.
15:42The beginning of a broader public debate
15:44about how to bring the pay of those
15:47who were calling ascential workers.
15:50The pay and also the socialist scheme.
15:54Into better alignment with
15:56the importance of their work.
15:59But there's something else we
16:02need to reconsider.
16:03We need to reconsider the meaning of success.
16:07To question our meritocratic hubris.
16:12Do I really deserve the talents
16:16that enable me to flourish?
16:19In a market driven society such as ours,
16:21or are my talents gifts?
16:26For which I'm indebted.
16:27And what about the fact that I live
16:30in a society that happens to prize
16:32the talents that I happen to have?
16:35Is that my doing or is that to my good luck?
16:41Insisting that my success is my do makes it
16:45hard to see myself in other people shoes.
16:49Appreciating the role of luck in life.
16:52Appreciating my talents as gifts for which
16:56I'm indebted can prompt a certain humility.
17:00Can prompt me to to say
17:02and to think that there,
17:04but for the accident of birth or the
17:08grace of God or the mystery of fate go I.
17:12This civic virtue is of humility.
17:18Is in short supply these days,
17:20but it seems to me it could be a potent
17:25antidote to the meritocratic hubris.
17:28The harsh ethic of success
17:31that drives us apart.
17:33Now that in very brief compass.
17:38Is the main argument of the tyranny of merit.
17:43But it's connected.
17:46To the theme of the earlier book.
17:49About genetic engineering for enhancement.
17:52The case against perfection and
17:55it's connected in the following way,
17:58what in?
17:59In describing the connection I will be?
18:02Maybe overly telegraphic because I
18:05wanted to see what Mark has to say and
18:09Sarah and and to begin the discussion.
18:13But in the case against perfection,
18:15I argue against the use of
18:18genetic engineering for purposes
18:21that go beyond medical purposes.
18:24To enhance our cognitive abilities,
18:28for example, or those of our children.
18:32To prescribe off label uses,
18:35let's say of human growth hormone for
18:38kids who don't suffer any abnormality but
18:40who want to make the basketball team,
18:43let's say.
18:45Performing performance enhancing drugs.
18:50Or for that matter,
18:52genetic alterations for athletes.
18:54Now there is a vast debate in
18:58biomedical ethics about the moral
19:01status of genetic engineering for
19:04purposes of enhancement beyond health.
19:08And.
19:10For those of us who are critical of that use.
19:15It's not easy to explain exactly
19:18what the moral objection consists in.
19:21One moral objection has to do with fairness.
19:25In an unequal society,
19:27wouldn't the affluent be able
19:28to gain yet more advantages for
19:31themselves and for their kids?
19:33In fact,
19:34might we even inscribe inequality in
19:38genetically overtime if the affluent had
19:42access to an enhancement technologies?
19:44That others do not.
19:48That objection could be met in
19:50principle by providing a form of
19:54universal healthcare that included
19:56access to enhancement technologies.
20:00In the case against perfection,
20:02I argue that there is a further.
20:05Deeper object in this objection
20:08has to do with the way in which
20:12the disposition the attitude that
20:15animates the drive for enhancement.
20:18Is corrosive of important human
20:22and civic goods?
20:25And involves a certain kind of hubris,
20:28and a certain kind of project of mastery.
20:32And the assumption that ultimately we
20:35are self made and self sufficient.
20:38Human persons and that this assumption.
20:42That we are self made and self
20:45sufficient cuts us off from an
20:47appreciation of the gifted character
20:50of our talents and of our children.
20:53End of our human circumstance.
20:57Let me explain.
20:59Take the example of parents.
21:03Who want the best for their kids,
21:05including if it were possible?
21:08Enhancing their cognitive abilities
21:10or their musical ability so
21:13they're they're athletic prowess.
21:15What would be wrong with this,
21:17apart from the worry about fairness
21:20and access to such technologies?
21:23Argued that it would be
21:25corrosive of the notion.
21:27How children as gifts?
21:31This is the ethic of giftedness,
21:34that is, the counterweight to the image,
21:37that we are self made and self sufficient.
21:40It's a counterweight to the
21:42ethic of mastery that informs,
21:44so it seems to me the project of
21:47genetic engineering for enhancement.
21:49Here's what I mean.
21:51To appreciate children as gifts.
21:55Is to accept the mistake come?
21:58Not to treat them as objects of
22:00our design or instruments of our
22:03ambition or products of our will.
22:06Parental love is not contingent on the
22:10talents and attributes our children have.
22:14We choose our friends and spouses
22:16at least partly on the basis of
22:19qualities we find attractive.
22:21But we do not choose our children.
22:24Their qualities are unpredictable and
22:27even the most conscientious parents.
22:31Can't be held wholly responsible
22:33for the kind of child they have.
22:37This is why parenthood,
22:39more than other human relationships,
22:42teaches it,
22:43teaches what the theologian William May.
22:47Calls and openness to the Unbidden.
22:54This is a potent resonant phrase
22:56and openness to the end didn't.
22:58It describes a quality of character
23:01and heart that restrains the
23:04impulse to mastery and control.
23:07It prompts the sense of life as a gift.
23:11It helps us see.
23:13The deepest moral objection.
23:17To genetic engineering for enhancement
23:21lies not in the perfection it seeks,
23:25but in the human disposition,
23:26it expresses and promotes.
23:31The problem isn't that parents
23:33usurped the autonomy of the child.
23:36It's not as if the child
23:39could otherwise choose.
23:40Her genetic traits for herself.
23:44The problem lies in the hubris of
23:47the designing parents in their drive
23:50to master the mystery of birth.
23:53Even if this disposition doesn't make
23:56parents tyrants to their children.
23:59It disfigures the relation
24:01between parent and child.
24:03It deprives the parent of the humility.
24:06And of the enlarged human sympathies.
24:10That and openness to the
24:13Unbidden can cultivate.
24:16Now to appreciate children
24:20as gifts or blessings.
24:23Not to be passive in the
24:25face of illness or disease.
24:28Healing a sick or injured child does
24:32not override her natural capacities.
24:35It permits them to flourish.
24:39So although medical treatment
24:42intervenes in nature.
24:45It does so for the sake of health.
24:48And so does not represent a boundless
24:52bid for mastery and Dominion.
24:56Even strenuous attempts to cure or
24:59treat disease do not constitute
25:02a kind of Promethean assault.
25:05I'm the given.
25:08The reason?
25:10The reason is that medicine is governed,
25:13or at least guided.
25:15By the norm of restoring and
25:18preserving the natural human
25:20functions that constitute health.
25:25Another way of putting this
25:27is to say that medicine.
25:29Is a practice with a purpose.
25:32Ority loss that orients and constrains it.
25:40Of course, what counts as good health?
25:42Or natural human functioning
25:45is open to argument.
25:47It's not only a biological question.
25:51People disagree, for example.
25:53About whether deafness is
25:56a disability to be cured.
25:58Or a form of identity and
26:01community to be cherished.
26:03But even disagreements such as
26:05these proceed from the assumption
26:07that the point of medicine.
26:09Is to promote health and to cure.
26:13Disease.
26:15Now, some people argue that a
26:17parents obligation to heal a
26:20sick child implies an obligation
26:22to enhance a healthy one.
26:24To make them better than,
26:25well to maximize the child's
26:28potential for success in life.
26:32But this is true only.
26:35If one accepts the utilitarian idea.
26:39That health is not a distinctive human good.
26:43It's simply 1 means, among others of
26:46maximizing happiness or well being.
26:53One utilitarian bioethicist argues,
26:55for example, that health is
26:58not intrinsically valuable,
26:59only instrumentally valuable,
27:01a resource that allows us to do what we want.
27:08This way of thinking about
27:10health rejects the distinction
27:13between healing and enhancing.
27:15It leads to the view that
27:17parents have not only a duty to
27:20promote their Children's Health.
27:22That they may be morally obligated to
27:25genetically modify their children,
27:27provided it can be done safely.
27:31But it's a mistake to think of health
27:34in wholly instrumental terms as a way of
27:38maximizing something else good health.
27:42Like good character is a constitutive
27:47element of human flourishing.
27:50And although more health is better than less,
27:53at least within a certain range,
27:56health is not the kind of good.
27:59That can be maximized.
28:03Nobody aspires to be a virtuoso at health.
28:07Except perhaps hypochondriac.
28:12During the 1920s, eugenicists held
28:16health contests at state fairs.
28:20They awarded prizes to the
28:24so-called fittest families.
28:26But this bizarre practice illustrates
28:29the folly of conceiving health
28:32as something to be maximized in,
28:35and, in purely instrumental terms.
28:38Unlike the talents and traits that
28:40bring success in a competitive society,
28:43health is a bounded good.
28:46Parents can seek it for their children
28:50without the risk of being drawn
28:53into an ever escalating arms race.
28:59So how does this connect up with
29:02my argument against meritocracy?
29:06The flaw, the moral defect in
29:08both and unbridled,
29:10unbridled meritocratic competition that
29:12persuades at the successful their success,
29:15is their own doing and the big from Mastery
29:19and Dominion reflected in the drive for.
29:23Genetic engineering to enhance.
29:27Human capacities what they share.
29:31Is the idea?
29:33That ideally at least.
29:36We are to be fully free.
29:38We must think of ourselves.
29:41As self made and self
29:44sufficient moral agents.
29:48And.
29:49But this misses something
29:51important about our humanity.
29:55The problem. What it misses rather.
30:00Is an appreciation of the gifted character.
30:07Of human powers and achievements.
30:09To acknowledge the giftedness of
30:12our talents is to recognize that
30:16they are not wholly our own doing.
30:20Nor even fully ours,
30:22despite the efforts we expend to
30:25develop and to exercise them.
30:28It's also to recognize that not
30:31everything in the world is open to
30:34any use we may desire or devise an
30:39appreciation of the giftedness of
30:41life conduces to a certain humility.
30:45And this humility, should I think,
30:49lead us to question the harsh
30:52ethic of success.
30:53That arises in a competitive
30:57meritocratic society, such as ours,
31:00that persuades the successful
31:02they've done it on their own,
31:05just as it should lead us to question.
31:08The drive.
31:10To employ genetic engineering
31:13to go beyond health to enhance.
31:17Our capacities, our talents,
31:20or those of our children?
31:23That it seems to me,
31:24is the common thread between the
31:27case against the tyranny of merit.
31:30And the case against perfection
31:33understood is the drive to engineer
31:37our way to greater cognitive and
31:42other capacities than health
31:46itself would require.
31:48Mark what do you think?
31:53Oh, this, this ought to be a piece of cake.
31:55Michael, this is no problem.
31:56I I should have seen this coming,
31:57which is each time I thought wait a
31:59minute I can I can have something to
32:01say about that and then three sentences
32:02later you actually anticipated my
32:04concern and addressed it beautifully.
32:07So I have a couple comments that
32:08that I can make and open it up.
32:10But I I, I think what you say is
32:12extremely insightful and I don't
32:13take issue with any of it obviously.
32:15I mean it's not my place to take
32:16issue with it, but a couple of points.
32:18I read a really good book recently which I
32:20recommend everybody says book here it is.
32:21Here is the case against perfection.
32:23By Michael Sandel. So I read this
32:25and what's interesting about this.
32:26This is your penultimate book.
32:27Yes this was not penultimate but not
32:29the most recent. Of course come.
32:31But but in this I can see the seeds
32:34of the tyranny of meritocracy.
32:36Yes, in which you wrote here and
32:38in particular one of the things
32:39that many things comma but one of
32:41the things that didn't request you,
32:43touched on it tonight was about gift
32:45in this and I think that's such a
32:47beautiful concept. And I absolutely agree.
32:49I think that to paraphrase you that
32:51our natural talents are the result
32:53of good fortune.
32:54The genetic lottery and it's therefore
32:56a conceit to think we're entitled
32:58to the full measure of bounty as
33:00you put it on that stem.
33:02From these talents,
33:03there's an obligation to share with
33:05those who lack comparable gifts.
33:07I quite agree, and this is,
33:08I mean this to me was reminiscent of of
33:11a Bible verse I learned as a as a young man,
33:14which was those to whom much has been given.
33:16Much will be expected that that the idea of
33:20sharing this and the idea of gifted this,
33:22though to me,
33:23had its limits,
33:24which I'll get to in a second.
33:25And I think it has to do with with the
33:28role of parents in all of this and in
33:30in the in the talk that you gave here.
33:33So to some extent I wonder if this
33:35doesn't come down to the common good
33:37because everything you say I think
33:39speaks beautifully for the common good.
33:41And it speaks,
33:41I think of a of a largely
33:43communitarian ethic.
33:44Let's take a look at how to build a world,
33:46how to build a society that's really going
33:48to be the best for all of us overall.
33:51And and I think that that that
33:54makes perfect sense,
33:55but as a physician and as a parent,
33:58one could look at things and say,
34:00well, really,
34:00my obligation isn't to make a better world.
34:03I realize that if I make the world
34:04this much better for everybody,
34:05that's good for my kids too.
34:07But if I can make it this much
34:09better for my kids,
34:10and there is, I think perhaps that.
34:14That tension between our obligations
34:16to society overall to mankind overall,
34:20and our obligations to our
34:21individual kids and as physicians,
34:23our obligations to our individual.
34:28Patience, I would say that that
34:29one of the points you made which
34:31I just raised parenthetically,
34:32I thought was right on the money was the
34:34idea of essential workers and all of
34:36a sudden people had to say well who's
34:38really essential here and who ain't now.
34:39In fairness, a lot of people who
34:40were home working on their computers.
34:42They were essential to for the
34:44functioning of our society.
34:45No doubt. Nevertheless, I mean,
34:47it's the hope that this opens the window
34:49to better pay and better dignity for
34:51people who do things that aren't as
34:54honored in our culture in worldwide,
34:55and so that that.
34:57Looking at I mean,
34:58this pandemic has been very much a game
35:01changer in so many ways for all of us,
35:03and so part of what we spend a lot
35:05of time wondering is how is the
35:07world gonna stay changed even as we
35:09eventually get through the pandemic?
35:10How are things going to stay changed
35:12and one can hope that that's one
35:14way as as a a new appreciation
35:15for the people who who,
35:17who as you say deliver the packages.
35:20The people who stopped to grocery store etc.
35:23People whom for whom we absolutely
35:24depend on and people who had
35:25to put themselves at increased
35:27risk compared to so many others.
35:28In order to keep the wheels turning.
35:31But getting back to my concern about
35:34the parents view, the individualistic
35:36view versus the communitarian view,
35:38which is that I think that what parents
35:40want when we look at the idea of giftedness,
35:43and I think with parents may
35:45want and it maybe is not so much
35:48to accept them as they are.
35:50Of course I think that parents should
35:52accept their children as they are,
35:53but I think that there's also a what we
35:56really want is to maximize any parent wants
35:58us to maximize their child's happiness.
36:00In the long run, in the short run,
36:01but most especially in the long run so.
36:06And openness to the Unbidden,
36:07as you quote Bill may,
36:09and saying is perhaps countered
36:11by an eagerness to optimize and to
36:14optimize specifically our children's
36:16lives as individuals,
36:17and how there might be some tension there,
36:20which is,
36:20if I can use some of this specifically,
36:21the genetic engineering or other things,
36:24if I can capitalize on these
36:26things for my child.
36:28Do I have as a parent some kind
36:30of obligation to my child over
36:33and above the obligations I have
36:35to the Community to society?
36:37And I think the short answer
36:39that for many people is yes.
36:40I have a greater obligation to
36:42my kid and I have to the world.
36:44And if that's so, then again,
36:46that openness to the unbidden may
36:48be tempered by countered by an
36:51eagerness to optimize their lives,
36:53and specifically what parents
36:54want for their kids.
36:55I think, is that happiness,
36:57and sometimes that equates
36:58to financial wealth.
37:00Sometimes that equates to all sorts
37:01of things, but ultimately for some,
37:02if they say well,
37:03I think that my child has a
37:04good shot at happiness.
37:05If he's 5 foot 7 inches tall,
37:07but he has a better shot of happiness
37:09if he's 6 feet tall, I'm so.
37:11Then then,
37:12if I have the means to give him to
37:14optimize his happiness that way,
37:15and my somehow obligated to him,
37:17even though if we all thought that way,
37:20it would be less good.
37:21I mean, there this requires,
37:23I guess what I'm saying,
37:24I think is what you're recommending
37:26rings true to me,
37:27but I think it may run counter to the.
37:29Instincts of many individuals,
37:31specifically with regard to the
37:33obligation of parents and even the
37:35regard to the obligation of physicians
37:37to their individual patients.
37:38So I'm I'm with you.
37:40With that one caveat that I think
37:42that tension is going to exist
37:44for those two groups.
37:45Parents and and health care providers
37:47who looked at the individual.
37:49I thank you so much.
37:50This was an absolute Tour de force and
37:52I I will tell you that, truthfully,
37:53I'm writing things down, saying,
37:55well, I've got an answer for that.
37:56And then you gave me the answer for that.
37:57So this was a real exercise for me.
38:00I appreciate the chance to speak and I
38:02want to turn it over to our moderator,
38:04Sarah and Sarah.
38:05Why don't you take us from here?
38:08Great, well thank you.
38:09Thank you so much to both of you.
38:13Not that there were, really, I I.
38:15I would just echo that there were so many
38:17points that really resonated with me.
38:19But before we open it up, I I just I.
38:23I think it's it's very noteworthy.
38:25What would particularly resonated
38:26with me was your comment that not
38:28everything in the world is is open
38:30to use and and when I think about
38:33using in this sense I I'm really
38:35thinking about the concept of almost
38:38exploitation and the reason I will
38:40say that this is particularly salient
38:42to me is I I just returned from.
38:45A really life changing trip in
38:47Antarctica a few days ago and it was.
38:52It it was a time of a lot of
38:55reassessment of of my privilege,
38:57and also of my my responsibilities
39:00of of environmental stewardship
39:02and planetary stewardship and and
39:04particularly how that's commensurate
39:06with with the excessive amount of
39:08privilege I have with respect to
39:10the average human on the planet.
39:12And I, I think that you know that
39:16that really dovetails nicely with
39:17this with the concept of of having
39:20some degree of of humility.
39:23And you know.
39:26Providing a really important
39:27balance to this sort of very human.
39:32Instinct to sort of conquer and
39:35dominate and exploit you know,
39:37every time we find a natural resource,
39:40we think about how.
39:40How can we exploit this.
39:42To make money,
39:43you know whether that's drilling
39:46for oil or wailing or cutting down
39:49forests so that we can so that we
39:51can herd beef so that we can sell
39:53it to people who want to eat it.
39:55And you know it,
39:56it it really we we have not been good
39:59stewards of of the planet and I think.
40:02You know that that actually dovetails
40:04with this idea of the idea of giftedness,
40:07in that I think that that you can
40:10almost frame the the idea the the
40:13counterweight to meritocracy,
40:14as almost a sort of stewardship of 1's gifts,
40:17meaning that rather than thinking well,
40:19you know I I'm gifted or you know,
40:22I'm I'm smart, I'm hardworking,
40:25all of my success is my own doing
40:26and I therefore I deserve it.
40:28But rather thinking well,
40:29you know I've I've been born
40:32into this privilege.
40:33Where you know I had all of these
40:36advantage given advantages given to me?
40:38What are my duties to give back to really
40:41serve as the best possible steward of these,
40:44the the natural lottery,
40:46these genetic resources or these societal
40:48resources that were bestowed upon me?
40:50And so I think there's a common
40:52thread of this idea of stewardship.
40:54The the one other thing that I think
40:56is also really particularly salient is,
40:58you know,
40:58in our very hyper polarized world.
41:01I think it's important when we,
41:02when we push back against certain.
41:04Instincts to make sure that we're framing,
41:06not just in a way that appeals
41:08to like minded individuals,
41:09but also framing in a way that those who
41:12disagree with us can can understand.
41:14And I think stewardship helps with
41:16that as well because I think a lot
41:17of times sort of a more conservative
41:19rebuttal to this idea of, well,
41:21you know we should be cognizant of the the
41:24role that luck and the genetic lottery.
41:26And you know, unfair societal
41:28privilege plays in our success.
41:30That's not to deny that that hard
41:32work isn't essential for success.
41:34In most cases, hard work is necessary,
41:35it's just it's simply not sufficient for
41:38most people and and sort of reframing
41:40that in a way where we do acknowledge
41:43the important role of hard work,
41:44but but acknowledge it in a way that
41:47that we should feel grateful for our
41:49ability to work hard and and see that
41:52as something where we're proud of it
41:54and we want to give back to share in our
41:58bounty rather than to sort of hoard,
42:01I think is a way that maybe we
42:03could bring some more people.
42:04Into that umbrella because I I
42:06think that it's it's so common we
42:08hear divisive language and people
42:09just automatically bristle.
42:11It's like, oh, you can't.
42:12You can't talk about the role
42:13of luck or the genetic lottery,
42:15because then you're saying hard
42:16work isn't important.
42:17And I think no one saying that.
42:19But it's really important that we're
42:21cognizant of of our framing when
42:23when trying to convince others.
42:24And obviously I know you're aware of that.
42:26But anyway, that came up.
42:28So I I am going to take the liberty
42:31of asking the first question before
42:32we launch into into moderating.
42:34Which is to specifically when you
42:37mentioned about the importance of
42:39renewing the dignity of work and sort
42:41of centering this in our politics,
42:44I was wondering if you could speak in a
42:46little bit more detail on a policy level,
42:48how you envision doing this.
42:50Obviously it's going to be
42:52probably related to,
42:53you know,
42:54changing the way that that payments are made,
42:56or perhaps a tax code,
42:57but I'd love to hear sort of more
42:59of your specific thoughts in that
43:01day. Well, thank you thanks to both of you.
43:04To Mark and Sarah for these generous and and
43:10also illuminating reflections and adjust
43:13if before getting to the dignity of work,
43:16Sarah, if I could just.
43:19Say about your notion of stewardship,
43:21I think this contrast.
43:23Is very important and it's it's
43:26a way of construing.
43:27What I've described is the
43:29ethic of giftedness.
43:31To treat our talents.
43:34To regard ourselves not as
43:36the owners of our talents,
43:38but rather as the stewards of our talents,
43:41which not only implies that
43:44they aren't fully only.
43:46Exclusively ours.
43:48But the the fruits of the
43:51exercise of our talents, Sarah.
43:54We have an obligation to share the
43:56fruits of the exercise of our talent,
43:59but also that there are there
44:01are certain duties that go along
44:04with regard with stewardship.
44:06And in the case of talents,
44:07it would be the the duty to
44:09cultivate our talents and to
44:11deploy them for the common good,
44:13not only for our own.
44:15Individual benefit.
44:16And I think you're right to extend this
44:20to the whole way of thinking about the
44:23environment and climate change to treat.
44:26The natural world that we
44:29inhabit and that we share,
44:31not from the standpoint of ownership or
44:35mastery or dominion or use unfettered use,
44:39but from the from an ethic of
44:42stewardship that also carries with
44:45it certain duties and obligations.
44:47So I think that's a really important
44:51elaboration of what I was describing.
44:54Is the ethic of giftedness
44:56As for the dignity.
44:58Of work.
45:001. I think to renew the dignity of work.
45:07Means beginning with a recognition.
45:12That work is not only a way of
45:14making a living. It's also.
45:16A way of contributing to the common
45:19good and winning social recognition
45:21and esteem for doing so, I think.
45:26One source of the resentment that has given
45:29rise to the polarization in our society.
45:32Is it not only the wage technician as such?
45:37But for for a great many workers.
45:40For four decades.
45:43But also the sense that the
45:45work that many people do,
45:47and here I'm thinking people
45:48without a college degree,
45:49a sense that the that the work
45:53many people do is not recognized
45:56or appreciated or valued.
45:59400 in the way it should be that
46:03we have so valorised professional
46:06degrees in advanced degrees,
46:08and the kinds of work associated
46:11with those credentials.
46:13That we have,
46:15maybe unwittingly devalued and
46:18failed adequately to recognize
46:20and appreciate and honor.
46:22The the forms of work and of contribution.
46:28That do not involve or require.
46:31Professional credentials so advanced degrees,
46:34and I think this is part of
46:36the one of the ways in which.
46:39Meritocratic attitudes toward success.
46:42Have narrowed our notion of what counts
46:46as contribution to the common good.
46:48We often assume that the money
46:50people make is the measure of their
46:52contribution to the common good.
46:53The measure of their merit.
46:56But this is a mistake.
46:58I mean, nobody really believes.
47:02That a hedge fund manager makes a
47:05contribution. Whose social value?
47:07Is 1000 times greater than that of a nurse?
47:11Or a school teacher,
47:13even though that's what the labor
47:15market measure would indicate.
47:19But if that's true,
47:21if the market is a poor measure
47:24of genuine social value.
47:26Then that suggests that we we should
47:30no longer outsource our moral judgments
47:32about social value to markets.
47:34We need to reclaim.
47:36Those judgments,
47:37as democratic citizens and
47:39deliberate publicly about them,
47:41which raises the question.
47:43What actual policy debates might prompt?
47:47More explicit.
47:48Debate about what really counts as a
47:53valuable contribution to the common good.
47:56Well, here are a couple of examples.
47:59This is not a policy agenda,
48:02but a couple of examples of what
48:05it would mean to debate more
48:08explicitly what really counts
48:10as a valuable contribution.
48:12The tax system.
48:14Yeah, and tax policy is 1 area we should.
48:18We should be debating.
48:19For example,
48:20why is it that we tax earnings from labor
48:24at a higher rate than we tax earnings
48:27from dividends and capital gains?
48:30Why is that?
48:31And what does that say and
48:33reflect about the dignity of work?
48:37There are lots of debates about the
48:39tax code having to do with fairness.
48:41And who can best bear the burden of taxation?
48:46Those arguments about distributive
48:48justice and fairness are important,
48:50but they're not the only questions
48:52to be asked.
48:53Question I'm suggesting we should
48:55ask about tax policy and other
48:58policies is what's the expressive
49:00significance about what we value,
49:03and in particular about the dignity of work?
49:07Here's another kind of example.
49:10An economist whom I quote in the
49:12book in the tyranny of Merit,
49:14calculated that the federal government
49:18spends 164 roughly $164 billion a year.
49:24Helping people. Go to college.
49:29And about 1.1 billion helping people who want
49:34to go to vocational or technical training.
49:39Forms of learning.
49:42162 I think to 1.1 billion
49:44that's a vast disproportion.
49:46We woefully under invest.
49:48In those forms of learning and
49:51which most people depend to prepare
49:53themselves for the world of work.
49:56And here I'm thinking of community colleges
49:58as well as vocational and technical training.
50:01It's not only a matter of funding.
50:04It also reflects the steep
50:07hierarchy of prestige.
50:10That we've created and bought into.
50:12Between the higher education.
50:15Especially prestigious private universities.
50:17And those forms of learning on what,
50:21on which most of our fellow
50:24citizens actually depend.
50:25So finding ways to reverse that steep
50:29hierarchy of prestige in the way we
50:32invest in education and in the way
50:36we regard those who perform work.
50:38Dependent on those different
50:40forms of of education,
50:42I think would be another way of
50:44prompting this broader debate, Sarah.
50:48Thank you so much.
50:51Wonderful, and I absolutely agree.
50:55I'm going to move on to our
50:58first Q&A from the audience.
50:59So this is a long one, so brace yourself.
51:03Wouldn't the arguments against enhancement
51:06based on inequality apply equally
51:08to enhancements derived from books
51:10or tutoring or exercise in training,
51:13or any resource requiring way we improve
51:15ourselves and don't all modes of enhancement,
51:18social or biological require resources?
51:21It seems the primary lesion
51:23is not enhancement,
51:24but excessive inequalities of resource.
51:26Equally, I'm struggling to understand
51:28how life as a gift argues against
51:30enhancement without at least.
51:32Similarly,
51:32arguing against genetic engineering
51:34to remove serious life limiting
51:36conditions such as cystic fibrosis
51:39both seem to be driven by a somewhat
51:41problematic notion of natural,
51:42more assertive than established.
51:46Well, it's certainly true that we do
51:50need some notion of natural human
51:54flourishing natural human capacity.
51:56In order to make any distinction
51:59between health on the one hand.
52:02And enhancement on the other.
52:06Now I I certainly don't and and
52:10didn't assert, merely assert a
52:13conception of the natural that,
52:14as I mentioned in the in the
52:17talk and mentioned in the book.
52:19This what's natural?
52:21That's a contested concept.
52:23It's not biologically defined.
52:27It's it's a normative question.
52:30And it's a normative question that
52:32we need to debate and reflect on not
52:35only within the medical community,
52:36but more broadly in civic life.
52:39So I think the question it's important
52:42to ask how can we reason about what
52:46counts as health and what counts as.
52:51Curing disease or repairing
52:54injury as against. Bulking up.
52:58To hit 75 home runs.
53:02It isn't self happening and we need to
53:04reason about that and argue about that.
53:07And As for intervening to deal with.
53:11Abilities such as cystic
53:13fibrosis fibrosis there too.
53:16We do need a conception of
53:18what it what is it to restore?
53:22Natural human function or flourishing?
53:24We can't get away from that,
53:26but to discuss any account of natural
53:29human function or flourishing,
53:31though these are in some
53:33respects medical categories.
53:35They are also moral categories because
53:38the answers will reflect different
53:41conceptions of what it is to be
53:43a human person. So this actually.
53:48Highlights the continuity.
53:51Rather than the division of intellectual
53:54labor between medical decision making
53:57and biomedical ethics on the one hand,
54:00and normative and civic debate
54:03and reflection on the other,
54:05I see these as continuous,
54:07not as separate specialized compartments.
54:13Which is not to say that that I think
54:17there's a fixed definition for for the
54:20natural or or for human flourishing.
54:22It is to say that what counts as is
54:26health and what counts as a justifiable
54:30medical intervention is a human question,
54:33not only a biological 1.
54:36OK, great, this question sort
54:39of dovetails with some of the
54:42issues brought up in the last.
54:44Please say more about the moral
54:46difference between parental attempts
54:47to genetically modify their children
54:49for success in meritocracy and
54:51parental attempts to educate their
54:52children for success in meritocracy.
54:55Well, it depends.
54:56It can be a thin line.
54:58It depends whether the education
55:02is purely instrumental.
55:04Simply to get in simply for the
55:07sake of making more money or for
55:10accruing the the private benefits
55:12that go with winning admission.
55:15To a college or university.
55:17That's how the education is serving,
55:20and if that's what animates the education.
55:23Then it is instrumental and
55:27objectified in the same kind of way.
55:31As a genetic intervention would be.
55:34Not all education.
55:36Is of that kind.
55:39Not all education is purely instrumental.
55:42Purely for the sake of maximizing
55:45the future earning capacity of
55:47the child or the young person.
55:49When parents educate their children or
55:52promote and support their education,
55:54ideally they're doing so at least in part.
55:59For the to cultivate in the child.
56:02A love of learning for its own sake.
56:06For its intrinsic.
56:08Benefits to make the child to
56:11open the child to learning.
56:14That will enable them better to
56:17develop their human capacities,
56:19their inquisitiveness.
56:22And to to make them fuller human beings.
56:26Now, if that's what education aims at,
56:29and I think it it should,
56:31then it's quite different
56:35from genetic manipulation.
56:38Because it's not.
56:39It's no longer purely instrumental.
56:42It's no longer objectifying the child.
56:45Even making the child an object,
56:49an instrument of its own,
56:50future earnings stream.
56:52That's what's objectionable about both.
56:55So I would agree that sometimes
56:57some forms of education,
56:59especially the kind of cram courses
57:02and tutoring for the sake of learning
57:05the tricks on entrance exams.
57:09The better to get in,
57:10the better to get a good job and so on.
57:14If they're done in the same spirit
57:17as genetic fix would would reflect,
57:21then I think they're morally
57:23problematic in the same way.
57:26It makes sense.
57:29Continuing along the theme of education,
57:32we have another great question.
57:34The need to share our gifts
57:36and bounty translates from many
57:38students into a need to fight social
57:41injustices in medical schools.
57:42Commitment to a variety of causes
57:44has become its own measure of merit.
57:47How do you reconcile the need to
57:49restrain hubris with the concomitant
57:51need to share with others and
57:53demonstrate merit by fighting injustice?
58:00You think that there?
58:05Raining and recognizing our obligations
58:08to those less fortunate than ourselves,
58:11and therefore to obligations to to
58:15serve social justice, I think there
58:17is a close connection between them,
58:20and so I would say that the
58:26moral education that emphasizes
58:28the contingency of our gifts or
58:32Sarah to go to your distinction.
58:34It emphasizes how a stewardship
58:36relation to our talents and gifts,
58:39rather than an ownership relation,
58:41is conducive to social justice into
58:44a greater sense of obligation to
58:46those who may lack the talents that
58:49the society or the opportunities
58:51that the society happens to reward.
58:56Yeah, I'm you know.
58:57I'm reminded as as as you speak.
58:59I'm I'm taken back to that time
59:01almost 20 years ago when I took
59:04your course and you know, I,
59:05I believe you summed it up very
59:07succinctly as as the concept of doing
59:09the right thing for the right reason.
59:11And I, I think that distinction
59:14is is really critical here.
59:16You know, as simple as that sounds,
59:17it it really it?
59:19It's really a very powerful
59:20concept that you know doing
59:22things because they're they're
59:24intrinsically the right thing to do.
59:26Rather than because of
59:27their instrumental value,
59:28is is a really critical concept here.
59:33Well, Sarah, in response to this
59:35with Michael's comment was is that
59:37I think one is relevant to that.
59:38Much necessarily follows from the other.
59:42Which is to say that once one accepts
59:45the notion of that we are not that
59:49we have not earned all of our gifts,
59:51that that in fact that we are
59:54the benefactors of the genetic
59:56lottery or the financial lottery,
59:57or we are lucky with the parents
59:59we had or with the circumstances
01:00:00where we were born etc.
01:00:02Once if if one can get students
01:00:04or others to accept that premise,
01:00:06which I think is a very good premise
01:00:08and I agree with it that we're here
01:00:10largely because of our good fortune,
01:00:12that we have these talents largely
01:00:13because of our good fortune.
01:00:15Economic, genetic circumstances, whatever.
01:00:16Then it's then if one doesn't move
01:00:19from that into an appreciation for
01:00:21the need for greater social justice,
01:00:24then something is missing and someone
01:00:26is just general moral compass.
01:00:27If you actually believe everything I
01:00:29have I earned, I deserved just me.
01:00:32Then I think it's totally moral as to say.
01:00:36Therefore, I'm not obligated to share it.
01:00:38I think once one accepts that I didn't
01:00:41actually get all this on my own,
01:00:43that that I don't deserve all this,
01:00:44then I think.
01:00:45Most folks with a sound moral
01:00:47compass will then say therefore,
01:00:49I really have an obligation to share it.
01:00:51I really have an obligation to make
01:00:53this road easier for other people
01:00:54who didn't get the same gifts
01:00:55who didn't have the same luck.
01:00:57I'm so it follows,
01:00:58but I think it starts with the premise
01:01:00that's really in both of the books, right?
01:01:02And it was in and so beautifully
01:01:03presented in your talk, Michael,
01:01:04it starts with the premise that it's not all.
01:01:08It's not all earned, and it's not.
01:01:11Therefore,
01:01:11we don't deserve all the bounty
01:01:13as you put in the book.
01:01:14From what we from those gifts.
01:01:16Once that premise.
01:01:17So I think that in terms of trying to
01:01:19teach the students about social justice,
01:01:21I think 90% of it would be to
01:01:23get not just the students,
01:01:25but all of us to appreciate that
01:01:27first fundamental point that
01:01:28that Michael made in his talk.
01:01:31Absolutely.
01:01:35So kind of following from that
01:01:37I think we have another question
01:01:39that nicely moves us along.
01:01:42So in a society where we do not value merit,
01:01:47what drives us to succeed
01:01:49and what defines success?
01:01:51How do concepts of laziness
01:01:53versus hard work change?
01:01:57Well, I'm not suggesting that we should not.
01:02:01Value merit understood as meaning
01:02:04the exercise of our talents for
01:02:08the sake of the common good,
01:02:11that's a way of understanding merit.
01:02:14The question is whether we consider
01:02:17our success our own doing the the
01:02:21question is whether we consider.
01:02:24The exercise of our merit.
01:02:27A ground for thinking that we deserve
01:02:30the benefits that flow deserve.
01:02:32As individuals,
01:02:33the benefits that flow from it.
01:02:36So valuing merit in the
01:02:39sense of appreciating people,
01:02:42cultivating their talents for
01:02:43the sake of the comment, would.
01:02:46That is not something that I'm criticizing.
01:02:51To the contrary,
01:02:53but that's a very different way
01:02:55of valuing merit than believing
01:02:58that my success is my own doing,
01:03:02and I therefore deserve.
01:03:04As an individual that benefits
01:03:06that flow from it now,
01:03:08you might think there or the questioner
01:03:12might worry that loosening the hold.
01:03:18Of the conviction.
01:03:22That our success is our own doing.
01:03:26And we therefore deserve the benefits
01:03:29that flow from it will lead people
01:03:32to be lazy or to fail to exercise.
01:03:36Their talents and gifts.
01:03:40I'm skeptical about that.
01:03:42Because I think what really motivates
01:03:46people are motivated by extrinsic
01:03:49rewards to work hard to make money to win,
01:03:52honor and recognition.
01:03:55But also by intrinsic rewards.
01:03:59To feel that they are fulfilling
01:04:02an important mission in curing
01:04:04the sick or healing the injured
01:04:07or contributing generally to the.
01:04:10To the common good. So.
01:04:13I I think.
01:04:15That loosening the hold of individualistic
01:04:20notions of moral desert deserving Ness.
01:04:25I think that might diminish the
01:04:28incentives that animate some.
01:04:30I think it actually would clear the way.
01:04:34Four in place.
01:04:36Greater emphasis on more intrinsic
01:04:38sources of satisfaction and of
01:04:41motivation in cultivating our guests
01:04:43and contributing to the common good.
01:04:46It's an open question,
01:04:48but it seems to me that the individualistic
01:04:53notion of merit and its success,
01:04:56the ownership notion.
01:04:59Of our talents that Sarah identified is.
01:05:05Actually corrosive,
01:05:06not only of the common good,
01:05:08but if the intrinsic satisfactions.
01:05:11That we derive when we.
01:05:15When we work to contribute
01:05:17to the common good,
01:05:18and when we win recognition.
01:05:20And and esteem for having done so.
01:05:26So is there a middle ground? Michael?
01:05:27Is there a middle ground to be had where
01:05:30one says that your your your success?
01:05:33Your wealth is a is a combination
01:05:35is a result of a combination of your
01:05:37good luck and your hard work and and
01:05:39therefore to some extent you still
01:05:41want to incentivize that hard work.
01:05:44I I appreciate your point that for many
01:05:46of the incentive is going to be this
01:05:48internal satisfaction or the recognition,
01:05:52but I think for many the the incentive
01:05:53is still going to be economic.
01:05:55So is is there a middle ground where we say.
01:05:57That those who have greater luck
01:05:59as well as work hard should see
01:06:02a responsibility to share some
01:06:04as opposed to to surrender all.
01:06:08Well, the middle ground mark I think has
01:06:11to do above all with our stance toward.
01:06:18Tord effort
01:06:21to loosen the hold. As I am arguing,
01:06:24we should loosen the hold of the
01:06:27idea that our success is our own.
01:06:29Doing is not to embrace
01:06:33or encourage fatalism.
01:06:35That there is no human agency that
01:06:40everything that happens to me,
01:06:42my fate in life is strictly a matter
01:06:46of the luck of the draw or the genetic
01:06:50lottery or the mysterious grace of
01:06:53God unrelated to anything I do.
01:06:56That would be a kind of fatalism.
01:07:00That would be hard to reconcile
01:07:03with any notion of human agency.
01:07:06What I'm arguing against is
01:07:08a kind of hyper agency.
01:07:11Bound up with notions
01:07:13of mastery and dominion,
01:07:15and self sufficiency that.
01:07:18I think our corrosive not only
01:07:21of the common good,
01:07:22but of any sense of indebtedness.
01:07:26To say nothing of luck.
01:07:28Now, how does strike the balance mark?
01:07:31That's that's a hard question to answer.
01:07:34One way to think about it.
01:07:37Is to ask ourselves how as parents.
01:07:41Would we encourage our children?
01:07:45Tu regarde either a great
01:07:48success that they had,
01:07:50whether in sports or in school or
01:07:53on the playground or with friends.
01:07:56And how would we encourage them to
01:07:59think about a setback or a failure?
01:08:02Now when we we do this naturally all
01:08:05the time, sometimes we wrestle with it.
01:08:07The answer is not always obvious.
01:08:10But if our child enjoys a great success.
01:08:15Winning a debate tournament.
01:08:19Being getting good grades,
01:08:22making the Deans list.
01:08:24Winning a sports championship.
01:08:27Pitching a no hitter.
01:08:31We do think about what form of
01:08:35praise and encouragement to convey.
01:08:38And when we think about that Mark,
01:08:40we always calibrating exactly the
01:08:43balance that you're asking about.
01:08:45We want the child to take
01:08:48pride in her achievement.
01:08:50Let's say on the sports field.
01:08:53Without forgetting.
01:08:57The the child's indebtedness.
01:09:01And good fortune. And.
01:09:06So the way we calibrate this with the
01:09:11way we couch our praise and calibrate
01:09:15our judgment shapes the message we sent.
01:09:18It's a kind of moral teaching praise of kids.
01:09:22And also helping them contend with failure.
01:09:26Is one way that in human terms we calibrate
01:09:31this this difficult balance all the time.
01:09:34We don't want our children to believe.
01:09:37That nothing they do will matter
01:09:39and how well they will fare in life.
01:09:41That's the pure fatalism.
01:09:43But neither do we want them to believe that
01:09:47every time they fall short it's their fault.
01:09:51Or that every time they succeed.
01:09:55It's thanks only.
01:09:56To their effort in striving.
01:09:59So I've not given a direct answer.
01:10:01I suppose mark to your question,
01:10:03it's too difficult to question,
01:10:05but it's the kind of question we put to
01:10:08ourselves, sometimes even unreflectively.
01:10:09Whenever we're trying to figure
01:10:11out what to say either to console,
01:10:14our child who's encountered a set back,
01:10:17or to praise our child when
01:10:19they've achieved some success, no.
01:10:22No, I think that's a very insightful answer.
01:10:24In fact, I mean and you
01:10:25can't have it both ways.
01:10:26As you point out, so that if I
01:10:28tell my child when he fails, well,
01:10:30you know it wasn't entirely your fault.
01:10:32Then it seems that I can't
01:10:33really have it both ways,
01:10:34that when he succeeds I can't say.
01:10:35Well, that's all entirely due to you,
01:10:38exactly, that there's the the
01:10:40balance has got to be there.
01:10:41I think that's very insightful
01:10:42answer actually, exactly.
01:10:45I you know I would just piggyback on that.
01:10:47I think there's a natural tendency to want
01:10:49to cast luck and skill as a false dichotomy,
01:10:52when in fact they're both interrelated
01:10:55in in almost all of our outcomes,
01:10:57perhaps to different degrees,
01:10:59and certain outcomes may be more
01:11:02dependent on luck versus skill.
01:11:04But for for most metrics I I think that it's
01:11:08overly simplistic to to cast them as being
01:11:11the product of just one versus the other.
01:11:14And I and I think that recognition.
01:11:15Can allow for room for both pride and a job.
01:11:18Well done and for some humility and gratitude
01:11:21with respect to to those gifts that that we
01:11:24have through no moral desert of our own,
01:11:26but rather through the the genetic
01:11:29lottery or through through society.
01:11:33And you know the one other thing that that I
01:11:35I would add to this discussion is, you know,
01:11:38it's it's interesting the the paradoxically,
01:11:41even though we like to the defenders
01:11:44of the status quo may argue, Oh well,
01:11:46you know that it's important to keep things
01:11:48as they are because they encourage hard work.
01:11:49But but to your point,
01:11:51earlier in in fact,
01:11:52a lot of the financial incentives that
01:11:54currently exist don't do that at all.
01:11:57And you know to your point about why is it
01:12:00that passive income is taxed at a lower rate?
01:12:03Then labor related income.
01:12:05That's actually a slap in the face
01:12:08to people who argue about the
01:12:10the merits of of working hard.
01:12:12What about the fact that you know the
01:12:15relatively low taxation rates for estate tax?
01:12:17Doesn't it?
01:12:18That seem very even.
01:12:19If and again, they're.
01:12:20They're two separate questions, right?
01:12:22One is it is a meritocracy ethical at all,
01:12:26and two if if it is ethical, it does.
01:12:29Our system actually reward merit in
01:12:31the way that we think it does, and.
01:12:33And I think that even if you you
01:12:35accept the notion that you know
01:12:37merit based on hard work,
01:12:39it is a reasonable metric to reward people.
01:12:41Actually,
01:12:42our system doesn't really
01:12:43support that at all.
01:12:44Our system,
01:12:45it supports very entrenched wealth
01:12:48and and opportunity through a
01:12:50taxation system that that actually,
01:12:53you know,
01:12:54enhances and and perpetuates
01:12:57generational wealth,
01:12:58which is is very anti meritocratic
01:13:01and and passive income and.
01:13:03So we don't actually have a system that
01:13:05that rewards hard work above all else,
01:13:08and if we did I I think it would
01:13:10look very different both in terms
01:13:12of of taxation policies and also
01:13:15in terms of of dignity and respect
01:13:17for certain work that is very hard,
01:13:20but that often isn't regarded very highly.
01:13:22If it doesn't come along with a lot of
01:13:25technical or professional skill or training.
01:13:28Yeah,
01:13:28well said thank you.
01:13:30This next question is is short but I think it
01:13:33it kind of dovetails nicely with this idea.
01:13:35How do these arguments relate to
01:13:37the ongoing drug overdose epidemic,
01:13:39which I I will add has
01:13:41often been described as
01:13:42sort of an epidemic of of despair as
01:13:44as it certain populations who who
01:13:47may not feel that they have a lot of
01:13:50of dignity or purpose or or meaning.
01:13:54This this is a closely connected
01:13:56to this very important book,
01:13:59deaths of despair by two economists
01:14:03and case in Angus Deaton.
01:14:06And what they found was that during
01:14:08these very same decades that I
01:14:11write about in the tyranny of merit,
01:14:13essentially the last three to four decades.
01:14:18Of finance driven globalization
01:14:21widening inequality wage stagnation
01:14:23for most working people,
01:14:27there has been an upsurge
01:14:29in deaths of despair,
01:14:31which is to say deaths due to suicide.
01:14:36Alcohol abuse or drug overdose.
01:14:41Among. Those and this is what
01:14:45connects it to the tyranny of merit.
01:14:48This increase in deaths of despair
01:14:51disproportionately has taken place
01:14:54among those without college degrees.
01:14:57Which reflects not only diminished
01:15:02economic prospects.
01:15:04But also a sense.
01:15:07Of demoralization and even
01:15:09humiliation by the system of
01:15:12work and by the credential list,
01:15:17prejudice and privilege.
01:15:20Of.
01:15:23Of those on top.
01:15:26It really excludes or devalues.
01:15:30Appreciation for the kind of work
01:15:32that working people do so and and
01:15:36case and Deaton mentioned the the
01:15:42powerful meritocratic pressures.
01:15:45That seemed to be at work is
01:15:48certainly one factor in explaining.
01:15:51The increase in deaths of despair
01:15:54among those without college degrees.
01:15:56One of the most one of the deepest sources
01:16:00of the divide in our polarized society,
01:16:04politically is between those with
01:16:06and those without a college degree.
01:16:09We saw this in the voting for Donald Trump.
01:16:13We saw this in the Brexit vote in Britain,
01:16:17and sadly we see it in the.
01:16:21Incidents of deaths of despair.
01:16:24So I think there is a very close connection.
01:16:29Thank you.
01:16:31Work we have some questions now.
01:16:33Going back to two concerns about enhancement,
01:16:36so we're going to shift a little bit here.
01:16:39You argue against enhancement
01:16:41of one child potential.
01:16:43How does that influence the opposite action?
01:16:45That is, a decision to terminate
01:16:47a pregnancy when informed
01:16:48of the genetic impairment,
01:16:49such as Down syndrome?
01:16:50What about pre implantation
01:16:52decisions to use or not use a
01:16:54genetically abnormal embryo in IVF,
01:16:56right? Well, this is really an important.
01:17:01Question. And. It depends.
01:17:04I mean terminating a pregnancy.
01:17:11On to avoid it goes back to the
01:17:15discussion we were having about the
01:17:18distinction between a health related.
01:17:24Ailment and. A kind of choice
01:17:29now Down syndrome Down syndrome.
01:17:33There are many who would argue.
01:17:37Including parents of
01:17:39children with Down syndrome.
01:17:41That Down syndrome? Is.
01:17:47Not inconsistent with leading. A.
01:17:52A full and satisfying human life.
01:17:56With distinctive contributions.
01:17:59And sources of joy.
01:18:04For the child and for the parents.
01:18:08And many parents have
01:18:10written and spoken movingly.
01:18:13About what they had learned in human terms.
01:18:17Raising a child with Down syndrome,
01:18:20they would contest vigorously the notion.
01:18:25That this constitutes a health impairment
01:18:29that justifies terminating a pregnancy.
01:18:33So. I think that. This is a.
01:18:39This is morally complicated terrain.
01:18:42Now there are other. Conditions.
01:18:48That cannot be described in a similar way.
01:18:54As blessings or as distinctive ways of being.
01:19:00Clear, unambiguous, genetic abnormalities.
01:19:06That lead to.
01:19:09Serious health impairments and
01:19:12radically reduced life expectancy.
01:19:16That would be in a different category
01:19:19and the line is not clear and distinct,
01:19:22nor is it a merely biological line.
01:19:24This is back to our discussion about what
01:19:27constitutes Health and Human flourishing.
01:19:30But terminating a pregnancy?
01:19:34For the OR or selecting an IDF.
01:19:40For. Let's say picking and choosing
01:19:46on consumerist like grounds.
01:19:49Wanting a boy rather than a girl.
01:19:51Let's say sex selection.
01:19:53To take one straightforward example.
01:19:57That seems to me unrelated to health.
01:20:00That seems to me more like a eugenic choice,
01:20:03more like a consumer choice.
01:20:08Where as selecting for against embryos
01:20:14with serious health related genetic
01:20:19abnormalities, that's different.
01:20:22Even though there may be borderline
01:20:24cases where we could debate,
01:20:26you know what counts as a serious
01:20:31health related genetic abnormality,
01:20:34which I think morally.
01:20:37Would be different from simply choosing if
01:20:40if as if we if we could screen embryos for,
01:20:46you know, IQ, let's say or athletic prowess.
01:20:50If we could do that.
01:20:52Then it becomes really morally
01:20:55analogous to enhancement.
01:20:56Then it becomes a kind of eugenic. Choice.
01:21:02Rather than a choice that is genuinely
01:21:05for the sake of the health of the child.
01:21:07So sex selection.
01:21:10I would say purely preferential sex
01:21:13selection would fall on the the eugenic,
01:21:17not the health related
01:21:18or the medical purpose,
01:21:20and would be morally objectionable.
01:21:23I think terminating a pregnancy
01:21:26because you want a boy rather than a
01:21:28girl which happens in many parts of
01:21:30the world is morally objectionable.
01:21:33And it's clearly unrelated to
01:21:35a medical purpose.
01:21:38Down syndrome I, I think.
01:21:42Well, I've I've spoken about the.
01:21:45The moral argument against selecting
01:21:49against a fetus with Down syndrome,
01:21:53but there are other clear genetic
01:21:56abnormalities that would be such
01:21:59significant impairments that they would
01:22:01they would be in a different category.
01:22:05And perhaps one way of measuring that
01:22:07Michael just simply be the degree
01:22:10of suffering when might anticipate
01:22:11for the child. That you know.
01:22:15I think that would certainly
01:22:16be an important part of it.
01:22:17That would be a very important part of it
01:22:19and and what parents have Down syndrome,
01:22:23children emphasized.
01:22:24Is the richness of the life
01:22:27and the happiness of the life.
01:22:31So I think the.
01:22:34I think the prospect of suffering
01:22:35is certainly a very important
01:22:37ingredient in the judgment.
01:22:40I I think you know.
01:22:42Interestingly, a lot of disability
01:22:44advocates bring up the fact that healthy,
01:22:48able bodied individuals grossly
01:22:50overestimate the decrement in quality of
01:22:53life that certain displays would play,
01:22:56and that and that when,
01:22:58when previously able bodied people
01:23:01become disabled, they actually,
01:23:03or they realize that actually
01:23:05does not really significantly
01:23:06decrease their quality of life and.
01:23:09And this is something that's come up a lot.
01:23:11In particular, during the COVID pandemic.
01:23:14With disability advocates really
01:23:16underscoring the importance not to
01:23:18use quality of life considerations.
01:23:20For example,
01:23:20in in in decisions about rationing,
01:23:23scarce resources.
01:23:24Because because of these sort of
01:23:27institutional ableism of the medical
01:23:30profession and of society in general,
01:23:32and so it's it's you know that while it it
01:23:36it does seem like that would be a great,
01:23:39or at least a helpful metric to use it,
01:23:42it too is really fraught with a lot of.
01:23:44Of of Ablist thinking that that that those
01:23:49in the establishment are often prone to.
01:23:54Yes, and if I could just add Sarah this,
01:23:56the ableist prejudices
01:23:59that you're describing.
01:24:01Really have a long history and
01:24:03the name of that history is the
01:24:05history of the eugenics movement.
01:24:07And so I think we need to think very
01:24:10hard about the ablest prejudices
01:24:13and the the Providence of them in
01:24:18eugenic thinking and, and that,
01:24:20I think should should should
01:24:22bring us up short in in failing
01:24:25to reflect on those on ableist
01:24:27prejudices in this context.
01:24:30Absolutely alright.
01:24:31Well we have only a few minutes left,
01:24:34so one more question that
01:24:36sort of piggybacks onto this?
01:24:39It's a two part question,
01:24:40so it's it's a lot, but well,
01:24:42you can take a quick stab at it.
01:24:44A question regarding enhancement.
01:24:46Many have suggested that generalized
01:24:48artificial intelligence is very
01:24:49likely within the next century.
01:24:51Some have suggested that enhancement
01:24:52of humans is important in order
01:24:54to be able to deal with impending
01:24:56artificial intelligence on anything
01:24:57approaching a basis of equality.
01:24:59Your thoughts, and then the second part.
01:25:00And I'll let you choose which
01:25:02which you want to address more,
01:25:04because again of our limitations,
01:25:06assuming that enhancement is coming
01:25:07for the sake of this discussion,
01:25:08do you have thoughts on how to address
01:25:10concerns regarding worsening inequity?
01:25:14Well, I I'm aware that there are people
01:25:17who who would make this argument,
01:25:20since artificial intelligence is looming.
01:25:24If we don't want our machines
01:25:26to be smarter than we are,
01:25:27we'd better do what we can to enhance
01:25:30our own cognitive capacities, but.
01:25:361st. I think that we need to reflect
01:25:40on what artificial intelligence
01:25:42consists in and what it can do.
01:25:47Whether it poses a threat?
01:25:512. Our own capacities.
01:25:55Really depends on the purposes.
01:26:00To which artificial intelligence is put?
01:26:03If it's used to determine.
01:26:07Who should be convicted of a crime?
01:26:09For example AI algorithmic?
01:26:13Prediction models or if it's used to
01:26:16determine how to grade the paper,
01:26:19is the philosophy papers in my class,
01:26:22or if it's used to determine whom
01:26:24to arrest her and where to send,
01:26:26in what neighborhoods to send police.
01:26:30Or if it's used to determine how better
01:26:33to target advertising to people so
01:26:36that they will consume more, I mean.
01:26:41Or if it's used to to replace.
01:26:45Workers rather than used.
01:26:49To augment the productivity of workers.
01:26:54There are a multitude of possible
01:26:57uses and purposes of AI technology,
01:27:01and whether these weather AI is threatening.
01:27:05Or whether it's liberating.
01:27:08Depends not so much on the technology,
01:27:11but on the purposes to which we put it.
01:27:15So I think once one recognizes that
01:27:18it's not a technological matter,
01:27:20AI is coming as if it were a fact of nature.
01:27:24Only a technological development.
01:27:27And we had better.
01:27:31Better enhance our genetic
01:27:33cognitive capacities to keep up.
01:27:36I think that misunderstands
01:27:38the role that human judgment,
01:27:41and I would say also going back
01:27:43to the common good civic judgment.
01:27:45Could play in determining how
01:27:48exactly we want to develop AI
01:27:51technology and for what ends.
01:27:54I would rather we focus our deliberation
01:27:57as democratic citizens on that question.
01:28:01Then assume that AI is a technologically
01:28:06determined force of nature to
01:28:09which we will have to adapt,
01:28:11and that if we want to catch up and hold
01:28:14our own against these autonomous machines,
01:28:17we'll have to crank up our own genetics.
01:28:19I think that's the wrong
01:28:21way to think about it.
01:28:22I think it's a disempowering.
01:28:24Way to think about technology.
01:28:28Both the technology of AI and the
01:28:32genetic technologies of enhancement,
01:28:36it assumes that technology is a
01:28:40determined force rather than and it
01:28:44forgets the importance of of our deciding.
01:28:49Based on human and civic considerations.
01:28:53How technology should be used to
01:28:58advance human flourishing and
01:29:00to promote the common good?
01:29:02So that's how I suggest we we
01:29:04think about the prospect of AI.
01:29:07On the one hand and cognitive
01:29:09enhancement on the other.
01:29:11Well, thanks, that is beautifully said
01:29:13and I and I think that's a perfect
01:29:16note upon which to end because we
01:29:19are actually a hair over our hearts.
01:29:21Stop in fact, but I I'm really so
01:29:24pleased and so grateful that that
01:29:26we could have this discussion.
01:29:28Thank you so much again,
01:29:30Professor Sandel for for taking
01:29:31the time to speak with us.
01:29:33This was a really really enlightening and
01:29:35and very important and timely discussion.
01:29:38And I'm so glad that that we could host you.
01:29:41Virtually, and I would like to thank
01:29:45everyone else for coming tonight.
01:29:47And since this is our last session
01:29:50of the calendar year,
01:29:51I'd like to wish everyone a
01:29:54happy holiday season as well.
01:29:56And lots of health and happiness in
01:29:58the New year and we look forward to
01:30:00seeing you then mark any less comments.
01:30:03No, except thank you to both of you.
01:30:05Search for a wonderful job
01:30:06tonight and it's leading this
01:30:08conversation and Michael for
01:30:09making the time to join us.
01:30:10It was a terrific night.
01:30:11We're really grateful.
01:30:12Thank you. Thank
01:30:13you, mark. Thank you, Sarah.
01:30:15I've really enjoyed it.
01:30:16Thank you so much.
01:30:18That bad? Goodnight