Category: Morality

What’s the right thing to do, and is that even a question that we can answer?

The ‘Protect Life Act’ and Republican conservatism

As submitted to the Daily Maverick.

While President Obama could be accused of trying to curry favour with moral conservatives in rejecting the FDA’s recommendations on the “morning-after pill”, liberals can find some comfort in the fact that he’s at least pro-contraception, and isn’t planning to criminalise abortions just yet.

This puts him at odds with nearly every (plausible) Republican candidate with the exception of Mitt Romney who, while having changed his mind and become pro-life in 2004, is at least not a signatory to the regressive “Personhood Pledge” that has to date been signed by Santorum, Gingrich, Perry and Paul.

Ron Paul’s case is complicated by the addendum to his signing of the pledge, in which he disagrees with the Pledge’s assertion that the 14th amendment (which protects individual liberties from state encroachment) has a role to play in defending the interests of the unborn. While the addendum has led to some questioning of the sincerity of his commitment to the Pledge, he is nevertheless clear that “life begins at conception”, and that “it is the duty of the government to protect life”.

Of those who have not signed the Pledge (Huntsman and Romney), both want to repeal Roe vs. Wade, and Huntsman supports the introduction of a right to life amendment to the Constitution. While Romney thinks that current legislation has “cheapened the value of human life”, his stated intentions are to put abortion legislation in the hands of the state, rather than the Federal government.

Broadly speaking, then – because the details are, well, very detailed – all the candidates are pro-life to varying degrees of commitment. And while Romney and Paul can be credited with at least attempting to introduce a level of sophistication to their positions instead of simply appealing to the emotive fervour of a conservative base, the rest of the contenders speak of pre-born humans in terms that assume that the debate has an obvious conclusion, where a woman’s rights over her own body, and what to do with it, are significantly weakened.

As in most emotive issues, language is important here. A bias is immediately introduced in using terms like “pro-life”, given that it suggests an anti-life stance on the part of those that support abortion. Speaking of “unborn” or “pre-born” children introduces a similar bias, in that it encourages us to think of blastocysts, zygotes, embryos and foetuses as if they already had desires and aspirations capable of being dashed by those callous “anti-life” Democrats.

It is in the Personhood Pledge that these biases come to the fore in all their glory, where “every human being at every stage of development must be recognized as a person possessing the right to life”. While the Pledge’s opposition to assisted suicide and euthanasia increase the intended threats to individual liberty, it’s the language on abortion that is of most concern here.

Because it’s not only this pledge, but also a legislative move that should be seen as a concern. It should be concerning to Americans – most directly American women – but also to the rest of us, in that these sorts of developments can easily serve as example and inspiration to those who want to undermine South African liberties in this regard. It’s not only the ACDP that might want to do so – President Zuma’s visit to the Rhema Church during campaigning in 2009 included a reassurance that he’d be willing to entertain changes to legislation permitting both abortion and same-sex marriages.

The (American) legislation at issue is H.R.358, the Protect Life Act, which passed the House of Representatives in October 2011. The bill is considered unlikely to pass in the Senate, and President Obama intends to veto it even if it does. But in the hypothetical absence of the current Democratic Senate and President, the bill gives a clear insight into the how dedicated the current crop of Republicans in the House are to defend the unborn human, no matter how nebulous its form.

The first version of the bill submitted to the House by Rep. Joe Pitts (R-PA) called for a modification of the Patient Protection and Affordable Care Act to only allow for health plans to cover abortions in cases of “forcible rape or, if a minor, an act of incest”. Women who fall pregnant as a result of gentle rape – or adult victims of incest – must presumably have had it coming.

That language was removed in the bill that passed the House (you can see each version here), which now allows for coverage in the event of “an act of rape or incest”. But this concession to the reality of women sometimes needing an abortion through no fault of their own does not address some of the worst aspects of the bill.

The Protect Life Act, if signed into law, would prevent women from buying even a private insurance plan through a state health care exchange (these are not insurers themselves, but entities that attempt to promote insurance transparency and accountability) if that plan covers abortions – even though most private insurance plans currently cover abortion.

It would require any insurer that operates under an exchange and covers abortion to also offer otherwise identical plans that exclude abortion coverage. The administrative costs of managing two near-identical schemes – where one would do, save this conservative agenda – might well result in many insurers thinking it’s simply not worth the trouble to offer a plan that covers abortion.

Of course, consumers can join a plan that isn’t offered through an exchange. But because of the extra visibility of plans offered under an exchange, and the consumer protections ensured by these exchanges, it seems likely that the only women who would do so are those who are well-informed and financially advantaged – raising the possibility of this bill introducing a bias against the poor, who need more protection than most.

Perhaps worst of all, the bill opens up an avenue for softening current requirements under the Emergency Medical Treatment and Active Labor Act (EMTALA), signed into law by Reagan to protect poor and uninsured patients who need emergency care. The Protect Life Act would allow hospitals that are morally opposed to performing abortions to withhold treatment in cases where a woman requires an emergency abortion in order to save her life.

As Rep. Jackie Speier (D-Calif.) says of her own experience in this regard: “I was pregnant, I was miscarrying, I was bleeding. If I had to go from one hospital to the next trying to find one emergency room that would take me in, who knows if I would even be here today. What my colleagues on the other side of the aisle are trying to do is misogynist”.

Nobody should be required to die for the sake of someone else’s religious beliefs. And while I can understand the desire for abortion to be treated as a non-trivial matter, we shouldn’t satisfy this desire at the cost of eroding an existing and thinking person’s rights over her own body. While life might begin at conception, individual rights do not. This is the sort of case in which we might hope that public representatives attempt to fight the tide of populist sentiment, rather than allowing the most reactionary forms of that sentiment to stand the chance of influencing policy.

Ritual sacrifice and the ANC centenary

As submitted to the Daily Maverick.

Happy birthday, African National Congress. Congratulations on your centenary, and thank you for your tireless efforts to liberate South Africa from the unprincipled inequality that the majority of our population suffered under. As you enter your second century of existence, please consider eliminating various items of your own cultural baggage that are themselves unprincipled, and that become increasingly offensive within a modern democracy.

Besides the most obvious and most toxic tendencies, such as a patriarchal disposition that often seems inseparable from misogyny (as with President Zuma’s statements in his 2006 rape trial), or the apparent desire of some of your members to introduce new forms of racial nationalism, you could perhaps start with something small.

Small, but still meaningful, in that it would demonstrate not only a concern for the suffering of sentient creatures, but also an awareness that actions should be justifiable on objective evidence and impartial reasoning – and that nothing can be justified by an appeal to cultural traditions alone, no matter how longstanding those traditions are.

Please think about whether the 21st century is still an appropriate time to be slaughtering animals in rituals such as ukweshwama. I do understand that killing a bull or an ox with a spear is a deeply symbolic act, and that these non-human animals are not simply meat, but are instead signifiers of things like prosperity, or devices by which you attempt communication with ancestors.

My understanding here is of course not a lived one, and is no doubt incomplete. But you surely know as well as I that prosperity begins with gainful employ, and that the bread and circuses nature of some of what went on in Mangaung are a time-honoured (and no doubt useful) way of distracting those who don’t have jobs from that uncomfortable truth. These rituals unite, placate, and give hope for a future that might escape resembling the past.

Hopefully, you’re also aware that your ancestors are in fact dead and no longer capable of interceding on your behalf, no matter how many animals are slaughtered. Again, paying one’s respects to the dead is something we can all understand – but causing another animal to suffer as a method for doing so requires a justification beyond the simple assertion of cultural habit.

As I’ve said before, defending a practice on grounds of culture alone offers a slippery slope towards not being able to condemn anything at all. And we’d like to be able to condemn some things that are part of some cultures, like racism or sexism. We’d like to be able to say they are wrong – not simply illegal or unconstitutional.

So what else stops outsiders such as myself from saying that it’s wrong for President Zuma to have participated in the ritual killing of a black bull earlier this month, during the ANC’s centenary celebrations? The argument can’t end with silencing any opposition, simply on the grounds that they aren’t themselves part of the culture in question.

Perhaps those of us on the outside can’t say it’s wrong to stab a bull with spears, or (in more enthusiastic versions), to rip out its tongue and tear out his eyes. At least Zuma didn’t attempt to have sex with the bull, as Swaziland’s King Mswati is recently alleged to have done. Not simply because we don’t understand, but because we’re being inconsistent.

Or so one claim goes: those of us who eat meat cannot judge these rituals as wrong, because of our own complicity in needless suffering via the industrial farming of non-human animals for food. But this appears to privilege the relativistic defence of the argument from culture, in that it is possible to be a less or a more compassionate meat-eater, whereby those who are concerned with suffering can attempt to source their meat from farms which try to minimise it.

And even for the suffering that can’t be avoided in an omnivorous diet, there is still a noticeable difference between killing something slowly, tormenting it with the pointed end of a spear in a drawn-out ritual, and putting a bolt through its brain for the purposes of securing dinner. The former exhibits a bloodlust, the latter a dietary preference.

Wally Serote was quoted in the Mail&Guardian as saying “We spill the blood of these animals in the hopes that our ancestors will help us prevent spilling human blood in the future”. But what will stop us from spilling human blood in the future cannot be our deceased ancestors. It can only be the examples that they have set, and the lessons we can learn from those examples.

Perhaps we can best avoid spilling human blood in the future by continually moving toward a future in which needless suffering is always to be avoided, and in which we make our choices based on reasons that would be considered defensible, if not always acceptable, to any impartial observer. The ritual slaying of non-human animals, by contrast, is an artefact of the past.

Cultures can and frequently do change, even though these changes are sometimes slow to occur. And attempts to change them from the outside are typically doomed to failure, especially because they might be difficult to understand from a distance. In the 2009 case brought against King Goodwill Zwelithini, KwaZulu-Natal Premier Zweli Mkhize and others by Animal Rights Africa, Judge Nic Van der Reyden said it was difficult for him to rule on the matter of ukweshwama as the ritual went to the heart of Zulu tradition.

And so it does, as evidenced again in Mangaung last week. But the fact that these rituals are not proscribed by law does not mean we should endorse them, simply through a desire to appear politically correct. For those who engage in these rituals, their legality means they are permissible – not that they are necessary, or even appropriate.

If they are not appropriate, discovering this requires giving it some thought – not simply asserting the privilege of culture, but rather, debating the issue in order to determine which cultures happen to have gotten this one right, and whether the others shouldn’t consider changing their minds.

Brief thoughts on Jack Bloom

While I’ve previously commented on the illiberal nature of some of Helen Zille’s recent public utterances, at least she’s mostly kept her personal religious beliefs out of the equation. Sure, they no doubt inform her conservative moral stance, but her arguments and proposed interventions are nevertheless supported by arguments (regardless of your, or my, views on the quality of those arguments).

By contrast, Jack Bloom (DA Leader in the Gauteng legislature) seems to have no qualms in putting God at front and centre as a potential answer to South Africa’s ills, regardless of the diversity of belief among those who voted for his party (not to mention a large number of those who work for his party). In fact, God seems to have been here all along, not only facilitating the “transition from Apartheid”, but also working abroad in spurring the abolitionist movement against slavery, and inspiring people to formulate the “democratic concepts that led to the American Revolution”.

There’s no question that Bloom is sincere, and that he believes religion can play a role in encouraging people to think about their moral obligations. Sadly for those of us who think morality can only be principled if also secular, he’s in agreement with the DA’s general position here, where the party says that religion “should serve as a moral and spiritual inspiration“.

But even this view (the mistaken one, that morality and religion are easy bedfellows) is at least comprehensible, given that our country is mostly religious. Comprehensible, not reasonable, because if we need more prayer and less politics (as Bloom argues), surely the ACDP would have a far higher share of the votes?

What’s most egregious about Bloom’s opinion piece is that he by and large simply makes things up as he goes along, plucking historical events out of the timeline and – without any evidence (unless you count dubious correlations as evidence, which you shouldn’t) – attributes them to prayer and religion. It’s true that Lanphier drove a large Christian revival movement in the US during the mid-1800’s, yes, but to say that it was the Christianity – rather than basic human compassion or economics – that informed the abolition of slavery is an entirely circular argument, which assumes what it purports to demonstrate.

The American Revolution – also offered by Bloom as evidence for the power of prayer – seems more plausibly explained by something like the first 13 colonies revolting against rule by the British Empire, regardless of whether some or many the revolutionaries were religious. Their desire to be free doesn’t need religion to make sense, and it seems entirely spurious – and again circular – to use this as evidence for us needing more prayer and less politics.

And then of course there’s the elephant in the room: namely, that the data overwhelmingly suggest that on any benchmark of morality you care to pick, secular countries usually outperform religious ones. Corruption? Check. Divorce rates? Check. Crime? Check. Do a comparison for whatever measure you like using something like Google’s public data explorer, or read a simple and short book like Sinnott-Armstrong’s Morality without God.

One of the saddest aspects of public utterances like this from DA leaders, for me, is the fact that the DA has one clear advantage over other contenders in the political arena: the effective, and entirely pragmatically motivated, delivery of goods and services. That’s their clear competitive advantage, and the drum they should be beating more loudly than any other. But when a DA official – and a highly placed one at that – tells us that he hopes to outsource his job to God (at best) or collective insanity (at worst), it only reinforces the fear that populism is taking the place of common sense.

Bloom closes his piece with “maybe if we all prayed more the social change we desire will happen”. Seeing as all the existing studies of prayer’s efficacy show no effects (or in at least one case, negative effects), don’t hold your breath.

Edit: This post as well as a reply from Jack Bloom can be found on PoliticsWeb, where you’ll also find some entertaining comments. Also see another Christian perspective from Jordan Pickering.

 

Reasons for optimism in 2012

Earlier this year, I was asked to contribute to Cosmopolitan magazine’s January edition – 50 Things to be Grateful For (or to Look Forward To) in 2012. Here’s what I said:

When we think about the evolution and development of society, we often emphasise competition rather than cooperation. But nature – including our natures – is only partly described by Tennyson’s famous description of it as ‘red in tooth and claw’. We also evolve through cooperation aimed at finding better ways to live, to educate, to govern and communicate. It’s worth highlighting three aspects here of relevance to South Africans.

The first, relevant to all humans, is that we seem to be getting less violent. Kurt Schock’s 2005 book Unarmed Insurrections, and more recently Steven Pinker’s The Better Angels Of Our Nature: How Violence Has Declined present compelling cases for the notion that the past few decades have seen a substantial shift from away from war and towards resolving differences in less destructive ways.

The second, related to the first, is the rise of civil society as a force in accomplishing these resolutions. In South Africa, the Right to Know campaign has reminded South Africans that they can make a loud enough noise for government to be forced to pay attention. Elsewhere, tyrannical regimes are even being caused to fall, partly as a result of this (usually) nonviolent form of people’s power, as in the so-called Arab Spring.

And finally, we shouldn’t forget that a peaceful and prosperous future is only possible if we empower everybody to determine the course of their own lives, and help them develop the resources to do so. A vital foundation for having such control is education especially for women, who have historically suffered a disproportionate share of social inequality – often propped up by high fertility rates and low levels of economic agency. While readers of Cosmopolitan will no doubt be less affected by these factors than many other women, the welfare of our fellow citizens affects us all through impacts on government spending and social harmony (amongst other things). It is thus immensely heartening to note that while still unacceptably high, literacy rates are steadily increasing, and fertility rates are falling.

We have a long, long way to go, but it’s not only Polyannas who dare to imagine that they see light at the end of the tunnel.

There are of course countless reasons for little or no optimism. But seeing as those are undoubtedly all over the news as per usual, I’ll leave it there, and wish you all a good year.

#Jugcam – private, public and the paparazzification of the everyday

At some point last night, a debate on “jugcam” started raging on Twitter, which I’m probably well-advised to stay out of. But seeing as nobody is around to give me that advice, here are a few thoughts on the matter. First, for those who haven’t heard about jugcam is, it’s a Twitter meme involving the broadcasting of photographs of the breasts (more accurately, cleavage) of female cricket spectators. Some women are offended by this, claiming that it’s a violation of their privacy and that it could inhibit them from wearing bikinis or other revealing clothes to cricket stadia.

What this might immediately bring to mind is the furore and 2010 lawsuit involving “Girls Gone Wild”, where “Jane Doe” sued the makers of the show for damaging her reputation, after her breasts were exposed during the filming of an episode of the show. But the cases are not at all symmetrical, in that Jane Doe had near-certain knowledge of this sort of thing happening with some regularity at parties filmed for GGW, and also knew that the filming was taking place. This is not to excuse the person who pulled her top down, or to express a view on whether Jane Doe was violated in any way, but simply to say that the case is different to that of a woman sunning herself while watching cricket.

Having said that, it’s always been the case (well, for many years now) that the cameramen and producers of the live cricket feed for television tend to focus on attractive females with some regularity. Lingering close-ups of cleavage are a common occurrence, and frequently involve whole-body shots – making identification and potential embarrassment that much easier. By contrast, many of the jugcam shots are simply of cleavage, making claims of any sort of violation more difficult to sustain. Many do also include faces, though, so are at least potentially violations of privacy.

One difference between GGW, the TV camera feed and jugcam is that these involve a sliding scale of implied consent. You fully expect to be filmed at GGW, you partially expect that you might be filmed by the TV cameras, and you don’t (or hadn’t, until now) expect to be photographed by random strangers while watching cricket. And the latter typically involves the opportunity to give actual consent – especially if you’re the focus of the photograph, rather than merely a character somewhere in the background of one.

So I can sympathise with the idea that there has been a failure of courtesy on the part of those who take these jugcam shots without obtaining consent. But treating this as an analogue to rape, or linking it with SlutWalk, is taking things too far. SlutWalk (which I’ve criticised here and here) is about protesting victim-blaming, where those unsympathetic to the exploitation or abuse of women imply (or make explicit) the claim that women invite sexual abuse through what they choose to wear. With jugcam, there’s no suggestion that these pictures lead to sexual violence, merely that they are creepily invasive and that they objectify women.

But if you go to a stadium containing 40 000 spectators, where the goings-on are being broadcast on television, many people are going to see you. Many of those might find you attractive, and enjoy looking at you. This applies to both men and women, although men are far less likely to mind the attention given their artificial (and unwarranted) social privilege. To think that you welcome sexual abuse based on what you wear is obviously offensive – but to think that people shouldn’t look at you if they find you attractive is insane.

These thoughts (of finding someone attractive) and the subsequent behaviour (of looking at them) are entirely normal, and to regard them as constituting objectification is political correctness gone mad. We would not be able to meet, marry and/or procreate without these impulses. As I commented with regard to the Foschini T-shirt episode, it’s dangerous for us to keep amplifying our feelings of offence and responding with increasingly hyperbolic outrage – the real offences could simply get buried over time by self-important bleating. Furthermore, an excessive focus on symptoms of patriarchy might do little to address the underlying causes – not to mention the possibility that even focusing on patriarchy itself could obscure the more general (and more important, to my mind) fight against inequality in all forms.

Jugcam goes further than simply looking, though – it involves public exposure via Twitter (and websites). Do those wielding smartphones have an obligation to ask for permission to take photographs that TV cameramen do not? Paul Jacobson says no, arguing that

we live in a time when we are increasingly online, socially connected and capable of publishing a dizzying amount of content on the Web for virtually anyone to see. … We are getting to a point where you can’t go anywhere without seeing smartphones or other devices being used to take photos, record video and publish that content to sites you have no control over.

When it comes to the #JugCam meme (which is an organized version of what guys have probably been doing at sports events for some time now), we have to start making decisions about how we behave in such a connected world. I know how this next bit sounds but I think it has to be said and really does have some merit as an argument: women who wear bikini tops at public sports events like cricket matches must be aware that their photos could be taken and uploaded for broader consumption. I’m not saying its ok for that to happen, it is a little creepy, but it happens. Arguing that people (ok, men) shouldn’t be allowed to do this in public spaces without express permission is a little disingenuous. If a woman is opposed to being photographed in a bikini top and having her photo published online then she should reconsider wearing a bikini top at these events. Women should also be free to express outrage at their photo being published and demand that it be removed but whether that actually happens will likely come down to a decision based on the rights to freedom of expression, dignity and privacy being weighed up. I suspect the legal position will be something along the following lines: women in public wearing bikini tops have no real legitimate expectation of privacy when they are in public and can’t complain if their photo is taken and published online, particularly where they are aware that this could (and does) occur.

He’s right that we are at the point where this sort of thing often happens – but that doesn’t make it right that it does. As I outline above, there are some known risks of public exposure when attending a public event like a cricket game, and you might think there’s some chance of a TV camera focusing on you. Things like jugcam add to those risks. The point is not only a “real legitimate expectation of privacy”, but also that the bounds of what is private and what is public are being affected, where everyone you meet could take on a paparrazzi role. Yet we are not all celebrities, and it seems disingenuous to argue that we can treat any random female cricket spectator as if she were (leaving aside the question of whether even celebrities deserve this sort of intrusion).

My point is this: The fact that something like jugcam is not illegal, and also not offensive to the extent that some have argued on Twitter, does not make it a meme to be encouraged or defended. Jugcam is simply an excuse for being an ass, and an attempted legitimisation of a boorish and juvenile impulse to entertain yourself and your fellow frat-boys. There’s a simple question of courtesy and respect here – genuine celebrities know what they’re in for, and can’t be surprised by the attentions of photographers. The average cricket-watcher can not only be surprised, but more importantly, she can have preferences in this regard that outweigh the value you get from posting her picture online – even if it’s not that offensive to post her picture online.

It’s really not a lot of trouble to ask. And not asking – where someone might have a good reason to refuse – is rude. And it’s the sort of rudeness which comes from the invisibility of privilege, where the protagonists of jugcam can appear incapable of understanding why anyone would mind. The reason for being incapable of this understanding is the key thing – namely that it’s incomprehensible for some to think that their understanding of what is and is not problematic aren’t universal. Here’s a simple take-home lesson: if something you do affects someone else, and you have the opportunity to establish whether they welcome that effect or not, the default behaviour should be to ask them to express a view.

Having said that, we shouldn’t be at all surprised when people act like asses – and not every slight or insult needs to be spoken of as evidence for civilization’s downfall. Unauthorised jugcam pictures are rude, sure, but that’s all they are.

What happened to Plan A, Obama?

As submitted to Daily Maverick.

The man who said “We will restore science to its rightful place, and wield technology’s wonders to raise health care’s quality and lower its cost” in his inaugural address seems to have left the building. The building in question is the White House, and the man is of course President Obama.

We can hope that his absence is temporary, intended merely to provide for potential excursions into the hearts and minds of some Republican or undecided voters. But his endorsement of the decision to overturn the Food and Drug Administration’s (FDA) decision to allow “Plan B” (also known as the “morning-after pill”) to be sold over the counter to young teenagers rather than by prescription seems little more than a violation of that pledge to respect science.

Instead, he’s kowtowing to moral conservatives, alarmed at the prospect of their teenage daughters having sex. Seeing as many of these conservatives are equally fond of taking life guidance from religious texts, this is also another step back from the reassuring name-checking of “non-believers” in that same inaugural address.

Plan B is not an abortion pill, nor is it related to RU-486. The 1.5 milligrams of progesterone it contains helps to prevent ovulation and makes the lining of the uterus less hospitable to a fertilised egg. As the New York Times rightly points out, “this latter effect — shared by all hormonal and intrauterine contraceptives — makes it anathema to anti-abortion activists”.

Anti-abortion activists are perhaps unlikely to be voting for Obama in large numbers in any case. This is, after all, the President who shortly after taking office lifted the Reagan, then the George W. Bush, ban on federal funding for international health groups who support abortion rights. (The ban was briefly reversed by president Clinton before being reinstated by Bush.)

Then again, the man who campaigned as a pro-choice candidate did later sign an executive order ensuring that the healthcare law of 2010 would maintain the ban on federal money being used to pay for abortions (except in cases of rape or incest). So while it’s perhaps the case that his stance on abortion ends up evening out in terms of effects at the ballot box, this particular decision nevertheless stands out for its sacrifice of principles for potential political gain.

I say this for two reasons: first, this is the only time that an American Secretary of Health and Human Services has overruled an FDA recommendation. While the Secretary, Kathleen Sebelius, is the one who made the decision to do so, it’s clear that the decision was endorsed by Obama himself. A White House statement last week said:

The reason Kathleen made this decision is that she could not be confident that a 10-year-old or an 11-year-old going to a drug store should be able — alongside bubble gum or batteries — be able to buy a medication that potentially, if not used properly, could have an adverse effect. And I think most parents would probably feel the same way.

With eleven months to go before the US Presidential elections, the unprecedented overturning of an FDA recommendation is difficult to understand as anything more than an attempt to reassure conservatives that Obama is sympathetic to that nebulous concept of “family values” (which, like the term “neo-liberal”, seems in cases like these to mean whatever you do or don’t like about what the other guy is doing).

Second, the FDA recommendation appears to be well thought-through, making a principled objection to allowing over the counter sales of Plan B difficult to sustain. The need for drugs like this is clear in that the US has the highest teen pregnancy rates of any industrialised nation. Plan B is already available without prescription for women over 17, and by prescription for younger females.

The FDA’s proposal was for the drug to be available without prescription for younger teenagers also. It should of course go without saying that Plan B does not induce teenagers to desire having sex – many or most of them have that desire in any case, and would already have acted on it if they were trying to get hold of the drug in question . Furthermore, while making the uterus less hospitable to a fertilised egg could induce an abortion, the pill only lowers your chances of becoming pregnant to one in 40 (compared to one in 20 for unprotected intercourse), making it implausible that teens will use Plan B as licence for spontaneous orgies.

Sibelius’s claim is that we can’t be sure whether Plan B has harmful effects on eleven-year-olds, who can of course also fall pregnant. And naturally there might be risks. But in this case, we’re speaking of a drug which the FDA’s panel of experts regards as safe, and of which the assistant dean at the University of Southern California School of Pharmacy says: “very few medications are this simple, convenient and safe”.

A double-standard, informed by a moral panic around teens having sex, is clearly at play. Former F.D.A. assistant commissioner Dr. Susan Wood points out that drugs like acetaminophen (an analgesic found in Tylenol and many other over-the-counter medicines) can be fatal, but had not been specifically studied for effects on 11-year-olds, despite being potentially far more dangerous to them. She asks “why are contraceptives singled out every single time when they’re actually far safer than what’s already out there?”

We can of course also ask whether pregnancy itself is riskier to an 11-year-old than Plan B is. We can ask whether any of the people who might be heartened by this overrule, and Obama’s endorsement of it, were ever likely to vote for him in any case. More pertinently, we can perhaps ask what happened to the man who promised to restore science to its rightful place, and how did he become the man who seems willing to play politics with the bodies of the next generation of voters, for the sake of hypothetical sympathies from the current generation?

TopTV plans to “release a flood of filth into our communities”

Or so says Errol Naidoo, in any case. I wasn’t planning to say anything about TopTV’s plans to launch 3 porn channels (provided by Playboy TV), because besides this involving TopTV rather than Multichoice, the salient details are identical to those in the DStv porn saga last year. But a few people have enquired as to my views, so here they are.

First, it remains true that we have no compelling evidence that pornography necessarily causes harm in itself. I can’t dispute that some people have had miserable lives, or been exploited and abused in the production of pornography. It’s true that it’s an industry which conduces to trafficking, and it’s plausible that it might lead some consumers to dysfunctional attitudes towards sexuality, gender equality and so forth. These are unwelcome and regrettable correlates of porn.

But as one can’t seem to say often enough, correlation doesn’t equal causation. The fact that many people consume pornography from within healthy relationships, or as singletons who are not disposed towards seal-clubbing, satanic rituals or violence against women and children shows that it’s possible for porn to come without these complications. Which tells us that as much as some production and consumption of porn can come with problems, those problems can be addressed directly without needing to shut down an entire industry. If it ends up being true that these problems are inescapably part of porn production, then I’d agree that porn should be more strictly controlled, and perhaps even eliminated (if that were possible). But they’re not, or at least we have no good evidence that they are.

Which leaves us in a position of having to balance various interests. On the one hand, we have TopTV (or Multichoice), who want to make money. They do this by offering a service that consumers want, in this case porn. If they’re wrong, and consumers don’t want it, then the channels will most likely be pulled. But what they are planning to offer is legal, and they are entitled to do so. Of course they should (from their own self-interested point of view, as well as from the point of view of not causing needless offence) do so in a responsible way. Their plan is to offer these 3 channels as an opt-in service at an extra cost each month. So, parents need to choose whether to allow these channels in their homes or not.

This is stage 1 of the firewall that protects the innocent, fragile children. Unless a parent chooses to subscribe, Jenny and Johnny won’t be exposed to any part of the “flood of filth”. Then, in stage 2 of the firewall, each viewing of one of the porn channels requires the viewer to enter a PIN code. A parent could change this code every day, if they so choose. What this firewall adds up to is that, if Jenny or Johnny end up watching any porn on TopTV, it’s the fault of the parents, not of TopTV.

Naidoo might of course say that this shouldn’t be broadcast even to parents (or adults). For consistency’s sake (although I’m not sure if he’s familiar with that concept), he might also have to say that there can be no violence on TV. There should certainly be no booze on TV – and perhaps there should be no cars on TV, seeing as those can also be used irresponsibly. But none of this really matters to Naidoo and his ilk, seeing as personal choice needs to make way for his fascist world of obedience to the dictates of God. Well, not your god, perhaps, but the one that he insists you believe in. You know, the homophobic one.

He also says that these parental controls aren’t sufficient because:

Despite TopTV’s assurances of parental controls, it will not stop sexually depraved adults from sexually abusing women and children. The majority of the 55 000 rapes of women & sexual abuse of 25 000 children in SA every year, are perpetrated by TopTV’s target market – adult men!

He’s right. TopTV’s parental controls won’t stop sexual abuse, because we’ve got no reason to believe that a) TopTV’s porn will cause their target market to want to go out and rape women or children, and b) all these people already have access to porn, for god’s sake. In the course of his “research”, surely Errol has come across porn that would make whatever PlayboyTV provides look like scenes of Bambi running through a forest?

Naidoo closes his December 8 newsletter with this:

I appeal to you to urgently write to TopTV CEO, Vino Govender and inform him that you will stop paying your subscription fees, cancel your contract or support a targeted boycott of TopTV advertisers if he launches his proposed porn channels in South Africa.

Email Vino Govender at acidrais@toptv.co.za and copy in Melinda Connor at mconnor@toptv.co.za

Christian consumers stopped Multichoice from launching a 24 hour porn channel on DStv last year. You and I can do it again! Christian citizens must stand up and do what is right!

Before you take a well-deserved holiday with your family – please consider the families that will suffer because of TopTV’s greed. Please encourage your family & friends to write today!

PS: Please forward this email to your family & friends and NOT TopTV [my emphasis]. Please also join us on the official FPI Facebook page for more updates and info about TopTV’s evil agenda.

Perhaps he doesn’t want TopTV to have advance warning of the tsunami of self-righteousness heading their way. I don’t know. But there’s the CEO’s email address. Feel free to write to him to express your support for freedom of choice. Or to say that, even though you don’t like porn yourself, you commend him for his efforts to ensure that it reaches only it’s target market, rather than innocent bystanders. And if you want to mail the other public protector, Errol Naidoo, you can do so here: enaidoo@familypolicyinstitute.com

Sometimes we’re just like the rest of us

As submitted to Daily Maverick

We’ve read plenty of opinion in Daily Maverick on Premier Zille and HIV in recent weeks. And while encouraging thinking and debate on HIV and Aids is crucial, emotive topics such as this lend themselves quite easily to caricature – perhaps especially when protagonists in the discussion describe opposing views using hyperbolic labels such as “fascist”.

In Sipho Hlongwane’s column linked above, he asks whether Zille’s followers agree with her views on criminalising HIV and if not, why their opposition is mostly silent. While I reject the implicit association of a political party and its policies with one individual’s views (even if that individual is the party’s leader), I’ve expressed my opposition to those views in a previous column.

A broader issue raised by both the idea of criminalising HIV transmission as well as something like the Get Tested campaign is the extent to which scientific knowledge should inform policy. To put the issue that baldly might lead to some shaking of heads, in the sense that it might seem obvious and unworthy of debate that our scientific knowledge should inform policy.

But judgements often need to be made, and regardless of what the facts might be, we know that many – perhaps the majority – of votes are cast on the basis of perception. This is part of the reason that it becomes plausible to accuse a leader of populism, as some critics of Zille have done in this instance, or for her to accuse critics of fascism or “slacktivism” (itself often a grossly unfair charge, in that the only voice most of us have comes from behind our computer monitors, from where we are typically not able to control the budgets of state organs).

What I mean is this: On the one hand, the issue of whether criminalising HIV is a good idea or not could be regarded as a simple one, answerable though data telling us whether doing so results in fewer cases of transmission. With Get Tested, we could ask whether the campaign results in more people knowing their status, thereby potentially entering the treatment and counselling net. (Briefly, on the topic of Get Tested, I must regretfully withdraw some of my previously expressed support for the campaign, now that we know that baseline figures for testing rates pre-Get Tested are not available – meaning that we have no way of knowing how effective the campaign has been.)

On the other hand, the issues can never be this simple, because even if we all agree that control of the HIV epidemic is our most pressing concern, other values can nevertheless limit our pursuit of that goal. But what if the data did show that criminalising HIV transmission actually worked, or that Get Tested resulted in a 10% increase in the number of people who were tested for HIV? Would opposition to these measures cease?

My suspicion is that they will not, because we seem reluctant to trust the data to inform policy above all else, and because we’re unwilling to regard ourselves as one trivial data point in the aggregate. We’re of course not trivial to ourselves, and justifiably fear (for example) the imposition on our time that mandatory HIV testing would entail. At the same time, we might be perfectly happy for our sexual partners to engage in such testing, and to hypocritically insist that they do so.

In other words, we assign individual agency a greater value than we do the collective good. Which is as it should be much or even perhaps most of the time, at least if you subscribe to broadly liberal principles. But liberal-minded folk are still part of that collective, and can sometimes benefit more as individuals by focusing on the good of that collective, seeing as there are so many more of them (capable of doing you harm or good) than there are of you.

One particularly interesting test-case involving this conflict between perceived impositions on individual liberty versus the good of the collective is blood donation; and in particular the question of whether the South African National Blood Service and their international equivalents should accept donations of blood from homosexual men.

Gay men who have had oral or anal sex with another man in the last six months (whether protected sex or not) cannot donate blood in South Africa. In the UK, the deferral period for this category of donor was recently reduced to one year, while a lifetime restriction still applies in the USA for men who have had any sexual encounter with another man since 1977.

The phrase ‘category of donor’ is key to the issue I am raising here: We don’t easily think of ourselves as belonging to a category, no matter how clearly the data shows that people of type X, or who engage in behaviour Y, on aggregate merit treatment Z. This is the curse that actuaries have to bear: Their models that price our insurance premiums or motivate for medical interventions such as those mentioned above are in constant competition with the Pythonesque reality of all of us insisting in unison that “We’re all individuals”.

But laws or insurance premiums can’t be tailored to individuals. As much as we are individuals to ourselves, interventions intended to work on aggregate have to treat us as belonging to a category – and the question then becomes how those categories are defined. And here, we need to start thinking about the least wrong way of doing this, and perhaps being more willing to tolerate principled ways of treating us simply as a number.

Legislation based on one person’s moral viewpoint, in opposition to the available evidence, is far closer to most wrong than to least wrong. And science utterly divorced from morality offers its own nightmares, as a Twitter friend reminded me in a conversation on this topic. I’ll return to the specific case of blood deferrals for homosexual men – and other “categories” of human – in a future column.

For now, though, the concern is this: Seeing as most of us know little about science beyond misleading headlines, and our understanding of morality is largely subjective, perhaps more of us should be willing to respond as that lone voice in the crowd did in Monty Python’s Life of Brian. When Brian told the crowd “You’re all different!”, and they responded “Yes, we are all different!”, his muted response was simply “I’m not”. And neither, most of the time, are the rest of us.

Premier Zille is nudging people to Get Tested

As submitted to the Daily Maverick

As T.O. Molefe pointed out in a column last week, we can legitimately question whether a campaign like Get Tested will have any long-term effect on the willingness of South Africans to get tested for HIV. Launched by Premier Helen Zille to coincide with 16 Days of Activism for No Violence Against Women and Children, Get Tested offers a financial incentive for knowing your HIV status. Anyone who volunteers for HIV testing between November 28 and December 9 stands a chance of winning a first prize of R50 000 or one of five R10 000 runner-up prizes.

You might recall that Zille attracted a significant amount of criticism for her stated intentions of criminalising HIV transmission. As was the case then, an apparent problem with Get Tested is that according to Molefe, it tries “to achieve individual thought and responsibility by taking away thought and usurping responsibility”. Furthermore, Molefe draws on the work of Daniel Pink in arguing that the effects of the incentive will only be short-term, falling away once the prizes are no longer available.

Both of these criticisms are to my mind at best not compelling, and at worst unfounded. While it’s true that behavioural economics is a contested science, the contestation more typically relates to whether findings in experimental conditions cross over into informing policy in the real world, and to whether the rise of “choice architects” – in other words, those who design the “nudges” – present an illiberal incursion into our freedom to choose.

Pink’s claim that carrots and sticks are less effective, and potentially harmful, in addressing complex 21st century problems raises questions relating to the design of these nudges. These questions don’t however rule out the potential usefulness of nudges. If the desired behavioural change depends on tweaking complex motivational forces, we might struggle to achieve it – but there seems little difference in kind from more simple behaviours. The question is one of degree only.

Of course, there might be problems too subtle to address via these sorts of nudges, but given that we’re talking about a science that arguably only came into existence in 1979, with Kahneman and Tversky’s “Prospect theory: An Analysis of Decision Under Risk”, it seems rather hasty to claim that the experimental work conducted by George Ainslie, Gary Becker and a host of others has been premised on problems already superseded by newer and more complex ones.

Despite this question, it remains true that our models of intertemporal choice behaviour and hyperbolic discounting (in this context, the choice habits that could result in people being tested now for the chance of winning money, instead of for their own long-term benefit) are imperfect. They could perhaps even be critically flawed, and as I mentioned earlier, applicable more to experimental conditions than to real-world policy.

But the successes of these sorts of interventions – at least on pragmatic criteria – seem to be far outweighing their failures. Long-term trials such as the 3-year J-PAL immunisation intervention in rural India have been tremendously successful. Offering parents 1kg of lentils and a set of metal meal plates upon completion of a course of immunisation for their child resulted in a more-than-doubled immunisation rate at half the cost, thanks to economies of scale resulting from increased uptake.

There are similar tales of success with HIV testing in South Africa. The 2008 intervention by the Men By the Side of the Road charity, which offered unemployed men R75 to test for HIV had a 100% uptake in the group it targeted, along with a waiting list in the thousands. The Discovery Health/Sunday Times Right to Know campaign (July 2008 to June 2009) attracted 55 000 volunteers for testing, thanks to the promise of one person per month becoming R100 000 richer.

But the question is of course sustainability, and whether these incentives have a long-term impact on behaviour. And here is where I’d urge Zille’s critics to a little more temperance, in that if relatively low incentives of one R50 000 prize and five R10 000 prizes end up resulting in significantly increased rates of testing, the R100 000 total spend could end up being a very worthwhile (and sustainable) investment, given that the Province currently spends a reported R661 million on its HIV/AIDS programmes per year.

What of the criticism that choice-architecture of this sort is somehow grossly illiberal, “taking away thought and usurping responsibility”? First, it’s perhaps worth noting that the liberal goal of securing freedoms is surely maximised by both good health, and by decreasing expenditure on preventable diseases so that the funds can be used elsewhere. The question is how we secure those goods, and whether we impinge on liberties excessively in doing so (as we would do by criminalising HIV).

While it’s true, as Molefe says, that HIV testing should be its own incentive, I’d suggest that those of us who know this already get tested. Offering people the chance of a cash prize for HIV testing can only increase the likelihood that any first-time testers can be exposed to that message, resulting in a probable net gain in terms of awareness. It’s not the case that the Get Tested campaign is replacing ordinary awareness campaigns – it’s a supplement to them, and one that seems worth trialling given its low cost.

Furthermore, it’s a supplemental sort of intervention that is widely accepted, rarely attracting the sort of criticisms Zille is confronting here. What, for example, do critics of choice architecture think of Discovery Health’s Vitality programme, which by Molefe’s reasoning “sends the unintentional message that [good health], something which is an incentive in itself, is so abnormal and exceptional a behaviour that those who get tested are entitled to a reward”?

While nudges like the Get Tested campaign are sometimes accused of violating human autonomy, it’s difficult to be sympathetic to these charges. South Africans retain their choice to be tested or not – and if some who would otherwise not be tested now come forward, they do so because they autonomously desire money. Their exercising that autonomy is potentially to all of our benefits, given the level of public expenditure on AIDS.

In short, the harms of Get Tested are unclear while the possible benefits are not. Given that it will cost us little in terms of money – and nothing, as far as I can tell, in terms of liberty – we should give it a chance. If it ends up working, some of those entitlement horses might eventually end up being able to find their own way to the watering-hole.

Helen Zille on HIV

As submitted to The Daily Maverick

It’s easy to understand why the Premier of the Western Cape, Helen Zille, wants to do something to minimise the prevalence of and costs associated with HIV infection. According to her remarks at a wellness summit earlier this month, HIV treatment costs the provincial government close to R2 billion per year – and that is no small sum to spend on a preventable disease. Her proposed solution to this includes wanting to charge men who have unprotected sex with multiple partners with attempted murder.

In an interview with John Maytham on CapeTalk567 on November 9, Zille presented three complementary measures for minimising the problem of HIV infection: compulsory testing, compulsory disclosure of HIV status to potential sexual partners, and compulsory wearing of condoms in non-monogamous sexual relations. We were told that she desires for these measures to become law, and that similar sorts of responses to AIDS had been effective in various other jurisdictions.

There is much one can agree with in terms of her motivations – even if not in terms of the proposed remedies. It is in all of our interests to have public funds spent in the most effective possible ways, and it’s also normally in our interests to safeguard ourselves against threats to our health. But we pursue those interests unreliably and sometimes irrationally. Humans are disposed to something called hyperbolic discounting, namely the preference for smaller but sooner rewards over larger but later rewards.

What this means is something we all know well – thinking we’ll go to the gym, stop smoking, or start eating more healthily tomorrow. We’re enjoying it now, and we find it easy to discount the long-term costs of satisfying our immediate desires. This is not to say that it’s obligatory to care about your own health or longevity. It would certainly be weird, but not impossible to imagine being enough of a hedonist that you commit yourself to a shorter but more Bacchanalian life, understanding the potential consequences in full.

The concern raised by Zille is that we might be accused of excusing or forgiving reckless behaviour by funding treatment of its consequences from public coffers. While the state guarantees the right to medical treatment, the argument was made that these rights entail certain responsibilities – namely those three responsibilities outlined above.

But this conclusion would be somewhat hasty. While the idea that “rights entail responsibilities” seems axiomatic to many, it isn’t quite true. A positive right, where something is provided (such as a right to healthcare), is provided by the state as an obligation funded by our taxes. It’s certainly regrettable that we cause inefficient spending of that money through poor choices, but those poor choices don’t make us liable for an increased contribution to healthcare funding.

Leveraging that regrettable inefficiency into changed behaviour is a moral issue, but not one that can easily be legislated (whether doing so is desirable or not). We can try to persuade people to live healthier lives – for their own good as well as for the good of efficient healthcare spending – and we can try to guilt them into not allowing their preventable conditions from swallowing a disproportionate share of available funds.

However, if HIV infection following unsafe sex should become your legal responsibility to avoid, one can start to wonder where these sorts of responsibilities would end. I don’t have to have a car accident for alcohol consumption to become a cost to the state. I could drink to excess most nights in the safety of my own home, and still eventually require treatment for cirrhosis. Likewise for smoking and lung cancer or emphysema, and of course for my dietary choices also, where my diabetes or high cholesterol end up requiring expensive medication, surgery, or both.

These things might differ in scale, but not in type. It’s easy to find examples of self-inflicted harms that cost everyone else money through public provision of treatment, and it serves us well to try and eliminate all of them. But doing so always comes at a cost, and that cost can be a significant erosion of our liberty. We could, for example, require that everyone hand their car keys to the restaurant host, to only be returned on your successfully passing a breathalyser test. We don’t do this because of the belief that it’s appropriate to punish people for actually causing harms to others, and not appropriate to regulate their lives to the extent that it becomes impossible for them to cause those harms.

It’s not only concerns regarding the erosion of liberty that should make us wary of calls to criminalise unsafe sex in general, or force us to be tested for HIV. Readers of The Daily Maverick would mostly be in the position of having ready access to medical care, including things like HIV testing. It could be performed as part of an annual check-up, or even provided at the workplace. But this won’t be the case for the rural poor, meaning that the state would have to spend the money to roll out nationwide testing – or inadvertently make it the case that being poor automatically means being a criminal under this sort of legislation.

Then, it is also not clear that criminalisation of HIV does any good, despite Premier Zille’s claims to the contrary. Edwin Cameron’s 2008 paper in the Journal of the American Medical Association makes reference to a study comparing HIV infection in Illinois (which requires HIV disclosure and criminalises sex without informed consent) and New York (which has no such laws). No statistically significant difference in sexual behaviour was found in this comparison – and this in a country with significantly higher literacy than ours, and also one in which myths regarding HIV and its spread are largely absent.

There is also a stigma attached to HIV, and its criminalisation cannot but exacerbate that. Cameron points out that:

Tragically, it is stigma that lies primarily behind the drive to criminalization. It is stigma, rooted in the moralism that arises from sexual transmission of HIV, that too often provides the main impulse behind the enactment of these laws.

Even more tragically, such laws and prosecutions in turn only add fuel to the fires of stigma. Prosecutions for HIV transmission and exposure, and the chilling content of the enactments themselves, reinforce the idea of HIV as a shameful, disgraceful, unworthy condition.

This is not to say that we shouldn’t criminalise knowing infection of others with HIV, just as other sorts of intentional harms to others are criminalised. As I started out by saying, one can sympathise with Premier Zille’s frustrations, and her desire to go further than this. HIV and AIDS are significant problems, and large sums of money are being spent on treatment that could instead be spent on the treatment of unpreventable medical conditions. But addressing this one – HIV – with the force of law requires something like a camera in every bedroom, and could also be accused of unfairly targeting the poor and women.

Public awareness and understanding of the harms we can do to each other and our responsibilities to avoid those harms takes time to generate, especially in a context where under-education and mythology – in this area as well as others – abound. We need to keep informing and educating, but the law is too blunt an instrument to arrest HIV without compromising other values we hold dear. To think that it’s our best recourse seems utterly wrong-headed, and just about as crazy as believing that you live in a haunted house.

Also read Gavin Silber and Nathan Geffen on this topic.