Avoiding deaths cannot be the be-all and end-all of public policy

Here’s a thought experiment. Consider two possible worlds, A and B. World A has more freedom, higher levels of happiness, and less misery than world B. But world B has a slightly less deaths per year than A. Life expectancy is about a year higher in B than A. Suppose, for example, that it’s 81 in A, and 82 in B.  Which world would you prefer to live in? Most people are intuitively going to prefer A. (I’m supposing that there are no hidden horrors in world A.)

This shows us that avoiding death, or living longer is not the most important thing in life for us, or at least, it’s not the be-all and end-all for us. Obviously it’s very important, and clearly we value it extremely highly. But it’s not like it outweighs everything else. It will be a complex matter, deciding which bundle of goods, and in what proportions, we would prefer, and what trade-offs we would prefer in the inevitable absence of perfect worlds that we can inhabit. And, of course, different people will differ on these things. But in general we can say that for almost everyone, avoidance of death doesn’t trump every other consideration.

(Just to be clear, I’m not arguing for any sort of crude and callous utiliarianism which says that it’s all right for the government or private companies to, say, murder people for some supposed ‘greater good’, or anything like that.)

Think of it this way. If we were asked to decide on a personal utility score for worlds A and B, there would be various things you’d rate, at various levels. Life expectancy would be one of them, and it would be very important, maybe even the most important for most people, but it wouldn’t be the only thing that contributed to the utility score for each world. Of course, you may set up your utility score that the lower the life expectancy is than a certain year, the more negative the utility score (the disutility) goes. You may even have this set up so that it works in an exponential manner. A world with a life expectancy of, say 75, scores a bit less than a world where it’s 81, but a world with a life expectancy of 45 scores enormously lower.

Anyway, whatever the details, you get the picture. We can’t make everything about death. I’m not even talking about the fact that if we focus too much on doing whatever it takes to avoid a death and not enough on things like prosperity then inevitably deaths start increasing whether you like it or not, because less prosperous countries have lower life expectancy. I’m talking about the fact that even apart from this, there are other things that matter in life. Happiness matters. Careers matter. Families matter. Love matters. Dreams matter. And freedom matters.  It matters whether you live your life in fear and terror, like in so many Communist countries, or whether you are free to express your own beliefs. It matters whether you can go to shops where there is plenty of food, or whether you must queue for hours just to get a loaf of bread. It matters whether you are free to take the air if you wish, or visit friends or family, without needing a government permit to do so. It matters whether there is some stability in the business environment, or whether a government can just destroy perfectly good and healthy economic sectors as they see fit.

All these sorts of things must be taken into account when we weigh up the rights and wrongs of public policy. The one thing we cannot say is that everything else must be sacrificed to save just one death.

People who do risk-benefit analysis face this issue all the time. Even in this modern world where possible deaths are, in my view, given too much prominence over freedoms, it is recognised by the risk-benefit analysts that you cannot prioritise every possible death without harming too many other things of value. Here’s an example given by Andrew Lilico:

Some years ago I led a study for the European Union considering its rules on chemicals in toys. If we made the rules more restrictive, fewer children would die but it would become more expensive to produce the toys so fewer poor children would get toys. I had to devise ways to help policymakers trade off the risk of more child deaths versus fewer poor children getting toys at all, so as to find the optimal compromise. I do not accept my devising such a calculus was callous.

You cannot ban every possible chemical that might kill someone because in doing so you harm the economy too much, and impinge on the happiness of many people. Even though in the modern world the pendulum is swinging very much (too much, in my view) towards the ‘Death overrides everything else’ view — especially with chemicals — it hasn’t quite managed to win out, because explicitly adopting that view would be impossible. It would mean banning almost everything, because almost anything can kill someone. So that view is nonsensical. Anyone who says it should not be taken seriously. We must make trade-offs between deaths and other things. Anyone who says otherwise is a fool.

So our general principle is vindicated. But that, of course, is hardly the end of the matter. For one thing there will be disagreement on how such trade-offs should be achieved. But, more importantly, modern safety culture is constantly pushing the views of policymakers, and people in positions like Lilico’s, towards the side of excessive safety. The view of most members of the enlightened class these days is that safety takes priority, and risks must continually be eliminated. A possible death overrides almost everything.

Or, more specifically, it overrides those things that they’re not keen on. They’re remarkably unconcerned about possible deaths resulting from things they like, such as climate change initiatives. Safety culture has thrived mainly because the leftists and the wannabe world rulers like Bill Gates have found that it is a useful weapon to advance their own interests. That is why, no matter how keen you are on safety issues, and no matter how worried you are about your loved ones dying from coronavirus, it is important not to let our liberties vanish, and not to let the state get away with a massive and sudden power grab, under the cover of ‘We must do whatever it takes to protect people from coronavirus’. There are some things we should do yes, but not ‘whatever it takes’.

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35 thoughts on “Avoiding deaths cannot be the be-all and end-all of public policy

  1. How much of this is the oedipal mother complex? The ever-lasting protection from harm in exchange for lifelong dependence.

    All I can say is it’s all very unmanly.

  2. David Moore: “All I can say is it’s all very unmanly.”

    Highly insightful, Mr. M. The Safety-At-All-Costs attitude is probably inseparable from the feminization of society. Fortunately, this is Prof. Drummond’s blog — otherwise you would be banned for DoublePlusBadUnspeak and I would be similarly defenestrated for agreeing with you.

    Feminization probably started to become an issue back in the 1980s, when Affirmative Action intended to assist the poor descendants of slaves somehow transmogrified into assisting the well-to-do daughters of the Upper Middle Class. That was 2 generations ago. Rule of Thumb — it is likely to take at least that long to change attitudes away from today’s feminized over-concern about safety. Tough sledding ahead!

  3. “Fortunately, this is Prof. Drummond’s blog — otherwise you would be banned for DoublePlusBadUnspeak and I would be similarly defenestrated for agreeing with you.”

    The anger with which any contesting of the majority view is met with on a more mainstream venue is quite breathtaking. Any pointing out of relatively straightforward data that questions this consensus get cry’s for me to be ‘silenced’ and accusations that misinformation will cost many lives.

    “The Safety-At-All-Costs attitude is probably inseparable from the feminization of society.”

    Yes, it’s hard to doubt this. I wonder how much of it is also the result of a health service that is more and more feminine. That perhaps, is a factor in the idea all life must go on hold so as not to ‘stress’ the NHS.

  4. Surely the current problem is not avoiding deaths but of delaying deaths, largely of people many of whom have a low quality of life due to co-morbities, and at a very high cost to the rest of the community.
    Disclaimer: At 81 with hypertension under control, I am in the relevant high-risk category. However, as much as I’m not keen on dying, I would be horrified to think that the community might be destroyed economically to give me a few months (or even years) of poor quality life.

  5. In my view, I don’t really think they are thinking of you and protecting your life. The claims that people are motivated by ‘protecting life’ rings empty to me. I really think they are motivated by their own fears for their own lives.

    31 residents at an old folks home in Montreal have died due to neglect because the staff abandoned them.

    If this was about protecting the vulnerable, there would be far more room for debate on the best course of action.

    It’s really makes me choke on this when so many people claim the moral high ground, while their actions are directly harmful to others.

  6. Are we actually saving any lives at all with our lock down? My understanding was that this action was intended to slow the spread of the disease so as not to overwhelm the health service. In the long run though, the disease has to run its course so that enough people develop an immunity to it and it dies down. Isn’t it likely that the same number of people will probably die either way? I’m a 61 year old diabetic so I am certainly at risk, but I would like to see life returning to normal now really.

    I live in a rural part of East Yorkshire and I don’t actually know anyone who has had the bug yet. That is just an observation.

  7. Hector’s opening question is a good one and very relevant in today’s hysteria.
    All this talk about life expectancy and quality of life can, in my opinion, be summed up by quotes from two excellent English writers:

    “There is no pleasure worth forgoing just for an extra three years in the geriatric ward”-John Mortimer, and:

    “No pleasure is worth giving up for the sake of two more years in a geriatric home at Weston-super-Mare”-Kingsley Amis.

    I seem to remember Kingsley was a little more pithy than that, but sufficient unto the day etc.

    So, it isn’t just about numbers, in my opinion. We’re all, all of us, going to expire, so how you live your ever-shortening day is important.
    I’m 74 next week, asthmatic, overweight and every night I regularly exceed the government’s “recommendations” on weekly alcohol intake.
    I have done everything possible throughout my life to avoid meaningful work and I concern myself only with matters that I can actually do something about. Death has no fears for me, but the thought of having my face washed and my arse wiped for me by some fellow from Latvia, while I lie in a “care” home bed, staring longingly out of a condensation smeared window, scares the crap out of me.
    I despise utterly the fear, the panic and the hysteria that has overtaken my country.
    Apologies for intemperate language.

  8. @Stonyground “Isn’t it likely that the same number of people will probably die either way? ”

    Not really, no. The idea is (based on the Chinese and Lombardy experience) that once you overwhelm the health service, the fatality rate rises very sharply. So you’re right that the lock-down is not necessarily about reducing the overall long-term number of people who become *infected*, but it is about reducing the number of people dying.

    There are other reasons why simple delay might be worthwhile in reducing overall death: it allows you time to expand the health service and their supplies of equipment and it allows time for the expertise of the medical profession in treating the condition (or at least, its symptoms) to improve.

    Of course, it’s entirely debatable what the balance between these aims and the survival of the rest of society should be. That’s partly why civilised countries have different degrees of response.

  9. “There are some things we should do yes, but not ‘whatever it takes'”

    Especially if whatever it takes is a Pyrrihic victory which causes early but invisible deaths in the long run, and the economy is so knackered that we can’t afford another such victory against the virus.

  10. Well Gavin and David – that all fits well with the idea that –

    “If you want to anger a person of the right – tell them a lie

    If you want to anger a person of the left – tell them the truth”

  11. “In the long run though, the disease has to run its course so that enough people develop an immunity to it and it dies down.”

    Agreed Stony – but not if Bill Gates gets his way, and he funds Imperial College.

  12. Hector, based on knowing 1300 deaths occoured in week 13, can the graphs be adjusted to show the extra 1300 in week 13, and reducing the 1300 from week 14?

    I think it would follow the more standard upward slope around this time of year

  13. Imagine two worlds: A) and B)

    A) where the population at large achieves herd immunity through exposure to a relatively benign pathogen. Any second waves are mild.

    B) where exposure of the population to said pathogen is restricted. Cases of benign exposure isolated in their homes, and serious cases centralised in overcrowded hospitals. Positive selective pressure is placed on the virus toward a more virulent form. Restrictions are then relaxed and the naive population exposed to this more deadly virus leading to more deaths.

    Scenario B) is what happened (albeit through different means) during the spanish influenza:

    “This increased severity has been attributed to the circumstances of the First World War.[104] In civilian life, natural selection favors a mild strain. Those who get very ill stay home, and those mildly ill continue with their lives, preferentially spreading the mild strain. In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus. The second wave began, and the flu quickly spread around the world again. Consequently, during modern pandemics, health officials pay attention when the virus reaches places with social upheaval (looking for deadlier strains of the virus).”

  14. Exactly. Both my parents died in their early sixties, my mother after 45 years of ill health. At 65 it looks like I may live a little longer. I have been enjoying an early retirement. But I like to go out while I am still enjoying it.

  15. @Stonyground, the “general” lockdown is likely to actually increase deaths: If 80% of the populace are going to be exposed, sooner or later, there will be 20% that wont be. With a general lockdown we are ensuring that the 20% not exposed will be representative of the population. If we had a more targeted isolation plan, one could ensure that 20% was made up disproportionately of old and vulnerable at the expense of kids, who have virtually zero risk anyway. The “doing good” reflex response, actually does more harm, but allows the do-gooders to feel virtuous. I guess feelings of virtue have utility too, and may actually be worth the shortened lives of others in a cost-benefit analysis???

  16. *They’re remarkably unconcerned about possible deaths resulting from things they like, such as climate change initiatives.*

    Great post and some top replies. You’re getting to the nub of it in that final para.

    There’s a maxim in sales: ‘Win the argument, lose the sale’, which ‘unpacked’, as the ‘analytics’ like to say, means that people are *political*, ie will sooner take a hit economically than lose face or be proved wrong.

    Not only that, in our affluent culture material abundance creates a market for asceticism, ie self-advertisement by apparent self-denial. Except if you’re very well off you’re not being denied anything by economic repercussions of ‘Extinction Rebellion’ / ‘lockdown’.

    The more people can fly or drive nice cars the less value they confer, since value is premised on scarcity. Hence advocacy of Green politics and/or ‘socialism’ correlates to a great degree with wealth. And even if you’re not that well off you can still make your mark by investing your identity in rejecting material affluence.

    That’s why I see economic rationalism, whether ‘socialist’ or ‘libertarian’ as equally false, premised on the same rationalist optimism, as if there could be a ‘correct’ economic model, as if people *weren’t* political, or that politics should be understood as a question of calculating optimum utility / satisfaction, and will be once people are properly informed about ‘socialist’/’free market’ economics.

    We’re supposed to be against ‘socialism’ because untrammelled economic power is bound to engender political corruption. Billionaire plutocrats whose great wealth shields them from economic adversity are no less of a peril and should be opposed for the same reason.

    Others have mentioned safety-first feminisation of public realm. Worth bearing in mind that no society has ever survived where women got upper-hand in political life. Can’t be a coincidence that the most enduring form of political allegiance in world history is designed to make it impossible.

  17. “Can’t be a coincidence that the most enduring form of political allegiance in world history is designed to make it impossible.”

    Catholic Church?

  18. I suppose that’s got to be true of RC internal politics, but I meant Islam because it recognises only God’s law, whereas even if RC serves as a symbol of political identity, as it once did in England and still does in Belfast or Glasgow, theologically Christianity distinguishes between God’s law and mans’s. Even if pope can’t be a woman that doesn’t make RC a form of political allegiance. If RC membership indicates one’s political leaning, that’s in spite of its theology rather than an integral element of it.

  19. That’s why I see economic rationalism, whether ‘socialist’ or ‘libertarian’ as equally false, premised on the same rationalist optimism

    I hear this a lot and as a pessimistic person allergic to faith-based arguments I want to address it. In my view libertarian thinking (or classical liberalism which is close enough to call equivalent) is the least optimistic worldview, and seeks to harness human greed and self-interest as opposed to human kindness and communitarianism. It is a philosophy addressing government’s role and effect on a society, but people often interpret as a philosophy on society.

    IE, libertarianism has no dog in your culture war, except insofar as it intersects with government policy. Socialism, on the the other hand, posits that everything in society is under the government’s purview, and therefore actually is a comment on culture etc. They are not opposing viewpoints, strictly speaking. Authoritarianism is the other pole, as dictatorships can arise in nearly any society or form of government.

    Anyway, the classical liberal view of the scope and power of government (ie, modern libertarianism) is nicely summed up in Benjamin Franklin’s answer to the question of what the USA’s Founders had created: A republic, if you can keep it. The infrastructure for liberty is there, but if we scream at our pols to step on us harder we only have ourselves to blame when they do.

  20. @Hector

    Your opening paragraph sums up my thoughts while reading Dominic Lawson’s spiel today

    It’s the grim, miserable life Greens, PHE and Left want us to live

    Like Guy Martin I’ve had lots of broken bones, but the pleasure and adrenaline rush of dangerous sports (MX, Skiing) and fast road rides (100-180mph) far outweigh the death risk

    “Even in this modern world where possible deaths are, in my view, given too much prominence over freedoms” spot on

  21. Every form of transport takes a toll in human life, yet all of us take this risk on a daily basis on the principle that the benefit outweighs the risk. We all do it, even the emotionally incontinent on social media wailing about saving lives by staying home and thereby trashing the economy because the economy isn’t as important as saving lives.

  22. I didn’t mean that libertarianism or socialism weren’t right or wrong according to some system of values but that they’re *false*, in the sense of not being true, i.e. that conceiving of politics as a “battle of ideas” between rival systems or economic models understood as promising more or less liberty or equality, which are supposed to be intrinsically desirable depending which side you’re on, misrepresents the true nature of political rivalry.

  23. Dr. John Ioannidis has crunched some numbers and the risk of dying from Covid 19, if you are under 65, is about that of a truck driver dying from a road accident if you live in the US.

    In Germany, it’s about that of a standard person commuting daily in a car.

    If you have no pre-existing conditions, the risk effectively zero.

  24. In response to commenters claiming ‘safety at all costs’ is related to the ‘feminisation’ of society, there is actually a large body of feminist theory that posits that control over life and death is a patriarchal prerogative. Women are the nature ordained gatekeepers to life through our gestation and birthing capacities. Arguably men as a group resent, envy and fear these powers and therefore attempt to colonise them. There is a long history of female midwives and healers being persecuted by male dominated medical institutions. A couple of more recent examples of this would be the drive towards commercial surrogacy in the UK, where women’s pregnancy and birthing abilities become capitalist products available for purchase by the richer and more powerful. Also, the worldwide high levels of obstetrics violence and state pressure on women who attempt to give birth with minimal medical intervention (at home, with a doula, refusing ultrasounds during pregnancy etc.)

  25. Men take risks.
    Women take fewer risks.

    Don’t confuse bureaucracy with patriarchy. Nobody wins any grievance studies prizes for that.

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