APR 11

22: APR 11: What do we owe strangers?

Assigned

• Sapolsky, Chapter 17, “The View from the Bottom” from Why Zebras Don’t Get Ulcers. Recommended p. 353-383. If you don’t have time for the whole chapter, read from 362 to 383.

In-Class

• Resources for PP1: A Continuum of Justice Positions
• Methodological Reflection on Justice and evolution
• More on SES and health - [1]
• PP1 Assigned

Sapolsky, Chapter 17, “The View from the Bottom” 353-383

• Example of social epidemiology in practice. [2]

• tension between reductive biology which focuses on immediate mechanisms of disease and illness and social or behavioral medicine, which looks at socio-political causes of illness.

• Famous pioneer in social medicine: Rudolph Virchow -- noticed in 1847 Typhus outbreak that disproportionately affected people living in poor social conditions.

• Focus of the chapter on how social rank (SES- socio-economic status) is a determinant of health and mortality.

• Pecking Orders Among Beasts with Tails

• wide range of animals engage in dominance hierarchies -- hens, baboons -- examples of types of dominance behavior. Subordinate male baboons have elevated resting glucocorticoid levels. Chronically activated stress levels predict a range of other physiological disregulation, including cholesterol, testosterone, immune response, etc. Stress related disseases.

• On the other hand, low rank in a dominance hierarchy in many species does not result in a chronic stress response. Ex: marmosets, wild dogs, and dwarf mongooses (359). Why? Short answer: in some species being low ranked isn't such a bad deal and being dominant is stressful. Typical factors that decide this question: being harassed by dominant members and being denied social support predict health effects from dominance. Stable dominance hierarchies also matter (for humans this would mean not expecting to get out of a low SES status).

• Do Humans have Ranks?

• Need to distinguish dominance from aggression. A Type a personality can be aggressive without being dominant. Studies of corporate hierarchies suggest top execs "give ulcers rather than get them". It's the middle managers who are stressed - responsibility without control. Sapolsky is a bit skeptical of these studies (363), especially as most of human history has been, we think, unhierarchical. (Hunter-gatherers were likely egalitarian.)

• The question of dominance among humans is also hard to assess because we are complicated. You can have low status and high stress at your job, but high status from church or community engagement. We also think about our challenges is diverse ways. (You may be far from winning the Bloomsday race, but having a great time.)

• One place Sapolsky is not skeptical about: being poor is a huge health risk.

• Socioeconomic status (SES), stress, and disease

• Description of poverty stress factors p. 364.

• Poverty also limits coping strategy resources (frequent crises, lack of social support, few resources in general). Poverty reduces personal choices for outlets for stress and limits personal safety (the poor experience crime more than high SES people).

• Only a few studies, but they support this claim. Montreal study: low-SES kids have double circulating glucocorticoids as high SES kids.

• Health risk from poverty is the biggest effect in behavioral medicine. Cardiovascular disease, resporatory disease, ulcers, rheumatoid disorders, psychiatric disorders, some cancers, infant mortality and mortality from all causes. Low SES predicts low birth weight (which has life long effects). Could be a 5-10 year difference in life expectance depending upon the country. Nun study (367)

• Puzzle of Health Care Access

• You would think access to health care would explain the difference, but only part of it. SES gradient in England worsening in spite of universal health care. You might suspect that people don't get treated equally in the health system (Carla's story!).

• But also, it's a "gradient". Marmot study used British Civil service ranking and found a gradient by job status. 4x great carido risk from low SES.

• The SES gradient exists for diseases not sensitive to health care access. juvenile diabetes and rheumatoid arthritis, for example. (369).

• Risk factors and protective factors

• Poor people smoke more, eat less well, don't exercise as much, have less adequate heat in winter, more exposure to crime. Being poorly educated is a big risk factor, because it can affect your understanding of risks and ways to protect yourself (the poor are less likely to wear seat belts). These are risk and protective factors. Controlling for these factors may only account for about 1/3 of the SES gradient.

• You might think living in a wealthy country is a protective factor. One study of wealthies 1/4 of countries showed no relationship between wealth and health of citizens.

• Stress and the SES gradient

• Sapolsky thinks psychological factors, such as stress, may be part of the explanation for the SES gradient.

• 1. Poor have higher stress levels.
• 2. The SES gradient tracks stress related diseases.
• 3. Not clear what the competitor explanation would be, if not stress.

• Being poor versus feeling poor

• Newer research on "subjective poverty" not just actual SES status, but also how one perceives their SES status. Research question for subjective poverty 374. Subjective SES predicts health outcomes better than objective SES.

• Subjective SES is also about education, income, and occupational position, but also includes satisfaction with one's standard of living and feeling financial security about the future.

• Poverty v Poverty amid Plenty

• Wilkinson research (375): Income inequality increases the effect of the SES gradient. Other research compared most and least egalitarian states in the US (New Hampshire v Louisiana), finding 60% higher mortality rate. Canada / US comparisons also show an "inequality" effect, esp interesting as Canada is a bit less wealthy overall than US. (The inequality effect is less apparent within highly egalitarian societies.)

• The most relevant comparison in subjective SES is to your immediate community. Could be that modern life makes for more comparisons outside of community as we see more of how others' live.

• Technical issue (377)

• You might wonder if correcting for inequality simply makes wealthy people less healthy and poorer people more healthy. But the Wilkinson research suggests that lower inequality improves health across SES.

• How does income inequality and feeling poor translate to bad health?

• Research on "social capital" -- def at 378. read ("civic participation, volunteerism, safety" "trust, reciprocity, lack of hostility, heavy participation in organizations for common good") . Kawachi research: high inequality predicts low social capital. General Trust Question (378). Kawachi argues that reciprocity requires equality, while dominance is inequality. Can't have high income equality and high social capital

• Inequality in a society also predicts high crime rates (even better than poverty does), which visit low SES citizens more.

• Spending on public goods - transit, safety, clean water, schools, health care -- reduces effects of inequality. In unequal society, wealthy have disincentive to support public goods spending as they depend less upon it. (pause for examples and application to current US politics.) Comparisons of Eastern block countries after fall of Soviet Union -- high income equality, but differential access to public goods. And US: high wealth, high inequality, low social capital. Unprecedented health disparities.

• Why is the stress - disease connection so variable in primates, but so consistent in humans. Sapolsky speculates that agriculture may be the difference. Agriculture may have invented poverty.

Resources for PP1: A continuum of justice positions

• One very straightforward way to approach PP1 is to arrange the theories of justice we have been considering on a continuum. In this case the continuum is based on "thin" v "thick" theories of justice. A thin theory commits you to less and has a lower "burden of proof" while a thick theory demands a stronger set of expectations (values).

• We will fill in notes in class, but here are some of the main resources we have for PP1. Left to right...

• Formal theories of justice as a framework of formal rights.

• Could be libertarian, but not necessarily.
• Justice not so much about outcomes and fair rules. Whatever happens as a result of fair dealing is considered a just state.
• All of the following views embrace the idea of formal justice.

• Rawls. -

• 1. Egalitarian about rights and liberties (includes formal justice).
• 2. Justifies inequality by Difference Principle.
• Based on a theory of rational risk.

• Capabilities view. Amartya Sen.

• Capabilities are possibilities for choice that affect well-being.
• For Sen, capabilities realize human freedoms.
• Just societies create conditions for people to realize their freedom.

• Strong Well-Being Approaches

• Utilitarian - think Dillon. Just societies maximize well-being
• Some Happiness Economists - Use SWB measures instead of GDP to guide policy.

Methodological Reflection: Justice from an Evolutionary Ethics Standpoint

• Old model: We need to pursue justice and fairness to overcome a "bad thing" about us. We are fallen, we are selfish.

• New model: evolutionary ethics model:

• 1. We need to pursue justice because some of the really good, useful, and even beautiful things about us as socially evolved creatures create injustices.

• "Actions from love can lead to an unjust world" (from last class). Partiality is one of those beautiful things.

• 2. If morality is part of an evolved functional system for individual and collective “surviving and thriving” then we ought to assess the quality of the society that our values produce rather than only campaigning for the values themselves. What does the just society look like? Could a just society include a lot of suffering? A lot of exclusion? Maybe. Consider some examples.

• Our evolved (automatic) responses have a bias toward discounting the well-being of outgroups and strangers. This leads to bigotry, groupishness, and racism.

• One could argue, then, that partiality is justified because it is part of our evolved social behaviors for benefiting from cooperation. On the other hand, the moral limit of partiality might be found at the point that it promotes injustice. PP1 invites you to give an analysis of how we would know that we were at that point.

Resources for thinking about Justice and the limits of partiality.

• Our small group exercise on estate planning helped us as the question of justified partiality from a "first person singular" perspective. But it really only gave you a little information about your intuitions about impersonal prosociality, generous, and maybe dozen other little things about you. But this could also inform an intuition about justice.

• Now we consider the question from the "first person plural" perspective. "What do we owe strangers?" "How big is our "us"? What does a just society look like?. To take on this question, we need to round up some resources and take stock of some of the theories we have already been studying.

• Theoretical and reflective resources for developing a position on the question, "What do we owe strangers?"

• 1. Which "goods" does justice involve?

• a. Promotion of basic subjective well-being (Utilitarian Justice) -- Do we owe any strangers (perhaps those in our social contract) an obligation to promote their basic happiness? I'll bring in some ideas from "happiness economics" here. Happiness economists critique the use of GDP as a sole goal of public policy. They point to the limited ability of money (after a threshold amount) to improve subjective well-being (SWB). Some argue that the "just society" promotes human development and that there are basic goods that at least wealthy societies could provide that would raise SWB. A typical list includes: child care, education, food security, employment security, health security, and security in meeting the challenges of aging and dying.
• b. Economic justice (Rawls, but also arguments about Inequality, SES, and health) -- Are there economic outcomes in a society or in the world that would be fundamentally unfair or unjust? If inequality continued to increase even from normal market behaviors, would it ever be unjust? Consider the Sapolsky reading, “The View from the Bottom” here.

• On an international level, should we think of Rawls' "veil of ignorance" on a global level? (If you were behind the veil of ignorance and didn’t know who in the world you would be, what principles of international justice would it be rational for you to assent to?)

• c. Promotion of rights and anti-discrimination (Formal Justice / Libertarian) --
• d. Promotion of goods related to autonomy, “actual” freedom and choice (Capabilities) -- rights, se

• 2. Which obligations of justice extend to which strangers?

• Strangers in your own community, your nation, and the world -- With any of the "goods" mentioned above, you may decide that they extend to different types of strangers. For example, you may not believe obligations to promote happiness go beyond borders, but you might still believe that personal or collective beneficence (charity) is a good thing. Or, you may address all of these groups with the same theory of obligation if you think obligations of justice apply to all strangers equally. Notice that the more you are like Dillion (a strong utilitarian), the less you will distinguish among kinds of strangers.

• 3. What are the limits of justified personal partiality -- For some of you, this earlier work may set a "baseline" for thinking about obligations to strangers. Partiality is wrong if it promotes injustice and discrimination, but within limits it reflects a natural, evolved strategy for cooperation.

• 4. Standard moral and political theoretical resources:

• Libertarianism -- A good starting point if you feel very minimal "collective" obligations (such as through taxation). For libertarianism, the primary duty is not to impede other's rights while pursuing their life plan, but also to voluntarily aide those whom they wish to help (remember, Liberatarians can be individually beneficent). So, "live and let live," plus help those you like or feel deserving.

• Rawls' Theory of Justice -- which addresses both rights and economic justice.

• Capabilities Approach - a theory from development studies that real freedom involves promoting actual capabilities that people need to make choices that affect their well-being.

• Utilitarianism -- The principle of utility has several theoretical virtues. For meeting acute human needs, it gives us a way of prioritizing need and calculating benefits. Accepting the "equal happiness" principle allows you to compare goods globally (a latte vs. saving a life). Within a single country, utilitarianism can be thought of as a theory of justice in different ways depending upon how you think about utility. If you focus on “preference satisfaction” in a market, then GDP might be a good focus for the Justice society. But if you focus on happiness, then substantive goods that make people happy - Research from happiness studies often supports these goods as a “top 6” for promoting happiness: Security about food, employment, health, education, childcare, and housing.

• 5. Use your understanding of culturally evolved values -- We have been studying the origins and value of cooperation, as well as psychological adaptations of WEIRD culture, such as impersonal pro-sociality, impartiality in rules, and other traits that seem to orient our obligations away from kin and friends. There is some evidence that these psychological adaptations facilitate markets and some forms of justice, such as those "impersonal" virtues mentioned above. If you endorse these aspects of WEIRD culture (if you think humans "survive and thrive" better with these mental adaptations), you may draw on them in thinking about your obligations to strangers. You might argue that strengthening the bonds of impersonal virtues like honesty and trust require specific justice commitments. We have also studied two theories (Haidt and Hibbing) that help us think about standing challenges we face as a social species. You might argue that we have duties toward those in our community to help with the most basic challenges life poses for humans.

• 6. Consult your moral matrix. Work from your identity, especially as it is reflected in your "moral matrix." Write from your own moral matrix.

PP1: "What Do We Owe Strangers" Position Paper: 1000 words

• Stage 1: Please write a 1000 word maximum answer to the following question by Tuesday, April 18, 2023, 11:59pm.

• Topic: What do we owe strangers in our society, as a matter of justice? Consider the various approaches to justice we have been discussing and whether, why, and in what ways we should go beyond the "personal preference" we show friends and family and obligate ourselves to strangers in our society, perhaps through a "social contract." Consider theories of justice which focus on formal rights, as well as theories that argue for more substantive or material rights, like capabilities, or well-being.

• Keep in mind:

• You are answering this prompt in the "first person," but you are giving reasons for your view and, implicitly, recommending it as a standard. So this is not just a statement of personally felt obligation, but also a view about what we should all accept as our collective obligation. This should be reflected in the kinds of reasons you provide as well.
• Your readers will not necessarily share your view, so you should say why your position should be acceptable to someone with a different point of view. You will not be assessed on which view (within a wide range) of justice you adopt, but on the quality of your writing and reasoning, and your focus on the prompt.
• You should assume that any obligations you have to strangers are contingent upon adequate resources (national wealth and personal wealth). You do live in one of the wealthiest countries in the world, but you may not be personally obligated to help strangers if you are struggling to survive. (Philosopher's generally believe "ought implies can" - you aren't obligated to do something you can't do.)
• For this prompt you are only considering Justice to strangers in your society, the US.

• Advice about collaboration: Collaboration is part of the academic process and the intellectual world that college courses are based on, so it is important to me that you have the possibility to collaborate. I encourage you to collaborate with other students, but only up to the point of sharing ideas, references to class notes, and your own notes, verbally. Collaboration is also a great way to make sure that a high average level of learning and development occurs in the class. The best way to avoid plagiarism is to NOT share text of draft answers or outlines of your answer. Keep it verbal. Generate your own examples.

• Prepare your answer and submit it in the following way. You will lose points if you do not follow these instructions:

1. To assure anonymity, you must remove your name from the the "author name" that you may have provided when you set up your word processing application. For instructions on removing your name from an Word or Google document, [click here].
2. Format your answer in double spaced text, in a typical 12 point font, and using normal margins. Do not add spaces between paragraphs and indent the first line of each paragraph.
3. Do not put your name in the file or filename. You may put your student ID number in the file. Always put a word count in the file. Save your file for this assignment with the name: "ObligationsToStrangers".
4. To turn in your assignment, log into courses.alfino.org, click on the "PP1 - What do we owe strangers" dropbox.
5. If you cannot meet a deadline, you must email me about your circumstances (unless you are having an emergency) before the deadline or you will lose points.

• Stage 2: Please evaluate four student answers and provide brief comments and a score. Review the Assignment Rubric for this exercise. We will be using the Flow and Content areas of the rubric for this assignment. Complete your evaluations and scoring by Tuesday April 25, 2023 11:59pm.

• To determine the papers you need to peer review, open the file called "#Key.xls" in the shared folder. You will see a worksheet with saint names in alphabetically order, along with animal names. Find your saint name and review the next four (4) animals' work below your animal name. If you get to the bottom of the list before reaching 4 animals, go to the top of the list and continue.

• Use this Google Form to evaluate four peer papers. Submit the form once for each review.

• Some papers may arrive late. If you are in line to review a missing paper, allow a day or two for it to show up. If it does not show up, go back to the key and review the next animal's paper, continuing until you get four reviews. Do not review more than four papers.

• Stage 3: I will grade and briefly comment on your writing using the peer scores as an initial ranking. Assuming the process works normally, most of my scores probably be within 1-2 points of the peer scores, plus or minus.

• Stage 4: Back-evaluation: After you receive your peer comments and my evaluation, take a few minutes to fill out this quick "back evaluation" rating form: [3]. Fill out the form for each reviewer, but not Alfino. You must do the back evaluation to receive credit for the whole assignment. Failing to give back-evaluations unfairly affects other classmates.

• Back evaluations are due TBD.