Moral Utilitarianism and Coronavirus Treatments

It is clear by now that the president's failed response to the pandemic has caused a painfully high human and economic toll. One might even call it a catastrophe. The longer it takes to develop and distribute an effective vaccine or drug, the greater the toll will be.

It usually takes 10-15 years to develop a new vaccine. New drugs tend to take 6-8 years to develop. One exception is the annual flu vaccine, which has to be developed for new strains each year. Producing the vaccine on that short timescale is greatly accelerated by decades of past experience with flu vaccines and the manufacturing infrastructure and methods that have been developed and built up over time. Despite some claims that a coronavirus vaccine will come sooner, it is reasonable to think that despite accelerated research and development efforts, it will take at least another year or two before an effective vaccine is found and begun to be produced in large quantities.

Could the process be sped up?

It is probably possible to significantly reduce the time needed to develop a coronavirus vaccine or drug if ethical concerns are addressable. Specifically, if people are allowed to volunteer to be infected with SARS-CoV-2, the process could be greatly accelerated, shaving months or even years off the process. At present it is unethical and illegal to allow people to be infected with such a deadly serious virus.

But from a utilitarian moral point of view, it is arguably immoral to not allow people to volunteer to be infected to test a vaccine or new drug candidate. Not only would a lot of time be saved, the number of people involved in clinical trials could probably be reduced by 10-fold or maybe more. Some of those people would die, but more people would die in the time it would take to develop a treatment under normal clinical ethical constraints. If that reasoning is correct, and I believe it is, the great human and economic toll could be reduced to the point that the anticipated deaths from clinical development would be morally justified.

A clinical trial that includes volunteers of 18 to about 50 years old could be set up. To minimize volunteer deaths the trial would require people who do not have any of the known or possible conditions that are correlated with increased SARS-CoV-2 deaths or uncertainty, e.g., pregnancy, obesity, lung conditions, high blood pressure or age above 50. Also, those people would be monitored and given the current standard of care when they become sick. The vaccine or drug would have to perform better than existing treatments to demonstrate a tangible clinical benefit.

A group of effective altruists (moral utilitarians) called One Day Sooner, points out that such human challenge trials have been used in the past to test vaccines. A 2016 WHO guidance document points out that in such challenge trials, humans were intentionally challenged or infected with an infectious disease organism, with or without vaccination. The challenge organism may be close to wild-type and pathogenic, adapted and/or attenuated from wild-type with less or no pathogenicity, or genetically modified in some manner. Some of the moral implications are discussed here.

The folks at One Day Sooner have recruited 30,108 volunteers from 140 countries who are willing to be infected with SARS-CoV-2.

Questions: Given the seriousness and toll that SARS-CoV-2 has caused and will continue to cause, should the US engage in SARS-CoV-2 human challenge trials to try to speed up vaccine and drug development? Should qualified prisoners be allowed to volunteer in return for a shortened sentence?

Some Erosion in Support for Trump

The New York Times reports on a poll that indicates that about 6% of the people who supported the president in 2016 say they will not vote for him again in 2020. Another 8% are unsure to some extent. The poll was focused on the six states most likely to be critical for his re-election. For some, they dropped their support shortly after the president was sworn into office in January of 2017. For others, (i) the botched federal coronavirus response, or (ii) the current social unrest, led to their loss of support.

On the flip side, about 2% of voters in battleground states who voted for Hillary Clinton in 2016 indicated that they will vote for the president in 2020.

Reasons for loss of support vary from coherent to incoherent. The NYT quoted one former supporter as coherently saying “He said he was going to, quote unquote, drain the swamp, and all he’s done is splashed around and rolled around in it.” Another incoherently said “I think if he weren’t such an appalling human being, he would make a great president, because I think what this country needs is somebody who isn’t a politician. But obviously with the coronavirus and the social unrest we’re dealing with, that’s where you need a politician, somebody with a little bit more couth.”

Another former supporter gave a combination of coherence and incoherence, “he was a great businessman, [incoherent]” but in the wake of the killing of Mr. Floyd he reasoned “It was kind of the last straw. It was like, this dude is just in it for himself.[coherent] I thought he was supposed to be for the people.[incoherent]”

Some who will not vote for the president again say they won't vote for Biden, which strikes me as incoherent. That attitude indicates that they see nothing exceptional about the president or his performance that would warrant voting for the only candidate with any chance of winning the election. Obviously, people will disagree over what is coherent here and what isn’t. 

Other than handling of the economy, most defectors disapprove of the president’s performance on every major issue.

As usual, there is a caveat to all of this. This is just one poll 4 months in advance of the election. Some people can and probably will change their minds before then. The fact that the defectors see the president as doing well with the economy indicates that the president can pound away on that issue, despite the fact that the perceptions of a good economy ignore increasing federal debt and an increased trickle up of wealth to wealthy people and business interests.

Religion Takes More From Taxpayers

The US Supreme Court handed down a 5-4 decision (on straight party lines) in Espinoza et al. v. Montana Department of Revenue. The court held that Montana’s Constitutional provision barring state government aid to any school “controlled in whole or in part by any church, sect, or denomination” is unconstitutional. The court reasoned that the ban of state aid to religious schools violated the Free Exercise Clause of the First Amendment to the US Constitution. In essence, Montana’s “no-aid” provision to a state program providing tuition assistance to parents who send their children to private schools discriminated against religious schools and the families whose children attend or hope to attend them because aid ban violates the free exercise clause.

One commentator discussed the decision and what it might mean:

“Once again, a Supreme Court majority has gone to the edge of the cliff, ready to push the concept of no aid to religion over the side but stopping short. Even though the concept still exists (barely) in the form of making a distinction based on the “use” of tax funds rather than on the “status” of the recipient of those funds, the rule prohibiting government financial support for religion is all but dead. As Justice Ruth Bader Ginsburg observed in her dissent, even though the majority did not reach the ultimate conclusion, its opinion ‘seems to treat the [state’s] no aid provision itself as unconstitutional.’ 

It is not an overstatement to say that the U.S. Supreme Court’s holdings on public financial aid to religious institutions have not been a model of clarity or consistency over the past 75 years. In 1947, the court announced an apparent rule of “no aid” to religion: “No tax in any amount, large or small, can be levied to support any religious activities or institutions.” After declaring that rule, a majority then upheld the aid program in question, eliciting a torrent of criticism from the dissenters. Despite that statement’s absoluteness, the court has long allowed types of neutral and tangible assistance to flow to religious institutions, such as providing secular textbooks to religious schools. Over the past three decades, however, a majority of justices have slowly been dismantling the remaining vestiges of the no-aid principle to authorize forms of divertible aid (e.g., vouchers, tax credits), leaving the establishment clause a shell.”

In addition to Montana, 37 other states have constitutions that contain similar no-aid provisions prohibiting tax dollars being spent for religious institutions or education. It seems reasonable to think that the Espinoza decision casts at least some doubt on the validity of all those no-aid laws. Given the endless appetite of Christianity in America for public financial support, one can imagine that those laws will be challenged to nudge the court into total capitulation. 

Religion will aggressively pursue every tax dollar it can get. Once the tax dollar floodgates are opened, which is exactly what GOP supreme court judges want to do, the power of Christianity in government will increase with its increased revenue flows and accompanying wealth. America is drifting into some sort of a Christian theocracy-lite. From what I can tell, what is coming is not going to be a benign or forgiving form of Christianity that is willing to live and let live. It is going to impair our civil liberties as much as it can in the name of sacred Christian moral values. 

In reporting on the decision, the AP commented:

“Roughly three-dozen states have similar no-aid provisions in their constitutions. Courts in some states have relied on those provisions to strike down religious-school funding. Two states with existing private education programs, Maine and Vermont, could see quick efforts to force them to allow religious schools to participate.”

Tax subsidies for religion

In 2013, Ryan T. Cragun, a sociologist, and two of his students tried to analyze the value of tax subsidies that all of the American people are required by tax laws to provide to religion in America. Cragun estimated the subsidies were worth about $82.5 billion/year. I wrote to Cragun and asked him how accurate he thought that estimate was. He indicated it was very conservative because many churches and religious organizations refused to disclose their financial details. My guess is that tax breaks for religion in America were probably worth closer to ~$110 billion/year and possibly a lot more.

Cragun’s analysis of tax benefits 

Churches are public charities, called Section 501(c)(3) organizations in the tax code. They are generally exempt from federal, state, and local income and property taxes under the law. Unlike most other Section 501(c)(3) organizations, federal law allows religious groups to keep their finances secret. In 2018, the Freedom From Religion Foundation sued the Treasury Department to get its hands on religious financial documents. I don't know how that lawsuit has played out so far. I suspect the court will protect religion from public financial disclosure.

On occasion, religious groups have been caught hiding sleaze and corruption behind the secrecy shield. Forbes wrote this about the 2108 FFRF lawsuit:

“Form 990 is a required filing that creates significant transparency for exempt organizations. In 1971, it was harder to get your hands on a Form 990, but a team of reporters working for Warren Buffet's Omaha Sun took the trouble which allowed them to expose the extent to which fundraising had outstripped service delivery at the venerable Boys Town.

But, in contrast to other not-for profits, the Internal Revenue Code does not require reporting for churches. Reverend Frank Benson Jones in Stop The Prosperity Preachers argues that a 990 requirement would help root out church financial abuse.”

The Mormon Church has used the secrecy shield to allegedly cheat on taxes. A December 2019 article in the Washington Post commented:  

“A former investment manager alleges in a whistleblower complaint to the Internal Revenue Service that the Church of Jesus Christ of Latter-day Saints has amassed about $100 billion in accounts intended for charitable purposes, according to a copy of the complaint obtained by The Washington Post.

The confidential document, received by the IRS on Nov. 21, accuses church leaders of misleading members — and possibly breaching federal tax rules — by stockpiling their surplus donations instead of using them for charitable works. It also accuses church leaders of using the tax-exempt donations to prop up a pair of businesses.”

Given the aggressiveness of religion in clawing tax dollars from taxpayers and its now powerful influence at all levels of the federal government, it is reasonable to demand at least transparency in their finances. It is also reasonable to demand the end of all tax subsidies at least for all religious groups that participate in politics and policy making. The Espinoza decision fits my definition of religion making policy in service to its own interests at the expense of both the public interest and honest, transparent governance.

White Person's Burden: the Cost of Meaningful Change

Kelsey Smoot writes at The Guardian about the nature of "allyship" - of being more than a mere sympathizer - and of the costs one must bear to do so.  The lead poses a striking question:

If the White people in my life could hit a button and instantly remove the privileges afforded to them along racial lines, would they hit that button?

Now here is a powerful question, and one that gets right to the heart of the true extent of inequality in the United States.  Reparations are relatively easy for us to support, since any reparations will necessarily be paid for through tax revenue and, I think, is likely to be relatively insubstantial on a family's bottom line.  Smoot's question, however, dispenses with any theoretical considerations of reparations and straightforwardly demands that Whites should return to Blacks the value they inherited through centuries of slavery and generations of systematic exclusion of Blacks from the opportunities that the parents, grandparents, great grandparents and great great grandparents of Whites benefited from.

What's more, Smoot argues that the donations, the expressions of support, the flag waving and social solidarity afforded the BLM movement by Whites is a way of buying forgiveness of the sin of racism, an exculpatory expression simultaneously of guilt and superiority, an indulgence of the secular church of progressivism.  She writes:

In my direct circle, it has become obvious to me that many of my White peers are at a loss for what to do in this critical moment to prove themselves different from the ones they have come to view as the true agents of White supremacy. I imagine them, phone in hand, scrolling on social media and seeing messages of disdain and moral indictment pointed at them directly. They think to themselves: “I am not the type of White person who would murder someone in the street. I don’t use racial slurs. I voted for Obama. I have Black friends.” Unable to reconcile the dissonance of their allyship being broadly called into question in the digital sphere, these White individuals turn to me, to us, the proverbial “Black friend”, as a cathartic release of such inner turmoil. They want us to vindicate their longstanding inaction – their culpability in White supremacy – by accepting their monetary donations, their well-wishes and genuine feelings of sympathy at what is only now crystalizing in their minds as another sort of pandemic; one which has only ever kept racially marginalized individuals quarantined away from enjoying the liberties promised to all Americans in the governing documents of the nation.

The word "afforded" in this context should ring with dissonance.  It suggests that support for BLM by Whites is as much a form of privilege as any other.  It is a way of Whites saying "my conscience is worth this much, and this much only," to which Smoot rightly responds by questioning how much they've gained through generations of tacit ( at best ) support of White superiority.  She goes on to say:

The truth is, genuine allyship is not kindness, it is not a charitable act, nor is it even a personal commitment to hold anti-racist ideals – it is a fall from grace. Real allyship enacted by White Americans, with a clear objective to make equitable the lived experiences of individuals across racial lines, means a willingness to lose things. Not just the extra $50 in one’s monthly budget by way of donating to an organization working towards racial justice. I mean palpable, incalculable loss. The loss of the charmed life associated with being a White person in America. Refusing a pay raise at one’s job and insisting that it be reallocated to co-workers of color who are undoubtedly being underpaid. The loss of potentially every close relationship with other White friends and family members who refuse to acknowledge or amend their behaviors that reinforce systemic oppression. The loss of bodily safety, by way of physically intervening when violence is being inflicted on to Black bodies.

A "fall from grace," now that is a powerful description.  It denotes a state of being in which one has been gifted a reprieve from the consequences of one's own sins, a reprieve which is moreover unmerited.  For Whites, being a true ally to Blacks means sacrificing all the entitlements and privileges they have - often without thinking of it.  That pay rise which is not shared with people of color, regardless of performance.  ( One might also say so of gender. )  Access to loans, housing, education.  The "charmed" life did not come to be by accident, nor even by one's own hard work.  It came as a result of violence, violence which is still being inflicted on black bodies and brown.

If the benefits of a culture which prizes whiteness often go unnoticed by them, while at the same time prises those benefits from people of color, then the beneficiaries share responsibility for that violence.  As difficult as it is to wake from this ignorance into the uncomfortable knowledge of one's own complicity in these crimes, it is more difficult still to appreciate the vastness of them, and of the true scale the benefits of these crimes has afforded the United States.

One of the key works attempting to understand the value of slavery and its contribution the US economy is The Economics of the Civil War by Roger Ransom.  One way of looking at the problem is to evaluate the value of all slaves in the US at the height of slavery, in 1860.  Ransom presents data suggesting a valuation of nearly $3.5 billion in 1860 dollars.

Normalizing values across this distance of time is difficult, and there are a variety of ways of doing so.  Samuel Williamson and Louis Cain take Ransom and Sutch's data to estimate that the 1860 value of slaves in 2015 dollars comes to between six and thirteen trillion US$.

Wealth in Slaves in Trillions of 2016 dollars
As Measured by the Share of the GDP

Ian Webster at Officialdata.org uses BLS statistics to derive the aggregate increase in inflation from 1860 to 2020, which he puts at 2,989 percent.  Measured this way, the 1860 value of slaves in the US comes to roughly ten and a half trillion, about half of US GDP in 2019.  But this is just a representation of the purchase price for all slaves in 1860.  The real value of slaves was the labor they produced over their working lives.  Williamson and Cain offer a sense of what that value actually was:

While some slaves were rented out for farm and other types of work, most slaves worked on the farms and plantations of their owners. In both cases, the work they did was mostly unskilled, so a comparable measure of the value of these services is reflected in the unskilled wage. In other words, we can assume that to hire a free employee to do the work of a slave would cost the unskilled wage of that day. Thus, a measure of the average value of a slave would be the present value of the net rental cost over the life expectancy of the average slave...Unlike hired hands, slaves were responsible in large part for producing their own room, board, and clothing. Given that the work week today is significantly shorter than in 1850 and that slaves were made to work harder during the same amount of time as free workers, it would take more than one hired hand today to replace the labor supplied by a slave then.

According to Salary.com, the average wage for a general laborer today comes to $16 an hour.  Non-slave industrial work ran between 60 and 70 hours per week by 1860, and had been steadily decreasing since 1840.  In 1860 slaves certainly worked more hours per day than non-slaves, and agricultural work generally demanded more hours than industrial work.  An 80 hour work week is probably a very conservative estimate, then - and that's not counting the work slaves were required to do to maintain their own living standards.  Today that brings the cost of such labor to roughly $66,500 per year.  Williamson and Cain suggest the average working lives of slaves ran to 20 years.  There were one million slaves in the US by 1860, bringing the value of their productive work in 2020 to 66,500,000,000, a value which slaveholders could expect to get twenty times over.  Thus the purchase price of all 1860 slaves today comes to ten and a half trillion $US, and the value over their working lives to roughly twelve trillion.

Now the net value slaveholders actually saw from slavery is hard to evaluate, and the headline numbers here are not representative of that.  Those numbers do represent the gross value generated by those slaves, however, and therefore the value lost to them.  If we consider the potential of interest gained in the intervening 180 years, the total lost revenue to slaves and their families could well be much higher.  There is nevertheless value in simply using these numbers to provide a first approximation of the total value of the labor stolen from Blacks in 2020.  There are 40 million or so blacks, and we estimate some $23 trillion worth of stolen labor, which comes to roughly half a million dollars for every Black person in the US today.

So yeah, giving up that raise doesn't begin to address the problem.