Yesterday I posted on Compassion as Luxury.
As a physician and a biologist, as well as a guy who is improvising his way through life like everyone else, I have come to believe we don’t pay enough attention to the animal, visceral motors that drive us. Those biological drivers, and our ignorance of them, cause unending problems. There are, of course, those who insist that we are entirely logical animals, that we are John Locke’s pure tabulae rasae, all nurture, no nature.
We’ll talk about that as we go.
But to my point on compassion, I find it interesting that fundamentalists excoriate Charles Darwin. Because to my mind, the real villain — if we are to blame the messenger — is one Thomas Malthus. As an English cleric, Malthus would have probably rejected Darwinism as heresy even though he proved essential to it.
In Malthus’s Essay on the Principal of Population* he points out that animals, including people, eventually reproduce beyond their resources. For humans, that means expanding our numbers beyond the food that the Earth can possibly produce. It doesn’t matter how much land we farm, it doesn’t matter how efficiently we produce food. It doesn’t matter if we colonize the whole universe. If something does not restrain us, we will reproduce more people — more children — than food. Which creates a very ugly game of musical chairs.
I was thinking about this in the clinic the other day, when a profoundly handicapped man came in with one of his two full-time caretakers. Government pays for his caretakers; for his food, clothing, necessities and perhaps a small amount for entertainment; for his sizeable medical and other therapy bills; and for the bureaucracy that manages all of it. And of course, because Medicare doesn’t pay the full medical sticker price, some of the cost is padded on to everyone else’s bill. The total amount would probably support two or more families comfortably. Or to put it another way, since the average household pays about 20-25% of its income in taxes, supporting that one man requires all of the taxes from 8 or 10 households.
I’m not complaining. I, like most people, don’t want to consider any other option. But it doesn’t matter; Malthus is sitting in the background, and if our system fails, he steps in. Most scholars curse Social Darwinism, which is the idea that the poor and the weak should be allowed to die. But ironically Social Darwinism didn’t need Darwin. It could have been Social Malthusianism.
What would happen to that handicapped man if our country weren’t so incredibly wealthy? I remember a film that came out years ago, The Colour of Paradise. I think anyone concerned about the human condition should have to watch it.
But only once. It is beautiful, but heart-breaking.
It takes place in Iran, which is also the home of the nomads in my previous post. The story revolves around Mohammed, a blind boy whose mother dies. He is adored by his sisters and grandmother, but his father sees him as an obstacle to obtaining a good marriage. The boy wonders why God does not love him and made him blind, and he constantly searches the plants and nature around him, trying to find the Braille message God might have left for him. Finally while traveling with his father, the boy falls into a rapid river — another similarity with the story of the nomads — and for a few moments his father simply watches, relieved to be free of his burden. He eventually jumps in the water to save the boy, but he is too late.
Most of us would never watch a child, even one with a profound handicap, drowning without jumping in to save him. I could not. But as a biologist let me ask an ugly question: Did the father make the right decision? If you find that repulsive, let me change it. What about the nomads in the previous post? Should they let a blind child drown?
Most of us could never consider such a thing. But for people living hand-to-mouth, with absolutely no luxury, would the sin be in letting the child die?
Or if the cost of supporting a child who cannot contribute threatens a tribe surviving at the fringes, is the sin in saving him?
There is a reason economics is called ‘The Dismal Science.’ Animals, including humans, who do not make tough economic decisions perish. It is only in the last few decades that we have had sufficient luxury to escape ugly realities. But the instincts, and the traditions, are still with us. That is why we need to consider those hard realities, so that we might design strategies around them, and address human suffering.
*The full title is “Essay on the Principle of Population as it Affects the Future Improvement of Society, with Remarks on the Speculations of Mr. Godwin, M. Condorcet, and Other Writers, Printed for J. Johnson, in St. Paul’s Church-yard, 1798.” St. Paul’s Church-yard, London. Not exactly a model of brevity. The complete essay can be read at Gutenberg.org.
Picture is of Mohsen Ramezani, playing Mohammed in The Colour of Paradise. © 1999, Sony Pictures Home Entertainment.