When Do The Ends Justify The Means? : Hidden Brain When we are asked to make a moral choice, many of us imagine it involves listening to our hearts. To that, philosopher Peter Singer says, "nonsense." Singer believes there are no moral absolutes, and that logic and calculation are better guides to moral behavior than feelings and intuitions. This week, we talk with Singer about why this approach is so hard to put into practice, and look at the hard moral choices presented by the COVID-19 pandemic.
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Justifying The Means: What It Means To Treat All Suffering Equally

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Justifying The Means: What It Means To Treat All Suffering Equally

Justifying The Means: What It Means To Treat All Suffering Equally

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SHANKAR VEDANTAM, HOST:

From NPR, this is HIDDEN BRAIN. I'm Shankar Vedantam. In 2017, Oliver Herrera (ph) made a rookie mistake. He works for the United Nations. And he just arrived at a refugee settlement in Angola in southern Africa. For the first few weeks he was there, Oliver went to sleep at night without a bed net. Bed nets are a must to protect against mosquito bites and malaria. About a month into his stay, Oliver came down with a fever.

OLIVER HERRERA: I felt quite weak.

VEDANTAM: He urgently needed to see a doctor. His organization arranged for a driver to take him to a local clinic. When he got there, his heart sank.

HERRERA: There were dozens and dozens of peoples outside the clinic, some of them carrying kids, some of them sitting on the ground.

VEDANTAM: The line stretched outside the clinic, down the block. But Oliver didn't join the queue.

HERRERA: I cannot recall if the driver had a conversation with the nurse, but what I know is that they just walked me into the clinic. And I just sat down to wait for the blood test.

VEDANTAM: As dozens of other sick people waited their turn, Oliver saw a doctor within minutes. He got tested. He discovered that he did have malaria. He was flown to another city for treatment. Looking back, Oliver doesn't feel relieved that he got the care he needed. He feels something else.

HERRERA: I felt guilty. And I still am guilty. I believe that everyone's equal. No one should have privileges just because of the way they look or because the power they have or the money they have. I feel guilty because I know that I'm not better than anyone else, so I should have received the same treatment as anyone else.

(SOUNDBITE OF MUSIC)

VEDANTAM: This week on HIDDEN BRAIN, we ask what it would mean to take Oliver's principle, that all suffering should count the same, and actually put it into practice. We speak with Australian philosopher Peter Singer, who has tried to do this in his own life. What followed might surprise you. Some people have come to think of him as a monster.

When we're asked to make a moral choice, most of us imagine it involves listening to our hearts. We all know right from wrong. And if we listen to the voice of conscience, it will guide us. My guest today says, nonsense. The intuitions that produce moral judgment are unreliable and biased. It's far better, he says, to rely on logic, even mathematics.

Peter Singer is a moral philosopher and professor of bioethics at Princeton University. His ideas have attracted the kind of outsize admiration and passionate criticism not normally associated with philosophers. As the world grapples with an unprecedented moral dilemma - what to do in the face of the COVID-19 pandemic - we decided to take a deep dive into his ideas. Peter Singer, welcome to HIDDEN BRAIN.

PETER SINGER: Thank you very much. It's a pleasure to be with you.

VEDANTAM: I understand that your parents were Jewish and fled Vienna for Australia in 1939. When you were a child growing up, did your parents tell you stories about what had happened? Did their experience fleeing Nazi Germany shape the way that you talked about ethics or ethical issues around the dinner table?

SINGER: Certainly. We were very well aware of the fact that they had had to flee and that their parents - my grandparents - had not been able to escape with them. And although one of my four grandparents - my mother's mother - survived the war and came out to join us around the time that I was born in 1946, the others had perished in the Holocaust. Once I became a teenager and started reading history for myself, I developed a deeper understanding of the terrible events that my parents had been through and that their parents had died in. I remember friends who had tattoos on their arm because they'd been in concentration camps.

VEDANTAM: This family history was a subtext as Peter grew up, left Australia and went to Oxford for his studies. He gravitated to philosophy and a specific theory - utilitarianism.

SINGER: Utilitarianism is the view that the right thing to do is the one that has the best consequences and, by best consequences, does the most to increase the net surplus of happiness over misery. So in other words, increase the total amount of happiness to the greatest extent possible.

VEDANTAM: So someone could listen to just what you just said and said that's entirely uncontroversial. Who would disagree with the idea that we should actually increase happiness to the net extent possible? What could possibly be the objections to this idea?

SINGER: Well, one objection is that it leads you to act contrary to generally accepted moral rules. So one of the examples that my lecturer H. J. McCloskey urged to show that, in his view, utilitarianism was wrong imagined a situation in a Southern town of the United States going back into the '50s, let's say, when a white woman had been raped and said that she had been raped by an African American. And an angry mob of whites had grabbed half a dozen young African American men and was about to lynch them from a tree. And you're the sheriff of the town. And you are powerless to stop this. You can't actually prevent - physically prevent them carrying out this lynching. They've got guns, too. If you tried, there would just be more bloodshed. So the only thing you can do to stop them lynching six people is to say, I've got proof that that's the one and point to one of the people that they've got. And then they will let go of the other five. But, of course, you don't have this proof. So you're lying. And you're unjustly condemning one person to death.

Now, McCloskey thought that that would be the wrong thing for the sheriff to do because the sheriff is an officer of the law, should uphold justice and truth and not lie about evidence that he has. I didn't find that convincing. If you really believed the situation that there's no other way to prevent six people dying, I thought that it was justified to do something that would let only one person die. Sure, that person is innocent, but all of the six people are innocent, too, presumably.

So many people do think that that would be wrong, that you must be truthful. As an officer of the law, you cannot violate the promise to uphold the law faithfully and truthfully. And that's just one of many possible examples that people give against utilitarianism - that it will lead us in some circumstances to tell lies or even to kill an innocent person in order to save more or to violate individual rights in various ways. And some people think that these are moral absolutes, that you must never do something that would violate individual rights or tell a lie or kill an innocent person.

VEDANTAM: And so when you sort of wrote the critique about what your professor's thesis was, your critique was basically, you know, those absolutes in some ways matter less than the absolute of saying, we should actually decrease the amount of suffering and increase the amount of happiness, that whatever does that is, in fact, the morally correct thing to do.

SINGER: That's right. I rejected and still reject the idea that there are some things that are always wrong, no matter what the consequences. I think that the consequences do determine what is right or wrong. And there are no moral absolutes where you must never do something in any imaginable circumstances.

(SOUNDBITE OF MUSIC)

VEDANTAM: Many of us have heard the admonition the ends do not justify the means. If doing something good requires us doing something bad in the process, you shouldn't do it. Peter has spent a lifetime asking this simple question - why not?

SINGER: I do think that the end justifies the means. I think that that's the point, in a way, that, of course, bad ends don't justify means. And if the means involve harming people and there are other means that you could have taken, then you should take those other means. But if the only way to prevent something very bad happening is to do something which would itself be bad but not as bad as the very bad thing that you're trying to prevent happening, then you're justified in doing the lesser evil rather than allowing the greater evil to occur. So if killing one innocent person is the only way to save a larger number of innocent people from being killed, then I think that is the right thing to do.

VEDANTAM: So it's interesting - when you sort of presented the thought experiment to me and I sort of put myself in the role of the sheriff, clearly, of course, I can tell it certainly would be better to save the lives of five people than to not. I can clearly see that. But the idea of pointing at one person really makes me upset. And it really makes me feel this would be just terrible. Do you feel that, Peter? Do you feel that this would be a terrible thing to do? Do you experience that emotionally in terms of how horrible the choice is?

SINGER: Oh, I do experience it emotionally, yes. It's the same idea, incidentally, that is in Dostoevsky's famous example in "The Brothers Karamazov," where he poses the question, suppose you could create utopia forever, basically, peace on earth forever. But to do so, you first have to torture this little child in front of you. Torture the child to death, I think he says. I don't remember exactly. Of course, that's a horrendous idea. Maybe I couldn't possibly torture a small child to death. But if you asked me, would it be right to do that if you could and if somehow that torturing this child really would mean that there was peace on Earth forever and all of the millions of children who get killed and maimed and probably tortured, too, in all of the wars that will otherwise occur for thousands of years into the future are spared that horrible fate, then I think torturing the child in front of you would be right, even though it would be incredibly repugnant and, as I say, maybe something that I just couldn't possibly bring myself to do.

(SOUNDBITE OF MUSIC)

VEDANTAM: Peter says in many circumstances, this feeling of repugnance can be useful. There are systems in the brain that automatically prompt us toward certain behaviors or away from certain behaviors. Much of the time, these intuitions are correct. But there are times when we need to override these impulses to account for the complexity of modern life. Doing this requires something that looks easy but is very hard. It requires you to ask what your principles are and then to act on them, regardless of the consequences, regardless of whether you feel like it. Peter has spent a lifetime overriding his intuitions. One of the earliest examples in his life came while he was studying at Oxford and went to have lunch with another student, Richard Keshen.

SINGER: We walked in the dining hall, and there were two options for lunch. There was a hot dish, which was a plate of spaghetti with some kind of brown sauce on the top of it, and there was a cold salad plate. So Richard asked the person serving, can you tell me whether there is meat in that sauce on the spaghetti? And the person said yes, it's a meat sauce. So Richard then took the salad plate. I took the spaghetti, didn't think that a salad plate was going to satisfy my hunger. And we went off to eat together. And I was curious, so I asked Richard - I said, so what's - why did you ask that question about the spaghetti sauce? Do you have a problem with meat?

And Richard said something that was really quite simple and that took me by surprise. You know, I thought maybe he'd say, well, I'm an absolute pacifist, and I think it's always wrong to kill any living being, something of that sort. Or perhaps he might've had some weird health views - well, what I would've thought of weird at the time - suggesting that meat wasn't good for you. But instead he just said I don't think it's right to treat animals the way we do treat them in order to turn them into meat.

That surprised me because I'd thought that animals basically have good lives on farms, that they get to live a sort of natural life out in the fields. Then, of course, I knew that they get rounded up. They get trucked to the slaughterhouse, and they get killed. But I suppose, you know, I hadn't thought about this issue very much at all. But my view would have been, well, they have good lives, and then they have one really bad day. You know, that's not such a bad thing overall.

But Richard said, no, that's not true. More and more animals are now indoors. They don't have good lives. They're very crowded. And people do all sorts of things to them in order to produce their meat more cheaply. And I became aware of a whole lot of things about the way we treat animals that I really had no idea of. It just hadn't been an issue on my radar until then. But once I did become aware of all of that, I just felt that I couldn't really justify it.

(SOUNDBITE OF MUSIC)

SINGER: I talked to my wife about this. I was - we got married just before I'd come to Oxford. And she was ready to make that change to stop eating meat. And we became vegetarians within, I'd say, about a month or so of my meeting Richard.

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VEDANTAM: So there was another incident maybe around the same time that also, I think, reveals how you sort of are taking these ideas and sort of acting on them in ways that other people say, yeah, I sort of agree with the ideas, but it doesn't necessarily change my behavior. There was news breaking out of South Asia from the country of what is now Bangladesh. Can you describe to me what it is you heard and what it prompted you to do?

SINGER: Well, when I was as a student in Oxford, Pakistan essentially had two geographically separate parts on different sides of India. There's what is now Pakistan, was then West Pakistan. And there was a separate part of the country called East Pakistan. And there was a movement in East Pakistan for more autonomy, for it to not be ruled by West Pakistan, which dominated the nation as a whole. So I was reading in the news about this autonomy movement. And it seemed like a democratic movement, the kind of thing that I would support.

But it was brutally repressed by the Pakistani army. Refugees started fleeing across the border from what was then East Pakistan into India, so essentially into the Indian part of Bengal. Nine million in total fled across the border, so, you know, a very large flow of refugees into what was then a very poor country. India was much poorer then than it is today. And India simply said, you know, they cannot cope with 9 million refugees. The cost of providing shelter, sanitation and food and so on was overwhelming for that country. And they appealed to help to the affluent countries. And some organizations in England where I was living, in particular Oxfam, started appealing for funds to assist the refugees.

And that led me to start thinking about, what are my obligations? Here, I'm living in Oxford. I'm certainly not rich. I was on a graduate student scholarship. And my wife was a high school teacher. But we have more than we need. We're planning a holiday in Europe over the summer across the continent. And so should we be doing something about this? And that led me to start thinking, yes, it's not enough to just throw a few coins in a tin when it's rattled under your nose, that we ought to be making a more substantial commitment. And my wife and I started giving 10% of what we earned to Oxfam, both for the crisis in East Pakistan, which was eventually resolved by the Indian army invading East Pakistan and allowing the autonomy movement to declare the independent state of Bangladesh, which, of course, exists today.

But I was aware that even though that temporary crisis had been resolved - that there were millions of people in the world in great need who were dying or whose children were dying because of extreme poverty that we, more affluent people, could help to alleviate and could help to change the situation for significant numbers of people.

VEDANTAM: Are you still donating 10% of your income?

SINGER: I'm not donating 10% of my income now because I've got a lot more income than I had when I was a graduate student. And I can afford to donate significantly more than 10%. So now I'm donating at least a third of my income each year. Sometimes, it's been closer to half. But it's in that sort of region between a third and a half.

VEDANTAM: I'm wondering whether you yourself still experience any struggles with your own impulses. Do you feel excuses, as you call them, bubble up inside you to say, I really wish there was a loophole around my principles?

SINGER: Well, I do struggle, but for me, the struggle is that I don't think that giving a third or even half of my income really would be enough. I think that I'd be a better person if I were to give, let's say, two-thirds or 80% and live more cheaply than I do. I'm still living a very comfortable life. So, yes, there's always a struggle, unless you're a complete saint and you've given away everything except what you need to live and perhaps to be an effective campaigner for change. Until you get to that point, I think you should be struggling. I acknowledge I'm not a saint, so there is a struggle going on.

(SOUNDBITE OF MUSIC)

VEDANTAM: This struggle between our values and our actions is one that has ramifications across many dimensions of our lives. That's especially true as individuals and nations respond to the COVID pandemic. More when we come back.

Philosopher Peter Singer has built his life around a radical idea - logic and calculation are better guides to moral behavior than feelings and intuitions. Reason dictates that your suffering doesn't count for more than someone else's suffering. If you believe that all lives are equal - and most people say they do - you should make choices that limit the greatest amount of suffering, regardless of whether that suffering is your own or that of an animal in a factory farm or that of a stranger halfway around the planet.

Lots of people can think of a simple way to follow these principles. If you believe all lives are equal, and all suffering counts the same, do your best to avoid causing harm to others. Don't hurt people. Don't cause suffering. But most of us don't think of the suffering that we don't cause as our responsibility. Peter Singer says uh-uh. Acts of omission matter just as much as acts of commission. If you're the sheriff faced with the moral dilemma of killing one innocent to save the lives of five innocent people and you wash your hands of the problem because it's not of your causing, then, yes, you too have blood on your hands.

SINGER: The idea that we're responsible for our omissions, as well as our acts is one that struck me most in terms of life-and-death decisions in medicine, in health care. One of the issues that I came across this time when I was a graduate student in thinking about ethical issues was the practice of allowing severely disabled infants to die but refusing to take active steps to end their lives.

VEDANTAM: Among the case studies that Peter looked at were infants born with spina bifida. This is a condition in which the spine and spinal cord don't develop properly, sometimes leading to problems that can range from cognitive impairment to paralysis.

SINGER: Now, I learnt that there was a doctor in Sheffield called John Lorber. And Sheffield happened to be a kind of hotspot for spina bifida for reasons that weren't clearly understood. So he got a lot of these cases. And he'd observed them for many years. And he decided that, sometimes, he was saving babies for lives that were miserable for them and very difficult to cope with for their parents or other children that their parents might have. So he decided that, sometimes, in the more severe cases, it was better not to operate, not to try to save the child's life. But he then described the fate of the children. They died slowly. They - Dr. Lorber would not treat an infection if they got, for example. So they would get an infection. They would get feverish. And they might die from the infection because he thought that was better than surviving. Or maybe they would not feed them. And, essentially, they would starve. Perhaps they would be doped up, so they weren't suffering, but they would die of lack of food or water.

And I thought, this is crazy. Here's a doctor who's decided that it's better that these babies should die. But he's letting them, with the parents' agreement, I suppose - but he's letting them die slow, lingering, painful deaths that are bad for the babies, a terrible strain on the parents and also on the hospital staff, the nursing staff in particular - you know, was against all their instincts to not treat a treatable infection in a small child. So I thought, well, if you're going to make the decision, why not end the child's life? Why not give the child a lethal injection? Now, you know, that was illegal. And I guess Lorber couldn't do it for that reason, even if he thought it was best.

But I looked at the medical literature. And a lot of doctors seem to think that that would have been wrong, that what Lorber was doing was OK. So, you know, that's the clear example where I thought, you're responsible for what you're doing in these circumstances. You're responsible for ending the child's life. Why do it in a way that causes more suffering than another way that would have the same result that is actually the result that you're trying to seek - the death of the child?

VEDANTAM: The combination of these two basic principles - acts of omission matter as much as acts of commission and all suffering counts equally led Peter to develop a thought experiment that has now become famous.

SINGER: I asked my readers to imagine that they are walking across a park that has a pond in it, an ornamental pond. And when they walk past the pond, they see that a small child seems to have fallen into the pond and is evidently in danger of drowning. The first thing that they do is to look around and say, who's looking after this child. There must be somebody, must be a parent or a babysitter who's looking after the child. But I'm looking around. They don't see anybody. There doesn't seem to be anybody in the park except them and the small child.

So the next thought is, I'd better help this child. I'd better jump into the pond and save the child. And they know that there's no risk to them in doing so. But there is a cost because they're going somewhere special. They've put on their best clothing - very expensive pair of shoes that they're wearing. I don't really have time to get rid of them if they're going to save the child.

So then they're struck with the thought that, well, would it really be wrong if I just ignored this child. And I don't want to ruin my nice shoes. I don't want to get all cold and wet from the pond. It's not my child. It's not my responsibility. Nobody asked me to look after this child. So why don't I just go on my way? And at that point, I ask you, the listener or reader, to think about whether that would be the right thing to do or an acceptable thing to do or whether it would be wrong?

VEDANTAM: And, of course, most people would say it's unthinkable to walk by and let the child drown.

SINGER: Exactly. Most people say that would be terrible. That would be an awful thing to do. What kind of a person could put a pair of shoes, no matter how expensive, above the life of a small child? So that's the reaction that I'm hoping people will have. And as you say, overwhelmingly, they do have that reaction. But then I point out that even though no doubt they would jump into the pond and save the child, they are saying that we are under an obligation to help - or it would be awful not to help - people whose lives we could save at a small cost to ourselves.

So if that's the case, then how are we situated with regard to people in extreme poverty, given that there are people who are dying for, let's say, the lack of a bed net to protect themselves or their children from malaria. And bed nets are very cheap. You know, you don't save a child's life with every bed net. But if you give enough to the Against Malaria Foundation, you can be pretty confident that you will have saved a child's life. So if it would be awful not to save the child in front of you, isn't it also awful not to do anything to save children who you know are dying, who are not in front of you, who are far away from you? You can't see them or even identify as individuals the children whose lives you're saving, but you can be highly confident that you are saving the lives of some children. And isn't it wrong just to go on with our lives spending money on things we don't need when that money could be saving lives?

And that's the core argument that I've been making over many years now, for saying that if we really want to live an ethical life, it's not enough just to observe those moral rules and say, don't do this. Don't do that. We really also need in the world in which we're living to do something significant to help people who, through no fault of their own, are in great need and who are in danger of dying or whose children are in danger of dying because of things that we could provide for them.

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VEDANTAM: What would happen if we took these ideas and applied them to the COVID-19 pandemic? For a start, it should prompt many of us who can to reach for a checkbook and send money to groups that are working to relieve suffering around the world. That's the easy part, but there are much more difficult implications. Let's go back a second to that thought experiment involving the sheriff and the six innocent men who are about to be killed. If you're a utilitarian, you think it's better to cause the death of one innocent if that means you can save five others.

But it doesn't stop there. You can also ask, which of the six should I kill? From a utilitarian perspective, you would take into account how all the men are, whether they have underlying illnesses. If one of them is more likely to die sooner than the others, ending his life imposes the smallest costs. It's the least evil. In the context of a pandemic, Peter asked me to think about how this logic might apply to questions of triage.

SINGER: When a hospital has more people who need to be on a ventilator than they have ventilators - and so they have to make decisions. And traditionally, medical ethics has taken the view that if somebody is on a ventilator and someone else needs a ventilator, the person who is on the ventilator has priority. It's kind of first come, first served. But in the pandemic, I think that has shifted a bit and particularly because there are many older people affected by the pandemic.

So people in Italy, for example, considered the question. So suppose that the person on the ventilator is 85 years old and will need the ventilator for quite a long time, whereas you have a young person who's having acute respiratory distress but probably will only need the ventilator for a short time and, in any case, once they get over this, will have the prospect of maybe another 40 years of life, whereas, obviously, the person who is 85 can't expect anything near that in terms of life expectancy. So doctors in Italy developed codes which suggested that it's OK to remove people from ventilators in order to put other people with better chances of survival and greater life expectancy onto the ventilators.

Clearly, you are choosing some lives over others. It's a matter of years of life that you're saving, rather than lives that you're saving. But possibly, you may be saving more lives, too, because if one person is going to need a ventilator for a month and there are 10 other people who would need it only for three days, then you'll save more lives, as well, if you save it for the people who have a short-term need for it.

VEDANTAM: Now, if you're 85, this kind of logic could make you very angry. As I said, few philosophers have drawn the kind of admiration and the kind of anger that Peter has attracted. But Peter wants you to remember something through that anger. The doctor who decides not to intervene in who gets the ventilator, just like the sheriff in the moral dilemma, is making life-and-death choices. Why not make them rationally, deliberately, honestly? How is it morally superior to allow a greater amount of suffering just because one person showed up in the emergency room 10 minutes before another person. Is the first come, first served rule designed to minimize harm? Or is it designed to keep doctors from having to make painful choices, to keep doctors from feeling like that sheriff?

(SOUNDBITE OF MUSIC)

VEDANTAM: Peter says utilitarianism has something important to say about the responses of many governments to the COVID-19 pandemic. In a recent essay that he co-wrote with another researcher, he said, it pains us to say this, but U.S. President Donald Trump is right. We cannot let the cure be worse than the disease. I asked him to explain what he meant.

SINGER: Well, Trump was suggesting that, possibly, the lockdown might actually have worse consequences than the virus itself would have if it spread through the community. Now, what we were saying is that that's a reasonable question to ask. If there is evidence that the costs of the lockdown are worse than the costs of leaving the virus to spread throughout the community, then we should not have the lockdown. We were not saying - we tried to take pains to make clear that we were not competent to say - that that was the case or that the costs of the lockdown are worse than having the virus.

That's something for the medical experts and the other social scientists who can tell us what the costs of the lockdown are - a very big and complicated question - and, of course, the hypothetical question of what would happen if the virus spread unchecked through the community. But we do think that that's the right question to ask. You know, we have to try to think, what are we doing with this lockdown? How bad is it, and how bad is the alternative? That's the only rational basis on which you could make policy decisions about whether to go into lockdown and, once you're in lockdown, when to start lifting the restrictions.

VEDANTAM: So I want I want to make clear that there are - it's a very complicated issue, and there are lots of nuances here. The question is, even if you lift the lockdown, maybe people actually won't come back and engage in economic activity until they're actually confident about their public health. There's lots of nuances in terms of, you know, how much of a choice governments are actually making and so forth. But separate from the specific policy prescriptions, just to stay with the domain of the moral choices that we're making, I want you to try and articulate for me how it is that this can actually have moral consequences because the downstream effects of some of the choices we are making can affect people down the road in ways that are unpredictable.

You describe, for example, at one point in this essay that, you know, one way to make progress is to consider that a lockdown, if it goes on long enough, will bring about a smaller economy that can afford fewer doctors, nurses and medicines. You say in the United Kingdom, the National Health Service estimates that for about $30,000 - can buy a patient an extra year of healthy life, basically making the argument that a smaller economy can have health consequences. Articulate this for me a little bit more. And, again, I think less in terms of the specific prescriptions in terms of COVID-19 as much as exploring sort of what the moral terrain is on which these discussions are based.

SINGER: The ultimate moral question here is, what are our values? And what is it that we are trying to promote? Now, clearly, it's a bad thing when people who want to go on living die. And that's a bad thing even if they are quite elderly and would only have one or two years to live. It's still a bad thing. But we need to balance that against a broader range of consequences that can occur from an economic recession.

And those consequences are very many. One of them is widespread unemployment. We've seen more than 30 million Americans registering for unemployment in the past month or so. So that has its costs. Perhaps people are going hungry or unable to do other essential - meet other essential needs. There have been reports of higher incidences of domestic violence because people are locked up at home together and feeling frustrated and angry at not being able to get out of the home.

And in the long term, the effects of a smaller economy, that governments have less money to spend, and that can have an effect on saving lives - it can have an effect on how many health care workers can be educated and trained, what kinds of facilities they can have, how good the health care system might be. So we need to have some kind of common unit to weigh up these quite diverse costs of the lockdown against the more specific and identifiable costs of how many extra people will die.

And I would say not just number of people who will die, but the number of life years that will be lost because I do think that it's worse for somebody who's 30 to die than it is for somebody who's 85. So in the article, we suggest that we should be trying to look at years of positive life - years of life with certain levels of satisfaction and trying to compare the loss of what economists call quality-adjusted life years in the two situations. So quality-adjusted life years will be lost in whether you are talking about deaths from the virus or whether you're talking about the reduction in quality that comes through the lockdown.

VEDANTAM: You talk in the essay about something you call an identified victim effect and an identified cause effect. In the second case, you sort of say, could the images of people dying on stretchers, in tents and hospital parking lots be blinding us to the greater harm we may be causing across society through our efforts to avoid those awful deaths? What are these two ideas - the identified victim effect and the identified cause effect?

SINGER: The identified victim effect is something that is well-known and has been widely studied. And that is that we are much more reluctant to harm a person who is identified or not to help a person who is identified than a stranger. And this, I think, is operating in my example of the drowning child in the pond. You can see the child in front of you. So you have an identified victim. And people think it would be terrible not to save that child. And emotionally, there is a very strong pull to save the child in front of you, whereas when people say to you, you could save a child by donating to the Against Malaria Foundation, there is no identified victim. It's just an anonymous child. And in the nature of the bed nets, you'll never be able to identify the victim, in fact, because you don't know which of them would've got bitten by a mosquito and died if you hadn't provided the bed nets.

So people are - don't feel the same emotional pull to donate to what we sometimes call statistical victims. We know that, statistically, bed nets save lives. But we can't say, this is the child that you've saved. So that's what operates - familiar phenomenon that operates in terms of who people are willing to donate to rescue.

Now, in the case of the choice between allowing the virus to spread and the lockdown, what we have is not identifiable victims because we don't know in advance who the virus will kill. But we have an identifiable cause, the virus. So we can count the number of deaths caused by the virus. There's some borderline inaccuracy in doing that. But we can get a rough idea of that. And we can say, oh, this is terrible. If the government had locked things down, these people wouldn't have had to die. The virus would not have spread. But when people are dying because of the broader effects of the economic recession because of the fact that the government has not got so many resources to train health professionals or even to make roads safer or to do a whole range of other things that save lives, we don't know. We don't really know whether that was caused by the recession or whether it had some other causes.

So I think we are biased to give more weight to the identifiable cause rather than the causes that are much more disparate and difficult to identify but which we can still estimate will cause losses of life. And that perhaps tends to push us in the direction of favoring the lockdown to avoid the deaths from the identifiable cause, the virus, rather than to give full weight to the deaths that are going to be caused and the loss of quality of life that are going to be caused by this much broader and vaguer range of effects that will come from the lockdown.

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VEDANTAM: When we come back, how Peter Singer, a descendent of Holocaust survivors, has come to be identified with the people who carried out the Holocaust.

SINGER: One of these Autonomen jumped up on the stage, ripped my glasses off my face and smashed them under his shoe.

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VEDANTAM: Peter Singer's life has been animated by a willingness to take ideas that lots of people believe in and then do something radical, actually act on them. He argues that doing this, while difficult and often running against his own feelings, leads to more moral outcomes. He saw a friend make a case against factory farming and became a vegetarian. He heard about people suffering in South Asia and decided to give away a substantial amount of his income. He says that if we were willing to think about moral decisions with logic, with mathematical clarity, we may not feel better, but the results would be better.

SINGER: I think it is a general issue and not only related the pandemic about, to what extent are we prepared to change our lives on the basis of reasoning and evidence rather than something that is emotionally appealing to us? The other really big issue, I think, where this is a very serious problem is climate change because we don't see the effects of climate change. We don't see the effects of our emitting greenhouse gases. They're invisible. They're odorless. And we have to rely on the scientific evidence that tells us that this is contributing to climate change. And this is having and will have increasingly in future a wide range of devastating effects that will cost lots of lives and cause immense hardship to a very large number of people. And we have to change our lives on the basis of that. This is going to be a very bad thing for the long run for people all over the world and for our children and grandchildren.

VEDANTAM: So I sense sort of a great paradox here, Peter, which is that, you know, you're clearly someone who has reached his moral views after thinking very seriously about what is right and what is wrong. And in some ways you've grappled with these questions more seriously, probably, than most people. At the same time, as you point out, you've reached your conclusions in some ways by trying to strip away your natural emotional reaction from your moral calculations. And I'm wondering - in part of this is why you sometimes might generate anger among people. You generate a lot of controversy. It's because people feel that moral judgment should be emotional. It should not be logical.

SINGER: I'm not sure whether people actually go so far as to say that moral judgment should be emotional or whether they are just feeling the emotions, and that leads to the reaction. I certainly think it's true that people do feel these emotions, and they have an emotional response to it - to what I say. And they want to cling to more widely accepted moral views, which have a strong emotional basis, that, as I say, may have been formed in our past - the past of our ancestors when we lived in small face-to-face societies, and we always had identified victims of anything that was wrong. And now we live in a completely different world - vastly larger, billions of unidentified victims. And I think, often, people who get upset by what I'm saying are simply giving full play to those emotions that we have as a result of our evolutionary past but that are no longer really suitable for the world today.

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VEDANTAM: When Peter was appointed to Princeton University in 1998, protests and blockades broke out. Many people felt it was unconscionable that Princeton would hire someone who would recommend that some severely disabled infants be killed. Peter's views were compared to those of the Nazis. He was called a baby killer and an enemy of civilization. One time at a conference in Zurich about the morality of euthanasia, these emotions spilled out into actual violence.

SINGER: So I'd been invited at the University of Zurich to give a lecture on my views about euthanasia for severely disabled infants and questions about life-and-death choices in medicine. And there had been some protests about those views, particularly in German-speaking countries. And Zurich is in a German-speaking part of Switzerland. And there were a number of people with disabilities there who had been accommodated there in the front row in wheelchairs. And they were wanting to argue with me, you know, as philosophers do, of course. You know, after I'd spoken, they wanted to present their objections.

There were also, though, a group of people in the audience who were not themselves disabled but who identified as a political group that in German is called the Autonomen, essentially, the autonomous ones, if you like. They're kind of quasi-anarchists, I suppose. They were dressed in black. And they had brought a whole lot of noise-making devices. And when I started speaking, they activated these noise-making devices, essentially drowning me out so that it wasn't really possible for me to speak.

There was an overhead projector there. This was some time ago. It was in the pre-PowerPoint days. But there was an overhead projector there. So I used that to start writing some of the essential points since I could no longer be heard. And at that point, one of these Autonomen jumped up on the stage, ripped my glasses off my face - I'm severely short sighted - and smashed him under his shoe. At that point, of course, the lecture was canceled.

VEDANTAM: I mean, it's interesting - many people in the disability community or at least some people in the disability community think of you as an evil person because you're asking these questions about how much lives are worth. And maybe lives are not all completely the same because people have different quality of lives. I think sometimes you've even been called a Nazi, which is ironic, of course, given your own family history with the Holocaust. But I'm wondering, as you hear this, do you sort of say, I understand why it is you see things this way?

SINGER: I do understand people's responses. In the case of this response that's specifically from German-speaking countries - and as I say, remember this happened, really, a generation ago - I think people were trying to distance themselves from what, in many cases, their own parents had done, perhaps had done to my grandparents during the war. And they were trying to be at the opposite extreme.

I think they were making a bad mistake. I think, you know, suppressing freedom of speech is one of the things that the Nazis did and that was necessary for the Nazi regime to take and retain power. So I think they are making a bad mistake about how to be a non-Nazi. But probably, they thought that, somehow, standing up for the idea that all human life has absolutely equal value was an important way of rejecting racism.

VEDANTAM: I'm wondering, as somebody who is in his 70s today, Peter, whether your own thinking about something like COVID is something that you would think about in your own life. God forbid, if you were to fall sick, would you sort of apply the same logic to sort of how hospitals ought to treat you versus others. In other words, would you say, well, maybe the ventilator is best not used on me but given to someone much younger?

SINGER: Certainly, if there's a choice between me and somebody much younger who doesn't have any kind of underlying health conditions that mean that their life expectancy is no greater than mine, then I think it should go to the person who's younger. I would regret the fact that there weren't enough ventilators and so that we couldn't both be on ventilators. But if it came to a choice, I hope I would have the courage to say the right thing is to give it to the 30-year-old.

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VEDANTAM: Peter Singer, thank you so much for joining me today on HIDDEN BRAIN.

SINGER: It's been my pleasure.

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VEDANTAM: This week's show was produced by Parth Shah, Rhaina Cohen and Thomas Liu and edited by Tara Boyle and Jenny Schmidt. Engineering support from Joshua Newell. Our team includes Laura Kwerel, Cat Schuknect and Lushik Wahba. Special thanks to Carrie Kahn and Olivia Sanchez (ph). Our Unsung Hero this week is Emily Littleton. Emily is NPR's vice president for communications. In recent weeks, she's played a pivotal role sharing information within the organization as we deal with the COVID-19 pandemic. I admire Emily because she is so devoted to her work and cares deeply about the well-being of those around her. The world could use more Emilys.

Next week on the show, we continue our exploration of what it means to treat all suffering equally and consider how actions that come from a place of kindness can sometimes lead to an unjust world.

UNIDENTIFIED PERSON: I think that kind of act of helping towards people with whom we have some shared group identity is really the modern way in which discrimination likely happens.

VEDANTAM: You can find more HIDDEN BRAIN on Facebook and Twitter. If you like today's show, please consider sharing it with your friends. Afterwards, set up a video chat with them to debate the moral issues raised in this conversation. I'm Shankar Vedantam, and this is NPR.

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