Thursday, April 30, 2009

The Rape Doctor Hypothetical

Dr. A is a research psychologist who also has a private clinical practice. He specializes in treating Female Sexual Arousal Disorder (DSM-IV 302.72) - similar to what used to be called frigidity. Female Sexual Arousal Disorder consists of a persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement. The inability must cause marked distress or interpersonal difficulty, and is not better accounted for by another disorder (e.g. depression), a general medical condition, or substances, including medication. From the DSM-IV:
The individual with Female Sexual Arousal Disorder may have little or no subjective sense of sexual arousal. The disorder may result in painful intercourse, sexual avoidance, and the disturbance of marital or sexual relationships.

Dr. A has identified a syndrome (a cluster of symptoms) common to a subgroup of his FSAD patients with a particularly severe version of FSAD - Criteria A, B, C, and D. Members of this subgroup, he believes, are unable to achieve sexual arousal except in cases of forced sexual contact. A highly statistically significant number of patients who meet Criteria A, B, C, and D who have been raped report the rape as their only enjoyable sexual experience, compared to rape victims who do not meet the criteria. Dr. A labels his syndrome Forced Sexual Contact Arousal Syndrome (FSCAS). Based on his research, Dr. A has statistical grounds to believe that, of FSAD patients who meet Criteria A, B, C, and D, 99.9% will experience sexual enjoyment exclusively from forced sexual contact. Beyond that, Dr. A notices that his FSCAS patients who have been raped are much more socially and emotionally well-adjusted than those who have not. It is statistically reasonable for him to believe that, out of 1000 patients with FSCAS who have not been raped, 999 will experience a great deal of sexual enjoyment and a much better quality of life if raped; one will experience the usual extreme distress that rape would cause a normal woman.

You can probably guess where I'm going with this. Should Dr. A rape his FSCAS patients?

I think it's hard to answer anything but CHRIST, NO! to this one. The harm of rape is so intrusive and severe that any possible benefits to its victims simply do not count against the harm that may be sustained. It is not conscionable that one person should be raped to provide a pure benefit to even 999 others. (Note, however, that it may be moral to allow the rape of one person in order to prevent extreme harm to an enormous number of others.) Both those who identify as consequentialists and those who subscribe to a more deontological perspective would likely share this conclusion (though some more extreme consequentialists would not).

I have highlighted the common intuition that, in the case of a serious violation or harm, the possible benefits do not count against the possible harms (in an essay about dosing someone with ecstasy against his will - see Inflicting Harm and Inflicting Pleasure on Strangers). My correspondent Arthur Tilley points out that there is a limit to this intuition, however. While the intuition about the ecstasy case is strong, he says, "we probably can't say that doing nothing is ALWAYS better than taking a (teeny tiny) chance at doing harm." His example:

Consider my setting up a cookie stand by the side of the road and offering free cookies to passersby. It is probably reasonable to
assume that a percentage of the population (one not nearly as high as the percentage that doesn't like being dosed, but still nonzero) has some sort of phobia of cookies or aversion to being offered free things.

But it seems that in these cases where the probability of harm is really low, the action (in this case, having the cookie stand) is morally permissible.

Arthur's insightful example illustrates that, though the intuition that inflicting serious harm to strangers cannot be offset by providing them pleasure, taking a chance on inflicting minor harm to strangers can definitely be balanced by the probability that one will do them good. How could we live otherwise, since all actions or inactions entail some possible unconsented harm? The morally restricted action is one that will produce serious or especially intrusive harm.

One antinatalist argument, propounded by Seana Shiffrin, is based on just this intuition: that, while it is fine to inflict harm on a stranger in order to prevent greater harm (e.g., to break his arm in order to rescue him from a burning car), it is not permissible to inflict harm on a stranger in order to provide a pure benefit.

A major, though often unspoken, point of contention between pronatalists and antinatalists is what counts as harm. Pronatalists often only admit that harm has occurred through procreation if, on balance, the person brought into existence finds his life not worth living. Since most people report finding their lives worthwhile, to a pronatalist, the risk of "harm" in bringing a being into existence is slight.

Antinatalists, on the other hand, recognize as harm all suffering inflicted on a being who is brought into existence - pain, hunger, unrequited love, violence, sickness, aging, and ultimately death. Most lives include positive aspects such as pleasure, love, and a sense of meaning - but the persons experiencing these benefits also experience extreme harm - at the very least, the harm of death.

Dr. A may not chance inflicting the harm of rape on a patient in order to likely provide her with pleasure and increased quality of life. It follows that, since the harm of life (separate from its pleasure and meaning) is so serious and so great, it may not be inflicted on a person in order to provide him with a pure benefit (that is, the pleasure and meaning of life). The harm of life is not slight or unlikely. It is extremely great. The pleasures and benefits are also likely and extremely great; what I wish to illustrate is that, in similar cases, that simply does not matter.

32 comments:

  1. This comment has been removed by the author.

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  2. Neither. The living person may well find that the benefits of his life substantially outweigh the bad, and he's not necessarily deluded at all. Equally, someone dosed with ecstasy without his consent may come to the same conclusion about that experience (benefits > harm). This doesn't negate the harm done to him; there was still harm, there were just benefits as well. A harm can be quite small (or quite unlikely) and still count as harm, as in the Rape Doctor case and the ecstasy case. In both of those cases, we are not weighing the harm against the benefits, but only focusing on the serious harm part of the equation. If serious or especially intrusive harm is likely, then don't do the action, no matter what the benefits.

    h = expected harm
    b = expected benefit

    This is the way we "think" we think about doing harm to others:

    "If b-h > 0, then inflict action." (maximizing expected utility).

    But in the Rape Doctor case, we were not willing to do that. The fact that h is large (or particularly severe or intrusive) was enough to decide not even to consider whether b > h (which it might well be).

    So what we really do is:

    "If h >>0, avoid the action."

    One's life has h and b, too. I am pushing the notion that the choice to bring a person into existence is the type of situation where we use

    if h >> 0, don't inflict the action

    as in the Rape Doctor and Ecstasy case, rather than

    if b > h, inflict action.

    We could grant that, for most people,

    b > h

    but that doesn't make b zero - b could be, and, I argue is, enormous, no matter how high h is.

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  3. That's helpful. I wonder, though, if there aren't significant problems with analogizing the ecstasy and rape cases. The former concerns an occurrent, transient state of 'delusion' or cognitive impairment, whereas the reports that life is worth living I take to be indicative of something more substantial, a relatively stable mood, attunement or orientation to (one's) life.

    The rape case seems problematic to me because I assume part of what makes the harm of rape so peculiarly awful is precisely its lasting impact on one's quality of life; and yet this is precisely canceled out for 99+% by an improvement in quality of life. Perhaps, of course, the sheer violative nature of the act is enough to sustain a categorical moral prohibition on Dr. A's raping his patients, but then I keep returning to the lasting impact when trying to encompass as fully as possible on what is so distinctively awful about rape, in addition to the immediate violative, intrusive, severe aspects involved.

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  4. I'm not sure the harm of rape is its lasting impact on quality of life. We wouldn't allow a person in a persistent vegetative state to be raped, even though it will have zero expected impact on his or her quality of life. As in Posner's rape-license example, I think the rape case is one particularly well-suited to pop us out of crude consequentialism.

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  5. Yeah, I guess it's just not clear to me that forced intercourse for the purpose of effecting a statistically highly likely and significant increase in the victim-patient's quality of life merits, on reflection, the same absolute condemnation rape incurs without call for reflection. And though personal autonomy is violated in both instances, does the moral harm of being treated as a means apply equally? Just thinking aloud. (Maybe I'm just registering an inordinate susceptibility to consequentialism -- aggravated further, perhaps, through a lens of gender bias?)

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  6. I think it's possible to bite the extreme consequentialist/act-utilitarianism bullet here and allow the rape - or, for that matter, allow us to kill the occasional unconsenting, young, healthy person and distribute his organs among many people who need them. It just seems to be an uncommon, extreme position - and don't you think it's really only tenable if the benefit is much, much greater than the harm? If the odds were more like 75%, I think it gets back to "unthinkable" territory. Or not?

    No gender bias necessary, by the way - just imagine all Dr. A's patients are men.

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  7. I think some of my confusion has been stemming from an unreflected assumption that if a person sincerely thinks their life is worth living, this must consist in more than a judgment that there are both benefits and harms, and that the former outweigh the latter, but in some kind of overall acceptance of the latter that isn't reducible to the antinatalist harm/benefit equation. (I suppose I should finally read Benatar's book, as this seems to be a fairly fundamental issue, perhaps akin to what distinguishes Nietzsche from Schopenhauer.)

    So, in the rape case, I've been importing this assumption into whatever other content the improvement in "quality of life" consists of, thereby raising the (still quite remote) possibility of the extreme consequentialist position. For the analogy with acceptance of the harms in one's life (on the basis of which one judges one's life worth living) would be an acceptance of having been raped.

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  8. I wonder: supposing such acceptance is a widespread phenomenon, as it appears to be, what should be made of the fact that it's so frequently, if not overwhelmingly, mediated by false beliefs (about an afterworld, etc.) and commitments to illusory goals (imperatives of providential cosmic order, etc.)? Is the sense that one's life is worth living somehow less than what it purports to be because it's predicated on false beliefs and commitments to illusions?

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  9. Benatar makes that argument, to some degree - that subjective reports of life being worthwhile are not necessarily reliable (in specific ways). But actually I think "commitments to illusions" are indistinguishable from "values" in many cases. I wouldn't want to second-guess the judgments of an already-existing person about the work of his or her own life.

    I'm not sure if I understand your "acceptance" idea. It sounds like something that an individual may do regarding his own life, but I'd want to keep straight acceptance of one's own life (including suffering) and foisting life upon someone else. It sounds a little subjective to justify the latter.

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  10. Didn't this blog used to have a search bar?

    Though he hasn't commented in this thread, I'd like to thank Chip for reminding me of it and Shiffrin's hypothetical. While anti-cube-dropping argument would seem to agree with intuitions, the utilitarian in me balks at generalizing it and shunts aside ethical intuition. A tremendous amount of actions have some small probability of causing large amounts of harm to people. We might say that in the individual cases where harm is caused the causer may be held responsible, but the action itself cannot be prohibited on the grounds that it has some possibility of causing harm. So the frequency with which new lives are worth vs not worth living (and even the relative deviations from "neutrality" of the cases) is relevant.

    I recall a while back you mentioned one of the hazards of a market in suicide-murders was that one might end up with a rapist-torturer. As it turns out, one of the few known cases of consensual murder was Sharon Lopatka, who required that she be tortured. I agree with Robin Hanson both in prioritizing efficiency over liberty if I have to choose one and viewing liberty as the best known heuristic for liberty (and additionally taking an "outside view" skepticism regarding paternalistic claims that certain situations are special enough to override the liberty heuristic). The reconciliation of liberty & efficiency (or deontological ethics & utilitarianism) would be for the doctor to explain this to the patient and see if she agrees she would be better off and (since not everyone is a utilitarian) and so would consent to rape in the abstract. One might object that by consenting it thus loses its status, but there is some threshold of similarity through which it would be indistinguishable. It quite is plausible that the psychological aspect of believing it is real plays a major role (this is why waterboarding is easier to endure for those who agree to undergo it in a controlled environment, and also why you can turn up the heat in a car you're driving to torture your passengers if you know you can turn it off when you want), and this can be accomplished as well. If the doctor distributed information making the patient vulnerable (perhaps through a website analogous to what Lopatka used) the patient could not know whether a the rape was caused by the doctor (and hence her consent) or "genuine" (this is similar to the logic behind the blank cartridge in a firing squad, though that's a "known unknown" that can be more easily calculated and proportionately dismissed by a rational actor). Even in the former case, as the patient only agreed in the abstract rather than in that specific situation it could still be considered genuine.

    Rob Sica, are you suggesting "false consciousness"? I reach for my gun when I encounter the phrase. It proves too much. Once we admit the possibility I can't see any situation in which it can be shown not to apply.

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  11. Hehe... I'm not sure, really, what I'm suggesting. (Surprise.) I just don't know what to make of the conflict between (a) the quasi-Schopenhauerian anti-natalist assessment of life's sufferings and (b) the 'life is worth it' assessment to which most people are apparently prone. The latter seems to me to undercut the prescriptive authority of the former, even if the former is somehow true and the latter somehow false.

    The problem, it seems to me, is that the result of that assessment 'from the inside' of an individual life is at least partially constituted by that perspective, and I don't see how it can be eclipsed or countermanded by the anti-natalist assessment 'from the outside' that no, if you only saw clearly you would realize it's not. If this claim can't be made (generally, that is, as I suspect it can be made of some people who in some way are deluded about their evaluating), then I don't really understand the basis on which anti-natalism stands: since it apparently happens that most people find their lives worth living, it's highly likely that the life you bring into existence will also find it worth it.

    I suspect these are pretty elementary objections, and I'm missing something painfully obvious, so feel free to tear this thinking-aloud pieces.

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  12. There has been enough bitching and moaning from my loyal readers that I reverted some of my edits.

    A tremendous amount of actions have some small probability of causing large amounts of harm to people.Yes, but the actions we're talking about here have a 100% probability of causing serious harm to someone. (The benefit might outweigh the harm - but it's still harm.)

    I shouldn't even discuss this, but I have no problem with consensual torture-murder (or pretty much consensual anything). There's at least one other case on record I know about of consensual torture-murder. This shows up again and again as a utilitarian argument for libertarianism: prohibiting some kinds of consensual "harm" (consensual murder, prostitution, drugs) allows even more serious harm to happen (non-consensual torture, rape, drug adulteration).

    Are you familiar with Posner's "efficient rape" hypothesis? The idea is that spousal rape was legal for along time in part because it was a situation where it was usually efficient - e.g. the harm of avoiding a "market" was outweighed by the benefit. (Of course, harm to male owners was the only harm considered - harm to women was not part of the equation.)

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  13. Rob,

    Pessimism isn't essential to antinatalism. There is also the problem of non-consent, the problem of unknowable risk, and there is the asymmetry which remains conspicuous even under the best imaginable conditions. And since you mentioned Benatar, it's worth noting that he takes great care in BNthB to distinguish the question of whether a life is worth starting from the question of whether a life is worth continuing.

    I do think that self-deception is relevant and real, and I think Benatar fairly nails the problem in his critique of "objective list" theory where a "sub specie aeternitatis" assessment of life's value is considered against the necessarily relative "sub specie humanitatis" view preferred by list makers. If the average human life lasted a thousand years, for example, dying at 100 would be considered tragic.

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  14. I don't have anything to contribute to the above dicussion, I'm afraid, but here are a few words about the initial article.

    I'm not sure the rape doctor example is a good one. In the text, you seem to support the view that the reason we reject it is the 1 in 1000 who would suffer immensely.
    If so, then I don't see why it would be relevant for what follows about antinatalism. Could you elaborate a bit on what you want to show with this example?

    By the way, I'm not sure this asymmetry of Shiffrin's is really what guides our intuitions. (I'm suspicious in principle of the harm/benefit distinction.) I think that maybe something else may play a role: We know that the ranking of unpleasantness of physical harm is rather constant among individuals. We feel justified in assuming that everybody finds it worse to burn alive than to have an arm broken.
    However, we are reluctant to allows procedures where we can't be sure that the things we exchange are really ranked by the affected person the right way.
    Someone may not mind a broken arm when he gets a bar of gold. However, it is perfectly conceivable that someone prefers the integrity of his arm to the gold.
    Taking away from him ten dollars and then giving him the bar seems alright again. Taking away a seemingly worthless old clock doesn't, because we don't know what immaterial value is attached to it for the owner.
    In fact, it doesn't strike me as unproblematic to exchange rape somebody in order to save her life. This is probably because the ideo of death is not so terrible to me as it may be to others, so that I find it conceivable that someone should prefer it over being raped. Other (cheery...) people's judgments may deviate here because they might not find this possibility worth considering.

    PS: [i]Note, however, that it may be moral to allow the rape of one person in order to prevent extreme harm to an enormous number of others.[/i]

    At any rate not for Kantians...

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  15. Chip,

    "...and there is the asymmetry which remains conspicuous even under the best imaginable conditions." (Chip)

    Personally, I don't disagree. But to most people this asymmetry is apparently not conspicuous, or not conspicuous frequently enough for them to integrate it into their attitude towards reproduction. So, I guess I'm wondering if it can be true of a life when it is not apparent to a life. I would think the same applies to the issue of non-consent: there's a very small risk of bringing someone into existence who suffers from having been brought into existence without their consent, so why should one be inhibited from bringing someone into existence without their consent?

    The problem of unknowable risk, however, is one which especially resonates for me since my antinatalist predilections are based primarily on aesthetic considerations -- i.e. the enormously high risk of adding to the clutter of boring and ordinary lives. I think the likelihood of bringing into existence an extraordinarily interesting and exemplary human being is a more important consideration than than those stemming from the asymmetry and consent issues. (Of course, the 'to a life'/'for a life' problem applies again...)

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  16. Hey Constant, good to see you.

    I don't intend the hypothetical as a general model/analogy for the antinatalist idea. It's meant to be a concrete example of the fact that, when harm is severe enough, counterbalancing "good" simply does not count. It's intended for people who don't grasp the antinatalist asymmetry and want to keep saying "but what about all the good stuff? doesn't it balance it out?" As I mention above, you can totally bite the ultra-utilitarian bullet and claim it does balance out - but this is a somewhat unusual and non-intuitive position that I doubt the majority of people would share. Anyway, at the very least I intend it to point out what people are saying when they want to balance out severe harm with great good.

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  17. Rob, even someone who is very happy to be alive can acknowledge that he or she has suffered some harm. For instance, he or she will suffer the harm of death, which most people perceive to be a great harm. The benefits of life may outweigh this harm - but it doesn't make the harm go away.

    I don't think the antinatalist position at all requires people to subjectively perceive their lives as an overall harm to them. Clearly, most people do not! We don't even have to say that they're wrong to not perceive life as an overall harm - they can be completely justified in believing that, in their own lives, the positives outweigh the negatives. What I'm getting at, at least, is that regardless of the counterbalancing positives, the negatives are so severe that they must not be inflicted on nonconsenting others.

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  18. Rob,

    "Conspicuous" is one of those words that I use too easily and too frequently. I might have said simply that it remains philosophically problematic. As to what's apparent, that's the intuitional crux of that thing that Sister Y is attempting to re-imagine with her provocative thought experiment (which also challenges common rejoinders hinging on the non-identity problem).

    I must disagree with you when you state that "there's a very small risk of bringing someone into existence who suffers from having been brought into existence without their consent." I think the chance in this particular is not small. In fact, I would argue -- and will, if challenged -- that the chance must edge near 100%.

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  19. Chip,

    I just mean that there's a very small risk of bringing someone into existence who suffers from the particular fact -- the fact per se -- of not having chosen to exist. Maybe I'm wrong; it's just not a complaint I hear voiced often. But when it is, I think it tends to be derivative, an expression of frustration and regret for existing because of the more tangible and pedestrian sufferings (apparently mediated or mollified for most people by the pollyanna principle).

    Curator,

    I guess I'm hung up on the notion (probably a hangover from Thus Spoke Zarathustra) that to regard one's life as an overall good to one is a kind of retroactive consent.

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  20. Benatar touches upon the distinction ("they think it's better than it really is") in this interview, after the last caller, but without developing it, so I'm getting the book.

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  21. He spends at least a chapter on it in the book - but it's not necessary to the theory.

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  22. So I've reached the final paragraph of the second chapter, where Benatar addresses my concern, but I still don't get it:

    Even if one cannot be mistaken about whether one is currently glad to have been born, it does not follow that one cannot be mistaken about whether it is better that one came into existence. We can imagine somebody being glad, at one stage in his life, that he came to be, and then (or earlier), perhaps in the midst of extreme agony, regretting his having come into existence. Now it cannot be the case that (all things considered) it is both better to have come into existence and better never to have come into existence. But that is exactly what we would have to say in such a case, it it were true that being glad or unhappy about having come into existence were equivalent to its actually being better or worse that one came into existence. (pp. 58-9)

    But why can't the answer to the question whether it is better that one came into existence alternate between yes and no over time, according to the vicissitudes of one's attitude towards one's life? It wouldn't be that "it is both better to have come into existence and better never to have come into existence", but that at time A it's better to have, at time B it's better never to have, at time C it's better to have... etc.

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  23. In his review of the book [1], Saul Smilansky raises the concern I have:

    "[Benatar] should be much more worried than he is by the fact that relatively few people consider suicide for any length of time. This fact again raises the thought that for most people, most of their life is quite good, and on balance more good than not. Most people are simply very different from how they should be if Benatar's views are to be plausible."

    (Personally, I'm the reverse of how Benatar expects most of his readers to be: I readily accept the anti-natalist conclusions, but disagree with a few details en route to them.)

    [1] Philosophical Quarterly 58, no. 232 (July 2008): 569-71.

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  24. I'll bite the bullet and say that the rape has expected good consequences in this case.

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  25. I must first admit my shame, I haven't read all of the above comments, and someone may have made this point already.

    You should forget about rape and think about peanut farmers. There are a reasonably large number of people with deadly peanut allergies, and they do die on a fairly regular basis. If it's true that "...in the case of a serious violation or harm, the possible benefits do not count against the possible harms" even if that's restricted in that "The morally restricted action is one that will produce serious or especially intrusive harm" then peanut farmers are, essentially, murderers. I consider this a reductio ad absurdum to the proposition, but of course, you may disagree.

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  26. What we are talking about is a serious harm committed intentionally and without consent.

    One of my lovers actually has such a serious peanut allergy that I can't even kiss him after I've eaten peanut butter chocolate ice cream. But that's the thing: he has the opportunity to avoid the harm. It's not wrong to farm peanuts (at least, no more wrong than farming tobacco), but it would be completely wrong for me to kiss my lover after eating a Snickers, despite the non-trivial pleasure a kiss from me no doubt brings.

    With the peanut farmer, people can choose to buy or avoid his product; he's not shoving them down anyone's throat, the way a parent shoves existence down a child's throat, or a rapist - well, you know. Also see the cookie example in the text.

    I deal with the question of feeding a non-consenting stranger peanuts (and ecstasy) in my post Inflicting Harm and Inflicting Pleasure on Strangers.

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  27. I'm the same anonymous as the one who posted on September 16, 2010 at 7:32 PM. If I respond again I'll get a handle to make this easier.

    I don't think you can properly view peanut farming/allergies as an issue of consent, at least in general. Accidents do occur. Sometimes products don't list peanuts as an ingredient even though they contain them, someone at a restaurant (or even a friend) isn't careful enough, and I'm sure there's sometimes accidental cross-contamination even for things which are explicitly listed as not containing peanuts. We can limit our discussion to only being about these accidents fairly easily, thus (almost) totally ignoring the issue of consent.

    It doesn't really matter, for the propositions I referred to, how common these accidents are, or even if we have a documented instance. As long as this has happened once, or even could happen, then we're stuck with peanut farmers being murderers. The only ways out I see are to modify your rule to include frequency of harm or claiming that not being extremely paranoid all the time (by only eating food which they made themselves from ingredients which they farmed/ranched in a high security area) constitutes consent from those with peanut allergies.

    If you introduce frequency then at some arbitrary percentage you main example breaks down. I don't think you're trying to say that if 99.9% of the raped experience pleasure it would be wrong, but if it's 99.999% (or whatever) it's OK.

    If you go with the "not being extremely paranoid is consent" I think we're back at a reductio ad absurdum.

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  28. I like the direction you're taking this. So there are two concepts here: (1) consent by the victim and (2) voluntariness/intention of the agent of harm. I have been treating them as very binary. Consent tends to be treated in a binary manner by the law, but I think, as you point out, it's more properly thought of as a spectrum. I consent in writing after legal advice to some things, I consent verbally to others, in other situations my failure to object is taken as consent, and perhaps driving on the freeway I consent to the risk of getting in an accident without doing much of anything except being there.

    Voluntariness/intention (mens rea or scienter) is seen as somewhat binary under the common law, although the common law puts in shades of intention - either it wasn't a voluntary action, or (a) it was voluntary and you intended the harmful consequences, or (b) it was voluntary, but you didn't intend the harmful consequences.

    Modern legal thinking divides it up even further, so we have intentional, knowing, reckless, negligent, and involuntary actions - not to mention issues of infancy, insanity, intoxication, etc. What it comes down to is that just as consent is a spectrum, voluntariness/intention is a spectrum as well.

    I would like to develop this further, but for now I want to point out that just because concepts are not purely binary and slide into each other does not mean that they are useless. We just have to be aware of their slippery nature when we use them. But I think the edge cases absolutely matter. I am interested in the moral obligations of the peanut farmer, the drug dealer, the prostitute, etc.

    Amusingly, I'm teaching my students about statutory ambiguity today.

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  29. If the good outweighs the damage, go for it.

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  30. I don't think it's wrong to risk to inflict harm if there's a significant benefit to be gained, but it must happen with consent of the potential victim/beneficiary... and since rape happen without consent by definition, that condition can never be satisfied.

    So we are stuck with a group of people who are either unhappy or require the violation of an essential part of morality to be happy. So I'd ask a return question: assuming this trait is hereditary, should Dr. A sterilize these women, thereby preventing the unhappiness or moral transgression of all their potential descendants, or let them be? It's easier this time, because we can ask the women themselves, but how much should they take their own wishes on the matter into account, and how much those of their descendants and future society?

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