Sam Harris's Moral Landscape: What are the flaws in his use of health as an analogy for morality?

Question

Old ground perhaps, but in his Response to Critics of The Moral Landscape, Sam Harris draws a comparison between the way science is deemed foundational to our health goals, and the ways in which science might similarly be deemed foundational to notions of wellbeing:

It seems to me that there are three, distinct challenges put forward thus far:

There is no scientific basis to say that we should value well-being, our own or anyone else’s. (The Value Problem) Hence, if someone does not care about well-being, or cares only about his own and not about the well-being of others, there is no way to argue that he is wrong from the point of view of science. (The Persuasion Problem) Even if we did agree to grant “well-being” primacy in any discussion of morality, it is difficult or impossible to define it with rigor. It is, therefore, impossible to measure well-being scientifically. Thus, there can be no science of morality. (The Measurement Problem)

I believe all of these challenges are the product of philosophical confusion. The simplest way to see this is by analogy to medicine and the mysterious quantity we call “health.” Let’s swap “morality” for “medicine” and “well-being” for “health” and see how things look:

There is no scientific basis to say that we should value health, our own or anyone else’s. (The Value Problem) Hence, if someone does not care about health, or cares only about his own and not about the health of others, there is no way to argue that he is wrong from the point of view of science. (The Persuasion Problem) Even if we did agree to grant “health” primacy in any discussion of medicine, it is difficult or impossible to define it with rigor. It is, therefore, impossible to measure health scientifically. Thus, there can be no science of medicine. (The Measurement Problem)

What are the flaws in this analogy? Is one of them that a person can point to a broken bone and say with certainty that "the bone is broken", but one cannot in a similar fashion point to a moral claim and state with certainty, "your claim is broken"?

Related reading:

Sean Carroll's rebuttal of Harris's approach, You Can't Derive 'Ought' from 'Is'

S.E. Post: Is Sam Harris's view of morality innovating? What philosophers innovated specifics on morality?

Answer 1

"Science of morality" is not comparable to "science of medicine." The "science of morality" would seek to answer why we should value well-being. A directly comparable "science of medicine" would seek to answer why we should value health, and indeed there is no science of medicine capable of telling us why we should value health.

The science of medicine we do have is only an instrument - it tells us how to achieve positive health outcomes, assuming we want them.

Answer 2

In both cases there are two separate questions: the meta- question: What definitions and goals should we use? - and the conditional question: Given a particular definition and goal, how does it all fit together and how can we achieve it?

In both cases, science bypasses the first as being outside its scope, but can attempt to answer the second.

The three objections are all to the meta-morality question. Out of all the moral systems, which one is 'right'? Science can't justify, argue for, or measure the 'goodness' of a moral claim independent of the assumption of a particular moral system defining how to measure it. (Personally I don't entirely agree, but let's accept it as so for the sake of discussing Harris.) But science can certainly list and classify moral systems and claims, identify relationships between them (logical, historical, cultural, etc.), model moral minds with psychology, predict consequences, and thereby suggest how a given moral goal might be practically achieved.

Likewise, medicine can't address the meta- question of what constitutes good health. That's why medicine demands informed consent of its patients to define what counts as a good outcome, an acceptable risk, etc. This part of medicine is not a science. Only when the patient (or a responsible guardian acting on their behalf) has defined what state of health they want or should have does the science of medicine then tells you what pills, surgery, therapy, etc. will best achieve that goal.

Harris first compares the meta- study of morality with the meta- study of medicine, and finds the three arguments equally applicable. But then equivocates definitions part way through the argument, suddenly interpreting the science of medicine in the how-to-achieve-it sense, and concludes that because medicine is a science despite the applicability of the three arguments, morality can be a science, too.

Answer 3

I have to add some considerations to my old answer, which was a bit too crude, I guess.

The health-morality analogy is pretty flawed anyway.

For most physical conditions, especially serious ones, like cancer and heart disease, the desire for treatment is strongly externally supplied.

And there is very strong consensus: people of all genders, age, religion, political conviction, ethnic background, personality etc. usually want their cancer be treated ASAP.

The patients create the demand. They want to be treated. And medicine tries to satisfy the demand.

But outside of this very straightforward situation (which perhaps describes 80% of medicine), it suddenly gets highly controversial:

• mental health / psychiatry
• disability
• harmful physical conditions that are actively maintained by a certain lifestyle (e. g. obesity)
• drug abuse
• behavioral addictions (e. g. gambling, heck even "gaming disorder")
• reproductive health
• gender identity, sexual orientation (e. g. asexuality vs. sexual dysfunction)

In those cases the desires are not strongly externally supplied and consensus is lacking.

And, surprise, it's where the endless, highly polarized debates start.

E. g.

• harm reduction vs. abstinence
• the social model of disability
• the social model of mental health (Michel Foucault)
• sterilization
• addiction as a disease or moral failure
• people who are functional and see nothing wrong in their personality "disorder", etc.

Of course you can double down and believe that if the WHO or AMA declares something a disease, it must be so. They're the professionals, after all.

I find this totally unconvincing.

Those other 20% of medicine and 100% of public health (where policies are enacted on the population without consent and on the basis of weak evidence) are just too controversial.

The debates around it seem way too philosophical, not objective, and easily devolve in irrefutable dogmatism:

The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes. (AMA)

... yes, that's the "quality" of the discourse. It seems to elude the AMA that lung cancer cannot be cured by quitting smoking. Obesity OTOH goes away by consuming fewer daily calories than you burn.

And similarly Harris' science of morality has few strong externally supplied desires / values.

Instead it would be 98% about "discovering" the "right" values.

So it is 98% old-fashioned utilitarianism and perhaps 2% applied social science.

Is utilitarianism correct? Even if it is (a big if), what is gained by Harris' rebranding?

We're still stuck with all its deep philosophical problems and conundrums. Like consistent quantification of well-being (less homicides vs. the happiness of gun ownership).

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Original Answer

If Harris would’ve just proposed a “collective well-being science”*, his argument would make some sense. There are all kinds of sciences that are based on very contested, normative concepts (e. g. criminology).

But he aims to replace ethics, a whole branch of philosophy. As if all the hard questions there had already been solved. He does this by simply presupposing that ethics is about maximizing well-being, i. e. that consequentialism / utilitarianism is correct. Which is a galaxy-sized petitio principii.

* IMHO such a “well-being science” could be of some use for public administration. Especially at a local level where the difficult moral issues have already been decided and little wiggle room is left. The remaining options are then best analyzed with well-being maximization as the standard. But I guess that already exists, it’s probably some flavor of “policy analysis”.

Answer 4

1. Scope

Medicine mostly operates on the scope of the single human body, and then often at the scope of a single problem at a time, without great loss of meaning; whereas the proposed science of morality operates on a collective level. At best we're comparing an apple with a ton of apples. For an example of how this is relevant, note how in health it is possible to restrict your attention to reducing pain, reducing reducing blood sugar, ..etc; depending on the issue faced. When no specific target is available we can fall back on longevity. This is not as available to a discussion of collective well-being because not only is every aspect of one's existence on the table all the time, but also those of everyone else's are. There are of course some potential work-arounds, but the differences are signficant.

A similar point can be raised in regards to the Persuasion Problem, as differing values (or even differing definitions) of health between different individuals do not obstruct the study of one or the other; whereas most of morality would deal with a given person's conduct towards others.

However...

2. Misrepresentation

The premise here is that a science of morality would be the scientific or experimental practice of determining what manner of conduct leads to an increase in the total sum of human 'well-being', and thus deemed moral.

The analogy (and indeed the entire argument) is misrepresenting the issue by mistakenly assuming that critics have accepted this premise, are happy with this objective, and are just discussing whether it would be technically possible within the scientific method. This is only correct for the Measurement problem, which I've discussed above, but the problems of Value and Persuasion are brought up as attempts to explain that this definition of morality and this proposal are themselves based on philosphical standpoints, not science, so the concept of "science" is not itself a viable defence for handwaving centuries of philosophical discussions. If these problems are actually brought up as technical arguments, then Harris is correct in finding them lacking.

So, if you do agree to ignore the countless problems with this idea of morality or its study, and are sure this is what you want to do, then the proposed science of well-being is perhaps viable, and the analogy is technically problematic but not fundamentally flawed.

Answer 5

Define health.

As you said, this is old ground, and Harris neglects much of what Plato neglected thousands of years ago.

There are many issues at play here, but my biggest one is that the definition of health is such an incredibly wooly, shaky concept as to be practically useless when trying to define absolutes, especially when talking morality.

For a start...

Health is non-comparable.

We all have an idea of the ideal human form, somewhere inside of us; stereotypically, a muscle-bound he-man for males, and a voluptuous Eve-like figure for females.

But this idea is extremely shaky. Ever seen Olympic sprinters? Know why they're so lean? Because every pound of muscle is another pound of flesh to propel across the finish line. More weight, more work.

What about heavyweight boxers? Most could kill Usain Bolt with one punch. Provided they could catch him!

Nobody would deny that Mohammed Ali or Usain Bolt were in peak physical condition at the heights of their careers, but they can't both be of the Ideal Form, because they are diverging.

What's more desirable? Speed, or strength? These two properties would both be desirable in an Idea Human, but they are (somewhat) mutually exclusive: strength gained is speed lost, so one cannot ever be Ideal in both.

Health is subjective.

To give an example: a vasectomy. By the old ideas of the Platonic "ideal form" that this argument often uses, to have a vasectomy is undesirable, because it damages the ideal form (i.e. a human capable of reproduction).

Saying all that doesn't negate the fact that millions of people every year elect to have a vasectomy; these people appear to desire this operation despite the fact that, by some definitions, it is injurious to health. Nevertheless, it is typically well-received by those who undergo it.

Indeed, it has been argued that readier access to vasectomies and other forms of theoretically injurious birth control would be a moral good, in preventing unwanted pregnancies.

This example illustrates that:

1. The definition of "positive health outcome" appears to be quite flexible, and not at all as concrete as Plato would have us think.
2. An event that is injurious to health can be desirable, and even argued as moral.

Conclusion

Arguments for health as morality have been played out to death; they have been used variously as everything between a get-up-and-go call in self-help books, to justification for genocide.

The core refutations for this angle are:

1. Is != Ought: The classic razor against most moral prescriptivism.
2. Health is not useful to us as a comparative property (We can't compare two individuals, nor can we compare to the Ideal Form).
3. Health is not useful to us as an objective property. (The Ideal Form is incoherent because health is subjective.)

Answer 6

I'm sorry, I take issue from the first sentence (and onward):

"There is no scientific basis to say that we should value well-being, our own or anyone else’s. (The Value Problem)"

Oh, really? "scientific basis" is a catch-all straw man. Has Sam considered all the aspects of the (not defined by him) term "well-being"? Clearly not, as I, an atheist, definitely value my own well-being, whatever that is (I take the basic interpretation of the English phrase).

On top of this ribald assertion, he packs "(The Persuasion Problem)" and "(The Measurement Problem)" It all falls to the sand the argument is built on. It's obfuscation and it is bullshit.