Friday, November 03, 2006

Obesity, Wireheads, and the case for and Against Paternalism

I'm currently working on a chapter of my book Future Imperfect dealing with mind drugs. It occurred to me, listening to a lunch talk by a colleague, that the issue I am raising there is central to the most recent of the World's Great Problems—obesity, which I discussed briefly in an earlier post.

Suppose we come up with really good pleasure drugs, drugs that give us lots of pleasure without negative side effects such as hangovers or cirhosis of the liver. If we accept the economist's model of the rational actor, their invention is clearly a good thing. It expands our choice set, provides us one more and possibly better way of getting what we want.

To people sceptical of the rational model, that conclusion is less clear. To see the problem, consider an extreme version. Larry Niven, in some of his stories, describes wireheads, people who have had a wire inserted into the pleasure center of their brain and stimulate it with a mild electric current. The intense pleasure that results dominates all other concern, making it possible for a wirehead to die of hunger and thirst because getting food or drink is simply more trouble than it is worth.

For a more homely example, consider a pleasure drug that many of us overdosed on a couple of days ago: Chocolate bars. If you have more elevated tastes, substitute dinner at a four star restaurant in Paris. While it is true that food is useful to keep us alive, sufficient food for that purpose--lentils, powdered milk, vitamin pills, rice or potatoes--does not cost very much or taste very good. Most of what we spend on food buys pleasure. In modern societies, calories, even moderately tasty calories, are cheap. People like to eat. Voila: An obesity "epidemic."

I would like to be thinner, but am not very good at getting that way. Considering the situation as an economist, I conclude that the benefit of lost weight must be less than the cost. Introspection provides a less complimentary picture of my role in the situation. It looks rather as though I am, like Niven's wireheads, irrationally willing to sacrifice my own long term welfare to my own short term pleasures.

For a different angle on the situation, consider a question I raised in another recent post: Does consumer sovereignty, the principle of accepting individual actions as proof of what we value, apply if we have good reason to regard the actions as due to evolutionary mistakes, adaptations to a past environment very different from the one we now live in? In most past environments, after all, eating when you had the chance, eating enough to get fat, was a sensible strategy, since next month might be famine. From an evolutionary standpoint, current obesity is simply one more case of humans being poorly adapted to their current environment.

Following out the logic of that argument, one would conclude that greater choice sometimes makes us worse off. If so, is that an adequate reason to abandon libertarian conclusions—to, for example, support government restrictions on fat in food, cheap junk food in restaurants and grocery stores, and the like. Is it a good argument, following out the line other economists have taken with regard to gasoline, to support high taxes on food, designed to force consumers to compensate for their irrational tastes?

If we had a government run by benevolent philosopher kings, that might make sense. The problem with it in the world we live in is that although I may sometimes be a bad judge of my own welfare, sometimes even a bad judge in predictable ways--arguably the central point of behavioral economics--I have one enormous advantage over any one else when it comes to making decisions about my own welfare. Unlike almost everyone else in the world, I can be trusted to put my own welfare very high in my priorities. Once we shift the decision to someone else, however rational, we can expect him to make decisions for me in his interest rather than mine.

Which brings us back to an old libertarian argument—for certifying doctors instead of licensing them. Patients, however rational, are imperfectly informed about the competence of doctors. Why not solve that problem by having some competent authority decide which physicians are allowed to practice? That is the theory of medical licensing as it now exists. The practice, as shown long ago, is that the medical profession uses licensing to hold down the number of physicians, sometimes in ways unrelated to their professional competence. That is why it would be better to allow the competent authority to certify doctors, telling patients whether that authority considers them competent, and then let the patients decide for themselves whether to accept the authority's judgement.

If you do not find that claim convincing, you might consider the wide range of other professions that also require licensing—yacht salesmen, egg graders, barbers and the like. It would be a curious coincidence if it turned out that medical licensing existed, and functioned, for wholly benevolent purposes—unlike every other example of professional licensing.

19 Comments:

At 4:18 AM, November 04, 2006, Blogger Mike Huben said...

Here's the crux of your dilemma, David. "Once we shift the decision to someone else, however rational, we can expect him to make decisions for me in his interest rather than mine."

Essentially, you're saying that because we cannot expect perfect behavior from actors acting on our behalf, we shouldn't use them where ever libertarianism is offended.

The heck with whether there's evidence that the benefits exceed the costs in real world experience. Your suspiscion overrides any possible validations, any feedback systems, any other measure of the real world.

As I say in my Libertarianism in One Lesson, "Require perfection as the only applicable standard to judge government: libertarianism, being imaginary, cannot be fairly judged to have flaws."

 
At 4:18 AM, November 04, 2006, Blogger Mike Huben said...

This comment has been removed by a blog administrator.

 
At 5:51 AM, November 04, 2006, Anonymous Anonymous said...

Is it a good argument, following out the line other economists have taken with regard to gasoline, to support high taxes on food, designed to force consumers to compensate for their irrational tastes?

No. The reason why is that there is no "average" against which to measure what "normal" should be. I'm probably an extreme example (but, hey, the personal is political, right?). I have a very high metabolism, almost pathologically so, or so the doctors have told me. I eat about 4K calories a day in order to maintain a 6ft/155Lb. frame, and I'm not that active (I try to stay in shape, but not very well, and I'm a desk jockey by trade.)

Meanwhile, my partner eats very little, because she puts on weight easily.

If I were taxed for eating for two, I would see that as a severe injustice. Not to mention that it would encourage "food embezzling", for instance, between me and my mate. Should the IRS police eating habits?

I do suspect that soon, the ability to control one's self for radical shifts in environmental, social, and economic attributes will be favored. I don't think government can teach adaptability.

 
At 10:25 AM, November 04, 2006, Blogger Lester Hunt said...

Mike Hubin misses David's point, which is not that other-control is imperfect (by some non-comparative standard) but that other-control is less effective than self-control. And we know a lot about both sorts of regime because we have a great deal of experience with both. David is right, as usual.

Actually, I think other-control is even worse than David makes it sound. When others control me, I have noticed, they often aren't even trying to promote their own rational self-interest (at least as we would intuitively think of it). They often are trying to make me do what is "right" (not use drugs, not use hate-speech, not carry a hand-gun, etc.). One trouble with this sort of decision-making is that it does not set up any feed-back mechanism that would cause the controller to change his or her policy. If they were trying to exploit me economically then at least they could look at the bottom line and see whether they are making any money off of me. But if the decision was made just because it was "right," why, no amount of bad stuff that happens either to me or to them would prove them wrong. If I am unhappy with my drug-free life or get killed because I didn't have a gun, those are just some of the costs we have to pay on order to do our duty!

 
At 4:01 PM, November 04, 2006, Anonymous Bryan Eastin said...

There is a wonderful maxim that I once found while searching the web for the meaning of life. To quote the folks at aristotle.net, “The World Doesn't Want to be Saved.”

This is, I think, a very deep and accurate truism.

I could list off volumes of supporting examples, from fools and sinners to bigots and gluttons, but I'm sure you could too, so I won't. Instead I'll say that I don't see any point in trying to force salvation on people who actively don't want your help. Where is the value of human life if not in the ability to make decisions about what you do and do not want, even “bad” ones?

In response to Mike's comment, I would argue that a very convincing case can be made for David's claim that individuals are better maximizers of their own welfare than institutions. An informal poll of acquaintances seems to indicate that people place their own happiness very high on their list of priorities, while an informal poll of governments yields no such clear cut results.

But even putting aside matters of intent, there are tremendous practical problems with paternalism. How is a government to judge what would make a person most happy, and furthermore, how is it to enforce that judgment without engendering greater problems than it sought to correct? Most parents have a pretty mixed record on this account, and they are in a much better position both to control and evaluate their children.

In general, I think that paternalism in government should be limited to that least intrusive form of parenting, the giving of good advice. The great thing about advice is that it improves the odds of “sensible” behavior while still allowing people to make their own decisions. Labeling, non-mandatory guidelines, and certification all fall into this category.

Of course, everything I've said up till now assumes that an individual's actions affect only themselves. The real value of government is in finding a way for large groups of people to coexist. It is on this point that I think there is a major difference between gasoline consumption and food consumption. I do not consider gasoline taxes to be a sin tax. We don't tax gasoline because we think that individual drivers are in a poor position to decide how much gas would make them happy; we tax it because we don't think individual drivers care much that their usage causes problems for others. A food tax would have much more in common with cigarette, liquor, and gambling taxes, where the primary impetus behind taxation is that we've decided people ought not to be using/doing such things. In my opinion, one of the better (though still not convincing) arguments against universal health care is that it would give the government a much more legitimate reason to regulate all sorts of behavior.

 
At 6:18 PM, November 04, 2006, Anonymous Arthur B. said...

First of all, what if we could come up with a perfect drug, with no negative side effects? First of all people would be extremely warry of such a drug, an old Judeo-Christian reflex that tells you you cannot get something good without suffering to get it. This is a good cultural strategy on an evolutionnary point of view since its often right, but obviously not only. See how much suscipsion there has been around diet soft drinks for example.
The wirehead is not a side-effect free drug as it overrides the eating instinct, so it does not fit your description. That is knowing that we may choose to die of hunger after using this device we will want not to use it knowing ex ante that it will affect our will...
People are very often paying for others to control their will and I think there's nothing wrong with that... a drug junkie can rationnaly ask friends to lock him up in order to get rid of his addiction... But not need to look that far, people are very often engaging in financial investments for the only purpose of destroying liquidity! Buying real estate for example or locked-in fund shares is often a way to bind oneself and guarantee that we will not be tempted to spend our savings. Similarly, we can rationnaly ask a Casino to forbid us entrance (in some countries Casino provides this service privately, not the state).
I remember seeing ads in NYC a few years ago for a gym trainer that wouldn't be buying your excuses :). There's also a novel, by Stephen King I believe, where a company offers to help you quit smoking and do it by threatening to kill you if you smoke again ever. Actually many smokers support raises in tax of tobacco as a way for them to pay to control their own addiction. There's a market for holding will in trust and no need for a government to do that... Of course we can think of Rothbard's inalienability of human capital and argue that this wrong and so on but it'd be foolish to refuse to see that there is a factual need for these services in the free market... we can argue that will is not really alienated, it is put in trust and we can espace anytime... you can still give up your gym membership but while you have it you may want to "pretend" that you have to obey the orders of a trainer without being a slave... The same thing exist I believe in SM fantasies where each party remains free but like to pretend submission. The same thing also exist regarding parental authority, as most children are really free but will voluntarily submit to authority even though when it appears to be against their will.
So when will the next generation of super-dominating-but-not-for-real-dieteticians spawn ?

 
At 6:37 PM, November 04, 2006, Anonymous albatross said...

Wouldn't another way to look at professional licensing be to say that it's sometimes valuable, but that a good idea gets hijacked for bad reasons sometimes? That is, maybe licensing doctors is such a good idea that it has great arguments behind it, and florists (say) decide to try using parallel arguments so they can get an unnecessary licensing scheme to exclude competition. Similarly, maybe licensing doctors is a good idea, but there's the risk of regulatory capture, where the licensing scheme gets turned into a competition-exclusion scheme.

I'm not sure whether it's true that licensing doctors is a good thing. But I'm also not sure that the existence of misuses of either doctor-licensing or florist-licensing is an argument against it. By the same token, most libertarians think government is a fundamentally necessary thing whose features have been hijacked to do all kinds of goofy things. That doesn't obviously mean that government is bad; perhaps it simply means it needs to be tightly restricted in size and power.

 
At 6:42 PM, November 04, 2006, Anonymous albatross said...

I think the paternalism issues get caught up in the dispute between thinking in terms of rights and in terms of utility. Imagine the ability to magically get rid of all the world's heroin, cocaine, meth, etc., and make it impossible to get any more. Using that ability would be paternalistic--it would make other peoples' decisions for them. If we think in terms of rights, I think we'd conclude that it was wrong to use that ability. If we think in terms of utility, I suspect (though maybe I'm wrong) we'd decide to use the ability, because the pleasure from the drug is overwhelmed by the suffering of both addicts and others.

 
At 5:32 AM, November 05, 2006, Blogger Mike Huben said...

Lester and Bryan, you are both missing the forest for the trees: property, rights, and thus markets are all based on "other control", on government prohibitions.

"Other control" (a cacaphonous term) and paternalism (a loaded term) are part of a continuum between the government policies you cherish (such as stable property) and the government policies you despise. The question of whether a policy brings about a net benefit or not is EMPIRICAL: even markets and liberal property had to pass that test.

Friedman's jawboning about agent interests serves to remind us that the test is important, but it hardly disproves anything except credulous certainty.

Most of the other arguments here have to do with the granularity of decision making. Government-made decisions have different information costs than individualy made decisions, consequently we'd expect different information to be used by each. This would give different decisions with different utility. Which total utility is higher is (once again) an empirical question.

 
At 8:34 AM, November 05, 2006, Blogger Lester Hunt said...

"Government-made decisions have different information costs than individualy made decisions, consequently we'd expect different information to be used by each. This would give different decisions with different utility. Which total utility is higher is (once again) an empirical question."

So is whether water runs downhill. That doesn't mean there are no well-grounded generalizations to be made here.

 
At 9:05 AM, November 05, 2006, Blogger Jim said...

A spell checker would fix cirhosis and judgement. We don't need government licensing of bloggers.

 
At 10:43 AM, November 05, 2006, Anonymous Bryan Eastin said...

Mike, you are making wonderful, cogent arguments, but they seem to be directed at some idealized libertarian straw man. As an example, please note that I am not actually a libertarian. By political affiliation I am currently a democrat. In very brief summary, what I was saying is, “In cases where an individual's actions harm only themselves, government intervention should be limited to education.”

I feel this way because I (like, I think, most people) do not respond well to somebody else telling me what is good for me, and, moreover, I think it is a very dubious claim that I am less well equipped to make that call than a completely indiscriminate ordinance based on questionable motivations.

So far as empirical evidence goes, what evidence exactly do you refer to? Are you in possession of rigorous studies showing that happiness is increased when, say, the tax on tobacco is raised? If so then you could at least make an argument that cigarette taxes are a good thing. (Though, perversely, you might find that people prize freedom of action even above happiness.) The whole point of this discussion is that empirical measures like health, lifespan, and productivity are difficult to relate to the elusive notion of happiness. If I am killing myself with booze but I'm happier doing that than not, then that is my business. You may note, correctly, that my health would be better if I didn't, but that is completely beside the point. Not killing myself with booze is preferable as measured by your evaluation, not mine.

In the interest of fairness, let me restate some valid points you made and add my own two cents.
1. Just because something isn't perfect doesn't mean we should abandon it. - Here, here. Life would be brief if we subscribed to this. There's a difference between slightly imperfect and fundamentally flawed however.
2. Evidence should be considered when making decisions. - Absolutely. But that goes for you too. Using the word “evidence” or even “empirical” is not evidence. It's also pretty important to think about what your evidence proves and whether it's even related to the question at hand.
3. Ideologies assume perfection and then trumpet their superiority to imperfection. - No argument there. Pure ideology = bad.
4. The government is the enforcer of property rights and contracts and our bulwark against coercion. These things are vital to the libertarian ideal. - Completely true.
5. The arguments on this blog are not a proof. - No. They're not.

Arthur, I guess this is rather off topic, but I would argue that both intimidation and threats are a very real part of most people's childhood. The fact that we think of children as free doesn't change the reality that parents have the power to hurt them bodily and deny them almost anything, and, from a child's perspective, seem preternaturally cunning. Suppose you were “free” but you were hurt and/or deprived whenever you angered your guardian who was much more clever than you and actually knew their way around the system that you would have to appeal to in order to get away from them (assuming you knew the system existed). There are a lot of things mixed in with parenthood, both good and bad, but coercion is certainly one of them.

Your wirehead point reminds me of something that someone once told me about heroin. When I asked them what it was like they said, “I can understand why people get addicted to heroin. I can't deal with that.” When I asked them what they meant they replied, “It just feels so good.”

Albatross, you raise a good point. I'm not sure if I'd magically wish away drugs even if given the option. I guess I'm a strong proponent of letting people find their own damnation or, as you put it, in rights. Law is for handling the cases when peoples rights conflict.

 
At 3:05 AM, November 06, 2006, Blogger Mike Huben said...

Bryan, in case you didn't notice, my arguments are not directed at some straw man, but at the very real libertarian ideologue David Friedman. Who does use straw men such as "If we had a government run by benevolent philosopher kings, that might make sense." What my arguments are aimed at showing is that we can have real benefits without straw man requirements, and indeed we do with the institution of property, markets, courts, etc by government. Also with government programs that address major market failures such as roads, public health, education, and a host of other goods.

We gain plenty of evidence in the widespread experimentation in provision of these government regulations and services by assorted government bodies. Even without explicit measurement, it is obvious that most government programs are plausibly beneficial. (We can agree on some obvious exceptions such as the drug war.)

Your booze example ignores the major externality of families: individual excess strongly affects other family members in terms of wealth, care, and violence. Your happiness is not the only factor: your family's is also.

So when do "individual's actions harm only themselves"? Perhaps a lot less often than libertarians would have you notice. And more significantly than you might think at first.

 
At 3:24 PM, November 06, 2006, Anonymous Bryan Eastin said...

Mike, and so it comes down at last to a simple difference of opinion. In my opinion, a person's job is not to make other people happy. It is a wonderful goal, but one you are free to choose or not choose as you see fit. People are individuals first and foremost; you should be free to engage in any activities that do not interfere actively and tangibly with others. To argue that every person's actions affect everyone else is accurate but just as spurious as arguing that the world isn't perfect. I could replace the phrase, “harm only themselves” to “minimally harm non-participatory parties” where minimal here relates to the amount of offense versus the offense of preventing it and participatory refers to people who choose to associate with you. Pissing off your family, ruining your marriage, or messing up your job do not qualify as reasons to criminalize your behavior. Your family can disown you, your wife divorce you, and your employer fire you. If they put up with you anyway then that is their own choice based on their judgment of what would make them happy. People are not subservient to society. Society is a means, not an end.

To expand on “harm only themselves”: It irritates me to see people driving hummers; I think it's wasteful. Drivers of hummers harm me by, if nothing else, making me angry. They are also a good approximation to the “harm only themselves” category, since the amount of harm they do to me is very small compared to the harm that would be done to them by forcing them to buy sensible cars. For an example of participatory parties, consider my father. My father doesn't take care of himself, and I will be really crushed if he dies. By ignoring his health he harms me, but I have chosen to care about him and be involved with his life. Forcing him to live in an approved manner would harm him in a non-voluntary way.

You denigrated David for declaring that there are no perfect rulers, yet you happily assailed me by declaring that no one exists in a vacuum. Each of you could defend yourself by saying that you really meant that the world was a long way from the ideal in question. That would be a perfectly good defense; writing is about conveying ideas, not pedantic technical perfection.

With regard to government regulations, the word “obvious” is not an argument. It's a statement of belief. There's a joke among students that when you get to the hard part of a mathematical proof you write “obviously” and then the answer you were shooting for. Personally, I prefer to write “miracle”, but that doesn't seem to be as convincing.

If you want to debate you should present some evidence above and beyond your conclusion. I do not feel that it is at all obvious that most or even many non-advisory paternal laws are desirable. Once again, what we mean by paternal here is that the primary function of the law is to protect you from yourself. The ones that come to mind are laws pertaining to: drugs, prostitution, gambling, usage of (as opposed to availability of) safety equipment, legal approval of medication, licensing, suicide, body modification, and dangerous sports. In my opinion the most defensible of these is FDA approval since you can argue that many people are really not equipped to understand the issues involved in making informed decisions about medication. I can also tell you, however, as a person with a serious chronic illness, that drug approval is not a strictly beneficial process. People die for lack of medication, and those of us who wait on the edge of our seats for the FDA to reach a decision often feel that we would rather be allowed to think for ourselves.

Well, surely I'm up to four cents by now. I promise to quit lecturing for a while. Happy election everyone.

"I distrust those people who know so well what God wants them to do because I notice it always coincides with their own desires.”
-Susan B. Anthony

 
At 5:28 PM, November 06, 2006, Blogger Mike Huben said...

Prick an ideologue, and wait for the bang.

I didn't state an opinion about "a person's job" or what is "first or foremost": I pointed out that David used a straw man and that your booze example was a classic case of ignoring important externalities. So we don't have a difference of opinion: we have you spouting yours.

You point out that "Pissing off your family, ruining your marriage, or messing up your job do not qualify as reasons to criminalize your behavior." And indeed, none of those three are criminal behaviors right now. So why are you raising these straw men? However, driving while drunk, assaulting your family, and neglecting to support them (as may be required by law) are real, common externalities of drinking. And those are often criminalized. It is also legitimate to help reduce criminal behavior through regulation to help prevent it.

"... you happily assailed me by declaring that no one exists in a vacuum." No I didn't. I specifically addressed your example with direct and important counter evidence showing it to be badly wrong.

"...what we mean by paternal here is that the primary function of the law is to protect you from yourself." Paternal laws do far more than that: they allow others to rely more on you, which has huge productivity (and happiness) benefits. For example, it might be nice if you don't contract HIV/AIDS through your spouse's illicit sexual or drug activity.

"If you want to debate you should...." I'll be happy to take debate advice from you when you learn to quote what people actually said and address that, rather than paraphrase it into a strawman that you can attack.

 
At 8:57 PM, November 06, 2006, Blogger Michael Duff said...

Delighted to see you with a blog. Your thoughts are particularly well suited to this format.

I'd like to suggest a post if you haven't already done it.

What five things have you changed your mind about in the past ten years?

 
At 9:33 AM, November 07, 2006, Blogger markm said...

"Imagine the ability to magically get rid of all the world's heroin, cocaine, meth, etc., and make it impossible to get any more. Using that ability would be paternalistic--it would make other peoples' decisions for them. If we think in terms of rights, I think we'd conclude that it was wrong to use that ability. If we think in terms of utility, I suspect (though maybe I'm wrong) we'd decide to use the ability, because the pleasure from the drug is overwhelmed by the suffering of both addicts and others."

The problem with getting rid of "abused" drugs in terms of utility is that there's no clear dividing line between those and drugs that are very useful medically. In a report by the Florida medical examiner's office, many prescription drugs cause more deaths than heroin.

http://blogs.salon.com/0002762/2006/11/07.html#a1871

Would you save lives by getting rid of just the drugs on that list with few, if any, medical uses? No, cocaine and heroin users would simply switch to stolen or black market prescription drugs. IMO, a possible slight reduction in OD's would be outweighed by patients selling medication they truly needed, patients getting mugged, and drugstore holdups... A lot of users already have switched to unapproved doses of prescription drugs. For instance, #2 on the list is methadone - which is prescribed as a treatment for heroin (#13) addiction. Methampetamine or closely related substances are prescription stimulants. We already know how banning alcohol works...

 
At 9:38 AM, November 07, 2006, Blogger markm said...

"However, driving while drunk, assaulting your family, and neglecting to support them (as may be required by law) are real, common externalities of drinking." Technically, driving badly while drunk is the externality. Criminalizing driving at all while drunk is how we try to reduce that externality, even though some people are better drivers with .08 blood alcohol than I am stone sober and tired from a long day at work.

 
At 1:40 PM, June 02, 2012, Anonymous Anonymous said...

what a crock of shit, you negate free will and the ability to realize that is what is going on. You devalue humans to the level of semi-concious beasts.

Put the donut down, step away from the big gulp. And eat like humans are supposed to eat, fresh fruit and vegetables and meat, fish and fowl. Chicken is cheap and so is spinach ditto mustard greens and kale, zucs are rock bottom and oranges, apples and bananas cost less than a big gulp.

 

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