We live under an irrational tyranny that the people in the present are more important than people in the future.
This is probably obvious: certainly, we spend much more treating diseases than it would cost to prevent the diseases in the future. Also, we experience this phenomenon in other areas of our lives; being unable to delay ‘gratification’ and going for early gains. But is it acceptable when delivering aid?
Tyranny is a strong word, but I think that it’s apt. People in the present are the only ones with a voice and a claim for resources, resources that are finite. From health to the environment we are selling those yet to exist short. Granted, people in the future don’t exist now just as people in the past don’t exist now. The difference is that our decisions now will affect people in the future. And they don’t have a say in our decisions, they live under our tyranny.
Delaying gratification is often cited as a mark of maturity and rationality. The idea of credit and investment is central to this. We would save more lives, in the long run, if we invested in future generations with the money that we spend on the present.
There is another tyranny plays out as an irresponsible bias: the tyranny of location. This has two features: tyranny of things that happen close to us (local) and tyranny of things that happen more often in one place (locality).
The first is well known and complicated by the fact that people close to us are also like us. The second, the tyranny of things happening in the same place, is different. We pay much more attention to tragedy when it is localized than when it is spread out. Bono tells us that 30,000 children have died in the last 3 months in Somalia because of the Famine. When he tells us this he does so as if this is some dirty secret that no-one wants to talk about. But we are talking about it. We’re not talking about the estimated 3,000 children that die each day from malaria, for example. That happens in their own homes and is difficult to capture within one shot. The numbers are not the issue, it is the concentration of misery which is attracting celebrity attention.
What does it mean to save a life? Or at least, what do we mean by it?
The first thing we need to do is stop and think a bit about causation. Causation, notorious in philosopher’s circles, is not normally the best way to make a clear definition. But here we are talking about a psychological interpretation of cause, as in how do we cause this or cause that, and so it is sufficient to suggest a loose picture of causation that we can accept. A very popular interpretation is, ‘if I had not done this, then that would not have happened.’ Now, beset with problems, I believe this is roughly how we each think about when we have caused and outcome, more especially when we have not caused it.
Next we need to be explicit about what we mean by ‘a life’. This is tricky because we probably don’t mean a couple of hours but we also don’t mean living until 74. There is some middle ground and I think that it is defined by our action: ‘life’ is what you get when the immediate risk to your life is removed by someone who has saved it. For example, if a nurse delivers nutrients to a child who would have died of starvation then that is a ‘life saved’ and we don’t wonder how much longer that child does actually live. You have ‘saved a life’ when in the counter factual case the person would have died but instead the person does not die from the cause of death you intervened on.
What is clear, is that it isn’t actually that clear what it really means to ‘save a life’. But I think that there is a type of apparent clarity that is associated with humanitarian work that is not found in say vaccine delivery. The psychological effect of delivering aid is to feel like you are saving lives. There is immediacy and contrast between the results of action and non-action. If you were not there, if we didn’t send food, then people would die. Saving lives, therefore, is just a matter of delivering aid. With vaccines you need to appreciate a population level effect. You might not be saving this child, or the next child, from measles but there is a vague counter factual world where more children die for lack of vaccination. There is no immediacy and no certainty of the results of your actions.
This psychology is found in all areas of reactionary care. This sense of cause and effect is motivation for working in the humanitarian industry; getting ‘out there’ and saving lives.