Against Sacrifice

This book is directed at the sort of raw utilitarian approach to making hard choices in public life which uses in one form or another the idea of the cash value of a human life. This arises with the use of so-called QALYs in Health Economics and spending caps in Health and Safety at work. These are often forced choices, forced by ethical decisions taken at the centre but then outsourced to the harsh frontiers of ethics. They go hand-in-hand with pernicious attitudes which blame the victims or thinks of them simply as collateral damage. The ethics of war should not be used in peacetime, with loaded words like “proportionality”. The response should be to value life itself and the human qualities of empathy and imagination, requiring us to listen to the narratives of victims. The best option is to remove the hard choices wherever they occur but if that is impossible give generous and swift compensation. The central message is that it cannot be part of the “public good” to sacrifice someone for the public good. That happens with vaccination, but in the long run is not acceptable. We need safer vaccines, better intensive care and so on. These ideas can be captured in the terms “duty of care” and “deliberative democracy”. Every regulator and agency which has power over human life should have duty of care written into its constitution and we need new forms of democracy to debate the issues, particularly within communities. The essay draws on the community-based and experimental ideas of the great American Pragmatist, John Dewey.