Why protect speech?

The U.S. Supreme Court has extended more protection for speech than other major courts that adjudicate rights, such as the European Court of Human of Rights. Nonetheless, the Supreme Court is frequently wrong about why speech deserves constitutional protection. That error has undermined the First Amendment that the Court purports to protect. Continue reading

The Why of Religious Freedom

The blogosphere has exploded over wedding cake. The Supreme Court has splattered the internet with fondant and rage. Baker Jack Phillips, who refused to bake a cake for a same-sex wedding, has achieved a modest win: human rights commissions cannot exhibit a hostility toward religion when enforcing anti-discrimination laws.

When a major religious-rights case hits the news, I’ve noticed a pattern. The outrage extends not to just the individual case but to the concept of religious freedom generally. Angry bloggers and tweeters love to insert scare quotes around the phrase “religious freedom,” as if donning latex gloves to handle toxic sludge. And the Colorado judge below certainly showed deep disdain for Mr. Phillips’ religious beliefs, which is perhaps the major reason that Phillips won. This pattern of skepticism toward religious freedom writ large signals that we should perhaps retreat to first principles. Why do religious practices and beliefs receive special treatment? Continue reading

Role of a Citizen in Hegemonic Authoritarianism

I want to begin a n-part series on Hannah Arendt. Why Arendt? Because I wrote a paper on her last semester and have been obsessed ever since. I will pick up one theme (or a sentence and sometimes just a phrase) from her work and try to either describe it in contemporary political terms or evaluate it against legal theories, political and moral. All this, I will do under the presumption that there are some political ideals like democracy, constitutionalism, liberalism that exist within the domain of possibility for polities irrespective of their legal culture. What I will also presume is that all political ideals function on a spectrum and it is difficult to accurately pin point exactly when something has turned from being tolerable to just plain rotten.

 

At various points in history, societies become obsessed over a political concept. Every once in a while, societies experience an onslaught of violations. Violations of their personal, maybe innate, sense of justice. I am not going to argue on the nature of this sense of justice. Instead, I will point towards our basest moral instincts. If you agree that there is such a thing as conscience that can not only exist but also develop outside of the legal system, you will see that it relates to how we think about what is wrong and what it right. Ergo, justice.

The violation of justice shakes things up enough for us to evaluate and figure out which political ideal, if protected, could have saved us. Against the Nazi regime it was the Rule of Law, for feminists it is Equality, against the Nanny State, it is liberty, and so on. In a bid to make amends, we compensate by institutionalizing it, giving it a place of honor in public discourse, and protesting all violations, big or small.  Every once in a while, the political concept finds a life of its own – growing differently in different parts of the world, becoming an essentially contested concept. After a point of time, the omnipresence of the principle starts to define the terms of the debate in matters unconnected with it.

Today, it is Authoritarianism. Not one where the ruler does not even wish to keep up the pretense of legality and justice but the kind which creeps up when no one is looking. Hannah Arendt was worried about the latter. She worried not just about the big bureaucratic state with its mechanical application of law and antipathy towards political moral ideals, but also about the citizen under such a regime who observed and obeyed and said not a word because the violations were too minor and too remote to care about.

The citizen who refuses to think is the power source of authoritarian regimes. One can ask if Arendt expects her model citizens to practice constant vigilance, continuously evaluating the judgements of their sovereign for potential violations of some sense of justice. After all, her theory of power is based on a conception of power working through communication and co-operation as opposed to the traditional understanding of power emanating from coercion and commands. ‘Power corresponds to the human not just to act, but to act in concert’, said Arendt. She challenges the notion of power having a mandatory connection with sovereignty.

We must take note of the existing political background to her writings. She, along with half the world, stood against the Soviet Union. Communism was not just a bad word, it was inherently evil. So strong was her position against Marx’s writings that she blamed ‘the social’ for the destruction of the political realm. The political realm was the place for public discourse. Deliberation helped in protecting freedom whereas the urge for leveling down of human life resulted in the destruction of democratic practices. However, what was most egregious was the tendency of communism to regularly violate the autonomy of the individuals.

The ‘social’ was not just a command of a sovereign, it was implicit in hegemonic structures through which obedience was guaranteed. Why is this relevant today? It is relevant for its implications on how we judge regimes. Are we to be satisfied with just a form of legality or do we want to prevent violations to whatever principle it is that we have chosen to hold dear, albeit for the century? If we choose the latter, then Arendt’s expectations from a model citizen do not seem too demanding. We must constantly sit in judgment, not just of the laws that govern us (plenty of people do that already) but of the tools of reasoning we use in our political discourse. It is our justifications and not just our positions in a political debate that catalyzes hegemonic authoritarianism.

The Impossible Trinity of Liberal Democracy

In the first part of my series on democracy published a few years ago, I made a distinction between four senses in which the term “democracy” is used. To briefly recap, I made they were: a) a term of empty political praise for policies which partisans like b) an institutional decision-making process emphasizing the primacy of majoritarian opinion c) a generic term for the type of procedures which have been prevalent in the west, and d) an overarching term for the ethical commitments of liberals. In that series, I focused on the tension b) and d), mostly ignoring a) and c). (For Present purposes, my highly speculative musings on anarchism are irrelevant.

In a recent podcast of the Ezra Klein show  (which I highly recommend) discussing his book The People vs. Democracy: Why Our Freedom Is in Danger and How To Save It, Harvard political theorist Yascha Mounk and Ezra Klein were debating how pessimistic we should be about the prospects for the future of American Democracy. I don’t really wish to comment on whether we should be pessimistic or not, but I want to make a further distinction that clarifies some of the disagreements and points towards a deeper issue in the workings of democratic institutions. I will argue that democracy consists of a liberal, majoritarian, and procedural dimension and these dimensions are not reconcilable for very long.

Mounk makes a similar distinction to the one I made between democratic majoritarianism and liberalism as a reason to be pessimistic. Klein tended to push back, focusing on the ways in which modern American political culture is far more ethically liberal than it has ever been, as seen through the decline in racism since the middle of the twentieth century and decline in homophobia since the 1990s. Mounk, however, emphasized how respect for procedure in the American political process has declined during the Trump Era, as evidenced by Trump’s disrespect for the political independence of courts and agencies like the Department of Justice.

However, throughout Klein’s and Mounk’s debate, it became clear that there was another distinction which needed to be made explicitly, and one which I have tended to heavily under-emphasize in my own thinking on the feasibility of democracy. It seems to me there are at least three dimensions by which to judge the functioning of democracies which are important to distinguish:

  1. Majoritarianism—the extent to which a democracy is sensitive to majority public opinion. Democracy, in this dimension, is simply the tendency to translate majority opinion to public policy, as Mounk puts it.
  2. Liberalism—this refers to the ethical content towards which democracies in the west try to strive. This is the extent to which citizens are justly treated as moral equals in society; whether minority religious freedoms are respected, racial and ethnic minorities are allowed equal participation in society (economically and politically), and the extent to which general principles of liberal justice (however they may be interpreted) are enacted.
  3. Legal proceduralism—the extent to which political leaders and citizens respect the political independence of certain procedures. This dimension heavily emphasizes the liberal belief in the rule of law and the primacy of process. This can include law enforcement agencies such as the Department of Justice or the FBI, courts, and respect for the outcomes of elections even when partisan opponents are victorious.

It seems that there are reasons why one would want a democracy to retain all three features. Majoritarianism could be desirable to ensure stability, avoiding populist revolutions and uprising, and perhaps because one thinks it is just for government to be accountable to citizens. Liberalism, clearly, is desirable to ensure the society is just. Proceduralism is desirable to maintain the stability of the society given that people have deep political and philosophical disagreements.

Klein and Mounk’s debate, considering this explicit triadic distinction, can be (crudely) seen as Mounk initially emphasizing the tension between majoritarianism and liberalism in modern democracies. Klein pushes back saying that we are more liberal today than we’ve ever been, and perhaps the current majoritarian populist turn towards Trump should be put in context of other far more illiberal majoritarian populist impulses in the past. Mounk’s response seems to be that there’s also been a decline in respect for legal procedure in modern American politics, opening a danger for the instability of American democracy and a possible rise of authoritarianism.

First, it seems to me that both Mounk and Klein overemphasize respect for procedure in the past. As Robert Hasnas has argued, it has never been the case that anyone treats the law as independent simply because “the law is not a body of determinate rules that can be objectively and impersonally applied by judges” and therefore “what the law prescribes is necessarily determined by the normative predispositions of the one who is interpreting it.” There is always an ethical, and even a partisan political dimension, to how one applies procedure. In American history, this can be seen in ways that courts have very clearly interpreted law in motivated ways to justify a partisan, often illiberal, political view, such as Bowers v. Hardwick. There has always been a tendency for procedures to be applied in partisan ways, from the McCarthyite House Unamerican Committee, to the FBI’s persecution of civil rights leaders. Indeed, has Hasnas argues, the idea that procedures and laws can be entirely normatively and politically independent is a myth.

It is true, however, that Mounk does present reason to believe that populism makes disrespect for these procedures explicit. Perhaps one can say that while procedural independence is, in a pure sense, a myth, it is a constructive myth to maintain stability. People believing that elections are not independent, Trump’s disrespect for the independence of courts and justice, allows for a disintegration of those institutions into nothing but a Carl Schmitt-style, zero-sum war for power that can undermine stability of political institutions.

On the other hand, it seems worth emphasizing that there is often a tension between respect for procedure and the ethics of liberalism. Klein points out how there was large respect for legal procedure throughout American history that heavily undermined ethical liberalism, such as southerners who filibustered anti-lynching laws. Indeed, the justification for things such as the fugitive slave law was respect for the political independence of the legal right to property in slaves. All the examples of procedure being applied in politically biased and illiberal ways given moments ago support this point There is nothing in the notion that legal and electoral procedures are respected that guarantees those procedures in place will respect liberal principles of justice.

I remain agnostic as to whether we should be more pessimistic about the prospects for democracy in America today than at any other point in American history. However, at the very least, this debate reveals an impossible trinity, akin to the impossible trinity in monetary policy, between these three dimensions of democracy. If you hold majority opinion as primary, that includes populist urges to undermine the rule of law. Further, enough ink has been spilled on the tensions between majoritarianism and liberalism or effective policy. If you hold respect for procedure as primary, that includes the continuation procedures which are discriminatory and unjust, as well as procedures which restrict and undermine majority opinion. If you hold the justice of liberalism as primary, that will generate a tendency for morally virtuous liberals to want to undermine inequitable, unjust procedures and electoral outcomes and to want to restrict the ability of majorities to undermine minority rights.

The best a conventional democrat can do, it seems to me, is to pick two. A heavily majoritarian democracy where procedures are respected, which seems to be the dominant practice in American political history, is unlikely to be very ethically liberal. An ethically liberal and highly procedural government, something like a theoretically possible but practically unfeasible liberal dictator or perhaps a technocratic epistocracy (for which Jason Brennan argues), is a possible option but might be unstable if majorities see it as illegitimate or ethically unpalatable to procedural democrats. An ethically liberal but majoritarian democracy seems unworkable, given the dangers of populism to undermine minority rights and the rational ignorance and irrationality of voters. This option also seems to be what most western democracies are currently trending towards, which rightly worries Mounk since it is also likely to be extremely unstable. But if there’s a lesson to be learned from the injustice of American history and the rise of populism in the west it’s that choosing all three is not likely to be feasible over the long term.

On the rift between economics and everything else

The line is often heard: economists are “scientific imperialists” (i.e. they seek to invade other fields of social science) jerks. All they try to do is “fit everything inside the model”. I have this derisive sneer at economists very often. I have also heard economists say “who cares, they’re a bunch of historians” (this is the one I hear most often given my particular field of research, but I have heard variations involving sociologists and anthropologists).

To be fair, I never noticed the size rift. For years now, I have been waltzing between economics and history (and tried my hand at journalism for some time) which meant that I was waltzing between economic theory and a lot of other fields. The department I was a part of at the London School of Economics was a rich set of quantitative and qualitative folks who mixed history of ideas, economics, economic history and social history. To top it all, I managed to find myself generally in the company of attorneys and legal scholars (don’t ask why, it still eludes me). It was hard to feel a big rift in that environment. I knew there was a rift. I just never realized how big it was until a year ago (more or less).

There is, however, something that annoys me: the contempt appears to be self-reinforcing.  Elsewhere on this blog (here and here) (and in a forthcoming book chapter in a textbook on how to do economic history), I have explained that economists have often ventured into certain topics with a lack of care for details. True, there must be some abstraction of details (not all details are useful), but there is an optimal quantity of details. And our knowledge grows, the quantity of details necessary to answering each question (because the scientific margin is increasingly specialized) should grow. And so should the number (and depth) of nuances we make to answer a question.  There is a tendency among economists to treat a question outside the usual realm of economics and ignore the existing literature (thus either rushing through an open door or stepping in a minefield without knowing it).  The universe is collapsed into the model and, even when it yields valuable insights, other (non-econs) contributors are ignored.  That’s when the non-econs counter that economists are arrogant and that they try to force everything into a mold rather than change the mold when it does not apply. However, the reply has often been to ignore the economists or criticize strawmen versions of their argument. Perceived as contemptuous, the economists feel that they can safely ignore all others.

The problem is that this is a reinforcing loop: a) the economists are arrogant; b) non-economists respond by dismissing the economists and ridiculing their assumptions; c) the economists get more arrogant. The cycle persists. I struggle to see how to break this cycle, but I see value in breaking it. Elsewhere, I have made such a case when I reviewed a book (towards which I was hostile) on Canadian economic history. Here is what I said for the sake of showcasing the value of breaking the vicious circle of ignoring both sides:

These scholars (those who have been ignored by non-economists) could have easily derived the same takeaways as Sweeny. Individuals can and do engage in rent-seeking, which economists define as the process through which unearned gains are obtained by manipulating the political and social environment. This could be observed in attempts to shape narratives in the public discourse. According primacy to the biases of sources is a recognition that there can be rent-seeking in the form of actors seeking to generate a narrative to reinforce a particular institutional arrangement and allow it to survive. This explanation is well in line with neoclassical economics.

This point is crucial. It shows a failing on both sides of the debate. Economists and historians favorable to “rational choice” have failed to engage scholars like Sweeny. Often, they have been openly contemptuous. The literature has evolved in separate circles where researchers only speak to their fellow circle members. This has resulted in an inability to identify the mutual gains of exchange. The insights and meticulous treatments of sources by scholars like Sweeny are informative for those economists who consider rational choice as if the choosers were humans, with all their flaws and limitations, rather than mechanistic utility-maximizing machines with perfect foresight (which is a strawman often employed to deride the use of economics in historical debates) . In reverse, the rich insights provided by rational choice theorists could guide historians in elucidating complex social interactions with a parsimony of assumptions. Without interaction, both groups loose and resolutions remain elusive.

See, as a guy who likes economics, I think that trade is pretty great. More importantly, I think that trade between heterogeneous groups (or different individuals) is even greater because it allows for specialization that increases the value (and quantity) of outputs.  I see the benefits of trade here, so why is this “circle of contempt” perpetuating so relentlessly?

Can’t we just all pick the 100$ bill on the sidewalk?

Leftism = Victim blaming

Trying his best to become a martyr, former President Lula didn’t surrender to the police as it was stipulated by judge Sergio Moro.

Lula and his gang stole billions of dollars from the Brazilians. Now, all of a sudden, the left is worried about the rule of law.

Lula wanted to surrender Brazil to the interests of Foro de São Paulo, a supranational organization whose aim is to transform Latin America into a new USSR. Now, all of sudden, the left blames judge Sergio Moro for destabilizing Brazil’s democracy.

The only faction responsible for Brazil’s predicament is Lula and his gang. Thanks, judge Sergio Moro and his team for giving Brazilians a glimpse of hope.

The President’s commission on opioids (2/2)

Here’s the second half of an abridged essay I wrote for a public policy course. First half is here, and next week I’ll write about the FDA’s new enemy, kratom.


 

Epidemic status

The DEA’s 2015 declaration of an opioid epidemic was the first sign of large-scale federal attention to prescription analgesics, to my knowledge. On the CDC’s official glossary, “outbreak” and “epidemic” are interchangeable: “the occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.”

The classification of addiction as a disease is sometimes controversial. (See also Adam Alter’s Irresistible for a popularized form of the psychological takes on addiction.) For the opioid problem to be an epidemic, the focus must be the addition rate, and not the overdose or death rate alone. The federal government usually refers to the opioid situation as an epidemic or emergency (which presupposes a value judgment), and when media has covered it (as with the deaths of Philip Seymour Hoffman, Heath Ledger and Prince) they use the same language. One definitive media moment might have been last year, when John Oliver announced for a young progressive crowd that “America is facing an epidemic of addiction to opioids.”

Oliver was referring specifically to addiction — criticizing companies like Purdue Pharma (creator of OxyContin) for misleading or misinformative advertising about addictiveness. But usually it does not seem like the focus is on addiction. As stated, nonmedical usage of opioids is generally down or stabilized from the last couple years, and the problem is mostly overdoses. (True, these are intimately connected.) This might indicate that cutting the pills with other drugs or general inexperienced use are greater problems than general addiction. So, there is an epidemic in the colloquial usage — extensive usage of something which can be harmful — but only questionably in the CDC’s medical definition, as the usage rates are expected to be up as synthesized morphine-, codeine- or thebaine-based pain relievers diversified, and these have mostly stabilized except for heroin (thought as often beyond opioid status) and fully synthetic derivatives which get less attention (fentanyl, tramadol).

Why the standard of abuse fails

John Oliver — worthy to talk about because much of the public plausibly started paying attention after his episode — noted that the pills are assigned to patients and then, even if the patient doesn’t develop an addiction, they end up in the “wrong hands.” What happens at this point? The Commission recommends that companies design their prescription drugs for “abuse-deterrent” formulations (ADF). After spikes in opioid abuse, Purdue Pharma and other companies began researching mechanisms to prevent abusers from easily obtaining a recreational high by tampering with the pill or capsule. In a public statement, FDA commissioner Scott Gottlieb asserted that the administration’s focus is on “decreasing unnecessary exposure to opioids,” but, recognizing the real role that prescription opioids play in pain relief, Gottlieb continues that “until we’re able to find new nonopioid forms of pain management … it’s critical that that we also continue to promote the development of opioids that are harder to manipulate and abuse, and take steps to encourage their use over opioids that don’t offer any form of deterrence.” Some of these abuse-deterrent options are crush resistance or wax coating to make dissolving more difficult.

However, opioid abuse comes in two forms which are conflated by the legal language. The first is when a patient takes more than their recommended allocation or takes it in the wrong way. The second is when someone with or without a prescription consumes them purely for recreation. Many drug savvy abusers of the second variety have adapted methods to get a recreational high but avoid potential health risks, the most popular method being “cold water extraction” (CWE). Most opioid pills contain both a synthesized opium alkaloid (from morphine, codeine or thebaine) and acetaminophen: Percocet contains oxycodone and paracetamol; Vicodin contains hydrocodone and paracetamol. The acetaminophen or APAP has no recreational benefits (a pure pain reliever/fever reducer) and can cause severe liver problems in large quantities, so recreational users will extract the opium alkaloid by crushing the pill, dissolving it in distilled water, chilling it to just above freezing, and filtering out the uncrystallized APAP from the synthesized opium. This way a greater quantity of the opioid can be ingested without needlessly consuming acetaminophen. Other recreational users that want less of the opium derivative can proceed without CWE and insufflate or orally ingest the particular pills.

ADFs might be able to dent the amount of abusers of the second variety. If the pills are harder to crush (the route of Purdue’s 2010 OxyContin release) or, for capsules, the interior balls are harder to dissolve (the route of Collegium Pharmaceutical’s Xtampza), amateur or moderately determined oxycodone enthusiasts may find the buzz is not worth the labor. As the Commission observes, more than 50% of prescription analgesic misusers get them from friends and family (p. 41) — these are not hardcore aficionados, but opportunists who might be dissuaded by simple anti-abuse mechanisms. Abusers of the first variety, though, are unaffected: at least in the short term, their abuse rests on slightly-over-the-recommended doses or a natural tendency to develop an addiction or non-medical physical dependency. And, if the political core of the opioid emergency is patients that develop an addiction accidentally (those that stay addicted to pharmaceuticals and those that graduate to heroin), abuse-deterrent focuses are unlikely to create real change in addiction rates. It could even have the unintended consequence of higher overdose deaths for amateur narcotics recreationalists, who aren’t skilled enough to perform extractions and opt to consume more pills in one sitting instead.

And furthermore, ADFs can be incorporated into the naturals and synthetics that are usually bonded with APAP like codeine, oxycodone, hydrocodone and tramadol, but cannot for the drugs that come in pure form like heroin or fentanyl. And those are the problem drugs. The NIDA research on drugs involved in overdose deaths across the board, for one, shows that overdose deaths are on the rise as a whole (except for methadone), and also that the synthetic opioids are much more deadly than the naturals and semi-synthetics: fentanyl is the biggest prescription analgesic killer (it’s much more potent than morphine, and tramadol is not very good for recreation).

drugoverdosedeaths

(This graph also shows, however, that the natural/semi-synthetic usage rate was possibly leveling out but resuscitated in 2015.) So ADFs are useless for the drugs most massively causing the “opioid epidemic.” Making them harder to abuse only dents the second category of abuser, and does not limit their addictiveness for those prescribed them for postsurgical pain or otherwise.

Moreover, from a libertarian standpoint, the second category of abuser does not really belong in the “public health crisis” discussion. Those who knowingly consume opioids for recreation are not a problem, they are participants in a pleasure-seeking activity that doesn’t tread on others. So long as their costs are not imposed on other people, it might be better to separate them from the “epidemic” status. Blurring the lines between the groups that fall under “abusive” means that those with a side-interest in OxyContin on Friday nights are lumped in with addicts suffering from physical dependency. Someone who has a glass of wine each night is not “abusing” alcohol, but we can recognize someone who is an alcoholic; the same distinction should be applied medically to opioid users. By painting all consumers outside of direct medical usage as “abusers,” there can be no standard for misuse, and thus no way for a recreationalist to know how much is too much, when health problems might set in, if they are really trapped in their recreation, etc. Research and knowledge are threatened by the legal treatment and classification.

Conclusion

To summarize, the government terminology of “abuse” obscures a legitimate distinction that is justified on both medical-political and civil liberty grounds. Some of the approaches in the Commission report, like the market-based CMS package recommendation, will likely succeed at quelling opioid exposure (and thus addiction and overdoses), while other maneuvers like an education campaign or ADFs should be treated with cautious skepticism. The trends show that heroin and fentanyl are actually the biggest contributors to the opioid epidemic, although semi-synthetics are climbing again in overdose deaths after leaning toward stabilization two years ago. Evidence that prescription abuse and street use are linked, as well as testimony from former addicts, indicates that drug users easily swing between the legal and black market.