How Many Kidneys Does Sam Harris Have?

Why Refuting Moral Skeptics Is Not Enough

Science, Sam Harris tells us, can answer moral questions. At one level, his argument is unassailable. But at another level, it illustrates why no one believes atheists when they say there can be an objective secular morality.

According to Harris, the separation of facts and values is an illusion. Values are simply facts about the well-being of conscious creatures. No one can honestly deny that well-being is better than than suffering, and that there are facts about what constitutes well-being and what constitutes suffering.

Sure, well-being isn’t a fully defined concept, but neither is health. And just as we know the difference between food and poison, so we know that, for example, the life of the Dalai Lama is better than the life of Ted Bundy. Science may not be able to answer every moral question, but to treat all moral questions as matters of opinion is senseless and unjustifiable.

There is something right about this. Everyone knows on some level that some things are better than other things. Reality beats us over the head with this fact from birth. The most committed moral relativist makes moral judgments all the time. The secular left, for example, does not refrain from denouncing white nationalists on the grounds that their “culture” is equal to every other, nor do they say that it’s a matter of opinion whether we should help the needy.

But demonstrating that moral relativism can’t be right is no way sufficient for establishing what is right. Knowing that Auschwitz is worse for human beings than America is far different from being able to prove that capitalism is good. And while we may be able to gain universal assent to the proposition that the Dalai Lama is morally superior to Ted Bundy, this tells us almost nothing about how to make decisions about how to live our life.

To illustrate just how inadequate Harris’s moral framework is, consider this question: do you have a moral obligation to donate your kidney to a stranger? If your moral approach cannot give a clear-cut answer to this question, then you don’t have a moral approach.

Exhibit A: An Effective Altruist Donates A Kidney

Scott Alexander of Slate Star Codex recently wrote about his decision to donate his left kidney to a stranger. The initial inspiration, he says, was a Vox article where Dylan Matthews explains his decision to give his kidney to a stranger, “and why you should consider doing it too.” Alexander quotes Matthews:

As I’m no doubt the first person to notice, being an adult is hard. You are consistently faced with choices—about your career, about your friendships, about your romantic life, about your family—that have deep moral consequences, and even when you try the best you can, you’re going to get a lot of those choices wrong. And you more often than not won’t know if you got them wrong or right. Maybe you should’ve picked another job, where you could do more good. Maybe you should’ve gone to grad school. Maybe you shouldn’t have moved to a new city.

So I was selfishly, deeply gratified to have made at least one choice in my life that I know beyond a shadow of a doubt was the right one.

All of this resonated with Alexander. He pored over the research about the risks of kidney donation and the scale of the benefits to others. Eventually, he decided to give away his kidney. When a doctor asked him why he was doing it, Alexander answered: “Have you heard of effective altruism?”

Effective Altruism is the view that you should “do the most good.” How do you know you’re doing the most good? You must, argues leading Effective Altruist spokesman William MacAskill, use “evidence and reason to figure out how to benefit others as much as possible” and take action on that basis.

If that sounds straightforward, you aren’t familiar with how Effective Altruists think. Most people think they’re being altruistic whenever they do something good for others without any expectation of getting something in return. That’s wildly insufficient for an Effective Altruist. They are committed to calculating the greatest overall good they can possibly do for others, and it turns out these calculations are not only difficult, but can lead to some bizarre results.

Alexander, for example, calculated that a kidney donation “produces about 10 - 20 extra quality-adjusted life years.” That sounds pretty good.

But it only costs about $5,000 - $10,000 to produce this many QALYs through bog-standard effective altruist interventions, like buying mosquito nets for malarial regions in Africa. In a Philosophy 101 Thought Experiment sense, if you’re going to miss a lot of work recovering from your surgery, you might as well skip the surgery, do the work, and donate the extra money to Against Malaria Foundation instead.

On a strict cost/benefit analysis, Effective Altruism would call for malaria nets, not kidney donations. But this sort of calculation has a downside:

Obviously this kind of thing is why everyone hates effective altruists. People got so mad at some British EAs who used donor money to “buy a castle”. I read the Brits’ arguments: they’d been running lots of conferences with policy-makers, researchers, etc; those conferences have gone really well and produced some of the systemic change everyone keeps wanting. But conference venues kept ripping them off, having a nice venue of their own would be cheaper in the long run, and after looking at many options, the “castle” was the cheapest. Their math checked out, and I believe them when they say this was the most effective use for that money. For their work, they got a million sneering thinkpieces on how “EA just takes people’s money to buy castles, then sit in them wearing crowns and waving scepters and laughing at poor people”. I respect the British organizers’ willingness to sacrifice their reputation on the altar of doing what was actually good instead of just good-looking.

But, according to Alexander, doing what is “actually good” instead of what’s “good-looking” exacts a high psychological toll on Effective Altruists, in two ways.

One way is that they worry that they’re lying to themselves. Are they really trying to the most good—or are they just rationalizing doing good by easy things?

The other way is that it’s really hard to do what’s good and have everyone hate you for it. Donating his kidney solved both problems for for Alexander. Donating his kidney obviously wasn’t easy—and, he says, it was prompted by “wanting, just once, do a good thing that will make people like you more instead of less.”

All of this is utterly consistent with Sam Harris’s view. Harris tells us that morality is about minimizing suffering and maximizing well-being, and Effective Altruists are simply trying to work out what will, in fact, minimize the world’s suffering and maximizing its well-being. And if they can’t quite work out the math, they can at least find clear-cut ways to sacrifice their own interests for others—and who could possibly object that?

But don’t rush out and become an Effective Altruist quite yet.

Exhibit B: Should You Sell Your Grandmother to Sex Traffickers?

Ted Gioia studied philosophy at Oxford, where he was saturated in Effective Altruist-style moral reasoning. But that kind of reasoning bothered him. Taken seriously, he says, “you might sell your granny to sex traffickers.”

That seems…extreme. But Gioia illustrates:

Effective altruists don’t look at the actual actions at hand or their consequences today—hah, that would be too obvious. They only think about long-term holistic results, and hope to maximize pleasure and good feelings in the aggregate:

So it stands to reason that:

(1) Granny is old and doesn’t have long to live, so she can’t experience much pleasure even under the best circumstances.

(2) But the sex traffickers could use Granny to increase the pleasure of many of their customers.

(3) Hence….

For Gioia, there was something toxic about this philosophy, and it was unsurprising to him that an Effective Altruist like Sam Bankman-Fried turned out to be a criminal. Sure, maybe he stole a bunch of money, but if you looked at the “full context” it was all for the greater good of being able to give away a bunch of money.

You can use this philosophy to justify almost any terrible act.

You merely need to point to the larger context. Embezzling billions of dollars is only a start. Just consider the current social media justifications of atrocities in the Middle East.

These hatemongers explain that it may seem wrong to murder babies or rape or kill innocent people, but you only need to understand the larger context, and it’s all okay.

Whenever you hear this vague reference to the larger context, you better start running.

But what’s the alternative? Gioia observes that there are plenty of alternatives: “Kant’s categorical imperative or Aristotle’s virtue ethics or the natural law espoused by Gandhi and Dr. Martin Luther King or even the Ten Commandments.” These views tell us to focus, not on raw consequences, but on cultivating “core human values—such as love, compassion, forgiveness, trust, kindness, fidelity, decency, hope, etc.” He adds: “Gratuitous actions of generosity and kindness are best done without calculating rewards or consequences.”

Gioia’s approach, too, is consistent with Sam Harris’s argument. No, it doesn’t strive to minimize total suffering in the universe, but it seems to reduce suffering rather than increase it. Certainly it puts you more on the side of the Dalai Lama than Ted Bundy. Indeed, Gioia’s critique of Effective Altruism is that, by liberating individuals from any concern over their own moral character in order to maximize some impossible-to-calculate “greatest good,” it can lead people to behave more like a Ted Bundy than a Dalai Lama.

Should someone on Gioia’s approach donate a kidney to a stranger? The answer appears to be: maybe. It would be an enormous act of love, compassion, and generosity. But it’s not morally mandatory. There are plenty of good people with two kidneys.

Exhibit C: Two Egoists, Three Kidneys

Effective Egoism’s take is straightforward. Your job is to pursue your own happiness, neither sacrificing yourself to others nor others to yourself. You absolutely should not donate your kidney to a stranger. You should be free to sell your kidney to a stranger, and you may very well give your kidney to save a person that you love, but you won’t give it away to someone you don’t know.

But Effective Egoism, too, is consistent with Sam Harris’s approach to morality. According to Effective Egoism, human well-being can’t actually be achieved through human sacrifices. Self-sacrifice achieves no good for anyone. Human beings don’t thrive by giving or collecting sacrifices, but by pursuing and achieving values.

But doesn’t the kidney recipient benefit when a stranger donates his kidney? The issue here is clouded by the fact that it is illegal for a person to sell his kidney. This has led to a radical shortage in available organs, meaning that we have forced people with kidney problems to depend on sacrifice if they are not lucky enough to have a loved one in a position to donate.

In a free society, I would never be put in a position where I depended on someone’s sacrifice. But restrictions on freedom can make sacrifice the only viable way to gain values. Imagine, for example, that altruists decided that since it’s wrong to “profit off the sick,” it should be illegal to pay doctors for their services. If you want to be a doctor, it has to be an act of charity.

In such a system, yes, I would benefit in some sense from self-sacrificial doctors. But the point is that I would overall be way worse off for living in that system. Since there would obviously be a shortage of doctors, whether or not I found a doctor willing to treat me would be a lucky accident. I would be much better off in a free society where I wasn’t dependent on self-sacrificing doctors.

What, then, about the self-sacrificing kidney donor? The altruist claims he’s sacrificing himself for strangers, but is that really true? Sure, he may worse off in some ways—he’s risking his own health, and robbing himself of the ability to help the people he cares most about. But didn’t Dylan Matthews declare that he “was selfishly, deeply gratified” to give away his kidney? Who is Don Watkins to say that donating a kidney to a stranger is an act of self-sacrifice?

It’s a fair question, so I asked my girlfriend. She is now an Effective Egoist in good standing, but years earlier she donated her kidney to a stranger. I asked her to describe why she did it, and whether it made her happy.

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From the desk of Samantha Westmoreland

I was 19 when I decided to donate my kidney. I donated to a stranger, to the friend of a girl living in my dorm who cried during our hall Bible study one night asking us to pray for him. His dad had been exposed to Agent Orange during the Vietnam War and his kidney problems, as well as a host of other medical issues in years past, could all be traced to that.

There are many reasons why I decided to donate:

Because I had always been a bleeding heart who couldn’t stand to see pain—even of a gnarly spider in my 5th grade classroom that everyone wanted to kill but I just had to save. Because, a la Joan of Arc, I believed God had spoken to me; he had given me this mission. Because I was an idealist who believed it was right to do what’s right—and that no amount of personal discomfort, pain, or loss should stand in my way of doing it.

But it’s interesting to look back on my journal at the time. Because though the above reasons are alive and discernible in my explanations, they’re not what stands out. Instead, what I felt the need to emphasize and call out explicitly was this:

[People] often tell me I'm selfless. … [But] I'm not selfless. … This surgery makes me feel like I have a purpose. I'm doing something that really means something. I like feeling that way. It's obviously not the focus. But how can an action be selfless if there is a known benefit to me? It's a nice thing, a good thing. But not ever a selfless thing.

And I was clear, too, about why donating was a “nice,” “good” thing and why it gave me purpose:

I can't help thinking there is something eerily beautiful about physically taking on the pain of someone else. It gives me goosebumps to think that for just a little while I will wear [the recipient’s] pain.

I want to live my entire life like this. Giving extremely. Giving in a way where I can't explain the desire that has come over me. I want to be and do good. Giving extremely doesn't mean exciting and revolutionary things like this surgery. Giving extremely means giving despite the desire not to. It means to give out of love in every circumstance, big or small. It means listening for that voice, the one that tells you when to act. It means being faithful in all moments, not just the big ones when everyone is looking.

Most of the moments granted to us in life are small, after all.

I continue on in my journal, giving example after example of how I’m certain I can exhibit the same level of “giving” in the small moments of life—at the grocery store, doing chores, day-in and day-out as a teacher.

But what is revealed by these lengthy protestations is a thinly veiled panic. This is evident in how I conclude the entry:

I want to always say that I am content with my place in life. Not to say that I won't always be seeking to improve, I will. But instead, content with the daily mission that I have been given. Every day is a mission. Every person, every moment.

I have no other specific calling or 'heart' other than to "Be completely humble and gentle; be patient, bearing with one another in love. Make every effort to keep the unity of the Spirit through the bond of peace" Ephesians 4:2-3

Honestly, that's hard enough a mission to keep me busy. I have no time to think of "bigger" purposes or passions. I must pray every day that I will lose my vanity and finally learn this lesson.” (emphasis added)

What “vanity” am I speaking of? The clearest presentation of what I was afraid of comes in an entry, written two days before the surgery, where I’m venting my frustrations:

Everyone proclaims, as do I, that this [surgery] shows that God has big plans for [the recipient]. He has so much to show the world. He has so much purpose.

I wonder though, am I wasted and used up after this is all over? My disobedient heart cries out. What is my purpose? What am I alive for? Is there nothing left after this?

It’s clear, then, the “vanity” I was speaking of was that of purpose and ambition—of wanting to move from one achievement to the next, to build on what I’ve accomplished and reach new heights, not to stagnate, but to grow and do even greater things in the name of my ideals.

But what I was wrestling with was an inherent contradiction between those ideals and my desire to live with purpose and ambition.

When your ideal is centered around ‘giving up’ things, around sacrifices, the only direction you can move is down, not up. There is only so much you can give. You only have one kidney to donate, only one life to drain—whether gradually or in one fell swoop. And the more you give, the more depleted you become, and the less you have remaining to give the next time.

To whatever extent you live up to such an ideal—one centered on sacrifice—you are weakened and increasingly reduced in your ability to continue doing so. And to whatever extent you shirk, make “exceptions,” or assert your own needs, you are racked with guilt and an inveterate sense of your own corruption and unworthiness.

In either case, your sense of purpose and self-esteem is undermined or obliterated. Any fulfillment gained from attempting to enact such an ideal is superficial, short-lived, and counterfeit. As much as I tried to convince myself that donating my kidney wasn’t selfless, as much as I insisted that it gave me a sense of purpose, in the end, it didn’t because it couldn’t.

After the surgery and recovery was over, I entered a serious depression. Not the temporary restlessness that often comes post-achievement, when you haven’t yet found the next mountain you want to climb, but the bleak despair that comes from knowing there is nowhere to go.

It took years—years of fighting off existentialism and nihilism, of seeking “refuge” with stoicism and taoism—to find a new ideal. One unlike all the others, not centered on giving up and retreating, but on building. On creating a life I loved, on working to shape the world in the image of my highest values, on forming a character that makes them both possible and capable of being enjoyed.

I’ll leave the philosophical justification for such an ideal in the able hands of Don, but what I’ll end with is this: when choosing between an ideal made up of self-sacrifice and an ideal made up of self-exaltation, there is your whole life to gain.

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The Verdict

Sam Harris is right that values aren’t separate from facts. And he’s right that flourishing is self-evidently better than suffering. He is also right that this is sufficient to make some actions obviously superior to others. Torturing an innocent person for kicks is obviously worse than treating people with kindness.

But without a more robust framework, almost none of life’s pressing questions can be answered. We cannot even know whether giving away our kidney to a stranger is morally mandatory, morally optional, or morally wrong.

To make moral progress, we have to be able to answer questions like:

• What is well-being?

• Whose well-being should you be trying to achieve?

• What are the principles that will allow you to achieve it?

Religion offers answers to those questions. So do Kantians, and virtue ethicists, and Effective Altruists. Effective Egoists offer answers as well. Sam Harris may have refuted those who deny the possibility of moral answers—but we can do so much better.

Effective Egoism 101

The conception of earthly idealism I champion was defined by Ayn Rand. Here are three key works that summarize her perspective:

• Faith and Force: Destroyers of the Modern World by Ayn Rand

• Causality vs. Duty by Ayn Rand

• The Objectivist Ethics by Ayn Rand