NOTE: The author of this post concludes that the killing of Brian Thompson was wrong. (I’ve added this statement because some people sharing the post on social media are making misleading statements about it.)
The killing of UnitedHealthcare CEO Brian Thompson earlier this month has ignited moral debate around the world.
Many have condemned the killing as they would any other murder. Others, though, have thought that the morality of the killing was less clear. And some people have celebrated it.
Sometimes moral ambiguities and moral disagreements are intractable. But sometimes these things arise from conflicting judgments about what in fact happened, or about what to think about the distinct aspects of what has happened, or about how to bring together what we think about those distinct aspects into an overall judgment. In these kinds of cases, a careful consideration of the relevant facts and moral considerations could help us better understand disagreements, or better identify the sources of ambiguities, and perhaps even help us resolve them, or make some kind of moral progress.
Saba Bazargan-Forward (UCSD) is a philosopher who works primarily in moral philosophy, with an emphasis on topics related to war and coercion. He’s the author of, among other things, Authority, Cooperation, and Accountability (2022).
In the following guest post, Bazargan-Forward discusses the ethics of Thompson’s killing, carefully looking at the factors relevant to our moral assessment of it, and offering us a diagnosis that may help us better understand the varied reactions to it. He concludes that the killing was wrong, arguing for that position by trying to take seriously some of the considerations that might be on the minds of those who disagree with this conclusion.
Complications: The Ethics of the Killing of a Health Insurance CEO
by Saba Bazargan-Forward
• 1 •
On December 4, 2024, UnitedHealthcare (UHC) CEO Brian Thompson was gunned down in New York City while attending an investment conference. He is survived by his wife Paulette Thompson, and their two children. Since news of his death, many individuals on social media have expressed frustration over UHC’s history of denying claims for medically necessary healthcare treatments. Others have gone further, celebrating the death of its CEO.
In what follows, I will attempt to morally evaluate his assassination. The moral evaluation I present here will be preliminary, in two ways. First, I set aside issues pertaining to the state of the healthcare industry in the US more generally; instead, I focus on UHC and Thompson’s role in it specifically. Because the assassination cannot be wholly abstracted from the healthcare industry in the US, or, for that matter, from the growing rampant wealth disparity endemic to the US, what I say here will be incomplete. Second, many of the claims I make depend on empirical facts currently unavailable to me. Hence, what I say here will be conditional. Nonetheless, my hope is that this incomplete, conditional moral evaluation will assist in formulating a more conclusive verdict.
Currently, the chief suspect in Thompson’s slaying is Luigi Mangione. Perhaps we can surmise what his intentions and motivations are, based on a ‘manifesto’ he allegedly wrote. In general, I believe that intentions and motivations can affect the permissibility of what we do. If it turns out that Mangione’s intentions were quite different from what the evidence shows—if, for example, that he killed Thompson solely for looking at him the wrong way—then what he did was impermissible, no matter Thompson’s accountability for his actions as CEO of UHC. Because Mangione’s intentions and motivations have yet to be decisively revealed, I focus not on whether the assassination he committed can be justified, but on whether an assassination can be justified.
I should mention that my areas of specialization, which include the ethics of violence, do not include healthcare ethics. This piece would be best written by someone who does both. I am no such unicorn. I accordingly invite corrections by those who are better versed in that field than I am.
• 2 •
Let’s start with some facts about Brian Thompson and the corporation for which he served as CEO. In 2004, Thompson joined UnitedHealth Group (UHG)—the largest healthcare conglomerate in the country, with over 2,300 different companies. Currently, UHG is ranked fourth in the 2024 Fortune 500 list of the largest companies in the US by revenue. Thompson held a variety of leadership roles in UHG over the course of his career, serving as chief financial officer for several of the company’s businesses and as a director for corporate development. In 2021 he was named CEO of UHC, a division of UHG, which insures more than 46.4 million Americans, and which made $16.4 billion in profit last year with Thompson at the helm.
Thompson’s tenure as CEO marked a period of growth for the company during which profits surged from $12 billion in 2021 to more than $16 billion in 2023. Thompson received an annual compensation package in 2023 valued at $10.2 million, ranking him among the highest-paid executives at UHG. His net worth was approximately $43 million, according to Wallmine. The Daily Mail reported that Thompson’s salary was about $10 million per year.
Under his leadership, UHG was accused of denying claims for medically necessary procedures and medications, and of fraudulently manipulating medical and patient data to maximize profits. In an October 2024 report, “How Medicare Advantage Insurers Have Denied Patients Access to Post-Acute Care,” the majority on the US Senate Permanent Subcommittee on Investigations (PSI) released a report claiming UHC’s prior authorization denial rate for post-acute care more than doubled between 2020 and 2022. Denial rates for skilled nursing centers “experienced particularly dramatic growth” in that claims were denied nine times more frequently in 2022 compared to 2019.
According to the PSI’s report, soon after Thompson’s was named CEO a UHC committee began exploring the possibility of using AI and machine-learning to predict which instances denying post-acute care would be appealed and which of those appeals would fail. By 2023, the insurance company was served with a class-action lawsuit accusing it of relying on computer algorithms to systematically deny the claims of Medicare beneficiaries in nursing homes. The suit claimed the company illegally deployed “artificial intelligence (AI) in place of real medical professionals to wrongfully deny elderly patients care owed to them under Medicare Advantage Plans by overriding their treating physicians’ determinations as to medically necessary care based on an AI model.” The suit also claimed that UHC knew that this model “has a 90% error rate.”
According to the suit, the insurer “continue[s] to systemically deny claims using their flawed AI model” because they know that only about 0.2% of policyholders will appeal the denied claims. The overwhelming majority will either pay out-of-pocket costs or forgo what remains of their prescribed care. “Defendants bank on the patients’ impaired conditions, lack of knowledge, and lack of resources to appeal the erroneous AI-powered decisions.”
Journalists have also investigated UHC’s denial practices. In January 2023, the health news outlet Stat published a detailed investigation revealing that NaviHealth, a UHC subsidiary, used algorithms to deny care for seniors enrolled in the company’s Medicare advantage plan.
Denying medical coverage is not itself morally wrong. The goal of any insurance company is to collect more in premiums than they pay out in claims. Denying claims is par for the course. The issue, rather, is whether UHC denied medically necessary claims. This is important in part because health insurers agree to cover medically necessary claims. If it fails to cover such a claim, it is in violation of that agreement. Of course, what counts as medically necessary will be subject to dispute. But in such cases, as a matter of law, the insurer makes the final determination; this authority is conferred upon them contractually. Though in the US there might be legal consequences at the federal or state level for denying claims in bad faith, it is not inherently illegal for an insurance company to deny a claim they deem medically unnecessary.
Whether or not it turns out that as a matter of positive law UHC’s conduct is illegal, it clearly should be, if the allegations against them are accurate. These allegations suggest that the insurer operates by intentionally misleading policyholders into believing that UHC will cover claims which they will ultimately deny—claims that by any reasonable standard are medically necessary. For example, when the insurer agrees to cover medically necessary treatments, it seems that by any reasonable standard they have agreed to cover the cost of medication necessary to treat a crippling case of ulcerative colitis—an ailment that caused a student at Penn State to suffer severe arthritis, debilitating diarrhea, numbing fatigue, and life-threatening blood clots. ProPublica reported that UHC refused to cover the cost of medication on the grounds that it was “not medically necessary.” The report uncovered the lengths to which the insurer went to deny the claim, which included burying medical reports and soliciting rubberstamped recommendations from company-paid doctors. If UHC, under Brian Thompson, routinely denied claims for treatments that any reasonable party would deem medically necessary, it routinely defrauds its policyholders by violating its contractual obligations. If the insurer has a contractual obligations to cover an expense that you end up paying out of pocket, then it has defrauded you by precisely that amount. The PSI’s report suggests that this was standard practice, supercharged by AI.
• 3 •
Many of the allegations against UHC are just that. But suppose they are accurate. How wrong is it to systematically defraud policyholders in the way UHC is alleged to have done?
It might be argued that if UHC covered the medically necessary treatments it actually denies, the insurance would be more expensive, it which case it would likely cover fewer people, which would result in more harm. But this reasoning fails to justify UHC’s acts of fraud. There is a general moral prohibition on wronging some to aid others (unless that’s the only way to prevent a moral catastrophe). With a profit of $16 billion and with its parent company at number five on the US Forbes Fortune 500, UHC seems fully capable of providing contractually obligated coverage for medically necessary treatments without pricing out existing policyholders, all while still maintaining a very substantial profit margin. It’s a false dichotomy to suggest that UHC must choose between defrauding its policyholders and raising premiums.
Alternatively, it might be thought that, though defrauding policyholders is wrong, even in the aggregate such acts do not rise to the level warranting assassination. After all, these acts of fraud do not cause the diseases, disorders, or injuries for which UHC denies treatment. Health insurers—when they operate in the way they’re supposed to—fund medical treatments where these treatments prevent harm. It might seem, then, that a health insurer violating its contractual obligations doesn’t cause harm so much as it merely fails to prevent harm.
This is important, since, all things being equal, failing to prevent harm is not as bad as causing harm. By this reasoning, UHC didn’t worsen anyone’s health when it violated its contractual obligations. Instead, it just failed to improve their health. The insurer’s mantra might be: “Yes, we defrauded you—but we didn’t make you sick.” This makes it all the more difficult to justify acts of lethal violence against UHC executives.
But this reasoning is flawed. UHC, by violating its contractual obligations, doesn’t merely fail to prevent bodily harm; it does something much worse than that. There are three reasons for thinking this. The first two are not decisive. The third, I believe, is.
First: a contractual obligation to render aid should it be required can be a cause of a need for assistance. A patient suffering from cancer might be uncertain as to whether to undergo chemotherapy. She might ultimately decide to do so given that her insurer has led her to believe—falsely—that they will cover expenses for medically necessary ancillary treatments, such as anti-nausea medication. If the insurer violates its contractual agreement, then it serves as a cause of the harms that the ancillary treatment would have prevented. Cases of this sort, though, are not typical—I mention them only to largely set them aside.
Second: if UHC defrauds a policyholder by denying coverage for medically necessary treatment that an alternatively available insurer would have covered, then UHC might serve as a but-for cause of the bodily harm it failed to prevent. Of course, it might be that the counterfactual insurer would have also denied coverage for the treatment in question. But it seems UHC denies claims at a much higher rate than other insurers do. According to the personal finance platform ValuePenguin, UHC denies 32% of claims compared to the industry average of 16%. Of course, this evidence is not decisive; different insurers might cover different demographics within the US. So, though UHC’s fraud might count as a but-for cause of the harms it fails to prevent, it’s exceedingly difficult to determine how often this is true.
Third, and most importantly: though we all have Samaritan obligations to help one another in times of dire need, those who promise to render such aid, especially in exchange for payment, obviously have a special, stronger duty to render such aid. This partially effaces the moral relevance of the distinction between doing and allowing. Though UHC didn’t cause the harms their defrauded policyholders suffer, their culpable violation of their contractual obligation to fund the prevention of those harms means they are nearly as accountable as they would be if they had. Much more needs to be said here, but if something like this claim is correct—that contractual obligations vitiate the moral relevance of the distinction between doing and allowing—then this helps vindicate accusations that many members of the public seem to be making against healthcare insurers in general and UHC specifically: that they are doing something morally tantamount to causing widespread bodily harm.
• 4 •
Suppose that UHC is indeed engaged in widespread fraud of the sort I’ve described. I take this to be an empirical supposition. And suppose that such fraud, by culpably violating a contractual obligation to provide funds necessary to prevent bodily harm, is as bad or nearly as bad as culpably causing such harm. I take this to be a moral supposition. If these suppositions are both correct, could that justify assassination?
To answer this, we first need to determine whether and to what extent a CEO like Brian Thompson, is accountable for what his corporation does. A CEO’s power is not absolute—they are accountable to the board of directors who represent shareholders. This board has the authority to hire and fire the CEO and must approve major structural corporate decisions. Still, the CEO has unparalleled influence and authority over the direction of the corporation, the strategies it adopts, and oversees major decisions about operations. In this regard, the CEO is not a mere figurehead, but rather a leader with the delegated authority to implement their vision for the corporation. If UHC was systematically defrauding its policyholders in the way I described, it was either because Thompson wanted it or allowed it. Indeed, there is some reason (though not decisive) to believe it was the former: the wrongs detailed in the PSI’s report and the NaviHealth class-action lawsuit—including the use of AI with a 90% error rate to deny claims en masse—all occurred during his tenure in which he was handsomely rewarded. It might be argued that if he hadn’t authorized or allowed these policies, someone else would have in his stead. But even if he is not a but-for cause of UHC’s policies, he is still a cause. Based on this, I believe we can tentatively conclude that Thompson bears significant accountability for the policies UHC adopted.
Supposing Thompson is accountable for these wrongs, what would justify violence against him? Perhaps such violence against those responsible will lead others to think twice about implementing similar policies. Though this might sound like wishful thinking, it’s worth noting that on December 5, the day after Thompson was killed, Anthem Blue Cross Blue Shield—one of the largest health insurers in the US—abruptly reversed its recent decision to cap anesthesia coverage amid widespread backlash. Though we cannot know whether the assassination is what motivated the reversal, it’s hard to believe that it’s mere coincidence.
This might seem like terrorism—in which innocents are targeted with the aim of using their deaths to ultimately affect policy. But it is not clear that Thompson counted as an innocent. He might have been morally liable to be used as a means to deterring others from committing the same wrongs that he has. That is to say, Thompson might have forfeited the right against deprivations instrumental to disincentivizing the kind of wrongful conduct he committed. As I noted, it is wrong to harm one person for the sake of preventing harm to others (unless doing so is necessary to prevent a catastrophe). But if someone has forfeited their rights against being harmed in furtherance of that good, then harming them in that way doesn’t wrong them.
Even supposing this is all correct, is extra-judicial killing warranted? At first, it seems like the answer has to be ‘no’. Imagine the ideal civil and criminal justice system. Imagine further that in that system, Thompson is tried before a criminal court and found guilty, in his own person, for authorizing policies systemically defrauding policyholders at UHC. Presumably, execution would not be appropriate punishment for those crimes. If it’s wrong for the government to execute Thompson—even in a world where, as a matter of positive law, it is pellucidly clear that his activities were illegal—then surely it is wrong for a private citizen to execute Thompson in this world. It’s one thing for a private citizen to take the law into his own hands. But it is another for a private citizen to do what even the government would not be permitted to do. Or so it might be argued.
Importantly, though, it would be wrong for the government to execute Thompson because the government would have another, less harmful option at its disposal: it could imprison him. Given that this mode of punishment would sufficiently deter others from engaging in similar misconduct, there would be no need to resort to execution. But a private citizen doesn’t have this option. What is permissible for you to do depends on the menu of options available to you—given that imprisonment is an option, execution will often be impermissible. But remove that option, and execution might indeed be warranted.
To see this, imagine again the ideal civil and criminal justice system—except this time, imagine that for whatever reason the government is unable to incarcerate Thompson or those like him. He has to be either executed or let free to continue his activities. Under these circumstances, it’s far less obvious that execution is impermissible. The upshot is that (given all the suppositions I’ve detailed so far), a private citizen committing an extra-judicial assassination is doing what a government would be permitted to do—provided we imagine that the government, like the private citizen, is incapable of incarcerating the offender. The suggestion here is that the government violates the constraint of necessity should it execute Thompson, whereas perhaps a private citizen does not.
Against this, it might be asked: couldn’t have the private citizen merely wounded Thompson? Perhaps that would still have had a sufficient deterrent effect. If so, this suggests killing violates the necessity constraint after all. For that matter, one might worry that killing violates the proportionality constraint—death might be too severe a harm relative to the harms that the death prevents. Thompson’s, culpability, though, affects the stringency of the proportionality constraint.
This entire discussion of Thompson’s liability, though of academic interest, seems to neglect an important issue: the law.
• 5 •
Even if there is some sense in which Brian Thompson is morally liable to be used as a means in the way I have indicated, the law forbids private citizens from taking action of that sort. As private citizens in a legitimate state, we are prohibited from acting unilaterally in this way against one another. On an influential Lockean view of a democratic state, each of us vests in the state the authority to discharge vicariously the rights we have against one another, which is what prohibits us from acting unilaterally in our own person. On some versions of this view, the reasons we have to abide by laws prohibiting killing are not merely very strong reasons outweighing competing reasons to dispense justice privately. Rather, the reasons to abide by such laws are exclusionary in that they typically silence competing reasons which ought to carry no weight at all in our deliberations. This is all very rough, of course. But the point is that, according to this influential family of views, Thompson’s assassin acted immorally even if all of his unilateral judgments about the CEO were correct. Thompson’s moral liability to be used as a means is, in a sense, irrelevant to what private citizens are permitted to do to him, not just legally but morally—presuming a legitimate state.
This is to say nothing of the risk that condoning the assassination would have on social stability, which is itself a valuable good. Already in New York City “Wanted” posters have appeared, targeting healthcare executives. It might be thought that some instability is warranted given the systemic wrongdoings healthcare insurers are committing. But I personally do not trust armed Americans, acting privately, to determine which CEOs should be killed and which should be allowed to live, especially in a social environment where misinformation is rampant. It is not hard to imagine a future in which private citizens begin assassinating academics they view as a danger to society.
We are, then, at an impasse. But in a way, it is a felicitous one. I tentatively suggested that:
a. UHC systematically defrauded its policyholders by refusing to cover contractually obligated medically necessary treatments,
b. failing to prevent harms resulting from refusing to cover medically necessary treatments is as or almost as wrong as causing those harms, and
c. Brian Thompson as CEO of UHC is accountable for authorizing or allowing policies that systematically defrauded its policyholders.
By harming Thompson as a means to deter others of his ilk from authorizing or allowing similar policies, a private citizen is doing the sort of thing the government should be doing (provided that he has the right sort of intentions and that the proportionality and necessity constraints are met). Yet this private citizen’s actions are still not morally justified, because he lacks the requisite authority to act unilaterally in that way. This two-step reflects the ambivalence some might feel about the assassination.
I have suggested that Thompson and those like him are morally liable to be used by the government, but not by a private citizen. This, though, can change. Assume something like the Lockean picture is correct, in which our rights are vouchsafed by the government. A government that consistently and systematically reneges on its duties to protect rights within a particular domain, thereby weakens the exclusionary power of the reasons private citizens have to refrain from acting unilaterally within that domain. In such a case, the government loses legitimacy within that domain. With respect to health insurers, we are still, I believe, in early days; for example, the use of AI is a relatively new phenomenon for which regulations have yet to appear. But we may yet get to the point where it becomes clear that the government will never be willing or able to regulate these industries in the ways that morality requires and that the people demand.
1) Even if he’s liable, killing him could be terrorism. Putting heads on pikes is terrorism even if the beheaded parties were unjust attackers.
In the case of Mangione, the fact that he wrote messages on shell casings indicates that he was mainly sending a political message by killing Brian Thompson. That’s terrorism.
2) I thought this was the best point in the piece:
I’m reminded of Locke on the “inconveniencies” of “every man’s being the judge in his own case.” But I’m also reminded of the horrors of lynchings, pogroms, the Cultural Revolution, etc. — it’s really bad when lots of people don’t feel inhibited about killing their enemies!
Platypus, if someone has forfeited their rights against being used in ways instrumental to affecting political change, then that harm is not terrorism — or at least, it isn’t morally impermissible terrorism — provided it falls within the bounds of proportionality and necessity. The kind of case you describe, of putting “heads on pikes” will typically violate those constraints.
I wasn’t talking about “impermissible terrorism.” Just plain terrorism: the use of criminal violence for ideological ends.
It sounds like you’re conceding my point, which was that it’s coherent to think that someone is both liable to harm and the victim of a terrorist attack.
Unfortunately, dictionary.com isn’t the best source for a conceptual analysis of terrorism.
I was using a short version of the FBI’s definition of “domestic terrorism” as
I would have used the definition established by international law — except there isn’t one, to my knowledge.
There are some definitions of terrorism in UN Security Council Resolutions (e.g.1566 in 2004) and UN judicial decisions (e.g. by the Appeals Chamber of the UN Special Tribunal for Lebanon in 2011). But these are too narrow to apply to the domestic case. (Resolution 1566 says that terrorism must violate existing international conventions, and the Appeals Chamber held that terrorism must have some “transnational element.”)
One interesting feature of the FBI’s definition is that it can’t be terrorism if it’s legal, so for instance if the state makes it legal for your neighbor to put your head on a pike, that wouldn’t be terrorism. My impression is that philosophers tend not to be impressed with this aspect of that definition.
Another worry is that typically “violence” includes violence against property, which means that pacifists freeing animals from a slaughterhouse are terrorists according to this definition. A huge chunk of domestic “terrorism” investigation and prosecution in the United States focuses on going after non-violent environmental and animal rights activists. One might think some mistake has been made.
That’s really interesting — thanks for sharing, Daniel.
“I have suggested that Thompson and those like him are morally liable to be used by the government, but not by a private citizen. This, though, can change. … we may yet get to the point where it becomes clear that the government will never be willing or able to regulate these industries in the ways that morality requires and that the people demand.”
So, if the government doesn’t do what “the people” demand, the morally correct response isn’t to win an election and change the government; it’s to send armed vigilantes to gun down the enemies of the people in the streets? I’m not a political scientist, but I have the sense that there are some downsides to this theory of political change as compared with the boring democratic one, and that past attempts to try it have not been unalloyed successes.
David, I believe Saba’s “the government will never be willing or able…” should be read as taking into account the methods of change you suggest (e.g., change via winning elections). That is, it should be read as about the possibility that the “government will never be willing or able, nor could it be made to be willing or able through elections or other peaceful means…”
I don’t think it makes a lot of difference to my point. It is hardly historically unprecedented for individuals or groups in democracies to decide that they’re never going to get their way through the democratic process and that the answer is to start murdering people. It rarely ends well.
I don’t think it makes a lot of difference to my point. It is hardly historically unprecedented for powerbrokers in nominally democratic governments to decide that they’re never going to get their way through the democratic process and that the answer is to subjugate the people by weakening democratic norms and undermining the democratic process. It rarely ends well.
Your argument seems to be evolving into a general case for violent revolution.
Nothing wrong with that of course, as long as it is justified. Without revolutions we would be lingering in a more advanced feudalism / unregulated early industrialism. That’s were we seem to be headed too, if we don’t put an end to the current marriage of big business and politics.
I had an intro class once, who after a very insightful examination of Marxism announced that violence was the only thing governments understood and that Marx was right. I don’t have an opinion I just report the news.
Justin is exactly correct here in articulating what I intended. I should have made this clearer in the piece.
As someone who’s found it hard to make sense (morally speaking) of the assassination, I really appreciate such a careful and thoughtful discussion of some of the relevant moral considerations. I don’t know if I agree with all of your tentative claims, but reading this is helping me to think about the case in a more clear and systematic way. Thank you!
I was a bit puzzled by your claim that by refusing to cover medically necessary treatments, UHC fails to prevent harm but does not cause harm. I don’t think this claim is the most important part of your argument, especially given your later point that “[UHC’s] culpable violation of their contractual obligation to fund the prevention of those harms means they are nearly as accountable as they would be if they had [caused the harms].” So I’m mainly raising this out of curiosity.
You write:
“After all, [UHC’s] acts of fraud do not cause the diseases, disorders, or injuries for which UHC denies treatment. Health insurers—when they operate in the way they’re supposed to—fund medical treatments where these treatments prevent harm. It might seem, then, that a health insurer violating its contractual obligations doesn’t cause harm so much as it merely fails to prevent harm.”
If someone prevents me from accessing food, this will result in my suffering various harms – including, eventually, death. My (and I suspect others’) strong intuition is that this person is causing me harm, not merely failing to prevent harm to me.
Imagine someone with diabetes who needs daily insulin injections to survive. If UHC prevents this person from getting those injections, resulting in that person suffering various harms including death, why not say that UHC is causing harm to that person, rather than merely failing to prevent harm to them?
I can think of a few distinctions one might use to try to justify describing the first case, but not the second, as a case of causing harm:
(i) Maybe the intuitive plausibility of describing the starvation case as a case of causing harm is due to the assumption that, prior to being denied access to food, I did have access to food. So the person is not merely denying me something I need for survival; they are taking that thing away from me. Whereas if UHC merely refuses to start covering the insulin for the diabetic policyholder, they are denying this person something needed for survival, but not taking it away – because the person didn’t have it to begin with.
But I think this distinction fails to capture all the relevant cases on either side. If there is a newborn baby who has never had access to food, someone who denies the baby food is causing the baby harm (I think), even though they are not taking anything away from the baby. And on the other side, health insurance companies like UHC often stop denying coverage for a treatment that they have previously covered. In these cases, they are taking something away from people that those people need for their well-being and/or survival. So the denying/depriving distinction doesn’t work to justify describing UHC as failing to prevent harm rather than causing harm.
(ii) One might argue that in the starvation case, there is no threat to my survival until the person prevents me from accessing food; they introduce the threat. Whereas in the diabetes case, the threat to the policyholder’s survival is present before UHC does anything; the diabetes is the threat, so rather than introducing a threat, UHC merely fails to mitigate it. This seems to be your (Saba’s) thought here (which of course you later qualify): “UHC didn’t worsen anyone’s health when it violated its contractual obligations. Instead, it just failed to improve their health. The insurer’s mantra might be: ‘Yes, we defrauded you—but we didn’t make you sick.’” On this view, the starvation I suffer is like a car running me down that the person starving me set in motion, whereas in the second case the “car” is the diabetes, which UHC did not set in motion and simply fails to stop.
But I don’t agree that the threat to my survival in the starvation case is solely introduced by the person who prevents me from getting food. Like the diabetic policyholder, I have a physical condition that makes me vulnerable to suffering and death if I don’t get certain things. That condition is: “needing food to survive.” I’m not saying we should classify this as a “medical condition” or disease (I know there are complicated philosophical questions about how to define “disease,” and I can think of many good reasons for excluding “needing food to survive” from that category – not least that it is common to all humans). But if I’m right that the person who prevents me from getting food is causing me harm, then the fact that the harm A suffers partly as a result of B’s (in)action causally originated in a state of affairs that B had no role in causing (e.g., A’s prior physical condition) does not suffice to show that B did not cause harm to A.
I think the impulse to assess these kinds of cases differently is natural and understandable, but I worry that it might be motivated by an assumption that I sometimes find myself making but that on reflection I think is false: namely, that unusual vulnerabilities and needs, like the diabetic’s need for insulin injections, are in some way less morally weighty – perhaps giving rise to moral reasons that are weaker or less binding – than universal or near-universal vulnerabilities and needs, like my need for food. Not saying that you are making or committing yourself to this assumption, since there could well be other, better ways of justifying the distinction. Or perhaps you disagree that the starvation case is a case of causing harm at all, in which case you won’t make that distinction at all!
Thanks for this thoughtful response. I agree that someone who prevents you from getting food is causing you harm. But as I see it, the insurer, by failing to cover the diabetic’s treatment, is not preventing the diabetic from receiving injections (injections which, in turn, prevents the diabetic from suffering various harms including death) This is because, but for the insurer, the diabetic presumably wouldn’t have been able to afford the insulin anyway. This is true regardless of whether the insurer starts and stops the coverage, or never covered it in the first place.
You anticipate something like this move and argue that it yields the implausible conclusion that we don’t harm others (such as children but also adults) by denying them access to food. But that depends on what you mean by “denying” food. Sticking with the child example, if by “deny” you mean prevent the child from eating – i.e., the child would have been able to eat but for your interference – then I agree, that harms the child. But if by “deny” you mean not feeding the child, then I don’t think that counts as harming the child unless you brought the child into existence or agreed to care for the child, since in both cases the child presumably would not have starved otherwise (either because the child would not have existed or because someone else would be caring for it). So I guess, as you anticipate at the end, I deny that the starvation case (properly disambiguated) is a case of causing harm.
I’m not quite following why you claim that “but for the insurer, the diabetic presumably wouldn’t have been able to afford the insulin anyway.” For one thing, if the insurer had not decided to not cover the insulin, then the insurer would have decided to cover it, and the diabetic would have been able to afford it. For another thing, if the insurer had simply not existed in the first place, then the diabetic would have gone with another insurer who may have covered the insulin. Altogether, I am tempted to conclude that, but for the insurer’s decision or existence, the diabetic would or could have afforded the insulin.
“For one thing, if the insurer had not decided to not cover the insulin, then the insurer would have decided to cover it, and the diabetic would have been able to afford it.”
This reasoning overgeneralizes; it annihilates the metaphysical difference between doing and allowing.
“For another thing, if the insurer had simply not existed in the first place, then the diabetic would have gone with another insurer who may have covered the insulin.”
I address this possibility in the original piece. And in any case, many Americans don’t have access to alternative insurers.
Would you expand on what you mean by, and why you think that, “This reasoning overgeneralizes; it annihilates the metaphysical difference between doing and allowing.”?
Here’s one argument for thinking that the reasoning does not overgeneralize. Contrast my doings to the insurer’s doings. Each of the particular concrete things I do fails to cover the diabetic’s insulin. But notice that if I had not done each of these particular concrete things, I would not have covered the diabetic’s insulin anyway. (I would have done other things instead totally unrelated to the diabetic.) The same cannot be said, however, for the insurer. One particular concrete thing the insurer does is decide to not cover the diabetic’s insulin. If the insurer had not done this, they would have covered the diabetic’s insulin.
Altogether, then, my doings fail to make the insulin affordable for the diabetic, but the insurer’s doings do much more. The insurer’s doings also prevent the insulin from being affordable for the diabetic.
This seems less a disagreement about unusual vulnerabilities and more one about basic moral obligation.
Think of Singer’s iconic pond and compare someone who happily holds the child’s head under the water with an idle passerby who could easily save the child at no real cost but chooses instead to sit down and watch the show while he eats lunch.
There are good reasons to think the first person does something worse, but it seems to me that that the choice not to save makes the spectator responsible for the same harm. I don’t think he gets off the hook by shrugging and saying he didn’t cause the problem in the first place.
On this view, we share substantive standing obligations of rescue (not mere Samaritanism) and wider duties to play our part in securing a safe social environment responsive to basic human needs.
Personally and directly allowing the child to starve is a wrong here, regardless of whether you caused the problem, as is indifference to a social world in which starvation is commonplace. So too is failing to provide your spare insulin to a needy diabetic you encounter in your travels and refusing to play your part in ensuring a system in which diabetics have access to the life-sustaining care they need.
This is obviously a more demanding picture of obligation, but it also seems to me to better capture intuitions we have about this case. It would be wrong of any of us to fail to provide easily provided life saving care to but it’s especially wicked for someone to profit from selling the assurance of such care to do so.
I agree with the substantive claims you’re making — specifically, with the more demanding picture of obligation. But part of my strategy was to argue that even if we deny (as many do) that the more demanding picture is correct, it *still* turns out that insurers are mistreating their policyholders in ways morally tantamount to harming them.
Thanks! This all makes sense, and now that I’m clearer on the distinction between preventing someone from getting something vs merely denying them that thing, I think I’m with you in saying that UHC is failing to prevent harm rather than causing it. (I also agree that, given other features of the situation, this is at least almost as bad as causing the harm.)
Health insurance was a moral disaster long before AI was used to systematically deny claims.
I agree. But my hope is that regulation to curb the use of AI will serve as a foot in the door that might prompt other regulations as well. But I’m not holding my breath.
The only really interesting question here is why so many (including me) feel absolute giddy glee at something they know at the same time to be unambiguously morally wrong.
Perhaps not so much interesting as monstrously disturbing
If I were disturbed about my glee, I could easily explain it away as a type of moral weakness. The problem is that my glee strikes me as completely and utterly undisturbing – in fact, it strikes me as utterly banal, and almost rational. I actually find it hard to take seriously anyone who doesn’t share this same sort of glee, or anyone who claims to be ‘monstrously disturbed’.
You find it *hard to take seriously* anyone who doesn’t share your *absolute giddy glee* at the *gunning-down of a father of two in the street*. Do you really mean that?
I find your regarding your absolute giddy glee as ‘almost rational’(?), and as a litmus test for worthiness to be taken seriously, hard to square with your concession that the murder was ‘unambiguously morally wrong’.
I’m also puzzled by the idea that one might regard as ‘a type of moral weakness’ one’s being disturbed by one’s own ‘absolute giddy glee’ at the murder of a father of two that one acknowledges to be ‘unambiguously morally wrong’
Do you also refer to bin-Laden as a father of nineteen?
No, but someone who thought his killing ‘unambiguously morally wrong’ might
Once one has acknowledged that a murder is ‘unambiguously morally wrong’, I think it’s too late to dismiss the victim’s having two children (one still a minor) as an emotive irrelevance
This seems slightly off to me. An otherwise identical assassination of a single childless healthcare executive would be morally impermissible, and on the same basis, as is this one.
His having children adds futher grounds to regret the consequences of the act, but strikes me as irrelevant to the impermissibility of the act. That is more than an “emotive irrelevance”, but his children strike me as irrelevant to the fundamental wrongness of the act.
I also think there is an important difference between HIS HAVING CHILDREN being an emotive irrelevance and PEOPLE CONSTANTLY MENTIONING HIS HAVING CHILDREN being an emotive irrelevance. The latter seems pretty propagandistic to me even though I think the act was (unambiguously) morally wrong.
I never thought his having children made his murder any less permissible than it already was. I just mentioned it in a no-doubt-futile attempt to make those who were giddy with glee feel ashamed of themselves.
That is because he is an immoral man, so you don’t feel so bad that someone else committed an immoral act against him. You feel your side has room to diminish their own behavior because your enemy (as you intrinsically feel his interests are at odds with your own) has lesser morals guiding him. None of this makes you moral, in fact it simply detracts from claims of moral superiority because you chose violence instead of peaceful resolution, which is why you feel a sense of shame at arm’s length aside your glee. None of this makes murder a good thing, you recognize, which means you still do have a conscience telling you what is right and isn’t. You think: murder is wrong, but murdering someone who you see as so beneath you? A virtually non-human man? That is fine of course, he is not you, he is on the losing side, the bad side.
I think this is spot on.
(A conjecture that seems to fit my experience is that the discourse surrounding these issues–particularly, though far from exclusively, at the level of mass media–has been so warped, for so long, that it feels a little like a pressure valve has been released.)
Interesting? Seems fairly mundane to me. Was there not a lot of glee when Gaddafi, or bin-Laden were killed? Even if you disagree with extra-judicial killing, it’s only human to feel that that the world is a better place having less mass murderers in it.
Mass murderers, yes.
But it’s hard to argue that the United States would be a better place having even less health insurance in it.
Most people agree that the primary problem is that many people don’t have access to financial means to cover the health interventions that would be good for them. Health insurance companies give at least some people the means to cover health interventions that would be good for them, even as they wrongfully deny other claims.
The likely effect of a culture of terror against health insurance executives that wrongfully deny too many claims is not an increase in the rate of coverage of claims, but rather a lot of companies getting out of the health insurance business and effectively denying *all* claims.
Or the US would have to rethink it’s health care provisions and come up with something better…. aren’t hypotheticals wonderful?
“The likely effect of a culture of terror against health insurance executives that wrongfully deny too many claims is not an increase in the rate of coverage of claims, but rather a lot of companies getting out of the health insurance business and effectively denying *all* claims.”
FWIW my guess is that it would just mean insurance companies would spend a lot of money on personal security for their senior leadership, and probably also increase their pay to compensate.
I find the main point of disagreement between those who find the assassination permissible and those who find it impermissible to be whether there truly is a legitimate way in which the government could be made to regulate insurance in ways that are morally required. You assert that it is not yet clear that government could not, but show no evidence to support that. In contrast, the opposing view that government will not and could not regulate insurance in a morally obligatory way has heaps of historical evidence to rely on. They point to the ballooning salaries, share prices, increased premiums and increasing denials. They point to special interest groups that lobby the government to look away. They point to the well-documented regulatory capture by the industry. If we take public choice theory seriously, the incentives of most politicians now and in the near future would not move them toward more regulating the insurance industry.
The permissibility of assassination cannot hinge on whether change is merely possible. Any political change is possible given a long enough timeframe. The more significant question is whether democratic actions by private citizens would be likely to enact such just change that is morally required, given the current political system. That is answer, to me, is clearly no.
For what it’s worth, I agree with much of this. I just worry about a problematic unilateralism when private citizens make these kinds of assessments. They might get it right when it comes to healthcare, but they might get it wrong when it comes to other domains. Given the stakes — killing — open the doors to that kind of unilateralism worries me. This is why I’m inclined to set the bar very high for its use.
Thanks for the clear post above, I really appreciate it. I do agree that unilateralism from private citizens is worrying.
Should unilateralist actions of a different kind undergo similar assessment? Consider recent actions/statements made by certain individual private citizens relative to a certain U.S. Legislative proposal (Continuing Resolution/CR). Is the CR issue within a domain of relevance for the analysis? Is oligarchical proximity to power problematic as a general proposition??
The insurer’s mantra might be: “Yes, we defrauded you—but we didn’t make you sick.”
Since paying for the treatment of the sick is the primary reason for any contact or arrangement between the parties I find it difficult to accept that this in anyway moves the moral balance in favour of the insurers, or against the actions of the accused. The fact that they didn’t make the individual ill is irrelevant.
I agree. It’s like promising to catch someone doing a trust fall and then not doing so. The only reason they’re in a vulnerable situation (falling, or having spent money that might be spent on another insurer who would pay for the treatment) is because you misled them.
I would say it’s more like hiring a nurse to look after your sick mother. As your mother starts to choke, the nurse, instead of helping just watches tv. When you see what’s going on and try to help your mother, the nurse locks the door and does everything she can not to let you in.
“Supposing Thompson is accountable for these wrongs, what would justify violence against him? Perhaps such violence against those responsible will lead others to think twice about implementing similar policies. Though this might sound like wishful thinking, it’s worth noting that on December 5, the day after Thompson was killed, Anthem Blue Cross Blue Shield—one of the largest health insurers in the US—abruptly reversed its recent decision to cap anesthesia coverage amid widespread backlash. Though we cannot know whether the assassination is what motivated the reversal, it’s hard to believe that it’s mere coincidence.”
Okay–but that choice was a bad decision. It is not the equivalent of stopping denials of medically necessary treatment, it’s giving in to misleading propaganda by a provider organization seeking to protect its profit margins and ensure the cost of medical coverage continues to rise. For more on this, see Anthem anesthesia controversy: The people rose up against Blue Cross Blue Shield and won. That’s bad. | Vox
Which is part of the problem here, attempting to solve an extremely messy, and painfully complicated systems by killing individual actors has essentially no chance of success and large chances of counterproductive backlash, or misuse by other parties.
For what its worth, I share some of your worries, though perhaps not with the degree of confidence you express. And thanks for the link — I found it informative.
Do you think Thompson’s killing will improve peoples’ condition? More generally, would a society that legitimizes extrajudicial killing actually produce less suffering? Does this matter to your assessment of its morality?
Popepizzaball, I recommend reading a recent piece I wrote which, coincidentally, addresses precisely these issues. You can find it here.
Your essay doesn’t substantively address any of these questions.
W.r.t the Thompson’s killing you say that it may deter insurers from adopting UHC’s practices but do not show that the induced behavior would actually improve anyone’s well being. In the example you cite in which BCBS and Anthem decided not to adopt medicare style billing the likely effect will just be raising premiums. No one was being denied anesthesia if their surgery went over time; the change was supposed to stop providers from adding costly surprise bills. While I’m skeptical that this event will have any long term effect at all, I’m even more skeptical that insurance companies making decisions based on fear of populist violence will produce good healthcare policy.
You briefly discuss the potential for social instability but 4 sentences is remarkably short shrift to give to the chaos that typically follows a break down of the rule of law. It should go with out saying that such environments tend to not render the best and most just health outcomes.
Finally, its not clear how much weight these utilitarian appeals carry in your judgement.
I didn’t spend more time on these issues because it’s ultimately a moot point: the assassination was unjust in any case, since no private citizen has the authority to unilaterally commit extra-judicial killings.
I asked these follow up questions because you contradict that reasoning in your concluding paragraph.
Is this not a unilateral judgement of when to void the social contract ? Clearly this allows for morality outside the exclusionary purview of the law. More over in your analysis of Thompson’s guilt you use a standard for fraud thats clearly different from the legal one. Why would you not defer there?
Its absurd to conclude that the killing of man is good if not for lockean issues of authority — that you yourself don’t think are binding — without throughly considering the consequences.
This was an interesting read, but very little is said about the responsibility of the government, which seems to be the crux of the matter. What does it mean for a government to “renege on its duties to protect rights within a particular domain”?
In most domains, responsibilities are shared by citizens and the government. When you buy a new phone, for example, you should acquire information about its quality from independent sources. When buying health insurance, it is even more important to make an informed choice. The government cannot fully take over this responsibility.
Uncontroversially, the state should provide options for individuals after they have purchased insurance, such as taking the insurer to court. But it seems that Bazargan-Forward wants the government to go after insurers pro-actively. This may be a good thing, but it is not clear to me that a government who fails to do so reneges on its responsibilities. It seems that it is permissible for a country’s citizens to assign the government a more restricted set of responsibilities (through the democratic process) and retain individual responsibility for deciding who to purchase insurance from – without this leading to a situation in which it becomes morally permissible to assassinate CEOs.
I agree that people who make mistakes when they chose to purchase products and services on the market should be held responsible for the mistakes they make. I do not want to say that the government can or should take responsibility for these mistakes. But even libertarians think that *fraud* is a legitimate basis for state interference. The kinds of cases I discuss and I am focusing on are not mere cases where policyholders made bad decisions — but where they were victims of fraud resulting in bodily harm.
I agree that victims of fraud should have the option to take the perpetrator to court in order to get what they were promised plus damages. The question is whether a state that only offers this, and does nothing more to prevent fraud, reneges on its duties. I believe it doesn’t (perhaps you agree), which would make it quite unlikely that extrajudicial killings will (on your account) become morally permissible in the future.
This is a good point, but I worry that ex post compensation will often be too late when matters of life and death are involved.
I do healthcare ethics and specialize in the ethics of killing, and I can say, without reservation or qualification, that the killing of the CEO was wrong. He was innocent in the material sense — he was defenseless and posed no imminent threat to any single identifiable person in the circumstanced in which he was killed. Whatever wrongs he was involved with by virtue of his overseeing of a company that regularly withholds resources from deserving people who may die as a result (which may throw some shade on his formal sense of his innocence) does not justify this act of killing — it was murder.
Those that smile on this act of murder anyway strike me as bolsheviks whose ethics can easily be turned on themselves, depending on who has the gun, who has the will to denounce, and whether there some popular sentiment behind shooting the gun.
I see based on your publications you work on healthcare ethics, but not on the ethics of violence. An individual need not pose any imminent threat to any single identifiable person in order to be morally liable to be harmed.
And in any case, I’m not sure who you’re arguing against — as I mention in part 5 of my piece, the assassination of Thompson was not justifiable. It was murder.
Also, I find your ad hominem at the end condescending and unbecoming of reasoned debate. You are welcome to respond to this; I won’t be responding any further to you.
Let the reader see that I spoke of killing not “violence”, I am arguing against anyone who thinks this is a tough question (not necessarily the author of this piece), and that I stand by my ad hominem if the shoe fits.
The idea that one must pose an imminent threat to a single identifiable person to end up liable to lethal force is wool the powerful have pulled over the eyes of the hoi polloi drafted into the military to explain why nobody should blink an eye when two million innocent people die in a war that could’ve been avoided by assassinating one dictator. The ruling class have been giggling for hundreds of years over convincing everyone that the rightful targets are the people with the guns instead of the people telling the people with the guns what to do. Thankfully we have a counter-tradition to this in philosophy, represented by lots of different voices, including socialists who talk about violent revolution, decolonial theorists who talk about violent decolonization, and (most relevant to your particular point here) revisionist just war theorists who push back against the idea that any number of dead soldiers is better than one single assassinated leader.
That of course does not get us a straight line to shooting health care CEOs (see Saba’s point above) but it’s relevant to your larger claim that you have to be about to kill someone to be liable to lethal force.
What difference does it make that he was not an “imminent” threat and defenseless? Some find it permissible to lock up and even kill individuals who are not an imminent threat, but could pose harms to a number of unidentified individuals in the future, say terrorists who plan to poison the water supply.
Take as a real example, the extra-judicial killing of Iranian nuclear scientists. They were of no immediate threat, probably working in labs, to those around them. Whatever wrongs they were involved with were only in virtue of their overseeing of a research lab that created weapons (which may throw some shade on their formal sense of innocence).
Sorry, non-philosopher: he does healthcare ethics and specializes in the ethics of killing. You, in contrast, are a non-philosopher without authority. Argument disregarded—better luck next time!
In Adam’s defense, I think he was picking up on this passage from Saba’s piece:
Yes, that is certainly what he was referencing. I find both his comment and the original passage off-putting. (No, I will not elaborate on that.)
For the record, I appreciated “non-philosopher’s” follow up comment to me the most. I don’t think his/her example defeats my point since I didn’t saying anything about detaining someone, which is to be preferred to killing. As for the scientist, I don’t think that’s decisive either. I’d like to know a bit more about the circumstances and so on and I doubt they are relevantly similar to the CEO. We could get into a big long back and forth about that, Chisholming the principles, etc. but I don’t have time for it and don’t really care enough to defend myself from the criticism. In any event, I took my potshots and I am willing to receive them.
Lastly, I don’t care for credential mongering either. I introduced myself that way ironically because I don’t think it takes any special expertise to condemn this egregious act of murder.
This line of argument appears to ignore the morality of acting rationally. No matter how repugnant its actions appear to be, UHC is acting rationally when it squeezes more profit from people. It is even acting rationally when it denies claims fraudulently knowing that the penalty is less than the profit. Calling it immoral when they don’t do the ‘right thing’ is the real problem. Think of this from another direction, do we want a company trying to define what actions are ‘right’ and ‘wrong’ and then follow them? Because that is what we are doing when we argue that they shouldn’t take every possible step to make a dollar. A company’s only incentive is profit so allowing them to change the rules in their favor is the only irrational, and therefore immoral, action that has been made, and that action was taken by society, not UHC. We should assume that any company will, and should, take the most profitable move. Asking that they make any other move is to ask them to act irrationally and that is immoral. In short, I argue it is moral to act rationally, that society sets the framework for commerce and and that it is irrational, and therefore immoral, that we give them any voice or influence and further that it is irrational and immoral to have delegated the definition of what are ‘good’ or ‘bad’ actions to companies. That means that the only real argument that UHC is immoral is that they, or any company, makes an effort to change the rules or guide legislation. Or put even more bluntly, society is to blame here, not UHC, so any argument that violence against UHC by an individual is justified is misplaced.
“Acting rationally” in the economic sense, for a corporation, refers to maximizing its profit. Maximizing profit by causing harm to others is very often wrong. Therefore acting rationally is often wrong. That part of “the morality of acting rationally” seems pretty simple.
“Do we want a company trying to define what actions are ‘right’ and ‘wrong’ and then follow them?” Yes, of course. That’s what they do every time they follow policies of sustainability, DEI, fair labour practices, etc. and even when they get that wrong, it’s less likely to lead to morally wrong outcomes than the ruthless pursuit of profit maximization irrespective of the consequences.
“Asking that they make any other move is to ask them to act irrationally and that is immoral.” Uh, no. That’s like saying “asking a racist not to be a racist is to ask him not to be himself and that is immoral.”
If society is lax about punishing breaking and entering in a particular place, then from an economic sense it may be perfectly rational economically to break into a small business in that place and steal from it. By your logic, we should only be blaming society for that action, not the thief. Asking that the thief make any other move is to ask them to act irrationally and that is immoral.
Eichmann was dang effective, doing what was rational based on his job description and prevailing laws, and given what his superiors expected from him. A case of perfect limited instrumental rationality. Also, a case of why this is in itself – without looking at the broader moral, political, economic framework it occurs in – it is entirely irrelevant to morality.
**** Hi all. I didn’t get a chance to respond to everyone – I apologize to those I missed. I’m signing off because at this point it seems I’m just repeatedly reminding readers of the verdict I reached: the killing of Brian Thompson was an unjust act of murder which should not be condoned. Apparently, for some people, I took too long to reach that conclusion. Thank you in any case for the lively discussion. ****
Many commentators argued in bad faith against the original post or didn’t read it carefully, or both. Great post!
Yes, you reached the right conclusion. But it is appalling that apparently some philosophers need 3500 words to reach a conclusion established by the simplest moral syllogism:
This is interesting- at first I thought you were wildly misrepresenting the argument, but I see the implication now. Of course though, the author cannot help themselves to premise 2, and on their argument, the door is open to reversing the conclusion (while with yours it is not), depending on whether we can conclude that the government has defaulted in ensuring certain protections for the people.
Readers, I’m going to leave Tristan’s comment up because I think it’s a good example of a disappointing comment from a fellow philosopher.
I don’t know Tristan, and I don’t know what he is like or what he thinks about anything apart from this comment he has left here, so don’t take the following as being about him.
The comment is disappointing for a few reasons:
– its sneering tone (“appalling”…”simplest moral syllogism”)
– the lack of curiosity it evinces about ideas and why people might hold them
– the absence of any engagement with the text (e.g., Bazargan-Forward does discuss Thompson’s “innocence”)
– its point seems to be to assert the author’s moral superiority (not an especially virtuous use of virtue signaling)
I know I don’t intervene in the comments a lot, and I imagine some readers have in mind other examples, perhaps in this thread, of places I ought to have. I accept that criticism.
I guess I’ve gotten increasingly grumpy about these kinds of comments. I expect them on Twitter/X (etc.) but I do hope for better here.
When I read a draft of Saba’s post, I found it riveting. My own view is that there are several individually sufficient reasons Thompson’s killing was wrong, but I know how good a philosopher Saba is, and the way it is written—by taking seriously the moral arguments that might be marshalled to morally justify Thompson’s killing or something like it—had me wondering at the start whether I’d be forced to change my mind.
That kind of philosophical excitement is to be treasured, no?
Far from finding the piece “appalling”, I was grateful for it. I would hope that this is a very normal philosophical response (a la Socrates or Mill).
That’s a fair criticism, Justin. And I appreciate that you left my comment up. You are right that it was primarily expressive. I apologize to the author and your readers for the lack of charity and the sneering tone. It’s certainly not in the spirit of the season.
If I may give some defense: I was not so much concerned with the substantive merits of the piece, but rather about the state of our field, where the value of “philosophical excitement” competes with even the most basic moral standards (i.e., you shouldn’t kill innocent people).
Maybe it has always been thus (e.g., Socrates and Mill). But just as a philosophers like to see themselves as making the world a better place, I would also like to hold ourselves to the standard of not making it a *worse* place. And in my view, this piece and your promotion of it here, does more harm than good.
Except this argument is clearly unsound. It’s obviously sometimes permissible (if tragic) to kill innocent people. The clearest examples would be self-defense or warfare (unless you’re a radical pacifist, I guess). To ignore that is silly, and to criticize philosophers of all people for discussing where the limits of that permissibility lie is even sillier.
In addition to becoming a radical pacifist, there are a few (more time-honored but in my mind less compelling) routes chosen by people tempted by the kind of view Tristan defends. The routes are typically combined so as to allow for as much killing as possible.
One route is to find expansive ways of classifying people as guilty. For instance, having been drafted at the point of a gun with one’s family threatened by a brutal dictator typically renders one guilty, so long as one is wearing a uniform and holding a gun (and often they are willing to relax the holding a gun condition, and even sometimes the wearing a uniform condition, to accommodate the realities of modern warfare, where one must lob high explosives a long distance if one is interested in victory).
Another tactic is to suggest that so long as you satisfy exactly the sort of constraints someone like Saba places on killing innocents (proportionality, necessity, etc.), you’re allowed to maim and kill as many of them as you’d like so long as your goal is something else, like blowing up a factory.
After having put into effect these and other tactics to explain why the proletariat must always bear the brunt of the wars, leftover time is often devoted to supercilious descriptions of their opponents, who are characterized as so morally corrupt that it’s not worth talking with them: one should only shine a spotlight on them and then tut tut about how awful philosophy is for having people like this and not enough enlightened and morally upright people like oneself. Happily not everyone defending Tristan’s view acts like this (or at least they don’t always act like this…) so some useful discussion does sometimes occur. (It’s not as if there’s nothing to say for the above sorts of arguments, although ultimately I think the first one is ludicrous and the second one is casuistry.) But one sometimes wishes we could have the discussion without the insults.
The question of whether to have a long nuanced discussion of the ethics of killing Thompson can’t really be separated from the first order question of whether it was ethical.
Daily Nous did not, I am fairly sure, publish a long and thoughtful discussion of the ethics of mass shooting in the wake of the Uvalde murders in 2022. And I think if it had done so, there would have been widespread agreement that it was wildly inappropriate. That’s not to say that philosophers should not be permitted to discuss even such basic ethical questions as why it is bad to murder small children: it is to say that there is a time and a place for such discussions.
If Thompson is different, it is presumably because Justin thinks that reasonable people might differ as to the ethics of gunning down business leaders in American streets. Fair enough. But those like Tristan – or me – who find the first-order ethics pretty obvious are also likely to question the appropriateness of the second-order conversation, only two weeks after Thompson’s murder.
(There are more intermediate – and hence perhaps more interesting – cases than Uvalde. Daily Nous wasn’t around when the abortionist George Tiller was murdered, but of course plenty of people – on a rather different side of the political debate, for the most part – celebrated or at least sympathized with his killing, and if you accept the antecedent political/moral views in each case the Tiller and Thompson murders look quite similar. Daily Nous did host a post on the ethics of the Charlie Hebdo massacre, and I recall being fairly impatient with those who thought this was a good time to discuss the limits of free speech, but so far as I recall there was no actual discussion of whether killing them was ethical.)
Hi David.
When millions of people hear about an apparent murder and respond not with condemnation but with something like, “yeah, I can see that,” that’s interesting. It’s an initial reason to think “maybe we should take a closer look at this” or ask “what could these folks be thinking?” or double-check our own judgments about the case.
I don’t recall any similarly anomalous widespread reactions to the Uvalde murders. (If there had been, that would have been very interesting indeed, no?)
So I think the matter is less directly about first-order normative judgments and more about the occurrence of a moral-philosophy-relevant social phenomenon. (If there was such a phenomenon accompanying the Tiller murder, I think I would have considered a similar kind of post about it.)
(And just to be clear, folks: I think all of the killings discussed in this comment were wrong.)
I take the point, up to a degree. It is interesting and disturbing, and certainly a reasonable topic of discussion, that so many people had this response (I’m not sure I’m persuaded it’s ‘millions’ of people, but certainly it’s widespread). Still, one could say the same about the attempted murder of Donald Trump this summer, or of Paul Pelosi in 2022, both of which were celebrated in some (largely non-overlapping) quarters of the internet. I can’t say I was inclined in any of those cases to reevaluate my moral judgement that it’s bad to murder people.
(BTW, ‘apparent’ murder?)
(I think my first attempt to post this was discarded as spam)
First, as David said: ‘apparent’ murder?
Secondly, Justin’s principle seems to be applied selectively. Probably millions of people did celebrate the murder of abortionist George Tiller, but I’m pretty sure (correct me if I’m wrong!) Justin would have taken that as a cue to condemn those people, not to regard the celebrations as a ‘moral-philosophy-relevant social phenomenon’, or double-check his judgment about the murder, or describe it as ‘complicated’, or illustrate a guest post about it with two bullets labelled right and wrong.
In this case too, it’s not clear why it would be unreasonable to regard the gleeful celebration of cold-blooded murder as telling us something about the people celebrating, rather than as calling upon us to re-assess our condemnation of cold-blooded murder as perhaps too hasty.
And one’s eventually reaching the correct conclusion on the ‘question’ (gunning down a health-insurance CEO in the street: right? or wrong?) doesn’t entail that it was a good idea to raise it in the first place — or even to mention it only to dismiss it:
‘An effective way for actions to be ruled out is that they never come into thought at all, and this is often the best way. One does not feel easy with the man who in the course of a discussion of how to deal with political or business rivals says, “Of course we could have them all killed, but we should lay that aside right from the beginning”‘ (Bernard Williams)
(It is not relevant to my point that Mangione was not dealing with a business rival)
The difference between the Tiller case and this one is that, in the Tiller case, if millions celebrated, it’s likely that they had different basic moral intuitions (viz. fetuses are persons) as those who believed it was easy to condemn his killing.
in this case, the millions of people celebrating likely have the *same* basic moral intuitions (viz., the CEO was a person (with all the moral significance that comes from that) as those who believe it is easy to condemn his killing as morally wrong (which I do).
That is why this case seems to be a moral-philosophy-relevant-phenomenon (whereas the Tiller case doesn’t seem to be)
I would have thought that one who found it easy to condemn the murder would regard a readiness to celebrate it as itself a strong indication of a wide gulf in ‘intuitions’
Speaking for myself, I have no more ethical fellow-feeling with the one group of celebrants than with the other.
If these people share your ‘intuitions’ about what was due to Thompson as a human being, what are they doing celebrating his murder?
I don’t understand this argument. Justin also published several discussions on the massacre in Gaza. Did you argue against publishing thoughtful discussions about the genocide of civilians? Sometimes people disagree on important real world things instead of just abstract philosophical puzzles. Philosophy can be a benefit (and probably should be) in those cases too.
I wish you’d bring the same kind of nuanced thinking to other issues where someone is quick to claim that their academic freedoms or free speech is violated by other people contending that some discussion or other is inappropriate in the form that it is being conducted.
I do, I think. Pretty much all the free-speech discussions on DN concern not criticisms of speech but coercive acts to prevent it, or else discuss whether some activity is speech or non-protected conduct. Criticizing a speech act is perfectly compatible with defending a right to that speech act. I am skeptical that a nuanced exploration of the morality of a man’s murder is an appropriate topic of discussion on Daily Nous, but Justin uncontroversially has a free-speech right to host that discussion. To re-use an example from a previous time this came up: if I didn’t just criticize its appropriateness but hacked DN to delete the post, *that* would be an offense against free speech.
I think I’ve said this to you before, but moral criticism is useless without it having practical implications.
Since you are against coercive intervention after the fact (and also against coercive prior restraint, I suppose), I guess you aim at something weaker. At least, perhaps, the aim to convince Justin not to do this again (or even to see the error of his ways and removing the post). Without such (or similar) practical consequences, your moral claims are pointless, hardly *moral* claims to begin with.
I remember you as someone who takes really very great exception to arguments aimed at getting someone to not say something again or to retract something they said. I’m unfortunately not crazy enough to have kept receipts.
Regardless, I’ll remind you of this the next time. Til then.
“At least, perhaps, the aim to convince Justin not to do this again (or even to see the error of his ways and removing the post). ”
Not even that: just to communicate why I (and I think some others) thought it ill-judged, and to log for third parties that not all philosophers think this is a subtle or difficult question – but also to hear counter-arguments (Justin’s counter-argument is interesting even if I wasn’t fully persuaded). DN remains interesting even after 10+ years, whereas most philosophy blogs have tended to die on shorter timescales, and I attribute that to Justin having a good instinct for topics; I’d strongly prefer him to carry on following his nose even as I disagree with some individual calls.
“I remember you as someone who takes really very great exception to arguments aimed at getting someone to not say something again or to retract something they said. I’m unfortunately not crazy enough to have kept receipts.
Regardless, I’ll remind you of this the next time. Til then.”
There’s not much I can do with “I recall you expressing strong views that contradict what you say here, but I can’t prove it”. But if you look (e.g.) here, I say explicitly that ‘ “debate me” and “shut me up coercively” are not exclusive options. “Ignore me” and “persuade others not to listen to me” are also available, and don’t violate anyone’s free speech rights.’ I think I’m being consistent.
“There’s not much I can do with “I recall you expressing strong views that contradict what you say here, but I can’t prove it””
Yeah fair. I’d honestly thought you’d just agree with those strong views and then we’d talk about whether they contradict what you do here. Sincere apologies for the mishap.
“But if you look (e.g.) here, I say explicitly that ‘ “debate me” and “shut me up coercively” are not exclusive options. “Ignore me” and “persuade others not to listen to me” are also available, and don’t violate anyone’s free speech rights.’”
Sure, but this bears little relation to the matter of what you think about morally condemning the mere having of a particular debate.
Based on this response, it seems to me now that you generally agree that some debates can be immoral to even have. As in, we shouldn’t have such debates and those who pursue them are morally in the wrong. And, moreover, that it is not wrong to point that out.
Additionally, you claim that interfering with an ongoing debate (even when it is itself immoral) would be wrong. If we want to fight the mere having of a debate, we could do so by starving it through nonengagement etc.
Let’s see how it goes the next time someone feels wronged by their peers morally disapproving of the debate their work engages with. I trust you’ll join me in the “sounds like a you problem” camp.
I think that’s about right, though FWIW I’d lean pretty hard towards active tolerance to debates (especially on university campuses) in most circumstances (I’m not even sure what I think about this one, more trying to express why I and I think some others find it a bit disturbing) and I dislike the notion of actively trying to “fight the mere having of a debate”, though perhaps that can be construed as just “persuade individuals not to participate in the debate”. (And I think universities qua universities ought to practice institutional neutrality and not commit on the rights or wrongs of any debate.)
But sure, some debates can be immoral, and no-one is wronged by having people disapprove of their speech. The cases I tend to weigh in on are usually when the response goes beyond disapproval into harassment, shouting down, trying to get people fired, and the like.
Certainly the analysis was a thorough investigation of a very complicated issue of personal and societal guardrails against abandoning morality, or so that is how I felt about it. It may have been bound by the limits of the writer’s experience, which were explained before the main topics were explored, but it left me less confused about the topic and its many complications, as did a few of the posts that explored the context of the topic in additional directions.
As an engineer I sometimes attempt to bring my limited understanding of the philosophy of morality into the process of providing products and services, I find the perspectives of thoughtful philosophers helpful and instructive and often have a relevant tome at my bedside that I crack open a few times a week thought this is mostly to guide my personal life rather than for work. I do not have the tools that the author, editor and others have to shine a flashlight of reason into all of the possible corners that are the cause and effect of thought, words, and actions. But I can read their thoughts and work to understand them and integrate them into my thoughts. We all have our various educations and skills and I appreciate those who have spent a lifetime on such difficult subjects. Having the ability to read in places like this leaves me with many questions answered and many thoughts to be explored further and an understanding that I need to slow down and look more broadly at an issue and more deeply at the specifics that impact others. Every philosophical discussion pushes me to slow down and consider more information. Sometimes it helps guide me in simple daily interactions with other people and when successful, I am more satisfied with who I am. I wish I had had more time for more than just a single course in philosophy in college, events like this leave me wishing for a more thorough education in these topics.
This particular event has very much pulled at the edges of what I thought was a solid moral foundation and places like this website are helping me process the event, understand my own and others feelings, and then find a moral and just path that continues to see how complicated the topic is without leaving me unable to find a moral and just way to place my thoughts within the context of the discussion. This article in particular was a positive and thoughtful reading exercise. It validated my emotions while appealing to my understanding of morality and justice and why they are important if I wish for a just and fair society and not anarchy.
I guess I could have just said thank you but I felt like the efforts here deserved showing that I did read and think before posting. And rather than just move on to the next article; show appreciation for enriching my ability to consider and digest such a difficult (for me) topic. But just in case…
Thank you!
Saba did not use 3500 words just to give his positive case for his conclusion. Much of his piece was devoted to laying out the empirical context that many people believe – rightly or wrongly – to be morally relevant to the assassination, and to addressing (I think with admirable carefulness and seriousness) some of the objections that someone might raise against his view. I think he was right to do those things in addition to giving his positive view, but even if you think I’m wrong about that, your characterization of what his piece is doing seems disingenuous.
I agree with the positive things Justin said about Saba’s piece. If I’d initially thought the assassination was justified, Saba’s piece as written might have persuaded me otherwise, but it certainly wouldn’t have done if he’d just presented the syllogism you gave (and especially if he’d presented it as being so self-evident that anyone who doubts it is appalling). In fact, I initially thought the assassination was not justified, but after reading the piece I feel I have a much better basis for that view, partly because I’ve more carefully engaged with the opposing arguments.
I’ll also just report for the record that, as a grad student who wants to do work on some controversial moral questions about which people (appropriately) feel very strongly, one of the things I find most inhibiting is the possibility of facing exactly your kind of reaction: the idea that not only is it appalling to hold some view, but it is appalling even to engage seriously with that view, and even if I so engage in the process of disagreeing with it.
I especially worry about a possible third-party effect that idea might have in the classroom: that a student for whom some topic/question is particularly personally relevant – say, someone with a chronic illness who takes a philosophy class about healthcare ethics – will be primed, by cultural/internet exposure to reactions like yours, to believe that a teacher or classmate who engages seriously with competing views on that topic – some of which may seem to (and may in fact) treat the student’s interests with insufficient respect – is herself disrespectful of the student. I can easily imagine different scenarios where students might feel that way, non-culpably but also, in my view, mistakenly. That would be bad, because it would make it harder to generate good classroom discussion in which everyone feels comfortable thinking out loud and risking making mistakes, and because it’s bad for students to feel that they are disrespected by their teachers and classmates. Of course, we can do lots of things to mitigate that risk. But your kind of comment (both the content and the tone) makes that part of the job harder.
Thank you for the piece. It reminded me of this story:
A poor man went door to door in the winter asking for a coat or blanket or whatever could save him from the cold outside. Days and nights passed and he suffered as no one helped him. One evening he knocked on a door and when the residents saw his destitute situtation, they promised to provide him with a warm dinner and blankets for the night. The residents went back inside to fetch what they had promised, but got distracted by something, forgetting to return. In the morning, they found the frozen lifeless body of the man on their porch with not next to it that read: I survived many nights by relying on myself, but this night you gave me hope so I let down my defenses. As you find my lifeless body know that my blood is on your hands because my dependence on your failed promises is what broke me.
As a muslim, I would like to add this: in Islam, a failed promise is a calamity on par with some of the worst sins.
Well privately-run insurance companies have definitely kept their promises to their shareholders.
This ongoing discussion misses a distinction between the justice of an act and the justice of the resulting state. We can imagine cases where a just outcome is achieved by an unjust act. E.g. the vigilante killing of a murderer who went free because they bribed the jury; or an innocent person going free after a false accusation only because they bribed the jury.
Such cases, familiar from various fictions, lead to this mixed feeling of satisfaction in justice being done combined with queasiness about the methods. We have, as people here have iterated, very good reasons to demand that justice be achieved through a just process and it would be a grave mistake to give up on this demand. But we also take satisfaction in justice being achieved period. This is the likely origin of the bifurcated moral response to this particular case that cecil burrow notes above. There is a sense that some justice has been achieved, even if the means were unjust.
The very existence of this broad response (over and above the mere occurrence of the actual assassination) demonstrates that in the eyes of many, insurance CEOs pattern with the type of cases in my first paragraph: they appear to be literally getting away with “murder” because they “bribed” the “jury” (“murder” being social murder; the “jury” being the elected representatives; “bribes” being campaign contributions etc.)
This much has been laid bare through this episode, and what has been laid bare now demands to be faced.
Plaintive indignation about the injustice of the assassination itself or high-minded explanations of the dangers of vigilantism are not likely to make this go away. These aren’t even on target. The “masses” have demonstrated a need not for education on justice, but a need for justice itself. (Whether or not they truly are lacking in justice is a different matter.) A more interesting (and more useful) philosophical project would thus be to investigate the justice of the circumstances that precipiated the assassination and that led to this peculiar emotive response.
Or, in brief: “vigilantism is bad” won’t convince anybody or change anything; “the assassinated person did not actually participate in an unjust practice” might. But the latter case is also so much harder to make.
While it is true that UHG is 4th in terms of revenue and has large (numerical) profits, it is worth thinking about this a little more clearly because it complicates the “big company makes huge profits off of little guys.” Revenues are the total amount the company makes in a year. So, the larger the revenues compared to the profits, the smaller the profits expressed as a percent. Looking just now, Apple and UHG have similar revenues ($383 billion vs $372 billion). But Apple had $96 billion in profits compared to $22 billion for UHG. This puts Apple’s profits at about 25%, compared to UHG’s 5.9%. I guess my point is that if you want a quick take on how well a company is doing, it looks like UHG is doing just ok–a lot of business for not very much profit, compared to a lot of other large companies (and small ones). As a general rule I don’t think health insurance is an incredibly profitable industry. Relatively speaking, UHG is not a very profitable company and its CEO was not relatively well paid (average Fortune 500 CEO pay was $17 million compared to his $10 million). Like many things about this case, the optics play well to people who don’t know much about what CEOs are, how companies work, etc. In other words, to most people. Why not err on the side of educating readers about how to evaluate the relative success of the company and the CEO compared to its peers?
Noah Smith had an interesting breakdown of the situation recently. I’m agnostic about the claims but I found it helpful context.
https://www.noahpinion.blog/p/insurance-companies-arent-the-main
Another way to think about it is that there are companies that are making even more obscene profits than UHG, usually because they have access to many more means of exploiting people, such as third world labour, etc.
Denying health insurance isn’t morally wrong? Get bent. Prioritizing profit over care is absolutely morally wrong. You’re morals are broken and you shouldn’t be trusted
Moreover, we’re not talking about denying insurance due to some possibly reasonable criterion. We’re talking about a deliberate strategy to not pay people what they are owed, and hoping that *they will die* before the claim is made! If people on this blog see no moral problems with this then the philosophy of ethics truly is a great waste of time.
John Locke: Locke maintained that governments are formed to protect the natural rights of life, liberty, and property. When a government fails in this duty, citizens have the right to alter or abolish it.
The key word is “alter”. The one component that is left out is that UnitedHealth has money and power. In power, I mean strong lobbyist to protect it’s interest over citizen’s rights. The United States isn’t going to protect it’s citizens from UnitedHealth’s unethical practices. So, vigilante’s (and yes, I am uncomfortable with vigilante’s being public citizens) have the right to alter government’s hold on citizens for the sake of justice. Now, this will play out in democracy but the one Jurist who hold that Luigi Mangione’s actions were justified given the situation.
The overall reaction to this killing feels like a real world confirmation of emotivism as if not actually the case, certainly how we actually behave.
Really? To me it feels more like a real world confirmation of class sympathies.
I think there’s some oversight here: “Thompson is tried before a criminal court and found guilty, in his own person, for authorizing policies systemically defrauding policyholders at UHC.” … “Importantly, though, it would be wrong for the government to execute Thompson because the government would have another, less harmful option at its disposal: it could imprison him.”
From a purely fiscal perspective, sure UHC defrauded its policyholders. What was the effect? While there hasn’t been a study performed directly on claim denials leading to death, a Harvard study in 2009 found that lack of coverage correlates to about 45,000 deaths per year. There’s been some research showing a potential link to claim denials correlating with increased mortality rate, though nothing super concrete. Assuming that a claim denial roughly correlates to lack of coverage, there’s a link that claim denial can lead to fatality.
Assuming a couple of things:
The above fulfills generally the three criteria of 1st degree murder:
If one were able to make a good-faith argument that the claim denial wasn’t an act of Deliberation or Premeditation – for example the insurer in good faith believe the denial of claim wouldn’t lead to loss of life – it’s possible to still consider it 2nd degree murder via Extreme Indifference to Human Life (pending individual state determinations on what exactly that constitutes).
Now multiply that by the possible thousands of deaths caused by claim denial, and implying culpability to UHC’s CEO, it’s plausible that many states may find the death penalty more than reasonable for effectively several thousand murders.
But this is why we have courts of law. If (I find this incredibly implausible, but I’m not a lawyer) it can be established that CEOs have committed thousands of murders according to the legal definition of murder, it’s for a state prosecutor to establish it before a jury, not for a private citizen with a gun to decide it unilaterally.
What a naive view of politics you have. Why do you think the insurance companies spend so much money lobbying politicians? As for a citizen taking a multi billion company to court… (lots of loud laughter)… you first.
Did I say anything about citizens? Criminal prosecutions aren’t a private affair in the US.
But in any case, I apologize for my naivete to the sophisticated political thinkers who understand that the sensible, practical way to make progress on difficult issues in a democracy is to make an individual assessment of who the Bad People are and then to murder them.
You’re naive because you think corporate strategies that include the deliberate killing of citizens are somehow going to be prosecuted by a government that the same corporates pay for. I would have loved to hear your arguments when democracies allowed the owning of slaves as to what sensible and practical strategies the slaves should employ to free themselves.
Maybe instead of fetishizing ‘Democracy’ you should try to gain a more realistic picture of the oligarchy you live in.