Monday, March 31, 2008

Hows and Whys

It is a cliché to say that science answers “how?” questions and religion answers “why?” This particular cliché has been trotted out many times in the newspapers over the last few days as we have witnessed the debate over whether Labour MPs should be given a free vote on the Human Fertilisation and Embryology Bill now before Parliament. Thankfully, sense prevailed and the government will no longer try to force MPs to vote against their consciences.

Oliver Kamm attacks the how/why cliché in his blog but makes the common mistake of not realising that it represents a rather stronger argument than journalists either express or, in all likelihood, understand.

“How questions” are shorthand for things answerable in the objective domain of science. It is an extremely important strength of the scientific method that it is, in its ideal state, heroically objective. Needless to say, this ideal is rarely met and on a philosophical level, collides with the problem of under-determination (whereby it is impossible to say exactly which theory is being demonstrated by a particular set of facts).

“Why questions”, in the same shorthand, do not just stand for the meaning of life. Many atheists, Kamm probably among them, share the view of Douglas Adams’s on such matters. Adams famous answer of 42 for the meaning of life, the universe and everything means no more than he thought it was a silly question. But not all “why” questions are so easily dodged. In particular, atheists are in philosophical difficulty with ethics.

It used to be supposed that science might provide an objective basis for ethics in much the same way as it does for kinematics. These hopes, despite the discovery of a natural ethical architecture, have been dashed by even the latest research. Secular ethics in the West is essentially Christianity with a bit of free love tacked on the side, and it has to be admitted that the free love is causing some trouble. Arguments for embryonic stem cells and animal/human hybrids, which have dominated the discussion of the limits of scientific research, are essentially utilitarian. But no right-thinking person believes utilitarianism is an acceptable basis for ethics. Indeed, nowadays it is rarely brought out except in this rather special case. Interestingly, research by Marc Hauser and others shows that human beings appear to be naturally opposed to utilitarian solutions even if they are divorced from religious concerns.

This leaves the western atheist, whose ethics are Christian at one remove anyway, in rather an odd position when they start to whine about the Church having too much influence in a secular society. They have no alternative ethical system to the one proposed by the church and their historical make-up is largely determined by previous religious decisions anyway. This is why Kamm is wrong to dismiss the how/why dichotomy, at least until he can present an alternative system of ethics that does not rely of plundering religious thought and then claiming atheists thought it up first.

Incidentally, the case for animal/human hybrids has always been a bit sparse. Some scientists have made out that such things will allow them to cure Parkinsons and Alzheimer’s disease. Quite why these particular conditions are the ones mentioned is a bit of a mystery, of course. What said scientists really mean is that they would quite like to have a go at making hybrids and maybe some useful research will come out of it. Like my three year old daughter and her relationship with chocolate, they don’t seem to understand the difference between the words “would like to” and “need.” Given we were previously assured that embryonic stem cells were essential when it turns out they are nothing of the sort, we could have hoped that these people would not try and pull the same stunt twice.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Tuesday, March 18, 2008

The Problem with Attachment Theory

At its base, traditional attachment theory makes the following prediction – take identical children and separate them at birth. One is brought up in a loving family where it forms stable attachments to its adopted or real parents. The other is less fortunate. It is moved through a children’s home, to foster parents, back into care and has no chance to enjoy a proper upbringing. Child one goes to a good school, child two goes to lots of bad schools. According to attachment theory we should see marked differences between the children once they grow into adults. But we don’t.

Even if no one has been cruel enough to do the experiment mentioned above, there have been hundreds of studies of identical twins separated at birth. The researchers were trying to establish how much their personalities and behaviour were affected by nature and how much by nurture. The answer was that identical twins showed a correlation with each other of about 50%. But this figure was almost the same whether they were brought up together by their natural parents, brought up together by adopted parents or separated and brought up apart. Nurture seemed to play no part. Likewise, adopted children did not correlate to their adopted parents anymore than a stranger off the street would. There were some nurture effects while children were still growing up, but once they were adults, these disappeared.

The first person to try to make sense of these results (which were the opposite of what most researchers had expected), was Judith Rich Harris in her book The Nurture Assumption. She was not a psychologist, still less a geneticist and some felt her outsider-status gave them a license to ignore or insult her. Contrary to popular belief, Harris did believe in nurture, but from peers rather than parents. Since attachment theory is generic enough to handle peer-to-peer relationships, some attachment theorists responded to Harris’s criticisms of family-based nurturing effects by shifting their attention from the parlour to the school yard.

The trouble is that there is hardly any evidence for Harris’s peer pressure hypothesis and quite a lot against it. For a start, it is, at first sight, unlikely that parents could have practically no effect and other children such a lot. Work comparing children sent to nursery at six months and those kept at home has found some evidence that the former are more confident and aggressive, but this wears off before they grow up. The Chicago work on school places I referred to a few posts ago suggests it doesn’t matter which school you went to, although this was based on academic results rather than personality. More work is required and we are still hamstrung by having no reliable way to measure intelligence, but things are looking pretty grim for the peer-to-peer hypothesis. The family hypothesis is already dead, if not buried. If peer pressure goes the same way, as seems very likely, there will be nothing left for attachment theory to attach itself to as far as long term outcomes are concerned.

Of course, attachment theory still feels it has something to say about relationships. We are all happier in a stable unit than cast out on our own. Single people are sadder than married people, orphans are less happy than children with both parents. But I’m not sure that we need a special theory to tell us this or that attachment theory’s explanations rise much above the level of psychobabble.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Thursday, March 13, 2008

The Rise of Attachment Theory

On the rare occasions that I make it back from work before her bedtime, my two year old daughter leaps up from whatever she is doing to rush to the door, open it for me and throw herself into my arms. There is no doubt that young children form very strong emotional attachments to their parents, as their parents do to them. Deprived of these attachments, children become miserable but as they grow up they become better able to cope with parental absence. I see mine every few weeks, my wife sees hers, who live in Australia, about once a year.
Observing the difference between a happy child in a stable family with strong bonds to its parents and one without such supports, it is easy to conclude that these early attachments have a lasting impact on the way that we develop. Shortly after the Second World War, John Bowlby, a psychologist, first published his theories about the importance of bring up children in a loving environment where they can form solid relationships with their parents. He developed his work over the years and more recently it has been carried on by Mary Ainsworth, among others.

Attachment theory quickly became the core idea behind child development. It made logical sense and it could be empirically proven. Numerous studies showed that children brought up in loving homes where they could form stable attachments developed into well-adjusted adults. On the other hand, children from broken homes who had been neglected, or were brought up in foster care, had much less successful outcomes. The statistics did not lie and attachment theory was enthroned as a scientific success.

There were a couple of flies in the ointment. Autism was one. In the 1950s, an attachment theorist called Bruno Bettelheim suggested that autism was caused by cold or withdrawn mothers who did not allow their children to form emotional bonds with them. As a result, he claimed that the children withdrew into themselves and became autistic. A generation of mothers was condemned as the reason that their children were handicapped, just adding to their anguish. But eventually it was realised that if one of a mother’s children was autistic but the rest were not, there was little justification for blaming her. Attachment theory, of course, need not be disproved by a single failure, and a veil was drawn over the autism debacle.

By the 1980s, attachment theorists had to deal with another more formidable fly – feminism. Feminists hated the idea that they were supposed to stay at home bringing up baby rather than getting on with their lives. Battle lines were drawn between breasts and bottles, and between stay-at-home mothers and career girls. Political conservatives discovered attachment theory was an excellent argument for traditional lifestyles. But after some hard fighting, this was a battle the feminists won and it is, in general, no longer acceptable to cast aspersions on a woman who places her baby in a nursery at six months so that she can go back to work. But there is no reason why women’s lifestyle choices should cast doubt on attachment theory as a scientific success. Today it remains the first thing that anyone studying child development covers; it is the foundation of the social services system in the UK; and it supports an entire industry of psychologists and councillors. It has only one drawback – it is almost complete rubbish. Next time I’ll explain why.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Wednesday, March 12, 2008

Are Deaf People Disabled?

There is a Human Fertilisation and Embryology Bill going through Parliament at the moment which, among other things, has a clause which forbids couples undergoing IVF from ensuring that their children have the same disability that they do. Actually, the bill does a great deal more and is frankly, a bit of a mess. Other than the deafness question, it hasn’t much made the news although you can read a wildly biased account of what it contains here. The Catholic Church is trying to get MPs a free vote on the most contentious matters.

In a radio interview on the BBC, a deaf person who wanted a deaf child flatly denied to the incredulous presenter that deafness was a disability. The interviewer pointed out that not being able to listen to Beethoven is surely a disadvantage but the deaf person, who had been born with no hearing, denied this too. How could he miss something he had never experienced? There is a distinction to be made between people born deaf and those, like Beethoven, who lost their hearing later it their lives. The later is probably more of a disability than the former, partly because you know what you are missing and partly because you never quite learn to cope. Among deafened people, it is the loss of an ability to hear music that hurts the most. One person I know dreams music and can be quite upset that he cannot continue to listen when he awakes. As the memory of the Sanctus in Mozart’s Great Mass in C Minor fades, he knows he has lost something valuable (although perhaps it is better to have loved and lost then to have never loved at all).

So, for many of us, deliberately engineering that your child is deaf sounds horrendous. I should say that very few deaf people would want to do this, but there is a small militant minority that insist that deafness is simply a facet of who they are, like race or nationality. Deaf people use sign language which is not just a kind of miming but a fully expressive language with the complete set of tenses, parts of speech and other verbal equipment that you find in spoken English. Nor is it just a signed version of spoken language, but as different from them as, say, German from French. With the language comes culture and this is what the deaf militants want to share with their children. I think they are being selfish and putting their own interests ahead of those of their offspring.

However, just if it is wrong to reject an embryo on the grounds that it will grow into a child who can hear, it is also wrong to reject an embryo just because the resulting child is likely to be deaf. Some commentators have missed this point. Would a child thank its parents for choosing that she be deaf, they ask? Probably not, but the choice is a false one. It is not a question of the child being able to hear, but of never existing in the first place with another child with functioning ears in her place. Deafness sucks but it beats death any day.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Tuesday, March 11, 2008

Social Insecurity

Welfare is a huge issue in the US and the UK and I think genetics can help us understand it a bit better.

In general, welfare policies are informed by two different theories. The first is associated with the political right and had its genesis in economics. The idea is that if you get the incentives right, hearts and minds will follow. According to this theory, people make rational choices about what is best for them. If staying of welfare pays then that is what they do. If having a multitude of babies out of wedlock means a cascade of welfare payments, then they get breeding. The right concern themselves with removing the poverty trap where people find that there is no short term way to improve their condition without also worsening their cash flow as the benefits are withdrawn.

Their solution is to create a welfare environment where work and stable families pay. If you withdraw benefits from the lazy, eliminate the poverty trap and put a time limit on how long welfare is payable for, then you encourage people to get on their bikes and find work. You have to keep benefits sufficiently low so that no one in their right mind would be content to live on them. As I have said, these solutions are generally favoured by the political right. They assume that environment is the key and that you can encourage families to stay together through welfare policies. They also assume that stable families cause better lifetime outcomes for the offspring. Furthermore, they assume that people on welfare are quite capable of doing a job where they are paid more than the state is willing to provide.

Many on the left disagree. They say that people do not choose to be on welfare and that those who claim benefits have little choice in the matter. They are not making rational decisions and are not capable of just getting up and finding a job. Girls are not deliberately getting pregnant for material gain or to obtain social housing. The people whose welfare is withdrawn when they don’t find work are precisely the most vulnerable who need help from the rest of society. Clearly, the left reject the idea that people are moulded by their environment and believe that welfare payments should be made on the basis that the recipients cannot help themselves get out of the situation they are in.

So nature versus nurture matters. What’s more, the battle lines are not always drawn where we expect them. In welfare policy, it is the political right who are the nurturists and the left who are the nativists. Who is correct?

On the most basic level, I think the left have the best understanding of the issue. I take it as axiomatic that we must help the less fortunate and cannot leave people destitute. Furthermore, welfare cannot be set at such a low level that it leaves those on benefits without any of the comforts we take for granted. But if we are as generous with benefits as we should be, that inevitably makes them attractive to freeloaders who could be working. Over the years, the number of people who should not be on benefits but have decided it is an easy option has increased markedly. This means that right wing policies do have an effect of reducing the number of social security recipients, but at enormous cost to the core of claimants who have no choice but to stay at the bottom of the pile. The only solution I can see is to try and finely balance welfare policy to minimise the number of scroungers while maximising the benefits available to the needy. We must also accept that some people will always need our help and that a zero welfare policy is not acceptable in a civilised society.

I would also suggest that a lack of appreciation for the genetic roots of human behaviour has meant both left and right are approaching the problem too simplistically.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Thursday, March 06, 2008

Getting some Flak over Nature and Nurture

Over the last few months, some correspondents have been unsympathetic towards my contentions that nurture, upbringing, schooling and other environmental factors appear to have much less effect on how children develop than might be expected. I accept that this is a radical idea, but it is also one where the evidence is quite conclusive. But perhaps I have been remiss in presenting that evidence.

A few posts ago, I mentioned studies on the Chicago state school system where it was found that there was no direct correlation between an individual’s results and how ‘good’ the school they went to was. As explained in Freakonomics, that is not quite the full story. The system in Chicago is that you can either accept the local school or, if you are unhappy with it, you can enter the lottery. The academics found that children whose parents entered them into the lottery did better than those who just went to the school to which they were originally allocated – even after allowing for the fact that children entered for the lottery might end up at a better school than otherwise. They also found that middle class parents were much more likely to enter their children for the lottery than just accept the allocation. It was a classic case of middle class children doing better wherever they ended up at school.

So was it the middle class upbringing that led to children performing better or the middle class genes? The academics dug deeper and found that there was not a single factor in the children’s upbringing (whether they were read to at bed time, or there were plenty of books in the house etc etc) that correlated to exam results. It looked like it was genetic.

Here’s another example, taken from Steven Pinker’s The Blank Slate. It is uncontroversial that the children brought up by single parents have worse school results, worse outcomes and are more likely to be single parents themselves. Traditionally, this has been assumed to be due to the lack of a father-figure, poverty or the stress involved in living in a broken family. In other words, it is a classic case of how nurture effects the way people turn out. But when you split the figures up between families where the husband has absconded and where he has died, you get different results. Children brought up by widows do not have worse outcomes than in general and are as likely to stay married. Children brought up by divorced or never-married mothers are more likely to be divorced themselves, do less well at school and have lower lifetime outcomes.

How can you explain this? It is certainly not stress. Upsetting as it is for a father to leave home, it is nothing compared to a bereavement. It isn’t poverty either. Widows are not richer than divorcees. The only correlating factor appears to be the parents themselves, in which case the differences must be caused by genes.

This is not just an academic question. All our social and education policies are based on the idea that nurture matters and is something we can change. It is generally agreed that our policies are not working as they should. I would suggest that much of the reason for this is that they are based on an axiom that is untrue.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Saturday, March 01, 2008

The Retiring Richard Dawkins

So, it’s official. Professor Richard Dawkins, the Charles Simonyi Professor for the Public Understanding at Oxford University is to retire in September. I would not counsel breathing a sigh of relief. He is now likely to have even more time for his forays into subjects of which he knows nothing. Actually, any academic duties he had do not seem to have unduly occupied him over the last decade and so I doubt whether we will see much difference in his output.

Oxford is already advertising for a successor so we can happily speculate about who the new occupant of the chair will be. Actually, this is a waste of time and I will reveal at the end of this post who will definitely be getting the job. First, the happy speculation.

Of course, I’d love it if they could tempt Steven Pinker over from Harvard. But they can’t. The trouble is that any big-name American will be being paid way over the paltry £50,000 or so that Oxford can offer. All those dreaming spires do count for something to our American friends, but I fear that Pinker would expect a salary beyond the means of the impoverished UK higher education sector.

Many of the other big names in popular science are now too old to move to a new chair. This rules out Paul Davies of the pompous popular physics books that don’t make any sense, while Peter (Poisonous) Atkins who has just retired himself. Stephen Hawking is both too old and probably wouldn’t be interested anyway. Evolutionary biologist Steve Jones is 63 but would have been an admirable choice otherwise. Oxford may feel that they don’t want another biologist, but the field is a bit too narrow for them to be choosy. Of course, the greatest popularisers of science are not just old, but dead. Sagan, Feynman and Gould stand in a pantheon quite separate from today’s breed. Admittedly, Sagan was wrong about almost everything, but he made astronomy sexy and launched thousands of scientific careers.

Science writer Matt Ridley has a relevant PhD and some books to his name. He is also looking for a new job as he has just been ousted as chairman of Northern Rock after leading that bank to ruin. It is unlikely that Oxford would want anyone so rightwing, though. Being a failure in business is unlikely to count against him. The trouble is that most science writers, like Matt Ridley before he took up banking, are journalists. The biggest selling popular science writer is Bill Bryson who, we can only hope, is not academic enough for the post.

So, enough of who won’t be appointed. Who will get the job? At 58, she’s getting on a bit too, but you would never know it from measuring the length of her skirt. The new Professor will be Susan Greenfield the neurologist, baroness and director of the Royal Institution in London. Oxford born and bred, she is telegenic, clever, has no embarrassing religious beliefs and has a very high public profile. Perfect.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Tuesday, February 26, 2008

A Reason for Success

In my last post I explained why it doesn’t much matter which school you send you kids to, as long as it reaches some minimum standards. So we can all relax.

Except we can’t, because, juding by the comments, most people don’t believe it. All our experience suggests a straightforward cause and effect relationship between successful kids and good teaching. We enjoyed the maths lessons of Mr X while the history class of Miss Y sent us to sleep. Surely, we did better at maths and worse at history as a result. But think back honestly. My best subject at school was physics but I had a succession of boring teachers who actually put me off doing the subject at university (I changed back to physics after a year at college).

This is why I am so excited by the work on genetics that has shown nurture to be largely irrelevant. Science is at its best when it is utterly counter-intuitive. That the earth orbits the sun still seems ridiculous if you sit down and think it through. Ditto, that upbringing, quality of teaching and environment make a significant difference to outcomes. Remember how we are all taught to talk endlessly to our toddlers to help them develop their language skills? It’s rubbish. Healthy children are no more capable of not learning to talk then they are not learning to walk.

As for anecdotes, I can’t accept them as evidence in this case. The experience of particular individuals does not invalidate a general thesis that never claims to be exhaustive. But the varied experience of individuals does show us that we cannot use science as an excuse to discriminate. Science can inform large scale policy – hence it should help us get over the irrelevant grammar school debate. But it cannot be allowed to pigeon hole particular people because they come from a group which has a higher or lower average level of some trait.

Bearing that in mind, let me briefly explain why middle class children, on average, do better at school. Membership of the middle class really just means earning a good wage. Brains are valued more than brawn, so ‘white collar’ workers are paid more than ‘blue collar’. The more intellectually demanding the role is, the more that the people who do it get paid. Today, being middle class is almost synonymous with being a ‘knowledge worker’ or a ‘professional’. This much, I hope, is not controversial.

Clever women and clever men tend to marry other clever men and clever women. This trend has become increasingly pronounced now that women have taken their rightful place in the workforce. In other words, feminism has probably entrenched the middle classes by making it more likely that men will marry their intellectual peers.

Finally, clever parents are more likely to have clever offspring. If both parents have brains, as is now usual in middle class families, the kids’ chances of inheriting the genes that built them are enhanced even further.

And that is why middle class children will always, on average, have better academic results. It’s not because their parents are pushy, or get their kids into the best schools. It’s just that their children have inherited the same genes that made their parents middle class in the first place.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Thursday, February 21, 2008

Why Choice of School Does not Matter

It is a commonplace in British political debate that the middle classes hog all the good schools. By ‘good’ schools, I presume we mean those that get the best exam results and end up highest up the league tables. The argument, which even the Conservatives have started to make, is that a good school attracts middle class parents who move the earth to get their offspring into it, to the detriment of working class kids whose own parents are not so pushy. As a result, the Labour government spends a huge amount of political capital trying to prevent middle class parents from being able to influence the chances of their children getting places at ‘good’ schools. The latest fad is to allocate places by lottery. Both parties think that ‘good’ schools have a massive effect on the life-chances of the pupils lucky enough to attend them.

I’m sorry to say that all the premises of this debate are utter hogwash. First, let’s look at what makes a ‘good’ school. Does a school get the best exam results because of the excellence of its teachers, or the management style of its headmaster or the religious character of its ethos? Or is it because the kids that go to that school happen to be cleverer than the ones down the road? Testing this is quite hard to do because the ‘good’ schools automatically tend to attract the clever pupils (for reasons I’ll explain in my next post). So, how can you distinguish between the push effect of good teaching and the pull effect of bright kids?

The Labour Party’s pet lottery scheme can help us. As chapter five of the book Freakonomics explains, in Chicago many school places are allocated randomly. This means that the ‘good’ schools can’t attract the bright kids because they have to go where the lottery places them. Economists examining the results of Chicago schools found that the school an individual attends has absolutely no effect on their own exam results. The schools that do best, the ones that appear ‘good’ enjoy that status thanks to the brains of their pupils, not the quality of their teaching.

Steven Pinker enthusiasts will not be surprised to learn this. Of course, intelligence is innate and where you happen to go to school won’t affect that. Nor will any other factors connected to upbringing or nurture. The Chicago economists found that factors like the number of books in the child’s home or whether their parents read to them were all as irrelevant to exam success as the school that the child went to. I am willing to admit that very bad schools probably have a detrimental effect, but I would probably put that down to the behaviour of the pupils there as well, rather than the inadequacies of the teachers.

This means that all sides in Britain can take heart. Labour can stop worrying about the middles classes hogging the places at the top schools. The workers do just as well at the schools they are at. The middle classes can relax if they can’t get their child into their first choice of school. It probably doesn’t matter anyway. The lottery system is unlikely to screw up or enhance anyone’s life chances. And as for selective schools, the panacea for the right and the bugbear of the left, they don’t make a blind bit of difference either. They do well in the league tables because they have clever kids at them, but the kids would do just as well at any school that met minimum standards.

If you thought that the Chicago experience was a one-off, a report just out finds the same results in English schools. The researchers interviewed middle class left-wing parents who sent their kids the local comprehensive as a political statement. Even though the local schools were rated as poor, the bright children of the lefties still did just as well as we would expect them to – including getting into Oxford or Cambridge. Predictably, the academics who did the research, together with the BBC reporting it, utterly misinterpret the results. They accuse the middle classes of hogging all the resources at the schools. In my next post I’ll explain why middle class children really do better than working class ones, and why there is nothing anyone can ever do about it.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.

Tuesday, February 19, 2008

Sandwiches, the NHS and Fairness

When I was about ten I was sent to a dreadful little prep school in Surrey called St Edmunds. It had lots of traditional rules whose origins were lost in the mists of time but no one had ever taken the trouble to write them down. So, new boys had to figure it all out by themselves. One of the pathetic regulations was that you were not allowed to make sandwiches at tea time. During the three years I endured at the school, the purpose of this rule was never disclosed, largely because there was no earthly reason for it. One day, I had the audacity to make a sandwich. My refusal to unmake it and worse to actually eat it meant the dispute escalated until I was standing in front of the headmaster. Eventually, as a ten year old alone at a boarding school, I was browbeaten into submission. In return, I have thought of the school and its staff with undisguised contempt ever since.

The only justification that the headmaster could muster for preventing me from eating my sandwich was that if he let me do it, then he would have to let everyone else do it as well. Fairness was used as a justification for stupidity. I expect many people are familiar with this excuse. It is one of the favourites used by bureaucrats as they seek to justify upholding their petty regulations in wildly inappropriate circumstances.

Sadly, the situation is sometimes more serious than a child’s right to make sandwiches. Recently, a cancer patient was told that she could not buy drugs with her own money without forfeiting the right to free treatment on the NHS. Disgustingly, Alan Johnson, the health secretary has supported the health authority's inhuman policy, apparently on the grounds of fairness. Now it is too late for poor Mrs Mills. If there is any justice Alan Johnson will be struck down by something that the NHS won’t treat with the latest drugs and be faced with the same choice between ‘fairness’ and an early death. This is not just a terrible parable about the perils of socialised medicine, but also shows the limits of using fairness as the final arbiter in morality.

The golden rule says, "Do unto others what you would have done to you." That means putting yourself in someone else's place and asking how you would feel if Alan Johnson banned you from buying a life-prolonging drug with your own money.

Click here to read the first chapter of God's Philosophers: How the Medieval World Laid the Foundations of Modern Science absolutely free.