charlene dill and the consequences of consequentialism

Es­ti­mated reading time is 5 min­utes.

CHARLENE DILL, 32-year-old mother of three and part-time vacuum cleaner sales­person, col­lapsed and died on a stranger’s floor. She was at an ap­point­ment to try to sell a cleaner, one of jobs she worked to try to make ends meet for her family. Her death was a re­sult of a doc­u­mented heart con­di­tion and equally un­doc­u­mented con­se­quen­tialism that could have been prevented.

Ac­cording to an ar­ticle ti­tled “This 32-Year-Old Florida Woman Is Dead Be­cause Her State Re­fused To Ex­pand Med­icaid” by Tara Culp-Ressler for ThinkProgress (April 9, 2014):

“Dill was unin­sured, and she went years without the care she needed to ad­dress her chronic con­di­tions be­cause she couldn’t af­ford it. Under the health re­form law, Dill wasn’t sup­posed to lack in­sur­ance. She was sup­posed to have ac­cess to a public health plan through the law’s ex­pan­sion of the Med­icaid program

But Dill, a Florida res­i­dent, is one of the mil­lions of Amer­i­cans living in a state that has re­fused to ac­cept Obamacare’s Med­icaid ex­pan­sion after the Supreme Court ruled this pro­vi­sion to be op­tional. Those low-income people have been left in a cov­erage gap, making too much in­come to qualify for a public Med­icaid plan but too little in­come to qualify for the fed­eral sub­si­dies to buy a plan on Obamacare’s pri­vate exchanges.

Florida has one of the highest unin­sur­ance (sic) rates in the na­tion, and is home to a dis­pro­por­tion­ately large number of res­i­dents who struggle to af­ford health ser­vices. Nonethe­less, law­makers have con­tinued to re­sist ac­cepting gen­erous fed­eral funds to ex­pand Med­icaid to an es­ti­mated 750,000 low-income Florid­ians like Dill.”

Consequentialism: Photo of Charlene Dill with her heart medications.

Florida legislators have healthcare

In an ar­ticle ti­tled “GOP Sadism: Grayson’s Candid Talk About a Young Mother’s Death,” Richard Eskow for Cam­paign for Amer­i­ca’s Fu­ture (April 17, 2014) asked why the Rep*blicans let a young mother of three die rather than ac­cept fed­eral funding for her health insurance?

“ ‘Sadism,’ ac­cording to Rep­re­sen­ta­tive Alan Grayson (D-FL). That—along with ex­treme ide­ology and a cer­tain amount of po­lit­ical expediency—explains why Florida Gov­ernor Rick Scott re­fused to ac­cept Af­ford­able Care Act funding to ex­pand Med­icaid coverage.

‘How (else) can you ex­plain it? Re­pub­li­cans have been blinded by their own ide­ology. Every single member of the state leg­is­la­ture in Florida has health­care—every single one of them—and yet they voted to deny that health cov­erage to al­most a mil­lion other people.’

A Har­vard study es­ti­mates that 8,000,000 people will re­main unin­sured as a re­sult of this ac­tion by 25 gov­er­nors. The study es­ti­mates that this will lead to more than 7,000 un­nec­es­sary deaths per year, a rate of roughly 19 people each day. That in­cludes 1,158 deaths per year in the state of Florida as the re­sult of Scott’s actions.

Scott made an enor­mous sum of money from the Medicare fraud com­mitted by his cor­po­ra­tion while he was CEO. And, as Grayson ex­plains, Scott con­tinues to make de­ci­sions as gov­ernor that ben­efit that corporation.”

Consequentialism: cartoon about Rep*blicans and healthcare by David Horsey.

Car­toon by the bril­liant David Horsey.

Consequentialism, ends, and means

Merriam-Webster has one pri­mary and three sec­ondary de­f­i­n­i­tions for ide­ology: the first—“visionary theorizing”—is not ap­plic­able in the above in­stance. It’s the three sec­on­daries that meets our needs for an ex­pla­na­tion for the above be­havior of cer­tain hard­line governors—elected of­fi­cials whose sworn duty is to see to the needs of their constituency.

These three sec­ondary de­f­i­n­i­tions are sim­ilar and apply di­rectly to the use of the word ide­ology in the para­graphs above:

a) “a sys­tem­atic body of con­cepts, es­pe­cially about human life or culture”
b) “a manner or the con­tent of thinking char­ac­ter­istic of an in­di­vidual, group, or culture”
c) “the in­te­grated as­ser­tions, the­o­ries, and aims that con­sti­tute a so­ciopo­lit­ical program”

Ide­o­log­ical thinking often leads to ide­o­log­ical be­havior. This be­havior often fits too com­fort­ably into the be­lief that the ends jus­tify the means, which can be re­ferred to as con­se­quen­tialism.

Con­se­quen­tialism is the class of nor­ma­tive eth­ical the­o­ries holding that the con­se­quences of one’s con­duct are the ul­ti­mate basis for any judge­ment about the right­ness or wrong­ness of that con­duct. Thus, from a con­se­quen­tialist stand­point, a morally right act—or omis­sion from acting—is one that will pro­duce a good out­come, or consequence.

In an ex­treme form, the idea of con­se­quen­tialism is com­monly en­cap­su­lated in the saying, ‘The ends jus­tify the means.’ This means that if a goal is morally im­por­tant enough, any method of achieving it is ac­cept­able.

Con­se­quen­tialist thinking/behavior is eth­i­cally and morally neu­tral: it can lead one (or one’s group) to pos­i­tive or neg­a­tive be­havior for the group or for an en­tire so­ciety. An ex­ample of the former is self-sacrifice; an ex­ample of the latter is sac­ri­fice of another.

An ex­treme in­stance of self-sacrifice for one’s be­liefs is that of Bud­dhist monk Thich Quang Duc, who burned him­self to death (self-immolation) on June 11, 1963, in front of the cam­eras of in­ter­na­tional jour­nal­ists. He did this as an act of protest against the re­pres­sion and per­se­cu­tion of Bud­dhists in South Vietnam by Pres­i­dent Ngo Dinh Diem, a man many con­sid­ered an Amer­ican puppet.

The so-called “Bud­dhist crisis” was jump-started by the murder of nine un­armed pro­tes­tors by the South Viet­namese Army and re­lated se­cu­rity forces the month prior. It even­tu­ally led to a mil­i­tary coup and the as­sas­si­na­tion of Diem in No­vember 1963, three weeks be­fore the as­sas­si­na­tion of an­other pres­i­dent, which made this ex­tremely im­por­tant event seem in­con­se­quen­tial. It was any­thing but!

An ex­treme in­stance of the sac­ri­fice of others for one’s be­liefs is the use of Jews as a scape-goat to focus the fears anx­i­eties ha­tred of the Ger­mans by Adolf Hitler and theN­ational So­cialist German Workers’ Party, or Nazis—good Chris­tians all.

Or the sac­ri­fice of Char­lene Dill and “more than 7,000 un­nec­es­sary deaths per year” for one’s beliefs.

Consequentialism: Photo of protestors regarding the death of Charlene Dill.

One last reflection

If your own be­liefs are in ac­cord with those of one who is willing to self-sacrifice to achieve a set of goals, you see him or her as acting in the in­terest of others, of so­ciety, of the oppressed.

You see him as heroic.

If you are not in ac­cord, you tend to be baf­fled by such be­havior, or dis­mis­sive of it, as in­dica­tive of an un­bal­anced psyche—such as an anti-authoritarian.

If your own be­liefs are in ac­cord with those of one who is willing to sac­ri­fice others to achieve a set of goals, you see him or her as dis­playing strength, faith, individualism.

You see him as heroic.

If you are not in ac­cord, you tend to be baf­fled by such be­havior, or dis­mis­sive of it, as in­dica­tive of an un­bal­anced psyche—such as a psychopath/sociopath, like Hitler or, well, you know where I’m headed with this . . .


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