WHAT DO WE DO WHEN VALUES COLLIDE IN DECIDING CONTROVERSIAL PUBLIC POLICY ISSUES?

While most public policy issues are easily viewed from a liberal or conservative perspective, any rational person must acknowledge that there are opposing moral views involved in some of the most controversial issues America confronts today. Such moral conflicts should be dealt with in thinking about the use of torture in interrogating terrorist suspects, providing the best health care for all people, and determining the appropriate limits of legal immigration. I think that we should be most critical of people, including politicians, who do not seriously consider and attempt to counter the moral convictions of those who come down on the other side of each of these issues.

One: Torture. When legal techniques fail to elicit information regarding terrorist plans, should the United States employ criminal interrogation techniques, including waterboarding (simulated drowning), when these methods may produce information that will enable us to disrupt terrorist plans and prevent terrorist actions?

John Kiriakou spent 14 years at the CIA, including a tour in Pakistan from 1998 to 2004. He was involved in the capture of Abu Zubaydah, an Al Qaeda militant, and was one of the first to interrogate him. The initial questioning bore no fruit, so waterboarding and other exceedingly harsh methods were applied. Kiriakou states that new or severe interrogation techniques were never applied without the approval of superior officers. Because Kiriakou was on his way to another assignment after the initial interrogations of Abu Zubaydah, his recounting of events after that point is based on classified cables and private communications with his colleagues. (Kiriakou says that he did not know that the interrogations was taped, and disagrees with the decision to scrap them. The faces of CIA interrogators could have been blurred to protect their identity.) Although Kiriakou’s recent public account omits details regarding the method of waterboarding, he has confirmed that the simulated drowning of Abu Zubaydah lasted 35 seconds. Before waterboarding, this Al Qaeda operative was “defiant and uncooperative”; afterward he was compliant and provided valuable information. Kiriakou’s conclusions are that waterboarding is torture; it worked in the case of Abu Zubaydah, and it “probably saved lives.” He also believes it is no longer necessary.

Waterboarding is torture. It is contrary to the Geneva Conventions and American law. Its use by the United States justifies the use of criminal methods by other nations against American nationals. It may lead prisoners to provide false information in order to appease their interrogators. And yet, as Kiriakou asserts was the case in with Abu Zubaydah, it may lead the prisoner to reveal information that will result in the saving of lives. Is it then justified?

Two: Health care. Optimal health care coverage can provide the highest practical level of medical care for all Americans. This can be achieved by barring independent medical practice for the benefit of people prepared to pay the additional cost for extraordinary treatment. Should the United States underwrite a health care system that provides extensive universal medical insurance, setting limits for those who are prepared to pay for more?

Any system of public health insurance must have finite limits. As generous as the nation might be in preventing and treating disease and ill health and however advanced medical science has become, some treatments will be so expensive, risky or rare that their coverage cannot be justified. Medical science seeks to alleviate and cure both common and rare medical conditions, but there comes a point at which choices must be made. American society cannot afford to employ limited medical resources in order to treat every adverse condition of every person.

There are always experimental and costly treatments that are available only to those prepared to pay the price. To the extent that society offers that option, it restricts the employment of medical resources for less costly treatments for a larger population. This option exists in America’s present system of health care and in every socialized system such as Great Britain’s in which doctors and patients can choose between public and private coverage. It would not exist in a genuinely socialized scheme of universal single-payer coverage. Should the United States subscribe to the utilitarian principle of “the greatest good for the greatest number,” knowing that carried to its logical extent this principle would deny the right of those who could afford it to buy even greater medical support for themselves?

Three: Immigration. For millions of impoverished people in Central and South America, the United States holds out hope for a better life. The millions of illegal immigrants already here pose challenges to the American economy, the ability of educational and medical institutions to serve them, and the nation’s social coherence. Should we attempt to compel those already here to leave? How can we keep millions more from gaining entry?

From its founding, the United States has represented to the rest of the world a haven for “your tired, your poor, your homeless masses yearning to breathe free.” Geographically, its vast borders provide access for those with the cash or courage to seek entry. We are all (so-called Native Americans included) immigrants or the their offspring. Today’s immigrants perform the crop-picking, dishwashing, and taxi-driving jobs that those of us long-settled here do not want. Nearly all illegal immigrants obey the laws in every other way and seek to adapt to American values.

At the same time, illegal immigrants unwittingly change established communities, increase the strain on local resources (including an increased cost of English-language education), and are prepared to work longer for less pay, challenging the living standards of unskilled American citizens. Nations must have the right to protect themselves against invasions, even invasions by unarmed hordes. What can we do? At what cost can unwanted aliens be expelled? How long and how high would the wall have to be that would succeed in keeping them out? Or should the United States welcome and not resist the entry of anyone who wishes to come here, short of permitting the entry of criminals, carriers of contagious diseases and those who would immediately become wards of the state? Beyond such considerations, may we draw a line? Where do we draw a line? And how do we draw the line?