On the complexity of moral argument

Understanding that good people, for good reasons, hold on to ideas we strongly disagree with

Your neighbors voted for the candidate you cannot stand. They are also friendly, congenial neighbors and regularly bring you baked goods.

Your cousin works in marketing at a tobacco company. They are also a wonderful parent, and you enjoy spending every Thanksgiving together.

Your friend since childhood is avowedly against any form of regulation to industry, convinced that those who cannot make it in a completely free market are simply not trying hard enough. You have enjoyed going on vacation with them every year since you were young.

In a time of partisan rancor, it is becoming — at least in the public narrative — almost impossible to engage with those whose perspectives might differ markedly from ours. For anyone who is engaged in the business of population health, political choices, and the candidates who espouse them, matter, as does caution to create the right framework for corporate incentives and disincentives, and minimizing the impact of harmful products.

How could rational, good people, feel so strongly, so differently than we do?

And how can we reconcile that with the fact that the people who may hold such different opinions are not cartoonish “others,” but our families, friends, and neighbors?

It seems almost transgressive to say out loud: Most people are mostly, fundamentally good, even if they do or say things we may strongly disagree with and find inexplicable.

We humans may hold perspectives that others may consider misguided, but we are all mostly seeking the good, or our own version of it, trying to make life a bit better for our families, our communities, our country, our world.

It is easy to lose sight of this. Perhaps it has never been easier. America has long been geographically divided between red and blue, left and right. This divide has been reinforced in recent years by the rise of media ecosystems that feed us perspectives with which we passionately agree, or show us the other side of the issue, but only in the worst possible light.

We are now able to be both fully engaged in politics and media, and completely oblivious to good-faith arguments for views with which we disagree. This makes it possible to start seeing those who hold these views less like people in all their complexity and more like pantomime villains, irredeemable. It is an ugly way to view fellow human beings, but it would be untruthful to suggest that many in this moment do not hold this perspective at least some of the time.

This poses many problems for our politics and culture, and our pursuit of health. Building on my writing last week, this is the first piece of a three-part series on values. Today, a focus on the challenge of making the value-based arguments that underpin the work of health, in a world where many very good people do not agree with our core values.

While the work of public health is informed by data, and always should be (more on that next week), our work is most effective when we combine our production of data with work to shift values, so that the world is receptive to data-informed change. At core, public health is an aspiration for a better world so that everyone can live longer, healthier lives. Everything we do starts with that.

The challenge for us is remembering that this is also true for others whose value sets may be foundationally different than ours. While good people of good conscience may all start from the same values place, to fix what is broken, we often follow paths that take us to very different places on the issues. And before we know it, our roads have so diverged that we can no longer see our common starting point. We start to feel we are the only ones acting on behalf of the true, the good, and those people over there, on the other road, are acting on behalf of something else entirely.

To take on an obvious, and rather fraught, example relevant to the health of populations, let us take the topic of reproductive rights, and specifically abortion. So heated is the debate over this issue that we can forget most people come to it from a place of deeply held, honestly felt, morally coherent personal beliefs. The challenge here is that people can hold views that are simultaneously sincere, rooted in a profound regard for human dignity — for bodily autonomy, for life — and are nevertheless abhorrent to those on the other side of the debate. While a resolution to this issue remains elusive — it may be irresolvable — it is possible, at least, to see the good faith motivating most of those who engage in it. And it is on us to try harder to do so, in this debate and in others.

This takes courage and imagination. Courage because it can be frightening to see how those with whom we strongly disagree are more like us than they are not. Courage because, when we look across the debate table and let ourselves see good faith, we might also start to see good reasons and suddenly face the possibility of being convinced by them. Imagination because it takes hard, creative work to truly put ourselves in the shoes of another person and consider his or her motivations. It is easy to do this in a superficial way, as a kind of anthropologist studying a different culture with interest but emotionally removed, understanding with the head but not the heart. To get at someone’s moral priors, the core of why they believe what they believe, takes time and a willingness to think about people in all of their complexity and contradiction.

Imagine, for example, a man who cares above all about making a better life for his kids. He does not have a lot of money. He lives in suboptimal, overcrowded housing. He works multiple jobs to make ends meet and, as a single father, is always very busy. But he manages to follow the news. He follows efforts to transition the economy away from fossil fuels and toward green energy. He thinks these efforts are deeply wrong. Each year his energy bill goes up. He barely affords heat as it is. He thinks green initiatives hurt his kids by hurting industries that supply cheap energy. He thinks people should work hard, trust God, and attend to what is right in front of them, and a changing climate feels far away.

How should we engage with this man? His priors align with ours: concern for the future, for his kids. The pushing of a fully divergent value set — green energy matters above all else — is not going to get us far. A more productive approach might begin with acknowledging our shared concerns. We might listen to what he has to say, agree with him when what he says is true, and offer respectful correction when it is not. If anything he says makes us reconsider something about our own position, we should tell him so. We might not have convinced him of anything, but we will have started a process, a dialogue. Something might come of that.

This is the work of engaging with individuals in the here and now whose value set leads them in different directions. It seems to me that our role in public health should be to tell the truth as we understand it, and to act whenever possible to advance policies that better align with our moral vision. And to speak to the values that precede policy, the desire for a better world that we all share, and apply clarity of vision toward finding common ground, a place where we can come together and build a healthier future.

None of this means holding back when we have a value-based case to make, or giving ground on core principles when they are supported by our data and our values. It just means doing so in a way that does not lose people, recognizing many may disagree and that this is part of the shaping of a social moral fabric. Making a moral argument can at times come across as moral bullying and we should take great care to avoid this. We can do so when we are mindful of the fundamental goodness of most people, of how good intentions can lead down all sorts of roads, and of how persuasion starts with recognizing our shared aspirations and speaking to them — respectfully, with the intention of bringing people in, not pushing them away.