Lowering Mortality Rates in Third-World Countries
In this essay, I am going to address the moral obligation of economically wealthy, nations, to help more economically underdeveloped nations, in lowering mortality rates that are unusually high, due to malnutrition, and disease. I intend to argue that this issue is complex, and needs to be analyzed and assessed before making a commitment to helping these nations. These include issues such as, analyzing the resources available to underdeveloped nations in order to determine if they are, being used properly, what type of government the nation has, and whether the nation is currently involved in a war. The reason for looking at these specific issues is that poverty, war, and disease tend to be common explanations for higher than average death rates in underdeveloped nations.
I. Deontological vs. Utilitarian Theories
There are two theories that guide moral decision making that are most applicable in addressing the issue of helping underdeveloped countries in lowering their mortality rates, deontological theory, and utilitarian theory. These theories looks at issues such as, moral obligations to those in need, what is given in return for the assistance to others if it is offered, and whether, or not one can put a price on help that one is obligated to give to others.
According the Legal Theory Lexicon, deontological theory says that, “ the rightness of action is a function of whether the action is required, prohibited, or permitted by a moral duty.” This theory determines that acts which society determines, as being wrong, are generally behaviors that go against the moral duty that all human beings have towards each other. Deontological theory is not very useful when it comes to determining the moral obligations of developed nations to help underdeveloped nations to lower mortality rates. This is because, deontological theory leaves moral decisions open to conflict, because, while my moral intuition might tell me that we do have a moral obligation to help underdeveloped nations lower mortality rates, another persons moral intuition may tell them something entirely different.
Utilitarian theory is part of a larger school of moral theory called Consequentialism.. There are many different perspectives on how these questions however, the best possible perspective in the case of the moral obligation to help underdeveloped nations in lowering their mortality rate would be Preference Satisfaction Utilitarianism, where we determine what outcomes are preferable, and then prioritize, these outcomes according to the scope of the decision , their maximum utility, and the actual or expected utility of the outcome.
II. Moral Obligation
When considering the question of whether we are morally obligated to help underdeveloped nations to reduce their mortality rates we must look at the reasons why a nation has such a high death rate. The first area that must be explored is the question of resources, this includes, available natural resources, economic resources, educational resources, and medical resources. Lack of resources in one, or more of these areas can create a situation that is termed by Singer as “ absolute poverty.” Absolute poverty is a lifestyle led by those in the poorest nations, and involves high death rates, illiteracy rates, malnutrition rates, disease, and low life-expectancy rates. There can be several reasons behind this lack of resources including, governmental interference, war, (primarily the root causes when a nation lacks economic educational, or medical resources) or the fact that some nations are simply resource starved (generally the case in lack of natural resources i.e. oil, metal ores, arable land, forests, and water). According to Hardin, “we must recognize the limited capacity of any lifeboat. For example, a nation's land has a limited capacity to support a population and as the current energy crisis has shown us, in some ways we have already exceeded the carrying capacity of our land.” We simply will not be able to lower the mortality rate in countries where their population has exceeded the ability of their resources to support the population . This would be like using a teaspoon to put out a forest fire, and simply would not make any sense.
The second factor that we must consider is whether, or not the government of a nation is responsible for a countries status as an underdeveloped nation. Dictatorial, totalitarian regimes tend to place the majority of the power, and access to resources in the hands of an elite minority group, who are both wealthy and powerful, while leaving the majority of the population dependent upon the largesse of this elite group. According to Green, “Each nation has a prima facie obligation to care for its own people, and in a well-ordered system of divided responsibility it will then have no further obligations.” Unfortunately, totalitarian regimes, and poorly organized governments in underdeveloped nations, do not see caring for their own people as a priority, and allow the majority of their population to live in absolute poverty. In cases where a dictatorial regime is limiting access to resources to an elite group of wealthy powerful individuals the only way in which developed nations such as Australia, the United Kingdom, or the United States can help to reduce the mortality rate would be to dispose of the dictatorial regime, and to replace it with a democratic, or Republican regime. This only leads to another problem that has a strong impact on a nation's mortality rate, war.
War also becomes an issue in determining whether it is our moral obligation to help underdeveloped nations reduce their mortality rates. Are we obligated to interfere in conditions of war, where helping an underdeveloped nation, may significantly affect the economic, and social stability of our own nations. War can also cause a nations mortality rate to be higher than normal, whether that nation is developed, or underdeveloped. In the end, if an underdeveloped nation is in a state of war, we must determine whether or nor helping them to reduce their mortality rates would be cost-effective, or not. If it would involve undue stress on the economy, and social fabric, of our own countries than we should wait until conditions of war no longer exist in an underdeveloped nation before offering aid.
I feel that given the circumstances we are morally obligated to help underdeveloped nations reduce their mortality rates. Given that the country simply lacks the technology to access their natural resources, given that they have a government that at least attempts (despite lack of technology etc) to fairly distribute what resources there are, and given that the underdeveloped nation is not in a state of war that causes their mortality rate to increase in an unnatural manner, we should offer them aid. However, this aid should not be in the form of money. Money, is too easy for corrupt government officials to siphon off into other projects.
According to Hardin, ‘The modern approach to foreign aid stresses the export of technology and advice, rather than money and food. As an ancient Chinese proverb goes: "Give a man a fish and he will eat for a day; teach him how to fish and he will eat for the rest of his days” It is better to give underdeveloped nations technological advice, and to help them to build schools, hospitals, and other infrastructure systems such as energy plants, road systems, and sewage disposal, and to teach them modern efficient farming and herding techniques than money. If they learn to use their available resources in an efficient manner, underdeveloped nations will gradually begin to become developed nations. The efficient use of resources will stabilize the economy of underdeveloped nations, reduce poverty rates, and therefore reduce mortality rates significantly.
The moral obligation to help underdeveloped nations lower their mortality rates is a morally grey area. One must be aware of factors such as , availability of resources, national government, and wars that may be occurring in that nation. In situations where a country lacks resources because their population outbalances available resources, where developed nations must go to war, in order to remove dictatorial regimes that limit access to resources, or where there is a war that significantly increases the mortality rates in an underdeveloped nation it makes little sense for developed nations to offer aid. However, given that a nation meets certain conditions, they should be offered aid in developing more efficient access to resources, in developing their economy, and in stabilizing sociopolitical situations that significantly effect mortality rates. After this assistance is provided they should be obligated to care for their own people. In conclusion, moral obligation in helping underdeveloped nations to reduce mortality rates should be looked at only in regards to the benefit of long term solutions (building hospitals and schools, attracting business to the country, stopping political and ethnic conflict) rather than in regards to short term solutions such as money.
Green, Karen. Distance, divided responsibility and universalizability. The Monist 83:3, p501-515
Hardin, Garrett. Lifeboat ethics: The case against helping the poor. Psychology Today, (September 1974).
Legal Theory Lexicon. Introduction to Utilitarian and Deontological Theory.
Singer, Peter. Chapter 8: Rich and Poor. In, Practical Ethics. Cambridge UK Cambridge University Press, 1993, p218-246.