Ethics in Practice

Paternalism and Risk

We have good evidence that using certain drugs - like heroin - is dangerous. That, according to Wilson, justifies the state's decision to continue legally prohibiting the possession and sale of these drugs. These laws will limit the drugs' use, thereby protecting potential users from harm. Although Wilson's primary focus is on the harm done to users, he also argues that drug use harms other people as well. For instance, people who use (certain) drugs are more likely to abuse their children and less likely to fulfill their familial and social obligations. Consequently, he argues, drug use is not a victimless crime.

One important aside. Wilson - like most people who oppose legalization of drugs - argues both that these restrictive laws prevent harm to the users and that they prevent harm to others. However, there is something odd about this strategy. For if we had compelling evidence that drug use harmed others, then that would be sufficient reason to restrict their use. There would be no need to claim that such laws would also prevent harm to users. To even raise the paternalistic argument only muddies the political and moral waters. So why does he raise the paternalistic argument? Because we do not have overwhelming evidence that drug use harms others. Hence, the claim that it harms users as well is thought to give added weight to proposals to keep (or make) drugs illegal.

There is, of course, one sense in which illegal drugs do cause harm: people commit robberies to get money to support their drug habit. However, their drug habit is so expensive in large part because the drugs are illegal. Making drugs illegal has costs, and sometimes those costs are enormous. That is one reason why the editors of the conservative National Review advocate making illegal drugs legal. They argue that the costs are not worth whatever benefits may accrue from keeping drugs illegal. These editors also echo Mill's view that we must respect an individual's decision to use drugs - even if those drugs demonstrably harm her. Autonomy demands it. Hence, the claim that it harms the user will not, in Mill's view, support the claim that we should make the action illegal. We have seen the significant role that autonomy plays

before. For instance, most of the authors writing on EUTHAN ASIA argued that autonomy was exceedingly important. However, as I noted in that introduction, autonomy is a slippery notion. Most of us have no trouble deciding that a careful and seemingly reasonable choice by an unstressed, intelligent adult is fully autonomous. Nor do we have trouble deciding that the desire of a two-year-old to put her hand on a hot stove is not. But there are many cases about which we are far less sure.

The entire discussion is further complicated once we realize that we can interpret "autonomy" both descriptively and prescriptively. To say that a decision is descriptively autonomous is to say that an individual has made an informed choice, based on a rational assessment of the evidence. On the other hand, if we say that a law would violate a person's prescriptive autonomy, we are simply saying that the law should not restrict a genuine choice that a person makes - even if the choice is demonstrably irrational. Classical liberals like Mill claim that an individual has prescriptive autonomy, i.e., that she should be able to act as she pleases, even if, in some particular case, her choice is uninformed or silly.

The only time we can legitimately force someone to act against her express will, on Mill's view, is if we think she does not comprehend the consequences of her action, and will, after the fact, be glad that we coerced her. For instance, ifI am about to cross a bridge that you - but not I - know is dangerous, you can legitimately stop me because: (a) you assume I do not know that the bridge is dangerous, and (b) once I fully understand the facts, I will be glad that you stopped me.

Goodin employs this reasoning to explain why he thinks some forms of paternalism are permissible. He shares Mill's misgivings about paternalistic laws that force rational adults to act against their will simply because someone else (the state) decides that an action would be in the citizen's best interests. However, Goodin argues, we cannot ignore the fact that most humans do not have only one preference, and that the preferences they do have change over time. Most of us have multiple preferences, and some of these conflict with others.

For instance, someone may want to smoke (because they enjoy it) and want to stop (because they know it is bad for them). In other cases someone may currently have only the first preference (to continue smoking), yet we have good reason to think they will later develop the second (to stop). Consequently, forcing people to stop smoking - or passing laws that make smoking less likely (by increasing the cost) or less attractive (by banning advertisements) - will be likely to clash with their immediate stated preferences. Nonetheless, if, we can reasonably infer that most smokers have mixed preferences or will later develop different preferences, then using legal means to restrict or forbid smoking is not crassly paternalistic. After all, the action is justified by the smokers' current or future preferences. In this way, Goodin claims to respect individual autonomy without sacrificing people's long-term interests on its altar.

There is a second worry here. While people who rob or rape or murder others do harm them, not every user harms others, nor does any user harm others all the time. Hence, allowing people to use drugs does not harm people in the same way that robbery harms them; rather it creates a risk of harm. Is that sufficient to make drug use illegal? Can we legitimately prohibit drug use because some drug users sometimes harm others?

This question sets the stage for the essays on gun control. Is the mere fact that allowing private ownership of guns is risky - if indeed it is - sufficient reason to make gun ownership illegal (or to deem it immoral)? Hughes and Hunt say "No." If we genuinely respect autonomy, they argue, then we should not prohibit people from owning guns, perhaps not at all, but certainly not unless we have compelling evidence of a significant causal relationship between owning

Paternalism and Risk

guns and causing harm. Moreover, since guns can serve to equalize the differences between a strong aggressor and a weak (potential) victim, then there are positive reasons (guaranteeing equity and self defense) for allowing people to own guns.

LaFollette acknowledges that a proper respect for autonomy requires that we restrict guns only if the evidence indicates that it is dangerous to allow their private ownership. However, since guns are inherently dangerous, people do not have a fundamental right to own them. Moreover, if we have empirical evidence that allowing private citizens to own guns is harmful, then we are justified in abolishing or at least restricting who can own which guns, under what circumstances. He concludes there is reason to believe that guns are quite risky, and therefore, that we should take some steps to control them.

Further Reading

Dworkin, R. 1977: Taking Rights Seriously. Cambridge, MA: Harvard University Press.

1984: The Moral Limits ~r the Criminal Law: Harm to Others. New York: Oxford University Press.

--1984: The Moral Limits of the Criminal Law: Harm to Self New York: Oxford University Press.

Goodin, R. 1989: No Smoking: The Ethical Issues.

Chicago and London: University of Chicago Press. LaFollette, H. 2001: "Controlling Guns." Criminal

Justice Ethics 20: 34-9.

Luper-Foy, S. and Brown, C. (eds.) 1994: Drugs, Morality, and the Law. New York: Garland Press.

Mill, J. S. 185911978: On Liberty. Indianapolis, IN: Hackett.

Sartorious, R. 1983: Paternalism. Minneapolis: University of Minnesota Press.

John Stuart Mill

The object of this essay is to assert one very simple principle ... to govern absolutely the dealings of society with the individual. ... [It is to govern the] control [over individuals], whether the means used be physical force in the form of legal penalties, or the moral coercion of public opinion. That principle is, that the sole end for which mankind are warranted, individually or collectively in interfering with the liberty of action of any of their number, is self-protec- tion. [T]he only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinions of others, to do so would be wise, or even right. These are good reasons for remonstrating with him, or reasoning with him, or persuading him, or entreating him, but not for compelling him, or visiting him with any evil, in case he do otherwise. To justify that, the conduct from which it is desired to deter him must be calculated to produce evil to some one else. The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign...

No society in which these liberties are not on the whole respected, is free, whatever may be its form of government; and none is completely free in which they do not exist absolute and unqualified. The only freedom which deserves the name, is that of pursuing our own good in our own way, so long as we do not attempt to deprive others of theirs, or impede their efforts to obtain it.... Mankind are greater gainers by suffering each other to live as seems good to themselves, than by compelling each to live as seems good to the rest....

[Of course] no one pretends that actions should be as free as opinions. On the contrary, even opinions lose their immunity, when the circumstances in which they are expressed are ... a positive instigation to some mischievous act. An opinion that corndealers are starvers of the poor, or that private property is robbery, ought to be unmolested when simply circulated through the press, but may justly incur punishment when delivered orally to an excited mob assembled before the house of a corndealer, or when handed about among the same mob in the form of a placard. Acts of whatever kind, which, without justifiable cause, do harm to others, may be, and in the more important cases absolutely require to be, controlled by the unfavourable sentiments, and, when needful, by the active interference of mankind. The liberty of the individual must be thus far limited; he must not make himself a nuisance to other people.

But if he refrains from molesting others in what concerns them, and merely acts according to his own inclination and judgment in things which concern himself, [then] ... he should be allowed, without molestation, to carry his opinions into practice at his own cost.

[A]s it is useful that while mankind are imperfect there should be different opinions, so is it that there should be different experiments of living. [We should give] free scope ... to varieties of character, short of injury to others. [T]he worth of different modes of life should be proved practically, when anyone thinks fit to try them. It is desirable, in short, that in things which do not primarily concern others, individuality should assert itself. Where not the person's own character, but the traditions of customs of other people are the rule of conduct, there is wanting one of the principle ingredients of human happiness, and quite the chief ingredient of individual and social progress.

[I]f it were felt that the free development of individuality is one of the leading essentials of well-being; that it is not only a coordinate element with all that is designated by the terms civilization, instruction, education, culture, but is itself a necessary part and condition of all those things; there would be no danger that liberty should be undervalued, and the adjustment of the boundaries between it and social control would present no extraordinary difficulty. But the evil is that individual spontaneity is hardly recognized by the common modes of thinking as having any intrinsic worth, or deserving any regard on its own account. The majority, being satisfied with the ways of mankind as they now are (for it is they who make them what they are), cannot comprehend why those ways should not be good enough for everybody. [W]hat is more, spontaneity forms no part of the ideal of the majority....

[However,] no one's idea of excellence in conduct is that people should do absolutely nothing but copy one another. No one would assert that people ought not to put into their mode of life, and into the conduct of their concerns, any impress whatever of their own judgment, or of their own individual character. On the other hand, it would be absurd to pretend that people ought to live as if nothing

Freedom of Action

whatever had been known in the world before they came into it; as if experience had as yet done nothing towards showing that one mode of existence, or of conduct, is preferable to another. Nobody denies that people should be so taught and trained in youth, as to know and benefit by the ascertained results of human experience. But it is the privilege and proper condition of a human being, arrived at the maturity of his faculties, to use and interpret experience in his own way. It is for him to find out what part of recorded experience is properly applicable to his own circumstances and character.

The traditions and customs of other people are, to a certain extent, evidence of what their experience has taught them ... and as such, have a claim to this deference. [However,] their experience may be too narrow; or they may not have interpreted it rightly. [Moreover] their interpretation of experience may be correct but unsuitable to him. Customs are made for customary circumstances, and customary characters: and his circumstances or his character may be uncustomary. [Finally] though the customs be both good as customs, and suitable to him, yet to conform to custom, merely as custom, does not educate or develop in him any of the qualities which are the distinctive endowment of a human being. The human faculties of perception, judgment, discriminative feeling, mental activity, and even moral preference, are exercised only in making a choice. He who does anything because it is the custom, makes no choice. He gains no practice either in discerning or in desiring what is best. The mental and moral, like the muscular powers, are improved only by being used.

He who lets the word, or his own portion of it, choose his plan oflife for him, has no need of any other faculty than the ape-like one of imitation. He who chooses his plan for himself, employs all his faculties. He must use observation to see, reasoning and judgment to foresee, activity to gather materials for decision, discrimination to decide, and when he has decided, firmness and self-control to hold to his deliberate decision. And these qualities he requires and exercises exactly in proportion as the part of his conduct which he determines according to his own

Paternalism and Risk

judgment and feelings is a large one. It is possible that he might be guided in some good path, and kept out of harm's way, without any of these things. But what will be his comparative worth as a human being? It really is of importance, not only what men do, but also what manner of men they are that do it. Among the works of man, which human life is rightly employed in perfecting and beautifying, the first in importance surely is man himself. ... Human nature is not a machine to be built after a model, and set to do exactly the work prescribed for it, but a tree, which requires to grow and develop itself on all sides, according to the tendency of the inward forces which make it a living thing ...

It is not by wearing down into uniformity all that is individual in themselves, but by cultivating it and calling it forth, within the limits imposed by the rights and interests of others, that human beings become a noble and beautiful object of contemplation. [A]s the works partake the character of those who do them, by the same process human life also becomes rich, diversified, and animating. [Such a life furnishes] more abundant aliment to high thoughts and elevating feelings, and strengthens the tie which binds every individual to the race. [B]y making the race infinitely better worth belonging to [by developing] his individuality, each person becomes more valuable to himself, and is therefore capable of being more valuable to others. There is a greater fulness of life about his own existence, and when there is more life in the units there is more in the mass which is composed of them. As much compression as is necessary to prevent the stronger specimens of human nature from encroaching on the rights of others, cannot be dispensed with. [F]or this there is ample compensation even in the point of view of human development. The means of development which the individual loses by being prevented from gratifying his inclinations to the injury of others, are chiefly obtained at the expense of the development of other people ...

It will not be denied by anybody, that originality is a valuable element in human affairs. There is always need of persons not only to discover new truths, and point out when what were once truths are true no longer, but also to commence new practices, and set the example

of more enlightened conduct, and better taste and sense in human life. This cannot well be gainsaid by anybody who does not believe that the world has already attained perfection in all its ways and practices. It is true that this benefit is not capable of being rendered by everybody alike: there are but few persons, in comparison with the whole of mankind, whose experiments, if adopted by others, would be likely to be any improvement on established practice. But these few are the salt of the earth; without them, human life would become a stagnant pool. Not only is it they who introduce good things which did not before exist; it is they who keep the life in those which already existed. If there were nothing new to be done, would human intellect cease to be necessary? ...

Persons of genius, it is true, are, and are always likely to be, a small minority; but in order to have them, it is necessary to preserve the soil in which they grow. Genius can only breathe freely in an atmosphere of freedom. Persons of genius are ... more individual than any other people less capable, consequently, of fitting themselves, without hurtful compression, into any of the small number of moulds which society provides in order to save its members the trouble of forming their own character. If from timidity they consent to be forced into one of these moulds, and to let all that part of themselves which cannot expand under the pressure remain unexpanded, society will be little the better for their genius....

I insist thus emphatically on the importance of genius. [We must allow it] to unfold itself freely both in thought and in practice, being well aware that no one will deny the position in theory, but knowing also that almost every one, in reality, is totally indifferent to it. People think genius a fine thing if it enables a man to write an exciting poem, or paint a picture. But in its true sense, that of originality in thought and action, though no one says that it is not a thing to be admired, nearly all, at heart, think they can do very well without it. Unhappily this is too natural to be wondered at. Originality is the one thing which unoriginal minds cannot feel the use of. They cannot see what it is to do for them: how should they? If they could see what it would do for them, it would not be

originality. The first service which originality has to render them, is that of opening their eyes: which being once fully done, they would have a chance of being themselves original. ...

In sober truth, whatever homage may be professed, or even paid, to real or supposed mental superiority, the general tendency of things throughout the world is to render mediocrity the ascendant power among mankind .... Those whose opinions go by the name of public opinion, are not always the same sort of public: in America, they are the whole white population; in England, chiefly the middle class. But they are always a mass, that is to say, collective mediocrity. And what is still greater novelty, the mass do not now take their opinions from dignitaries in Church or State, from ostensible leaders, or from books. Their thinking is done for them by men much like themselves, addressing them or speaking in their name, on the spur of the moment, through the newspapers.

I am not complaining ofall this. I do not assert that anything better is compatible, as a general rule, with the present low state of the human mind. But that does not hinder the government of mediocrity from being mediocre government. No government by a democracy or a numerous aristocracy, either in its political acts or in the opinions, qualities, and tone of mind which it fosters, ever did or could rise above mediocrity, except in so far as the sovereign Many have let themselves be guided (which in their best times they always have done) by the counsels and influence of a more highly gifted and instructed One or Few....

I have said that it is important to give the freest scope possible to uncustomary things, in order that it may in time appear which of these are fit to be converted into customs. But independence of action, and disregard of custom are not solely deserving of encouragement for the chance they afford that better mode of action. [qustoms more worthy of general adoption, may be struck out; nor is it only persons of decided mental superiority who have a just claim to carryon their lives in their own way. There is no reason that all human existences should be constructed on some one, or some small number of patterns. If a person possesses

Freedom of Action

any tolerable amount of common sense and experience, his own mode of laying out his existence is the best, not because it is the best in itself, but because it is his own mode. Human beings are not like sheep; and even sheep are not undistinguishably alike. A man cannot get a coat or a pair of boots to fit him, unless they are either made to his measure, or he has a whole warehouseful to choose from: and is it easier to fit him with a life than with a coat, or are human beings more like one another in their whole physical and spiritual conformation than in the shape of their feet? If it were only that people have diversities of taste that is reason enough for not attempting to shape them all after one model. But different persons also require different conditions for their spiritual development; and can no more exist healthily in the same moral, than all the variety of plants can in the same physical atmosphere and climate.

The same things which are helps to one person towards the cultivation of his higher nature, are hindrances to another. The same mode of life is a healthy excitement to one, keeping all his faculties of action and enjoyment in their best order, while to another it is a distracting burden, which suspends or crushes all internal life. Such are the differences among human beings in their sources of pleasure, their susceptibilities of pain, and the operation on them of different physical and moral agencies, that unless there is a corresponding diversity in their modes of life, they neither obtain their fair share of happiness, nor grow up to the mental, moral, and aesthetic stature of which their nature is capable....

The despotism of custom is everywhere the standing hindrance to human advancement, being in unceasing antagonism to that disposition to aim at something better than customary, which is called, according to circumstances, the spirit of liberty, or that of progress or improvement. ...

[Nonetheless] everyone who receives the protection of society owes a return for the benefit, and the fact of living in society renders it indispensable that each should be bound to observe a certain line of conduct towards the rest. This conduct consists, first, in not injuring the interests of one another; or rather certain

Paternalism and Risk

interests, which, either by express legal provision or by tacit understanding, ought to be considered as rights; and secondly, in each person's bearing his share (to be fixed on some equitable principle) of the labors and sacrifices incurred for defending the society or its members from injury and molestation. These conditions society is justified in enforcing, at all costs to those who endeavour to withhold fulfilment. Nor is this all that society may do. The acts of an individual may be hurtful to others, or wanting in due consideration for their welfare, without going the length of violating any of their constituted rights. The offender may then be justly punished by opinion, though not by law.

As soon as any part of a person's conduct affects prejudicially the interests of others, soci-

ety has jurisdiction over it, and the question whether the general welfare will or will not be promoted by interfering with it, becomes open to discussion. But there is no room for entertaining any such question when a person's conduct affects the interests of no persons besides himself, or needs not affect them unless they like (all the persons concerned being of full age, and the ordinary amount of understanding). In all such cases there should be perfect freedom, legal and social, to do the action and stand the consequences....

Note

This chapter has been abridged and edited from chapters 1 and 3 of On Liber~y.

James Q Wilson

In 1972, the President appointed me chairman of the National Advisory Council for Drug Abuse Prevention. Created by Congress, the Council was charged with providing guidance on how best to coordinate the national war on drugs. (Yes, we called it a war then, too.) In those days, the drug we were chiefly concerned with was heroin. When I took office, heroin use had been increasing dramatically. Everybody was worried that this increase would continue. Such phrases as "heroin epidemic" were commonplace.

That same year, the eminent economist Milton Friedman published an essay in Newsweek in which he called for legalizing heroin. His argument was on two grounds: as a matter of ethics, the government has no right to tell people not to use heroin (or to drink or to commit suicide); as a matter of economics, the prohibition of drug use imposes costs on society that far exceed the benefits. Others, such as the psychoanalyst Thomas Szasz, made the same argument.

We did not take Friedman's advice. (Government commissions rarely do.) I do not recall that we even discussed legalizing heroin, though we did discuss (but did not take action on) legalizing a drug, cocaine, that many people then argued was benign. Our marching orders were to figure out how to win the war on heroin, not to run up the white flag of surrender.

That was 1972. Today, we have the same number of heroin addicts that we had then - half a million, give or take a few thousand. Having that many heroin addicts is no trivial matter, these people deserve our attention; but not having had an increase in that number for over fifteen years is also something that deserves our attention. What happened to the "heroin epidemic" that many people once thought would overwhelm us?

The facts are clear: a more or less stable pool of heroin addicts has been getting older, with relatively few new recruits. In 1976 the average age of heroin users who appeared in hospital emergency rooms was about twenty-seven; ten years later it was thirty-two. More than twothirds of all heroin users appearing in emergency rooms are now over the age of thirty. Back in the early 1970s, when heroin got onto the national political agenda, the typical heroin addict was much younger, often a teenager. Household surveys show the same thing - the rate of opiate use (which includes heroin) has been flat for the better part of two decades. More fine-grained studies of inner-city neighborhoods confirm this. John Boyle and Ann Brunswick found that the percentage of young blacks in Harlem who used heroin fell from 8 percent in 1970-1 to about 3 percent in 1975-6.

Why did heroin lose its appeal for young people? When the young blacks in Harlem were asked why they stopped, more than half

Paternalism and Risk

mentioned "trouble with the law" or "high cost" (and high cost is, of course, directly the result oflaw enforcement). Two-thirds said that heroin hurt their health; nearly all said they had had a bad experience with it. We need not rely, however, simply on what they said. In New York City in 1973-5, the street price of heroin rose dramatically and its purity sharply declined, probably as a result of the heroin shortage caused by the success of the Turkish government in reducing the supply of opium base and of the French government in closing down heroin-processing laboratories located in and around Marseilles. These were short-lived gains for, just as Friedman predicted, alternative sources of supply - mostly in Mexico - quickly emerged. But the three-year heroin shortage interrupted the easy recruitment of new users.

Health and related problems were no doubt part of the reason for the reduced flow of recruits. Over the preceding years, Harlem youth had watched as more and more heroin users died of overdoses, were poisoned by adulterated doses, or acquired hepatitis from dirty needles. The word got around: heroin can kill you. By 1974 new hepatitis cases and drug-overdose deaths had dropped to a fraction of what they had been in 1970.

Alas, treatment did not seem to explain much of the cessation in drug use. Treatment programs can and do help heroin addicts, but treatment did not explain the drop in the number of new users (who by definition had never been in treatment) nor even much of the reduction in the number of experienced users.

No one knows how much of the decline to attribute to personal observation as opposed to high prices or reduced supply. But other evidence suggests strongly that price and supply played a large role. In 1972 the National Advisory Council was especially worried by the prospect that US servicemen returning to this country from Vietnam would bring their heroin habits with them. Fortunately, a brilliant study by Lee Robins of Washington University in St Louis put that fear to rest. She measured drug use of Vietnam veterans shortly after they had returned home. Though many had used heroin regularly while in Southeast Asia, most gave up

the habit when back in the United States. The reason: here, heroin was less available and sanctions on its use were more pronounced. Of course, if a veteran had been willing to pay enough - which might have meant traveling to another city and would certainly have meant making an illegal contact with a disreputable dealer in a threatening neighborhood in order to acquire a (possibly) dangerous dose - he could have sustained his drug habit. Most veterans were unwilling to pay this price, and so their drug use declined or disappeared....

Back to the Future

Now cocaine, especially in its potent form, crack, is the focus of attention. Now as in 1972 the government is trying to reduce its use. Now as then some people are advocating legalization. Is there any more reason to yield to those arguments today than there was almost two decades ago?!

I think not. If we had yielded in 1972 we almost certainly would have had today a permanent population of several million, not several hundred thousand, heroin addicts. If we yield now we will have a far more serious problem with cocaine.

Crack is worse than heroin by almost any measure. Heroin produces a pleasant drowsiness and, if hygienically administered, has only the physical side effects of constipation and sexual impotence. Regular heroin use incapacitates many users, especially poor ones, for any productive work or social responsibility. They will sit nodding on a street corner, helpless but at least harmless. By contrast, regular cocaine use leaves the user neither helpless nor harmless. When smoked (as with crack) or injected, cocaine produces instant, intense, and shortlived euphoria. The experience generates a powerful desire to repeat it. If the drug is readily available, repeat use will occur. Those people who progress to "bingeing" on cocaine become devoted to the drug and its effects to the exclusion of almost all other considerations - job, family, children, sleep, food, even sex. Dr Frank Gawin at Yale and Dr Everett

Ellinwood at Duke report that a substantial percentage of all high-dose, binge users become uninhibited, impulsive, hypersexual, compulsive, irritable, and hyperactive. Their moods vacillate dramatically, leading at times to violence and homicide.

Women are much more likely to use crack than heroin, and if they are pregnant, the effects on their babies are tragic. Douglas Besharov, who has been following the effects of drugs on infants for twenty years, writes that nothing he learned about heroin prepared him for the devastation of cocaine. Cocaine harms the fetus and can lead to physical deformities or neurological damage. Some crack babies have for all practical purposes suffered a disabling stroke while still in the womb. The long-term consequences of this brain damage are lowered cognitive ability and the onset of mood disorders. Besharov estimates that about 30,000 to 50,000 such babies are born every year, about 7,000 in New York City alone. There may be ways to treat such infants, but from everything we now know the treatment will be long, difficult, and expensive. Worse, the mothers who are most likely to produce crack babies are precisely the ones who, because of poverty or temperament, are least able and willing to obtain such treatment. In fact, anecdotal evidence suggests that crack mothers are likely to abuse their infants.

The notion that abusing drugs such as cocaine is a "victimless crime" is not only absurd but dangerous. Even ignoring the fetal drug syndrome, crack-dependent people are, like heroin addicts, individuals who regularly victimize their children by neglect, their spouses by improvidence, their employers by lethargy, and their co-workers by carelessness. Society is not and could never be a collection of autonomous individuals. We all have a stake in ensuring that each of us displays a minimal level of dignity, responsibility, and empathy. We cannot, of course, coerce people into goodness, but we can and should insist that some standards must be met if society itself - on which the very existence of the human personality depends - is to persist. Drawing the line that defines those standards is difficult and contentious, but if crack and heroin use do not fall below it, what does? ...

Against the Legalization of Drugs

Have We Lost?

Many people who agree that there are risks in legalizing cocaine or heroin still favor it because, they think, we have lost the war on drugs. "Nothing we have done has worked" and the current federal policy is just "more of the same." Whatever the costs of greater drug use, surely they would be less than the costs of our present, failed efforts.

That is exactly what I was told in 1972 - and heroin is not quite as bad a drug as cocaine. We did not surrender and we did not lose. We did not win, either. What the nation accomplished then was what most efforts to save people from themselves accomplish: the problem was contained and the number of victims minimized, all at a considerable cost in law enforcement and increased crime. Was the cost worth it? I think so, but others may disagree. What are the lives of would-be addicts worth? I recall some people saying to me then, "Let them kill themselves." I was appalled. Happily, such views did not prevaiL ...

It took about ten years to contain heroin. We have had experience with crack for only about three or four years. Each year we spend perhaps $11 billion on law enforcement (and some of that goes to deal with marijuana) and perhaps $2 billion on treatment. Large sums, but not sums that should lead anyone to say, "We just can't afford this any more."

The illegality of drugs increases crime, partly because some users turn to crime to pay for their habits, partly because some users are stimulated by certain drugs (such as crack or PCP) to act more violently or ruthlessly than they otherwise would, and partly because criminal organizations seeking to control drug supplies use force to manage their markets. These also are serious costs, but no one knows how much they would be reduced if drugs were legalized. Addicts would no longer steal to pay black-market prices for drugs, a real gain. But some, perhaps a great deal, of that gain would be offset by the great increase in the number of addicts. These people, nodding on heroin or living in the delusion-ridden high of cocaine, would hardly be ideal employees. Many would