I don’t want to die, but neither do I fear death. The reason I don’t want to die is that I hate the thought of not knowing what happens next. I want to see how this whole MS thing works out. What was the cause, and what year did they find a cure? How much did I miss it by — months or decades?

I’m also curious as to how humankind will fare. I’m optimistic. I think we’ll figure things out, and in doing so, our future selves will reveal our current selves as occasionally wise but more often woefully ignorant. One hundred years from now, I believe an enlightened society will cringe when they see how much pain and suffering people with MS endured, and will be taken aback by how much we struggled with some of the controversial issues of our day.  

Our public policy challenges fall into one of three categories: those with no answer, those that likely have answers but that we are struggling with, and those that have clear answers and should have been settled by now.

Challenges with No Answer (pendulum problems)

These are issues that, although contentious, have no clear answers and never will. Wise people, even 100 years hence, will always debate about where, on the continuum of possible choices, we should find ourselves. The pendulum will always swing back and forth on these issues, probably to a lesser extent over time, but will swing nonetheless. For example:

1. Taxation versus government spending — What role should government play in collecting taxes to support the general good versus allowing individuals to keep their hard-earned money. On one extreme are pure socialist or communist policies. On the other extreme are pure market/capitalism policies. No matter how unreasonable some of the debaters, the issue itself, where we ought to find ourselves on this continuum, will forever be a matter for reasoned debate.

2. What is the optimum amount of regulation? Without regulation, certain industries, in fulfillment of their fiduciary duties, can cause significant harm. If banks make loans to people who can’t afford to pay them back, then we place these borrowers in a difficult situation, and we destabilize the national economy. If we apply too many regulations, then we stifle commerce and unnecessarily interfere with individual and corporate autonomy. No matter how unreasonable some of the debaters, the issue itself, how much business regulation is fair and appropriate, will forever be a matter for reasoned debate.

Challenges That Likely Have an Answer, but Are Difficult to Solve

Enlightened societies in the distant future will eventually reach consensus on these issues. The problems are complex enough, however, that it is reasonable for us at this stage of our social evolution to be struggling with them. 

3. Recreational drug legalization – Would we be better off legalizing all mind-altering recreational drugs, some of them, or should we double down on the so-called war on drugs? I tend toward legalization, but that road is fraught with complications. There is no shame in us struggling with this issue for a while longer.

4. Regulation of pornography and prostitution in society — This is about an individual’s right to view pornography and/or make a living in the sex trade, versus society’s obligation to protect children from indecent images and to protect people from being in the sex trade against their will. My inner libertarian tends to think openness is the best solution, but I do worry about the over-exposure kids are already experiencing through the internet. This is the type of social problem we should be struggling with. This is a contemporary issue.

5. Euthanasia — When should physician-assisted death be legal and with what safeguards? I believe all individuals should have a right to choose their time and place of passing, but I understand some of the concerns. First, how can we be sure that individuals are not being pressured into a decision they wouldn’t otherwise make? Second, how can we be sure that we are not simply increasing the suicide rate for people who still have better alternatives than euthanasia? This is the type of social problem we should be struggling with. This is a contemporary issue.

Challenges That Should Have Been Put to Rest a Long Time Ago

Below are two issues that, in my mind, require no more debate. If you disagree with me, I think you are on the wrong side of history. I have every confidence that a more enlightened, future society will look back on these debates in much the way that we look back on debates about slavery, using leeches to cure illnesses, and whether the earth is the center of the universe.

6. LGBTQ rights — A certain percentage of people are born with or develop sexual orientations that are different from the majority. If the resulting acts occur between consenting adults, they are not unnatural, only unusual. If your reason for being discriminatory has to do with your religious doctrine, consider this. In addition to homosexuality, there are many other practices that the Bible forbids. These include eating pork, cutting your hair, and women speaking in church. Most religious people ignore these rules; why not ignore the Bible verses against homosexuality as well? If the reason that you discriminate against homosexuals is that they make you feel yucky, then you have to admit that the problem is more likely yours than it is theirs. Wrong side of history.

7. Pharmaceutical companies decide which medicines we get — Pharmaceutical companies have the resources to develop treatments, but they make their decisions based on how much money can be made rather than how many people can be helped. It’s not the fault of the individuals at these companies. They have a fiduciary duty to maximize shareholder value. The problem is, maximizing shareholder value and enhancing patient well-being are often at odds. Future societies will shake their heads when they consider how otherwise intelligent people from our time thought that the free market was the best method for developing treatments.  

There are so many subjects I could have mentioned and didn’t. There is so much more I could have said on each of the subjects I did raise, but I would’ve lost your attention, if I haven’t already. My point is, I find the exercise of imagining how we will be regarded by people 100 years from now to be enlightening.

I’m going to try not to die, so that I can see how all these things work out, whether it be MS or public policy. How do you think it will turn out?