Human Nature: Science, Technology, and Life.

Obama and Social Issues

Well, it isn't really mine. It's the ideas of a lot of other people who have worked on abortion, birth control, sex education, marriage, and gay rights a lot longer than I have. These ideas are good for the country, and they suit you. All I've done is wrap them up in a package. It's in Sunday's New York Times. Take it.

Basically, it's a framework for making tangible progress on moral issues. As you know, these issues tend to be incendiary, toxic, and impervious to compromise. You don't need them. But they need you. They need your pragmatism. The philosophy you sketched in your inaugural address—an era of responsibility guided by old moral truths—works just as well for social issues as it does for economics.

That's the starting point. Just be yourself: old-fashioned about values but practical about solutions. Stick to those two principles, and good ideas will fall into place, forming a moral agenda that's right for our times.

None of these ideas are mine. On birth control and sex education, they come from places such as the Hewlett Foundation, the Brookings Institution, and the National Campaign To Prevent Teen and Unplanned Pregnancy. On abortion reduction, you can find them at Third Way and Democrats for Life, along with commendable initiatives from Planned Parenthood and NARAL Pro-Choice America. On gay marriage, the thinkers to read are Andrew Sullivan and Jonathan Rauch.

I can't promise that all of these ideas will work out politically. If you lead on abortion reduction through contraception, most Catholics and even most Americans who think of themselves as pro-life will go with you. But the Vatican, the bishops, and the hierarchies of the major pro-life groups will fight you tooth and nail. If you lead on gay marriage, you'll be excoriated. Politically, Rauch's proposal to offer marriage by another name makes more sense. I'm just drawing a rough map of the way forward. How we get there is up to you.

There's my pitch. I hope it's helpful.

The Purple Brain

Are mental disorders as important as physical injuries? Many advocates say that they are and that we should treat them accordingly. Most of the fight is over insurance coverage of mental health. But part of the action is in the U.S. military. There, the question has been whether to award the Purple Heart for post-traumatic stress disorder. This week, the Defense Department announced its decision: No.

Eight months ago, when we first checked in on this debate, I was skeptical for two reasons. One was that PTSD would turn out to be widely overdiagnosed. In general, mental wounds are harder to define and identify than physical wounds are. There are obvious cases, but there are also fuzzy ones. Where do we draw the line? How do we keep the Purple Heart from being cheapened?

The second reason was that the Purple Heart, unlike basic health insurance, isn't a policy instrument. It's an honor. Officially, it denotes "meritorious action." And honor isn't the first step in a cultural transformation, no matter how worthy that transformation may be. It's the last.

I've been reading DoD's explanation of its decision and looking back at what I wrote eight months ago. And I'm beginning to think the decision may be wrong.

The reason has to do with gay marriage. The "honor" argument against the Purple Heart for PTSD is a lot like the argument against same-sex marriage. Marriage isn't a right or benefit, conservatives argue. It's a special commitment, a moral institution. Gays may deserve equal employment opportunity, just as mental-health patients deserve basic health insurance coverage. But marriage, like the Purple Heart, is a higher standard. It's an honor that should be awarded last, or maybe never.

Andrew Sullivan nailed this argument 20 years ago: Conservatives are largely right about what marriage is. They're just wrong that this understanding precludes extending it to homosexuals. In fact, they have it backward: Marriage would anchor gays, like straights, against "the chaos of sex and relationships to which we are all prone. It provides a mechanism for emotional stability, economic security, and the healthy rearing of the next generation." The key is to preserve the definition of marriage as commitment: to let go of the heterosexual requirement while fortifying the distinction between marriage and shacking up. My favorite proposal, to prove the point, is same-sex covenant marriage.

Something like that should be the solution to the Purple Heart debate. Opponents of the Purple Heart for PTSD say mental disorders can't qualify because the warrior doesn't "shed blood." That's foolish fundamentalism: Lots of people are wounded without literally shedding blood. DoD also says the wound must be "intentionally caused by the enemy." But the Purple Heart is already awarded for wounds that weren't precisely intended by the enemy. The enemy just throws his grenade at your platoon. Exactly which of you gets incapacitated and how—shrapnel, shock, whatever—isn't his concern.

On the other hand, DoD rightly points out that there have to be "objective" medical ways to distinguish clear-cut PTSD from fuzzy or fake versions. Otherwise, Purple Heart awards will become cheap or arbitrary. Along these lines, the department articulates three clear, reasonable, and tight criteria. First, the wound must be "the result of enemy action where the intended effect of a specific enemy action is to kill or injure the servicemember." Second, it must be "an injury to any part of the body." Third, it must be "caused by the enemy from an outside force or agent."

Can PTSD satisfy these criteria? In principle, I think so. The first criterion is relatively easy to address: You must face the same physical risks as any other Purple Heart recipient. The second is more difficult: Objective physical measures of PTSD must be established. This could be done, for example, with brain scans. We aren't there yet, so consider this a research project for the PTSD movement. The third criterion is a nexus of the first two: You would have to assemble some kind of case file showing that the signs of PTSD in the brain scans or other physical measures postdate the combat incident.

Will service members and veterans with PTSD actually meet these standards? Some won't, and even the most qualified cases will be hard to prove. But they should be, because the Purple Heart is sacred. It's just that there's nothing inherently more sacred about being wounded in your backside than in your brain.

Palin and Biden on Abortion

Tomorrow night, Joe Biden and Sarah Palin will meet in their only vice-presidential debate. Most of the discussion will be about economics and foreign policy. On the social issues, here are two questions moderator Gwen Ifill should ask.

1. Gov. Palin, you were asked this week whether it should be illegal for a girl to get an abortion in the case of rape or incest. Your answer was that the girl herself should not go to jail. What about the doctor? Should the doctor who performs that abortion face criminal penalties?

2. Sen. Biden, you said four weeks ago that you believe life begins at conception but that you can't impose your personal beliefs on other people. Yet you also voted for a law against gay marriage called the Defense of Marriage Act, and two years ago, you said this law expresses your view that "marriage is between a man and a woman and states must respect that." Why is it OK to impose your beliefs on gay marriage but not on abortion?

Here's all the background information Ifill will need when the candidates start fudging.

Palin's interview with Katie Couric, aired yesterday:

Couric: If a 15-year-old is raped by her father, you believe it should be illegal for her to get an abortion. Why?
Palin: I am pro-life. And I'm unapologetic about my position there on pro-life. And I understand good people on both sides of the abortion debate. In fact, good people in my own family have differing views on abortion and when it should be allowed. So ... I respect people's opinion on this. ...
Couric: But, ideally, you think it should be illegal for a girl who was raped or the victim of incest to get an abortion?
Palin: I'm saying that, personally, I would counsel the person to choose life, despite horrific, horrific circumstances that this person would find themselves in. And, um, if you're asking, though, kind of foundationally here, should anyone end up in jail for having an ... abortion, absolutely not.

Biden on Meet the Press, Sept. 7, 2008:

Biden: I'm prepared as a matter of faith to accept that life begins at the moment of conception. But that is my judgment. For me to impose that judgment on everyone else who is equally and maybe even more devout than I am seems to me is inappropriate in a pluralistic society. ...
Tom Brokaw: But if you, you believe that life begins at conception, and you've also voted for abortion rights.
Biden: No, what [I] voted against curtailing the right, criminalizing abortion. I voted against telling everyone else in the country that they have to accept my religiously based view that it's a moment of conception.

Biden's recorded vote for DOMA, Sept. 10, 1996.

Biden on Meet the Press, June 4, 2006:

We already have a law, the Defense of Marriage Act. We've all voted—not, where I've voted, and others have said, look, marriage is between a man and a woman and states must respect that. Nobody's violated that law, there's been no challenge to that law.

Biden on CNN, June 5, 2006:

We have already passed a law saying that—and the Defense of Marriage Act, defining marriage between a man and a woman.

The Biden campaign's evasive response to a same-sex marriage question on the Human Rights Campaign's 2007 survey of presidential candidates:

Senator Biden supports letting states determine how to recognize civil unions and how to define marriage. He believes that legal recognition should not be denied to same-sex couples.

Bonus peg: Biden will speak at HRC's annual dinner Saturday night.

All yours, Gwen. Go for it.