Dear Doctor: genocide by omission?

"Dear Doctor" (ENT) is a first-season episode of Enterprise. It is, if possible, an even worse Prime Directive story than Homeward (TNG).

The Enterprise encounters a pre-warp ship which is looking for help. The Valakians are dying of a disease they can't cure. They've already been visited by two warp-speed civilizations, one of which is the Ferengi (no one on Enterprise knows them yet), so Archer and T'Pol decide "contamination" isn't too much of an issue.[1]

They go to the planet and Dr Phlox goes to work. Meanwhile they discover something interesting: there is a second humanoid species, the Menk, who are less advanced in evolutionary terms. They don't get the disease. The two live together amicably, with the Menk in a somewhat subordinate position, and the Valakians are surprised that to learn that elsewhere the pattern is that only one species survives.

Phlox discovers a cure. (The Valakians have a genetic disorder.) But he argues that the Menk are evolving to become more advanced, and "the Menk have the potential to become the dominant species on this planet". But they can't do this if the Valakians are in their way. The Valakians dying out would be Evolution, which is a "fundamental scientific principle". Captain Archer is eventually persuaded and, foreshadowing the Prime Directive, says they are not there to play God. So they say goodbye, giving the Valakians some palliative treatment.

Incidentally, in terms of writing this is a good episode, whatever one thinks of its morality. The main story is framed in a letter from Dr Phlox in which he comments on human attitudes, and at first this seems likes it's going to be a gentle episode like "Data's Day" (TNG)—and then it goes dark. (Phlox's relationship with Crewman Cutler is interesting, and might have become a significant part of Enterprise, but the actress, Kellie Waymire, tragically died suddenly in 2003 of undiagnosed heart trouble.)

This episode has generated a lot of controversy.

The plot obviously makes no sense in terms of the real theory of evolution, but that isn't in fact such a fatal criticism as it might seem. It makes sense in terms of Star Trek's essentially religious concept of evolution. Evolution is, fairly consistently, shown as a directional process, that goes in foreseeable directions. It's teleological. Things are morally and metaphysically justified by the fact that evolution brings them about. In several cases there is a "next step" in evolution, such as "evolving" into energy beings. All this has a rather tenuous connection with the scientific theory of evolution in the real world; it's a sort of Intelligent Design without God, but on a much grander scale.

Having said that, it is a problem. The biggest criticism is that it pretends to be invoking the real theory of evolution, and even to suggest a link to denial of evolution in the United States. "Evolution is more than a theory. It is a fundamental scientific principle," says Phlox severely. Indeed it is. But the Star Trek version of teleological evolution is not science at all, and claiming the authority of science in this way seems a bit off.

However, let's grant that Phlox can know that the Menk are destined to become more intelligent. But why do the Valakians have to die? Apparently on other planets one species drives others into extinction, one way or another, but on this planet that hasn't happened. The Valakians seem to have been unusually positive in their attitude to their fellow-humanoids, and indeed still are. They're a bit paternalistic, admittedly, but the Menk seem pretty happy. So why would some future cleverer Menk need the Valakians to die? Why wouldn't they continue in peaceful co-existence? To judge by the present society, at most there would be some Menk civil rights movement.

But Dr Phlox and Captain Archer don't consider that. Dr Phlox says the Menk could be the "dominant species", but why does there have to be one dominant species?

Unfortunately, although Captain Archer argues with Dr Phlox, he doesn't directly address Dr Phlox's arguments. In "Pen Pals" (TNG) there is in fact a discussion of the let-them-die approach, with the officers explicitly raising the idea that there might be a cosmic plan that a particular planet should die—to which someone ripostes, how do we know that our presence isn't part of that plan? This is interesting, though odd, as it brings into the open the essentially religious nature of Star Trek evolution, whereas Star Trek normally wants to claim the scientific status of the real theory for it.

It's important to note that Dr Phlox is only worried about the cure because the Menk are there and are apparently destined to become "more evolved". Until he discovered that, he was apparently quite prepared to find a cure. It's only after this discovery that he starts talking about letting nature take its course, etc. Also, it is only then that Archer gets the idea that curing the Valakians would be "playing God". Clearly, it's not altering the fate of the Valakians as such that's the issue; it's interfering with the fate of the Menk.

Phlox makes the startling criticism that "I believe your compassion for these people is affecting your judgment." Archer replies, reasonably, "My compassion guides my judgment" but allows the doctor to talk him out of this. As the ancient Chinese philosopher Mencius put it, "All people possess within them a moral sense that cannot bear the suffering of others." He concluded that "we can see that one who lacked a sense of dismayed commiseration in such a case simply could not be a person." (Mencius 2A.6, trans. Robert Eno.) (See some further discussion of this which may make it clearer.)

One possible defence of Phlox is that it's comparable to those time travel stories where some apparently good change has to be prevented because of long-term consequences. In Star Trek, "The City on the Edge of Forever" (TOS) of course. Also novels like Stephen Fry Making History. In those cases, however, the consequences are known for certain, because someone has come from the future. But in this case, the consequences are speculative. Archer points this out. Phlox makes the reply that evolution is more than a theory, which as we have seen is not a sound argument if it refers to the real theory of evolution, which does not predict the future in this way. Even in the Star Trek evolution-as-providence system, it's not clear that it's the only interpretation of the situation.

The next question: is it genocide? The 1948 Genocide Convention was framed in terms of active measures. Possibly withholding medical treatment might be considered to fall under the category of "Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction". In Rwanda "reducing essential medical services below minimum requirement" was found to qualify. But perhaps this is not the best approach. A parallel has been suggested between the decision in "Dear Doctor" and the west's failure to act in the Rwandan genocide. Not that they did it themselves, but that they stood back and let it happen.

I have always wanted to see a sequel along the following lines. The Ferengi, who have been there already, turn up, having developed the cure, and sell it the Valakians—for a very good price, of course. The Valakians are happy with this. They are, however, mad as hell when they learn that the Earth people had the cure and withheld it. They now become fervent allies of the Ferengi, perhaps adopting some of their culture, and bitter enemies of Earth (the Ferengi also sell them warp drive and some weaponry), setting up a Wrath-of-Khan scenario.