Is it possible to be a Consumer without Contributing to Poverty in the Developing World?.
The ethics of eating talking plants
In a blog post on The Atlantic Wire, Sara Morrison writes,
“Just when moral vegetarians thought their meal of choice wasn’t sentient, it turns out that plants can totally talk to each other. Even weirder, they communicate through underground fungi. So mushrooms aren’t cool to eat, either. Sorry.”
Because that is how simple moral reasoning is. Morrison assumes, with no evidence, that moral vegetarians base their decisions on whether animals can communicate. This may be because others such as Descartes have denied that animals can have thought without language. Descartes further argued that without thought animals could no more experience suffering than a machine could. Perhaps to make a point, or not, he described some rather vivid scenes of vivisection.
But it is a mistake to think ethical vegetarians are motivated by Descartes’ thinking. We tend to think more along the lines of Jeremy Bentham, who famously said:
“Is it the faculty of reason, or, perhaps, the faculty of discourse? But a full-grown horse or dog is beyond comparison a more rational, as well as a more conversable animal, than an infant of a day, or a week, or even a month, old. But suppose the case were otherwise, what would it avail? the question is not, Can they reason? nor, Can they talk? but, Can they suffer?”
In response to the ethical vegetarian’s focus on suffering, some philosophers such as Daniel Dennett have shown that it is at least possible that animals can experience pain without the attendant suffering that vegetarians assume. It is possible that animals are automata that respond to pain without being aware of it, just as we may roll over in our sleep when we become uncomfortable (Dennett’s example). We can feel the pain and respond to it with no awareness whatsoever. (Interestingly, Dennett seems pretty sure dogs, and no other animals, may experience suffering in an otherwise uniquely human way.)
So, ethical vegetarians are stuck between those who claim that plant communication implies suffering that make moral demands on them and people who deny that clear expressions of pain are conclusive evidence that any given creature actually experiences suffering. For me, I’m quite content to assume that plants are not suffering until they express their suffering in a less ambiguous manner (or someone manages to measure it in a more convincing manner). At the same time, I’m content to assume animals with a nervous system similar to mine and pain expressions similar to mine are experiencing some kind of suffering that is enough to motivate some moral concern on my part.
At any rate, I can’t imagine how an indifference to the appearance of suffering can be something to go around bragging about. (And one final note: I really don’t understand vegetarians who are inexplicably eager to explain that they have no concerns whatsoever about the suffering of sentient beings but are only trying to lose weight or something.)
Dear Doctor…
Misunderstanding the Presumption Against Extraterritoriality
The proper way to grieve for a child
I hate Galveston.
When I look out over the seawall, I find no peace in the sounds of wind and wave or comfort in the roiling swirls of water gently crashing into the jetties. I see only the bodies of children being dragged and slammed with senseless violence against the sand just beneath the waves. As I look out over the Gulf of Mexico, I see only a sadistic child-eating monster mocking the hole in my chest.
And May is the cruelest month, because it was Mother’s Day in 1992 that I lost my niece and nephew to the powerful spring rip tides along the coast of Galveston. My niece, Cindy, who was seven, was pronounced dead on the beach, but my nine-year-old nephew, Doug, was flown to John Sealy hospital and placed on life support. Although the doctors offered us no hope of his recovery, he was kept on life support for 72 hours to monitor his brain activity.
During that agonizing 72 hours, we did what most families do. We held his hands, stroked his hair, talked to him, read to him, took him his favorite stuffed bear, massaged his legs, and loved him with every ounce of strength we had. At the moment they stopped life support, the Galveston radio station played his favorite song, “Born in the USA.” Yes, we were on the radio. We were on the news. Our family’s grief was broadcast on the nightly news. I avoided the cameras, but the children’s father was there, tears cascading down his face, explaining how he felt about the death of his children. Who needed this explanation?
Perhaps it is surprising, and perhaps it is not, that I decided to enter the medical humanities program at the University of Texas Medical Branch in Galveston. I spent years driving to Galveston and going into the hospital where my nephew died. Sometimes I avoided the building, but other times I went there and sat in the garden specifically to think of what had happened before. When I completed my required ethics practicum, I went on rounds with the doctors in the pediatric ICU—of all places.
As part of this experience, I was able to witness conversations with doctors and the parents of children who would never recover. The doctors were kind, caring, and professional, and every word destroyed me a little. I imagined the conversations the doctors and nurses must have had regarding my family in 1992. I imagined how they debated the proper course to take: how long to keep him on life support, how to break bad news to the family, and how to prepare for the death of a nine year old. I had thought this experience might help me come to grips with my past trauma, but I honestly cannot say it did.
As medical humanists, we study the ways people make meaning of suffering, but I want to tell you with great heartfelt certainty—there is no meaning in the death of a child. And when you try to make meaning of it, you rob me of my grief. I am entitled to my grief. My pain is my own. When you tell me the children were on loan from God, and he has called them home, I am only amazed that you worship a monster and call it God. When you tell me they are in a better place, I want you to know that the world they left behind is immeasurably worse for their absence. When you tell me anything, you amplify my pain and submerge me in the depths of despair with no comfort and no meaning.
What does someone grieving the death of a child need? Solitude. And comfort. Silence. And conversation. A distraction. A project. Time to do nothing. Time to think. Time to cry. Time to scream. Time to fall apart. Time to get it together. There is nothing you can do. But, really, you should try. And you should know when to back off.
I can remember talking to priests, ministers, social workers, counselors, and well-meaning friends. No one can really offer any comfort, but a few people managed to refrain from intensifying the pain. In particular, Robert Schaibly, who was the minister at First Unitarian Universalist Church in Houston at the time, offered sincere condolences with no advice, no explanation, and no demands. He was empathetic and shared my pain without taking it as his pain. No other clerical person I met was able to achieve something that seems so simple. Perhaps the simplest acts require the greatest art.
Related articles
- How Long Does Grief Last? (journeyingbeyondbreastcancer.com)
- Grieving – Note to Self – #Reverb13 (offcenteredthinker.wordpress.com)
- The Ethics of Grief (ethicsbeyondcompliance.wordpress.com)
A Realist’s Guide to Relieving Stress – Seven Tips for Reducing Tension
- Know your limits. If school is too demanding or overwhelming, set aside two hours each day for meditation and exercise.
- Learn to say no. If your job is draining too much energy, take an extended vacation or, if that is not possible, start leaving work in the early afternoon to have a walk in a park.
- Reduce your to-do list. If unemployment and search for work is stressful, set aside a couple of hours each day for watching a movie and eating snacks.
- Stay connected. If you are feeling lonely and unlovable, remember to discuss it with a friend or trusted family member.
- Avoid the people who stress you out. If your marriage is creating too much anxiety and uncertainty, abandon your spouse, children, pets, home, and reputation in order to gain some “me time.”
- Remember the silver lining. If being ill is stressful, remember to focus on the positive things in your life such as pain reliever and warm blankets.
- Focus on the big picture. If a diagnosis of a terminal illness is causing stress, remember it won’t last forever.
Bloomberg, human rights, and the ethics of soda
Recently, a New York court blocked New York Mayor Michael Bloomberg’s effort to limit the sale of sugary drinks of more than 16 ounces. The court and many individuals feel it is not up to the government to regulate the choices of individuals, even if those choices lead to death. And lead to death they do. A study at the Harvard School of Public Health claims that sugary drinks lead to 180,000 deaths worldwide each year, with 25,000 of those deaths in the US.
It isn’t at all clear whether limiting the size of drinks would reduce the disease burden, but I have to commend Michael Bloomberg for at least saying that the drinks are dangerous, which may help to raise awareness of the problem. The Harvard study links the drinks to the rise in diabetes, heart disease, and cancer. The beverage industry, of course, challenges the methodology of the study.
No one claims, however, that consuming large quantities of super-sweetened sodas is in any way healthful. People can choose to kill themselves with soda, but they should at least be aware of the danger. Perhaps warning labels, similar to those that appear on cigarettes, are in order. Smokers still choose a slow form of suicide, but they can’t claim they didn’t know what they were doing.
One problem with the large drinks, besides the harm, is the pricing structure. I’ve noticed that the largest drinks are often only slightly more expensive than the smaller sizes. Forcing retailers to sell the drinks on a per ounce basis might help achieve Michael Bloomberg’s objectives, though I’m sure this solution would not satisfy free-market libertarians, who are more concerned with private profit than public good.
But this focus on public health ignores a larger problem with the food we eat. As part of its Behind the Brands project, Oxfam recently released a briefing paper on food justice and the big 10 food and beverage companies (Associated British Foods, Coca Cola, Danone, General Mills, Kellogg, Mars, Mondelez, Nestlé, Pepsico and Unilever). The report notes:
“Today, a third of the world‟s population relies on small-scale farming for their livelihoods. And while agriculture today produces more than enough food to feed everyone on earth, a third of it is wasted; more than 1.4 billion people are overweight, and almost 900 million people go to bed hungry each night.”
The report goes on to say, “The vast majority of the hungry are the small-scale farmers and workers who supply nutritious food to 2 – 3 billion people worldwide, with up to 60 percent of farm laborers living in poverty.” The inexpensive food and drink we buy demands conditions that are often horrific for the people who farm and produce the food. Many of us buy drinks sweetened with real sugar to avoid the perceived harms of high-fructose corn syrup, but note that Coca-Cola is the world’s largest buyer of sugar cane, which is associated with rampant use of child labor and unconscionably low wages.
According to CNN, the International Labor Organization “estimates 2.4 million child workers are in the Philippines. Many of them, according to the ILO, are in rural areas working in fields and mines. The organization estimates 60% work in hazardous conditions.” According to Coca-Cola’s website, “A grant from The Coca-Cola Foundation funded the construction of a high school in Bukidnon, which has the country’s highest incidence of child labor and the highest number of school-aged children not working or attending school.” The idea is that the children who are in school will not be in the fields. Also, educated children will be empowered to seek and create better economic conditions and wages.
If efforts to educate children used in the supply chain for sugary drinks actually do reduce the amount of cheap (nearly free) labor, the price of sugary drinks is likely to rise, which may in turn reduce demand for the diabetes/heat disease-inducing drinks in the first place, achieving Mayor Bloomberg’s initial objectives. Will the drop in demand eliminate job prospects for the world’s farmers? The ethics of food, and drink, is complicated.
Cloud computing, your patient information, and privacy
In the not too distant past, healthcare providers sometimes worried that reliance on technology might put private patient information at risk. For example, they might have debated whether having a computer technician restore information from a damaged hard drive might be unethical, as the technician would see confidential patient information.
Gradually, both patients and providers became comfortable with the burgeoning reliance on digital storage of patient records. It was, in fact, the convenience of being able to share the information with specialists, pharmacists, specialists, and so on that made electronic medical records so appealing. Further, patients enjoy being able to access their records online, communicate with providers through email or other web-based technology, and make scheduling and payments over the Internet.
When I first heard the phrase “cloud computing,” I was excited to think I might be able to put things in “the cloud” and access them from various devices. Indeed, I do enjoy being able to access the music and videos I have on iTunes from my laptop, desktop, and handheld devices. I assumed, though, that my files were in the cloud because I wanted them there, but I was surprised when someone told me of having all her files restored by a technician who got them from the cloud. She had no idea that her files were in the cloud in the first place. As excited as she was to have these important files restored, it was a bit disconcerting to know that they were in the hands of third (and fourth or fifth?) parties in the first place. How many technicians in how many companies have access to our information?
So, now we move to electronic medical records, a digital archive of our most private information. As noted in the American Medical News blog, in 2011 55 percent of office-based physicians used electronic health records and 41 percent of those were in a cloud-based system. The blog, by Pamela Lewis Dolan, cites information from Jonathon Padron, senior client service analyst for comScore, and Internet analytics company. From the blog: “Because EHR data give marketers the ability to target messages in a more granular way to the specific physician, it’s very effective for marketers, Padron said. For example, the system can identify the condition a physician is looking at and automatically pup up a drug that can treat it.”
These ads are linked to keywords, of course, just as you see ads related to a condition you search on WebMD. We trust that our searches, the doctors’ searches, and our names and medical records are not combined for nefarious reasons. Howard Burde, a health IT lawyer, offers this assurance: “The technology is improving such that data is more and more secure all the time. The problem isn’t the technology, it’s the people.” Everything is all right then, see?
I see two bits of take-away information in all of this: 1. Our private health information is being spread further in cyberspace than we might care to think about. 2. Pharmaceutical and device manufacturers will aggressively use any means available to insert themselves into our healthcare decisions by targeting healthcare providers and patients with intrusive influence at all levels. Of course, if access to healthcare, or at least health insurance, is actually guaranteed by the Affordable Care Act, we may be less concerned about our information being shared. I don’t want to be embarrassed by my private information, but I prefer being embarrassed to being uninsured.
Curmudgeon Rant: “We don’t have small.”
I went to see a movie yesterday, which is something I don’t often do, and I decided to order a coffee, which is something I do even less frequently. When I got to the counter, the menu said “Cappuccino, $4/$5.” It was refreshing to see that the sizes didn’t have silly names, really.
So, I ordered a small cappuccino, and the cashier told me (I should have predicted it) that they do not have small cappuccinos. I would have to choose either a medium or a large. Of course, I do know that the United States, as a group of people, has become addicted to diabetes-inducing portions of food and drink. I also happen to think they shouldn’t force us to choose between oversized drinks and super-oversized drinks, but that isn’t what makes it the most annoying.
The most annoying thing for me is the fact that I truly do not believe anyone ever asked for a small without wanting the smallest size available. No one ever said, “Oh, you don’t have small? I will have a large then.” No, it is quite clear that anyone who asks for a small wants the $4 drink and not the $5 drink. Why rub our faces in the fact that we can’t actually order the size drink we want?
We are the 85 percent
Over the years, I have had several people in healthcare tell me that about 85 percent of patients in doctor’s waiting rooms have no medical problem that won’t take care of itself with a little time and patience, but patients have been trained to demand treatment for every ache and pain. I’m sure this made-up statistic does not appear in print or as part of any official statement, but there is a feeling that mildly sick people are a drain on a system that is already overloaded.
It isn’t a small concern, and doctors are not entirely to blame. Patients do sometimes demand treatments that are counterproductive, which has led to the excessive overuse of antibiotics, for example. Of course, patient perception is that doctors prescribed the antibiotics, leading them to believe they are effective for mild earaches and colds. Doctors say they feel pressure from patients to “do something” about their mild condition. Patients and doctors both feel they are doing what the other is directing them to do. I would guess that about 85 percent of doctors and patients feel this way, if I were to start making up statistics.
The result is that patients can become pushy and demanding or that doctors can become resentful of needy patients. And both conditions arise, I think, from a misunderstanding of the wishes of the other. I honestly don’t think either side wants to waste time or money on useless treatments. So, “communication is the key” to a better doctor-patient relationship, or so the shibboleth goes.
But it is more complicated that that, of course. When I was quite a bit younger, a member of my family began having fairly vague complaints and discomfort that prompted her to see her doctor. She was overweight. She smoked. She rarely got exercise at all. The doctor told her to lose weight, stop smoking, and check back in a few months. Each time she went to the doctor, she received the same advice, even if the wording changed a little, but her symptoms became more pronounced and harder to ignore.
Finally, the doctor ordered a biopsy, which was positive for colon cancer. She was then referred to an oncologist. On their first meeting, he said, “I wish you had come to me sooner before it had spread.” Perhaps he didn’t mean to blame her for her cancer or for her lack of treatment, but that is certainly how she heard it. Too many of us who have experience with cancer in our families have heard, “I wish you would have come sooner,” even when the patient has been seeing a doctor regularly for months or years.
So, patients are in a bind. If we go to the doctor at the first sign of a problem, we may be seen as hypochondriacs or as clingy whiners. If we wait till the symptoms manifest themselves more boldly, we may be blamed for neglecting our own health and causing our own deaths. Given this choice, most of us would rather be seen as frivolous. We say things like, “I’m sure it is nothing, but I watched my loved one suffer, and I won’t make the same mistake.”
This is why healthcare providers need to show a little understanding. With the possible exception of a few individuals with some rare psychological conditions, people don’t go to the doctor for the fun of it. They trust their doctors to tell them whether their symptoms are serious enough to warrant further attention, and they aren’t looking to waste time, money, or resources. To be on the safe side, I try to tell my doctors that I only want treatments that are both necessary and effective. This takes, I hope, the burden off the doctor to “do something, anything” for me.