Posted on August 9, 2019
The Benefits of Palliative Care: Beyond relief from suffering
This brief addresses the following question:
What benefits are there from palliative care beyond the usual relief from pain and suffering?
The benefits of palliative care beyond that of relieving pain and suffering are starting to come to light. Not only is palliative care showing signs of extending the life of terminally ill cancer patients by approximately 3 months, a feat that would be heralded by pharmaceutical companies had it been a drug, it is increasingly being seen as care which is to be used during the time that a person is getting treatment for a disease, in addition to when there are no useful treatments available.
Differing from hospice care, which focuses typically on the final 6 months or less of care and where death is known, palliative care is not limited to the end of life care, the hallmark of hospice. It has been rightly stated that “while all care that is provided by hospices can be considered palliative care, not all palliative care is delivered in hospices.” Indeed, palliative care within an integrated model of medical care is provided at the same time as curative or life-prolonging treatments.
Benefits of palliative care outside that of the normal relief of suffering are highlighted in the following excerpt:
Studies have shown that palliative care services improve patients’ symptoms, allow patients to avoid hospitalization and to remain safely and adequately care for at home, lead to better patient and family satisfaction, and significantly reduced prolonged grief and post traumatic stress disorder among bereaved family members. Palliative care also lowers costs, and reduces rates of unnecessary hospitalizations, diagnostic and treatment interventions, and non-beneficial intensive care. Particularly when initiated early in the disease course, palliative care also improves clinical and quality of care outcomes, and possibly survival.
With the benefits of early palliative care starting to emerge there have been calls to change the paradigm for management of patients with advanced life threatening diseases. Not only is earlier and increasingly thorough assessments of options, goals, and preferences being called for, calls are beginning to being made for tailored care done throughout the course of illness.
Palliative care offers older people with advanced chronic illness, structured discussions, specialized care coordination, palliative care teams which increase patient and family satisfaction, a combination of medications and complementary therapies, and targeted interventions and individualized support. All of the above have been shown to increase family caregiver satisfaction. In one study by Marie Bakitas, patients with advanced cancer and who were enrolled in a palliative-care program reported “higher quality of life and better mood than patients not enrolled in the program.”
The data on the beneficial aspects of early palliative care is starting to come. Four particular studies of note are mentioned below.
- In a landmark study, patients with newly diagnosed metastatic non–small cell lung cancer who were randomly assigned to early palliative care integrated with standard oncologic care had a better quality of life (QOL), less depressive symptoms, and longer median survival than did those who were assigned to oncologic care alone. The ambulatory palliative care assessment in this trial focused on symptom management, patient and family coping, and illness understanding and education. In a later analysis, patients receiving early palliative care received the same number of chemotherapy regimens as did those in the control group but they were less likely to have chemotherapy continued close to death and more likely to enroll in hospice for a longer duration.
- Another randomized controlled trial (the ENABLE II trial) demonstrated higher scores for QOL and mood in patients with any life-limiting cancer (prognosis of approximately one year) who received psycho-educational palliative intervention in addition to standard care.
- A third randomized controlled trial of ambulatory palliative care compared to usual care demonstrated that comprehensive outpatient palliative care in patients who continue to pursue disease modifying treatment improves symptom management and patient satisfaction.
- In yet another trial, patients with late-stage chronic obstructive pulmonary disease and heart failure who were randomly assigned to in-home palliative care as compared to usual care reported greater satisfaction with care and were more likely to die at home.
 Diane E. Meier et al. “Palliative care: Benefits, services, and models of care” pg.2
 Diane E. Meier et al. “Palliative care: Benefits, services, and models of care” pg.2-3
Posted on June 19, 2019
This paper summarizes Tom Regan’s theory of “subject-of-a-life” then through critical analysis of his main criteria examines how reasonable each criterion is in determining a “subject-of-a-life”. Regan’s theory is then tested on a specific ethical dilemma to see how applicable it is to everyday situations.
Tom Regan formulates an environmental ethics for animals using a concept he calls, a “subject-of-a-life”. To determine what is a “subject-of-a-life”, Regan uses a list of criteria to check if an individual is a “subject-of-a-life”. Under the criterion laid out by him, any being which fulfills the criterion would have inherent value and should not be seen or treated as receptacles.[i] The criteria are used to make that which has inherent value something which is more than just alive and conscious. One weakness of his criteria, however, is that he does not provide any rationale for them. He simply rejects that being alive and conscious is sufficient for providing something with inherent value without any justification for doing so. Furthermore, he provides no evidence as to why he chooses the criteria that he does. This lack of explanation weakens his argument, in that he does not initially show why being alive and conscious are not sufficient in determining what has inherent value.
There are four main criteria Regan uses in determining what is a “subject-of-a-life” and therefore has inherent value. The individual must have beliefs and desires, must have an emotional life, must have the same psychophysical criteria over time, and must care for the well-fare of their life.[ii]
The first mentioned is that of beliefs and desires. With regards to the belief aspect of the criteria, although it may seem reasonable, it would be extremely difficult to properly test. There are those in the epistemological community who could argue that we can not know if other people even have beliefs. Simply because someone is acting a certain way does not indicate we can know what their beliefs are or if they even have any. When looking at other people we assume that they must have beliefs, but no one has conclusively shown this to be true. Furthermore, even if other people do have beliefs the fact that people often go against their beliefs, in the case of someone on a diet eating pizza, questions the value and purpose of having such a criterion in the first place. The difficulties associated with this criterion are present among humans when looking at other animals which we cannot communicate with, the criteria of belief would be far too difficult to test for. Until it is shown how to test an animal to determine if it possesses a belief, Regan should abandon the belief criteria.
The desire criterion is just as troubling. It seems reasonable to assume that whatever an animal does on its own fruition, it desires to do. Someone might argue though that this is not necessarily true, animals are just going on instinct and so they do not really desire anything. If someone were working with the base assumption that one cannot have instinctual desires and that all animals have are instincts, the criteria would be impossible to pass. Regan must have had instinctual desires in mind as desires able to pass this criterion, or it would be extremely difficult to show that any animal could every pass, making the criteria too strong. Taking instinctual desires into account creates an opposite problem. Instead of a criterion too strong it becomes too weak. If instinctual desires are sufficient for fulfilling the criteria, it puts into question the ability of a conscious, alive being to fail this test. The reason for this is that if an animal were alive and conscious, it would at the very least have a desire to live. Thus, while the belief criterion is too strong, the desire criteria is too weak, nothing alive and conscious could fail it. If nothing can fail it, why test for it?
Regan’s next criterion is that in order to be “subject-of-a-life” it must be the case that the individual has emotional life. This includes things such as perception, memory, and a sense of the future. Of the four criteria, this one seems the least controversial. It seems that there are clear ways in which to test for these things without allowing every individual to pass or forcing them all to fail.
The third criterion Regan uses is that the individual must have a psychophysical identity over time. The individual must have continuous psychological experiences associated with the same body. The trouble with this is that it may rule out individuals with schizophrenia. Those who suffer from schizophrenia would not have a continuous psychological experience with the same body. They would have several psychological experiences with the same body. Hard to imagine that Regan thought that those with schizophrenia lack inherent value, but this aspect was certainly overlooked when developing this criterion.
The final criterion includes preference and welfare interests. The individual must care if their experiential life is good or bad. This is a good criterion in that it allows individuals to determine their own value, not others. If someone chooses not to care about their life then that is their choice, hopefully, an informed one. At the same time, it protects people from others determining what standard of life the person should live up to. It takes care of the messy standards of living judgments by leaving it in the hand of the individual affected the most and not some other party.
Once an individual has fulfilled these four criteria, Regan believes that they are “subject-of-a-life” and have inherent value. Individuals with inherent value are of equal value to everyone else who has inherent value, and no additional weight is given to someone over the other.[iii] Everyone is treated as having morally equal weight. The biggest problem though of Regan’s attempt to provide animal rights is that this “subject-of-a-life” is too abstract to be of help in specific situations where it would need to be applied. Not only are many of the criteria questionable as to how it counts towards providing an individual with inherent value, but it is even harder to imagine how most of the testing could be done. This is clear when having to use Regan’s theory to determine whether to save a pet dog or a comatose old man from a burning house.
How would the dilemma of having to save either your pet dog or a comatose old man be resolved under Regan’s theory of “subject-of-a-life”? In order to solve this dilemma the first step would be to test each individual against the criteria Regan provides. This will determine if both parties are to be weighed equally. If either pass or both fail the criteria then they will have the same amount of inherent value and one could not be weighed against the other. Only if one passes and the other fails would a clear answer be provided to the situation. Furthermore, it seems that Regan takes all of the criteria to be necessary and only all of them together with sufficient in determining who is “subject-of-a-life”. It is unlikely with all the difficulties in the criteria already mentioned, and that each criterion is necessary that a clear solution could be found.
When dealing with the comatose old man, it is reasonable to view him as someone who is asleep. Being in a coma is often described as being asleep, and by looking at it this way it would be helpful in evaluating the situation since it is then possible to draw on some personal understanding of what the old man is experiencing. If the old man is looked at as being asleep, then he would seemingly fail the desire criteria and perhaps depending on what one considers a belief, the belief criteria. The desire criterion fails because, in a state of unconsciousness, such as sleep or in a coma, the individual does not experience any desire. Only basic body function is maintained, nothing at the level needed for a desire. Whether there are beliefs is more difficult to determine. It can be argued that if someone has a belief prior to the unconscious state they enter, then they keep that belief with them at least until they exit the state of unconsciousness. Even if this were accepted the old man would still have failed the desire part. The old man also does not pass the second criterion of an emotional life either, since he does not have any sense of the future, nor could he have a sense of perception. Neither of these is present while someone is asleep, and so they are also not available to someone in a coma. The third criterion, psychophysical identity over time, is the only criteria the old man would pass. He maintains a psychophysical identity over time, just as it would be said someone asleep does not lose their psychophysical identity, nor does it make something to any meaningful degree non-continuous. The final criterion of preference and well-fare interests also seems to indicate that the old man does not have inherent values. When someone is asleep it would be hard to say that they have a preference and well-fare interests. It seems more reasonable that the person is in such a state that they cannot make a preference, thus failing the final criterion as well. The comatose old man fails most of the criteria, and therefore he has no inherent value according to Regan.
The problem with the comatose old man failing the criteria should seem clear. If someone in a coma fails to have inherent value, what does that mean for people who go to sleep at night and enter into a similar state of mind as the old man in the coma? This is clearly a problem Regan needs to address. One possible response might be that in the instance of someone in a coma, them coming out of that state is largely unknown, whereas it is reasonable to assume people will wake up after falling asleep. How this makes a difference is unclear though, and something Regan needs to examine.
Does a dog have inherent value? Regan does not provide enough evidence on how to test for things such as beliefs, desires, and whether or not the individual cares about their well-being. This is a problem when dealing with animals since it really boils down to guesswork, due to the communication barrier. It is difficult to comprehend how we could ever know that another animal has beliefs. Because it fails the very first criterion, belief, it must be concluded that under Regan’s theory of “subject-of-a-life” a dog does not have inherent value. When balancing a choice between a member of one’s own species to that of another, when they are of equal inherent value, in this case, no inherent value, it must be that the right choice is to choose the old comatose man.
Tom Regan wants to use “subject-of-a-life” theory to show what does and does not have inherent value in order to protect animals. He does not feel that something which is merely alive and conscious is enough to grant an individual with inherent value and this is where he first goes wrong. Many of the criteria used in determining “subject-of-a-life” require tests which may not even be possible or can be tested but virtually everything would pass or fail it puts into question the need for it in the first place. The most troubling part is that his theory is far too broad to implement in a practical setting where someone may have to make a quick decision. Despite all the difficulties with the “subject-of-a-life” theory it should not be abandoned altogether. Regan is at least on the right track, attempting to provide animals with some degree of protection.
[i] Tom Regan. The Case for Animal Rights (Berkeley: University of California Press, 1983), p.321
Posted on June 1, 2019
Hello Ethic Nutters,
This morning I found an interesting article in WIRED Magazine by Megan Molteni. It was about a research project by David Hill which examined if there is a link between our genes and income. The article then discussed the growing field of Sociogenomics.
David’s assertion was that there is a link between income and genes and predominately in the area of intelligence. Beyond his study alone, there have been others which have tried to, at least begin to understand and discover, if we can attribute social factors, e.g. conflict, isolation, with playing a role and having an affect on the genome. Molteni then continues in the article to share David’s belief that his work raises the possibility of personalized social interventions e.g. advanced education, change in environment, for those whose score warrants it.
Correctly noted at the end of the article, and earlier, is whether we should accept this research. In one reference, it is made to sound as though sociogenomics is the younger brother of eugenics. Difficult to say it is not true in my view. What is true is that clearly it is not appropriate policy when thinking of advancing John Rawls’ just society goal.
Are we lifting the veil of ignorance for a future kiss? If nothing changes I think that can be expected.
Thanks for reading,
Posted on April 27, 2019
Hello Ethic Nutters,
Recently in the news are reports of 23andMe not being as great as some people expect.
See news story: Don’t Count on 23andMe Study Warns
What I think the lesson here is, is that we shouldn’t rely on simple over-the-counter advice at any stage of the decision-making process. Which is what 23andMe essentially is as a product. We should instead trust what we have always done and go see a professional for health matters.
Obviously a professional with time can look at all the relevant information as it presents itself through screening of someone’s genes. Dishing out a few hundred dollar’s or even higher is not unthinkable to get the results and information needed by those who are concerned about their well-being. Better to spend the money and time and do it fully, or not at all.
The good news is that the direction that we have been heading on the past several years will produces a desired outcome eventually. We should never stop or give up on our objectives.
Hope you all had a great Easter weekend.
Posted on April 10, 2019
The focus of this paper is on determining whether necessity should be a defense to murder. In answering this I will examine the role of necessity as a defense, in the case of Dudley and Stephens vs. The Queen, in doing so I will also determine if the verdict in the case was correct. I believe that necessity can be used as a defense to murder, but not under the circumstances of the Dudley and Stephens case and that the verdict, guilty of murder was correct.
The Dudley and Stephens case can be summarized as follows. Thomas Dudley, Edward Stephens, Brooks, and a young English boy were stranded on a boat at sea. After twenty days with having survived on only two pounds of turnips and a small turtle which they had managed to catch, the boy, weakest of the group, was killed and eaten until four days later when they were rescued. A few of the following are points of consideration. After twenty days at sea suffering from starvation, the defendants may not have been of sound mind when they decided to murder the boy. The defendants had no idea when, if at all, they would be rescued. Had the defendants not eaten something they would not have survived four more days and that the boy was probably going to die before any of the others. If the others were to survive for much longer they would need to eat something. This raises the question whether the defendants were justified in the murder of the boy because of the necessity to survive, or to a lesser extent should they be excused for their actions. It is important to now look at how the law should work and more specifically what role does justification and excuse has in law.
How the legal system should work is typically divided into two sides. Those who believe that the law should be followed to the letter of the law, and those who feel that the law should not be rigid and our sense of what is right and wrong should play a role in our determining guilt. I believe in the latter, for reasons discussed by Paul H. Robinson. He states, correctly, that “No such code…can accurately prescribe the correct conduct in all situations; it can only provide an approximation of society’s intuitive judgments.” If one was to prescribe to the notion that the letter of the law was to be followed there would be many cases which are not specifically covered, yet are intuitively wrong. I believe Lord Justice Denning had a sound concept of the basis in which the legal system rests upon when stating, “In order that an act should be punishable, it must be morally blameworthy. It must be a sin.” This does not mean I agree every time someone has committed a crime it is a sin, for such instances raised by Hart, as breaking a law designed for a particular economic scheme such as a state monopoly on road transport. I do believe though that although morals may not play a role in determining a verdict in all cases, it should in murder cases such as the one we are investigating here.
It must be asked whether Dudley and Stephens did something morally wrong when they decided to kill the boy and eat him. This I feel can be answered by determining whether they were justified in their actions through necessity or not. If they were justified then they did nothing morally wrong and the verdict was incorrect, but if they were not justified, which I believe was the case, then they were immoral and the verdict was correct, unless they can show their action is somehow excusable.
I agree with what seems to be the widely held view, that an act which is justifiable is one in which no wrong has been committed. Best phrased by Robinson, “Justified behavior is correct behavior and therefore is not only tolerated but encouraged” It does not seem to follow for me that, if someone must do something in order to survive, that act is therefore justifiable, and can be used as a defense that what they did should not be punished. For instance, if in order for myself to survive I must kill another person, who is of no threat to me, or I am certain to die, and I then kill that person; the necessity for my survival does not make my act something which should be encouraged, or tolerated in all cases. To put some innocent person’s life ahead of yours simply because it is necessary in order to survive is inherently something which should not be tolerated. If a hot air balloon can only hold one person and two are on board, and it is known for certain that by pushing the other out of the balloon, the pusher can survive; we should not tolerate the action of one being pushed over. Killing an innocent person to ensure your survival is not tolerated, because it is clearly wrong has been committed and such an act is therefore not justifiable.
What about the issue of cases which the person which must be murdered is not innocent, as is the case of self-defense? It seems to be that it is at least tolerable to allow someone to kill that person which has put an innocent person, into a state, which it is necessary to kill, in order to save the life which has been threatened. The aggressor in this instance is not innocent, and because it is tolerable to kill that person nothing wrong has occurred and such an act is therefore justified.
In the case of Dudley and Stephens, they killed an innocent boy in order to survive. Of the two categories just discussed their situation would fall under that off killing an innocent person knowing it will save your life. The boy did not himself threaten the others survival, their situation did. “…and it is not even suggested that his death was due to any violence on his part…” He was killed because he was closest to death. Had they waited until he died naturally there would be no problem, but they did not. In addition to this, it should be noted at this point that it was not known for sure that the killing of this boy would ensure the others survival. The necessity of the situation was not known. Dudley and Stephens did not know if they would be saved at all. They did not know that by killing the boy they would be able to survive the four more days until they would be rescued. All that they did know was that by killing the boy before they got too weak, they would be able to survive a little longer. It is wrong to kill someone so that you may live just a little longer. As Lord Coleridge states, “To preserve one’s life is generally speaking a duty, but it may be the plainest and highest duty to sacrifice it.” I believe it is, in fact, the highest duty, in an instance where you must kill an innocent person to necessitate your own life, to sacrifice yourself. There are many cases in law, which reflect this duty, such as the one which Lord Coleridge stated of a ship sinking. When a ship is sinking, although it may be necessary for you to get on a lifeboat to save your life, you cannot justifiably do so by pushing another person off the lifeboat. This has been a long-standing position, one which should not be dismissed. Dudley and Stephens were in a similar situation in which they had a duty to sacrifice their lives above killing an innocent person to save themselves. Just as wrong has been committed when a man pushes another off of a lifeboat, a wrong was committed when the English boy was killed. A defense cannot use necessity when it is the killing of an innocent person. The question though is whether a defense of necessity can be used in excusing the person.
Again I find that Paul Robinson has the best explanation of how excuses work in the legal system. When an excuse is used as a defense it is an acknowledgment that the act was wrong but that the person should not be punished because of a characteristic of the person which society feels should exclude him from punishment. Necessity is sometimes used as a defense for excuse, if it can be shown that through the necessity to save one’s life, they are in the category which excludes someone from punishment. The common reasons for exclusion are if the person is, insane, under duress, or in self-defense. None of these three reasons for excuse properly apply to the Dudley and Stephens case.
Of the three reasons the claim that the defendants acted in self-defense to save their lives applies the least. The boy did not put them into any danger. A self-defense excuse, in this case, could only be used if Dudley and Stephens did something against Mother Nature which put them into this situation. The boy was totally innocent in this case. A stronger reason for excusing the defendants would be that the defendants were insane at the time of the crime. The evidence does not suggest that the defendants were insane at the time though. The act of killing the boy was proposed, discussed and finally agreed upon. This act was not rushed in a fit of insanity which may be excused; rather this action was planned and committed two days after it had been agreed upon. It seems clear that no one involved was insane at the time. Were the defendants however under such a large amount of duress that killing one of them should be excused? I do not believe so. Again I would like to refer to the example of a sinking ship raised by Lord Coleridge. If people in the past have been able to sacrifice themselves, instead of killing others to survive, and under equal if not greater duress, there is no reason to think that duress is substantial enough in this case to warrant an excuse. Those who go down with the ship are more certain of their death than the defendants were, and not only that but had those who went down with the ship killed someone to get onto a lifeboat, their survival was vastly more assured that the defendant’s fates were in the situation they were in. They did not know that they may have been saved the next day, or once killing the boy that it would last them until they were saved.
Some suggest that in a state of nature someone should be excused from their actions. I do not entirely agree with this claim. I do agree however that, someone whose life has just been threatened by another and is in a state of nature, for this reason, the person can kill the other and not be held accountable. This is not because it is excused, but rather because it is justified. If I am put into a state of nature by no means of someone else, it is not justified, nor excusable to do whatever I wish, as those who are against the verdict in the Dudley and Stephens must believe. The only way in which it may be seen that Dudley and Stephens were even in a state of nature is because their lives were about to end. This seems to be an invalid way of determining if someone is in a state of nature or not. For example, can an old man on his deathbed be excused for killing his nurse, and doctor who did not cure him? It is clear that he cannot. Being close to death is not sufficient to be in a state of nature, you must also be acting on instincts, and which anyone in the same situation would do the same thing unequivocally.
The verdict of murder in the Dudley and Stephens case was correct. It was not justifiable because they killed an innocent person. In addition, their action should not be excused. They were in no danger from the boy, were clearly not insane from the fact that they planned out the action and deliberated about it, and were not under enough duress to excuse the killing of the innocent boy or any of them for that matter. They should have either drawn straws as was suggested, or wait until the boy died naturally.
 Paul H. Robinson, “A Theory of Justification: Societal Harm as a Prerequisite for Criminal Liability” UCLA Law Review Vol. 23, pg. 271
 Denning, “The Changing Law (London: Stevens, 1953), pg. 12
 H. L. A. Hart, “Legal Responsibility and Excuses” in Punishment and Responsibility (Oxford 1968), pg. 36
 Paul H. Robinson, “A Theory of Justification: Societal Harm as a Prerequisite for Criminal Liability” UCLA Law Review Vol 23, pg. 274
 The Queen v. Dudley and Stevens  14 Q.B.; pg. 276
 Ibid pg. 276
 Ibid pg. 281
 Ibid pg. 281
 Paul H. Robinson, “A Theory of Justification: Societal Harm as a Prerequisite for Criminal Liability” UCLA Law Review Vol 23, pg. 275
 Ibid pg.275
 The Queen v. Dudley and Stevens  14 Q.B.; pg. 281
 Perka v. The Queen  2 S.C.R. 232 (12 pages)
Posted on February 2, 2019
Sharing is caring my friend used to say. As a fairly liberally minded University student studying moral ethics, I tended to agree. Although I was not particularly able to donate money earlier in life, I certainly donated considerable amounts of time. There were early volunteer positions for student bodies and later for the United Nations and for the Liberal Party of Canada. Now, my volunteer activities are largely done through my commitment to Rotary International.
It’s always nice to share. We grow up sharing with our siblings and a house with our parents. We share in school and the ball during recess. Sharing is a trait which on the surface is not only seen as highly ethical, right, and good, but it is a trait which is instilled in us early on in life. But is sharing always a good action? Sometimes we think we do not want that shared, whether it is a downloaded song or video, or in more real terms information about ourselves which we have chosen to keep private. So what is it that makes sharing sometimes good and sometimes bad, and what examples can be said to clearly offer delineation of this difference in moral judgment of the act of sharing? In the following short post, I aim to discuss that question as a starter for perhaps future thinking.
When thinking of perhaps a common example of sharing, we can think of passing the person in hardship taken to a life on the streets. As we see the same person day-in and day-out, we think increasingly of sharing enough change for a coffee or bagel. A coffee or bagel will minimally help the individual on the street living a life unlike ours, whose dedicated to finding help in the only way society has offered, but it is a nice gesture which provides limited happiness and some hope. Both the one on the street and the one providing the coffee know this act alone will not alleviate the situation. Really what is needed is for employment in a position they perhaps were in before the troubles began. Even with a coffee shared or a bagel bought for a lunch, the underlying issue remains. Devoid of alternatives and governments underfunded to help, or too slow to help before a crisis happens, the basic act of sharing does provide limited benefit. It is in this immediate benefit and the generated happiness created that the act of sharing is thought to be good and right to do. This is what is meant when it is said something is on the surface good or right.
So it seems that sharing change for a coffee or bagel is helpful and in that regard a good thing to do. What if however, we thought in longer terms though. A month, two months, four months, five years. Now we ask the question, is this fixing the situation. Is the individual getting richer or in more practical terms, better off from the day before? Well no. The same individual cannot buy their own coffee or purchase their bagel, and so nothing is fixed. Nothing is fixed but now let’s go a step further and ask is it actually indeed harmful? Are we perpetuating and offering an answer that is preventing progress? Time has shown that this is a complex problem and really beyond the scope of this post. There are proponents on both sides. What is shown though is that an act of sharing which seems prim facia good, can be said not to be when adding an extended time period on it, or even just a few additional variables.
From the fact that an act of sharing even in its most good manner may not be such a good thing, does that imply there are no instances of an always good act of sharing? Let us assume an expert has a grand volume of knowledge obtained over many years of study and practice in his or her field. Not only would we think such knowledge should be shared, but some might say there is a duty to do so. This speaks not only to the value placed on information and teaching but also on building the capacity of others so that the entire community e.g. professionals, progresses forward. Going about and sharing knowledge is a fundamental element of the human experience. Communities are shaped by the sharing of knowledge. It is known, that for people to thrive and flourish discussions and a sharing of knowledge must happen, and we know it has happened, increasingly in new ways.
Again the question will be asked though, with all of the benefits sharing of knowledge generates, and a duty for some to do so, should it always be shared and there be in one sense full transparency and flowing of knowledge? Great examples some readers may know well is with gossip and at a higher level, confidential business information. Gossip is a part of life and not the type of knowledge we are discussing. Everyone knows that is childish behaviour and not one that should be done as an adult or to worry oneself with. Confidential business information though is more serious and can be far more harmful. So why is it in one instance sharing of knowledge is beneficial while in another it is not? It is from exactly the fact that in one instance sharing of the knowledge is beneficial while in the other instance it is not. We as a society have developed the word private and confidential for the very reason to label information not as beneficial but as harmful if shared.
There are those though who say there is a right to know and that they are mature enough to deal with the information. While a person may be mature enough to deal with the information that has been labeled harmful if shared and thus confidential or private, the notion that there is a right to information is mysterious. It is certainly not amongst a Universal Human Right, and those working in the private sector know full well there are good reasons why people are not allowed to know the inner workings of a company. There is no right to information or knowledge, and especially that which is labeled as private or confidential.
In both the sharing of change for a coffee to the person in the streets, and knowledge to help progress a community, we can see reasons to think that the act of sharing is a good thing. When thinking of sharing change and of knowledge though we can think of reasons not to do so because it would be wrong. In all instances, we are thinking of the benefit in each example as a determining factor in its normative nature. The difference is utility and how much good is generated. When making the decision to share, we must avoid what we were always taught, that it is an automatic plus, someone who had nothing before now has something. We must begin to think in terms of utility. Is this act of sharing really benefiting all involved and for an overall increase in utility?
Posted on February 2, 2019
A 38-year-old father does not want his 18-year-old daughter to have a test done for Huntington’s disease on her fetus. His reason for this is that if the test comes back positive, he will also know that he has Huntington’s which he has carefully thought about in the past and decided he did not want to know. The reason why the daughter wants to have the fetus tested is to avoid bringing a life into this world which has Huntington’s. A conflict of autonomy is clearly present in this case. You have the decision of the daughter to not want a child with Huntington’s versus the decision of the father to maintain ignorance of his condition. What should be done in this situation?
The first step taken in this situation should be to try and activate increased discussion between the father and the daughter in hopes that they may be able to resolve the situation themselves. There are several benefits to this process. It would maintain a strong family bond between the two that might be broken when one of their autonomy is taken away by the other. An increased understanding of the other’s position and the rationale that exists behind there position may also be of benefit in helping to console the individual who has just lost a certain amount of autonomy. Only after serious attempts to reach a consensus have been tried and failed, should the consideration to override autonomy be made.
It will be assumed that is it is morally acceptable to abort the fetus if it is found to have Huntington’s. The reason for this is so that the issue of autonomy can be addressed rather than the ethical dilemma of aborting due to Huntington’s. It is a total dismissal of the case to say that the autonomy of the father should be respected because the autonomous decision of the daughter is morally wrong in the first place and then go on to argue for the immorality of abortions on fetuses with Huntington.
The proper course of action in this situation is to respect the daughter’s autonomy while overriding the autonomy of the father. There are three main reasons for accepting this course of action. The first is that accepting the daughter’s autonomy only potentially affects one life while accepting the father’s potentially affects two. The second reason is based on the amount of life which will be affected by following the autonomy of the father over the daughter. The final reason is that the autonomy of someone should never be allowed to override the autonomy of another when dealing with matters of health.
If the father’s autonomy is accepted it will potentially affect not only the daughter’s life but also the fetus’s life. Thus the autonomy of one individual will be imposed on two lives. If the daughter’s autonomy is followed then only one individual, the father, is being imposed upon. It is reasonable to pick the path which will impose autonomous beliefs on the fewest people. One objection to this might be that in both cases the autonomy of an individual is actually being imposed on two people, the father, and fetus, or the daughter and fetus. To include the fetus in one count and not another, it might be said, cannot be justified. This is not true, however. If one looks at how decisions for extremely young children are made, it will be seen that the values and beliefs of the parent are assumed to be that of the child except on rare occasions.
The autonomy of the father is less important than the daughter’s because it will only affect at most, the next ten years of his life. After ten years pass he will know whether he has Huntington’s or not while the autonomy of the daughter will affect not only many years of her life, but also many years of the fetus’s life. It is utterly selfish of the father to demand that the daughter refrains from testing the fetus so that he may remain in ignorance for only several more years, while the daughter is forced to bring into the world against her wishes someone who may have Huntington’s. The autonomy of one individual cannot be given such force that it overrides two lives for the sake of ignorance, especially when the ignorance that the father cherishes so much will be over shortly regardless.
The father really has no say in this matter. The daughter being pregnant and eighteen years of age is considered an emancipated minor, a child able to make their own medical decisions. When it comes to health issues there needs to be a much stronger reason to override someone’s autonomy in favour of someone else’s, than a desire to remain ignorant. To allow the father’s autonomy to override that of his daughters would be analogous to allowing someone to veto medical research for fear that it may contain results that the person does not want to know. This is unacceptable, as is giving the father veto power over the daughter’s medical decisions.
The autonomy of the daughter should be followed over the autonomy of the father. When dealing with medical decisions the will of the patient is followed, not a third parties desire to stay ignorant. The father’s ignorance will expire in such a short time the amount of life affected by that autonomy is insignificant when compared to the amount of life which will be affected by following the daughter’s autonomy. Furthermore, it is clear that the father’s autonomy will be imposed on two lives, whereas the daughters preferably are imposed upon only one person. As with any conflict, the autonomy of either the daughter or father should only be overridden as a last resort after serious attempts at a compromise have been attempted.
Posted on December 29, 2018
With TESLA being the darling of electronic and self-driving cars, and many following their lead, AI’s role in how we will be driven, no longer drive, is of significant importance. AI itself is in early stages and far from able to analyze the full environment around a car while in motion. Not only is it questionable the environment can be fully processed, but additionally, now attention is being given to decision making aspects affecting the passengers, and pedestrians.
In the article “Building a Moral Machine: Who Decides the Ethics of Self-Driving Cars?” by Thomas Hornigold the topic of how a Moral Machine is programmed is raised. Noted are large survey’s which ask many thousands of respondents what they would do in a given situation. From this, the thinking is that an answer is derived e.g. save the child running after a ball in the streets by swerving into the pole.
For the moment there does not seem to be another method but from this approach, a grand dilemma is created. If we build one Moral Machine e.g. the first truly self-driving car, would build another Moral Machine differently? I think naturally we would not. It would be a job done with no alternative. The study on what the majority would do was completed. This creates the problem that only one moral answer is set in stone.
In my car, I may want it to see things differently based on my morals than the cookie cutter answer that has replaced my view with set guidance. If a passenger says something e.g. a relative offering advice, I clearly do not need to follow it and rather go my own way. What buy-in will there be to bring people onboard with a Moral Machine that does not necessarily reflect their own, and in many instances would not. There is an unfounded presumption here that a Moral Machine will think better for us than our own thoughts. Perhaps, down the road, reality will be that we share what our opinions are and the driving reflects it. For now, I think everyone is in the dark. The truth is though it is likely some form of imposing of values will be necessary and that is troublesome.
Something has to be offered to replace our existing views and values. Perhaps that is safety or another essential human need. If nothing is offered a different course may result which does not accept this new Moral Machine if we are to call it that.
Posted on December 9, 2018
In the article, The Ethics of Sex Preselection Mary Ann Warren argues for the position that sex preselection is not always a sexist act and thus a complete ban on sex preselection should not be put into place. I believe, however, all that Warren manages to show is that sex pre-selection is not irrational in certain situations, and in this response to her article I will show why her example of sex pre-selection for economic reasons in a sexist society, is, in fact, a form of sexism.
One of Warren’s cases of when sex preselection is not an instance of sexism is when it is done for economic reasons within a sexist society. She presents the case in which a poor mother living in places such as rural Punjab, decides to have a son rather than a daughter. The reason for the mother’s decision is because the society is a sexist one and women traditionally make less money than men and are a greater drain on the family economically since they would have to provide a dowry for her to get married. If the family is too poor to provide a dowry then she would remain living with the family and be a further drain on resources that way. So the mother decides to have a son so that as a family they can increase their economic standing and he will be better able to support the mother in old age. Warren believes that in such a case the preselection by the mother to have a son is not an instance of sexism. Her rationale for this is because the woman is personally blameless, she is merely acting upon the sexism of the society in which she lives in, in an attempt to better their economic status, a rational desire.
Warren defines sexism as “wrongful discrimination on the basis of sex.” Wrongful discrimination according to Warren is discrimination based on false or invidious beliefs about one sex or the other. Even under the very definition, Warren provides of sexism, she fails to adequately show that her example of sex preselection to have a son based on economic reasons is not an act of sexism.
The idea that the woman is using sex preselection merely in response to the sexism of her society to improve her economic status and thus it is not an act of sexism itself, is ridiculous. If you are forced into making a choice which is sexist, the factors behind that choice do not change the fact that it is a sexist choice. There is nothing in the definition of sexism provided by Warren which states that the false or invidious beliefs must be that of the person making the decision. Part of the decision of the mother to have a son is based on the false beliefs of the society which believe that women cannot perform equally in the workforce with men and so the discrimination will still be based on false beliefs which according to Warren’s definition of sexism, indicates sexism. It is not difficult to imagine an analogous example of a situation in which society is pressuring someone into making a clearly sexist choice and yet we do not consider it excusable or non-sexist because of the role in which the society had in pressuring the person. We can imagine a situation in which a man looking to hire a doctor is approached by a woman for the position. He personally believes that women can do just as good a job as men can, but because society has told him women cannot become doctors, he is forced to turn her down. Even though he personally thinks the women could have done as good a job as a man could, her wrongful discrimination based on sex is still at the very base, based on false and invidious beliefs even if they were not the beliefs of the man doing the hiring. The fact that the doctor does not share the same beliefs as the rest of society is irrelevant if the decision is being made within that society, and according to that society false beliefs. This gains support from the fact that when we look at events and attitudes in the past we still assert that many of their actions were sexist. The fact that it was socially acceptable may excuse them at best, but it certainly does not change the fact that what was being done was sexist, just as it does not with the case of a woman preselecting a son in a society in which it is deemed acceptable. Social acceptability is not an indicator at all, of what is and is not sexist.
In response to this Warren could do two things. She could add an ad hoc clause to her definition stating that any wrongful discrimination against someone based on sex due to social pressure does not count as sexism. The problem with such thinking is that it would help to further perpetuate sexism within a sexist society. Warren is taking away individual responsibility. Any sexist act could seemingly be excused on the defense that it has done because of social pressures, and it would be very difficult to ever hold anyone accountable for what is clearly an instance of sexism.
A second response might be an attempt to show that the beliefs in which the decision is based on are true. This is the defense Warren actually uses when citing evidence that men statistically make more money than women. The problem with Warren’s argument here, however, is that showing that something is true and rational, is not enough to show that it is not a case of sexism. She would still have to show that the beliefs are not invidious which would be even harder to show. It seems clear from the fact that there is a large debate on this issue that if someone were to preselect the sex of their child it would cause at least a few people to get angry. Not only does she fail to successfully overcome the invidious part of her definition, but more importantly I believe she also fails to adequately show that the beliefs are true. Providing evidence that men on average make more money than women does not in anyway show that the belief that a daughter would make less money than a son is true. Only time can determine that. It is difficult to not get into epistemological questions about what a true belief is, but it seems reasonable to assume that someone who believes that daughters make less money than sons, could have a daughter which ends up in the small percentage of women who make more than men, thus making the belief, false.
 Warren, Mary Ann, The Ethics of Sex Preselection (New York, Oxford: Oxford University Press, 1992), pg. 232
 ibid pg. 232,233
Posted on November 30, 2018
In a stunning first in genetic engineering, a Chinese researcher has engineered a human. This incredible achievement is one of a number of firsts coming from China recently in the area of genetic engineering.
But is all of this at a cost to our morals? Can we allow this path to continue in one region while not in another?
In this globalized era, there is no question whether there should be some form of global oversight to regulate this science. It is not currently being conducted in a manner of speaking which fellow scientists and in particular ethicists can agree with. Why should we agree? Just because it has happened, does not mean we must now accept it.
Let the demonstrations begin.
Whether it is pushing for a new body in the United Nations or a branch from an existing agency, regulations are necessary and to be blunt, behind.
It is now a test of response. No longer is it preparing for the eventuality to come. It has arrived and this new era of evolution has begun.