Alice Dreger on technology, ethics, and birth

The Most Scientific Birth Is Often the Least Technological Birth - The Atlantic

A number of important points worth further discussion are slipped into this piece:

De Vries suggests that the organization of maternity care in this country -- "the limited choices that American women have for bringing their baby into the world, what women are not told about dangers of intervening in birth, and the misuse of science to support the new technologies of birth" -- actually constitutes an ethical problem, although we typically do not recognize it as one.

and also a quotation from a medical researcher

"We're all very interested in having healthy babies and it is pretty easy to make the kind of cognitive errors that people make, and attribute to technology benefits that don't exist. At the same time, when there are problems in a pregnancy, that very same technology can be life-saving. It is easy to make the [problematic mental] leap that technology is always going to be necessary for a good outcome."

In other words, that most pregnancies are treated as though they are high-risk does not create an overall benefit.

This issue, a personal one for me and many other women (and their partners) is tied to numerous philosophical issues: the appropriate role for medical ethics, how values are introduced into research design, analysis of evidence, communication of results, and translated into clinical practice. There are also issues of social epistemology: why don't women know which common procedures are couple with risk and which are not? Who benefits from the creation of ignorance in this case? And how can ignorance of risks (and even of variation from one practitioner to another, such that some OB's perform 'routine' episiotomies and some never perform them at all) continue to exist despite easy internet access to scads of information?

Conference papers and professional courtesy

What are the rules regarding conference paper submissions and fresh work in philosophy?

I've presented at and attended some scientific conferences, and the rules at those conferences are usually explicit in the calls for papers: submitted work must be presented at the conference for the first time, and it must not yet have been published. I think the rules on work that has been accepted for publication but not yet published vary, and they depend on how crucial it is to get information out to peers.

Granted, there are ways to bend these rules. Often, a scientific research project has been produced by a whole team of people and the data can be analyzed and presented in many different ways. If the team members come from different disciplines, then they may be able to present their research from different disciplinary angles at various conferences. Also, there may be different products that come out of a single study--one paper might focus on methodology, another on a new use of a technology, while another analyzes the consistency of that study's results with similar studies. But in any case, it's widely recognized as wrong to submit the exact same paper to two similar conferences, just as it would be wrong to submit it to two journals.

In philosophy, though, our work builds and our views shift in a more organic way, and there may be a good reason to present the same work to two quite different audiences. It seems fully acceptable to give a paper at a local symposium and also at a national conference. Is it acceptable to submit the same paper or abstract to more than one conference simultaneously, without intending to make any changes? To submit to more than one division of the APA? To submit to a group session and to the main program at the APA, perhaps betting that one would be rejected or could be withdrawn? To submit to an APA session some work that has been accepted by a journal but is still forthcoming? To submit to an APA work that has already been published? Where is the line?

More than once, I've attended papers delivered at the PSA which I've also seen delivered in a similar or exact same form elsewhere. In some cases, I've already read the journal article. In one case, I had read the journal article 4 years before seeing the presentation. Something like that might be acceptable if it extended or modified a prior published article, but in this case no changes had been made and the article's publication was not mentioned.

Conference program committees should review papers anonymously (that is, without knowing who the authors are, their affiliations, or their status). Is it fair for them to look up paper titles to see if a paper has been published or presented elsewhere? Or doesn't that undermine anonymity since many people now post paper drafts online?

Innovations in Ethics Curricula

Innovations?! Well, no. Here is yet another of my frequent complaints! Textbooks in ethics (and in Intro to Philosophy, and in Philosophy of Science, and in Environmental Philosophy, and I'm sure in most of our other areas) go through frequent editions but each edition contains the same old topics with the same old papers.

Yes, some of the old papers are classics and nothing else compares. Judith Jarvis Thomson on abortion. But in general, except for the addition of pieces on climate change, an ethics anthology now looks almost exactly like an ethics anthology when I was in college--over two decades ago! And some of the pieces seemed dated to me then.

Today's exemplar just arrived in my mailbox--Social Ethics: Morality and Social Policy, edited by Mappes, Zembaty, and DeGrazia and in its 8th edition with McGraw Hill. I don't think this text is any worse than all the others, but it's not better, either.

Take the example of the chapter on climate change. It contains 10 selections, but only 2 of them were written in the last decade! Both of those pieces are written by philosophers but were originally published in the popular press.

And let's look at the gender breakdown--something that should be informative about the degree of currency and creativity in an anthology. Women constitute 20% or so of professional philosophers but a much higher percentage among ethicists. In addition, this text has sections s on issues that have been extensively examined from a feminist perspective: sexual ethics, abortion, marriage, pornography, and global and economic justice. Finally, the text includes selections written by practitioners (rather than exclusively by philosophers) and published in the popular press (rather than just in philosopher journals).

So what can possibly explain this breakdown?

Of the pieces with named authors, only 15% have a female author. Some of those female authors have more than one piece in the anthology, so that only 12% of authors are female!

The cost of the text is over $100. Do any of these pieces come with an expiration date? I drink fresh milk, eat fresh eggs, and insist on fresh fruit. My mind requires fresh nourishment as well.

The Limits of Business Ethics

One thing going in my academic life while I wasn't posting has been work related to reconceptualizing our university's general education curriculum. We've always had a liberal arts and science "core," though it has dwindled in credit hours over the years. Right now, students must take two introductory-level humanities courses (two courses chosen from among English, fine arts, history, STS, and philosophy). Right, it's not much. In our new curriculum, any department, anywhere in the university, can apply to teach a course in the arts and science core. And the business college has decided that their business ethics course ought to count.

Many, many arguments have been constructed, dressed, gussied up, rearranged, and presented to the committee made up of people from all over the university, most of them with no background in liberal arts or sciences, to explain why this is a bad idea. What amazes me, though, is that the quality of arguments don't seem to matter to the committee nearly so much as the...well...the marketing. But isn't that the point?

The business college has resorted to constructing case studies to show why it's so important to teach ethics to their students their way. Imagine, they say, that someone is asked by her employer to do something immoral and illegal, but her job or her raise or her bonus hinge on it. She has a lot to consider! It's not easy to think through the ethics of such cases!

After watching Inside Job, I don't doubt that there is a need for ethics education in business, finance, and accounting. I do doubt whether it can come from inside.

And there is the recent case of the LaSalle University professor who somehow worked strippers and lap dances into an extra credit class meeting for a business ethics class. One wonders: bad egg, or just positioned at one end of a spectrum?

Engineers and Ethics

Are engineers more pre-disposed to become (right-wing) terrorists than others?

Apparently, violent jihadists are more likely to have been trained as engineers than to have attained degrees in other areas of higher ed. Three or four times as likely. Is this because terrorist organizations have the foresight to recruit highly trained technical experts?

Hertog and Gambetta argue in the New Scientist (and based on a peer-reviewed journal article) that instead it's due, in part, to the personality/cognitive traits that attract certain individuals to engineering in the first place. They found that the reason is

something at the individual level, that is, relating to cognitive traits. According to polling data, engineering professors in the US are seven times as likely to be right-wing and religious as other academics, and similar biases apply to students. In 16 other countries we investigated, engineers seem to be no more right-wing or religious than the rest of the population, but the number of engineers combining both traits is unusually high. A lot of piecemeal evidence suggests that characteristics such as greater intolerance of ambiguity, a belief that society can be made to work like clockwork, and dislike of democratic politics which involves compromise, are more common among engineers.

What we philosophers can take away from this is the importance of teaching ethics to engineers. And teaching it in a way that demonstrates comfort with ambiguity (not the same as relativism) and the difficulty of working through humanistic problems rather than jumping to some supposed take-home message. (My engineering students are the first to ask "Is this stuff going to be on the final exam? And if it is, what's the right answer supposed to be?")

Climate Change and Population Growth

A student from my ethics course sent along this link to a Yahoo News article on the relationship between climate change and population growth.

The news article starts with a strong, clear statement:

The battle against global warming could be helped if the world slowed population growth by making free condoms and family planning advice more widely available, the U.N. Population Fund said Wednesday.

But then the majority of the article goes into criticisms of this policy and, indeed, casts doubt on any need to control population growth at all:

On Wednesday, one analyst criticized the U.N. Population Fund's pronouncements as alarmist and unhelpful. "It requires a major leap of imagination to believe that free condoms will cool down the climate," said Caroline Boin, a policy analyst at International Policy Network, a London-based think tank.

She also questioned earlier efforts by the agency to control the world's population.

I've been teaching this topic in my ethics class, and the best work I've seen on the issue

supports a position like the UN's while acknowledging caveats such as the higher priority on reducing energy consumption in developed countries as well as the priority that must be put on preserving women's reproductive choices. But since providing access to family planning is generally agreed to increase rather than reduce women's control over their reproductive lives, I was surprised at the negative tone of the article. I retrieved the originals here.

Indeed, this seems to be a clear case of a news article that is slanted to favor an ultra-conservative political angle. The quoted expert is a writer for Britain's Conservative Party, and the other experts were simply misquoted as being cautious about the UN policy when in fact their editorial is strongly supportive of it.

The paper by Bryant et al., however, is the first to provide strong support for the third point – showing that the majority of the least-developed countries cite population pressure as an important determinant of their vulnerability to climate change. The fact that the affected countries themselves identify this as a local priority avoids the conflict that comes from framing population regulation as a way of reducing global greenhouse gas emissions.

Animal Rights and Teaching Ethics

In my Introduction to Ethics class last year I taught food ethics, including animal rights, for the first time. I've shied away from the topic in the past, thinking that the students--or, at least, the students at places where I've taught--would consider it too fringe to make a direct connection with the underlying thought patterns.

On the final exam I asked a question, "What is the most memorable, challenging, or thought-provoking idea that was raised in this class?" 

The most popular, though least illuminating, answer was along the lines of "ethical theories." The second most common answer had to do with a film we watched about farm animal rights, called Wegman's Cruelty. I was surprised by this large response, particularly since discussions after the film were short and shallow.

The film documents animal-rights activists, led by Adam Durand, breaking into the Wegman's egg farm to (illegally) investigate whether the farm violates animal cruelty guidelines. It did, and the footage is dramatic. The case occurred in 2004.

I learned yesterday that Adam Durand is one of my neighbors, and that he has a court date for resentencing tomorrow. His original sentence was illegal and was appealed to the state supreme court. Our court system is often described as biased in favor of defendants. While that's true, there is also a clear bias toward entities that have the money and the power to drag court cases out for years and years. How surprising that this case, a minor case of trespassing, has been in the system for 5 years!

Making Wise Choices About Environmental Goods

In my environmental philosophy class, this week we discussed preference utilitarianism, cost-benefit analysis, and whether we should trust people's stated preferences about how highly they value environmental goods.

I tend to be skeptical about economists' measurements of preference, though I don't know of a better and simpler tool that can be substituted.

Preferences can be discovered (only) by introspection, so it seems illogical to say that someone could be mistaken about what they prefer. The claim that someone can be mistaken rests on several observations:
1. Sometimes our actions do not follow our expressed beliefs. Which is the real preference: how we act or what we say?
2. People change their minds depending on how a choice is presented.
3. What we think will make us happy does not always, in fact, make us happy. Predictions of future happiness and unhappiness are wrong in systematic ways.

We talked about some of the mistakes that people make in estimating the value of their preferences and watched this video, from 6:00 to 12:54. I think Leroy's lottery ticket fallacy is particularly telling.

Local Economies and Ethics

In Deep Economy, Bill McKibben argues in support of local media and in support of distributed power generation. (This is my university's common text this year, and I'm teaching it in my ethics course.)

I’ve long believed that these are important and under-appreciated public problems (together with how recent expansions of intellectual property rights constrain creativity).

McKibben cleverly twins these issues as symptoms of a larger problem: the loss of local control over how we lead our lives. If local media were substituted for corporate nation-wide media, we would have the opportunity to develop our own tastes and ideas, not just swallowing what is mass-produced for everyone to consume. We might appreciate the diversity around us, learn more about our communities, and develop new tastes. If we had the ability to feed to as well as take from the electric grid, we might find pleasure in making this commodity for our neighbors to use:

Instead of something that you buy from far away, energy becomes something you help make and distribute to your neighbors. On a sunny day I can walk down to the electric meter under my porch and watch it spin the wrong way. As long as the sun stays out, the solar panels on my roof make me a utility. It’s a sweet feeling, knowing that my neighbor’s refrigerator is running off the panels above my head….Japan leads the world in building a decentralized solar-panel energy economy…[Perhaps] because people feel both an obligation to and an ability to trust one another… (p. 148)

But I’m left with the question: What is ethical about supporting local economies? Is this just a fancy twist on identifying and supporting what is in our own selfish interests? Sometimes McKibben presents localism as a way of keeping profits in the community: we support our neighbors’ businesses, and then they reciprocate and support us. We benefit by cutting out middlemen who drain profits out of the community.

This may be smart and it may be efficient, but is there any sense in which it could be ethical? Indeed, an emphasis on local communities over the universal public cuts against over 200 years of Kantian ethics and over 100 years of calculating “the greatest good for the greatest number.” I’ve been wondering how to fit this support for local economies into an ethics class. In an earlier post, I argued that virtue ethics can sometimes do the job, since virtue is aimed at guiding people to cultivate the virtues that we most admire in others, including virtues such as charity, friendliness, and living deliberately. Care ethics, in particular, prioritizes beneficence directed toward our circles of family, friends, and acquaintances over beneficence to strangers.

Without adopting a version of virtue/care ethics, it is impossible to say what drives a choice to consume local goods rather than imported ones (excluding, of course, the environmental cost of transportation). In utilitarian fashion, Peter Singer argues that buying food products grown in poverty-stricken areas directs our money to the people who benefit from it the most. He argues convincingly (in The Way We Eat) that this is true even when foreign growers are not participating in fair trade programs. Against this argument, McKibben’s plea to invest in local communities rather than poor communities seems to be supported by little more than self-interest? (Certainly, many of my students interpret it in that way.)

However, I think that support for local economies, local power generation, local media, and local agriculture can be justified in one more way. It can be justified on the grounds of the psychology of responsibility and on the limits of knowledge. Looking for justification from ethical theory is to look in the wrong toolbox. Instead, we should look to social epistemology and to moral psychology.

The greatest benefit of localism is that it functions to establish accountability. McKibben sells localism as a route to greater happiness—we are more likely to have friendly, meaningful conversations at the farmer’s market than the supermarket. But another benefit of localism is that it’s easier to know what’s going on in a limited sphere, and we are more likely to take an interest in it. “NIMBY” is a phrase that’s used to denigrate elites who would prefer exploitive, dangerous, unsightly, or polluting operations to be located out of sight, in other communities or overseas. But there’s a positive side to NIMBY movements, too. If something is so unpleasant or harmful that no one wants it, there is motivation to change our practices or improve our technologies or accept higher prices. When products and power come from under our noses, it's much more difficult to hide or externalize costs.

Perhaps McKibben's best example is of local, sustainable logging. In the forestry industry, it is efficient to clearcut an area and then replant it. One reason this is efficient is that it takes all of the value now, and thus hedges bets against an uncertain future. Another reason is that sustainable logging is more labor and equipment and time intensive. In fact, with the economy going the way it has been (barring global recession, that is), it is more economically efficient to harvest the value from forests now and to reinvest the profit. Any standard investment will reap a greater economic return over the time that it takes to regrow a forest than to actually regrow the forest. But this is a viable strategy only if you don't mind eradicating your forests, and forests have more than economic value. In McKibben's example, people are more willing to pay a higher price for sustainable forest products if those products come from woods that they know and enjoy.

The ethical aspect of McKibben’s localism is that it activates responsibility.

Ethical frameworks and sustainability

I'm teaching an Introduction to Ethics course with an emphasis on examining environmental sustainability. Although I've assigned a textbook that has some collected readings on ethical theories, the class is relying predominately on reading about environmental issues as they come up in non-philosophical venues.

I've had some difficulty illustrating the usefulness of Kantian ethics in the context of environmental problems. Any suggestions that readers have for how to apply Kantian ethics to such problems would be appreciated!

For instance, the class did work through the problem of overpopulation, achieving the insight that if everyone had large families, the human population would quickly exceed the earth's carrying capacity. But the implication that each and every one of us has a duty to limit family size to 2 children or fewer did little to guide recommendations for how that duty should be enforced or encouraged. Utilitarianism, by contrast, seems well suited to problems of global scope; increasingly, environmental and economic problems do have that scope.

Another problem that loomed was how to give theoretical ethical support to the lifestyle recommendations in Bill McKibben's Deep Economy. I happened across Peter Singer's recent book The Way We Eat: Why Our Food Choices Matter, which provides utilitarian support to some, but not all, of McKibben's views (a review here).

Singer, for instance, does not find an ethical justification for buying locally-grown foods. He acknowledges the environmental reasons to support buying foods grown nearby rather than those transported across the US. But he also believes that we are doing more good for others by buying foods imported from poverty-stricken countries than buying US-produced food, even when products are not the result of fair trade practices. Also, I find the utilitarian argument against speciesism to be, well, specious.

I think virtue ethics, though, is ideal for justifying the kinds of actions that McKibben endorses. Even its derivative, care ethics, can make sense of why people choose to buy local: people who have definable relationships to us, who live in our communities, have a greater claim on our consideration.

Peter Singer, by the way, is speaking at RIT tomorrow on "A Better, More Sustainable World" at 2:30 pm in Golisano Auditorium. All are invited.