Thomas Kuhn's Ashtray

A story and video illustration by Errol Morris, concerning his time as a student of Thomas Kuhn's, at the Times.

In the comments:

That's the problem with relativism: Who's to say who's right and who's wrong? Somehow I'm not surprised to hear Kuhn was an ashtray-hurler. In the end, what other argument could he make?

Covering Laws

Not that kind. This kind.

In April, Belgium became the first European country to ban wearing full-face veils in public. This week, one house of the French Parliament voted to ban face-covering veils in public. Headscarves are already banned for teachers and students in public schools. Some Spanish cities have a similar ban, and in June the Spanish Senate recommended that face-covering veils be banned in public nationwide.

While some Muslim countries, such as Iran, require a head covering in public, others, such as Turkey and Tunisia, ban veils for civil servants and public school students. In Turkey, the president's wife covers her head, and unless she removes it, she is banned from state institutions, including some hospitals. Whether or not to cover, and how, is a decision that can be based in religion, fashion, and politics.

The ban on face veils is portrayed as a defense of women's liberty and dignity, as a blow against religious oppression of women. With regard to the Spanish vote:

"Today, a very important step in favour of freedom and women's equality was taken," the deputy leader of the Popular Party, Maria Dolores de Cospedal, told reporters after the vote.

Martha Nussbaum examines, in detail, the arguments in favor of banning full-face veils. She finds them wanting, and her reasons are well worth reading.

An analysis of the dilemma on Feministe makes the more practical point that banning full-face veils may not so much have the effect of making women more present in public places as of forcing them to stay at home.

To me, it seems key to keep two distinction in mind: the cultural differences between wearing a headscarf and wearing a full-face veil, and the difference between such bans in countries where Muslims are a minority (like France) compared to where they are a majority (like Turkey).

Tierney and Women in Science

One thing that Tierney did not mention in his NYT article yesterday is a recent Harvard Business Review report, which says that although 40% of the scientists and engineers in the early stages of their careers are women, most of those women (52%) will quit a job due to gender-related issues.

The reasons? A major factor is "macho" work environments that isolate women. Indeed, 63% said they had been sexually harassed. Another factor is job requirements that are incompatible with maternity and family responsibilities. Most of the women who left jobs said that they would return if employers addressed the issues that made the jobs untenable for them. Pace Tierney, it's not the case that those who felt compelled to quit did so because they realized they were misplaced in a science/technology career.

More on Maternity and Paternalism

A friend pointed out to me that the dismay that greeted mother Paula Radcliffe’s New York marathon win was not simply focused on the fact that she ran while pregnant. After all, Radcliffe is the world record holder in the women’s marathon. Not many women run while pregnant, but not many women are professional runners, period.

Although attention is focused on the fact that Radcliffe ran while pregnant, it is also her status as mother that is treated as stunning. At the race's finish, both Radcliffe and second place finisher Gete Wami were asked to comment on motherhood.

Beyond the assumption that pregnancy is a disability (one that women are not expected to recover from, apparently), it’s also assumed that motherhood is incompatible with having a professional life.

Pregnancy and Paternalism

The New York Times ran a profile article about Paula Radcliffe, the female winner of yesterday's New York City marathon. The profile is written by Gina Kolata, of the Science and Health section. Because in addition to being the holder of the world record in the women's marathon, Paula Radcliffe has also been pregnant. Imagine that! An athlete AND a Mom!

Just about a century ago, pregnant women (well, pregnant women of a certain class) were cautioned not to exert themselves during pregnancy. Doctors were concerned that work or strain of any sort would stress the fetus. Women were cautioned not to write, not even to think, because using her cognitive powers would divert the woman's reproductive energy away from the babe growing inside of her.

Although our culture no longer has precisely this worry (and most women, including professors, are expected to perform their jobs up until they give birth), there is a residual worry that a pregnant woman's body is not able to sustain physical effort.

The article reports that Radcliffe continued to run while she was pregnant, but only under the close and constant supervision of a doctor. Nonetheless

"People were looking at her as if she were crazy."

Most pregnant women are cautioned by their doctors not to exercise strenuously or, sometimes, moderately or even at all. My OB told me to stop running and to walk instead. I continued to run through most of my pregnancy, as did several other women that I know. One ran until the day before she delivered her baby, and she ran a 10K when he was a couple of months old.

Radcliffe's doctor "allowed" her to keep running but told her to keep her heart rate below a benchmark and had her get extra ultrasound exams. Interestingly, the article also notes

Heart-rate precautions do not have scientific backing.

There is no scientific evidence to speak of concerning pregnancy and exercise. There are no controlled studies and very few epidemiological studies. In the absence of evidence, many obstetricians give out the same advice they were handing to women in the 1800s. At the same time, medical advice concerning exercise for other patients, who often have a real health problem, has changed across the board. Back-ache? Exercise. Arthritis? Exercise. Diabetes? Exercise. Elderly? Exercise. Depression? Exercise.

Given the anecdotal evidence and the new medical context which supports the benefits of exercise (for those who enjoy it, especially), it's hard to see any explanation for the cautions routinely handed out to pregnant women other than paternalism.

Evidence in medicine: Preeclampsia

Again on the theme of pregnancy, the July 24 issue of the New Yorker (not available online) contains an article by Jerome Groopman on the "The Preeclampsia Puzzle."Preeclampsia is characterized by high maternal blood pressure and protein in the urine; it can also cause kidney and liver problems, hemorrhage, and stroke. It affects 5% or more of pregnancies in the US, and globally it is a leading cause of maternal death and of lasting complications for mothers and infants.

The cause of preeclampsia is unknown, and the recommended treatment is delivery of the baby ASAP. Although the complex causal pathways that lead up to many diseases are unknown, it is worth pointing out that there is something special about pregnancy disorders: they are not well-studied.

There are several reasons for this. Fetuses cannot consent to participate in clinical trials. Pregnant women, understandably, are not motivated to take on risks to their pregnancy and fetus in order to test new drugs and therapies. Moreover, in some cases, as in preeclampsia, the best available treatment is to deliver the baby, which precludes further testing or treatment in utero.

But if pregnancies are so valuable, shouldn't it be possible to overcome some of these obstacles? Perhaps by running larger trials which permit deeper statistical inferences. But large trials take funding, and this is what the New Yorker article has to say:

Among medical researchers, obstetrics is often regarded as a dead end. "An enterprising young physician-researcher who seeks to make his [sic] name in a field faces huge hurdles if he wants to work with pregnant women"..."Our ability to truly understand what goes on in the fetus is poor," he [Sachs] said. "You can't predict physiologically how a fetus is going to respond to some treatment given to the mother. So people are very hesitant to do this kind of research, and the committees that protoect human subjects are, by and large, gun-shy"..."The only large clinical trials that have been going on involve innocuous treatments, like antioxidants, low-dose aspirin, or supplements like calcium," Sachs said.

Disorders of pregnancy receive relatively little research from the federal government, even though they exact a considerable medical and financial toll.

But it is not just studies of treatments that cannot get off the ground. Even descriptive studies and the development of registries for tracking diseases of pregnancy and post-delivery outcomes are lacking. As with gestational diabetes, the exact rates of preeclampsia in the US are not known, nor are the contributing factors well understood.

The culture of obstetrics is not oriented toward identifying causes that would permit prevention. This is also a relevant topic for feminist bioethics. As Laura Purdy has argued in her article, "What feminism can do for bioethics," bioethicists can and should take on advocacy tasks that shift the way that research is ordered and prioritized.