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Truth Through Combat

Would you have allowed Bill Gates to be born?

An interesting column on the meaning of “disability.” The article focuses on autism, but you could also perform the same sort of thought process with deafness, for example.

http://www.msnbc.msn.com/id/7899821/

Filed under: Bioethics, Uncategorized

Practicing on the Dead

Here’s a case study from a book titled “Ethics in Emergency Medicine.” I thought it would be of interest to some of you:

http://galenpress.com/extras/extra20.htm

Filed under: Bioethics, Uncategorized

Indiana Court Upholds Abortion Waiting Period

Essentially, this is an informed consent law. It requires that Indiana provide certain information to women seeking abortions at least 18 hours prior to their receiving the abortion.

The law has already been challenged at the federal level. It lost because the U.S. Supreme Court has already upheld a similar law in the case Planned Parenthood v Casey (1992). In that case, several restrictions on abortion by the Commonwealth of Pennsylvania were upheld, including a waiting period of 24 hours. Indiana’s waiting period is 18 hours. It requires that a doctor provide certain information 18 hours prior to an abortion.

Filed under: Bioethics, , , ,

What’s going on here?

Is it just me, or is there a pattern of historical development emerging out of the last few decades? I say this only because it seems that media management is becoming increasingly mechanistic; given the influence of media organizations on social change (perhaps a dubious assumption), it would seem that their mechanization would lead to the emergence of a pattern of social change as well. In other words, a pattern of historical development.

Perhaps Adorno and the Frankfurt School have already proven this thesis.

Filed under: Bioethics, Uncategorized

Importation of Drugs into the United States

The case of Brazil and the global AIDS crisis led eventually to raising a question about the relationship between drugs (and patent rights) and public health. Recently, it has become increasingly clear that the price of drugs in the U.S. is rising rapidly. This has caused people to look for “solutions” to the drug cost problem. The issue under consideration is whether individuals and organizations within the U.S. should be allowed to purchase drugs made outside the U.S. Currently, U.S. law prohibits such purchases.

Should U.S. states violate national U.S. law and seek agreements with generic drug manufacturers for use within their state’s borders? Illinois, Wisconsin, Vermont, Kansas, and Missouri participate in a drug importation program. The federal government–under the coordination of the FDA–is responsible for ensuring the safety of drugs. It does so in this country by inspecting drug laboratories, something it could not do if the lab was in Canada or Ireland. For that reason, it keeps the importation of drugs strictly under ban.

Nonetheless, the individual states named above are seeking ways to lower drug costs, and they figure that one way to do so is to import drugs from nations where the drugs are cheaper. Click here for information from Wisconsin’s program. Here is the FDA page on drug importation.

Regardless of what states are allowed to do, what should individuals be allowed to do? Should they be allowed to take the safety risk involved in purchasing unregulated drugs? Or should the federal government take a hard stance on protecting consumer safety and continue to prohibit drug imports?

Filed under: Bioethics, Uncategorized

AIDS in the Southern Hemisphere

The problem of AIDS is far smaller in the northern hemisphere than it is in the south, particularly in Africa. The following resources provide information on HIV/AIDS around the world:

Part of the problem faced by poor (or poorer) nations in the battle against AIDS is a lack of cheap access to AIDS drug cocktails. Drugs are expensive, and many of these nations argue that they are unable to pay the high prices of such medications. To understand the response of one nation in this situation (Brazil), we should look at some background.

Drugs are protected by patent law. Patent law gives a company the right to be the exclusive seller of a drug. Pfizer, for example, has the exclusive right to sell Viagra. In the United States, this effectively removes all competition from the market, allowing Pfizer to be the only company earning money from Viagra’s formula. Once the patent expires, others will be allowed to get into the game of selling the Viagra formula (at presumably lower prices, since the market will then have competitors instead of one player).

In 1996, Brazil’s AIDS crisis was large enough that it determined not to wait for drug patents to expire. So, it started violating those patents by making generic versions of patented drugs and giving them out to AIDS sufferers inside the country. Naturally, this prompted an outcry from drug manufacturers, who had invested billions of dollars into AIDS research and did not like to see their formulas copied without being rewarded.

Several questions arise from this international dilemma:

  1. Should drugs be subject to patent protection? In other words, should drugs ever be protected by the patent monopoly that companies currently enjoy? A strong argument could be made for the “No” answer by basing it on the claim that good health should not be a commercial product, but a basic human right.
  2. When should nations feel obligated to violate drug patents? What should be the conditions under which a nation decides to break a patent and either buy or produce generic drugs?
  3. Is Brazil a model for other poor nations? Check out this link for an argument to that effect; and this one for some recent news. Here’s a critical article on Brazil’s approach.
  4. Why should AIDS be treated with special considerations? If Brazil is justified in breaking patents for the sake of AIDS, why not other diseases as well?

Filed under: Bioethics, Uncategorized

A Critique of the Radical Conservative Approach to Affirmative Action

by Kimberly Fleury

U.S. seeks to halt minority, women fellowships – Race in America – MSNBC.com

“The court said you can’t categorize people purely by race,” said Mark Cordes, a law professor at Northern Illinois University. “The same thing would apply to a fellowship. At that point, you aren’t treating people as individuals.”

MY VIEWS:

Fellowships do NOT treat people as individuals. That’s the point of competitive fellowship programs, which establish criteria for selecting scholars to receive fellowship funding. These criteria generally stipulate “outstanding academic credentials.” That immediately disqualifies a lot of people, and it is most certainly intended to be discriminatory, but not unfairly so. The aim of estabilishing criteria for fellowship grants is to seek the cream of the crop in any given population so as to encourage scholarship in our best and brightest minds.

Beyond assessing academic credentials, various fellowships further narrow the eligible pool of applicants to those who meet factors such as program of study and group affiliation, among others. Group affiliation-based fellowships include those granted to the offspring of alumni or organizations such as private or civic clubs, or membership in said club. Additional criteria may include such factors as citizenship, and/or residency in particular states. Some fellowships specify an eligible “year of study” — e.g., “Applicant must be a junior in college”; “… hold a B.A. or B.S.;” “… have graduated within the past two years;” “… be a post-graduate student,” etc. Even the age of the applicant can be a factor in determining eligibility, with some limiting candidates to an age range (e.g., between 21-25), and others going so far as to restrict eligibility to those of a specific age (e.g., “Candidate must be 27 years old.”).

Law professor Mark Cordes notes, “The court said you can’t categorize people purely by race.” [Italics mine.] No fellowship does that. Fellowships that limit eligibility to traditionally underrepresented groups include more than just an applicant’s race in their eligibility criteria, including some of those factors discussed in the previous paragraph.

If race is an unfairly discriminatory criterion, then so too are other narrow criteria, including age and “year of study” requirements. These are, after all, extremely limited in their scope of potential applicants. Some of the most limiting factors determining eligibility for certain fellowships could even favor the children of the “The Center for Equal Opportunity” conservative think tank members who are behind this protest against counting race and gender as a fair criterion. Especially exclusive are those fellowships open only to members of certain private or civic organizations, and those available only to the children of alumni of particular colleges and universities. Not surprisingly, such fellowships are most often awarded to people who belong to traditionally amply-represented populations — i.e., middle- or higher-class white males. If the conservative think tank and U.S. Justice Department are correct in their call to end race-based fellowships, then they must be prepared to exclude other narrow eligibility requirements.

The curiosity is that the Center for Equal Opportunity and the Justice Department have chosen to target the Graduate Dean’s fellowships (begun in 2000), the Proactive Recruitment and Multicultural Professionals for Tomorrow fellowships (begun in 2000) and the Bridge to the Doctorate fellowships (begun in 2004) at Southern Illinois University. These are very recent fellowships targeting scholars from traditionally underrepresented groups There are many older fellowship programs that serve the same purpose at many other colleges and universities around the U.S. The C.E.O. could have chosen any of these to protest, yet it is focused on some of the most recently-established fellowships.

The answer may be that the older fellowship programs have a long track record of success. Since their inception, fellowships geared toward underrepresented populations have contributed to increased graduate enrollments, retention, and graduation rates for these groups. Consider that recently announced figures cite just a graduation and retention (G&R rate) of just 44% for Hispanics and 39% for African Americans at all levels (undergrad and graduate). These rates are dismally low, yet without financial assistance such as fellowships offer, those rates would be even lower.

The U.S. Department of Education website (http://www.ed.gov/policy/highered/reg/hearulemaking/2002/reauthhearing/c-terry-hartle.html?exp=7) notes:

Research has demonstrated that having adequate financial resources is by far the single most important consideration taken into account when making the decision about attending college. According to a 2002 report from the Advisory Committee on Student Financial Assistance, over 400,000 college-qualified students will not attend a four-year college and nearly 170,000 won’t attend college at all because of financial barriers. We believe that the federal government can and should take multiple steps to address this issue.

One of the myths that radical conservative groups like C.E.O. propagate is that programs and incentives targetting minority and underrepresented groups lead to lowering academic expectations and requirements for college admissions. The truth is that colleges and universities with policies encouraging student diversity recognize that there are differences in backgrounds that influence the individual’s prospects for academic success. Students who have backgrounds where a college degree is an expected path have, by far, a greater advantage for achieving success in academic pursuits – beginning with the application and enrollment process. It is not a matter of being *more intelligent,* but of lifelong training in the subtleties of maneuvering through academia. The training begins in early childhood – perhaps even in infancy – and is so ingrained that individuals who possess it don’t even know where it came from. Moreover, such individuals are unable to even IDENTIFY the trait. This helps to explain why so many believe that affirmative action requires lowering standards for minorities.

Until recently, primary education for minorities overwhelmingly focused on training workers for menial or – at best – blue collar work. Actually, all children in working class neighborhoods could expect an education geared towards this end. It was true that *some* were expected to go on to college, maybe be the first in their families to do so, but it was an abstract *Some,* consisting of only the *Best and Brightest and Most Dedicated.* To some extent, teachers in lower-income schools still recite that message today.

It sounds noble, and even proper — after all, only those with the intellectual aptitude and dedication to scholarship *should* earn a position in our institutions of higher learning. That in itself is not disputed. However, consider the tone in which this message is repeated: It is a tone which suggests that you can’t go to college unless you are *Good Enough.* Good enough to earn a scholarship, and work your way through college. OK, that’s fine too — there’s no problem with being a good enough student to earn a scholarship, and to work your way through school. Now consider further that, historically, these students were taught that competition for these scholarships is so fierce that only few would win. Many, students were told, might qualify, but only a few would win.

There is nothing inherently wrong with competition. The competition for scholarships among disadvantaged students has always encouraged some to strive harder. The *Wrong* arises when such competition results in shutting out otherwise qualified candidates who are unable to fund an education solely by working their way through school and taking out what student loans they may. This was the situation until financial aid programs of various types were established to assist these students in obtaining a higher education.

Compare that to primary schools with student populations who are expected to go to college. The schools’ families tend to be higher-income, so college funding isn’t generally an issue to consider in planning for college (other than setting aside the money). In those schools, teachers don’t bother warning students that they will only be able to go to college if they are the *Best and Brightest and Most Dedicated.* Teachers simply teach what will later be needed in college, without saying that’s what they’re teaching … and part of that teaching includes subtle socializing in the procedures of going to college. Individual ability has very little relevance in determining who, of these students, will or will not go on to college. (Consider George W. “himself”).

Now consider that college admissions testing does not aim to identify students’ knowledge, but aptitude. In other words, admissions tests such as the SATs seek to predict who will be able to learn and succeed in college. Conservatives complain about certain remedial courses offered by many colleges, citing this as evidence that *unqualified* students are being admitted (and, they fear, “taking the place” of “more qualified” white [male] candidates – an obvious fallacy when you consider that colleges and universities prefer to increase enrollment than to “squeeze out” prospective students).

What conservatives don’t discuss (perhaps because they don’t know) is that these remedial programs are designed to teach what is needed to succeed in college coursework, not because the students were *too stupid* or *too lazy* to learn it in high school, but because those courses were not OFFERED in their high schools or were offered in such a way as to be geared towards blue-collar and menial work! That is an extremely important distinction, and a vital factor in creating the “traditionally underrepresented population.”

It took more than one hundred years to create a traditional and persistent underrepresented population; it will take more than these forty years since the Civil Rights Act of 1964 to UNCREATE it. It will take more than these four years since the still-babystepping “No Child Left Behind” Act to redress the inequities of our diverse and disparate public primary schools. Even with affirmative action programs and accommodations in colleges, total minority enrollment* averages about 15% of the nation’s overall student population, representing less than their presence in total national population.

*total minority population figures include African American; Hispanic, Pacific Islander, and Native American.

By the time college students of any stripe [is that a pun?] succeed to graduation, they have – as a group – become more alike in terms of academic skill. This is somewhat due to retention failure rates (that is, failures due to academic shortcomings within the student – e.g., the rare discovered inability to learn material, or the more common neglect at effort – as opposed to hardship circumstances such as lack of finances). But it is also due, in no small part, to students whose access to remedial courses in their freshmen years enabled them to achieve to their full potential. In other words, at graduation, there is very little difference in the achievements of whites and minorities.

Also by the time college students graduate, they generally know whether they meet minimum academic criteria to qualify for advanced study fellowships. Yet, of even those who might qualify, only a small percentage continue their education.

The total graduate population at Southern Illinois University is 5,500. Of this number, only 8% are students from underrepresented populations. That is 440 – four hundred and forty, out of five thousand five hundred. Break that 8% further into its specific constituents — African American, Hispanic, Pacific Islander, Native American, and females. The breakdown illustrates just how few of each group is represented in SIU’s graduate program.

Further consider that, since the minority fellowships programs were begun, they have funded 129 students. One hundred twenty nine, out of four hundred forty individuals from various underrepresented groups.

What white boy’s place are those students stealing? What white boy is losing out on grant money that is instead funding a qualified student from minority group? Why do anti-affirmative action conservatives feel so threatened by such a small number of students?

What the………?

An example of a fellowship program serving underrepresented graduate students:

Arthur A. Schomburg Graduate Fellowship Program

Sponsored by the State University of New York, this highly competitive fellowship is available to individuals who have been traditionally underrepresented in graduate and professional programs, and who are accepted as first-time, full-time students in a graduate or professional program. Students are nominated by their department for this award, which provides a generous stipend for graduate students, plus a full tuition scholarship. If you would like to be considered for a fellowship, please indicate your intent when completing your online admissions application. For more information about the Arthur A. Schomburg Graduate Fellowship Program, please visit http://wings.buffalo.edu/psua/98comp/PSUA/SCHOMB.HTM

The Schomburg Fellowship Program offers support for historically underrepresented African American, Native American, and Hispanic American minority students in graduate programs across the university. Students in the program have outstanding academic credentials that contribute to an impressive graduation and retention rate of nearly 80 percent*. Schomburg fellows participate in conferences and seminars and present papers in their respective disciplines. Since its inception in 1987, more than 400 academically talented graduate students have received support through tuition scholarships and stipends.

*To be fair, it must be noted that it is not clear whether the “nearly 80%” figure represents Schomburg Fellows, SUNY graduate students, or all SUNY students. SUNY publishes data claiming an overall 80% G&R rate, but Schomburg, and indeed graduate student data are sorely lacking on the internet.

Filed under: Uncategorized

Dax’s Case

Issues presented by the film, in roughly chronological order. The major players are highlighted in bold.

  1. Dax argues that the theory that the ends justifies the means is a bad one. Is it unjustified in all cases, however? Note that his argument is anti-utilitarian.
  2. Cowart argues against the application of this theory in this case. He suffered a lot of pain because other people believed in this idea.
  3. His life has been changed as a result of other people’s decisions. It turned out OK, but it could have been worse.
  4. Repeated requests to die and treatment refusals: farmer, ambulance.
  5. Ada Cowart‘s (mom) recollection of the story. Can a good case be made for her decisions and collusion against her son’s wishes? She argues that he was not competent to make decisions at first. But at what point should he have been allowed to do so? Later in the film, she’ll point out that killing him would be unchangeable, but saving him would not be.
  6. Doctor: 65% deep burns; overview of the extent of damage to his body. Use of narcotics. Decision-making process (involving Mom as a decision-maker; Rex Houston’s (lawyer) role). Later discusses Dax’s desire to die. Tries to explain initial requests as those of an incompetent patient. “Later, I felt that most of his expressions to the nurses and other people were just means that this individual used in order to get what he wanted, to gain control of his environment, to get people to manipulate…” Is this doctor’s assessment of Dax’s psychological state relevant?
  7. Rex Houston‘s (lawyer) role as a lawyer required him to proceed as quickly as possible with a lawsuit. Did he commit any ethical wrongs in the process of carrying out his duties to Dax and his family?
  8. Nurse: How should her attitude to Dax’s treatment differ from the doctor’s, if at all? Should she have an attitude that is more in keeping with the patient’s wishes? Should she have helped Dax die? Why didn’t she?
  9. Friend: Remember virtue theory. Does the virtue of compassion require the friend to help Dax die? Would the ends (ending Dax’s suffering) have justified the means (killing him)?
  10. The fact that the decision to keep treating Dax is made by the family in cooperation with the doctors is offensive to the sense of individual autonomy, but is it in keeping with sound family values? How would a culture that valued the family over the individual assess Dax’s case and the way that mom and doctor evaluated his treatment options?
  11. Psychological examination showed no incompetence. “On the other hand,” the psychologist notes that Cowart was essentially healthy and was asking people to contribute toward his suicide. The solution was to persist in treating him until he could take his own life if he still wanted to do so. Psychologist also argues that the outbursts were “recreations of angry little boy feelings,” particularly those against his mother. Recollection of conversation between shrink and Dax…psychologist’s “verbal attack”–“If you want to die, then let me fix your hand…Don’t ask us to…literally kill you.”
  12. “If letting the patient die is characterized as playing God, then keeping the patient alive has to be as well.” — Dax. Later discusses depression that set in after he returned home from the burn unit.
  13. 1984 follow-up with Rex Houston. Beer; getting Dax back to work (real estate, law). Re-affirmation of original decision.
  14. 1984 follow-up with Ada. Her recollection of the time soon after his exit from the burn ward. Influence of religious beliefs. Struggles with apparent suicide attempts. Her re-affirmation of her decisions.
  15. 1984 follow-up with Dax. Source of depression (women, uselessness, shattered self-image, cabin fever, blindness and its role in helping him get back his social life). Student life at Baylor Law School. Subsequent success in life. His re-rejection of the “ends justifies the means” theory. Argument that Ada shouldn’t have been placed in the position of making decisions, and that he alone should have had the right to decide. Discussion of principles of freedom (“individual freedom should never be restricted unless it unreasonably interferes with the rights of other individuals”). Argues that it’s not about death with dignity, but quality of life (and that the individual should be allowed to decide what this means, what an acceptable minimum is–for Dax, the standard is now being unable to listen to music).
  16. 1984 follow-up with Doctor. Not treating a patient is to kill him, and that’s not why he’s in medicine.
  17. The fact that “everything worked out” for Dax — should we take this into account now in evaluating the case? Did time prove that Mom and Doc and Rex made the right decisions in 1974?
  18. Were his post-release suicide attempts just calls for attention?
  19. What should we make of the fact that we know burn victims go through a period of depression? Should this be seen as a reason to consider him incompetent?
  20. At what point after the accident was Dax competent? Was there any time at which he was incompetent?
  21. Online Resources:

Filed under: Bioethics, Uncategorized

Quotation

A few people recently inquired into the usefulness of neatly parsing
through the use of the English language. Ryle’s argument in the
textbook is an argument about the use of concepts, and his point is
that some of the concepts we use in the philosophy of mind only exist
because of errors we make in the use of language.

To the extent that he is right, however, a few of you have questioned
whether there’s any point to the discussion. At several junctures
during today’s discussion, the challenge of elucidating the point of it
all was laid at my feet. It seemed that some of you were simply
saying: “OK, so we misuse language. So Ryle is right. So what, though?
Why is this important?”

It occurs to me that the following quotation is applicable:

“A sharpened awareness of words sharpens our perception of the
phenomena.” — J.L. Austin

Austin’s statement can be rephrased as follows: a keen understanding of
the way we use words is helpful to an understanding of reality itself.

This is not to say that all we need to do to understand reality is to
understand our use of language. However, a clear understanding of the
use of words helps us see how our concepts can be flawed, confused, or
contradictory.

Filed under: Bioethics, Uncategorized

Philosophy of Mind–Resources

A few links in this field of philosophy:

Filed under: Uncategorized