‘Down with the patriarchy!’ he says…

Okay, so the title is pungently truthful, but it must be so. As strong of a statement as this is, I hesitate to call myself a feminist, only because I feel that I haven’t done enough research nor in-depth thinking to truly reach the moral standing of ‘feminist’. Moreover, I would probably refer to myself as a ‘feminist in training’. Perhaps this post can show you why.

Following is a picture of me at a global health conference earlier this year, taken in stealth by a woman who as a part of the (stellar, as I came to find out) organisation, Women in Global Health.

Screen Shot 2018-03-08 at 17.44.26

As a disclaimer, I’m trying to be really careful with the language I use (as always, I guess) in this post, but I guarantee you that, as a privileged, white male, I will undoubtedly make some sort of mistake in language or concepts — please comment to correct me if I err.

This specific panel was an all-women panel, occupied by leaders in their respective fields within global health, who also happened to be women. As someone who wants to end up in the field of global health, I thought this panel would be really useful in order to understand (or at least be introduced to) women’s role in global health now, and what is needed for women to excel unhindered by the patriarchy (by which many fields are unjustly ruled, not excluding global health). The amount of men in the room was astounding, mainly because I could probably count them on both hands without running out of fingers. (Here’s where a moral dilemma comes into play – as of now, I’m just trying to set the scene.) As this was a panel discussion, they gave space for questions to be asked — those who had questions merely had to queue up behind a microphone and wait their turn. I had a question, so I got up in the queue, and happened to be the first male to ask a question. One of the panelists noted, “Ah, you’re the first male to ask a question!” And the audience applauded. My question was, basically, “What is my role as a young male in the field of global health?”

The moral dilemma comes as such. Being honest, I loved getting this recognition as the ‘first male to ask a question’, the applause that came with it, and a twitter post from a women’s NGO in global health. One can see this situation as me being a champion for women’s rights, but I feel like the recognition that I received at this conference might have been a little ironic. In short, women do not need the approval of men to do well in global health.

This reminds me of a conversation I had with a friend (hey there, Saffy!) about Malcom X and what he wrote about the day Dr. Martin Luther King, Jr. gave his speech on Capitol Hill. The U.S. administration was terrified for that day, because the streets were going to be filled with ‘negroes’ and they had no way of sufficiently controlling this crowd of people throughout the march and the speech. However, it turned out that a fair amount of white people were in support of Dr. King, and were planning to come out to the march as well. This then calmed down the administration, which led to them coming around to accepting the speech and congregation of Dr. King’s listeners and advocates. Malcom X argues that this sort of assembly was only okay to the current administration because it had de facto ‘white’ approval. Had numerous white supporters not come out that day to listen to Dr. King, the assembly would not have seemed as okay to the administration. Malcom X tells us that this is a dire problem of (at least the U.S.) society.

I can’t help but draw a parallel to what I experienced this past spring at the global health conference. Yes, one could say that I’m doing my best as a white male to be a champion for women’s rights, and that may be required for all men in this day and age, but I might also add that it’s incredibly important to be keenly aware of what kind of moral consequences one’s actions may hold. One must also be aware of the history to which their actions and beliefs are tied. I, as a white male, must be aware that we (meaning, generally, white males throughout history), have taken control of women, their bodies, and their lives. Following this idea, I would think that ‘being a champion’ for women follows exactly that same mould of the control of women by being the voice that gives approval to women’s rights in society.

So going forward from here — what is my role as a white male in society (not just in global health)? I, too, wish to succeed in global health, but I don’t want to unfairly take opportunities of women in this endeavour. One solution that comes to mind is to be aware of the societal privilege that I am (unjustly) awarded as a white male, and to not ever think of utilising that privilege for a work opportunity or a forward move in my career.

Without trying to offer more solutions, the simple answer is that I will never fully know what is required for women to succeed in global health because, quite simply, I identify as a man, which equally means that I am not a woman. I do not know what a woman needs because I am not a woman. Hence, solutions and answers should not be coming from white men, but from women. Embedded in the preceding sentence is an equal moral imperative to listen to all women’s input, not just the white, middle-class, feminist woman from your local university (which is still an important view, but not the only important view).

I think the duty that I have as a male in society is a negative moral duty, which is to make sure that I am not hindering the autonomy or ability of any woman in my life to make her own decisions and lead the life she wants to live. Outside of this, I will do my best to train to be feminist, to be an advocate of women’s rights, to create a more equal world for all — but the knowledge I gain to back up these actions best not come from men, but women — as they, of course, know what the best is for themselves, and they do not need a man to explain that for them.

 

 

In writing this post, I’ve left out a lot of ideas and topics, not limited to race, heteronormativity, gender, and class. Granted, these topics are incredibly important, but you would most likely be reading a text the length of a chapter, or even a book, if I was left to leave all of my (perhaps too many) thoughts on the matter here.

My request for those reading this post is to do some research about one influential woman in their own society or another, and perhaps comment below to share the (undoubtedly amazing) stories of certain women with your fellow readers.

Duties to the (not so) distant

Greetings, friends!

I feel like every time I write, I give an excuse as to why I’m late in writing (perpetually, it seems, at this point). I was thinking about this while getting entranced by some (amazing) jazz at a show last week. I might have also mentioned this already in a previous post. Quite succinctly, I won’t be writing unless I feel that I have something valuable to share – I’d quite like to refrain from what an old english teacher, James Pinto (phenomenal teacher, would absolutely recommend his English 325 class to any U-M students reading this 🙂 ) referred to as ‘navel gazing.’

This past week, two of my classes have wonderfully coincided (not planned) within the topic of ‘foreign aid.’ My introduction to this topic (well, introduction within the realm of these classes) was brought on by Peter Singer and his 1972 paper, “Famine, Affluence, and Mortality.” For an explanation that’s not fully devoid of the philosophy that Singer utilises, you can see the TED talk here. Singer starts out his argument via his ‘drowning child in the pond’ thought experiment: If you were on our way to work, and noticed a child drowning in a pond on the side of the road, you would most likely save the child. This would require that you soak whatever clothes you’re wearing, and that you would probably be late to work. Saving the child’s life (obviously) justifies the inconvenience of getting your clothes wet and being late to work.

Singer frames his argument using this drowning example by saying that if we are witness to undue suffering (e.g. we see a child drowning), and if we have the power to stop that suffering without making sacrifices that put ourselves at an equal or worse undue suffering (e.g. getting our clothes wet by pulling the child out of the water), we ought to (i.e. we have a duty to) stop that suffering. To elaborate, Singer also says that distance or proximity to the suffering that we see neither adds nor subtracts moral imperative to do something about this suffering. Nor does the presence of others (at any number) have an effect on our own responsibility to alleviate this suffering. (Can you see where this is going?)

Using these last two clarifications as leverage, Singer extends his argument to the global realm, saying that we ought to donate any ‘extra’ money to foreign aid (e.g. our favourite charity) instead of using that money to, say, buy a new pair of shoes or a new car. His argument is important because it removes the altruistic nature of charity work. With the framework of altruism, one can refrain from giving to charity and not be at fault, but with Singer’s argument (at least the one he made in 1972 – he’s slightly eased his stance since then), if you refrain from giving to a charity and instead buy a new car, you may be morally at fault.

Singer’s argument has faced ample backlash, in many forms. One of the most prominent ideas presented against Singer is that once we give £200 to our favourite charity, that money never actually reaches those in need, rather the money goes into the hands of corrupt state leaders (look at the case of Equatorial Guinea), or gets lost to the ever-expanding black hole of bureaucracy and administration. Many simply say that Singer’s argument is too simple — he doesn’t consider the context around which aid is given, and he doesn’t know how much aid can actually hurt a country (see this article about “Why Foreign Aid is Hurting Africa”). By giving money to unjust states, are we further perpetuating the injustices that these states commit, casting their citizens into further poverty? Perhaps. However, we still must face the fact that suffering exists – how can we combat the suffering if not with money? (I’ll leave this question here without a complete answer. Some researchers at Oxford came up with the “Multidimensional Poverty Index,” which shows how lack of money isn’t the only thing that contributes to poverty.)

Furthermore, we might realise that the countries that are in worse-off states at this moment did not put themselves there — rather the responsibility for their demise rests completely in the hands of the most wealthy countries today. I was reading a paper that distinguished between the concept of ‘humanity’ and ‘justice’. The former is (this author argued) what Singer’s arguments rests upon, that it is simply inhumane for us to let a drowning child die, and this sort of inhumanity can be expanded to suffering across the ocean. However, to think that we are simply ‘being humane’ (which is not a bad thing at all), implies that we ought to do so because we are good humans (which we should be), but not because we are required to as a matter of justice, or fairness. The ‘humanity’ argument, in this sense, is too weak (in my mind) to ground any sort of requirement that will truly motivate anyone and everyone to work towards ending inequality and suffering (in the global scale). When we change our perspective just a little bit, and consider our duty to alleviate inequality (perhaps by giving aid, or perhaps not) in the eyes of justice, then the duty becomes stronger.

To clarify with an example, take the idea of colonisation – a country with a fair amount of money and resources decides to claim the territory of a far off land as their own. They claim the resources (and oftentimes the very people that live there) as their own, and reap whatever benefits they gain from from that land and people (e.g. harvesting (via slavery) and selling resources like oil or metal). The colonising country then realises (too late, of course), that they probably shouldn’t be doing this sort of thing, so they decide to give the land back to the people from whom they stole the land, and give them independence. This now-free country, of course, is left off in a terrible state, and needs some assistance. The colonising country has even more wealth than it had before colonising this nation, so they decide to use that wealth to loan money out to this struggling, newly-free nation, so long as this new country can pay back whatever aid they have been given.

With this situation, it is clear that some sort of unfairness exists — why would an aid-giving country be giving money to another state from which they had essentially stolen? As a matter of fairness, or fair play, it seems as though we ought to give back the wealth that we have taken from other countries, without any strings attached. Furthermore, with the concept that Rawls calls the ‘veil of ignorance’, we very well could have belonged to the state that had been colonised, and when making a decision based on justice, we ought not to consider the fact that we belong to the ‘rich’ country and not the ‘poor’ one, but simply make the decision as if we didn’t know to which country we belonged. Surely this would require that we compensate, and not give ‘aid’, because ‘aid’ implies charity, not fair redistribution.

 

I want to leave you with one more concept (of many) that I’ve learned this week about international aid. This comes from some daydreaming in class (two-hour lectures are long!) supplemented by further reading in the matter… I’ve realised that we have been having this entire conversation about aid while attending a top university in London, one of the biggest cities on the world, and that which contains vast amounts of wealth. In other words, we are considering these situations from a vastly privileged point of view. Danger is apparent in this situation, for mistakenly assuming that we (as philosophers, or as engineers (shoutout to the U-M CoE)) know better than anyone how to solve the world’s problems. We face the risk of becoming what William Easterly classifies as ‘planners’. Oftentimes it is those who work in aid who become the ‘planners’, when in reality we are meant to become what Easterly calls ‘searchers’.

Planners think they know exactly what is wrong, and what to do to ‘fix’ the situation (I cannot stress enough how innocently apparent this mentality can be in the young engineer’s mindset). Searchers realise that the world oftentimes contains so many unknowns (even as of yet) that we cannot know the full truth, that we must consult whatever vast amount of possible resources we can in order to fully understand the situation in which we are trying to work. In aid specifically, when the planners come into the scheme, oftentimes doubling as those with the money (perhaps, say, workers from the United States Agency for International Development (USAID)), they think that they carry the solution to the problems they see in ‘poor’ countries, and they fail to consult the local views on the matter. (They end up doing much more harm than good by perpetuating problems with their ‘well-thought-out’ solutions.) While I was sitting in class, I realised, why aren’t we consulting, for example, philosophers from Equatorial Guinea when we have spoken so often about the aid situation that deals exactly with that country?

I think two quotes from Easterly’s book, “Reinventing Foreign Aid”, come in handy here. My goal, in a quasi-conclusion, is to become the ‘piecemeal engineer’ in the social setting, to design policy and implementation not considering only my thoughts but local views that will undoubtedly bring us closer to equality and fairness in a grossly unjust society in which we live today.

‘‘The piecemeal engineer knows, like Socrates, how little he knows. He knows that we can learn only from our mistakes. Accordingly, he will make his way, step by step, carefully comparing the results expected with the results achieved, and always on the look-out for the unavoidable unwanted consequences of any reform; and he will avoid undertaking reforms of a complexity and scope which makes it impossible for him to disentangle causes and elects, and to know what he is really doing. Holistic or Utopian social engineering, as opposed to piecemeal social engineering . . . aims at remodeling the ‘‘whole of society’’ in accordance with a definite plan or blueprint.’’

‘‘It is . . . precisely because the authors of the report see economic development primarily as an intellectual or artistic exercise by leaders and governments that they fail to do justice to their examination of existing realities in underdeveloped countries. . . . Development depends not on the abstract national goals of, and the more or less enforced decisions by, a cadre of planners, but on the piecemeal adaptation of individuals to goals which emerge but slowly and become clearer only as those individuals work with the means at their disposal; and as they themselves become aware, in the process of doing, of what can and ought to be done.’’

~~~~

Some updates for you all – I’m leaving for Birmingham this afternoon to go on a weekend with the Jazz Society! Hopefully I’ll snap some pictures and I’ll get to sharing them here. Classes are going well, too. Some have asked that they see what I’m taking for this term, so here goes:

Global Justice and Health

Politics and Ethics

Health Policy and Reform

Key Principles of Health Economics

(might still audit a course called “Madness”).

I’ve also had some recent developments as to what I want to do for my dissertation, as well as what might be happening after this fellowship finishes up. Alas, these are items for another post!

Much love to you all.

Who said it was going to be easy?

This post serves a couple purposes. Firstly, it is to apologise for how late I have been in providing a blog post to anyone who has been waiting for one. Secondly, I felt like using this post as a means for explaining its very own tardiness (hint: it was to do with the title).

Grad school is hard. I can’t actually recall anyone telling me that grad school would be easy. Studying the humanities, at least philosophy (since that’s all I know right now), is hard. I equally don’t recall anyone telling me that philosophy would be easy.

I think embedded in two of the sentences above calls to attention a deeper belief that exists as common (but not necessarily conscious) thought throughout engineering and the sciences. I noticed an unfortunate reality when in undergrad, which was a general idea that the degrees doled out by the College of Engineering carried more weight than those given out by the College of Literature, Science, and the Arts (LS&A). I must add though that those who held these beliefs were, in my mind, rather innocently holding these beliefs. I don’t think they could be held responsible for thinking that their major was harder, and more credible, than another’s. Engineering is hard work, too.

I remember having to balance my music minor and other humanities classes with my engineering degree, such that I always felt like I was merely taking time away from engineering to devote to humanities classes. It was not always the other way around. Not often would I think I was taking time away from the humanities to get my work done for engineering. Neither discipline is better than the other, but I’m realising that now is the time when I finally don’t have to think that I’m taking away from another field of discipline to study (in this case) philosophy. (Don’t get me wrong – I still held a *massive* appreciation for the humanities (as I’m not sure I would be on the RMJ Fellowship had I not held such a view).)

Engineering could always be used as an excuse if I hadn’t entirely finished the reading for an english class, or for not being truly well-read enough in the theory of a topic being discussed a certain day in anthropology. I still managed to do what was necessary for most of my classes, and luckily my teachers managed to notice that I had a strong passion for (in my case) creative writing, anthropology, and music.

However, now that I’m able to devote 100% of my time to studying philosophy, the topic is no longer a superfluous, cool term that I used in describing an idealistic, romantic view of a discipline. I can’t now just read about virtue ethics, or moral relativism, and think, “Yeah, that’s cool, maybe I can throw that into my arsenal of interesting topics to discuss with people… hopefully they won’t inquire further into the topic.” This use of vocabulary quickly changed when I came to UCL. (I recall getting looked in the eye directly, being asked to delve into what I meant about something I had just mentioned, and getting extremely nervous with this task. This is becoming easier each time the situation happens, thankfully.) I find myself, instead of expressing solidly a thought or belief that I had always held, stopping myself in my tracks and thinking of all the possible counter-arguments and descriptions of my thoughts. I’ve literally stopped talking mid-sentence to a friend when speaking about some political issue in the States because I started to really think about what I was saying. I blame this (happily) on philosophy.

To give an example, I think I remember mentioning in my application to LSE something along the lines of “I will use the term ‘inequalities’ in this essay, but I really believe that we should be talking about inequities in life.” This sentence was saying that I really thought that most inequalities were truly inequities. I gave no significance to inequalities, and all moral significance to inequities. What mainly stirred these thoughts was the following graphic that popped up on my Facebook newsfeed:

However, after one lecture I had in my module titled “The Philosophy, Politics and Economics of Health” (the same as my course title), we delved into inequalities, specifically as they pertained to health. Some questions that came out of this discussion are as follows:

What makes an inequality an inequity?

What is the nature of an inequity? Is it the fact that it is unfair?

If an inequity is simply an unfair inequality, then what makes the inequality unfair?

What’s telling you that anything is unfair? What school of thought are you using — perhaps some form of egalitarianism?

Is unfairness dependent on who is responsible for the unfairness?

What if someone purposefully puts himself into a position of inequality? Is this unfair if their decision was completely free and autonomous?

What implies autonomy? Is it better to have more choice in life all the time? Is freedom directly related to the amount of choice one has?

As you can see, the questions can spiral into other areas that might not work directly back to our initial question, but this is the nature of philosophy (at least in my mind). I’m quickly learning that I need to truly develop a difficultly intangible frame of reference on which I can build my argument.

Since truly so many ideas have validity in philosophy, some may say that there is no right answer. However, I think this is really the beauty of philosophy. If there’s no right answer, then I had best be sure that I build my argument so well that, when I try to attack my argument as best I can with counter-arguments, the argument holds through and becomes believable by the reader.

I remember listening to a lecture by Dr. Christian Casper in my senior design course, about the failed launch attempt of the Challenger space shuttle (apologies if I get any information wrong in this account!). The day of the launch was predicted to be colder than usual, and those in charge of the launch asked those who manufactured the shuttle to determine whether they believed it was safe for the rocket to be launched that day. Embedded in all of the data gathered from tests on this rocket was the fact that an integral part of the design (an o-ring, I think) had a really great chance of failing if the outside temperature was below a certain point.

Essentially, it was going to be too cold to launch the rocket that day, but those in charge of the launch failed to be convinced by the engineer who worked with the o-rings and the shuttle. Alternatively, and perhaps more importantly, the engineer failed to present his data well enough so those in charge of the launch would be successfully convinced to not launch the rocket. The shuttle proceeded to explode and kill the entire crew aboard.

Here’s where (at least one) utility in philosophy comes into play. Independent of whether or not there is one true, right answer (Truth with capital T), the way in which you present your argument has a large part to do with how those listening or reading will receive this argument.

Humans do not function on facts. We can think of facts as blatantly true or false, or perhaps as 0’s or 1’s, the familiar binary code that computers use to process information. Humans, rather, are perceptive beings, despite how much truth our claims might hold, so we must present our ideas of the truth in such a way that will give them the best chance of being fully understood (where understanding is not the same thing as agreeing).

After I finish this post, I’ll move into an evening of becoming evermore well-read, searching for the best counter-arguments for my own views, such that I can reinforce (or respectively and consciously change) my thoughts on what I believe to be important and worthwhile. Hopefully this process will end in a way that prepares me well for fighting for the health and well-being of various populations and people with whom we inhabit this earth.

In ending, I want to address my use of the word “it” in my title. My old english teacher, James, abhorred the word “it”, only because he believed (and still believes) that the word is a terribly nondescript and useless word to use in writing. However, I wanted to utilise the generality of this painfully ambiguous pronoun. If we learned anything from this post, it is that each field of study has its worth, and is going to require a warranted level of expertise that is required by its students. As the old cliché phrase goes: if I am doing something that I see as easy, I’m most likely not properly challenging myself in the matter, and hence not letting myself grow to my full potential. (Keep in mind that ‘natural’ cannot be substituted for the word ‘easy’ in this sentence.)

~~~

Have a happy rest of your weekend, friends! In some news, I’ll be taking part in a couple jazz shows happening on campus soon – one is called Fiesta, and is a night full of Latin, fun-filled jazz and dancing. The other is called “Cross-Currents”, a jazz fusion show that’s going to be played with minimal instrumentation and for an audience in an intimate (meaning small) setting. I’m really looking forward to these shows.

On fearing death – why does it matter?

Screen Shot 2017-11-03 at 23.32.34

I can’t remember specifically when, but for a some time when I was younger, perhaps around my early grade school years, I would start tear up a little each time I went to bed. My dad would come in to say good night, and when he did, my tears would become stronger. He would notice my sadness, and in his comforting, caring tone, he’d ask,

“What’s the matter?”

“I’m afraid for when you die,” I’d timidly say.

I can’t remember what my dad would say in response to this, but whatever he said was enough to get me to calmly go to sleep. I guess nighttime was the time I saw best for confronting the nature of my parents’ mortality. Is this normal for the common seven-year-old? Keep in mind, I wasn’t forced to do this – both of my parents were healthy, along with my sisters, and most of my extended family as well. We didn’t really have many health issues in our family outside of those seen as “due to old age.” This is surely not the case for many, many children in this world – too many children are forced to confront the nature of their parents’ mortality all too soon in life.

I brought this story up in class last week, because the topic of class was simply, “Death.” This module, titled “Illness,” is where we try to take the idea of illness and examine illness’ place in society as a philosopher would. The first of a few readings we were assigned for this class was Epicurus’ letter to Menoeceus where Epicurus speaks, among other things, on the idea of fearing death, and what it means to think of death as being good or evil.

Epicurus tries to speak about why humans tend to fear death, and speak to why it might not be rational to fear such a thing. Pulling a quote from Epicurus:

“Death…is nothing to us, seeing that, when we are, death is not come, and, when death is come, we are not.”

Here we see that, considering two possible states (being dead or alive), we can’t really fear death as death itself, simply because we might cease to exist when we die, hence we cannot be present to do the fearing death. This isn’t necessarily contradictory to many religious beliefs, I think – in the Catholic tradition, life is found in death, hence I don’t really think Catholics (I can’t really speak much to other religions) believe in true death, but only physical death; Catholics believe in the eternal life of the soul. Going further, the only conclusive thing I can say about death are these words: “I don’t know.” I don’t know what lies on the other side of the passing of my body, I don’t know where my mind or soul goes.

If we take Epicurus’ words to be true, we might be able to say that it’s not rational to fear death. However, I was speaking with a classmate after this week’s session and she drew the distinction between the idea of fearing death as being reasonable versus rational. The distinction I’d like to make here is that while it might not be rational to fear death, it might wholly be reasonable. This idea hinges upon the mere fact that we are social beings, and live in relation to others. Since I really, honestly don’t know when my death will come, and I won’t actually be able to know that I am existing “in death” (again please don’t construe this with ideas noted in whatever religion you might hold), then I really shouldn’t worry about life for my own sake. What I should worry about, though, is my life in relation to others, and others’ lives in relation to mine. I think it’s perfectly reasonable to fear the death of those I love, because if they leave this earth, or this realm, there would be nothing in this world that could fill the gaping hole in my heart and soul that their exiting would create. I have yet the capacity to experience their absence, and that absence would undoubtedly cause me to suffer as a result.

I chose my words carefully in that last sentence, because the term “suffering” is an interesting one. Oftentimes, especially in biomedicine, suffering comes in tandem with pain (patient X is experiencing pain and suffering due to Z). However, after exploring the idea of suffering in class, it can’t really be said that all pain leads to suffering, nor that all suffering comes from pain. Suffering, in a broader sense, can be caused by all sorts of things in life, or simply by life itself. The loss of a loved one, a hard breakup, not getting that dream job… What I think I want to believe is that death is not the greatest evil in this world, rather it is the suffering that comes with death, or more generally, that suffering is something that we can rationally fear as humans.

Suffering consists not only of the item that caused its existence (pain, death, etc.) but also of a unique temporal element. That is, suffering exists only in a narrative of life – of past, present, and future. If we think ourselves as suffering, then we usually know when the suffering started, and hope for when the suffering will end. Some might say that suffering is a good thing, as it builds character – however I would only agree with this if we can reasonably see that our future holds a time when the suffering we experience now will not exist.

Without hypothesising any more on suffering, I want to turn towards biomedicine and the motives that drive biomedicine into such a high role in today’s society. It seems as though the role of biomedicine today is ultimately to stave off impending death, to relieve us of our mortal duties as humans, to keep us living as long as possible. I often turn to the concept of a quality adjusted life year, or the QALY. Yes, this time is adjusted for “quality” and not merely years lived – living off of a ventilator for 20 years, incapable of speaking or moving around, might in fact be worse than one year of being medically unhindered. However, the QALY is still attached to time – the QALY, and therefore our objectified goal in medicine, is temporally dependent. Why this dependence?

I could imagine that one might want to extend her life because this gives her the opportunity to make longer, more meaningful connections to others, to leave a lasting impact on this world, and to effect change in the best way possible. We live for the future, we prepare ourselves for what might happen later on in life, and what we might be able to do with one more degree, with a little more work experience, or with a little more time spent in connection with others. I can’t argue against having more time spent with loved ones, but bear with me here and take that idea to the extreme. What if we had eternity to spend with others?

If I had eternity to spend with my family, I might just pass up an opportunity to hang out with them for, say, another opportunity to go out and meet new people. However, strictly because I do not have eternity to enjoy my loved ones’ company, I might want to spend a little more time cherishing what time I do have with them. In this sense, our mortality, and its temporally limited nature, allows us to really cherish the relationships we have because we never really know when they’re going to end. Furthermore, if we spend all of our time fearing the end of our relationships, we would never have the time to really enjoy them in the present moment.

I’m going to leave the conversation there for now. I do want to talk more about the goals of biomedicine and the role that suffering and death play, but this would require many more words, and a lot more thought and time. I’ll also use that time to ponder more on suffering, and how to actually tackle this idea philosophically. In other words, I’m going to devote an entire blog post to the matter instead of tacking it onto this post.

~~~

Life update: we’re into reading week, so I don’t have class this upcoming week. I have a few things planned:

  • To play in the house band at Phineas on Tuesday night
  • To see a West End show on Wednesday night – The Exorcist (getting my socially necessary dose of Halloween activities in a little later than usual)
  • To go see a BBC jazz live recording session this coming Friday
  • To start (and finish) my first political philosophy paper (wish me luck)
  • To go visit a few museums in London (I just got a national art pass, so I have no excuses now!)

 

Legitimacy, Obligation, and the Authority of Illness

In writing this post, I hope to accomplish two things:

  1. To inform you a bit about what I’ve been learning so far in my classes. (Only specific highlights, to make things digestible.)
  2. To speak of another part of my past life, Camp Kesem, and the disease the camp addresses: cancer.

The ideas I’m going to address will pertain to two of my classes that I’ve had so far: Contemporary Political Philosophy (CPP) (on anarchy, democracy, obligation, etc.) and Illness. I’m thoroughly enjoying my other classes, but I think I’ll leave them out of this discussion for the sake of being concise.

Now, to dig into the matter… I think I might have mentioned a few questions regarding what I learned about in this CPP class. This past week struck me as profound after we discussed what are called the instrumentalist theories as well as the idea of consent. Consent turns into a real interesting topic, especially when we think about how integral this idea is especially in the field of health (see small text below for a short diversion).

~~~~~

Consent, in my mind, has been used as a shield to guard patient autonomy. Furthermore, in many circumstances patient autonomy is seen as something we must not infringe upon (almost taking up an anarchist view in this sense). It is completely unheard of practicing any bit of medicine on a patient without any bit of their explicit consent.

~~~~~

Without explaining much, the instrumentalist theories (slightly) contradicted what we learned about anarchism. Anarchism (as told by R.P. Wolff) states, among other things, that humans are to remain completely autonomous beings that should not relinquish any of their autonomy to an authority, because there is no way for a government or an authority to be truly legitimate. In other words, it’s never okay to submit yourself to the power of an authority if you want to respect your dignity.

Despite how many times the anarchist can keep asking “how” and “why” to your presumptions about what’s okay in terms of obligation, I couldn’t reason with myself that anarchism was the answer to living a successful life myself, nor for society to be successful in any way that wouldn’t end up like what happens in The Lord of the Flies. Plus, if medicine was a complete anarchy, we wouldn’t have the ability to actually give consent and almost “turn over” our power to the medical professional. How would any progress actually be made? (See another small text for another diversion.)

~~~~~

This merits an entire discussion on how we define autonomy. Some definitions might include:

  • Having complete freedom of choice, all the time. No exceptions.
  • The absence of any hinderance to the way one wants to live.
    • This means that, potentially, one could submit themselves to, say, a government or authority in order to give themselves more opportunities to live a better life, where if they denied the authority, they may in fact be hindering themselves more than if they didn’t.
  • Not ever submitting yourself to another individual’s power.

~~~~~

This week of class, and the connected readings, brought some clarity to the question I posed before the small text (at least as much clarity that is allowed in political philosophy). Joseph Raz, when speaking on authority and legitimacy, brought up one of the instrumentalist theories, or the normal justification thesis (NJT). Raz proposes that one is justified in resting his own power in authority if, in that case, he believes that the authority has the expertise, knowledge, and time to devote to making a decision for him/her (“him/her” being the hypothetical “one” that Raz introduces) than he/she might not have.” Furthermore, Patrick Durning adds to Raz’s thesis that if the subject claims to have more knowledge or expertise than the authority in a specific problem, then they are justified to override the authority’s power and make his/her own decision in the matter at hand. (This theory would then lend itself to the definition of autonomy that I posed in the second bullet point of my most recent “block” text.)

Raz’s theory makes a little more sense to me, and can lead (in my mind) to a society functioning much better than us all deciding to become anarchists and not give any recognition to any central authority. Atul Gawande, in his essay, Whose Body is it Anyway?, manages to speak of (or around, I should say) this theory without even mentioning the NJT itself. Gawande speaks of when his 11-day-old daughter, Hunter, stopped breathing due to an unknown reason, which led to Gawande and his wife taking their daughter to the hospital. After some testing, the medical professionals ended up at a proverbial fork in the road. It was suspected that Hunter had a lung infection, but they wouldn’t know for sure for a few more days until the lab results could properly come in. Hence they could have put Hunter on a ventilator, posing many risks to her little body, or alternatively they could have let Hunter push through, risking her body of a shut down and her subsequent death. As the patient (since a child’s autonomy is extended to her parents in most cases), Gawande had the complete ability to make the decision to put his daughter on a ventilator or let her push through. However, in this instance, he chose to defer the decision to the medical professionals, despite his ability and expertise that would give him full capacity to make his own decision.

Following Raz’s NJT, Gawande assessed the situation, showed that he had the right expertise to make a decision for himself and not pass on his autonomy to the authority. But he still refrained in making this decision. Would Raz say that Gawande was not justified in passing this decision to the medical professionals, when he was on par with them professionally and was more familiar with his own daughter, therefore making him more qualified to make his own decision regarding his daughter’s health?

Hunter ended up living, but what if she ended up dying because of this decision? Would Gawande have published this story? Largely with Whose Body is it Anyway?, Gawande is trying to make a point that sometimes a doctor’s paternalism might be justified, and I think Raz’s NJT supports this idea. (If the doctor, or the “expert,” is seen as the one with better faculties to make a decision for a patient (but not necessarily in Gawande’s case), then it would actually free up the patient to live a less hindered life if they release their autonomy to the doctor’s whim.)

Okay, so I might have just walked you through a pretty obvious point, making it more obvious with some cool philosopher’s knowledge and discussion. But the heart of the matter is what happens when we succumb to what I believe to be a truly dominating authority in our lives, that of which truly relinquishes our autonomy (in the “hindrance” definition I’ve used). I could speak of illness in general, but I want to highlight one in particular, that which has been a growing, silent, and deadly killer of our century:

Cancer. 

It’s highly likely that any one of you reading this blog has lost a loved one or at least knows someone who has been affected by cancer. I lost my grandma and my great grandma to cancer, and this may be considered lucky in relative comparison to other families. Cancer takes a hold of one’s life, not only physically but also socially: we see the disease literally wrapping its hands around the patient, the brother, the daughter, the mother… yanking them in to whisper in their ear: I will force you into thought about your mortality; I will hold you from normalcy; I will stigmatize you; I will make your life hell.

If a lawyer representing the U.S. government did the same thing I just described, I would be pretty skeptical of this government’s legitimacy. However with cancer, we must relinquish all of our faculties to make choices to this disease. Sure, we can make the choice to get chemotherapy or attack the cancer in some way, but these methods usually come with terrible side effects, are not 100% effective, and cast the patient into an eternal state of remission, never being cancer-free. In my mind, we lose autonomy when cancer takes over our lives. I couldn’t help but make this connection when I was reading about authority and obligation to obey in Raz’s work.

As much as I want to have an answer for you, or a theory about how truly deciding to obey or not obey cancer will actually do anything about the cancer itself. What I’m talking about is pretty theoretical and in reality, in practice, these ideas may collapse into thin air. But I want to explore this idea further, despite that risk: what happens when we do submit ourselves to the authority of cancer? I’m not speaking only about the patient, because cancer is something that affects the entire family. And this is where Camp Kesem comes into play.

In one sentence, Camp Kesem is a summer camp meant for kids whose parents have been affected by cancer. It’s not a camp for kids with cancer, and it’s not a camp where kids go to only talk about death, sickness, and the disease that has ravaged many families. This is a camp where kids come to have fun, to find kids like them who understand what cancer does to a family. They go to a place with families who all have one thing in common: they have had to obey to the authority of cancer.

For some reason, though, camp has turned into a place of refuge for me and for many of the campers who come back every year. Camp Kesem is a family, and some of the strongest connections that I am aware of in this life have formed out of being together for only one week. One week – that’s how much time has passed since my last blog post, and I think I stand pretty neutral on where most of my friendships are (which are in a good spot – don’t worry!). How can we find such refuge that was founded from cancer,  that which has coerced us into devoting our mental, physical, and monetary resources into a disease that many times ends in death? After asking this question, my mind pointed me back to the Dominican Republic. I think I might have described this situation before, but I’ll describe it again:

We, being myself and the fellow interns for a Dominican NGO called FUMSIL, were on a vacation day and decided to go to the south coast of the DR. We went to a beach town called Jarabacoa, were we could choose to swim in an (ice cold) river or in the sea. We chose the sea mainly because it was warmer. Before I left for the water, one of my Dominican friends, Kiko, told me to be careful with the ocean. Okay, if a Dominican tells you to be careful with the ocean, it means that this matter is pretty serious. So I go down the rocky beach and go towards the water. I enter in about four feet, only to be slammed by a wave that knocked me to by rear, then proceeded to drag me across the carpet of small pebbles and rocks. Woah, I thought, Kiko was right.

Now that I knew of how powerful this ocean was, I had a newfound respect for this beast of nature. The next time I went out into the waves, I gave in with all of my faculties – I believed the ocean to be a completely legitimate force of power, and let the ocean take control. And to let such a large, governing force of nature take over my life, toss me about, was in a sense liberating, because I had gathered a great sense of respect for the ocean as well as for how fragile my own life was.

Cancer is not the same thing as an ocean, but does submitting ourselves to some greater force of nature that is out of our control generate in us a newfound sense of respect in our lives? Does this respect for life, then, let us appreciate what we have more, and let us use our own faculties more efficiently and in better, more productive ways in our lives? With this question in mind, I think back to Camp Kesem. What I experienced with these kids, largely, was that they all had some kind of profound respect for life that I only really saw consistently in the kids who went to camp. Was this respect a factor of having had to learn how to obey the  nasty, authoritative force that is cancer?

Perhaps, without writing too much more, I might make a small conclusion from these thoughts. Instead of trying to resist the obligation to admit to the authority of cancer, why not admit to its authority? (Admitting to the authority of cancer would not be the same as admitting defeat, however.) Cancer, put bluntly, is an expert in matters of mortality, but in my experience, it is those who fully well acknowledge the authority that cancer has in their lives, who can then use more of their faculties to live with cancer and, hopefully, live past cancer. By ignoring cancer, and remaining in solitude to fight it alone, we cannot win against such a ravenous disease.

This conclusion might be weak, and I will probably have better skills to tackle these thoughts in a few months’ time, but consider this a chance to explore what goes on in my mind when I’m spending countless hours in the library reading through this new field of philosophy. To end, I’m going to leave a things a bit brighter and give you a picture of my birthday “cake” from yesterday, in addition to a birthday latte.

IMG_2721.JPG

 

WWYD? (What Would You Do?)

Hello friends,

It’s a little late here, and my sinuses are full of fluid, but I promised you all a post about my Public Ethics course, so this will be my pre-bedtime activity for the night. Today was a whirlwind, but was incredibly rewarding nonetheless. We had this incredible lecture that explored the true differences between inequality and inequity. We spent a lot of time trying to tackle the question, “If we see an inequality, is that inequality inherently unfair?” “If the inequality is unfair (and unjust), does that then turn the inequality into an inequity?” “How might we go about determining if an inequality is unfair and/or unjust, and what would we do to combat the inequality?”

But those questions are to be answered (or explored, rather) another day. I’m here to write about what I learned on Monday, or at least tell you how I experienced this Public Ethics class. My teacher reminds me of my old professor, Scott Stonington (shoutout!), as he was extremely enthusiastic about his field of study while being so personal with his students that anything he lectured on would seem interesting to me. I also share first names with him, so you could say that inherently makes him decently cool…

To start class, Jeff got us into groups of five and had us all learn each others names, while he made the same attempt. He then asks the class if anyone can explain the “James and the villagers” example that was in our readings for the past week (I can’t remember if this was actually the name of the experiment). Whoever knew what he was talking about was told to stand up and explain, as dramatic as possible (his words, not mine), the story. It went as such:

You are a foreigner in the colonial United States. You land on the coast and come inland, entering into a village that is run by a dictator, who is an imperialist eternally trying to exert his dominance over the community of Native Americans over which he rules. Seeing that you’re another white foreigner, he happily calls you over to what best resembles a town meeting place. You look to the wall of the meeting place where the dictator has lined up twenty Native Americans. The dictator says, “Welcome to the village! Now, there’s been some misbehaving in the community, so I’ve decided to show these Native Americans who’s boss. My plan was basically to kill twenty of them right here, death by gunshot. This will help them learn that I can’t be challenged as a ruler.”

“But, I’m going to turn this over to you. You, good sir, can shoot only one Native American by yourself, and the other nineteen walk. However if you don’t choose to kill one and you walk away, then I will kill all of them.”

What would you do as the foreigner?

The class was polled and we talked about why or why not we might have chosen between the two options. After exploring our options, Jeff kept modifying the situation. For those of us who said we would kill the one Native American for the others to go free, he asked what we would do if instead we had not a gun to use but a hammer. I brought up the question of age and (independently) quality of life. What if one Native American was willing to take the fall for the rest? Would that choice have been completely autonomous? What makes the choice justified? Is it your fault for the deaths of twenty Native Americans if you choose to walk away? A Deontologist might say no. A consequentialist might say yes.

This story is a good precursor to my year studying (predominantly) philosophy. Some say, “No, philosophy is not useful because the questions that philosophers ask never have the right answer!” However, I think we’re trained to believe that there really is only one answer to the deeper questions we encounter in life. However, the fact that these questions don’t have an answer gives them this incredible inner beauty that lets us truly explore the human condition. Exploring the grey area in philosophical thought experiments like these will let us really pin-point where our boundaries lay, and finding our limits (or others limits) is important, in my mind, when trying to truly understand another. My hope is that training myself in exploring the grey areas of life through philosophy will let me then be better equipped to provide solutions (not answers) to the most difficult problems that arise in the world global health.

That’s it for tonight, friends – thanks for thinking with me.