Fear + vaccines + autism = ?

Dear friends,

I was taking a break from some preliminary dissertation reading (that’s right – done with term papers and on to dissertation work!) via Tumblr and came across this post:

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There’s a nearly obscene amount of sass in this post, and I would personally refrain from expressing any thoughts on this matter in such an accusatory way. However, I think this post does point towards a few deeper issues that we need to confront.

I’m really interested in value judgments that humans give to medical treatments (or just value judgments in general, but that discussion is for another time), especially when potential death is involved. Specifically thinking about vaccinations, we might see value in vaccinations only for making us physically healthier, or for allowing us to avoid death caused by a little molecular entity having a field day with our bodies. However, the recent phenomenon of parents (not just mothers, as the post refrains to regard (we don’t want to gender the politics of decision-making for children’s health)) choosing to not vaccinate their children raises peculiar issues regarding value judgements regarding vaccination. With this phenomenon, we see a parent choosing that their child face the risk of losing their life, or having their life physically threatened, solely for the sake of avoiding what is perceived as a disability by contemporary society.

I (regrettably) don’t know enough about autism to make informed comments on this condition, but I want to raise a point that may let us circumvent having to know too deeply about autism.

What is the fear of a child having autism saying about our value judgments when it comes to disease risk versus risk for a ‘disability’ that (is said to, and might not actually) come from getting a vaccine? One of these outcomes will, quite objectively, kill you. The other is what I believe to be the simple consequence of a different neural network, one that causes ‘issues’ only due to the difference’s relation to what is perceived as ‘normal’ in our society. Additionally, having autism will not kill you. (That’s to say autism will not physically kill you. The stresses caused by having to conform to mainstream society might lead to more stress and premature death, but again, we must save that conversation for another time.) Must we assume, then, that the fear of a child having autism (what can be seen as a socially contrived condition) is greater than their child potentially dying (not to mention the potential risk of causing other friends’ and family members’ children the same demise)?

Moving along and assuming that this assumption is true, is it right to blame the parents who choose to not vaccinate their kids for acting irrationally? If they are acting irrationally, then are they acting out of impulse or emotion? Is this impulse born out of their own research (regarding the post’s mention of “access to the internet”), or born out of the larger societal notion that autism is a bad thing to have in our society, bad enough that we are willing to risk death by infectious disease to avoid autism?

Contrast this phenomenon with the idea of putting a loved one on life support to extend their living but possibly vegetative state. In this instance, we are putting objective physical health (staying ‘alive’ in a biological sense) over socially valued health (being able to interact with others in an unhindered way, or living comfortably without being connected to medical equipment 24/7). In essence, our value judgments have flip-flopped.

At the bottom line, we can see here that value judgments are by no means concrete or unchanging. Just because we might swing one way when it comes to vaccinating a child, does not mean that we are bound to swinging that same way when we might make a decision for our less-than-autonomous parent who is approaching a (dignified) end. What does this say about where our value judgments are based? If we see that value judgments are not coming from objective moral reasoning, and rather from impulse and emotion born out of highly external factors, then I fear that we cannot put sole responsibility on the non-vaccinating parents for making that decision.

We might instead see that we have a duty as a whole to work toward a re-conceptualisation on what is socially valued, especially with notions of what is deemed ‘good’ and ‘bad’ regarding action in the social setting (that which is affected greatly by autism). Hence, instead of blaming those who make these decisions to not vaccinate their children, I might think that we have a shared responsibility in resisting a (what I see as detrimental) shift in the perception of value in vaccines.

Furthermore, I might call attention to the fact that this vaccination issue is a manifestation of a larger social problem of how we create (yes, create) disabilities that result in unjust stigmatisation. Regarding the word ‘create’, I mean only that much of what we may see as a difference (in social interaction, or mental processes) is deemed a disability when, in reality, this difference is only a difference and nothing more. If we don’t address this detrimental social wrong that takes place all too often, then fighting the vaccine issue (by any means, including blaming parents who probably shouldn’t be fully blamed) will not fix the problem, and we will come out of this situation with two ‘bads’ (namely, sick children with antiquated diseases and further social stigmatisation). Certainly, we might (rationally, emotionally, however you like) fear this outcome.

RIP, Keith.

Dear friends,

On my way home today, I passed this set of flowers and messages on the wall outside of a Sainsbury’s (a UK grocery store chain).

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I tend to use this Sainsbury’s fairly often, mostly because it’s close to Uni and close to the tube stops that I use. I may have seen Keith outside, perhaps made eye contact with him a few times, but did not engage with him further than that. As a disclaimer, I want to fully respect the death of this man. I think his death (which I would not have known about had I not passed this memorial) brings about a few thoughts worth sharing. (I’m also not claiming moral high ground on talking about others’ actions – for all intents and purposes, I, too, belong to the ‘other’ that I write of in this post.)

Here’s what went through my head upon walking past this memorial:

  1. This is out of the ordinary – why are there all of these flowers outside of Sains?
  2. There’s a message posted on the wall – ah, it seems as it someone who used to sit out here has died. Perhaps a homeless man? – yes, confirmed by what’s pasted to the wall.
  3. It’s good that people are remembering his death with flowers – he must have been well-known by those who frequent this area.
  4. What were people doing during the time when Keith was alive?
  5. Were they spending the money that they spent on flowers to give food or other necessities to Keith?
  6. What makes one’s death worth drawing attention to, when the suffering it took to reach that death was probably an objectively worse thing than the death itself?

This article was pasted on the wall above the flowers – it gives a short overview of who Keith was, why he was on the street, and how he may have died that night. I want to expand upon a thought regarding death versus suffering, and why we notice death more than whatever suffering leads up to that death. Also, why would we feel a moral imperative to act on that death and not on the suffering that precedes the death?

It seems that these flowers may be a signal that others have chosen to show their sadness and lamentations over Keith’s death at this moment, only after he has died. Upon first examination, this seems a bit counter-intuitive to me. Quite bluntly, this man’s death might have been a form of respite from his life up until that moment. That’s not to say that it was okay that he died, but it may be safe to say that he isn’t suffering as much as he was (not to open up the debate on what ‘suffering after death’ actually means). What is it about death that makes us realise so suddenly the ‘badness’ of any lost human life? Think about that cliché moment in a film, when the antagonist’s family member or loved one dies – even the protagonist and their posse manage to find compassion for the antagonist’s loss. However, they can’t seem to find that compassion until death is involved.

One idea that may help explain this is Daniel Kahneman’s ‘peak-end thesis’. This topic is best explained using the experiment that Kahneman and his fellow researchers used, involving colonoscopies. In this experiment, the researchers had the whoever was conducting the colonoscopy leave the probe in the patient a little longer for some patients (which led to the patients getting a bit more used to the pain by the end of the test), as compared to leaving the probe in for a normal amount of time (this was the control trial). Patients then rated their overall pain experience as they remembered it, and it showed that the patients who had the probe in for longer (which might have caused a larger ‘total’ (think integrals here, calculus people) amount of pain) remembered less pain than did the patients who had a normal-length colonoscopy (who would have experienced less ‘total’ amount of pain).

This basically shows that people will remember the ‘badness’ of experiences by two things: the amount of pain at the worst moment (the peak) and the amount of pain at the end of the process (the end). Taking this idea to Kevin’s death (or anyone’s death, who is also suffering prior to that death), we might think that the ‘end’ of someone’s life ending has a great determining factor in how we actually remember that person’s life – i.e. death plays a large part in our perception of the ‘badness’ of the suffering in one’s life, and the length of that suffering plays less of a role in how we recognise the ‘badness’ in someone’s life.

This may be able to provide us with an explanation of why humans act more often (and perhaps why they feel more compassion) for someone when they die (as opposed to when we see a living person suffering).

If this is true, the implications of this sort of thinking are drastic, especially in explaining why homelessness (and more generally inequality that leads to human suffering) persists despite our clear knowledge of the sort of suffering that is caused by homelessness. If our reaction towards this sort of suffering is explainable using contemporary behaviour theory, then we can’t necessarily fault those who participate in that way. However, once we become aware of our implicit assumptions and actions, we may at the same time generate a duty to address these actions and not merely leave them up to the whim of nature. After all, we are rational beings (not meaning that we always act rationally, but have the ability to think about our actions and not merely ‘do’).

If we now can recognise why it may not be natural to go out of our way to recognise our compassion for the living homeless only until they die, our duty to do something about human suffering (and homelessness, surely) may be grow stronger with each passing day.

“Emergency sex and other desperate measures”

Dear friends,

At this point in the year, I’ve finished my formal lectures and teaching, and am on to the second set of essays due for the completion of this term’s modules. I’ve been working on an essay, trying to answer the question: “Is supporting international development aid a duty of humanity, a duty of justice, or no duty at all?”

As happens with the work that comes with essay writing, I seem to have found my way into a really deep hole of reading. It’s almost as if I, as a hypothetical burrowing animal, have stuck my head into the dirt and dug until I managed to even forget why I was digging in the first place. I’ve looked up, only to see dirt all around me, realising that I’ve lost the light of day (it was also quite rainy/overcast in London today), and staring me in the face is this book titled “Emergency sex and other desperate measures: a true story from Hell on Earth”.

The path my little burrowing self took from the surface of the excavated path up until this book has included these points:

  • Peter Singer concludes that we have a duty to support international aid (I’ll refrain from giving his moral argumentation scheme here).
  • Dambisa Moyo says that aid is hurting Africa for various reasons. We therefore actually have a duty opposite to that which Singer claims: to stop all aid.
  • Others have given reasons for stopping aid, re: the recent news about the Oxfam scandal. Oftentimes in the foreign aid sector, the power relation between the aid giver (usually a privileged Westerner) and the aid receiver (perhaps a victim of a natural disaster or disease) is wrongly utilised. This happened when vulnerable Haitians were paid for sex with Oxfam representatives after the 2010 earthquake in Haiti.

Okay, so we have these three little ideas that popped into my head – but what do we do with them? One set of writers (Søren Sofus Wichmann & Thomas Søbirk Petersen) make it a point to say that even in light of aid gone wrong, there’s a lot of aid that goes well. Singer makes this similar argument in his book, “The Life You Can Save”. Scandals and mishaps in the aid industry, it seems, are just bad apples in a bunch of good apples.

A lot of this argumentation reminds me of a work by the Kenyan philosopher Henry Odera Oruka, who manages to use quite well the term ‘supererogation’ when describing aid workers and foundations. Basically, if a human or an organisation is going ‘above and beyond’ (as viewed by society, I might add) in their work, then they have less moral imperative to be scrutinised in the work that they’re doing. With this framework, read the paragraph preceding this one again – it seems eerily reminiscent of supererogation. Ought we be questioning the work of charities, aid organisations, and foundations more often than we do?

Even without going so far as to scrutinise the acts of charity organisations themselves, could we even take a broader look at the idea of charity and aid in and of itself? I’ve been thinking, perhaps the mistakes that tend to happen in development aid, and especially in this Oxfam scandal, are happening not due to the bad apples in the bunch, but the fact that humans cannot control certain aspects of their nature. (This is an incredibly cynical way of viewing people, but I’m keeping it for the sake of the thought experiment at the moment.) By allowing a company to work within the framework of development aid, one must then accept the existence of one who has more and one who has less – this gap is where we find the power dynamic that humans cannot, perhaps, refuse to use when they are put in a catastrophic situation such as the disaster relief setting. Paul Farmer once said that he abhors the idea of charity (which I tie closely to the idea of aid), because the existence of charity requires the existence the powerful and the powerless (paraphrased, I think). So with this power relation in mind, I wanted to read this book on ’emergency sex’ to see a personal account into why these sex scandals may have happened. (I’ve only started, so I don’t know if this book will lead me towards any sort of conclusion.)

Let’s be clear: there is not excuse for sexual abuse, harassment, or anything of the like. I’m not trying to release those who contributed to this scandal of any blame, but the truth of the matter is that if the existence of these scandals is reliant not on ‘bad apples’ but on the ‘framework of inequity in power’, they’ll keep happening despite the knowledge that these sorts of acts that the Oxfam workers committed not so long ago are rightfully taboos to be refused. Is it time for a shift in the conception of what ‘aid’ and ‘development’ constitute?

Without entering too far into conversation on the matter, I might only ask, What are we to do with this sheer amount of inequity that exist in the world? If aid is not a part of the answer, then what is? This brings about questions of the global and local infrastructure, about long-term and short-term solutions, and about what current solutions, if any, are truly effective.

While I was reading this book, I came across the story of a Cambodian man and young man, both physicians-to-be in New Zealand. The Cambodian man, Vary, escaped the genocide in his country – he and his wife were luckily in the lucky 1/3, where the other 2/3 were brutally maimed, killed. Andrew, the other young man, ends up befriending Vary, and learns about living amidst a genocide, of having to sew the diamond of an engagement ring into the skin of one’s wife’s arm that would be later used to start a new life in New Zealand…

This just got me to thinking about privilege, growing up in a country like the United States, and what the aims of life are in the U.S., especially when we aren’t quite aware of what’s happening on the global scale. In reading this story, I only began to understand the immense notion of how truly privileged many of us, especially in the university setting, can be. My mind goes back to a conversation I once had with a dear friend: she asked, “Do you think it’s fair that I go to university, someone who comes from a privileged background? That I take away this university spot from someone who didn’t have all the opportunities that I had while growing up?”

This question still has me thinking, and I honestly don’t have a good enough answer at the moment. Perhaps, ‘use your degree for the better,’ but this implies that we use the power that we are unfairly given by society to then try, in some way, to make life more fair. Is there not a solution that doesn’t require we come from a position of power? Also, how many truly moral minds can we rely on to ‘use the degree for the better’? (My apologies for the cynicism again on humans.) I guess this may take us to a new realm of thinking, where we must take a step back, out of the accepted framework of power that we live in at the moment.

For lacking any answers, I do have one solid idea for you. We know, objectively, that we live in a world in inequity. Somehow, someway, this inequity must budge. In reading only a part of the vast literature that there is on foreign aid, it seems as though our old solutions to addressing this inequality are truly only relics of the past, and I may fear that we haven’t heeded the famous words, “Insanity is doing the same thing over again and expecting different results.”

The pit in my stomach only tells me that we need to think more on this issue, only that is all I know for now. This is a daunting task of sifting through an incredibly complex situation and problem, but we, if we wish to make any bit of change for the better, are here to tackle tasks such as these, no?

 

 

‘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.

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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.’’

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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.)

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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?

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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.

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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!)