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February 2013 posts

How must military medical ethics adapt to the realities of modern warfare?

Mark D. White

The latest issue of Bioethics (27/3, March 2013) features a brief but provocative paper by Steven H. Miles (University of Minnesota in Minneapolis) titled "The New Military Medical Ethics: Legacies of the Gulf Wars and the War on Terror":

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990–1991) and the War on Terror (2001–). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a ‘new kind of war’. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency.

Ronald Dworkin, RIP

DworkinMark D. White

I am profoundly saddened to report that pre-eminent legal and political philosopher Ronald Dworkin has died today in England. He was 81.

Aside from Immanuel Kant, no thinker has been more influential on my writing, and my classes devoted to his work have been some of my most enjoyable to teach. It is a pleasure to teach about a philosopher that has so affected the scholarly discourse and also comments widely in the popular press, particularly the New York Review of Books, where he often commented at length on important Supreme Court decisions. As a professor, it's so rare for the philosopher at the center of a course regularly apply the theories you're teaching; as a professor, scholar, and fan, I will greatly miss his timely insight, but his work will continue to enrich my life and my work for years to come.

Rest in peace, sir—today you trump us all.

Zak Responds

Jonathan B. Wight

Paul Zak emailed this morning about yesterday's blog "Beware the Neuro Bunk." Here's his response, edited slightly to remove extraneous stuff:

"Hi Jonathan, I think a very fair blog. There is a separation between the science (i.e. peer reviewed pubs) and discussing the science with a lay public (books, TED talks, etc.). Stealing S.J. Gould's phrase, I view these as separate magisteria as the audiences are different.

"One of my heroes was Lin Ostrom and she was fearless in making her research useful. I'm trying to do the same thing... Great to hear from you! --Paul"

Elinor Ostrom (1933-2012), Nobel Prize 2009.

Ostrom's work has obvious parallels with Zak's, attempting to understand voluntary cooperation to solve vexing exchange problems. Ostrom's and Zak's work makes me optimistic about the science of economics in the 21st century, leading us beyond the "greed is good" and other ideologies. Adam Smith made an effort to stamp it out in 1759, but like a noxious weed it keeps popping up again every few generations.

We need a new mantra: "Self-interest is good; greed is bad." For anyone who is confused, see The Theory of Moral Sentiments or my simpler summary novel, Saving Adam Smith.

Beware the Neuro Bunk

Jonathan B. Wight

Readers of this blog know that I am an admirer of Paul Zak (see here, here, and here). Zak is a pioneer in neuro-economics and the discoverer of oxytocin in exchange, the alleged "moral molecule." But the potential for abuse in neuro studies is enormous. Marketers are circling like vultures to take the information gleaned and use it for nefarious purposes.

Molly Crockett tackles this in an interesting TED talk, "Beware the Neuro Bunk." In it, she takes a swipe at Zak for stretching his conclusions on "love" beyond the findings of the study data. That's a good point. Words are a tricky thing, and English is not particularly adept when it comes to the concept of "love"—an all-encompassing phrase that means everything and nothing. Moreover, brain scans and hormones might tell us about biology, but not about intentions or ultimate meaning. So Zak has played a little loose with language and it's been a good selling point for his books.

I don't begrudge him for trying to connect biology with the emotional. I think that's what Adam Smith was also trying to do. Smith called affection "habitual sympathy" which is a stab at some version of love, arrived at by the steady co-mingling of emotional mirror-neurons.

Crockett cites another interesting paper by McCabe and Castel (2008), "Seeing is believing: The effect of brain images on judgments of scientific reasoning," Cognition 107(1): 343-362. In the images to the left, the same brain scan data is presented first as a map and second as a picture image.

Readers of a scientific article are "fooled" into rating as more believable the article with the picture image compared to the map. Why do plausible pictures resonate more with our sense of trust?

This is not news to marketers, who have known for decades that an actor wearing a white lab coat can usually convince an eager and gullible patient to buy almost any placebo. There was a time in recent past when Marcus Welby, MD was the nation's most trusted physician, despite the fact that Robert Young, the actor, never got beyond high school. The white lab coat gave him all the credibility he needed.

Peart on Leadership

Jonathan B. Wight

Sandra Peart, co-founder of this blog, published today an interesting op-ed in The Washington Post, "Overhauling how we teach leadership" (February 12).

Peart's thesis is that

"we spend too much time bemoaning the fact that our leaders aren't all really good people. Instead, we need to spend more time looking at whether we have good norms for choosing our leaders and holding them accountable, and good processes from which leadership emerges and functions ethically."

She goes on:

"It's time for those of us who teach and write about leadership explicitly to acknowledge the essential difference between studying leaders and studying leadership…. [T]he latest research indeed treats leadership as a phenomenon much more complex than the person who holds authority….

"We need to recognize and help our students appreciate that leaders operate within a set of culturally determined norms, within a particular temporal and spatial context…. The problem with using leaders as a starting point for studying leadership is that it draws attention away from the study of institutions, norms and rules within which leadership functions….

"Leadership is complex and requires many lenses to understand it. Psychology is helpful, yes, but so are history and philosophy, science and economics. It's time to recognize that leadership is more capacious than the study of leaders and followers. We must cut this Gordian knot."

So we need to peel back the layers of human interaction to uncover where and how moral norms and institutions arose and evolved. Sounds like a job for… Adam Smith!

To emphasize Sandra's point, watch the new Lincoln movie. Daniel Day-Lewis does a wonderful job depicting Lincoln's approach to leadership, understood by and colored by the time and place of mid-19th century America.

Interview with Julian Reiss, author of Philosophy of Economics: A Contemporary Introduction

Mark D. White

Phil of econThe good people at Routledge have posted an extensive Q&A with Julian Reiss, Professor of Philosophy at Durham University, regarding his forthcoming book Philosophy of Economics: A Contemporary Introduction. From the lead-in:

Philosophers since Aristotle have asked questions and offered opinions about economics, broadly defined. But during the 20th century economics developed into a field which was, as Julian points out in the beginning of his upcoming work, “hostile to philosophical reflection.” Economics became a science: economists began to see in “the economy” a space made up of empirically observable facts interpretable by the assumptions, methods, and models familiar to students enrolled in Econ 101 classes. In recent years, though, certain economic realities—the financial crisis, e.g.—have challenged those assumptions, methods, and models. A writer for the Economist described the consequence of recent challenges to the science of economics: “OF ALL the economic bubbles that have been pricked [since 2008], few have burst more spectacularly than the reputation of economics itself.”

Julian’s book introduces readers to the field in which many of those challenges are now being articulated. Questions of ethics, of the nature of human rationality when faced with economic decision-making, of the verifiability of economic models—these questions and more are all now being asked anew about economic practices and decisions. This interview hopes to open those questions to all curious readers.

Read the entire interview here.

Table Tennis, Brain Power, and Ethics

Jonathan B. Wight

In recent years I've taken up table tennis. It is stimulating and occasionally exhilarating, even if my friends make fun of it.

Now we learn from a science lab that table tennis stimulates blood flow to the brain, promoting focus and longevity:

To boost blood flow to certain parts of my brain, Amen suggested I .… take up table tennis - a co-ordination exercise to boost activity in my cerebellum, the region of the brain that plays an important role in motor control.

I'm no longer goofing off when I'm punching the paddle—I'm investing in human capital!

Table tennis has its own culture, and like golf has the norm of calling shots honestly. There are exceptions, but the sport teaches ethics to young people. Winning through cheating would leave someone feeling humiliated—which is as it should be. Adam Smith noted that:

"[T]he desire of doing what is honourable and noble, of rendering ourselves the proper objects of esteem and approbation, cannot with any propriety be called vanity" (The Theory of Moral Sentiments (VII.ii.4.8).

My table tennis mentor Vinny Petrone elaborated:

[Players are ethical] in general and almost without exception at the professional level. I have watched a lot of professional matches and the pro players will almost always point to the table if they can hear their opponent's shot make very slight contact with the edge. I have even seen pros deliberately serve into the net to give back a point to their opponent when the umpire refused to give their opponent credit for an edge ball. I have seen that happen many times. It's really a kind of honor code that has wide acceptance and is taken very seriously among the professionals in the sports.

The Chinese pros employ another honor rule: they never let their opponent lose by a score of 11-0. When they are ahead 10-0, they will deliberately make a poor serve or return to sacrifice a point to their opponent. Some Westerners are offended by this practice because they take it to be a condescending show of pity; however, I think the Chinese see it as a way to allow their opponent to save face and avoid the humiliation of a complete shut-out.

Rutgers Law Journal symposium on Amartya Sen's The Idea of Justice

Mark D. White

Sen iojThe latest issue of the Rutgers Law Journal (43/2, 2012) features a symposium on Amartya Sen's The Idea of Justice. As stated in the foreword by John Oberdiek:

The Rutgers Institute for Law and Philosophy, in conjunction with the Rutgers Law Journal, was honored to host a symposium on The Idea of Justice in May 2011 at the Rutgers School of Law–Camden. Sen’s intellectual acclaim, not to mention his well-known personability and grace, made it easy to attract a stellar roster of political philosophers from across the country: David Estlund from Brown, Samuel Freeman from Penn, Gerald Gaus from Arizona, Erin Kelly from Tufts, Henry Richardson from Georgetown, and Debra Satz from Stanford, all of whom, save for Estlund, have contributed an article to the present issue. Sen responded to each paper in turn at the conference, and we are delighted to be able to publish in this volume his full and considered written reply. This marks the first time a Nobel Laureate has been published in the Rutgers Law Journal.

The papers included in the symposium are:

Ideal Theory and the Justice of Institutions Vs. Comprehensive Outcomes, Samuel Freeman

Mapping Out Improvements in Justice: Comparing Vs. Aiming, Henry S. Richardson

Social Contract and Social Choice, Gerald Gaus

Amartya Sen's The Idea Of Justice: What Approach, Which Capabilities?, Debra Satz

Public Reason as a Collective Capability, Erin I. Kelly

A Reply, Amartya Sen

A Giant Falls

Jonathan B. Wight

They called it a "weed" tree. And it had to come down.

That language cannot describe this beautiful, soaring 70-80 foot tree. It has been around a long time, probably since FDR was president.

It shades the garden and the alley in the blazing sun of summer. It houses birds and squirrels. It soaks up carbon and releases tons of oxygen. When its leaves are out they absorb the smog and sounds of city life. It provides a gorgeous view shed for blocks.

But that's the problem: those positive externalities aren't paid for. The new owners want the space the tree inhabits for private off-street parking. I can't blame them. It's their land and they have a right to use it as they want. We neighbors may want to enjoy their benevolence, but we can't force them to save this tree for our profit. We ourselves took down big trees that threatened our house, and saddened neighbors in the process.

So cut it down. But please don't call it a "weed" tree. It is gorgeous, magnificent, and saintly. It is not a bastard, not misbegotten to those of us who loved it and now mourn it.