How should we think about it?

January 24, 2017

Pär SegerdahlMuch debated issues tend to be about how we should view important matters that are also multi-faceted. The school system is important. But there are many ways of thinking about the importance of education; many ways of reasoning about how it should be designed to carry out the important tasks that we think it has.

So how should we think about it?

The question is reflexive. It is about the matter, but also about how the matter should be described. How should we reflect important things in our ways of reasoning about them? It is in this reflexive dimension that we are debating school, health care, freedom of speech, or the ethics of stem cell research. It is a difficult to navigate dimension. We easily go astray in it, but we can also try to find our way in it and become wiser.

Philosophers have felt particularly responsible for this reflexive dimension. They have been thinking about how we think about things, if I may put it that way. They have been thinking about thinking. I do it now, by trying to understand debated issues in terms of a difficult to navigate reflexive dimension. I do not know how successful my attempt is. The risk is that what I call a reflexive dimension appears like a separate realm of pure ideas about things (absolute principles for how we should think).

I do not want to reinvent Platonism. I just want to point out that when we debate something, we reason not only about the matter, but also about how we reason about it. We work on ourselves. Debates that lack such self-awareness tend to be dogmatic and less fruitful.

A name for work on self-awareness could be self-criticism, or thinking. I believe it makes a difference if conversations in a society are marked by the attitude that “the matter” also includes ourselves. Responsibility has its origin in that attitude.

Pär Segerdahl

This post in Swedish

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The pharmaceutical industry and altruism

January 16, 2017

Pär SegerdahlI am currently thinking about a common gut reaction to the pharmaceutical industry. I sometimes have this reaction too, so this is an examination of my own reaction.

The reaction is a feeling of discomfort, when a central actor in the management of something as important as human health and disease is a multibillion-dollar industry with profit as overall goal.

Is it really possible to combine such a businesslike aim with a genuine desire to cure the sick?

Let us compare with another industry that radiates more compassionate desire to cure, namely, alternative medicine. Here too products are sold to people with various ailments. There is clearly a market and a business mindset. Yet the actors on this market radiate more love of mankind. It can sometimes even appear as if the products were manufactured and sold out of pure goodness!

What makes these business practices seem imbued with good will to cure? I suggest that it depends on the strong belief in the healing effects of the products. I do not deny that many of the products have beneficial effects. My point is only that beliefs about good effects are at the forefront and can make the provision of the products appear like an ethical act of noble actors.

The pharmaceutical industry is different from alternative medicine partly through being prohibited from being permeated with beliefs about the healing effects of the products. It is actually illegal for the pharmaceutical industry to act as nobly and compassionately as the actors within alternative medicine. It could invite quackery.

The pharmaceutical industry operates on a highly regulated market. There is specific legislation for pharmaceutical products and special authorities supervising the industry. Satisfying the quality and safety demands often requires decades of research and development. This means huge investment costs, which presupposes profits.

This is how we have solved the problem of providing safe and effective treatments through the health care system. By having a pharmaceutical industry that is not permeated with good faith and good intentions, but instead is highly regulated and supervised. The products must satisfy the quality requirements, period. Beliefs and good intentions are irrelevant.

Research, industry and healthcare together constitute a regulated system for managing health and disease. Within this system, researchers can be driven by curiosity, and industry by profit, while doctors want to cure their patients, and research participants want to support research that could lead to more effective treatments.

The point I am trying to make is that the gut reaction probably overlooks just this division of motives: In order for a whole system to work for the good, not every actor in the system needs to place good intentions first. It can rather pose a risk for the entire system.

There is no reason to glorify the pharmaceutical industry. Rather there are reasons to question it, for example, the marketing of products, which sometimes tries to create the faith that is prohibited in the development and approval of the products.

The industry is not altruistic. It is driven by profit. But through its place within the system it can make altruism and good will possible.

Pär Segerdahl

This post in Swedish

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