Who belongs to us?

October 2, 2019

Pär SegerdahlBioethics has a problem with human beings, the philosopher Roland Kipke writes. It must ask who belongs to our moral community. Who has rights? Who has human dignity? Who has the moral status usually attributed to healthy adult humans? Who has the right to life?

The question is: Who belongs to us? Are human embryos included in the community? Newborns? Those with advanced dementia? Intelligent animals?

A common response to the question is to propose a philosophical criterion. Two positions dominate in bioethics. One includes all biological human beings, thereby embryos, newborns and those with advanced dementia. Everyone who belongs to the species Homo sapiens belongs to the moral community.

The second position holds that species membership is irrelevant. Instead, the focus is on mental capacities that one holds characterize a “person.” For example, rationality and self-awareness. This excludes embryos, newborns and those with advanced dementia from the community. However, a rational chimpanzee may enter. All persons belong to the moral community, regardless of species affiliation.

Kipke shows how both criteria compel us to answer the question “Who belongs to us?” in ways that contradict most people’s moral intuitions. We might accept this if the positions could be justified by strong arguments, he says. However, such arguments are missing.

What should a poor philosophical gatekeeper do then? Who should be admitted into the community? Who should be kept out?

The solution to the gatekeeper’s dilemma, Kipke suggests, is our ordinary concept of the human. When we talk about “humans,” we usually do not use the scientific concept of a biological species. Our everyday concept of a human already has moral dimensions, he points out. We cannot see a human being without seeing a living person belonging to our community. According to this third position, all humans belong to the moral community.

The only problem is that the gatekeeper needs a criterion to distinguish the human members of the community. It is true that we have everyday uses of the word “human.” It is also true that we normally have no difficulties in distinguishing a human being. However, do these uses really contain a criterion suitable for more philosophical gatekeeper tasks? They do, according to Kipke. He holds that there is a characteristic “living human gestalt or the form of the body,” especially the face, which easily allows recognition of a human being, even when she is seriously injured and deformed.

The “living human form” would thus be the criterion. This form makes us equals in the moral community.

Kipke’s article is philosophically exciting and his criticism of the two dominant positions is revealing. Personally, I nevertheless find the still dominant preoccupation with the question “Who belongs to us?” somewhat terrifying, and perhaps even inhuman. Bioethics treats human concerns about, for example, genetics and stem cell research. Admittedly, people often express their concerns in the form of boundary issues. People who worry about the destruction of embryos in stem cell research, for example, can talk about the embryo as a human individual or as a potential person. However, addressing their worries by suggesting that our common language contains a criterion that has the authority to separate the members of the moral community will probably not still the minds of such worried and perhaps even angry humans. They need a lot more attention. Perhaps it turns out that the intellectual boundary issue concealed the living source of their concerns and made it impossible to treat the problem at its source.

I believe we need a bioethics that responds to moral concerns more humanly and communicatively than only as philosophical boundary issues. Could we not use our ordinary language to think together about the issues that worry us? To refer to an ordinary concept of the human as an arbiter that supposedly dictates the answers to bioethical boundary issues seems characteristic of a smaller community: one that is professionally preoccupied with philosophical boundary issues.

Is that not placing bioethics before life? Is it not putting the cart before the horse?

Pär Segerdahl

Kipke R. Being human: Why and in what sense it is morally relevant. Bioethics. 2019;00:1–11. https://doi.org/10.1111/bioe.12656

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Bioethics without doctrines

September 24, 2019

Pär SegerdahlEver since this blog started, I have regularly described how bioethical discussions often are driven by our own psychology. On the surface, the debates appear to be purely rational investigations of the truthfulness of certain claims. The claims may be about the risks of genetically modified organisms (GMOs), the private nature of genetic information, the moral status of the human embryo, or the exploitation of egg donors for stem cell research. The topics are, as you probably hear, sensitive. Behind the rational surface of the debates, one can sense deeply human emotions and reactions: fear, anger, anxiety.

Have you ever been afraid? Then you know how easily fear turns into anger towards what you think causes your fear. What happens to the anger? Anger, in turn, tends to express itself in the form of clever arguments against what you think is causing your fear. You want to prove how wrong what frightens you is. It must be condemned, it must cease, it must be prohibited. This is how debates often begin.

The debates hide the emotions that drive them. Fear hides behind anger, which hides behind clever arguments. This hiding in several steps creates the shiny rational surface. It sounds like we were discussing the truth of purely intellectual doctrines about reality. Doctrines that must be defended or criticized rationally.

As academics, we have a responsibility to contribute to debates, to contribute with our expertise and our ability to reason correctly. This is good. Debates need objectivity and clear logic. The only risk is that sometimes, when the debates are rooted in fear, we contribute to hiding the human emotions even more deeply below the rational surface. I think I can see this happening in at least some bioethical debates.

What we need to do in these cases, I think, is to recognize the emotions that drive the debates. We need to see them and handle them gently. Here, too, objectivity and clear logic are required. However, we do not direct our objectivity at pure doctrines. Rather, we direct it more thoughtfully at the emotions and their expressions. Much like we can talk compassionately with a worried child, without trying to disprove the child as if the child’s worries were deduced from false doctrines about reality.

If our objectivity does not acknowledge emotions, if it does not take them seriously, then the emotions will continue to drive endlessly polarizing debates. But if our objectivity is kindly directed to the emotions, to the psychological engine behind the polarization, then we can pause the sensitive mechanism and examine it in detail. At least we can make it react a little slower.

We habitually distinguish between reason and feeling. As soon as a conflict emerges, we hope that reason will pick out the right position for us. We do not consider the possibility that we can direct reason directly to the emotions and their expressions. It is as if we thought that feelings are so irrational that we must suppress them, should hide them. As parents, however, this is precisely how we reason wisely: We talk to the child’s feelings. Sometimes we need to handle our own feelings the same way. We need to acknowledge them and take good care of them.

In such a compassionate spirit, we can turn our objectivity and our wisdom towards ourselves. Not just in bioethics, but everywhere where human vulnerability turns into relentless argumentation.

By gently dissolving the doctrines that lock the positions and reinforce the hidden emotions, we can begin the process of undoing the mental deadlocks. Then we may talk more clearly and objectively about genetics and stem cell research.

Pär Segerdahl

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Learning from the difficulties

September 11, 2019

Pär SegerdahlIn popular scientific literature, research can sometimes appear deceptively simple: “In the past, people believed that … But when researchers looked more closely, they found that …” It may seem as if researchers need not do much more than visit archives or laboratories. There, they take a closer look at things and discover amazing results.

There is nothing wrong with this popular scientific prose. It is exciting to read about new research results. However, the prose often hides the difficulties of the research work, the orientation towards questions and problems. As I said, there is nothing wrong with this. Readers of popular science rarely need to know how physicists or sociologists struggle daily to formulate their questions and delve into the problems. Readers are more interested in new findings about our fascinating world.

However, there are academic fields where the questions affect us all more directly, and where the questions are at the center of the research process from beginning to end. Two examples are philosophy and ethics. Here, identifying the difficult questions can be the important thing. Today, for example, genetics is developing rapidly. That means it affects more people; it affects us all. Genetic tests can now be purchased on the internet and more and more patients may be genetically tested in healthcare to individualize their treatment.

Identifying ethical issues around this development, delving into the problems, becoming aware of the difficulties, can be the main element of ethics research. Such difficulty-oriented work can make us better prepared, so that we can act more wisely.

In addition, ethical problems often arise in the meeting between living human beings and new technological opportunities. Identifying these human issues may require that the language that philosophy and ethics use is less specialized, that it speaks to all of us, whether we are experts or not. Therefore, many of the posts on the Ethics Blog attempt to speak directly to the human being in all of us.

It may seem strange that research that delves into questions can help us act wisely. Do we not rather become paralyzed by all the questions and problems? Do we not need clear ethical guidelines in order to act wisely?

Well, sometimes we need guidelines. But they must not be exaggerated. Think about how much better you function when you do something for the second time (when you become a parent for the second time, for example). Why do we function better the second time? Is it because the second time we are following clear guidelines?

We grow through being challenged by difficulties. Philosophy and ethics delve into the difficulties for this very reason. To help us to grow, mature, become wiser. Individually and together, as a society. I do not know anyone who matured as a human being through reading guidelines.

Pär Segerdahl

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Transhumanism purifies human misery

June 18, 2019

Pär SegerdahlThe human is a miserable being. Although we are pleased about the new and better-paid job, we soon acquire more costly habits, richer friends, and madder professional duties. We are back to square one, dissatisfied with life and uncomfortable with ourselves. Why can life never be perfect?

Discontent makes us want to escape to better futures. We want to run away from worries, from boredom, from disease, from aging, from all the limitations of life, preferably even from death. We always rush to what we imagine will be a better place. As often as we find ourselves back to square one.

The eternal return of discontent thus characterizes the human condition. We imagine that everything will be perfect, if only we could escape from the present situation, which we believe limits us and causes our discontent. The result is an endless stream of whims, which again make us feel imprisoned.

Always this square one.

Transhumanism is an intellectual revivalist movement that promises that AT LAST everything will be perfect. How? Through escaping from the human herself, from this deficient creature, trapped in a biological body that is limited by disease, aging and death.

How can we escape from all human limitations? By having new technology renew us, making us perfect, no longer suffering from any of the biological limitations of life. A brave new limitless cyborg.

Who buys the salvation doctrine? Literally some of the richest technology entrepreneurs in the world. They have already pushed the boundaries as far as possible. They have tried all the escape routes, but the feeling of limitation always returns. They see no other way out than escaping from EVERYTHING. They invest in space technology to escape the planet. They invest in artificial intelligence and in the deep-freezing of their bodies, to escape the body in the future, into supercomputers that AT LAST will save them from ALL life’s limitations, including disease, aging and death.

Do you recognize the pattern? Transhumanism is human misery. Transhumanism is the escapism that always leads back to square one. It is the dream of a high-tech quantum leap from dissatisfaction. What does paradise look like? Like a high-tech return to square one.

We need new technology to solve problems in the world. When coupled with human discontent, however, technology reinforces the pattern. Only you can free yourself from the pattern. By no longer escaping to an ideal future. It does not work. Running to the future is the pattern of your misery.

Transhumanism is the intellectual purification of human misery, not the way out of it.

Pär Segerdahl

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Genetic risk information: lines and stage directions

April 23, 2019

Pär SegerdahlOutside of their practical contexts, simple messages quickly lose their meaning. Recall what it is like to find an old Post-it Note: “Don’t forget the disk!” – What disk? The risk is great that we invent a context. Incomprehensible messages awaken our imagination.

Similarly, messages about genetic risk need practical contexts that make the information meaningful and prevent nightmarish imaginations. The information needs to become part of a larger drama. Otherwise, we begin to fantasize: “Greatly increased risk of breast cancer.” – What do they mean, “greatly increased”? What do they mean, “breast cancer”? What do they mean, “risk”?

The difficulty of understanding and benefitting from genetic risk information is probably partly due to lack of context. The potential for generating risk information is growing rapidly. All this information is waiting for its dramas: contexts where people can ask concrete questions and get practical advice. Educational methods for explaining percentages cannot replace the loss of context. People who get genetic risk information need to know more about the disease they are at risk of developing. They may want to know if they should notify the employer of the risk. They may want to know if something can be done to reduce the risk. They may want to know what it is like to live with the disease, or with the risk of getting it. How is the family affected? Can you work having the disease? Should one worry or is it reasonable to hope that one will not get the disease? And so on.

In short, well-functioning genetic risk information has two dimensions. First, an individual dimension: “You have a greatly increased risk of…” Secondly, a general dimension: Practical instructions on a wide variety of issues that people need to know more about, and about which they otherwise begin to fantasize.

To speak the language of the theater: The individual dimension (the simple risk message) is the lines. The general dimension is the stage directions. Genetic risk information consists of both lines and stage directions.

When we discuss whether genetic risk information empowers people to influence their future health or just worries them, when we discuss the difficulty of understanding risk information, we should be clearly aware of these two dimensions of the information. Are we discussing the lines or the stage directions? Or are we discussing the lines together with the stage directions?

Which dimension of genetic risk information is most relevant to the individual? Perhaps the lines are merely a reason for moving on to the stage directions. The dramatic risk lines may speak mainly to the healthcare staff, while the individual above all needs the stage directions.

One could not work at a theater without distinguishing between lines and stage directions. Perhaps something similar applies to genetic risk information.

Pär Segerdahl

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Sometimes you do not want to be taken seriously

April 1, 2019

Pär SegerdahlWhat does taking something seriously mean? Seriously, I do not think there is a given answer. A common view, however, is that serious questions must have given answers: definitive either/or answers. Without either/or answers, truth seeking degenerates into irresponsible chattering. Embryo destruction is either murder or not murder (banging one’s fist on the table). Embryo research is either permissible or not permissible (banging one’s fist on the table).

Seriousness is polarized, one could say. If I were to take polarized seriousness seriously, which seems reasonable since nothing could be more serious than seriousness itself, I would have to ask: Is seriousness polarized or not? Either it is polarized or it is not polarized! I say this resolutely, banging my fist on the table. However, the question itself is polarized. My resolution and categorical banging suddenly appear comically embarrassing. My gestures seem to run ahead of me, answering the question I thought I asked seriously by making them. What happened? Did I reach the limit of seriousness, beyond which I no longer can ask serious questions about seriousness without ending up in self-contradiction?

Perhaps I just reached the limit of small seriousness, where great seriousness can begin. Contradicting myself need not be as bad as it sounds. Perhaps I did not even know I existed until I contradicted myself. My polarized reasoning ran aground. The sunken rock was myself. Self-contradiction allowed self-discovery. For we are not dealing with two contradictory propositions, so that we must seriously investigate which of them is the true proposition and which of them is the false proposition. I was contradicted by how I myself banged my fist on the table and said, resolutely, “either-or.”

Let us be grateful for the self-contradiction. It can open our eyes to another seriousness: the seriousness of self-reflection, where we, as Confucius says, turn around and seek the cause of our failure within ourselves. Thank you, dear self-contradiction. You may be embarrassing, but just for that reason I know that I am alive and not just a propositional machine that easily can be replaced by an online chatbot!

Why do I bring up these remarkable things? Perhaps because it would be tragic if we misunderstood contemplative thinking as superfluous in an empirically founded age. Schopenhauer said something similar: “Pure empiricism is related to thinking as eating is to digestion and assimilation. When empiricism boasts that it alone has, through its discoveries, advanced human knowledge, it is as if the mouth should boast that it alone keeps the body alive.”

Trying seriously to write a blogpost about seriousness, however, is risky. For blogposts are easily circulated as mere opinions. If you were to render the content of this post, you would almost certainly be forced to polarize it as a delimited position that is either true or false. If we followed Schopenhauer’s advice, however, we would give ourselves plenty of time to quietly digest, through thinking, the strange things said in the post. Such peaceful and quiet digestion of thoughts is beyond the capacity of chatterboxes and chatbots.

Do not misunderstand my joking style. It is meant seriously to avoid being taken seriously. The Chinese thinker, Chuang Tzu, did not want to be perceived as a pedant, so he said to his audience, “I’m going to try speaking some reckless words to you and I want you to listen to them recklessly.”

Chuang Tzu was a great thinker who did not want to be taken seriously as a small one.

Pär Segerdahl

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Reality surpasses our concepts

March 20, 2019

Pär SegerdahlAfter thinking for some time about donation of human eggs and embryos to stem cell research, I want to express myself as in the headline. Reality surpasses our concepts of it. This is not as strange as it sounds. For, if our concepts already reflected reality, then no one would need to do research, or to think. Just talking would be sufficient. An endless flood of words could replace all sincere aspirations to understand life and the world.

So what is it about donation to research that makes me want to express myself as in the headline? Everyone knows that blood donation is a gift to patients. This makes blood donation humanly understandable. People want to help fellow human beings in need, even strangers. But what about donation of eggs and embryos to stem cell research? Conceptually, the donation does not go to patients in need, but to researchers. This makes it difficult to understand donation to research. Are we to assume that people feel sorry for researchers and that they therefore want to support them by donating to them? Why do donors support research?

Not only does the concept of “donation to research” make donation difficult to understand from a human point of view. The concept also causes donation to appear suspiciously exploitative. The recipient of the donation is more powerful than the donor is. Moreover, if research results are commercialized, the recipient can make a profit on the work that the donation enables, without the donor receiving any share of it. So not only does literal faith in the concept of “donation to research” make a free will to donate difficult to understand. The donation also looks suspicious. Some argue that we should prevent an increasingly capitalized life science sector from exploiting self-sacrificing donors in this way.

Nevertheless, there are people who freely donate to research. Why? I guess it often is because they use research merely as an intermediary, to be able to give to patients. The patient is equally important in donation to research as in blood donation, although the concept does not reflect this relationship. Let me give an unexpected example of intermediaries.

About one kilogram of bacteria lives in our intestinal tract. Without these bacteria, our bodies would not be able to absorb many of the nutrients in the food we eat. When we swallow the food, these bacteria are in a sense the first diners, and our bodies have to wait patiently until they have finished eating. Even if we know this, we rarely think that we are swallowing food in order to allow bacteria in the stomach to eat first. We eat without being aware of the work that these “intermediaries” in the stomach have to do, in order for the nutrients to become available to the body.

The concept of “eating” does not reflect this relationship between bacteria and us. This is not a shortcoming of the concept. On the contrary, it would be very unpleasant if the concept reflected the bacteria’s work in our guts. Who would then want to say, “Let us sit down and eat”? However, problems arise if we have too much literal faith in concepts. Our vocabulary will then begin to impose limitations on us. Our own language will shrink our otherwise open minds to mental caves, where the words cast shadows on the walls.

Researchers, then, can be seen as intermediaries between donors and patients. I hope I do not upset sensitive minds if I suggest that researchers are the bacteria that we need to make donated material available to future patients’ bodies. That is why people donate to research. They sense, more or less intuitively, that research functions as an intermediary. “Donation to research” is at heart a gift to patients.

It is even more complicated, however, for research alone cannot act as intermediary. The task is too great. For the donation to become a gift to patients, a capitalized life science sector is needed, and a healthcare system, and much else. Moreover, just as the beneficiary function of bacteria in our stomachs requires a diet that regulates the balance between bacteria, this system of intermediaries, extending from donor to patient, needs regulation and monitoring, so that all the actors work harmoniously together. We cannot allow quacks to sell dangerous or inefficient drugs to the sick, and we cannot allow researchers to access donated material in any way they see fit.

Donation to research is a striking example of how reality surpasses our concepts. When we succeed in overcoming our literal faith in concepts – when we discover the way out of the cave and see the light – then donation to research finally becomes humanly understandable. The donor uses research to be able to give to patients. Moreover, donation to research ceases to appear as a suspicious transaction between unequal parties, since the donor uses the relatively powerful direct recipient to give to a more understandable recipient: the patient. Trying to counteract exploitation by paying the donor large sums, or by giving the donor a share of the profit, would tie the donor to the wrong recipient: the one emphasized in the concept.

As mentioned, the donor uses not only research to reach the patient, but a whole system of intermediaries, such as industry, healthcare and governmental control. This system of beneficial societal bacteria is therefore, to some extent, subordinate to the donor’s will to help patients. Or rather, the subordination is an aspect of the relationship, as is bacteria’s subordination to human eating. If we want to, we can always see the opposite aspect as well. Who really eats first and who last? Who really uses whom? The questions lack definitive answers, for the aspects change into one another.

With this post, I wanted to suggest the possibility of a bigger seeing, which we can learn to use wisely in our thinking when we discover how conceptually purified standpoints easily shrink our minds to mental caves.

Pär Segerdahl

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