Exactly when does a human being actually come into existence?

February 18, 2020

Pär SegerdahlThe one who prepares the food may announce, “The food is ready now!” when the food is ready. However, when exactly is the food actually ready? When the kitchen timer rings? The potatoes are cooked then. Or when the saucepan is removed from the stove? The cooking ends then. Or when the saucepan is emptied of water? The potatoes are separated from the cooking medium then. Or when the potatoes are carried to the table? The food will be available to the guests around the table then. However, is the food actually available for eating before it is on the plate? Should not each guest say, “The food is ready now,” when the food is on the plate? However, if the food is too hot, is it actually ready? Should not someone around the table say when you no longer burn your tongue, “The food is ready now”?

Yes, exactly when is the food actually ready? You probably notice that the question is treacherous. The very asking, “exactly when, actually?” systematically makes every answer wrong, or not exactly right. The question is based on rejecting the answer. It is based on suggesting another, smarter way to answer. Which is not accepted because an even smarter way to answer is suggested. And so on. Questions that systematically reject the answer are not any questions. They can appear to be profound because no ordinary human answer is accepted. They can appear to be at a high intellectual level, because the questioner seems to demand nothing less than the exact and actual truth. Such extremely curious questions are usually called metaphysical.

However, we hardly experience the question about exactly when the food actually is ready as important and deep. We see the trick. The question is like a stubborn teenager who just discovered how to quibble. However, sometimes these verbally treacherous questions can appear on the agenda and be perceived as important to answer. In bioethics, the question about the beginning of a human being has become such a question. Exactly when does a human being actually come into existence?

Why is this question asked in bioethics? The reason is, of course, that there are ethical and legal limits to what medical researchers are permitted to do with human beings. The question of what counts as a human being then acquires significance. When does a fertilized egg become a human? Immediately? After a number of days? The question will determine what researchers are permitted to do with human embryos. Can they harvest stem cells from embryos and destroy them? There is disagreement about this.

When people disagree, they want to convince each other by debating. The issue of the beginning of a human being has been debated for decades. The problem is that the question is just as treacherous as the question about exactly when the food actually is ready. In addition, the apparent depth and inquisitiveness of the question serves as intellectual allurement. We seem to be able to determine exactly who is actually right. The Holy Grail of all debates!

The crucial moment never comes. The Holy Grail is constantly proving to be an illusion, since the question systematically rejects every answer by proposing an even smarter answer, just like the question about food. The question of the beginning of a human being has now reached such levels of cleverness that it cannot be rendered in ordinary human words. Philosophers earn their living as intellectual advocates who give debating clients strategic advice on metaphysical loopholes that will allow them to avoid the opponent’s latest clever argument. Listen to such metaphysical advice to debaters who want to argue that a human being comes into existence exactly at conception and not a day later:

”Given the twinning argument, the conceptionist then faces a choice between perdurantist conceptionism and exdurantist conceptionism, and we argue that, apart from commitments beyond the metaphysics of embryology, they should prefer the latter over the former.”

Do you feel like reading more? If so, read the article and judge for yourself the depth and seriousness of the question. Personally, I wish for more mature ways to deal with bioethical conflicts than through metaphysical advice to stubborn debaters.

Pär Segerdahl

Efird, D, Holland, S. Stages of life: A new metaphysics of conceptionism. Bioethics. 2019; 33: 529– 535. https://doi.org/10.1111/bioe.12556

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Christmas blog post about contemplation and wide horizons

December 19, 2019

Pär SegerdahlWhat does it mean to be contemplative? In a conversation, the philosopher Ludwig Wittgenstein addresses the issue through a contrast: professional racing motorists. A successful racing driver has one goal in mind: to break the speed record. It is not wrong to have such a well-specified goal. It is required if you want to be a professional racing motorist. However, the attitude encapsulates the mind. Any questions that do not take you closer to the goal become irrelevant. Imagine the driver discussing improvements to the carburetor with the mechanics. How would the atmosphere in the garage change if an inquisitive Socrates suddenly appeared and quietly wondered about the meaning of the sport? Endless questions without the slightest relevance to the adjustments of the carburetor! A racing motorist who wants to be the world champion cannot stop and contemplate different possibilities for human sports competition. Above all, not the possibility of a world where no one tries to break speed records. Who is this crazy fellow? Socrates must leave the garage.

As I said, there is nothing wrong with the racing motorist’s attitude; it is natural and often unavoidable. It has the dynamics of joy (and that of frustration). However, when it becomes too dominant, it restricts something else: the openness to the unknown, the sense of the unexpected. Big questions without given answers are seen as obscure, irrelevant and perhaps even dangerous, as they lack competitive edge and reduce the speed. The carburetor adjustments must be prioritized. Life as a competition must never vanish from sight. It could jeopardize the team spirit and the competitive advantages. If we discussed too many big and thought-provoking issues together as a society, it could even seduce the youth. The new generation loses the momentum that society needs. Young individuals are distracted from identifying with the specific goals that successful careers require. Socrates must leave society.

To think freely, is it nothing but useless folly? Small and large, useful and useless, are two themes that run through one of the great books of Chinese philosophy, Chuang Tzu. The book begins with a story about a huge fish, which soon turns into a huge bird, both so incredibly big that one would like to say that they exceed all dimensions. The huge bird is contrasted with two smaller creatures, a cicada and a dove, who simply cannot understand the big one. The bird almost merges with heaven itself. Can it even be called a bird, when it never flies from bush to bush? The small creatures cannot grasp the great bird. It lacks boundaries, like Socrates’ endless questioning. A related theme in Chuang Tzu is the usefulness of the useless. The book contains several stories of knotty and smelly trees, which, because of their uselessness for human purposes, are left free to grow big. “Everyone knows the usefulness of the useful,” writes Chuang Tzu, “but no one knows the usefulness of the useless.” Who reads Chuang Tzu in today’s China?

Perhaps we can say that Chuang Tzu develops contemplation and self-examination so far, that the self loses its boundaries and becomes one with heaven, just like the big bird. The wisdom that we can hear in Chuang Tzu is open to the infinite. Its boundlessness cannot be defined by teachings, doctrines or theories. It cannot be encapsulated in a philosophy or a religion. “To use what has a boundary to pursue what is limitless is dangerous,” warns Chuang Tzu. Dogmatism is as ancient as the wisdom that opens us to the unknown. In short, the boundless surpasses any doctrine about “the boundless.” If we dare to live with such wide horizons, we may understand voices like this one, “Plunge into the unknown and the endless and find your place there!” Totally useless words, which therefore can be useful in times that only understand the usefulness of the useful.

When philosophies and religions are defined so narrowly that they virtually function as cultural norms or party programs, they inhibit the freedom that was the point of the infinite, which we sought in its uselessness. When the search instead questions everything that restricts the mind, the contemplative endeavor can free the self from its encapsulation: the inner condition of lack of freedom.

Could this enable a humanity where people do not assert their personal interests against others? Without boundaries around the self, there is no one else to outcompete. Is there even an exploitable environment to pollute? We would let the world (and each other) be. However, such unequalled harmony cannot be defined as a goal without once again limiting freedom and making us encapsulated beings such as the cicada and the dove. “The understanding of the small cannot be compared to the understanding of the great.”

Is this happy news or is it just useless folly?

Pär Segerdahl

The Book of Chuang Tzu. (Translated by Martin Palmer.) Penguin Books, 1996

Ludwig Wittgenstein, Rush Rhees, Gabriel Citron, (ed.). 2015. Wittgenstein’s Philosophical Conversations with Rush Rhees (1939–50): From the Notes of Rush Rhees. Mind 124: 1–71.

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Communicating thought provoking research in our common language

December 11, 2019

Pär SegerdahlAfter having been the editor of the Ethics Blog for eight years, I would like to describe the research communication that usually occurs on this blog.

The Ethics Blog wants to avoid the popular scientific style that sometimes occurs in the media, which reports research results on the form, “We have traditionally believed that…, but a recent scientific study shows that…” This is partly because the Ethics Blog is run by a research center in ethics, CRB. Although ethics may involve empirical studies (for example, interviews and surveys), it is not least a matter of thinking. If you, as an ethicist, want to develop new recommendations on informed consent, you must think clearly and thoroughly. However, no matter how rigorously you think, you can never say, “We have traditionally believed that it is ethically important to inform patients about…, but recent philosophical thoughts show that we should avoid doing that.”

Thinking does not provide the authority that empirical research gives. As an ethicist or a philosopher, I cannot report my conclusions as if they were research results. Nor can I invoke “recent thoughts” as evidence. Thoughts give no evidence. Ethicists therefore present their entire thinking on different issues to the critical gaze of readers. They present their conclusions as open suggestions to the reader: “Here is how I honestly think about this issue, can you see it that way too?”

The Ethics Blog therefore avoids merely disseminating research results. Of course, it informs about new findings, but it emphasizes their thought provoking aspects. It chooses to reflect on what is worth thinking about in the research. This allows research communication to work more on equal terms with the reader, since the author and the reader meet in thinking about aspects that make both wonder. Moreover, since each post tries to stand on its own, without invoking intellectual authority (“the ethicists’ most recent thoughts show that…”), the reader can easily question the blogger’s attempts to think independently.

In short: By communicating research in a philosophical spirit, science can meet people on more equal terms than when they are informed about “recent scientific findings.” By focusing on the thought provoking aspects of the research, research communication can avoid a patronizing attitude to the reader. At least that is the ambition of the Ethics Blog.

Another aspect of the research communication at CRB, also beyond the Ethics Blog, is that we want to use our ordinary language as far as possible. Achieving a simple style of writing, however, is not easy! Why are we making this effort, which is almost doomed to fail when it comes to communicating academic research? Why do Anna Holm, Josepine Fernow and I try to communicate research without using strange words?

Of course, we have reflected on our use of language. Not only do we want to reach many different groups: the public, patients and their relatives, healthcare staff, policy makers, researchers, geneticists and more. We also want these groups to understand each other a little better. Our common language accommodates more human agreement than we usually believe.

Moreover, ethics research often highlights the difficulties that different groups have in understanding each other. It can be about patients’ difficulties in understanding genetic risk information, or about geneticists’ difficulties in understanding how patients think about genetic risk. It may be about cancer patients’ difficulties in understanding what it means to participate in clinical trials, or about cancer researchers’ difficulties in understanding how patients think.

If ethics identifies our human difficulties in understanding each other as important ethical problems, then research communication will have a particular responsibility for clarifying things. Otherwise, research communication risks creating more communication difficulties, in addition to those identified by ethics! Ethics itself would become a communication problem. We therefore want to write as clearly and simply as we can, to reach the groups that according to the ethicists often fail to reach each other.

We hope that our communication on thought provoking aspects of ethics research stimulates readers to think for themselves about ethical issues. Everyone can wonder. Non-understanding is actually a source of wisdom, if we dare to admit it.

Pär Segerdahl

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Ethical issues when gene editing approaches humanity

December 2, 2019

Pär SegerdahlGene editing technology, which already is used to develop genetically modified organisms (GMOs), could in the future also be used clinically in humans. One such application could be genetic modification of human embryos, editing genes that would otherwise cause disease.

Of course, the scenario of ​​clinical uses of genetic modification in humans arouses deep concern and heated debate. In addition to questions about efficacy and safety for the people who would be directly affected by the treatments, huge issues are raised about the fate of humanity. When gene editing is performed on germ cells, the changes are passed on to future generations.

What is often overlooked in the debate are ethical questions about the research that would have to precede such clinical applications. In order to develop genetic techniques that are effective and safe for humans, much research is required. One must, for example, test the techniques on human embryos. However, since genetic editing is best done at the time of fertilization (if done on the embryo, not all cells are always modified), a large number of donated gametes are probably required, where the eggs are fertilized in the laboratory to create genetically modified embryos.

Emilia Niemiec and Heidi Carmen Howard, both at CRB, draw attention to these more immediate ethical concerns. They point out that already the research, which precedes clinical applications, must be carefully considered and debated. It raises its own ethical issues.

In a letter to Nature, they highlight the large number of donated eggs that such research is likely to need. Egg donation involves stress and risks for women. Furthermore, the financial compensation they are offered can function as undue incentive for economically disadvantaged women.

Emilia Niemiec and Heidi Carmen Howard write that women who decide on egg donation should be given the opportunity to understand the ethical issues, so that they can make an informed decision and participate in the debate about gene editing. I think they have a good point when they emphasize that many ethical issues are raised already by the research work that would precede clinical applications.

A question I ask myself is how we can communicate with each other about deeply worrying future scenarios. How do we distinguish between image and reality when the anxiety starts a whole chain reaction of frightening images, which seem verified by the anxiety they trigger? How do we cool down this psychological reactivity without quenching the critical mind?

In short, how do we think and talk wisely about urgent future issues?

Pär Segerdahl

Niemiec, E. and Carmen Howard, H. 2019. Include egg donors in CRISPR gene-editing debate. Nature 575: 51

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Honest questions examining our intellectual sinfulness

October 21, 2019

Pär SegerdahlWhy should we hold our philosophical tradition in high esteem? Why should we admire Socrates and other great thinkers? Because they strengthened reason? Because they taught humanity to set emotions aside and instead purify facts and logic?

If that were true, we should admire the philosophers for armoring humanity. For turning us into clever neurotics without contact with our emotional life.

I believe the greatness of these philosophers is more simple, humble and human. They were embarrassingly aware of their own intellectual sinfulness. They had the courage to confess their sins and to examine them closely. They had the courage to know themselves.

That sincere humility, I believe, marks true thinkers from all parts of the world. Just as Socrates, in the middle of a discourse, could hear an inner voice stop him from speaking with intellectual authority on some topic, Lao Tzu saw it as a disease to speak as if we knew what we do not know.

These genuine thinkers hardly spoke with intellectual certainty. At least not in their most creative moments. They probably felt ashamed of the cocksure voice that marks many of our intellectual discussions about prestigious topics. They probably spoke tentatively and reasoned hesitantly.

We are all fallible. Philosophy is, at heart, intense awareness of this human fact. How does such awareness manifest in a thinker? Usually through questions that openly confess that, I know that I do not know. A philosophical inquiry is a long series of confessions. It is a series of sincere questions exposing a deep-rooted will to control intellectually the essence of various matters. The questions become clearer as we come to see more distinctly how this will to power operates in us. When we see how our desire to dictate intellectually what must be true, blinds us to what is true.

Do you and I, as academics, dare to admit our intellectual sinfulness? Do we dare to confess that we do not know? Do we have the courage to speak tentatively and to reason hesitantly?

I believe that we would do a great service to ourselves and to humanity if we more often dared to speak openly in such a voice. However, we are facing a difficulty of the will. For there is an expectation that researchers should master facts and logic. Surely, we are not paid to be ignorant and irrational. Therefore, must we not rather disseminate our knowledge and our expertise?

Of course! However, without awareness of our intellectual sinfulness, which could stop Socrates in the middle of a sentence, we run the risk of contributing to the disease that he treated in himself. We display not only what we happen to know, but also a shiny facade that gives the impression that we control the truth about important matters.

In short, we run the risk of behaving like intellectual Pharisees, exhibiting an always well-polished surface. Below that surface, we wither away, together with the society to which we want to contribute. We lose touch with what truly is alive in us. It succumbs under the pressure of our general doctrines about what must be true. Intellectualism is a devastating form of fact denialism. In its craving for generality, it denies what is closest to us.

Do not armor yourself with rationalism as if truth could be controlled. Instead, do what the greatest thinkers in the history of all of humanity did. Open yourself to what you do not know and explore it in earnest.

You are vaster than your imagined knowledge. Know yourself!

Pär Segerdahl

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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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