A blog from the Centre for Research Ethics & Bioethics (CRB)

Tag: philosophy (Page 17 of 19)

Beware of the vanity of “autonomy”

Important words easily become totalitarian. They begin with communicating some humanly important point, so we listen with attention. But then it is as if the words suffered from vanity and assumed that our attention was directed at them; not at what they were used to say.

Over time, the words become like grammatical codes of importance in human life.

A word that underwent such a process in bioethics is autonomy. It was first used to communicate an urgency, namely, that patients and research participants must be respected. They have a right to information about what is about to happen, and to decide whether they want to undergo some treatment or participate in some experiment.

Patients and research participants have this understandable right to autonomy.

But as the word was used to communicate this urgency, the importance seemed to move into the word. If patients have a right to “autonomy,” mustn’t autonomy be a valuable trait that can be supported so that we increase the value?

Is autonomy perhaps even the most valuable aspect of the human: our characteristic when we are in our most rational state as rational animals. Perhaps autonomy is human essence?

From having been a comprehensible right, autonomy assumed the appearance of a super important value to constantly look for, like for a holy grail.

The question arose: Should we restrict people’s freedom to make own choices, if the choices threaten future autonomy?

We occasionally do disrespect people’s choices: for their sake. What I’m blogging about today is the tendency to replace “for their sake” with “for the sake of future autonomy.”

A new article in the Journal of Medicine and Philosophy deals with the question. You find the article by clicking the link below:

The article is written by Manne Sjöstrand, Stefan Eriksson, Niklas Juth and Gert Helgesson. They criticize the idea of a paternalistic policy to restrict people’s freedom in order to support their future autonomy.

The authors choose to argue from the opponent’s point of view. They thus start out from the interpretation of autonomy as super important value, and then try to show that such a policy becomes self-defeating. Future autonomy will be threatened by such a policy, much like the dictatorship of the proletariat never liberated humans but chained them to a totalitarian order.

The article is well-argued and should alert those enchanted by the word “autonomy” to the need of checking their claims.

Even though the article does not disenchant the concept of autonomy through the philosophical humor that I described in a previous post, I was struck by the tragicomedy of claiming that the ultimate reason why healthcare staff should not comply with a patient’s request for help to die is that… assisted death would destroy the patient’s autonomy.

Pär Segerdahl

Minding our language - the Ethics Blog

Disciplined behavior and original sin

This is a follow-up on my earlier post, Questionable questionnaires. In the article that I blogged about, Kevin P. Weinfurt provided two cautions to empirical bioethicists who are using questionnaires. I summarize them:

  1. Egocentrism: the all-too-human self-centeredness of the bioethicist who spent years thinking about particular ethical issues in particular ways, and who designs questionnaires as if these issues basically were real in the same way also for patients, doctors, nurses, research participants, donors…
  2. Literal-mindedness: partly because scholars have disciplined their linguistic habits, they easily overlook the possibility that people do other things with their words than literally describe what they think (e.g., when asked how they consider their chance of benefit from an experimental therapy, they may express hope or loyalty with the care team).

Today I want to highlight this remark in the article:

  • “These cautions are not in themselves new types of methodological missteps, but rather two potential underlying causes of frequently encountered missteps.”

Egocentrism and literal-mindedness are sources of methodological missteps, not further missteps. They are “pernicious habits of mind that plague all of us who are trying to understand patients, physicians, research participants, and others.”

I found this remark interesting, because it puts the emphasis on the researcher as a living person rather than on researcher behavior.

Poor sample selection, invalid inferences and other missteps occur in the behavior of researchers. Methodological rules address missteps on the same behavioral level: do this rather than that, and you’ll enter the secure path of science.

The two cautions are different. They challenge us to work on our habits of mind, on our self-awareness. Merely adopting other behaviors as researchers, which methodology typically aims towards, will not be sufficient if we refuse to face the persistent sources of the missteps within us.

It is no coincidence that the cautions are derived from the work of two philosophers, William James and Ludwig Wittgenstein. Philosophy is a self-searching activity.

I take Weinfurt’s article to be saying that there is no methodologically secured path of science, and certainly not if methodology is understood only in terms of disciplining researcher behavior.

Good and honest scientific work needs to include also exercises of human self-awareness. For researchers will continue to exist as living persons, not only as disciplined performers of more or less correct behaviors.

In a sense, one might say that the two cautions are reminders of original sin.

Pär Segerdahl

We think about bioethics : www.ethicsblog.crb.uu.se

Humorous and comical thinkers

In my philosophical reading experience it is striking that some thinkers crack really good jokes. They are humorous and I laugh with them. Others are comical in their unyielding seriousness: difficult not to make jokes of.

Humor is not exactly what you think of when you think of philosophy. Hardly anyone reads philosophy to get a good laugh, and neither do I. But when philosophizing, joking surprisingly often lies just around the corner.

Those unexpected jokes often pinpoint the really sensitive issues.

Philosophy approaches you with such extreme demands. Demands for absolute certainty; demands for complete universality: demands for vantage points so primordial that they don’t even belong to life, but “precede” all tying of shoelaces and other trivialities that people are busy doing without reflecting.

The need to joke arises under the pressure of these demands.

The contrast between the absolute demands and the life that you nonetheless live becomes comical. You can then either persist in making the demands even more rigorously, becoming a comical thinker, or you can become a humorous thinker who cracks jokes under the pressure of the demands – to return you to life.

In this spirit, Derrida made the following joke of the absolutely certain human vantage point that Descartes thought he found in his cogito ergo sum:

  • “I breathe therefore I am,” as such, does not produce any certainty. By contrast, “I think that I am breathing” is always certain and indubitable, even if I am mistaken. And therefore I can deduce “therefore I am” from “I think that I am breathing.”

“Even if I am mistaken”: even if I am dead. Derrida’s joke opens up Cartesian certainty to doubt. Absolute certainty about my human essence that is compatible with my no longer being alive: how can it be “what I am”!?

Wittgenstein said that he could imagine a serious and good philosophical work that consisted entirely of jokes. I could imagine such a work beginning with Derrida’s joke.

The need to think can be a need to joke!

Pär Segerdahl

The Ethics Blog - Thinking about thinking

What does responsibility mean within a widespread doping culture?

We tend to hold individual athletes responsible for doping behavior. This makes it tempting to assume that if we are to fight doping in sports, we need to more efficiently identify these individuals and impose sanctions on them.

But what if doping is a phenomenon with many ramifications? What if doping isn’t invented by individual athletes, but is a social reality where practices and attitudes are formed also by (and with) other actors, such as leaders, trainers, doctors, sponsors… and through the unreasonable expectations of the audience?

Ashkan Atry recently defended a thesis focusing on the social and cultural dimensions of doping. You find his thesis here:

Without denying that individual athletes have responsibility or that sanctions are needed, Atry questions whether it is responsible to primarily hold individual athletes responsible for doping behavior. He argues that we won’t change the current doping culture if we don’t broaden the scope of responsibility to include also individuals and groups other than the athletes themselves.

The thesis develops a broader and more prospective notion of responsibility, to allow us to identify responsibility more responsibly than we far too easily are tempted to do.

Pär Segerdahl

Approaching future issues - the Ethics Blog

Human existence and biological life: what is most fundamental?

My post last week tried to highlight a tension between human existence and biological life, using Henrietta Lacks as an example. She was a unique human being, existing in a human world; but the HeLa cells obtained from her cancer tumor function in laboratories all over the world as “bio-objects” representing biological life more generally.

This tension between a human world and a laboratory world, between human existence and biological life, could be questioned (as in a comment to the Swedish version of the post): There is no tension, for humans owe their “existence” to the biological processes of life. If cells didn’t organize human brains, there simply would be no “human existence.”

Biological life is fundamental: human existence should bow and scrape to its biological origins.

The tension could be questioned also from a humanistic perspective, however. On this view, the biological perspective is formed by humans. Human existence is the unnoticed condition for the biological notion of life. Once again there is no tension, for the biological notions of “cells” and “brains” owe whatever meaning and function they have to human existence.

Human existence is fundamental: the biological perspective should bow and scrape to its human origins.

Both attempts to reject the tension by determining who should bow humbly backfire. The tension is rejected by each party, but in opposed ways, making the tension surface instead as total intellectual war.

So let’s face the tension instead, and perhaps that’s what the article mentioned last week tried to do.

Pär Segerdahl

The Ethics Blog - Thinking about thinking

Save humanity from the human

We must enhance the human; or else humanity will come to an end. Thus dramatically one could summarize the bioethicist Julian Savulescu’s TEDx-talk in Barcelona in July.

The talk lasts fifteen minutes; you can watch and listen to it yourself: The Need for Moral Enhancement.

The idea is that we urgently need medicine and technology to enhance our moral skills; otherwise we will not be able to handle the global threats that we ourselves created: climate change, nuclear weapons, terrorism, starvation, escalating violence.

Globalization, in short, created a world with dimensions to which our hunter-gatherer morality isn’t adapted. Only a moral pill can save us now.

Listening to the talk, I’m struck by how archaic it sounds, despite references to modern medicine and technology. Thus fire-and-brimstone preachers always made people feel the proximity of the end of the world. Thus fire-and-brimstone preachers always made people feel that the cause of the despicable state of the world is their own moral failure. Thus preachers always forced a new awakening:

  • “You’re on the wrong path; I can show you the way!”

The difference is the use of what could be termed the modern rhetoric of empirical justification, in which all claims must be supported by evidence… that is to say, by PowerPoint slides. The rhetoric seems to direct the use of evidence, however, for evidence pointing in undesired directions isn’t cited.

Neither does Savulescu explore alternative ways of thinking. Has globalization really produced a world so big that we cannot handle it? Couldn’t one just as well claim that globalization created a world so miserably tiny and manageable that one might grieve for the death of all that is great?

In the talk, the most archaic form of moralizing is provided with a modernized rhetorical façade, in order to persuade us that only conversion to a biomedically perfected morality can save us now. It is slightly paradoxical.

No wonder the audience looks dejected.

Pär Segerdahl

The temptation of rhetoric - the ethics blog

Characterizing reality

Reality is on the move, and so are we. Therefore, we are continuously challenged to characterize it, and us, anew. What is it like today? What have we become?

I believe that Nietzsche made such a renewed characterization of reality, or of what we became in the nineteenth century, when he said: God is dead.

How does such a characterization work? Is it a statement of fact? Did Nietzsche go out into the backyard and found God lying dead on the ground, as one can discover a dead bird? Hardly, Nietzsche’s characterization of reality can be contested in a way that the death of a bird cannot.

Is it an ideological position, then, one that Nietzsche invented out of the blue and tried to impose on reality? Hardly, for it is connected with numerous factual features of nineteenth-century life, such as the steam-engine, newspapers, industry, exploration expeditions, science, democracy… I’m not enough of a historian to enumerate them all.

Taking the issue to our own times: Can you imagine a Bach writing music for the glory of God alone… living in a suburban row house area, with the car parked outside, just after shopping in the mall? It is difficult to imagine such a Bach, and Nietzsche’s statement could be said to characterize that difficulty.

If we accept Nietzsche’s statement as a striking characterization of the difficulty of imagining a modern suburban Bach, it appears almost factual. It is what reality is like; what we have become. And yet, someone could contest the characterization, and that reality, and see it as a degenerated frame of mind to resist.

So what do statements of Nietzsche’s kind do? Do they describe reality or do they merely express individual perspectives?

I find the task of characterizing our characterizations of reality as one of the most challenging philosophical problems. Its urgency is obvious in bioethics, which deals with realities that certainly are on the move. New biomedical practices continuously challenge our characterizations of embryos, of stem cells, of health and disease, of research participation…

As I indicated on The Ethics Blog last week, research participation is “on the move,” due to developments in biobanking. It no longer solely means participation in specific studies. It will more and more mean also contributing to biobank infrastructures that are constructed to support future, not yet specified studies.

Is that a fact or a position? I think we need a more nuanced characterization of our continuously renewed characterizations of reality!

Pär Segerdahl

We like real-life ethics : www.ethicsblog.crb.uu.se

Jumping over our own shadow

There are things that an educated human is supposed to know about the world. Like that the Earth is spherical and that it revolves around the sun.

But there are things we are supposed to know also about ourselves. Most prominently, we are supposed to know that we are animals, one of the primate species.

The question I’m pondering is this:

  • Can we have knowledge about ourselves in the same way that we have knowledge about the world?

I have noticed a tendency among those who straightforwardly answer this question in the affirmative. They marvel at the fact that evolution produced a species that understands the evolutionary process that produced that species.

It is as if the world finally bit its own human tail and thereby became closed as a natural world and nothing but that natural world.

And since the bite was achieved by the science that the human species produced, the closure of the world as nothing but a natural world is celebrated also as the closure of science. Science finally knows itself as a product of the world it knows.

Science is the world’s self-knowledge.

I’ve been reading Martin Heidegger, who has a different kind of answer to the question under discussion. His answer is: yes and no, depending who “we” are; for there are two ways of being human.

In one way, human beings are among the living beings that inhabit the world, and they can be scientifically studied as such. Heidegger would hardly reject biological knowledge about life and about human beings as one of the animal species on Earth.

But does biology also reveal a more profound fact, namely, that the world is nothing but a natural world so that all the things we are supposed to know about the world must be reinterpreted as the world’s self-knowledge? – Reinterpreted by whom? By the world? Can the world think? Can it rethink science as its own self-knowledge?

“No one can jump over his own shadow,” Heidegger wrote (in a slightly different context). But that is the weird feat that is celebrated when the world finally is supposed to understand itself.

Heidegger reminds that we are not just one of the living beings on Earth. We are also the beings for whom there is world; for whom there is Earth and sky; and for whom there is science accumulating knowledge about the world. Talking about this nearest way of being human, he emphasizes not closures but openings.

The nearest human is the opening up of a world (with living beings that can be studied scientifically).

The alleged completion of the history of the universe through the world’s self-knowledge is not produced by evolution, or by the science that a product of evolution produced. It is produced by people who forget the simplest and nearest way of being human, and who thus are led to such old-fashioned metaphysical absurdities as “the world’s self-knowledge.”

– And yet, Heidegger’s “nearest” human being can hardly be purified as unaffected by the world, or by what is known about human beings as part of the world.

Heidegger identifies a vital problem, but I believe that the relation between the two ways of being human is messier than in Heidegger’s elegant philosophical poetry.

I do not quite recognize the connections with the world, and with the animals, in Heidegger’s attempt to uncover the authentic way of being human in the age of science.

Who dares a renewed attack on these messy relationships?

Pär Segerdahl

The Ethics Blog - Thinking about thinking

Standing up speaking, sitting down thinking

Intellectual life overflows with regulated forms of discourse about all kinds of urgent matters. Sometimes they are called schools of thought; sometimes theories; sometimes ideologies or positions.

Philosophy could be viewed as the originator of the most prestigious and fundamental discourses about life, like

  • idealism
  • materialism
  • pragmatism
  • existentialism
  • structuralism
  • post-structuralism.

Although this to some extent is historically correct, such a view of philosophy stands in stark contrast to Socrates’ difficulties with speaking and acting publically. His inner voice, his daemon, caused him to hesitate and instead examine himself and his relation to such forms of discourse.

I can imagine Socrates suddenly pausing, torturing himself with questions like

  • why do I want to speak in this way?
  • couldn’t one say the opposite as well?
  • what led me to hold this view?
  • is this merely something I’ve learned to repeat, as a lesson learnt by heart?
  • am I wise, or do I only pretend I am?

My aim here is to draw attention to philosophy as engagement with the latter, self-examining questions. The importance of being sensitive to such questions derives from the fact that intellectual life resembles a marketplace for the former kinds of regulated discourse. Competing schools fight for dominance and accuse each other for neglecting the most decisive aspect of whatever is under discussion.

I want to highlight the importance of somtimes attacking oneself instead; the significance of asking if one is (perhaps) unjust, exaggerating… unwise.

Pursuing the latter questions, we as it were parenthesize our normal obedience to the rules of discourse and examine the extent to which we honestly can abide by them.

– But wouldn’t such questioning of oneself presuppose a discourse of pure self-examination within which the truth finally can be grounded – a discourse that, if it existed, immediately would achieve absolute dominance on the intellectual market?

The marketplace of ideas is attractive. It is the place where we can stand up, speak publically and influence the direction of the world (and achieve reputation). Not surprisingly, philosophers found it difficult to avoid presenting their self-examinations, especially if they found them successful, as being if not truth itself, then at least the right path to truth: as the the discourse that almost guarantees honesty!

To me, these temptations and pitfalls make it all the more important to emphasize the latter list of actually rather simple questions, by which any person can be haunted. Discourse that never is interrupted by pangs of intellectual conscience and consequent self-examinations soon runs amok.

Sometimes, one must sit down and think. Thinking in this sense is not a (silent) form of discourse. But we always compare it with one, and thus we constantly misunderstand philosophy as if it were the purest and most prestigious form of discourse.

Pär Segerdahl

The Ethics Blog - Thinking about thinking

The debate about after-birth abortion continues

Last year the Journal of Medical Ethics published an article by two philosophers claiming that the same arguments that support abortion also support abortion of newborns.

The article provoked strong reactions and I too felt I had to comment on the article here on The Ethics Blog.

What’s so provocative? I’m not so sure it is the conclusion that if we allow abortion we also should allow abortion of newborns. The two philosophers actually never concluded with any practical recommendations. They only wanted to theoretically explore the logic in the arguments for abortion.

And maybe this is what’s so provocative, or rather tragi-comical: the spirit in which one approaches questions of life and death as an entrepreneur might use the annual report to consider his reasons for terminating a project that can become a burden for the company.

Recently, the same journal reissued the article; this time with two editorials and a number of comments by ethicists (here).

The reissuing of the article reaffirms the attitude that the burning hot questions of life and death should be discussed as a rational entrepreneur manages his firm.

Should we allow infanticide? We’ll have to postpone decision until we’ve received the annual report from the neuroscientists on neonates’ capacity for thought.

Pär Segerdahl

We follow debates : The Ethics Blog

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