Doctor Suicides

One unfortunate statistic is the suicide rate for medical doctors: 300-400 per year. Interesting, the ratio between male and female doctors is 1:1 in regards to suicide. In contrast, the ratio in the general population is 4(male):1(female).

To break it down even more, the suicide ration of male doctors to other males is estimated to be 1.4:1. For women, the results vary from study to study, but a commonly cited figure for female doctors to other females is 2.3:1.

One common hypothesis is that the higher suicide rate is due to untreated depression (see ‘Doctors Who Kill Themselves”, by David Noonan, Newsweek April 28 page 16). While male doctors seem to be depressed at the same rate as non-doctors, they tend (as noted above) to commit suicide more often. female doctors have, based on some studies, twice the rate of depression of female non-doctors.

While one would think that doctors would be more likely to seek treatment because of their education, the opposite is true-they tend to avoid treatment. The main reason seems to be that they fear the impact of such a diagnosis: loss of respect, income and perhaps even their medical license. As such, a doctor is more likely to simply try to deal with depression on their own and hence are more likely to commit suicide than those who seek treatment. Doctors also are more likely to succeed in their attempts-their medical knowledge serves them well in this regard.

Another possible factor is one that is not commonly discussed in this context: the fact that doctors tend to have lower empathy. This has recently been supported by studies but has long been known to philosophers and the English. To be specific, in writing on the rights of animals, Immanuel Kant noted that doctors were not allowed to sit on English juries because their hearts had become hardened. This reduced degree of empathy can be harmful for the patients and a greater degree can be beneficial. This, of course, seems obvious: someone who has more empathy will work better with others, be more inclined to truly help others, and also be more effective in getting the patient to cooperate.

In addition to the effects on patients, it also seems likely that having little empathy would also have an effect on the doctors. A person who is lacking in regards to empathy is less likely to be able to establish healthy relationships that can provide the support needed to mitigate or deal with depression. Such a person is probably more likely to feel isolated and hence also more likely to give in to depression. Further, it seems possible that a person who who has less empathy will have less of a “feeling” as to how their suicide can impact others and hence might be more inclined to end his/her own life.

Fortunately, awareness of the problem of doctor empathy in the medical and academic community is growing. If the proper steps are taken, this might also help reduce the number of doctor suicides.

In addition to the general matter of suicide, the above findings are also interesting in terms of gender. To be specific, while male and female doctors kill themselves at the same rate, the same is not true in the general population. This seems to suggest suicide rates are influenced more by factors other than gender, such as profession. The gender difference in the general population could thus be explained by the differences between the jobs that are traditionally male dominated and those that are traditionally female dominated. Another factor worth considering is the empathy factor-perhaps the medical profession does a more thorough job of crushing empathy than other professions. Women, it is often claimed, are more empathetic than men and hence would be affected more by the damping of their empathy. This would help explain why female doctors kill themselves at rate of 2.3 to 1 relative to the general female population. In contrast, the impact is less on males (the ratio is 1.4:1)-perhaps because men are less empathetic or generally have their empathy dampened throughout life.

Wright is Not Alone (Obviously)

The views that Wright has put forth, most specifically his theory about AIDS and his view of 9/11, are not original to him and are actually not uncommon. I have heard AIDS conspiracy theories for years and, of course, governments are not above such things. Smallpox was used intentionally as a biological weapon during the colonial era in North America and, of course, there are the infamous Tuskegee syphilis experiments. Further, numerous biological weapons were developed during the Cold War. I don’t believe that AIDS was intentionally created by the United States, but I must admit that such a scenario is not impossible. I can also see how someone might be inclined to believe in such a claim.

In regards to 9/11, Wright’s view is shared by other preachers. For example, Jerry Falwell and Pat Robertson placed the blame for 9/11 on Americans:

“I really believe that the pagans, and the abortionists, and the feminists, and the gays and the lesbians who are actively trying to make that an alternative lifestyle, the ACLU, People For the American Way, all of them who have tried to secularize America. I point the finger in their face and say ‘you helped this happen.'”

Their discussion on the September 13, 2001 edition of the 700 Club can be read here.

As with the AIDS matter, I think this view is mistaken. But, Wright is not alone in his views in regards to these points.

There is something very appealing to conspiracy theories and hence it is easy to get drawn into them. Further, it is also appealing to want to believe in purpose rather than chance-even if the purpose is a malicious one. Just as people once attributed diseases to the gods, it is tempting to attribute them to human agents (and sometimes this is dead on correct). It is also tempting to believe that suffering is the result of sin-that people have brought harms upon themselves by their misdeeds. This is a common theme in religions.

As such, it is not surprisingly that Wright holds these views and that he is hardly alone in holding them.

There is the question about whether he is correct or not, In regards to AIDS, the best evidence seems to be that it is a naturally occurring disease. Nature certainly brings forth a multitude of horrific ailments and AIDS seems quite at home among them.

In regards to 9/11, it is obvious that past American actions helped motivate the attack. But, there is the further question of whether or not we deserved to be attacked-whether it was our chickens that were coming home or not. A strong case can be made that the United States has acted badly throughout the years and hence deserved to be attacked. However, a good case can also be made that America did not deserve such an attack. In any case, it is certain that those who were murdered that day in September did not deserve to die.

Obama & Wright

While Wright is clearly an impressive and powerful speaker, his recent public speeches have the potential to do impressive and powerful damage to Obama. While Wright was once Obama’s mentor, Obama has been cast into the unfortunate role of having to speak against his friend.

This must be a hard thing for Obama. After a the two men seem to have had an excellent relationship in the past-right up to the point where Wright started becoming a liability to Obama. Naturally, this current situation raises many questions.

One that is no doubt on the minds of many Americans is the truth about Obama’s views. As many conservatives have pointed out, Obama seems to have kept some fairly radical company in the past. Some have suggested that Obama actually shares the views put forth by Wright. As evidence, they point to the fact that he was part of Wright’s church for a long time and even wrote of him as a mentor. His book, Audacity of Hope, drew its title from a Wright sermon. As such, it might be suspected that Obama is only turning against his old friend because he knows he must do so in order to have a chance of being President. After all, most voters would not support a person who believed that AIDS was created by the US Government or that America seems to have brought terror upon itself.

Of course, it is quite possible that Obama’s outrage is genuine and that he honestly disagrees with his former mentor. After all, people do not always agree with their former mentors. Further, Obama claims that Wright has changed-that he is not the same man that he knew 20 years ago. This is also possible. People do change and sometimes change in ways that might be regarded as a change for the worse. Interestingly, many great philosophers went on to endorse some very odd things. For example, George Berkeley espoused the medical value of tar water and Jeremy Bentham advocated the use of preserved corpses as statues (called “Auto Icons”). Most people also know of friends and relatives who take up rather odd views later in life. I am not, of course, suggesting that Wright has gone mad. But, perhaps his views have changed considerably over the years and hence Obama is correct in saying that Wright’s views now are not the ones that he had when they first met.

Sex, Love and Money

Although the Spitzer scandal has dropped off the radar, I was once again led to think about it. Now that the semester is over, I can finally catch up on my neglected reading material. In some cases, this is a bit like having a time machine-by reading out of date publications, I’m transported back to the distant past of a few months ago.

Not surprisingly, men and women often tended to say different things about the Spitzer case and the behavior of the people involved. I noticed that women were often inclined to bring up their view of the differences between the sexes. Mainly, men were stereotyped as lust driven beings who did their thinking with their gonads. Women,in contrast, were presented in a much different light. Lenore Skenazy put it best in “Battle of the Sexes over Sex” (Funny Times May 2008, pages 10-11): “…for women, sex and love are still pretty much linked.”

This seems to be obviously false. First, the Spitzer scandal itself serves to undermine her claim. Spitzer was not having an affair with a woman who was in love with him. He was paying a woman to have sex with him. I assume that is how most prostitutes operate. After all, it is hard to imagine prostitutes taking the time to fall in love with their clients before having sex with them. If any love is involved, it is presumably a love of money. Thus, each time a man is driven by his gonads to have sex with a female prostitute, there is a  woman  involved who is having sex that is presumably not linked to love. So, the man is there because of lust, the woman is there because of money. This is not to say that all women have sex in return for financial gain (either cash on the nightstand or gifts). After all, to think that all women are this way would be just as bad as inferring all men are ruled by mindless lust.

Second, the same issue of Funny Times features a statistic in Harper’s Index (page 21) that noted that 61% of single American women in their 20s are “very” or “extremely” willing to marry for money. The survey in question also indicted that 74% of women in their 30s were willing to marry for money. If women do link sex and love, then presumably they either love money or they would be having sex with someone other than the man they would marry for money. Or perhaps it is love of money that is linked to sex. Then again, perhaps women would prefer to marry for money someone they also happened to love (or could grow to love). Men were, not surprisingly, less interested in marrying for money. Perhaps this is because men are ruled by their gonads rather than their bank accounts, whereas women are apparently the opposite.

The views put forth  do nicely match the stereotypes of the sexes: men are out to have sex, while women are willing to trade sex for financial security/gain. Naturally, people prefer to see their own sex in a positive light, they are happy to regard the other sex in a poor light. Perhaps both are quite right.

Wright’s Speech

Reverend Wright spoke today at the National Press Club in Washington. It was, in many ways, an important event and will probably have some implications for Obama.

Overall, Wright struck me as man who is clearly very intelligent, well educated, and charismatic. He has a sharp and quick wit as evidenced by his handling of the occasionally hostile questions put to him. He is also clearly passionate about his faith and politics. He is also a person who sticks with his views, even in the face of pressure to do otherwise.

Since politicians and the media have been dissecting his speech and firing off replies, my view is that philosophers should join in as well.

The first point of interest is actually psychological: why did Wright chose to make such a speech? Those who ask this question typically do so in the context of Obama’s campaign. They are, most likely, asking why Wright would chose to bring the spotlight back and thus risk harming Obama.

One possibility is that he sincerely wished to respond to the comments in the media. Ethically, it seems quite acceptable for a person to respond in such a situation. After all, if I were in his situation, I would also want to respond to such negative coverage.

A second possibility is that it is a matter of ego. The desire for fame and attention is a powerful force and perhaps this is why he sought the spotlight once again. If doing so hurts Obama, well perhaps that is part of the price of increasing his national fame and his share of the glory. If this is one of his motivations, this is hardly commendable and would seem to be a sign of the sin of pride.

A third possibility is that he is actually taking his revenge against Obama. While Obama was polite in his handling of the Wright incident, he did distance himself from his former pastor and mentor. That sort of treatment no doubt stung Wright and hurt him. The desire to strike back at someone who has wronged is a natural desire. When someone has poked you in the eye, you want to poke that person back in the eye. If someone knocks out your tooth, you would no doubt wish to strike their cheek and break his tooth as well. Forgiveness is a hard thing and revenge can be a sweet dish indeed. Of course, many moral views enjoin us to forgive those who have trespassed against us and to not walk the road of revenge.

A fourth possibility is that, as Wright claimed, he is not just defending himself but the black churches and religious traditions. Black religion in America is, as a matter of fact, is not well known outside of the black community. What is believed about black religion in America is often based on misinformation and ignorance. As such, Wright would be right to try to enlighten people about the rich and powerful history of black religion in America as well as its current role in American society. Such enlightenment would be a good thing and hence Wright would be doing the right thing by undertaking this mission.

There are, of course, various other possibilities. Also, Wright is clearly a complex man and no doubt there were many factors that motivated him.

The second point of interest is the matter of whether the criticism of Wright is actually an attack on black churches.

One on hand, this obviously need not be the case. Most of the criticisms I have seen have not been directed at the black churches but at Wright in particular and what he specifically said. While Wright is an influential person, he does not embody the entirety of the black churches and hence an attack on him need not entail an attack on black churches. To use an analogy, if someone is critical of Geraldine Ferraro for her remarks, it does not follow that they are attacking all Democrats (or all women). An attack can be directed against a person without that attack being intended for a group s/he belongs to.

On the other hand, some of the comments could be taken as being about the style of certain churches and hence could be construed as a general attack. However, these attacks can be distinguished from those that were addressed to Wright himself. It would, obviously, be correct for Wright to address criticisms against the churches that have no real merit. However, as noted above, taking the view that the attacks on him are general attacks on the churches would be a mistake.

The third point is the matter of what effect this will have on Obama’s campaign. On one hand, Obama did an excellent job in his speech on race and this will help shield him from any shrapnel that might by flying from this situation. Further, Obama has shown a skilled hand at damage control and hence can probably step up to the podium once more. On the other hand, Wright stepping into the spotlight once again serves to bring up the matter once more. Since Obama believed he had to respond to the first incident, this shows that Obama regards the Wright situation as a problem. Hence, each time Wright is in the news, the problem is brought up again. Wright has also made statements that could be seen as critical of Obama. This, ironically, might help Obama by widening the gap between them. Then again, this might hurt him by creating a negative impression. Time will tell what effect it will have on Obama.

The fourth point is one that is often overlooked. Wright’s controversial claims are often greeted with criticism and anger, but rarely are they subject to critical analysis. He does say some harsh things. But, the way to respond to such claims in a critical manner is not to simply give vent to one’s emotions. The proper response is to assess their merit. If Wright is saying untrue things, then the easiest way to deal with him is to simply disprove his claims. If he is saying true things, then these truths must be addressed.

Flying Woes

I’m not much for flying. Part of it is that I have a deep an abiding fear of heights (so, naturally, I always try to climb things). Part of it is that I have a deep and abiding annoyance towards being stuck in an airport staring at the monitors and seeing that my flight is still canceled.

Recent times have seen serious problems for airlines. Some have failed. Some are bleeding cash. Some have planes that didn’t quite pass the safety standards. All in all, it looks bad.

One problem is that our air transport system is simply not up to the task. What is needed is a better management system and perhaps more airports. Since air travel is an important social good, it seems acceptable to (as is often done anyway) to use tax dollars to help fix this problem correctly.

Another problem is that airplanes are expensive to operate…and so are CEOs. While the airlines really do need to do some major interior housecleaning, what would help with some of the expenses is a better sort of airplane. Of course, designing a plane with the suitable features would be costly and equipping airlines with them would also be costly.

Perhaps this is a situation that will require a major, national fix. It will, of course, be costly. But, as noted above, air travel is an important part of the economy for both goods and people. Alternatively, we might need to reduce our reliance on jets and find a more economical alternative. While trains have been put forth as an option, they also have their problems-such as putting in rails, stations and such.

I do suspect that this will remain a major issue for quite some time. My hope is that someone will find a way to revolutionize rapid travel once more. Going from trains to planes was a major change. The next change might be back to trains, or something new.

Going Nuclear

As the price of oil surges upward, nuclear power is being given serious thought once more. Naturally, this is met with optimism by some and worry by others.

The main concerns about nuclear power are obvious. First, there is the risk of an accident. In any debate about nuclear power, one merely has to bring up Three Mile Island and Chernobyl in order to score some easy points. While nuclear accidents are rare, they have the potential to be truly catastrophic. Second, there is the matter of the nuclear waste. While recycling can occur in nuclear power (for example, some US reactors are using material from Russian warheads as fuel), nuclear waste is radioactive and this makes it just about the worst possible waste. Not only is radiation from such waste rather harmful, it tends to remain dangerous for centuries. Hence, storing it in a safe manner is of great concern. Third, there is the concern that nuclear material can be used to create weapons-either nuclear bombs or contamination weapons.

All of these concerns are quite legitimate and need to be dealt with effectively. In some cases, they already have. While Russian nuclear power has been a scary thing, Western plants have an excellent safety record. While the nuclear waste is a serious concern, expensive facilities are being constructed and plans are being discussed. Finally, some claim that plants can be secured to reduce the likelihood that they can become the sources of weapons (for the wrong people, of course).

Nuclear power does have some factors in its favor. First, nuclear power is cheaper than many alternative power sources such as wind , gas, and solar. Of course, there is some debate about this. Second, aside from the nuclear waste, nuclear plants are very clean. Of course, that nuclear waste is still a matter of significant concern. Third, unlike solar and wind power, nuclear power is always available. Fourth, nuclear power is domestic power-it can be generated right here in the United States, thus lessening our dependency on foreign sources of energy.

While people tend to have an emotional reaction to nuclear power, we should consider it as a possible option. After all, it does have a great deal in its favor. But, it also has some serious potential problems-as shown by Chernobyl. The effective loss of an entire city tends to create a lasting impression that is hard to erase with facts and figures about the viability and safety of nuclear energy.

But, looked at logically, provided that the waste and safety problems can be dealt with, going nuclear can be an acceptable option. It can even be a green option (and hopefully not a glowing green one).

Boycott the Opening Ceremonies?

One debate that is raging in the media is whether the Western countries should boycott the opening ceremonies for the Olympics.

Those who are pro-boycott argue that China needs to be sent a message in regards to its bad behavior in the world-especially in Tibet. Those who are against the boycott mostly argue such a boycott would actually be harmful.

My own thoughts are divided.

On one hand, the Olympics are based on an ideal: the countries of the world are supposed to set aside their differences, squabbles and battles and come together in the spirit of sport. I rather like this ideal and think that it shows the better part of us. While sport is about competition, it is about competition with honor and respect. It is about coming together in the friendship of sport-that bond forged between athletes who are there to do their very best. While I am not an Olympic grade runner, I have been in competitive sports my entire life. My experience has, in general, matched that ideal. Athletic competition can bring out what is best, noblest and greatest in us.

In serving this ideal, we sometimes have to set aside some legitimate worries and concerns. Yes, China behaves badly. Yes, they should behave better. We should not forget this. But, we should go there to forge the bonds of sport and hope that they can grow beyond the realm of athletic

My optimistic heart feels this way and I want to believe in the ideal.

On the other hand, the modern Olympics has always been a political tool wielded to make this statement or that. To pretend otherwise would, one might say, be the height of naive blindness.

While athletic competition can have noble elements, the reality is that the Olympic competition is about each country trying to establish its status and power by winning medals. To this end, means foul and fair are employed. As such, the ideal served by the Olympics is the ideal of politics-everything is to be milked and exploited to gain advantages.

If boycotting the opening ceremonies can hurt China and help the West politically, than that stick should be poked into the dragon’s eye. If boycotting the ceremonies won’t have that desired effect, then it should not be done.

Going to the ceremonies can help the West in that while it will be granting China status, it will also help to encourage China to move further into the Western circle. After all, one way to get cooperation is to be cooperative and show respect.

But, boycotting the ceremonies can help the West as well. By doing so, a message is sent that China must do what the West wants (to some degree) or the West will not show China respect. Of course, this might serve to have the opposite effect. A snubbed China might decide to simply continue doing what it wants without much concern about what the West thinks.

My pessimistic heart is worried about China and my cynical intellect tells me that the West will have to deal with China sooner or later.

Fortunately, I can run for the sake of running and be free of politics. Sadly, the same cannot be said of the Olympics.

Falling into Chaos

Rwanda, as the world sometimes remembers, was drenched in blood in 1994 as the Hutus slaughtered between 500,000 to a million Tutsis. Somalia, as the world also sometimes remembers, is an ongoing disaster. Many have died there, many have fled and many are eking out an existence in horrible camps. Iraq and Afghanistan are plagued by violence. While these are fairly well known horrors, to those who know history, they are but the latest installments in episodes of chaos and blood that have plagued humanity.

In the case of Somalia, the West (well, the United States) tried to intervene and establish some degree of order. This, as everyone who saw Blackhawk Down knows, did not turn out well. Today, Ethiopian troops are trying to maintain order in the remains of the country. Not surprisingly, they are meeting with little success. The United States seems to lack the desire to go back into that mess and perhaps rightfully so. After all, what sane person wants to risk being murdered and having his corpse dragged through the streets by a cheering crowd of the very people he came to help?

In the case of Rwanda, the West failed to act. With the events of the battle of Mogadishu fresh in the minds of many Americans, the idea of sending Americans to risk death because yet another country was tearing itself to bloody shreds was hardly appealing. Whether the West should have acted is a matter that has been intensely debated.

On one hand, it can be argued that moral decency requires that we (Americans) act to do what is right. Genocide is an obvious evil, so we should have acted. Naturally, if we had done this, some would have shaken their heads at American imperialism and the thought that America was once again trying to play world police.

On the other hand, it can be argued that the people of a country are fundamentally responsible for their own order and that other countries cannot be morally expected to make up for their failures. If the people cannot create a functioning government, it might be the harsh reality that they are getting what they deserve. Further, each people is supposed to have a basic right of autonomy. They should be free to decide their own fate-perhaps even when that fate is chaos, blood and death. Finally, the West has long been criticized for taking the approach that it is the force of order and civilization in the world and thus has the right (or the duty) to act in this manner. Hence, the West should stay out of such matters and let people kill each other if that is what they want to do.

This position does, obviously enough, seem devoid of compassion. After all, it can be argued, the people who tend to suffer the most are the powerless and they cannot be held responsible for the failure of a state in which they had little or no input. To leave them to suffer and die would be an act of moral evil.

This brief discussion does show  two of the basic moral points. The first point is that letting people suffer and die is clearly not morally acceptable. The second point is that people are morally accountable and have a basic right to autonomy. One problem is balancing the two: doing the right thing without violating the principles of autonomy and accountability. There are also the practical problems: just how does one go about rebuilding countries from political and social ruin…and how does one pay for it?

A Step Backwards in Iraq

While almost everyone agrees that Saddam Hussein was a “bad man”, one of the ironies of the Iraq war is that the situation for women is now, in some ways, worse than when he was in power.

Iraq, for all its horrible problems, was a secular state under Saddam Hussein. As such, women were permitted (even encouraged) to attend colleges and to pursue careers. Now, Iraq is more of a collection of fiefdoms than an actual state and the conditions for women vary greatly among the various areas.

In some places, women are still permitted to attend college and to work. In other places, women have been pressured or forced to quit their jobs. In many places, women are encouraged to wear the traditional veil. The law also reflects a gender bias. If a man kills his wife for having an affair or murders his daughter for having sex before marriage, the maximum penalty is three years in jail. If a woman murders her husband for adultery, the she will be charged with murder.

While the United States has expressed the desire to bring democracy and equality to the region, our main goal now is far more modest-to try to establish order and curtail violence. To achieve that end, the United States has started cooperating with the local sheiks and religious leaders. Roughly put, in return for their assistance in maintaining order, the United States is willing to allow them to impose their values.

On one hand, this approach seems to be acceptable. First, it can be justified on utilitarian grounds. If the price of curtailing violence and enhancing order means accepting gender inequality, then it can be argued that this price is worth paying. After all, without such cooperation there would still not be gender equality but there would be more violence. Second, it can also be justified in terms of autonomy-people should be able to decide the nature of their culture and live in accord with that culture. To impose our values upon them would, it might be argued, be a form of cultural imperialism.

On the other hand, this approach seems problematic. First, while it is currently helping with the violence, it must be determined whether the price that will be paid later will be worth the gain acquired now. After all, the West once helped Saddam Hussein in order to achieve the goals of that time. Now the price is being paid for that decision. While our leadership clearly did not give the future if Iraq much thought, this is something that should be carefully considered. We must ask what today’s allies of convenience will be tomorrow.  Second, while cultural autonomy is a good thing in general, it (obviously) rests on the principle that autonomy and freedom of choice are good. Hence, there is a fundamental inconsistency in arguing for the right of a people to have a culture that violates the very principles of autonomy and choice.

While Iraq is not nearly as bad as Afghanistan was (and is), this matter is of serious concern. One of the dangers of radical Islam is that it is a clear enemy of equality and women’s rights. As such, it is a clear enemy of the basic principles the West espouses.  In any case, there is a terrible irony that the United States has played a significant role in transforming Iraq from a secular state to one that is gazing at theocracy.