A Philosopher's Blog

A Patient’s Right to Know

Posted in Ethics, Medicine/Health, Philosophy by Michael LaBossiere on April 29, 2016

English: Livingston, TX, 9/25/05 -- A doctor t...

All professions have their problem members and the field of medicine is no exception. Fortunately, the percentage of bad doctor is rather low—but this small percentage can do considerable harm. After all, when your professor is incompetent, you might not learn as much as you should. If your doctor is incompetent, she could kill you.

The May, 2016 issue of Consumer Reports includes a detailed article by Rachel Rabkin Peachman covering the subject of bad doctors and the difficulty patients face in learning whether a physician is a good doctor or a disaster.

Based on the research in the article, there are three main problems. The first is that there are bad doctors. The article presents numerous examples to add color to the dry statistics and this include such tales of terror as doctors molesting patients, doctors removing healthy body parts, and patient deaths due to negligence, impairment or incompetence. These are obvious all moral and professional failings on part of the doctors and they should clearly not be engaged in such misdeeds.

The second is that, according to Peachman, the disciplinary actions taken by the profession tend to be rather less than ideal. While doctors should enjoy the protection of a due process, the hurdles are, perhaps, too high. There is also the problem that the responses to the misdeeds are often very mild. For example, a doctor whose negligence has resulted in the death of patients can be allowed to keep practicing with only minor limitations. As another example, a doctor who has engaged in sexual misconduct might continue practicing after a class or two on ethics and with the requirement that someone else be present when he is seeing patients. In addition to the practical concerns about this, there is also the moral concern that the disciplinary boards are failing to protect patients.

One possible argument against harsher punishments is that there is a shortage of doctors and taking a doctor out of practice would have worse consequences than allowing a bad doctor to keep practicing. This would be the basis for a utilitarian argument for continuing mild punishments. Crudely put, it is better to have a doctor who might kill a patient or two than no doctor at all.

This argument does have some appeal. However, there is the factual question of whether or not the mild punishments do more good than harm. If they do, then one would need to accept that this approach is morally tolerable. If not, then the argument would fail. There is also the response that consequences are not what matters—people should be reprimanded based on their misdeeds and not based on some calculation of utility. This also has some intuitive appeal.

It could also be argued that it should be left to patients to judge if they want to take the risk. If a doctor is known for sexual misdeeds with female patients but is fine with male patients, then a man who has few or no other options might decide that the doctor is his best choice. This leads to the third problem.

The third problem is that it is very difficult for patients to learn about bad doctors. While there is a National Practitioner Data Bank (NPDB), it is off limits to patients and is limited to people in law enforcement, hospital administration, insurance and a few other groups.

The main argument advanced against allowing public access to the NPDB is based on the premise that it contains inaccurate information which could be harmful to innocent doctors. Interestingly enough, this makes it similar to the credit report data—it is notorious for containing harmful inaccuracies that can plague people.

While the possibility of incorrect data is a matter of concern, that premise best supports the conclusion that the NPDB should be reviewed regularly to ensure that the information is accurate. While perfect accuracy is not possible, it would seem to be well within the realm of possibility for the information to meet a reasonable standard of accuracy. This could be aided by providing robust tools for doctors to inform those running the NPDB of errors and to inform doctors about the content of their files. As such, the error argument is easily defeated.

Patients do have some access to data about doctors, but there are many barriers in place. In some cases, there is a financial cost to access data. In almost all cases, the patient will need to grind through lengthy documents and penetrate the code of legalize. There is also the fact that this data is often incomplete and inaccurate.  While it could be argued that a responsible patient would expend the resources needed to research a doctor, this seems to be an unreasonable request—a patient should not need to do all this just to know that the doctor is competent. A reason for this is that a patient might be in rough shape and expecting her to engage in all this work would seem unfair. There is also the fact that one legitimate role of the state is to protect citizens from harm and having a clear means of identifying bad doctors would seem to fall within this.

Given the above, it seems reasonable to accept that a patient has the right to know about her doctor’s competence and should have an easy means of acquiring accurate information. This enables a patient to make an informed choice about her physician without facing an undue burden. This will also help the profession—good doctors will attract more patients and bad doctors will have a greater incentive to improve their practice.


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Modern Philosophy

Posted in Philosophy by Michael LaBossiere on April 22, 2016

Portrait of René Descartes, dubbed the "F...

Here is a (mostly) complete course in Modern Philosophy.

Notes & Readings

Modern Readings SP 2014

Modern Notes SP 2014

Modern Philosophy Part One (Hobbes & Descartes)

#1 This is the unedited video from the 1/7/2016 Modern class. It covers the syllabus and some of the historical background for the Modern era.

#2 This is the unedited video from the 1/12/2016 Modern philosophy class. It concludes the background for the modern era and the start of argument basics.

#3 This is the unedited video from the 1/14/2016 modern philosophy class. It covers the analogical argument, the argument by example, the argument from authority, appeal to intuition, and the background for Thomas Hobbes.

#4 This is the unedited video from the 1/19/2016 Modern Philosophy class. It covers Thomas Hobbes.

#5 This is the unedited video from the 1/21/2016 Modern Philosophy. It covers Descartes’ first meditation as well as the paper for the class

#6 This is the unedited video from the 1/26/2016 Modern class. In covers Descartes’ Meditations II & III.

#7 This is the unedited video from the 1/28/2016 Modern Philosophy course. It covers Descartes’ Meditations 4-6 and more about Descartes.

Modern Philosophy Part Two (Spinoza & Leibniz)

#8 This is the unedited video from the 2/2/2016 Modern Philosophy class. It covers the start of Spinoza’s philosophy. It could not be otherwise.

#9 No Video

#10 This is the unedited video from the 2/9/2016 Modern Philosophy class. It covers Spinoza.

#11 This is the unedited video from the 2/11/2016 Modern Philosophy class. It covers the end of Spinoza and the start of Leibniz.

#12 This is the unedited video from the 2/16/2016 Modern philosophy class. It covers Leibniz.

#13  This is the unedited video from the 2/18/2016 Modern philosophy class. It covers Leibniz addressing the problem of evil and the start of monads.

#14 This is the unedited video from the 2/23/2016 Modern philosophy class. It covers Leibniz’s monads, pre-established harmony and the city of God.

#15 This is the unedited video from the 2/25/2016 Modern philosophy class. It covers the end of Leibniz and the start of the background for the Enlightenment.

Modern Philosophy Part Three (Locke & Berkeley)

#16 This is the unedited video from the 3/1/2016 Modern Philosophy Class. It finishes the enlightenment background and the start of John Locke.

#17 This is the unedited video from the 3/3/2016 Modern Philosophy class. It covers John Locke’s epistemology.

#18 This is the unedited video from the 3/15/2016 Modern Philosophy class. It includes a recap of Locke’s reply to skepticism and the start of his theory of personal identity.

#19 No Video

#20 This is the unedited video from the 3/22/2016 Modern Philosophy class. It covers Locke’s political philosophy.

#21 This is the unedited video from the 3/29/2016 Modern Philosophy class. It covers the first part of George Berkeley’s immaterialism.

#22 This unedited video is from the 3/31/2016 Modern Philosophy class. It covers the final part of Berkeley, including his arguments for God as well as the classic problems with his theory.

Modern Philosophy Part Four (Hume & Kant)

#23 This is the unedited video from the 4/5/2016 Modern Philosophy class. It covers the introduction to David Hume and his theory of necessary connections.

#24 This is the unedited video from the 4/7/2016 Modern philosophy class. It covers Hume’s skepticism regarding the senses.

#25 This is the unedited video from the 4/12/2016 Modern Philosophy class. It covers David Hume’s theory of personal identity, ethical theory and theory of religion.

#26 This is the unedited video from the 4/19/2016 Modern Philosophy class. It covers Kant’s philosophy.

#27 This is the unedited video from the 4/19/2016 Modern class. It covers Kant’s epistemology and metaphysics.

#28 This is the unedited video from the 4/21/2016 Modern Philosophy class. It covers Kant’s antinomies, God, and the categorical imperative


A Philosopher’s Blog 2015 Available on Amazon

Posted in Philosophy by Michael LaBossiere on April 15, 2016

A-Philosopher's-Blog-2015-CoverThis book contains essays from the 2015 postings of A Philosopher’s Blog. The topics covered range from robotic assassins to the ethics of performance based university funding. Side adventures include the ethics of “bathroom bills” and technological immortality.

Available on Amazon in Kindle format for 99 cents.

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Trump & Abortion

Posted in Ethics, Law, Philosophy, Politics by Michael LaBossiere on April 14, 2016

Abortion is a contentious matter in the United States and politicians must expect to answer questions about their position. As such, Trump should have been prepared when the questions turned to abortion during Chris Matthews interview of him on MSNBC.

While Trump has expressed a pro-choice position in the past, he told Matthews that he was now pro-life. When Matthews inquired about the legal implications of an abortion ban in terms of punishing women, Trump asserted that the “answer is that there has to be some form of punishment, yeah.” Since Trump has routinely been rewarded for talking tough and expressing misogynistic views, he was probably genuinely surprised when he experienced a broad backlash for his remarks—most especially from anti-abortion advocates.

In response to this backlash, Trump’s campaign released a statement saying: “If Congress were to pass legislation making abortion illegal and the federal courts upheld this legislation, or any state were permitted to ban abortion under state and federal law, the doctor or any other person performing this illegal act upon a woman would be held legally responsible, not the woman.”

Interestingly enough, many anti-abortion advocates hold to this view as well (at least in public statements): women should not be punished for getting illegal abortions and the punishment should be limited to the abortion provider.

While some might claim that Trump’s initial position was an expression of misogyny, his inference was certainly justified given the usual approach to illegal actions. If abortion was criminalized and crimes should be punished, then it would follow that a woman who chose to have an abortion should be punished. This is the case with other crimes.

To use an obvious analogy, if Sally hires Jean to kill Jack, then Sally has committed a crime and should be punished for her role in it. A just court would and should punish Sally for her role in this crime. It would be patently absurd for someone to say “If Congress were to pass legislation making murder illegal and the federal courts upheld this legislation, or any state were permitted to ban murder under state and federal law, the assassin or any other person performing this illegal act for a woman would be held legally responsible, not the woman.” As such, if abortion were a crime (which opponents often consider murder), then it follows that the woman should also be punished.

Another analogy is with illegal drugs. If Sally buys illegal cocaine from Jean, then Sally has also committed a crime and should be punished.  It would be ridiculous to say “If Congress were to pass legislation making cocaine illegal and the federal courts upheld this legislation, or any state were permitted to ban cocaine under state and federal law, the drug dealer or any other person performing this illegal act (providing cocaine) for a woman would be held legally responsible, not the woman.” Once again, if abortion were a crime, then the woman should also be punished.

Obviously, the analogies could continue through a multitude of crimes, thus showing that the position advocated by Trump and others is contrary to the usual workings of justice, namely that those participating in a crime are to be punished. That said, there is a way to hold to the position that the woman should not be punished and the abortion provider should.

Holding this position requires asserting that the woman lacks agency in the crime and is thus not responsible. One approach, which is not uncommon, is to argue that women in general lack agency. This sort of view was used to justify, for example, denying women the right to vote and treating them as property.

This approach would be analogous to that taken by some states in regards to child prostitution. Although prostitution is a crime, children lack the agency to consent to sexual relations and are thus not responsible for the crime. Instead, those providing or purchasing the sexual services are responsible for the crime. As such, they should be punished and the children should not.

While some might find this approach appealing, it is obviously problematic. One rather absurd implication is that denying that women have agency would give them this legal status across the board—thus undermining the possibility of fully holding women accountable for crimes they commit. There are, of course, so many other problems with this approach that it has no legitimate appeal.

Another option is to accept that while women have agency, they generally lack such agency when it comes to choosing to have an abortion. Or, rather, women do not truly choose to have abortions—they are coerced, tricked or beguiled into having them. If this were generally true, then the position that women should not be punished for illegal abortions while those performing them should be punished would be reasonable.

To use an analogy, if Jean kidnaped Sally and her daughter, then killed the daughter, Jean would be the criminal and Sally would be a victim. As such, Sally should obviously not be punished. The challenge is, of course, to show that abortion providers generally use coercion to compel women to get abortions against their will. This, however, seems contrary to the facts.

As another analogy, if Jean was able to beguile Sally into believing she was in terrible danger from Jane and only Jean could save her at that moment by killing Jane, then Sally should not be punished for agreeing to this. Likewise, if abortion providers beguile and trick women into having abortions that they would not have had without being under the mesmeric influence of the abortion providers, then women who have illegal abortions should not be punished. What would need to be shown is that abortion providers have such powers to beguile. This also seems unlikely.

It could be claimed that surely there are cases in which women are coerced or beguiled into having abortions against their will. This, I accept, probably does happen. I am also confident that people are also coerced or beguiled into committing other crimes. As with such cases, I would agree that the person who is forced or beguiled into participating in a crime should have any punishment reduced or eliminated based on the degree to which they lacked agency. Obviously enough, those that coerce or beguile people into crimes should be subject to punishment proportional to their contribution to the crime. This all assumes that the crimes are morally worthy of punishment—crime is a matter of law and there can be unjust laws.

Lest anyone be confused about my overall position, I would prefer that there were fewer abortions (as argued in another essay). But, I do accept that abortion is generally morally acceptable under the current social conditions. As such, I oppose banning abortion and certainly oppose punishing abortion providers or women who have abortions. My point is that those who wish to criminalize abortion need to accept that the punishment of women is entailed by this view. As such, the position that abortion is a crime and that abortion providers should be punished while women should not be punished for their role in the “crime” is an inconsistent and untenable position. This, naturally enough, is for cases in which abortion is not the result of coercion or deception.


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North Carolina’s Anti-Antidiscrimination Law

Posted in Ethics, Law, Philosophy by Michael LaBossiere on April 13, 2016

Apparently eager to do some serious damage to North Carolina’s reputation and economy, the state’s Republican controlled legislature passed “the bathroom bill” and the Republican governor signed it immediately. This law seems to have been in response to Charlotte, North Carolina passing a city ordinance extending legal protection for LGBT people and allowing transgender folks to use bathrooms based on their gender identity.

The “bathroom bill” makes it so that local governments cannot pass their own antidiscrimination laws—the state law, which is more restrictive than the Charlotte ordinance, trumps all local laws. The reason it is called the “bathroom bill” is that it has the effect of forbidding transgender people from using the bathroom that matches their gender identity. Instead, they must use the bathroom that matches the sex on their birth certificate. Interestingly enough, the law also precludes any local government from passing its own minimum wage laws—the minimum wage falls under the antidiscrimination law.

While the most plausible explanation for the law is prejudice against people who differ from the heterosexual norm, the proponents of the law obviously cannot make that the public reason for their support. Rather, there are two main reasons presented in defense of the law. The first is that the imposition of state control over local governments was an attempt to rein in “governmental overreach” on the part of Charlotte and other local governments.

There is a certain irony in Republicans passing a law that restricts the liberty of local governments—this is because the importance of local government and assertions about getting big government off the back of the people are stock talking points. However, many Republicans seem to be fine with local government only to the degree that the locals do what they want.

To be fair, there are legitimate issues here about the extent of the authority of local governments and the extent to which the state has the right to impose on local authorities. One approach is practical: having a hodgepodge of inconsistent laws across a state would be difficult for citizens and businesses—there are advantages to uniform, statewide laws. Another approach is a matter of ethics—the restrictions and liberties of laws should be the same across the state based on the principle of fairness. Of course, using a moral foundation for uniformity would require a moral assessment of the laws being imposed: having an unjust law imposed uniformly would be worse than a just law that was imposed in limited locations.

My own view is that antidiscrimination laws should be uniform but also just. As such, I do agree that the state (and federal government) should be setting these laws. But, these laws must be just. In the case of the North Carolina law, my view is that it is unjust because it codifies discrimination while forbidding local authorities from passing just laws. Hence, the state is in the wrong here. I now turn to the second justification for the law.

Proponents of the law contend that they do not support it from prejudice and that it does not discriminate. They claim that the law is needed in order to protect people, especially children, from being assaulted in bathrooms and locker rooms by transgender people.

On the face of it, the law does aim at meeting what I consider a basic justification of a restrictive law: it has the professed intent of protecting people from harm. This is an excellent justification for limiting liberty and is the principle that justifies, for example, forbidding companies from knowingly selling dangerous or defective products.

While the professed intent does matter, the proper assessment of a restrictive law aimed at preventing harm requires considering whether the harm in question justifies the restrictions being imposed.  In the case of the bathroom bill, the easy and obvious answer is that it does not. The reason is that there seems to be an exceptional lack of evidence that transgender people will present a danger to others if they are permitted to use bathrooms based on their gender identity.

While it is certainly not impossible for a transgender person to engage in such an attack, the statistical evidence is that there have been no attacks. There are currently numerous states and many cities that allow people to use facilities based on their gender identity—so there have been many opportunities for such attacks.

The obvious reply is to point to claims that such attacks (or at least sexual misconduct) have occurred, thus refuting the claim that transgender people are not a threat. The counter to this is to point to the fact that such claims tend to be mere urban myths and that the evidence shows that the myth of the transgender bathroom assault is just that, a myth.

It could be countered that while there is currently no evidence that allowing transgender people to use bathrooms based on their gender identity, an attack could happen and this possibility, however remote, justifies the law.

The easy and obvious response to this counter is that basing restrictive laws on the mere possibility that something bad might happen would be absurd. This principle would warrant incredibly restrictive laws across the board and would also warrant violating most, if not all, rights. For example, men might attack women on hiking trails, so trails must be restricted to one gender to avoid the possibility of attack. As another example, a car might be used in vehicular homicide, therefore people should be forbidden from owning cars. Naturally, if it could be shown that transgender people pose a serious risk to the safety of others, then restriction would be justified. However, the threat would need to match the restrictions imposed by the law.

As a final response, a proponent of the law could say that when a case of a transgender person attacking someone in a bathroom is confirmed, that will show the law is justified. The counter to this is to point out that this principle is absurd—if a car ban were proposed, it would not be justified by pointing to a case or even a few cases of vehicular homicide. As noted above, what would be needed is evidence of a threat that warrants the restriction.

In light of the above discussion, the “bathroom bill” fails the basic test of restrictive laws: it imposes restrictions without the justification of preventing a sufficient harm. This should come as no surprise—the law is not about protecting people but about prejudice.


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My Old Husky & Philosophy IV: Moral Decisions

Posted in Ethics, Philosophy by Michael LaBossiere on April 11, 2016

Isis LookingThe saga of Isis, my thirteen-year-old husky, continues. While she faced a crisis, good care and steroids have seen her through the storm of pain and she has returned to her usual self—ready for adventures and judging all lesser creatures.

Having a pet imposes morally accountability upon a person—the life of a pet is quite literally in one’s hands. When I took Isis in to the emergency vet she was in such rough shape that I thought that it might have been time for that hardest of pet decisions—to choose an end to the suffering of a beloved friend. It is my hope that I will not need to make this decision—I hope that when her time comes she will drift away in her sleep with no pain. I am hoping the same for myself. After all, no one wants to face that choice.

While some dismiss philosophy as valueless in real life, I have found my experience as a philosopher incredibly helpful in this matter. As noted above, I am morally responsible for my husky’s well-being. Having studied and taught ethics, I have learned a great deal that helps me frame the choices I have and will face.

When I brought Isis to the emergency vet, I knew that it would be expensive. There are, of course, higher fees for bringing a pet in outside of regular hours and Isis was in the sort of shape that usually indicates a large bill. So, when the vet showed me the proposed bill, I was not surprised that it was just under $600. I am lucky enough to have a decent job and fortunate enough to have made it through the financial folks driving the economy off a cliff a while back. While that was still a large sum of money for me, I could certainly afford it. While very worried about her, I did think about people who are less well off, yet love their pets as much as I love my husky—they could face a terrible choice between medical care for their pet and having the money for some essential bill or expense. Or they might simply not have enough money at all, thus being denied the choice. While there are those who do help out with the care of such pets, I am sure that there are daily tragedies involving those who lack the funds to care for sick or injured pets.

Since there are many systems of ethics, there are many ways to approach the moral decision of costly (in money or time) pet care. The most calculating is, of course, a utilitarian approach: weighing the costs and benefits in order to determine what would create the greatest utility. In my case, I can afford such care and the good for my husky vastly outweighed the cost to me. So, the utilitarian calculation was easy for me.

Others are not so lucky and they will face a difficult choice that requires weighing the well-being of their pet against the cost to them. While it is easy enough to say that a person should always take care of her pet, people can obviously have other moral obligations, such as to their children. In addition to the ethics of making the decision, there is also to moral matter of having a society in which people are forced to make such hard decisions because they simply lack the financial resources to address the challenges they face. While some might say that those who cannot afford pets should not have pets (something that is also often said about children), that also seems to be another evil. While I would not say that people have a right to pets as they have a right to life and liberty, I would accept that a system that generates such poverty would seem to be an unjust system. Naturally, some might still insist that pets are a luxury, like education and basic nutrition.

Another approach is to set aside the cold calculations of utility and make the decision based on an ethics of duty and obligation.  Having a pet is analogous to having a child: the choice creates a set of moral duties and obligations. Part of the foundation of these obligations is that the pet cannot make her own decisions and generally lacks the ability to care for itself. As such, taking an animal as a pet is to accept the role of a decision maker and a caretaker. An analogy can also be drawn to accepting a contract for a job: the job requires certain things and accepting the job entails accepting those requirements. In the case of a pet, there are many obligations and the main one is assuming responsibility for the well-being of the pet. This is why choosing to have a pet is such a serious decision and should not be entered into lightly.

One reason having a pet should not be taken lightly is that the duty to the pet imposes an obligation to make sacrifices for the well-being of the pet. This can include going without sleep, cleaning up messes and making a hard decision about the end of life. There are, of course, limits to all obligations and working out exactly what one owes a pet is a moral challenge. There are certainly some minimal obligations that a person must accept or she should not have a pet—these would include providing for the basic physical and emotional needs of the pet. The moral discussion becomes rather more complicated when the obligations impose greater burdens, such as burdens of time and money.

When Isis was at her low point, she could barely walk. I had to carry her outside and support her while she struggled to do her business. When I picked her up, I would say “up, up and away!” When carrying her, I would say “wooosh” so she would think she was flying. This made us both feel a little better.

She could not stand to eat or drink and had little appetite. So, I had to hold her water bowl up for her so she could drink and make special foods to hand feed her.  I found that she would eat chicken and rice processed into a paste—provided I slathered it with peanut butter and let her lick it from my palm. At night, she would cry with pain and I would be there to comfort her, getting by on a few hours of sleep. Sometimes she would not be able to make it outside, and there would be a mess to clean up.

I did all this for two reasons. The first is, of course, love. The second is duty—I accept that my moral obligation to my husky requires me to do all this for her because she is my dog. If I did not do all this for her, I would be a worse person and, while I can bear cleaning up diarrhea at 3:23 in the morning, I cannot bear being a worse person.

I am certainly no moral saint and I freely admit that this was a difficult (though it obviously pales in comparison with what other people have faced). It did not reach my limits, though I know I (like everyone) have them. Sorting out the ethics of these limits is a significant moral matter. First, there is the moral question of how far one’s obligations go. That is, determining how far you are morally obligated to go. Second, there is the moral question of how far you can go before your obligations are breaking you. After all, each person also has duties to herself that are as important as obligations to others.

In my case, I accepted that my obligations included all that I mentioned above. While doing all this was exhausting me (I was dumping instant coffee mix into protein shakes to get through teaching classes), Isis recovered before my obligations broke me. But, I did have to give serious thought to how long I would be able to sustain this level of care before I could not go on anymore—I am glad I did not have to find out.


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My Old Husky & Philosophy III: Experiments & Studies

Posted in Medicine/Health, Philosophy, Reasoning/Logic by Michael LaBossiere on April 8, 2016

Isis on the GoWhile my husky, Isis, and I have both slowed down since we teamed up in 2004, she is doing remarkably well these days. As I often say, pulling so many years will slow down man and dog. While Isis faced a crisis, most likely due to the wear of time on her spine, the steroids seemed to have addressed the pain and inflammation so that we have resumed our usual adventures. Tail up and bright eyed is the way she is now and the way she should be.

In my previous essay I looked at using causal reasoning on a small sale by applying the methods of difference and agreement. In this essay I will look at thinking critically about experiments and studies.

The gold standard in science is the controlled cause to effect experiment. The objective of this experiment is to determine the effect of a cause. As such, the question is “I wonder what this does?” While the actual conducting of such an experiment can be complicated and difficult, the basic idea is rather simple. The first step is to have a question about a causal agent. For example, it might be wondered what effect steroids have on arthritis in elderly dogs. The second step is to determine the target population, which might already be taken care of in the first step—for example, elderly dogs would be the target population. The third step is to pull a random sample from the target population. This sample needs to be representative (that is, it needs to be like the target population and should ideally be a perfect match in miniature). For example, a sample from the population of elderly dogs would ideally include all breeds of dogs, male dogs, female dogs, and so on for all relevant qualities of dogs. The problem with a biased sample is that the inference drawn from the experiment will be weak because the sample might not be adequately like the general population. The sample also needs to be large enough—a sample that is too small will also fail to adequately support the inference drawn from the experiment.

The fourth step involves splitting the sample into the control group and the experimental group. These groups need to be as similar as possible (and can actually be made of the same individuals). The reason they need to be alike is because in the fifth step the experimenters introduce the cause (such as steroids) to the experimental group and the experiment is run to see what difference this makes between the two groups. The final step is getting the results and determining if the difference is statistically significant. This occurs when the difference between the two groups can be confidently attributed to the presence of the cause (as opposed to chance or other factors). While calculating this properly can be complicated, when assessing an experiment (such as a clinical trial) it is easy enough to compare the number of individuals in the sample to the difference between the experimental and control groups. This handy table from Critical Thinking makes this quite easy and also shows the importance of having a large enough sample.


Number in Experimental Group

(with similarly sized control group)

Approximate Figure That the difference Must Exceed

To Be Statistically Significant

(in percentage points)

10 40
25 27
50 19
100 13
250 8
500 6
1,000 4
1,500 3


Many “clinical trials” mentioned in articles and blog posts have very small samples sizes and this often makes their results meaningless. This table also shows why anecdotal evidence is fallacious: a sample size of one is all but completely useless when it comes to an experiment.

The above table also assumes that the experiment is run correctly: the sample was representative, the control group was adequately matched to the experimental group, the experimenters were not biased, and so on for all the relevant factors. As such, when considering the results of an experiment it is important to consider those factors as well. If, for example, you are reading an article about an herbal supplement for arthritic dogs and it mentions a clinical trial, you would want to check on the sample size, the difference between the two groups and determine whether the experiment was also properly conducted. Without this information, you would need to rely entirely on the credibility of the source. If the source is credible and claims that the experiment was conducted properly, then it would be reasonable to trust the results. If the source’s credibility is in question, then trust should be withheld. Assessing credibility is a matter of determining expertise and the goal is to avoid being a victim of a fallacious appeal to authority. Here is a short checklist for determining whether a person (or source) is an expert or not:


  • The person has sufficient expertise in the subject matter in question.
  • The claim being made by the person is within her area(s) of expertise.
  • There is an adequate degree of agreement among the other experts in the subject in question.
  • The person in question is not significantly biased.
  • The area of expertise is a legitimate area or discipline.
  • The authority in question must be identified.


While the experiment is the gold standard, there are times when it cannot be used. In some cases, this is a matter of ethics: exposing people or animals to something potentially dangerous might be deemed morally unacceptable. In other cases, it is a matter of practicality or necessity. In such cases, studies are used.

One type of study is the non-experimental cause to effect study. This is identical to the cause to effect experiment with one rather critical difference: the experimental group is not exposed to the cause by those running the study. For example, a study might be conducted of dogs who recovered from Lyme disease to see what long term effects it has on them.

The study, as would be expected, runs in the same basic way as the experiment and if there is a statistically significant difference between the two groups (and it has been adequately conducted) then it is reasonable to make the relevant inference about the effect of the cause in question.

While useful, this sort of study is weaker than the experiment. This is because those conducting the study have to take what they get—the experimental group is already exposed to the cause and this can create problems in properly sorting out the effect of the cause in question. As such, while a properly run experiment can still get erroneous results, a properly run study is even more likely to have issues.

A second type of study is the effect to cause study. It differs from the cause to effect experiment and study in that the effect is known but the cause is not. Hence, the goal is to infer an unknown cause from the known effect. It also differs from the experiment in that those conducting the study obviously do not introduce the cause.

This study is conducted by comparing the experimental group and the control group (which are, ideally, as similar as possible) to sort out a likely cause by considering the differences between them. As would be expected, this method is far less reliable than the others since those doing the study are trying to backtrack from an effect to a cause. If considerable time has passed since the suspected cause, this can make the matter even more difficult to sort out. The conducting the study also have to work with the experimental group they happen to get and this can introduce many complications into the study, making a strong inference problematic.

An example of this would be a study of elderly dogs who suffer from paw knuckling (the paw flips over so the dog is walking on the top of the paw) to determine the cause of this effect. As one might suspect, finding the cause would be challenging—there would be a multitude of potential causes in the history of the dogs ranging from injury to disease. It is also quite likely that there are many causes in play here, and this would require sorting out the different causes for this same effect. Because of such factors, the effect to cause study is the weakest of the three and supports the lowest level of confidence in its results even when conducted properly. This explains why it can be so difficult for researchers to determine the causes of many problems that, for example, elderly dogs suffer from.

In the case of Isis, the steroids that she is taking have been well-studied, so it is quite reasonable for me to believe that they are a causal factor in her remarkable recovery. I do not, however, know for sure what caused her knuckling—there are so many potential causes for that effect. However, the important thing is that she is now walking normally about 90% of the time and her tail is back in the air, showing that she is a happy husky.


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Philosophy & My Old Husky II: Difference & Agreement

Posted in Medicine/Health, Philosophy, Reasoning/Logic by Michael LaBossiere on April 6, 2016

Isis in the mulchAs mentioned in my previous essay, Isis (my Siberian husky) fell victim to the ravages of time. Once a fast sprinting and long running blur of fur, she now merely saunters along. Still, lesser beasts fear her (and to a husky, all creatures are lesser beasts) and the sun is warm—so her life is still good.

Faced with the challenge of keeping her healthy and happy, I have relied a great deal on what I learned as a philosopher. As noted in the preceding essay, I learned to avoid falling victim to the post hoc fallacy and the fallacy of anecdotal evidence. In this essay I will focus on two basic, but extremely useful methods of causal reasoning.

One of the most useful tool for causal reasoning is the method of difference. This method was famously developed by the philosopher John Stuart Mill and has been a staple in critical thinking classes since way before my time. The purpose of the method is figuring out the cause of an effect, such as a husky suffering from a knuckling paw (a paw that folds over, so the dog is walking on the top of the foot rather than the bottom). The method can also be used to try to sort out the effect of a suspected cause, such as the efficacy of an herbal supplement in treating canine arthritis.

Fortunately, the method is quite simple. To use it, you need at least two cases: one in which the effect has occurred and one in which it has not. In terms of working out the cause, more cases are better—although more cases of something bad (like arthritis pain) would certainly be undesirable from other standpoints. The two cases can actually involve the same individual at different times—it need not be different individuals (though it also works in those cases as well). For example, when sorting out Isis’ knuckling problem the case in which the effect occurred was when Isis was suffering from knuckling and the case in which it did not was when Isis was not suffering from this problem. I also looked into other cases in which dogs suffered from knuckling issues and when they did not.

The cases in which the effect is present and those in which it is absent are then compared in order to determine the difference between the cases. The goal is to sort out which factor or factors made the difference. When doing this, it is important to keep in mind that it is easy to fall victim to the post hoc fallacy—to conclude without adequate evidence that a difference is a cause because the effect occurred after that difference. Avoiding this mistake requires considering that the “connection” between the suspected cause and the effect might be purely a matter of coincidence. For example, Isis ate some peanut butter the day she started knuckling, but it is unlikely that had any effect—especially since she has been eating peanut butter her whole life. It is also important to consider that an alleged cause might actually be an effect caused by a factor that is also producing the effect one is concerned about. For example, a person might think that a dog’s limping is causing the knuckling, but they might both be effects of a third factor, such as arthritis or nerve damage. You must also keep in mind the possibility of reversed causation—that the alleged cause is actually the effect. For example, a person might think that the limping is causing the knuckling, but it might turn out that the knuckling is the cause of the limping.

In some cases, sorting out the cause can be very easy. For example, if a dog slips and falls, then has trouble walking, then the most likely cause is the fall (but it could still be something else—perhaps the fall and walking trouble were caused by something else). In other cases, sorting out the cause can be very difficult. It might be because there are many possible causal factors. For example, knuckling can be caused by many things (apparently even Lyme disease). It might also be because there are no clear differences (such as when a dog starts limping with no clear preceding event). One useful approach is to do research using reliable sources. Another, which is a good idea with pet problems, is to refer to an expert—such as a vet. Medical tests, for example, are useful for sorting out the difference and finding a likely cause.

The same basic method can also be used in reverse, such as determining the effectiveness of a dietary supplement for treating canine arthritis. For example, when Isis started slowing down and showing signs of some soreness, I started giving her senior dog food, glucosamine and some extra protein. What followed was an improvement in her mobility and the absence of the signs of soreness. While the change might have been a mere coincidence, it is reasonable to consider that one or more of these factors helped her. After all, there is some scientific evidence that diet can have an influence on these things. From a practical standpoint, I decided to keep to this plan since the cost of the extras is low, they have no harmful side effects, and there is some indication that they work. I do consider that I could be wrong. Fortunately, I do have good evidence that the steroids Isis has been prescribed work—she made a remarkable improvement after starting the steroids and there is solid scientific evidence that they are effective at treating pain and inflammation. As such, it is rational to accept that the steroids are the cause of her improvement—though this could also be a coincidence.

The second method is the method of agreement. Like difference, this requires at least two cases. Unlike difference, the effect is present in all the cases. In this method, the cases exhibiting the effect (such as knuckling) are considered in order to find a common thread in all the cases. For example, each incident of knuckling would be examined to determine what they all have in common. The common factor (or factors) that is the most plausible cause of the effect is what should be taken as the likely cause. As with the method of difference, it is important to consider such factors as coincidence so as to avoid falling into a post hoc fallacy.

The method of agreement is most often used to form a hypothesis about a likely cause. The next step is, if possible, to apply the method of difference by comparing similar cases in which the effect did not occur. Roughly put, the approach would be to ask what all the cases have in common, then determine if that common factor is absent in cases in which the effect is also absent. For example, a person investigating knuckling might begin by considering what all the knuckling cases have in common and then see if that common factor is absent in cases in which knuckling did not occur.

One of the main weaknesses of these methods is that they tend to have very small sample sizes—sometimes just one individual, such as my husky. While these methods are quite useful, they can be supplemented by general causal reasoning in the form of experiments and studies—the subject of the next essay in this series.


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Philosophy & My Old Husky I: Post Hoc & Anecdotal Evidence

Posted in Medicine/Health, Philosophy, Reasoning/Logic by Michael LaBossiere on April 4, 2016

dogpark065My Siberian husky, Isis, joined the pack in 2004 at the age of one. It took her a little while to realize that my house was now her house—she set out to chew all that could be chewed, presumably as part of some sort of imperative of destruction. Eventually, she came to realize that she was chewing her stuff—or so I like to say. More likely, joining me on 8-16 mile runs wore the chew out of her.

As the years went by, we both slowed down. Eventually, she could no longer run with me (despite my slower pace) and we went on slower adventures (one does not walk a husky; one goes adventuring with a husky). Despite her advanced age, she remained active—at least until recently. After an adventure, she seemed slow and sore. She cried once in pain, but then seemed to recover. Then she got worse, requiring a trip to the emergency veterinarian (pets seem to know the regular vet hours and seem to prefer their woes to take place on weekends).

The good news was that the x-rays showed no serious damage—just indication of wear and tear of age. She also had some unusual test results, perhaps indicating cancer. Because of her age, the main concern was with her mobility and pain—as long as she could get about and be happy, then that was what mattered. She was prescribed an assortment of medications and a follow up appointment was scheduled with the regular vet. By then, she had gotten worse in some ways—her right foot was “knuckling” over, making walking difficult. This is often a sign of nerve issues. She was prescribed steroids and had to go through a washout period before starting the new medicine. As might be imagined, neither of us got much sleep during this time.

While all stories eventually end, her story is still ongoing—the steroids seemed to have done the trick. She can go on slow adventures and enjoys basking in the sun—watching the birds and squirrels, willing the squirrels to fall from the tree and into her mouth.

While philosophy is often derided as useless, it was actually very helpful to me during this time and I decided to write about this usefulness as both a defense of philosophy and, perhaps, as something useful for others who face similar circumstances with an aging canine.

Isis’ emergency visit was focused on pain management and one drug she was prescribed was Carprofen (more infamously known by the name Rimadyl). Carprofen is an NSAID that is supposed to be safer for canines than those designed for humans (like aspirin) and is commonly used to manage arthritis in elderly dogs. Being a curious and cautious sort, I researched all the medications (having access to professional journals and a Ph.D.  is handy here). As is often the case with medications, I ran across numerous forums which included people’s sad and often angry stories about how Carprofen killed their pets. The typical story involved what one would expect: a dog was prescribed Carprofen and then died or was found to have cancer shortly thereafter. I found such stories worrisome and was concerned—I did not want my dog to be killed by her medicine. But, I also knew that without medication, she would be in terrible pain and unable to move. I wanted to make the right choice for her and knew this would require making a rational decision.

My regular vet decided to go with the steroid option, one that also has the potential for side effects—complete with the usual horror stories on the web. Once again, it was a matter of choosing between the risks of medication and the consequences of doing without. In addition to my research into the medication, I also investigated various other options for treating arthritis and pain in older dogs. She was already on glucosamine (which might be beneficial, but seems to have no serious side effects), but the web poured forth an abundance of options ranging from acupuncture to herbal remedies. I even ran across the claim that copper bracelets could help pain in dogs.

While some of the alternatives had been subject to actual scientific investigation, the majority of the discussions involved a mix of miracle and horror stories. One person might write glowingly about how an herbal product brought his dog back from death’s door while another might claim that after he gave his dog the product, the dog died because of it. Sorting through all these claims, anecdotes and studies turned out to be a fair amount of work. Fortunately, I had numerous philosophical tools that helped a great deal with such cases, specifically of the sort where it is claimed that “I gave my dog X, then he got better/died and X was the cause.” Knowing about two common fallacies is very useful in these cases.

The first is what is known as Post Hoc Ergo Propter Hoc (“after this, therefore because of this”).  This fallacy has the following form:


  1. A occurs before B.
  2. Therefore A is the cause of B.


This fallacy is committed when it is concluded that one event causes another simply because the proposed cause occurred before the proposed effect. More formally, the fallacy involves concluding that A causes or caused B because A occurs before B and there is not sufficient evidence to actually warrant such a claim.

While cause does precede effect (at least in the normal flow of time), proper causal reasoning, as will be discussed in an upcoming essay, involves sorting out whether A occurring before B is just a matter of coincidence or not. In the case of medication involving an old dog, it could entirely be a matter of coincidence that the dog died or was diagnosed with cancer after the medicine was administered. That is, the dog might have died anyway or might have already had cancer. Without a proper investigation, simply assuming that the medication was the cause would be an error. The same holds true for beneficial effects. For example, a dog might go lame after a walk and then recover after being given an herbal supplement for several days. While it would be tempting to attribute the recovery to the herbs, they might have had no effect at all. After all, lameness often goes away on its own or some other factor might have been the cause.

This is not to say that such stories should be rejected out of hand—it is to say that they should be approached with due consideration that the reasoning involved is post hoc. In concrete terms, if you are afraid to give your dog medicine she was prescribed because you heard of cases in which a dog had the medicine and then died, you should investigate more (such as talking to your vet) about whether there really is a risk of death. As another example, if someone praises an herbal supplement because her dog perked up after taking it, then you should see if there is evidence for this claim beyond the post hoc situation.

Fortunately, there has been considerable research into medications and treatments that provide a basis for making a rational choice. When considering such data, it is important not to be lured into rejecting data by the seductive power of the Fallacy of Anecdotal Evidence.

This fallacy is committed when a person draws a conclusion about a population based on an anecdote (a story) about one or a very small number of cases. The fallacy is also committed when someone rejects reasonable statistical data supporting a claim in favor of a single example or small number of examples that go against the claim. The fallacy is considered by some to be a variation on hasty generalization.  It has the following forms:

Form One

  1. Anecdote A is told about a member (or small number of members) of Population P.
  2. Conclusion C is drawn about Population P based on Anecdote A.

For example, a person might hear anecdotes about dogs that died after taking a prescribed medication and infer that the medicine is likely to kill dogs.

Form Two

  1. Reasonable statistical evidence S exists for general claim C.
  2. Anecdote A is presented that is an exception to or goes against general claim C.
  3. Conclusion: General claim C is rejected.

For example, the statistical evidence shows that the claim that glucosamine-chondroitin can treat arthritis is, at best, very weakly supported. But, a person might tell a story about how their aging husky “was like a new dog” after she starting getting a daily dose of the supplement. To accept this as proof that the data is wrong would be to fall for this fallacy. That said, I do give my dog glucosamine-chondroitin because it is cheap, has no serious side effects and might have some benefit. I am fully aware of the data and do not reject it—I am gambling that it might do my husky some good.

The way to avoid becoming a victim of anecdotal evidence is to seek reliable, objective statistical data about the matter in question (a vet should be a good source). This can, I hasten to say, can be quite a challenge when it comes to treatments for pets. In many cases, there are no adequate studies or trials that provide statistical data and all the information available is in the form of anecdotes. One option is, of course, to investigate the anecdotes and try to do your own statistics. So, if the majority of anecdotes indicate something harmful (or something beneficial) then this would be weak evidence for the claim. In any case, it is wise to approach anecdotes with due care—a story is not proof.

“Trump” Terror at Emory

Posted in Ethics, Philosophy, Politics, Universities & Colleges by Michael LaBossiere on April 1, 2016

Donald Trump & Melania enter the Oscar De LA R...

It was the day that fear and pain came to Emory University. No, it was not another horrific campus shooting. This day of terror was inflicted by chalked “Trump 2016” messages. In response, students staged a protest. Comedians, such as Larry Wilmore, mocked. The administration, somewhat amazingly, decided to take no action to find the chalk wielding Trump terrorist.

While this incident can be easily dismissed as yet another case of the absurdly fragile state of the coddled college elite, it does have some philosophical interest that makes it worth considering. I will begin by offering a defense of the pained and frightened students, then move to a discussion of free expression.

While chalked messages are frequently encountered on campuses, there are three ways to argue that the students were legitimately threatened by the Trump chalk marks. One approach would be to argue that Trump’s extreme rhetoric and apparent bigotry make his name something to be feared, such that chalking it on campus is akin to chalking actually threats or hateful remarks.

A possible reply to this is that Trump is not actually bad enough to warrant such a fearful response from the mere writing of his name—that is, the reaction is far too extreme given the level of threat. Another reply is that even if Trump is truly a threatening bigot, the invocation of his name should not suffice as a threat. It is, after all, just his name.

A second approach would be to argue that the chalk marks occurred in a broader context—that the much dreaded hostile environment had been created and in this context “Trump 2016” is a dire threat. This does have a certain appeal since, given the right context, almost any words can present a frightening threat. That said, it would certainly require quite a remarkable context to make an expression of support for the leading Republican candidate to strike legitimate terror into the hearts of grown people.

A third approach would be to argue that the words were written with an intent the threatened students were aware of—that is, “Trump 2016” and similar messages are a known code for actual threats. If this is the case, then the students could be thus justified in their terror and pain. This does, however, create a bit of a problem—what if “Bernie 2016” or “Hillary 2016” become code words for vile threats?

As might be suspected, my own view is that the students were most likely not warranted in their terror and pain. However, if it turns out that there really was a coded threat that the students understood, then I would revise my view. What is, I think, more interesting about this situation is the matter of free expression.

As many folks on the right have noted, there seems to be an ever increasing hostility to free expression on certain “elite” college campuses. There does not seem to be such a problem at many other schools, such as my own Florida A&M University. This might be because the students are rather busy with classes, university activities and working to pay for school. Interestingly, even some people in the liberal spectrum have regarded such things as “trigger warnings” and “free speech zones” as signs of an intolerance on the part of some of the left. These concerns, at least at certain schools, do seem legitimate—as supported by the Trump Terror Chalk Incident of 2016 (as history shall know it).

This episode of terror has not resulted in any change to my view of free expression: people should have complete freedom to express their views, provided that doing so does not inflict actual harm directly or indirectly. Making threats of violence, inciting violence or engaging in harmful slander would be clear examples of expression that should not be protected. What is merely offensive, annoying, or even regarded as vaguely threatening should not be restricted.

One practical concern is sorting out what legitimately counts as harmful expression that should be limited under the classic principle of harm. In this specific case, the problem is deciding whether or not it suffices that the students felt pain and believed they were threatened. On the one hand, one could use an analogy to physical pain: if something hurts, then it did cause pain. So, if chalked Trump support hurts students, then they should be protected from it.  On the other hand, there is the matter of what can reasonably be considered painful and what would be an overreaction. After all, if people could merely claim pain or fear was caused by some expression and shut down free expression, silence would soon reign. Fortunately, good sense can prevail in such cases—supported by arguments, of course. In the case of the Trump chalk marks, this would be on par with someone claiming assault and battery when someone merely brushed past them while walking. Such contact might strike terror into some, but it would be absurd to consider it an attack. Likewise, sensitive students might fear the words “Trump 2016”, but to claim true pain would be an absurd overreaction. The real pain will come when Trump is president.

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