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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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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“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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The RNC & Gun Free

Posted in Ethics, Law, Philosophy, Politics by Michael LaBossiere on March 30, 2016

The Republican Party is well known for its consistent support of gun rights and opposition to attempts to impose restrictions on these rights. As such, it might strike some as odd that the gun-loving Republicans are holding their national convention in a gun free zone in Cleveland, Ohio. Though the party might seem helpless in the face of the Secret Service (which banned guns from the Republican national convention in 2012), brave patriots have risen in its defense. A petition to allow open carry at the Quicken Loans Arena during the Republican Party’s national convention has been signed by over 50,000 supporters of the Second Amendment.

While some have suggested that the petition is not the work of true gun-loving patriots but by wily Democrat James P. Ryan, it is well grounded in an interesting moral argument. In any case, to dismiss the moral argument because of the identity of the author would be to fall into a classic ad homimen fallacy. After all, the merit of an argument depends on the argument, not the identity of the author.

The argument used to justify the petition is based in the principle of consistent application—this is the principle that standards must be applied the same way in similar circumstances. Exceptions can be justified, but this requires showing that there is a relevant difference between the applications that warrants changing or not applying the standard.

Not being consistent is problematic in at least three ways. One is that the person or group runs the risk of hypocrisy, which is morally problematic. The second is that inconsistent application is unfair, which is morally problematic as well. The third is that such inconsistent application runs the risk of undermining the justification for the standard, thus suggesting that the standard might not be well supported.

The case for the inconsistency of the Republican Party, the NRA and the three remaining Republican candidates is rather effectively made on the petition site. As such, I will present a rather concise summary of the case.

First, the NRA has argued that gun free zones, like where the convention will be held, are essentially advertising the best places for mass shootings. The NRA consistently opposes such zones—or at least it did. Second, Trump, Cruz and Kasich have explicitly opposed gun free zones. Trump and Cruz have both echoed the NRA’s line that gun free zones are bait for mass shooters. Third, there are the stock arguments made by the NRA and pro-gun Republicans that people need guns to defend themselves—that a good guy with a gun is the only one who can stop a bad guy with a gun. As such, for the Republican Party to hold its convention in a gun free zone with Cruz, Trump, Kasich and the NRA agreeing to this would be a clear act of moral inconsistency. Since they all oppose gun free zones (including, in some cases public schools) they should insist that the same standard they wish to apply to everyone else must also be applied to them. That is, guns must be allowed at the convention.

It could be countered that the Republican Party does back private property rights and, as such, they could consistently say that the Quicken Loans Arena owners have the right to ban guns from their property (though they are just laying out irresistible murder bait by doing so). While it is reasonable to accept that private property rights trump gun rights, the obvious counter is to insist that the convention be moved to a private or public venue that allows guns unless Quicken Loans Arena is willing to change its policy for the event.

Another counter is to note that the Secret Service has apparently insisted that guns not be allowed at the event. The Republicans could thus say that they really want to have guns, but the government is violating their rights by forcing them to ban the guns they so dearly and truly love. That is, if it was up to them the convention would be well armed.

The easy and obvious reply is that the Republican Party and candidates could take a principled stand and insist that guns be allowed. After all, their position on the matter of gun free zones is quite clear—the least safe place to be is a gun-free zone. Presumably the Secret Service is concerned that someone might bring a gun to the convention and try to kill Trump, Cruz or Kasich. Since these three men believe that gun free zones would simply attract assassins, they should be able to convince the Secret Service that they would be safer surrounded by armed citizens and, of course, sign whatever waivers or forms would be needed to make this so. If the candidates and the party lack the clout to make the convention gun friendly, surely the gun-friendly Republican majority in Congress could pass legislation allowing guns to be carried at the convention. This, one might suspect, would be a law that Obama would be quite willing to sign.

If the Republicans do not approach this affront to their gun rights with the same will and tenacity they deploy against Obamacare, one might suspect a hypocrisy regarding their position on guns: doing without gun free zones is fine for everyone else; but the Republican establishment wants the protection of gun free zones. This does not, of course, show that they are in error in regards to their avowed position opposing gun free zones—to infer that would be to fall victim to the ad hominem tu quoque (the fallacy that an inconsistency between a person’s claim and her actions shows her claim is wrong). However, it might be suspected that if the Republican establishment is fine with the convention as a gun free zone, then they have some evidence that gun free zones are not, contrary to their professed view, murder bait and are safer than gun zones.

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Body Hacking III: Better than Human

Posted in Ethics, Philosophy, Technology by Michael LaBossiere on March 25, 2016

While most of the current body hacking technology is merely gimmicky and theatrical, it does have potential. It is, for example, easy enough to imagine that the currently very dangerous night-vision eye drops could be made into a safe product, allowing people to hack their eyes for good or nefarious reasons. There is also the model of the cyberpunk future envisioned by such writers as William Gibson and games like Cyberpunk and Shadowrun. In such a future, people might body hack their way to being full cyborgs. In the nearer future, there might be such augmentations as memory backups for the brain, implanted phones, and even subdermal weapons. Such augmenting hacks do raise various moral issues that go beyond the basic ethics of self-modification. Fortunately, these ethical matters can be effectively addressed by the application of existing moral theories and principles.

Since the basic ethics of self-modification were addressed in the previous essay, this essay will focus solely on the ethical issue of augmentation through body hacking. This issue does, of course, stack with the other moral concerns.

In general, there seems to be nothing inherently wrong with the augmentation of the body through technology. The easy way to argue for this is to draw the obvious analogy to external augmentation: starting with sticks and rocks, humans augmented their natural capacities. If this is acceptable, then moving the augmentation under the skin should not open up a new moral world.

The easy and obvious objection is to contend that under the skin is a new moral world—that, for example, a smart phone carried in the pocket is one thing, while a smartphone embedded in the skull is quite another.

This objection does have merit: implanting the technology is morally significant. At the very least, there are the moral concerns about potential health risks. However, this moral concern is about the medical aspects, not about the augmentation and this is the focus of the moral discussion at hand. This is not to say that the health issues are not important—they are actually very important; but fall under another moral issue.

If it is accepted that augmentation is, in general, morally acceptable, there are still legitimate concerns about specific types of augmentation and the context in which they are employed. Fortunately, there is already considerable moral discussion about these categories of augmentation.

One area in which augmentation is of considerable concern is in sports and games. Athletes have long engaged in body hacking—if the use of drugs can be considered body hacking. While those playing games like poker generally do not use enhancing drugs, they have attempted to make use of technology to cheat. While future body hacks might be more dramatic, they would seem to fall under the same principles that govern the use of augmenting substances and equipment in current sports. For example, an implanted device that stores extra blood to be added during the competition would be analogous to existing methods of blood doping. As another example, a poker or chess player might implant a computer that she can use to cheat at the game.

While specific body hacks will need to be addressed by the appropriate governing bodies of sports and games, the basic principle that cheating is morally unacceptable still applies. As such, the ethics of body hacking in sports and games is easy enough to handle in the general—the real challenge will be sorting out which hacks are cheating and which are acceptable. In any case, some interesting scandals can be expected.

The field of academics is also an area of concern. Since students are quite adept at using technology to cheat in school and on standardized tests, it must be expected that there will be efforts to cheat through body hacking. As with cheating in sports and games, the basic ethical framework is well-established: creating in morally unacceptable in such contexts. As with sports and games, the challenge will be sorting out which hacks are considered cheating and which are not. If body hacking becomes mainstream, it can be expected that education and testing will need to change as will what counts as cheating. To use an analogy, calculators are often allowed on tests and thus the future might see implanted computers being allowed for certain tests. Testing of memory might also become pointless—if most people have implanted devices that can store data and link to the internet, memorizing things might cease to be a skill worth testing. This does, however, segue into the usual moral concerns about people losing abilities or becoming weaker due to technology. Since these are general concerns that have applied to everything from the abacus to the automobile, I will not address this issue here.

There is also the broad realm composed of all the other areas of life that do not generally have specific moral rules about cheating through augmentation. These include such areas as business and dating. While there are moral rules about certain forms of cheating, the likely forms of body hacking would not seem to be considered cheating in such areas, though they might be regarded as providing an unfair advantage—especially in cases in which the wealthy classes are able to gain even more advantages over the less well-off classes.

As an example, a company with considerable resources might use body hacking to upgrade its employees so they can be more effective, thus providing a competitive edge over lesser companies.  While it seems likely that certain augmentations will be regarded as unfair enough to require restriction, body hacking would merely change the means and not the underlying game. That is, the well-off always have considerable advantages over the less-well off. Body hacking would just be a new tool to be used in the competition. Hence, existing ethical principles would apply here as well. Or not be applied—as is so often the case when vast sums of money are on the line.

So, while body hacking for augmentation will require some new applications of existing moral theories and principles, it does not make a significant change in the moral landscape. Like almost all changes in technology it will merely provide new ways of doing old things. Like cheating in school or sports. Or life.

 

 

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Body Hacking II: Restoration & Replacement

Posted in Ethics, Philosophy, Technology by Michael LaBossiere on March 23, 2016

While body hacking is sometimes presented as being new and radical, humans have been engaged in the practice (under other names) for quite some time. One of the earliest forms of true body hacking was probably the use of prosthetic parts to replace lost pieces, such as a leg or hand. These hacks were aimed at restoring a degree of functionality, so they were practical hacks.

While most contemporary body hacking seems aimed at gimmickry or rather limited attempts at augmentation, there are some serious applications that involve replacement and restoration. One example of this is the color blind person who is using a skull mounted camera to provide audio clues regarding colors. This hack serves as a replacement to missing components of the eye, albeit in a somewhat odd way.

Medicine is, obviously enough, replete with body hacks ranging from contact lenses to highly functional prosthetic limbs. These technologies and devices provide people with some degree of replacement and restoration for capabilities they lost or never had. While these sort of hacks are typically handled by medical professionals, advances in existing technology and the rise of new technologies will certainly result in more practical hacks aimed not at gimmickry but at restoration and replacement. There will also certainly be considerable efforts aimed at augmentation, but this matter will be addressed in another essay.

Since humans have been body hacking for replacement and restoration for thousands of years, the ethics of this matter are rather well settled. In general, the use of technology for medical reasons of replacement or restoration is morally unproblematic. After all, this process is simply fulfilling the main purpose of medicine: to get a person as close to their normal healthy state as possible. To use a specific example, there really is no morally controversy over the use of prosthetic limbs that are designed to restore functionality. In the case of body hacks, the same general principle would apply: hacks that aim at restoration or replacement are generally morally unproblematic. That said, there are some potential areas of concern.

One area of both moral and practical concern is the risk of body hacking done by non-professionals. That is, amateur or DIY body hacking. The concern is that such hacking could have negative consequences—that is, the hack could turn out to do more harm than good. This might be due to bad design, poor implementation or other causes. For example, a person might endeavor a hack to replace a missing leg and have it fail catastrophically, resulting in a serious injury. This is, of course, not unique to body hacking—this is a general matter of good decision making.

As with health and medicine in general, it is generally preferable to go with a professional rather than an amateur or a DIY endeavor. Also, the possibility of harm makes it a matter of moral concern. That said, there are many people who cannot afford professional care and technology will afford people an ever-growing opportunity to body hack for medical reasons. This sort of self-help can be justified on the grounds that some restoration or replacement is better than none. This assumes that the self-help efforts do not result in worse harm than doing nothing. As such, body hackers and society will need to consider the ethics of the risks of amateur and DIY body hacking. Guidance can be found here in existing medical ethics—such as moral guides for people attempting to practice medicine on themselves and others without proper medical training.

A second area of moral concern is that some people will engage in replacing fully functional parts with body hacks that are equal or inferior to the original (augmentation will be addressed in the next essay). For example, a person might want to remove a finger to replace it with a mechanical finger with a built in USB drive. As another example, a person might want to replace her eye with a camera comparable or inferior to her natural eye.

One clear moral concern is the potential dangers in such hacks—removing a body part can be rather dangerous. One approach would be to weigh the harms and benefits of such hacking. On the face of it, such replacement hacks would seem to be at best neutral—that is, the person will end up with the same capabilities as before. It is also possible, perhaps likely, that the replacement attempt will result in diminished capabilities, thus making the hack wrong because of the harm inflicted. Some body hackers might argue that such hacks have a value beyond the functionality. For example, the value of self-expression or achieving a state of existence that matches one’s conception or vision of self. In such cases, the moral question would be whether or not these factors are worth considering and if they are, how much weight they should be given morally.

There is also the worry that such hacks would be a form of unnecessary self-mutilation and thus at best morally dubious. A counter to this is to argue, as John Stuart Mill did, that people have a right to self-harm, provided that they do not harm others.  That said, arguing that people do not have a right to interfere with self-harm (provided the person is acting freely and rationally) does not entail that self-harm is morally acceptable. It is certainly possible to argue against self-harm on utilitarian grounds and also on the basis of moral obligations to oneself. Arguments from the context of virtue theory would also apply—self harm is certainly contrary to developing one’s excellence as a person.

These approaches could be countered. Utilitarian arguments can be met with utilitarian arguments that offer a different evaluation of the harms and benefits. Arguments based on obligations to oneself can be countered by arguing that there are not such obligations or that the obligations one does have allows from this sort of modification. Argument from virtue theory could be countered by attacking the theory itself or showing how such modifications are consistent with moral excellence.

My own view, which I consistently apply to other areas such as drug use, diet, and exercise, is that people have a moral right to the freedom of self-abuse/harm. This requires that the person is capable of making an informed decision and is not coerced or misled. As such, I hold that a person has every right to DIY body hacking. Since I also accept the principle of harm, I hold that society has a moral right to regulate body hacking of others as other similar practices (such as dentistry) are regulated. This is to prevent harm being inflicted on others. Being fond of virtue theory, I do hold that people should not engage in self-harm, even though they have every right to do so without having their liberty restricted. To use a concrete example, if someone wants to spoon out her eyeball and replace it with a LED light, then she has every right to do so. However, if an untrained person wants to set up shop and scoop eyeballs for replacement with lights, then society has every right to prevent that. I do think that scooping out an eye would be both foolish and morally wrong; which is also how I look at heroin use and smoking tobacco.

 

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Body Hacking I: Aesthetics

Posted in Ethics, Philosophy, Technology by Michael LaBossiere on March 21, 2016

Back in my graduate school days, I made some extra money writing for various science fiction and horror gaming companies. This was in the 1990s, which was the chrome age of cyberpunk: the future was supposed to be hacked, jacked, and bionic. The future is now, but is an age of Tinder, Facebook, and cat videos. But, there is still hope of the cyberpunk future: body hackers are endeavoring to bring some cyberpunk into the world. The current state of the hack is, to be honest, rather disappointing—but, great things arise from lesser things and hope remains for a chromed future.

Body hacking, at this point, is fairly minor. For example, some people have implanted electronics under their skin, such as RFID chips. Of course, my husky also has an implanted chip. As another example, one fellow who is color blind has a skull mounted device that informs him of colors via sounds. As one might imagine, body hacks that can be seen have generated some mockery and hostility. Since I owe cyberpunk for a few crates of ramen noodles and bags of puffed rice, I am obligated to come to the defense of the aesthetics of body hacking.

While some point out that philosophers have not given body hacking the attention it deserves and claim that it is something new and revolutionary, it still falls nicely under established moral systems. As such, body hacking is a new matter for applied ethics—but does not seem to require a new moral system or theory to handle it. This can, of course, be disputed. However, I will address the moral concerns about the aesthetics of body hacking by the simple application of established moral theory.

The aesthetic aspects of body hacking fall under the ethics of lifestyle choices, specifically those regarding choices of personal appearance. This can be shown by drawing easy and obvious analogies to established means of modifying personal appearance. The most obvious modifications are clothing, hairstyles and accessories (such as jewelry). These, like body hacking, have the capacity to shock and offend people—perhaps by what is revealed by the clothing or the message sent by it (including literal messages, such as T-shirts with text and images).  Unlike body hacking, these modifications are on the surface, thus making them somewhat different from true body hacking.

As such, a closer analogy would involve classic cosmetic body modifications. These include hair dye, vanity contact lenses, decorative scars, piercings, and tattoos. In fact, these can be seen as low-tech body hacks—precursors to the technological hacks of today. Body hacks go beyond these classic modifications and range from the absurd (a man growing an “ear” on his arm) to the semi-useful (a person who replaced a missing fingertip with a USB drive). While concerns about body hacking go beyond the aesthetic, body hacks do have the capacity to elicit responses similar to other modifications. For example, tattoos were once regarded as the mark of a lower class person, though they are now general accepted. As another example, in the past men (other than pirates) did not get piercings unless they were willing to face ridicule. Now piercing is passé.

Because the aesthetics of body hacking is analogous to classic appearance hacks, the same ethics applies to these cases. Naturally enough, people do vary considerably in their ethics of appearance. I, as veteran readers surely suspect, favor John Stuart Mill’s approach to the matter of the ethics of lifestyle choices. Mill argues that people have the right to interfere with liberty only to prevent a person from harming others—a rather reasonable standard of interference which he justifies on utilitarian grounds. Mill explicitly addresses the ways of life people chose: “…the principle requires liberty of tastes and pursuits; of framing the plan of our life to suit our own character; of doing as we like, subject to such consequences as may follow; without impediment from our fellow-creatures, so long as what we do does not harm them even though they should think our conduct foolish, perverse, or wrong.”

Mill’s principle nicely handles the ethics of the aesthetics of body hacking (and beyond, but I will get to that in a later essay): body hackers have the moral freedom to hack themselves even though such modifications are regarded as aesthetically perverse, foolish, or wrong. So, just as a person has the moral right to wear clothing that some would regard as too revealing or dye his hair magenta, a person has the moral right to grow a functionless ear on his arm or implant blinking lights under her skin. But, just as a person would not have a right to wear a jacket covered in outward facing needles and razor blades, a person would not have the right to hack herself with an implanted strobe light that flashes randomly into people’s eyes. This is because such things become the legitimate business of others because of the harm they can do.

Mill does note that people are subject to the consequences of their choices—not interfering with someone’s way of life does not require accepting it, embracing it or even working around it. For example, just as a person who elects to have “Goat F@cker” tattooed on his face can expect challenges in getting a job as a bank teller or school teacher, a person who has blinking lights embedded in his hand can expect to encounter some challenges in employment. Interestingly, the future might see discrimination lawsuits on the part of body hackers, analogous to past lawsuits for other forms of discrimination. It can also be expected that social consequences will change for body hacking, just as it occurred with tattoos and yoga pants.

One final point is the stock concern about the possible harms of offensive appearances. That is, that other people do have a legitimate interest in the appearance of others because their appearance might harm them by offending them. While this is worth considering, there does not seem to be a compelling reason to accept that mere offensiveness causes sufficient harm to warrant restrictions on appearance. What would be needed would be evidence of actual harm to others that arises because the appearance inflicts the harm rather than the alleged harm arising because of how the offended person feels about the appearance. To use an analogy, while someone who hates guns has the right not to be shot, he does not have the right to insist that he never see guns or images of guns.

The discussion has shown that body hacking that does not inflict harm to others falls nicely under the liberty to choose a way of life, provided that the way of life does not inflict harm on others. But, as always, a person who strays too far from the norm has to be aware of possible consequences. Especially when it comes to dating and employment.

 

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Trump, Violence & Protests

Posted in Ethics, Philosophy by Michael LaBossiere on March 14, 2016

Donald Trump has a talent for bringing out strong emotions in people, thus it is that some protest his rallies dressed as penises and other folks punch protestors and reporters. While Trump’s ideas have little or no philosophical merit, the situations arising at his rallies do raise interesting philosophical concerns about violence and protesting.

Some of Trump’s rallies have been marked by violence, including alleged attacks on protestors and even members of the conservative press. While Trump often seems to praise and encourage violence against protestors and even the media, the official line is that protestors should be handled by law enforcement and not attacked by Trump supporters. This official line is the correct moral line—the use of violence against non-violent protestors is not warranted, even if they are insulting, disruptive or annoying. The justification for this position is easy enough. While a political rally can be a place of heightened emotions, being a supporter of a candidate does not grant a person a special status that allows them to inflict violence on a protestor. The moral relation between the people is the same as it would be anywhere and just as merely being disruptive or even insulting does not warrant physical assault anywhere else, it does not warrant it at a political rally. This applies whether the rally is for Democrats or Republicans and regardless of the ideology of the protestor.

While there are certainly those who think that protestors (or reporters) they dislike should be punched in the mouth, such punching is not warranted in civil society. After all, while self-defense can be used justly against unwarranted physical attacks, one cannot justly claim that physical violence is warranted as defense against a protest, even if it is annoying, insulting or disrupting. This is because, to borrow from John Locke’s justification of self-defense, such protesting does not put one at risk in regards to life, liberty or property.

Naturally, a person has every right to counter protestors with words—to argue against them and perhaps even to respond to their shouts and taunts with shouts and taunts. That said, it is worth considering the possibility of fighting words—an insult so provocative that a person is warranted in responding with physical violence. This could be justified on the grounds that such an attack inflicts emotional harm that warrants a response with physical harm. This could be developed, perhaps, by considering the harms that alleged to be inflicted by hate speech. If it is accepted that words, images and such can do real harm, then there would seem to be a potential avenue leading to justifying a physical defense against a verbal offense.

The counter to this is that words, images and such are just that—they are not physical attacks and no matter how vile or provocative they are, they cannot do real harm. Or, they cannot do enough or the right sort of harm to warrant a physical defense.

It might be pointed out that harmful words and images do seem to warrant a physical response. For example, threats and non-physical bullying can be regarded as crimes that warrant action be taken against the offender. This point leads quite nicely to my next point of discussion, which is the right of Trump and any other candidate to be able to freely conduct their events and employ law enforcement to keep protestors from disrupting these events.

An immediate objection to even such a suggestion is that protestors have a right to free expression—they have every right to protest even at a private rally. This does have considerable appeal and I certainly agree that there is a right of protest that falls under a broader right of expression. It is, in fact, my support of free expression that causes me to support the seemingly ironic position that Trump and other candidates have the right to have disruptive and insulting protestors removed from private rallies by law enforcement. This is on the condition that the protestor is actually disrupting the event to a degree that it meaningfully interferes with the free expression of the candidate (or other speaker).

The reason, which is rather obvious, is that sufficiently disruptive protestors are infringing on the free speech of the candidate—they are endeavoring to drown out her voice with their own, which cannot be justified on free speech grounds. It could, however, be justified on other moral grounds (such as by using a utilitarian approach) but this matter goes way beyond the scope of this short essay. In any case, an appeal to free speech cannot justify protests that interfere with free speech.

In contrast, if a protestor protests in a manner that does not significantly interfere with the candidate’s free expression, even if the act of protest is annoying or even insulting (like wearing a provocative penis hat at a Trump rally), then the protestor’s right of free expression would warrant this expression. There is, of course, the practical matter of sorting out what degree of disruption warrants a removal of a protestor on the grounds he is violating the right of free expression of a candidate or other speaker.

While the right of free expression can be used to justify ejecting protestors, property rights can also be brought into play. If an event is being held on private property and is not open to the general public, then those in charge of the event have the right to control access. Even if the event is open to the public, those in charge have a right (or even responsibility) to act to ensure the integrity of the event. This is the same right that justifies excluding people who do not have tickets from concerts and also justifies movie theaters in removing people who insist on being excessively loud and disruptive. It is also the right that justifies having people removed from a class if they engage in behavior that makes teaching impossible, such as flipping over a desk and screaming at the professor.

This sort of property right is, like all rights, not absolute and moral arguments could be advanced that would justify protests that seem to violate property rights. For example, the terrible consequences of not protesting might warrant the protest as might the evil of what is being protested.

In light of the above discussion, Trump has the right to free expression; but protestors who do not violate this right also have the right to protest without fear of violence.

 

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