Health

In praise of ambivalence—“young” feminism, gender identity, and free speech

By Brian D. Earp (@briandavidearp)

* Note: this article was first published online at Quillette magazine.

Introduction

Alice Dreger, the historian of science, sex researcher, activist, and author of a much-discussed book of last year, has recently called attention to the loss of ambivalence as an acceptable attitude in contemporary politics and beyond. “Once upon a time,” she writes, “we were allowed to feel ambivalent about people. We were allowed to say, ‘I like what they did here, but that bit over there doesn’t thrill me so much.’ Those days are gone. Today the rule is that if someone—a scientist, a writer, a broadcaster, a politician—does one thing we don’t like, they’re dead to us.”

I’m going to suggest that this development leads to another kind of loss: the loss of our ability to work together, or better, learn from each other, despite intense disagreement over certain issues. Whether it’s because our opponent hails from a different political party, or voted differently on a key referendum, or thinks about economics or gun control or immigration or social values—or whatever—in a way we struggle to comprehend, our collective habit of shouting at each other with fingers stuffed in our ears has reached a breaking point.

It’s time to bring ambivalence back. Continue reading

Guest Post: Scientists aren’t always the best people to evaluate the risks of scientific research

Written by Simon Beard, Research Associate at the Center for the Study of Existential Risk, University of Cambridge

How can we study the pathogens that will be responsible for future global pandemics before they have happened? One way is to find likely candidates currently in the wild and genetically engineer them so that they gain the traits that will be necessary for them to cause a global pandemic.

Such ‘Gain of Function’ research that produces ‘Potential Pandemic Pathogens’ (GOF-PPP for short) is highly controversial. Following some initial trails looking at what kinds of mutations were needed to make avian influenza transmissible in ferrets, a moratorium has been imposed on further research whilst the risks and benefits associated with it are investigated. Continue reading

Video Series: Tom Douglas on Asbestos, a Serious Public Health Threat

Asbestos kills more people per year than excessive sun exposure, yet it receives much less attention. Tom Douglas (Oxford Uehiro Centre for Practical Ethics) explains why asbestos is still a serious public health threat and what steps should be undertaken to reduce this threat. And yes, the snow in The Wizard of Oz was asbestos!

Alcohol, pregnancy, experts, and evidence

In the United States, the Centers for Disease Control recently released a new advisory regarding the use of alcohol during or around pregnancy. According to the CDC, any drinking by women ‘who are pregnant or might be pregnant’ constitutes ‘drinking too much.’ The primary reason for the label is the risk of a fetus developing Fetal Alcohol Syndrome, although Sudden Infant Death Syndrome (SIDS) and miscarriage were listed as well. The range of the recommendation is rather wide – the CDC targeted any woman who might be or become pregnant (so, any sexually active woman capable of becoming pregnant). The recommendation has been widely criticized.
 
A number of commentators noted the shaky evidential basis for the advisory. Regarding Fetal Alcohol Syndrome, for example, there is a lot we do not know regarding the amounts of alcohol that are dangerous, and it has been suggested that genetics might play a role in propensity to develop the Syndrome. Regarding SIDS, some evidence suggests the link between alcohol and SIDS is moderated by parents co-sleeping with infants after abusing alcohol – but the advice offered by the CDC did not flag this indirect (potential causal) link.
 
Writing in the LA Times, the philosopher Rebecca Kukla also emphasized the contributions such messages make to creating a culture of shame surrounding women and pregnancy (here). Writing for Time, Darlena Cunha argued that the CDC advice is overly paternalistic, and discriminates against women (here).
 
I do not wish to justify the CDC. I rolled my eyes like many others when I first heard of the recommendations. But here’s a question: why might the CDC release such an advisory? I could imagine someone thinking like this. Well, there should be higher awareness of potential damages of alcohol on a developing fetus. The CDC has the function of alerting the US public to various health risks, and is something of a trusted source as it fulfills this function. But people will not base their decision on the CDC alone. They will be biased in their assessment of evidence, and they may also rely on the first bit of pseudoscience to pop up on Google. So we should come out forcefully, in the hopes that our voice will count for more than a more moderate recommendation might. This way, perhaps we will do more good. (Imagine trying to convince your kids not to run out into the road. You might scare them out of such a behavior by emphasizing the very unlikely but goriest possible outcome.)
 
Of course, I have no idea how the CDC reasoned nor what led to the nature of the advisory they released. What I want to ask is whether institutions we trust to deliver evidence-based advice ought to reason in this way.
Arguably, they should not. We want our experts to be experts, not to be another source of bloviating rhetoric in the public sphere. Evidence-based experts have the credibility they do because they know the evidence. It seems plausible, then, that our experts should fulfill their function in a certain way. They should pay attention to the way their messages are framed. Their messages should be framed in a way that respects people’s autonomy over their own health choices, and that treats decision-makers as reasonable individuals capable of weighing relevant evidence. Doing so would presumably lead to a more moderate message – one that, in this case, emphasized the potential links between alcohol use and fetal alcohol syndrome, that admitted just how much we do not know regarding this question, and that stressed potential reasonable responses to the existing evidence. Importantly, this can be done without overstating the case, without ignoring the nature of the risk (as seems to have happened regarding the alcohol-SIDS link), and without ignoring the amount of risk associated (as seems to have happened regarding the alcohol-Fetal Alcohol Syndrome link).

The unbearable asymmetry of bullshit

By Brian D. Earp (@briandavidearp)

* Note: this article was first published online at Quillette magazine. The official version is forthcoming in the HealthWatch Newsletter; see http://www.healthwatch-uk.org/.

Introduction

Science and medicine have done a lot for the world. Diseases have been eradicated, rockets have been sent to the moon, and convincing, causal explanations have been given for a whole range of formerly inscrutable phenomena. Notwithstanding recent concerns about sloppy research, small sample sizes, and challenges in replicating major findings—concerns I share and which I have written about at length — I still believe that the scientific method is the best available tool for getting at empirical truth. Or to put it a slightly different way (if I may paraphrase Winston Churchill’s famous remark about democracy): it is perhaps the worst tool, except for all the rest.

Scientists are people too

In other words, science is flawed. And scientists are people too. While it is true that most scientists — at least the ones I know and work with — are hell-bent on getting things right, they are not therefore immune from human foibles. If they want to keep their jobs, at least, they must contend with a perverse “publish or perish” incentive structure that tends to reward flashy findings and high-volume “productivity” over painstaking, reliable research. On top of that, they have reputations to defend, egos to protect, and grants to pursue. They get tired. They get overwhelmed. They don’t always check their references, or even read what they cite. They have cognitive and emotional limitations, not to mention biases, like everyone else.

At the same time, as the psychologist Gary Marcus has recently put it, “it is facile to dismiss science itself. The most careful scientists, and the best science journalists, realize that all science is provisional. There will always be things that we haven’t figured out yet, and even some that we get wrong.” But science is not just about conclusions, he argues, which are occasionally (or even frequently) incorrect. Instead, “It’s about a methodology for investigation, which includes, at its core, a relentless drive towards questioning that which came before.” You can both “love science,” he concludes, “and question it.”

I agree with Marcus. In fact, I agree with him so much that I would like to go a step further: if you love science, you had better question it, and question it well, so it can live up to its potential.

And it is with that in mind that I bring up the subject of bullshit.

Continue reading

Mindfulness and morality

Every day, for about thirty-five minutes, I sit cross-legged on a cushion with my eyes shut. I regulate my breath, titrating its speed against numbers in my head; I watch my breath surging and trickling in and out of my chest; I feel the air at the point of entry and exit; I export my mind to a point just beyond my nose and pour the breath into that point. When my mind wanders off, I tug it back.

The practice is systematic and arduous. In some ways it is complex: it involves 16 distinct stages. When I am tired, and the errant mind won’t come quietly back on track, I find it helpful to summarise the injunctions to myself as:

  • I am here
  • This is it

I alternate the emphases: ‘I am here’: ‘I am here’; ‘I am here’; ‘This is it’; ‘This is it’; ‘This is it.’

I note (although not usually, and not ideally, when I’m in the middle of the practice) that each of these connotations presumes something about the existence of an ‘I’. This is less obvious with the second proposition, but clearly there: ‘This’ is something that requires a subject. Continue reading

Should vegans eat meat to be ethically consistent? And other moral puzzles from the latest issue of the Journal of Practical Ethics

Should vegans eat meat to be ethically consistent? And other moral puzzles from the latest issue of the Journal of Practical Ethics

By Brian D. Earp (@briandavidearp)

The latest issue of The Journal of Practical Ethics has just been published online, and it includes several fascinating essays (see the abstracts below). In this blog post, I’d like to draw attention to one of them in particular, because it seemed to me to be especially creative and because it was written by an undergraduate student! The essay – “How Should Vegans Live?” – is by Oxford student Xavier Cohen. I had the pleasure of meeting Xavier several months ago when he presented an earlier draft of his essay at a lively competition in Oxford: he and several others were finalists for the Oxford Uehiro Prize in Practical Ethics, for which I was honored to serve as one of the judges.

In a nutshell, Xavier argues that ethical vegans – that is, vegans who refrain from eating animal products specifically because they wish to reduce harm to animals – may actually be undermining their own aims. This is because, he argues, many vegans are so strict about the lifestyle they adopt (and often advocate) that they end up alienating people who might otherwise be willing to make less-drastic changes to their behavior that would promote animal welfare overall. Moreover, by focusing too narrowly on the issue of directly refraining from consuming animal products, vegans may fail to realize how other actions they take may be indirectly harming animals, perhaps even to a greater degree.

Continue reading

The Ethics of Genetically Modified Mosquitoes and Gene-Drive Technology

Written by Jonathan Pugh

This is an unedited version of a paper by Dr Pugh which was originally published on The Conversation:

please see here to read the original article

In a startling development in ‘gene-drive’ technology, a team of researchers at the University of California have succeeded in creating hundreds of genetically modified mosquitoes that are incapable of spreading the malaria parasite to humans, and which could potentially spread this trait rapidly throughout mosquito populations in the wild. This success has the potential to be translated into a huge global health benefit. Although global malarial deaths have been in decline over the past decade or so, WHO estimates that malaria has been responsible for over 400’000 deaths this year alone. The Anopheles genus of mosquito acts as the vector for malaria, as infected Anopheles mosquitoes transmit Plasmodium parasites to humans via their bites, and it is these parasites that cause malaria. Continue reading

Treatment and Understanding in Psychiatry

Understanding is a fundamental concept in medical ethics. I want to discuss two contrasting senses in which medical treatments require understanding on behalf of the patient. The first of these is very familiar, and much discussed. The second is less so. Continue reading

Guest Post: Should the army abandon their zero-tolerance policy on substance use?

Written by Anke Snoek

Macquarie University

In the UK around 500 soldiers each year get fired because they fail drug-testing. The substances they use are mainly recreational drugs like cannabis, XTC, and cocaine. Some call this a waste of resources, since new soldiers have to be recruited and trained, and call for a revision of the zero tolerance policy on substance use in the army.

This policy stems from the Vietnam war. During the First and Second World War, it was almost considered cruel to deny soldiers alcohol. The use of alcohol was seen as a necessary coping mechanism for soldiers facing the horrors of the battlefield. The public opinion on substance use by soldiers changed radically during the Vietnam War. Influenced by the anti-war movement, the newspapers then were dominated by stories of how stoned soldiers fired at their own people, and how the Vietnamese sold opioids to the soldiers to make them less capable of doing their jobs. Although Robins (1974) provided evidence that the soldiers used the opioids in a relatively safe way, and that they were enhancing rather than impairing the soldiers’ capacities, the public opinion on unregulated drug use in the army was irrevocably changed. Continue reading

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