Rebecca Brown’s Posts

Expertise and Autonomy in Medical Decision Making

Written by Rebecca Brown.

This is the fourth in a series of blogposts by the members of the Expanding Autonomy project, funded by the Arts and Humanities Research Council.

This blog is based on a paper forthcoming in Episteme. The full text is available here.

Imagine you are sick with severe headaches, dizziness and a nasty cough. You go to see a doctor. She tells you you have a disease called maladitis and it is treatable with a drug called anti-mal. If you take anti-mal every day for a week the symptoms of maladitis should resolve completely. If you don’t treat the maladitis, you will continue to experience your symptoms for a number of weeks, though it should resolve eventually. In a small number of cases, maladitis can become chronic. She also tells you about some side-effects of anti-mal: it can cause nausea, fatigue and an itchy rash. But since these are generally mild and temporary, your doctor suggests that they are worth risking in order to treat your maladitis. You have no medical training and have never heard of maladitis or anti-mal before. What should you do?

One option is that you a) form the belief that you have maladitis and b) take the anti-mal to treat it. Your doctor, after all, has relevant training and expertise in this area, and she believes that you have maladitis and should take anti-mal. Continue reading

The Daft Discussion of Dangerous Dogs

Written by Rebecca Brown

Breed Specific Legislation

The UK currently imposes what’s called ‘Breed Specific Legislation’ in an effort to limit serious injuries due to dog attacks. The legislation was introduced in 1991 and made it illegal to own, sell, abandon, give away or breed dogs deemed to belong to one of four banned breeds. These are the Pit Bull Terrier, Japanese Tosa, Dogo Argentino and Fila Brasileiro. These breeds, having been selectively bred for purposes such as fighting, hunting and guarding, and are considered to have physical and behavioural attributes that mean they pose an unacceptable risk to the public. Dogs that meet the criteria for being a banned breed can be seized and either destroyed or permitted to remain with their owner under restrictive conditions. Breed specific legislation has been recently criticised in a number of organisations.

I do not intend to defend Breed Specific Legislation. It’s plausible that there are alternative, more effective and less damaging ways of reducing harm from dog attacks. However, many of the critiques of Breed Specific Legislation made by prominent animal charities and veterinary bodies are flawed. In pursuing what they no doubt see as a worthwhile end (the scrapping of Breed Specific Legislation), those publicly lobbying for change have made numerous confused and misleading arguments. Below, I outline why these arguments are misleading, implausible or weak, and how they fail to show that Breed Specific Legislation should be revoked.

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Honesty and Public Health Communication: Part 2

Written by Rebecca Brown

This post is based on two recently accepted articles: Brown and de Barra ‘A Taxonomy of Non-Honesty in Public Health Communication’, and de Barra and Brown ‘Public Health Communication Should be More Transparent’.

In a previous post, I discussed some of the requirements for public health institutions to count as ‘honest’. I now want to follow that up to discuss some of the ways in which public health communication seems to fall short of honesty. Continue reading

Epistemic Diligence and Honesty

Written by Rebecca Brown

All else being equal, it is morally good for agents to be honest. That is, agents shouldn’t, without good reason, engage in non-honest behaviours such as lying, cheating or stealing. What counts as a ‘good reason’ will vary depending on your preferred ethical theory. For instance, Kant (in)famously insisted that even if a murderer is at the door seeking out their victim you mustn’t lie to them in order to protect the victim’s life. A rule utilitarian, in contrast, might endorse lies that can generally be expected to maximise expected utility (including, presumably, lying to murderers about the whereabouts of their intended victims).

What will actually count as being dishonest will vary depending on your preferred conception of honesty. If honesty has very extensive requirements, failure to volunteer relevant information when you know someone would find it useful might be a failure of honesty. On a narrower account, perhaps even ‘paltering’ – misleading by telling the truth – might not count as dishonest so long as what the agent says is technically true. Continue reading

Decoupling, Contextualising and Rationality

Written by Rebecca Brown

In February 2020, just before science journalists had to start writing about covid full time, Tom Chivers wrote an article for Unherd, ‘‘Eugenics is possible’ is not the same as ‘eugenics is good’’. In it he describes a Twitter outcry provoked by Richard Dawkins who tweeted: 

It’s one thing to deplore eugenics on ideological, political, moral grounds. It’s quite another to conclude that it wouldn’t work in practice. Of course it would. It works for cows, horses, pigs, dogs & roses. Why on earth wouldn’t it work for humans? Facts ignore ideology.

Chivers analyses the fallout in terms of a distinction between ‘high decouplers’ and ‘low decouplers’, a distinction described by the blogger John Nerst, here and also here. Chivers (and Nerst) describe decoupling as a ‘magic ritual’ that a speaker can perform in order to disassociate the thing they are about to say from all of the baggage that might ordinarily attach to it. So, one might say “I don’t think we should kill healthy people and harvest their organs, but it is plausible that a survival lottery, where random people are killed and their organs redistributed, could effectively promote longevity and well-being.”

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Are Public Health Institutions Honest?

By Rebecca Brown

The COVID-19 pandemic has highlighted various cracks in the function of our public institutions. One notable concern is the way in which scientific – including health – information is communicated to the public. Communication can serve different purposes. In the context of COVID-19, communication has been essential: describing the nature of the novel coronavirus, the risks it posed to health, the measures likely to reduce its spread. Some of this communication was aimed at changing people’s behaviour in order to control the infection. For instance, people were told to wash their hands regularly, for at least 20 seconds, and to avoid touching their face. Much of this information was uncertain. Emerging data on COVID-19 presented ever-changing estimates for infection and case fatality rates.

There are particular demands that are made of health communication. It needs to reach a wide audience, delivering often quite technical, uncertain information to people with varying degrees of health literacy. It needs to encourage behaviours likely to promote individual and public health and avoid causing unnecessary panic and alarm. It must also, one might argue, avoid misleading people about the facts as they are best understood. This last point suggests that health communication should adhere to the demands of honesty. 

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Responsibility and Victim-Blaming

Written by Dr Rebecca Brown

The recent sentencing of Wayne Couzens for the murder of Sarah Everard, along with the murder of Sabina Nessa last month, has prompted discussion in the UK of the prevalence of violence against women and the shortcomings of the criminal justice system. Prime Minister Boris Johnson has himself criticised the police for failing to take cases of violence against women sufficiently seriously. In particular, there has been outrage at comments made by some regarding steps women can take to ‘keep themselves safe’. Continue reading

Imposter Syndrome And Environmental Sampling

Written by Rebecca Brown

Imposter syndrome has received recent, though still fairly limited, philosophical discussion. Scholars such as Katherine Hawley (and, drawing upon Hawley in a recent and excellent podcast, Rebecca Roache), amongst a handful of others have illuminated issues such as how we can develop a useful definition of imposter syndrome, the extent to which imposter syndrome may be adaptive, and the relationship between imposter syndrome beliefs and rationality. I want to pick up on this last question and suggest a further way in which people might rationally adopt ‘imposter attitudes’.

Imposter syndrome, as described by Hawley, involves believing that the external markers of esteem and success one receives are undeserved, and feeling at risk of being exposed as a fraud. Imposter attitudes refer to the negative attitudes one might hold regarding one’s own ability. Hawley challenges the common assumption that those suffering from imposter syndrome are simply too unconfident. She describes how people might justifiably (though mistakenly) hold imposter attitudes as a result of ‘hostile social environments’. This includes, for instance, people who are less likely to receive positive feedback in their work environment, or have reason to believe that any positive feedback they receive is insincere. For such people, although they have some evidence of their talent (e.g. publishing papers or winning awards), they have other evidence that this could be undeserved (e.g. lack of positive feedback from colleagues). Hawley is particularly concerned about minority groups who she suggests are more likely to experience hostile social environments and feel like impostors. Continue reading

Antenatal Care During The COVID-19 Pandemic: Couples As Dyads

Written by Rebecca Brown

 

During the pandemic, many healthcare services have been reduced. One instance of this is the antenatal care of expectant mothers. Ordinarily, partners of pregnant women are permitted to attend appointments. This includes the 12 week scan: typically the first opportunity expectant parents get to see the developing foetus, to discover whether it has a heartbeat and is growing in the right place. This can be very exciting and, if there’s bad news, devastating. It also includes scans in mid pregnancy and (for first-time mothers) at 36 weeks, as well as the entirety of labour.

During the pandemic, many healthcare providers have restricted attendance at antenatal appointments as well as labour and postnatal care. Even when lockdown restrictions were eased, with pubs, zoos and swimming pools re-opening and diners in England being encouraged to Eat Out to Help Out, some hospitals continued to exclude partners from all antenatal appointments and all but the final stage of labour, requiring them to leave shortly after birth. This included cases where mother and newborn had to remain on wards for days following delivery. With covid cases rising, it seems likely that partners will once again be absent from much antenatal, labour, and postnatal care across the country. Continue reading

Ecological Rationality: When Is Bias A Good Thing?

By Rebecca Brown

Many people will be broadly familiar with the ‘heuristics and biases’ (H&B) program of work, made prominent by the psychologists Amos Tversky and Daniel Kahneman in the 1970s. H&B developed alongside the new sub-discipline of Behavioural Economics, both detailing the ways in which human decision-makers deviate from what would be expected of homo economicus – an imaginary, perfectly rational being that always aims at maximising utility. For instance, in a famous experiment, Tversky and Kahneman gave people the following information (1983: 297):

Linda is 31 years old, single, outspoken and very bright. She majored in philosophy. As a student, she was deeply concerned with issues of discrimination and social justice, and also participated in anti-nuclear demonstrations. 

Participants were then asked which of the two alternatives was more probable:

1. Linda is a bank teller.

2. Linda is a bank teller and is active in the feminist movement.

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