Health and Medicine

Ethics Quiz: “13 Reasons Why”

/ Jack Marshall / 30 Comments

“13 Reasons Why” is a Netflix  television series based on the 2007 novel “Thirteen Reasons Why” by Jay Asher. A high school student receives a box containing 13 cassette tapes recorded by his friend Hannah Baker, before she committed  suicide. The show has been a critical and popular success (although the Times didn’t like it much) , and a second season is planned.

But Researcher John Ayers of San Diego State University has studied the results of the show on the culture by monitoring discussions of suicide on the internet following the debut of “13 Reasons Why.” The phrases “how to commit suicide” and “commit suicide”  have experienced a 26% and 18% increase in searches. Ayers sees no other explanation for this other than the show.  Searches for the phrase “suicide hotline number” also jumped, by 21%

Ayers now says, “Our worst fears were confirmed That is, thousands of people, thousands more, are searching online about ways to kill themselves.”

Ayers wants the first season to be re-edited to discourage suicidal behavior, and argues that the second season should be postponed. “Psychiatrists have expressed grave concerns because the show ignores the World Health Organization’s validated media guidelines for preventing suicide. The show’s staff instead continue to prefer their gut instincts,” Ayers says.

Your Ethics Alarms Ethics Quiz of the Day is this head-scratcher…

Is it ethical for Netflix to continue running the series in light of Ayers’ research and recommendations?

Continue reading →

Morning Ethics Warm-Up: 7/30/17

/ Jack Marshall / 23 Comments

Good Morning!

(I’m starting this post just a few minutes before noon, thank to a WiFi outage. I’m sorry.)

1. I finally saw “Passengers,” which most people and critics seemed to hate. I see no obvious inferiority to the over-praised and honored “The Martian” or “Gravity,” especially the latter, which bored me to tears, but never mind: it’s an ethics movie. It is also a moral luck movie, and that drove me crazy. I’ll bet so many viewers (SPOILER ALERT!) saw the film and came out saying, “She had to forgive him, because if he hadn’t awakened her prematurely to keep him company, everyone would have died!”

No, no, no! His (Chris Pratt’s) conduct toward her (that’s Jennifer Lawrence, and anyone who wrongs Jennifer Lawrence deserves the torments of Hell) was just as bad–and it was horrible—whether it turned out well by chance or not. Subsequent discoveries or unpredictable events cannot make an unethical act retroactively ethical.

2. San Francisco’s Medicaid program sends illegal immigrants this letter:

When the anti-Trump deranged argue that the President is “crazy,” my stock answer is going to be that nothing he has said or done is as “crazy” as the position that it is right and just to officially encourage foreign citizens to breach our borders, defy our sovereignty and break our laws….and the people trying to use the 25th Amendment to execute a coup are exactly the people who think the letter above is compassionate and right. (Believing that a coup is in anyone’s interest is also demonstrably nutsy-cuckoo, but that’s another issue.)

3. I am really going to be disappointed if NPR and PBS don’t get zero-ed out of the budget. I may be stuck with biased and incompetent journalism, but I shouldn’t have to pay for it.

In a segment of NPR’s “All Things Considered” this week (Yes, I generally think the show is excellent, but that’s not the point) about the “restorative justice” approach to campus sexual assault, reporter Tovia Smith quoted Columbia University graduate Emma Sulkowiczs, aka “Mattress Girl,” as a “survivor” of rape.

She’s not a survivor; she was a harasser, and Columbia just paid a financial settlement to her victim for permitting her to proclaim him as a rapist when the evidence didn’t back the claim. Columbia doesn’t believe Sulkowiczs was raped, and her accusation has been thoroughly discredited. Why in the world would NPR choose this cruel and discredited woman to profile while discussing actual campus sexual assault, and how could it be ethical journalism to still refer to her as a rape survivor?

Smith’s tweeted response to criticism was as damning as the choice of “Mattress Girl” itself:

“Sulkowicz considers herself a survivor & we ID her as such. We’ve clarified that their school found the student she accused ‘not responsible.” Continue reading →

Unethical Quote Of The Week: San Diego State University Political Science Professor Jonathan Graubart

/ Jack Marshall / 33 Comments

I find myself annoyed at the groundswell of good wishes for John McCain after his diagnosis of glioblastoma…McCain is a war criminal and, more to the point. someone who as a politician has championed horrifying actions and been lousy on state commitment to public health…But ultimately what troubles me is the urge to send such well wishes to an utter stranger as it reinforces the notion that some lives are more important than others. There are lots of people with glioblastoma and who have died from it (including my mother twenty years ago)….

—San Diego State University Political Science Professor Jonathan Graubart on Facebook, prompting some calls for him to be fired, and others on campus to second his opinion.

Is this an Ethics Quote or an Unethical Quote? I could call it  an Ethics Quote because it raises many ethical issues, and mere statements of opinions, even stupid and vicious ones, are not usually unethical in themselves. This quote strongly suggests that the speaker is unethical in  than one respect; it is also, at very least, irresponsible in its context, which is that he is a teacher, and represents the institution.

Jonathan Turley flagged this episode, as he reliably does any time a professor comes under fire for controversial speech. As always, he supports his fellow academic:

“Graubart’s comments are hurtful and hateful. It is a reflection of the incivility that has taken hold of our social and political dialogue. It is always sad to see a fellow academic rush to the bottom of our national discourse. However, we have free speech and academic freedom to protect unpopular, not popular, speech. Popular speech does not need protection. Graubart is expressing his deep political and social viewpoint on social media. He should be able to do that just as his critics have a right to denounce his views.”

San Diego State University is a government institution, and thus subject to the First Amendment, in addition to the principles of academic freedom. However, even a state institution  has a right to protect itself from harm. This isn’t just political speech; it is bona fide asshole speech, signaling that the speaker is not a trustworthy teacher, and that any school that would have someone this intolerant, doctrinaire, vile and contemptuous of kindness and compassion educating, aka indoctrinating students isn’t trustworthy either. Universities, public or not, should be able to insist on a minimal level of professionalism from faculty in their public behavior and pronouncements so the institution isn’t permanently discredited, embarrassed, and harmed.

Here is Graubart’s whole Facebook rant: Continue reading →

Integrity Check For Senator McCain

/ Jack Marshall / 27 Comments

Arizona Senator John McCain, a long-time leader of the Republican Party and a bona fide old lion of the U.S. Senate, has been diagnosed with an aggressive and malignant form of brain cancer. Surgeons removed the tumor this week, but the Vietnam war hero and former Presidential candidate knows he is facing the fight of his life. This kind of tumor tends to come back, so McCain’s treatment has to be as aggressive as the cancer.

The unavoidable truth is that Senator McCain has an ethical obligation to resign, and the sooner the better. Members of Congress, like Supreme Court Justices, should not drag their tenure into advanced age, when health, energy and mental acuity are likely to decline. McCain, who is 80, has shown unusual vigor as he has aged, but it is absurd to  imagine that he can do his job while undergoing life-and-death cancer treatments. For his own sake, that of his party, the institution of the Senate, his nation and his legacy, Senator McCain needs to be an exemplar to his colleagues and future elected officials who have the public’s trust. It is a time for him to model sacrifice, selflessness, humility and good judgment.

There is important work to be done, and if it is to be done well, men and women of health and focus must be the ones to do it. John McCain is an amazing and honorable man who doesn’t have to prove his mettle and fortitude to anyone. Now he has to have the courage and integrity to do the hardest thing of all: to know when to quit, and to do it.

I’m betting that he will. John McCain knows how to be a hero.

Ethics Headline Of The Month: “Vatican: The Body of Christ Is Not Gluten Free”

/ Jack Marshall / 76 Comments

Bravo to Johnathan Turley for neatly summarizing what’s wrong with the Catholic Church’s recent affirmation of its long-standing requirement that the bread and wafers used during communion in Catholic churches around the world must have at least some gluten in them, or the Church will collapse and Satan will reign, or something.  Meanwhile devout Catholics who must avoid eating gluten, including people who have Celiac disease, just have to plug along, get half a communion, or get sick. God wants it that way.

What a throbbing example of arrogant and compassion-free bureaucratic thinking. The Professor’s headline captured the idiocy and rigidity of it perfectly.

The Catholic News Agency shrugged the story off with a couple of rationalizations: “It’s always been this way” and “This is nothing new.” Neither are satisfactory excuses when making the communion dangerous to the increasing number of Catholics with Celiac disease. The issue is mirrored by the dilemma faced by alcoholics, who fear drinking wine; the Catholics, unlike the Methodists and other Protestant churches, insist on at least minimally fermented wine. Grape juice just won’t do. Why?

“Christ did not institute the Eucharist as rice and sake, or sweet potatoes and stout,” Chad Pecknold, a theology professor at Catholic University, told the Washington Post. “It may seem a small thing to people. But the Catholic Church has spent 2,000 years working out how to be faithful to Christ even in the smallest things. To be vitally and vigorously faithful … is something which is simply integral to what it means to be Catholic.”

[A long bitter section about how bureaucracies are habitually doctrinaire about small matters while ignoring pervasive corruption and destructive hypocrisy has been deleted here, in part because it is ugly, and also because anyone who can’t write their own version hasn’t been paying attention to the Catholic Church for the last 500 years…or even the last 17.] Continue reading →

Comment of the Day: “From The Law vs. Ethics File: The Discriminatory Charlotte Pride Parade”

/ Jack Marshall / 42 Comments

How to construct public policy regarding trans individuals is an increasingly varied and controversial ethics controversy (with another Ethics Alarms post on the topic in progress). This another whiplash ethics area where events and attitudes are moving and evolving too fast for some reasonable people to process. I remember as a child reading a vintage Readers Digest article about Christine Jorgensen and having my father answer my questions about her by saying, “He’s a freak.” The dialogue on the related issues here at Ethics Alarms is always  enlightening, in part because we have the benefit of some very well-informed authorities on the topic.

Pennagain added this impressive post to the latest round in the debate, in response to another commenter’s opinion. Here is Pennagain’s Comment of the Day on the post, “From The Law vs. Ethics File: The Discriminatory Charlotte Pride Parade”:

As far as I could find, the conclusion of Scientific American’s January 2016 article, “Is There Something Unique About the Transgender Brain,” speaks to the results of the all the legitimate studies that have been done to date: . . . given the variety of transgender people and the variation in the brains of men and women generally, it will be a long time, if ever, before a doctor can do a brain scan on a child and say, “Yes, this child is trans.”

So far,  so good. Nothing is proven either way as far as brain differentiation is concerned. But your personal observations are not at that level of science; they are your unsupported (and insupportable) opinions. The problem with that kind of observation is that it can easily be turned on its head, as with “Direct observations by my family, from many teachers and administrators: kids who want attention (for various reasons) tend to come out as trans.”

It’s rather: “Kids who are trans or gay tend to stand out and naturally attract attention.” What’s more, those who observe with knowledge can tell the difference easily.

What’s happening here is a common confusion between sexual orientation and gender identity. As simply as I can put it:

“Gay,” “Lesbian” and “Bisexual” refer to sexual orientation, in other words – who you are attracted to, namely, people of the same gender.

“Transgender” is a gender Identity: how you identify yourself in terms of maleness or femaleness. For a transgender person, the gender identity is one that is different from your biological sex. It can, in fact, have nothing whatsoever to do with whom you are attracted to.

Part of the confusion is that being queer (the word being back in vogue, stuck onto the LGBT as Q) designates one whose gender is known as fluid. In other words, the “stand outs” on the playground and even throughout their lives are those whose behavior is often that of the “opposite” gender. This occurs for two reasons: one is to be born with characteristics of another norm, the other is acquired as a copycat of society in general. What you don’t see,are those boys and girls, men and women, who are identical — naturally, biologically — with “straight” males or females… who can and do “pass”, as it were. Whether they look to you to be butch or femme, they are at home with their penis or vagina.

To get back to the question ‘What is the Difference between Gay and Transgender?’ – one has to do with sexual orientation (who you are attracted to sexually) and the other has to do with gender identity (who you feel yourself to be). Got it?

You are correct in thinking that transgender people, especially when in the (often difficult and painful) process of what is called coming out, used to identify as “gay,” because it was as close as they could come. But they had and have that one differentiation: the conviction and discomfort of being in the wrong gendered body. When a transgender person completes transition, he or she may turn out to have a straight orientation. Or not.

As far as your after finding that society no longer views them as special, have settled back into traditional sexuality goes, you display once again a conventional imagination in an attempt to dismiss both the reality of sexual orientation or gender identity and the complexity and difficulty of coming out against a society — a society that includes your own loved and needed ones — that hates, despises and rejects you. If you really believe this is an attention-getting pose, you are … ill-informed and unable to identify much less re-form your prejudices.

In short ‘What is the Difference between Gay and Transgender?”: One has to do with sexual orientation (who you are attracted to sexually) and the other has to do with gender identity (who you feel yourself to be). Continue reading →

Comment Of The Day (2): “Observations On Britain’s Charlie Gard Ethics Fiasco”

/ Jack Marshall / 19 Comments

This is the second outstanding comment on the Charlie Gard post, and it boldly ventures into the ethics jungle of euthanasia. The discussion must go there, for if society has limited resources, and we have more limited resources than Paul Krugman and Bernie Sanders admit, then when people use up their allotted portion, they either have to die or someone else has to pick up the bill. The recent surge in popularity for single-payer health care is due in part to the old saw about how soldiers think when going into battle. It’s everyone else who’s at risk, not you. Or as my dad liked to put it, “Gee, I’m going to miss those other guys!”

Increasingly, as I get older and think about how different my family’s life would be if both Mom and Dad hadn’t contrived to pop off quickly after relatively short illnesses and minimal hospitalization, I see the same consideration in planning for my loved ones. I don’t want to waste my son’s inheritance to pay for the last and worst years of my life; indeed, I think it would be unconscionable to do so. However, that needs to be my choice, not the Death Panel’s.

Here is Mrs Q’s Comment Of The Day on the post,  “Observations On Britain’s Charlie Gard Ethics Fiasco”:

When medical care is socialized, nihilism & scientism combine to control those who can be useful to the state & those who need to be eliminated from it.

Dutch lawmakers are looking at a Completed Life Bill that would allow those 75+ in age to choose medical euthanasia. The lawmaker pushing the bill, Alexander Pechtold, said it would allow the Netherlands to…

“take the next step for our civilization.”

And what step is that exactly?

The Gard case highlights the dark workings of Marxism for what it is by defining life in terms of how much of a burden it supposedly is to others. That the “greater good” is better served when certain people s lives are considered “complete.”

Baby Gard, as Jack noted, cannot continue to be a financial burden in the context of socialized medicine because in such a paradigm, there are not enough resources to support all of those represented by it. Remember socialism ALWAYS promises more than it can ever deliver and always spends more than it has.

I love it when people tell me how great the health care in France is, while many there complain the immigrants are a drain on the system because they have not put their money into it for years. Or Canada, where our friends cannot afford private insurance and go without certain medications & treatments because they’re not covered by state. Or Europe, where rates of Downs Syndrome are jarringly low because doctors have advocated so severely for abortion of these unborn, that in some countries it has literally been years since such a child has been born. Continue reading →

The New Rationalization #23: The Dealer’s Excuse, or “I’m just giving them what they want!”

/ Jack Marshall / 6 Comments

The new Rationalization #23, The Dealer’s Excuse. or “I’m just giving them what they want!” now bumps Woody’s Excuse: “The heart wants what the heart wants” to sub-rationalization status as 23A.

Good. Woody Allen doesn’t deserve a free-standing rationalization.

While narcissist Woody’s contribution to the Ethics Alarms Rationalizations list states that something is ethical if you want it badly enough, as in, “I really, really want to have sex with my adopted daughter,” its recently revealed parent hold that conduct becomes justifiable and benign if there is a market for it. Woody’s excuse is bad, but this is worse. For one thing, it’s usually disingenuous. Those who employ the Dealer’s Excuse aren’t providing a service out of altruistic motives, but out of the profit motive. They want the money they can make by doing unethical things that make society uglier, dysfunctional and dangerous, and they really don’t care if their customers come to a bad end or bring miseries to others.

The most famous exposition of The Dealer’s Excuse is in “The Godfather,” as Don Corleone and the other mafia heads discuss their “business.” The Godfather is balking at adding drugs to the mob’s businesses, and says:

When — when did I ever refuse an accommodation? All of you know me here — when did I ever refuse? — except one time. And why? Because — I believe this drug business — is gonna destroy us in the years to come. I mean, it’s not like gambling or liquor — even women –which is something that most people want nowadays, and is forbidden to them by the pezzonovante of the Church. Even the police departments that’ve helped us in the past with gambling and other things are gonna refuse to help us when in comes to narcotics. And I believed that — then — and I believe that now.

Continue reading →

Comment of the Day: “Morning Ethics Warm-Up, 6/30/17.”

/ Jack Marshall / 14 Comments

As he usually does, when he’s feeling frisky,  reader Extradimensional Cephalopod (above right) has dived into the issue of “health care rights” with gusto and perception. As I often do whether I’m feeling frisky or not, I have some cavils about the assumptions being made at the outset.

A right is a moral or legal entitlement to have or obtain something or to be able to do something. Moral and legal rights are two different things. When someone says, as did my friend on Facebook that started this debate. “I believe health care is a right,” he had to be asserting a moral right to healthcare, since a legal right to health care doesn’t exist. If he said, “I believe health acre should be a right,” then he would have clearly meant a legal right. That’s a policy issue. When someone argues that there is a moral right, then they are making the case for a legal right that doesn’t exist. The law in an ethical society ought to protect and advance moral rights, and society must agree what those rights are. Thus when he says, early on, “Note that a right isn’t something we owe Note that a right isn’t something we owe people just because they exist.,” he signals that he is describing legal rights only.   Moral rights are what we owe  people just because they exist. That’s why the Declaration begins with Jefferson saying that “we are endowed by our Creator” with “unalienable rights.”

Here is Extradimensional Cephalopod‘s Comment of the Day on #5 in the post, “Morning Ethics Warm-Up, 6/30/17.”

Let’s start at the beginning. We need to define the phrase “healthcare is a right”.

A “right” is a protection or entitlement we collectively decide to give to people at the expense of our some of our freedoms because we think that society will be more robust, sustainable, able to advance, or generally pleasant to live in as a result. That’s very similar to the basis for ethics, as far as I can tell. A right is a meta-law, a limitation on what laws can be made. Rights may be conditional. Note that a right isn’t something we owe people just because they exist. It’s something we decide we owe them because we want to live in a world where people have that right–because it’s safer for us, or because it means the world will still be there for our descendants, or because it allows civilization to progress to something better, or because we want others to be happy, or all of the above. This will be important later.

Therefore, when we say, “healthcare is a right”, what we mean is “in order to make society more robust, sustainable, able to advance, or generally pleasant, we choose to sacrifice some of our individual freedoms to provide everyone with healthcare.”

We’re half done. Now, what is “healthcare”?

Let’s actually distinguish it from health insurance, because we’re smarter than Congress. Health insurance, like any insurance, is a gamble, in which people periodically pay a small amount of money to an insurance company, which will pay them back a larger amount of money (whatever is necessary, to the limit of what they are insured for) if the person’s health is in danger in a way that neither of them can predict. The idea is that the insurance company can’t predict who needs the money, but they can predict how many will need money and how much, statistically, so they accept enough money from people that they can afford to pay the people who end up needing more money. Continue reading →

Observations On Britain’s Charlie Gard Ethics Fiasco

/ Jack Marshall / 40 Comments

A recipient of Great Britain’s national health care, infant Charlie Gard was born with  a rare genetic condition resulting in what is probably irreversable brain damage.  He cannot move his arms or legs, eat or even breathe without a ventilator.

After 10 months of being kept alive, Charlie’s caretakers, the Great Ormond Street Hospital for Children in London, announced that it was time for Charlie to die. Chris Gard and Connie Yates, Charlie’s parents, wanted to take him to the United States to try an experimental treatment available here. The doctors at the hospital refused to allow them to take the child, and vetoed their decision, even though the parents had received sufficient funds from donations to pay for the effort.  In  the resulting lawsuit, British courts sided with the hospital. The parents then brought the case  to the European Court of Human Rights, which declined to hear the case last week. The previous court rulings that it was in Charlie’s best interest to withdraw life support and that the state, not the parents, got to make this life and death decision stood.

The  parents, Chris Gard and Connie Yates, appeared on a video this week,, sobbing and saying their son would be removed from life support at the hospital. “He’d fight to the very end, but we’re not allowed to fight for him anymore,” Gard said in the video statement. “We can’t even take our own son home to die.”

Initially, the hospital would not delay the fatal  disconnection of the child from life support so family members could gather and say goodbye. It has since relented.

Observations: Continue reading →