To Define a Thing (#poem)

He broke her spirit when he declared

He didn’t even know what love is.IMG_7275

She had only asked a simple question

As she planned her own future.

Whilst he resisted closing his options,

He never noticed how open hers were.

She awaited his answer as her suitors

Sat on the sidelines biding their time.

 

He pretended he didn’t understand

The comfort of constant companionship

Or the fear of inestimable loss.

He needed time to think about

This question of love, to contemplate

The reality of solitude or the

Possibility of greater satisfaction.

And his hesitation was her answer.

 

She knew that whatever love is,

She would never feel it for him.

She could see a future free from

Waffling and wavering solidarity.

She imagined a life where love

Never demands a sacrifice.

For her, love was ultimately freedom

Of choice to soldier forth in unity.

 

And she knew love as a litany of lies:

Each person has only one intended.

Love is blind to the beauty of others.

Love is a freshly paved road.

Love is a bind, a prison, a restraint.

Love is devotion, obedience, compliance.

He saw love as a list of restrictions,

But she saw love as a prison break.

 

She no longer thought so much

About love. She only lived

With enthusiasm for those moments

That brought her unalloyed joy.

She decided to be selfish and

Forget about the cares of others.

And her dogged egoism brought her

Continually to your arms.

 

And if she had not, my dear friend,

You could not stand on your own.

 

Confessions (#poem)

At the interview, she said,

“These are some designs I’ve beentruth

Working on since I got out of jail.”

 

On his dating profile, he said,

“I’ve finished the last course of antibiotics

And feel I’m ready to date again.”

 

At dinner, she confessed,

“I listened to a Justin Bieber song to see what it was

And I ended up listening to the entire album.”

 

At the office sexual conduct training, he admitted,

“I once positioned myself in the audience

So that I could see Grace Jones changing costumes.”

 

And I feel I must disclose that

I saw you eating in a café,

And I wanted to break through the glass

To get to you as the door would take too long.

 

I wanted to be close enough to absorb

Stray electrons orbiting your body.

I wanted our consciousness to commingle,

So I could know all that you know.

 

I wanted to share your feelings of

Elation, sorrow, indifference.

I wanted eternity. I wanted permanence.

 

As your gaze rose, I started,

Coughed, looked toward the pavement,

And shuffled off, slack-shouldered, to the east.

 

Support the Troops (Remembrance Day Poem)

A farmer working in a field with his children formed

A bucolic scene in the countryside, maybe.Screenshot 2018-11-10 at 06.23.15

An older man crashed his bicycle and

Injured his leg, or so it would seem.

 

On the first tour, these scenes did not

Seem so ambiguous. The world

Had not given over to chaos then.

A soldier might still pass with a sense of purpose.

 

On the second tour, doubt set in,

And the soldiers sometimes faltered

In indecision–perhaps the wedding

Party was filled with combatants.

 

On the third tour, everyone is

A combatant. Everyone must die.

The universe is infinite and absolute

Hostility, death the only possible escape.

 

He asked whether I thought US soldiers

May have committed atrocities.

I asked whether he had support

For his mental health needs.

 

He answered only with

A desperate, pleading smile.

 

Uses and Abuses of Autonomy

If you’ve studied bioethics, you know that the principles of bioethics are autonomy, beneficence, non-maleficence, and justice. You also know that autonomy, especially in the early days, got most of the press. I was one of the people who saw bioethics and autonomyethics generally, really, as a matter of respecting autonomy. And I still think it is typically wrong to do things to people that they wouldn’t reasonably want done.

As it often happens when changing points of view, I first began to question the value of autonomy in the most extreme cases—those where someone had no autonomy at all. How do you show the proper respect to a cadaver for example? How should we go about respecting the autonomy of someone who is no longer conscious and may never regain consciousness? It seems that showing respect for a person’s life may not always mean respecting the person’s autonomy.

Even in those cases, though, we still try to preserve the notion of autonomy by calculating what would have been correct for that person if that person were a conscious being with autonomy. To what would a rational person want or be entitled? And here is a bit of muddy water already. Kant described respect for autonomy as respect for universal laws, not respect for individual wishes, for respecting someone’s wishes might only be to help them use themselves as a means (see: physician-assisted suicide). For Kant, respect for autonomy would mean that no one could morally choose to die, so certainly no one could morally help someone to die.

But we don’t adhere to Kant so closely, do we? So, respecting someone’s autonomy has come to mean respecting that person’s wishes by getting their consent before doing anything to them or not doing anything to them, as the case may be. But even having someone’s full-throated consent does not make it okay to do whatever we please, and we mostly recognize that. We have laws against doing things to children, for example, or to people with limited cognitive abilities because we recognize that some people are extremely vulnerable to exploitation.

We spend a lot of time trying to identify vulnerable populations, but my problem comes with trying to figure out who might not be subject to exploitation. It seems to me that even the most mature and intelligent people in the world are subject to exploitation at least some of the time. I can think of many examples, but one example is certainly whenever anyone gets sick.

I would say that anyone with even a minor illness has lost a degree of freedom. If I have something as simple as a stuffy nose, I will make decisions I would otherwise not make. You know, I may decide to give money to some stranger who promises that some chemical or other might make my breathing easier. If I will give away my money to avoid slightly congested breathing that will likely correct itself in a short time, what might I do to avoid rapidly approaching death?

If I’m frightened enough of dying, and most of us do want to avoid an early death, I might agree to almost any treatment dangled in front of me, and I might go to extreme measures to procure the treatment. Getting my consent to give me my only chance of relief seems a little strange, which is why neither healthcare providers nor their clients pay much attention to the whole informed consent process in routine cases. We generally go to healthcare providers with the intention of making use of the services they provide.

Yes, I know patients do need the information that makes up the “informed” part of informed consent, and sometimes genuine decisions must be made in collaboration with the doctor or other caregiver. Even in those cases where decisions must be made, most patients assume the doctor is in a better position to know what choice is best. Which is why so many of us respond with, “What would you do, Doctor?”

What we don’t say, though, is, “No, I don’t want any treatment. I only came in because I had a bit of free time and thought I’d spend it in an examining room.” It is only suffering, whether minor or extreme, that drives us to see a doctor. And it is that suffering that makes us vulnerable to exploitation, and that vulnerability renders the concept of free consent or undiminished autonomy questionable.

So I don’t think autonomy can shoulder the moral burden it is expected to carry. In fact, autonomy may not mean anything useful at all. Respecting a person’s wishes, especially in situations where wishes are so easily manipulated, may not be of any moral value at all.