Let’s say you make a lot of money in some industry or another, and you’re lucky enough to get an appointment to an agency that regulates that very same industry. Your regulatory decisions could affect your bottom line, and so you have a conflict of interest and you should either be forced to give up your job as a regulator or get rid of all your financial interests in the industry with the provision that you may never acquire financial assets in the industry again. And if you’re a doctor on the payroll of a pharma company, your employment status most definitely affects your medical decisions.
That’s a pretty simple and obvious concept to anyone who doesn’t work in industry. People who work in any given industry tend to think “outsiders” wouldn’t know enough about the industry to regulate it, so of course you’d need someone with major conflicts to understand what really needs to be done. And so it goes.
But other people are described as being conflicted when they really don’t have any conflicts at all. Let’s say you are a researcher, and you apply to a corporation for funding for your research. Congratulations, you now have a huge grant from Megacorp Inc. to fund your lab, materials, research assistants, etc. in hopes of developing new products. You are now just a handsomely rewarded employee of Megacorp Inc. Your only interest is in developing new products for them.
It’s true that some will describe you as conflicted because they think you should be looking out for the public good, but that really isn’t in your job description. You’re just developing products.
And this is why we need public funding for research. So we can demand that researchers we are paying work for the public good and not in the interest of for-profit corporations.
KM: Socrates liked Aspasia because she wasn’t a shrew, which is what he thought his wife, Xanthippe, was.
KIA: But Plato respected the opinions of Aspasia and Diotima.
KM: Because Aspasia knew how to manage a household and Diotima spoke of non-physical love as ideal Forms, but he had to invent Diotima to make his point.
KIA: Still, it was a woman who instructed the men on love.
KM: Yes, and she taught that the only true love was between men.
KIA: She taught that love was of the mind. Of ideas.
KM: And it is men, not women, who are ruled by their minds. Ultimately, The Symposium is just about Plato’s ideal forms, love being one of them. He speaks of true love between men because he didn’t see women as being capable of true understanding.
KIA: Not all the men. Not Alcibiades. He was a libertine and a horrible traitor to his country.
KM: And friend of Socrates—someone who wrestled with him, slept with him, and drank with him.
KIA: But Socrates rebuffed him.
KM: And everyone else. Or, all the men, anyway.
KIA: Socrates hated Alcibiades.
KM: But they slept together? As enemies do?
KIA: Again, nothing happened.
KM: Some might think naked wrestling is something.
KIA: But Socrates didn’t respond.
KM: I find it interesting that Alcibiades expected all wrestling matches to become sexual.
KIA: How do you know that?
KM: Why else would he be surprised that Socrates didn’t respond?
KIA: I think he was just disappointed Socrates didn’t return his feelings.
KM: Maybe it was just because Socrates was so old?
KIA: Socrates wasn’t interested because he was concerned with more important things.
KM: Maybe Socrates wasn’t interested because he wasn’t gay.
KIA: Socrates was a philosopher. Alcibiades wasn’t a serious thinker.
KM: Do you think Alcibiades might have represented Plato’s feelings?
KIA: What? Why?
KM: Well, I mean. Plato was gay, wasn’t he?
KIA: Why would you say that?
KM: Hey, remember in the Republic where it says women should do physical training like men? You know, naked? And it says it would be hard to look at the naked women, especially the ones who are ugly or old.
KIA: I’m sure he was just addressing the concerns of the day.
KM: Oh, I’m sure. By the way, who did Plato marry?
KIA: I don’t know. No one does.
KM: Socrates had two wives (see Myrto). So did Aristotle. If Plato had one, don’t you think someone would have mentioned it?
KIA: What does that matter, anyway?
KM: Well, it’s consistent with him being gay.
KIA: And why would Plato portray himself through such an awful person as Alcibiades?
KM: Maybe Plato wasn’t proud of his feelings.
KM: Maybe Plato wasn’t proud of his erotic love for Socrates, so he portrayed it in a disgusting manner.
KIA: Why wouldn’t he be proud? Homosexual relationships were encouraged in his society.
KM: I didn’t mean he was ashamed of being gay, but embarrassed that his own feelings for Socrates weren’t returned. Also, maybe being embarrassed by his less than “Platonic” love for Socrates. Also, it was Plato, not Alcibiades, who was the wrestling champion.
KIA: I think Plato was just committed to higher ideals.
KM: Or maybe Plato was wrestling with his own daimons, and he could only express them through a drunken Alcibiades.
KIA: That makes no sense.
KM: Did you see what I did there?
KM: Wrestling with his daimons? ‘Cause he was a wrestler? ‘Cause Alcibiades wrestled Socrates naked? ‘Cause daimons are spirits that impart wisdom and not demons?
KIA: Oh, yeah, I get it. Who do you think you are, anyway, Mark Henderson?
KM: If only Plato had made more puns instead of wrestling naked boys.
KIA: Like Socrates, Plato was a man of wisdom and honour, not a profligate!
KM: Sure. That’s why he shows the struggle only to have love of reason to win in the end. The lust of Alcibiades is defeated in the ultimate wrestling match.
KIA: Maybe he wasn’t interested in teenagers.
KM: Wasn’t Xanthippe a teenager at the time? You know, when Socrates married her.
Ask anybody about bioethics in the old days, like forty years ago, and they’ll talk all about autonomy and consent. It was all about how people didn’t have to do what you thought was good for them and how you couldn’t touch patients, even to help them, without it being some kind of battery or something. Everybody talked about all these famous examples where people were treated without wanting to, but most people only go to the doctor when they want and need to get treated. Most people these days only refuse treatment because they can’t afford it.
I’m sure a lot of them can’t afford the treatment but also don’t need it. It’s hard to argue with a doctor about that, though. If you want to feel better, stay healthy, live longer, or whatever; you’re going to listen to the doctor. You are paying the doctor to know more about it than you do. And the doctor may or may not be making money off every service you buy. It’d be good to know who makes money off what, wouldn’t it? It would also be good to know in advance exactly what everything would cost. It would be even better to be able to prepare costs.
In the early days of bioethics, it wasn’t all about costs, because most people could afford their healthcare bills. Money was a concern, of course, but people didn’t panic from fear that their life savings would be wiped out anytime they got sick. It wasn’t at the front of everyone’s mind, so when someone refused treatment, it was because they didn’t want to live longer, didn’t think the treatment worked, or something like that.
But now it’s all about costs. Can a doctor ethically prescribe you treatment knowing you can’t afford it? Can a doctor ethically not tell you about treatments you can’t afford? Should doctors help patients set up Go Fund Me accounts? How can anyone just stand by and let people die because they can’t afford insulin?
In the past, we didn’t notice how much autonomy and consent were tangled up in financial concerns. Most patients didn’t know doctors received so much money from industry. Most patients trusted their doctors, hospitals, and so on to have their best interests in mind, not to be focused on profit front and center. But things have changed, and bioethics can’t afford to have many debates that don’t deal with patients’ ability to access needed care.
So, if you are dealing with public health ethics and planning for pandemics, you might want to consider how many patients will walk around shedding viruses simply because they can’t pay for a visit to the hospital. And if people are forced into quarantine at hospitals, you might want to consider who will get the bill for that. It’s the same with vaccines. At least some people are opposed to vaccines because they think, right or wrong, that they are just being made to create more profit for pharmacy companies, clinics, and doctors. It’s just another way, they think, to get in people’s pockets.
I’m not saying that no one writing in bioethics is dealing with these topics. Great work is being done. What I’m saying is that all work in bioethics must include a discussion of economics and an expressed concern for how access to medicine can be guaranteed for everyone who needs it. You can have lots of detailed and technical disagreements over how much medicine is actually needed and what are the best ways to deliver needed medicine without bankrupting an entire country, but the focus should be on creating a society of healthy, financially secure people. That’s all anyone wants, I think, and anyone who doesn’t want it isn’t really worth my trouble.
A sock of sulfur by the door,
And you better not ignore
It before going out in the woods,
Or it’s certain you would
Pick up hitchhikers in the form
Of ticks, chiggers, and no-see-ums.
It really made no difference,
You’d be facing weeks of itching,
And soaking in Calamine lotion,
Epsom salts, bleach, magic potions,
Or anything you could find
To soak in and hope to die.
Chiggers are the worst,
They’re a sentence or evil curse
From the God’s of wooded adventure
Or the demons of dark overtures.
Burrowed just under the softest skin,
Dissolving flesh and turning it to poison.
So, anyway, don’t forget the sulfur,
Before you go stomping through briars.
And be sure to take a shower when you get back
To wash off the ticks and prevent an allergy attack.
And when your done you better be sure,
To thank God for the blessings of nature.
He couldn’t hear the word “hitchhiker”
Without also hearing John Fogerty
And the guilty sounds of the seventies.
And all that made him think of a tall
Girl with gray eyes who terrified him with
Her treks and trysts across the Rockies
And beyond on her own except
For her verve and bravado.
She wasn’t afraid of anything.
She took chances from Sherman to Denver
With no money and just one change of clothes.
Risky for a girl of 18, of course, but
God only knows what trouble she
Left in her wake, and he was
Enthralled, envious, and horrified,
But he listened to every word
She said on her return and became
Worldly through her words alone.
She told him the ways of the world,
And showed him the ways of a woman
With a condescending but caring grace
With only the slightest hint of cruelty.
She laughed at his naïveté, at first,
But gently removed it and did her best to leave
A campsite free from smoldering embers.
I was lucky, he said.
A sexy baby sitter took
My virginity off me before
It became a burden.
I became a man before
I finished being a child.
I knew my way around,
Worldly in the ways of women,
But lost in the wild abandon of boys.
The others were filled with envy.
If only they had had a nanny
With a name like big, fat Fanny!
They could have walked the world
With pride, chest out and shoulders high.
They would have been the rivals of the others,
And the heartbreak of daughters and mothers.
They would have lived on the loose,
The Lucky Ones.
And our brown-eyed boy
Was proud of his conquests.
He was the real wild one—
Drunk and disordered—
The loner untethered to anyone.
Promiscuity is praised in a boy,
And a sad loner has a certain mystique.
He was lucky no one could ever
Tie him down, and he
Tied the knot in the noose himself.
“I’ve had plenty of anonymous sex before,” she said, “and I still know how to find it.” Jan intended this as a threat or warning, obviously, but she also knew it stung in its own right. She first learned to weaponise her own sexuality when she saw the crestfallen look on her father’s face when she knew he knew what she’d gotten up to with John one night. Since that day, she had learned a number of ways to use her own numbness to sex to devastate men. Not that it made her feel that much better, but it was something.
Maybe it was revenge. Maybe it was something else, but it gave her a feeling of power, and who doesn’t want to feel that sometimes? Everyone wants to feel a little control over things. The way she told it, she had always controlled her own sexuality. She was 12 the first time, she said, and she knew exactly what she was doing. Her parents were gone for the day and she called her school band director on the phone and asked him over. It was her idea. That’s what she said.
She said it hurt, but he was very nice. He took care of her. When he lost his job at the school, she and some other girls formed a group to get signatures on a petition to get him his job back. They really liked him. When she graduated high school, she wrote to him to let him know she was doing all right, and he wrote back and said he was glad to hear it.
Bobby couldn’t believe what he was hearing. He told her she was only 12, for God’s sake, and definitely no child could be responsible for what she described. She had obviously been groomed and manipulated, and so had all the other girls. She was raped, he said, but she averred. “But I knew what I was doing was wrong,” she said, “That’s why I never told anyone before now.” Bobby told her it wasn’t her fault, but he wasn’t prepared for this conversation.
Somehow, he made her feel more judged than supported, not that he was trying to, but he really wasn’t equipped to respond to this information, and he felt a little sick. But Jan didn’t notice that. She was just trying to make a point about her prissy classmates who acted so shocked to find that a professor was having an affair with a student. She was just wanting to say, “Hello! I was having sex with a teacher when I was 12! Grow up.”
When the police made a routine visit
Next door, they arrived in full-body
Hazmat suits, as unneeded as they
Were insulting. It wasn’t AIDS then;
It was GRID (Gay-Related Immune Deficiency). Well-educated people
Actually believed just being gay
Would kill you, and the police seemed
To have a database of everyone with
The Gay Plague. Actually, they just had a
Database of their own prejudice and
Paranoia. And we watched in horror
As they spread indignity like butter on
Toast, fear and hatred choking their arteries.
Of my neighbors, Roger went first.
He was already sick when I met him,
And I never had the opportunity to know
Him. Mark was still working, though he had
Some early signs of sarcoma, so his future
Was already written. His partner, Don, appeared
Healthy. He was a landscape designer, responsible
For the most striking gardens of Houston’s
Most prominent residents, a celebrity gardener,
Treated like sewage by Houston’s finest.
When Mark died, his family showed up at Don’s
House to clear out their son’s belongings. They
Gave nothing to their son in life, but took
Everything in his death. Don had a right to nothing
But loss, shame, and seemingly infinite grief.
And Mark’s memorial service was just another
That week. Another loss and another step to an
Inevitable conclusion for the survivors.
That’s how it was, see? Calendars were not
Marked with birthdays, parties, and holiday
Trips. They were filled with funerals, memorials
Medical screenings, blood tests, hospital visits,
Learning the vernacular of T-Cells and viral loads,
And no fucking time left to just sit down and cry.
Grief was a luxury no one could afford, and
Activism was a necessity no one could ignore.
They say the community came together, but it
Was forced together by hatred, fear, and indifference.
When you hear public officials say the solution to AIDS
Is to “shoot the queers,” you bury your friends and lovers,
Cry and scream, and come together to Act Up. We went from
Being gay, lesbian, bi, and trans to being a Queer Nation.
We argued about what words, what language, would work
Best, but we never forgot our common cause: Survival.
In that book, Nausea, Jean-Paul Sartre’s
Antoine Roquentin gets kind of freaked
Out just looking at the root of a chestnut tree.
I thought it was pretty weird at first,
Because how can you get through life
If you freak out every time you see a
Tree root or some fool thing like a tree root?
You couldn’t go on, could you? It’d just be
One crisis after another until you went
Insane and did yourself in, but then
I kind of get it. I mean, if you look at
Anything for awhile, it can get you thinking,
And thinking is always the risky part.
Once you start thinking, everything comes
Into question, and you might not even
Be able to tell if a root is real, or you
Might start to think the root is conscious
And is staring at you, or you might start
To wonder if you are real. I mean, you
Could be part of the consciousness of
The root, but it wouldn’t have to be a root,
Either, would it? Any damn thing can send
Your thoughts careering out of control,
And you might just start feeling a little
Overwhelmed. You might feel like you can’t really
Talk to anyone, because you’re not sure whether
They are like you. Maybe they don’t see the same
Colors. Maybe they don’t feel the same feelings.
Maybe you are the only one who knows what
Pain is. Or maybe you’re just a character in their story.
But Sartre said he never felt that kind
Of nausea, and now you think maybe he was
Just an asshole. Maybe he just thought up a
Lot of stupid shit just to make money off
People who were socially anxious like
Roquentin or just anxious generally.
It was all just a joke to Sartre and his
Mescaline addled buddies, but you are
Starting to see things more clearly now.
You’re starting to want to punch that jackass
In the face, and you finally realize
Albert Camus was right about everything.