ethics
On Pharma-Funded Ethicists
Is it ever ethical for an ethicist to accept industry funding?
Why EMRs Are Crucial To Patient Satisfaction
How to Destroy Education (And a Nation)
- Instead of having instructors rate the scholastic achievements of their students according to effort and ability, rate the performance of instructors by how many of their students pass the class (or a standardized test). Alternatively, rate the performance of teachers by how entertaining their students find them to be.
- Turn student assessments over to the same corporation that prepares your textbooks and classroom resources.
- Expand online classes and purchase instructional modules prepared by the same corporation.
- Use instructional modules for both online and classroom lectures, reducing teaching to rote repetition of corporate-sponsored material.
- Tell instructors that the lecture is dead and should be replaced with professionally prepared audio and video materials, conveniently provided by corporate textbook publisher/testing service.
- Have students rate professors’ “effectiveness” as teachers. A study by Scott Carrell and James West found that “student evaluations reward professors who increase achievement in the contemporaneous course being taught, not those who increase deep learning.”
- By judging teachers on student success, ensure that teachers at the most selective schools are judged to be the best teachers.
- Promote best practices for teaching that are based on the success of teachers at the most selective schools.
- Ensure that teachers fear retaliation if sufficient students do not pass their classes. Establish a quota for passing grades.
- Give students the impression that they will pass the class no matter how little work they do (see previous). A blog post by Richard Vedder notes that a National Bureau of Economic Research study by Philip Babcock and Mindy Marks found that “In 1961, the average student spent 40 hours a week engaged in their studies—attending class and studying. By 2003, this had declined by nearly one-third to 27 hours weekly.” Probably gotten worse since 2003. Students are doing less and less work while simultaneously being rewarded with better grades.
- Cut funding for education, forcing colleges to seek “public-private partnerships,” which enable corporations to determine the educational objectives of the college.
- Have adjuncts teach most of your classes with low pay and no benefits.
Is Bill Gates a Trojan Horse?
Bill Gates gives away huge sums of money. I could provide some links here to verify that he gives away huge piles of cash, but, really, is anyone going to claim he does not? It is obvious that he could not give away so much money if he did not happen to have enormous bank balances to begin with. So, thank goodness Bill Gates was able to become so insanely rich. And thank goodness all those corporate sponsors of aid were able to amass gigantic storehouses of funds to distribute globally to alleviate poverty and disease while promoting free markets and democracy. Except maybe it is not that simple.
Andrew Carnegie saw philanthropy as a duty of the wealthy. The mere fact that someone was able to obtain great wealth is evidence enough for man that that person is a great judge of what should be done with the money. The wealthy must serve as role models and administer funds in ways that are good for the poorer members of society, even if their choices are not popular. Carnegie said:
Apparently, the wealthy fear giving the money directly to the poor might corrupt them or tempt them to bring about their own destruction. So, the benevolent man of means, and Carnegie does not mention women of wealth, should work for the care and improvement of the lower classes.
And in doing so, the wealthy establish not only their honor, but also their power. As Thomas Hobbes said, “There can be no greater argument to a man, of his own power, than to find himself able not only to accomplish his own desires, but also to assist other men in theirs: and this is that conception wherein consisteth charity.” Through charity, the wealthy shape the aspirations of society, the resources for improvement, and the goals of the impoverished. The poor cannot be trusted to make autonomous decisions about what is good and proper for the course of society. In order to receive the generosity of the powerful, the weak must assume a position of obedience and servitude. The superior minds will lead with love if only the grateful masses will follow.
But it does not end there—the wealthy engage in a kind of philanthropy that actually seeks to oppress and exploit the poor. This is true in many instances, but it currently most obvious in some forms of foreign aid donations.
In the current political climate in the United States, we often hear that aiding people engenders a culture of dependence. Most people imagine that the recipients of aid become too lazy to work for their own improvement, but that is not how aid creates dependence. Rather, it can create dependence by destroying any possibility of self-sustaining local markets. Economist Dambisa Moyo sums up the problem of aid to Africa when she says, “One wonders how a system of flooding foreign markets with American food, which puts local farmers out of business, actually helps better Africa.” Michaela Schieesl made a similar point, saying, “The United States spends $1.2 billion on food for the world’s hungry, making it the biggest provider of food aid. It is also the biggest contributor to the UN’s World Food Program (WFP). But this seemingly charitable commitment comes with a major hitch: Instead of donating money, the United States donates food, almost all of which it produces itself.”
The US donates food not as a means of helping struggling societies, but rather as a means of subsidizing American farmers and agribusiness. By dumping free food grown in the US, farmers in foreign countries are put out of businesses. Of course, if they turn to alternative crops such as poppy, coca or even tobacco, the farmers are condemned for contributing to the global drug trade and supporting violence and addiction.
The ETC Group in Canada now warns us of another scheme to use philanthropy to help entrench monopoly powers of transnational corporations under the guise of aiding poor farmers:
This international aid effort has the effect of ensuring more and more of the world’s food production will be controlled by transnational corporation promoting market-based “solutions” to global food insecurity. The ETC Group notes that the World Economic Forum’s New Vision for Agriculture, which includes all the giant gene producers, describes itself as working with G8 and G20 to “foster multi-stakeholder collaboration to achieve sustainable agricultural growth through market-based solutions.”
Not all aid is bad, however, and giving can save and improve lives. Moyo and other critics of aid are quick to point out the difference between rescue or relief aid and aid that permanently alters economic structures. My opinion is that smaller donors tend to choose charities based on how they relieve suffering rather than how they either guide, manipulate, or oppress the poor. Modest earners give a higher percentage of their income than the super rich. In an article for The Atlantic, Ken Stern noted, “In 2011, the wealthiest Americans—those with earnings in the top 20 percent—contributed on average 1.3 percent of their income to charity. By comparison, Americans at the base of the income pyramid—those in the bottom 20 percent—donated 3.2 percent of their income.” Stern added that among donations from the wealthy, “Not a single one of them went to a social-service organization or to a charity that principally serves the poor and the dispossessed.” More modest earners are more likely to look out for the interest of the poor.
Addressing income inequality would have two positive effects: First, it would help alleviate the need for any aid. Second, it would help more modest earners to give more and give more effectively. And, no, lifting people off the floor will not make them behave as those at the very top (in the stratosphere of wealth disparities). Rather, as the poor enter the middle class, they give more than the super wealthy and give with an aim to relieving suffering and not to creating monopoly power or consumer dependence.
Also, be sure to read Peter Buffett’s comments on the same subject here.
Finally, for an example of a charity operating from the ground up, please see Shoulder to the Stone.
[youtube=http://www.youtube.com/watch?v=UlnLojVPacM]
Related articles
- Rich People Aren’t Makers, They Are Takers (huffingtonpost.com)
Teaching Ethics to Greedy Bastards
When a corporate executive, high-powered lawyer, or well-funded medical researcher is exposed for egregious unethical behavior, we often say it would have been a good idea for that person to have had a class in ethics with some follow-up training. We’d like to think that with the proper ethics training even the most heartless sociopath could be encouraged to at least follow some of the rules.
And if we can’t (note: we can’t) encourage bad people to be good people, what are ethicists worth? Well, our roles fall into several categories: 1. Providing ethical answers to dilemmas. 2. Offering ethical analysis of a particular problem. 3. Teaching ethical decision-making, which makes a good-faith assumption that the decision maker is sincere in wanting to be ethical. 4. Holding wrongdoers accountable for their behavior.
The first category is offered to clients who don’t want to take complete responsibility for their ethical decisions. Once a professional ethicist has offered an opinion on whether something is above board, an organization can say, proudly, “All our policies and procedures have been reviewed by someone with extensive training and expertise in ethics and found to be compliant with all ethical and legal codes.” Indeed, it can be a very good idea for an organization to get an outsider to review policies for possible ethical problems.
The second category is related, perhaps a subset of the first. When institutions encounter a particularly sticky issue, they might ask an ethicist to help them work through all the ethical considerations and explore how various ethical theories can help them solve the dilemma. Again, a useful role for the ethicist.
The third category involves training. Rather than giving answers to ethical questions, the ethicist can teach motivated individuals to analyze various conflicts on their own. Most people know how to think ethically, but they sometimes forget some of the considerations that professionals might find to be second nature. Developing a more thorough approach to ethical approaches can benefit individuals and organization alike. It cannot, however, turn a bad person in to a good one. Evil people don’t lack ethical tools—they lack a conscience.
So, what do we do about the evil people? An important role for ethicists, in my considered and passionately held opinion, is to cry foul when individuals and institutions engage in egregious behavior. And when ethicists disagree on what is an egregious action, fervent debate erupts in the public sphere, benefitting the public and everyone involved, or so it should be. When ethicists sound the alarm that some behavior is abhorrent and shameful, a public chorus against such actions can at least ensure that the bad actors confront public scrutiny.
Think it doesn’t work? Remember in 2011 when executives at Transocean received bonuses for their safety record after the explosion in the Gulf of Mexico killed 11 and sent millions of gallons of oil streaming into the water? After public outcry, the executives thought better of keeping those bonuses and donated them to the Deepwater Horizon Memorial Fund. Social regulation pushes and pulls behavior through honor and shame. In responding to abhorrent behavior, Kwame Anthony Appiah says, “Shame, and sometimes even carefully calibrated ridicule, may be the tools we need. Not that appeals to morality—to justice, to human rights—are irrelevant.”
Most of us evaluate ethical theories in the following way: Knowing that I am an ethical person, which ethical theory best fits my behavior? Following this method, we can all justify our actions through theoretical ethics as we simply seek out the theories that validate our behavior. Given that we all have justification for our behavior, public outcry is not likely to immediately shake our perception of what is appropriate, and, indeed, the public rarely speaks as one voice. Further, the common view is often wrong, or so I judge it to be. Bertrand Russell once said, “In view of the silliness of the majority of mankind, a widespread belief is more likely to be foolish than sensible.” Indeed.
Many people, especially those in power, feel their behavior is beyond reproach. They seem to think they could not have gained power if they were not deserving of it. Public outcry and public discourse, can remind them that they are, in common with the rest of us, flawed and fallible human beings. What this means is that we must raise our voices, express what we find shameful and honorable, and join or create a conversation over morality, dignity, and justice. Only when we suppress our voices do we lose. Only our common humanity makes our salvation possible.
Modern Libertarians Hate Thomas Malthus
Whether they are familiar with his work or not, many modern libertarians echo some of the ideas of Thomas Malthus when they advocate austerity in public policy. Most notably, Malthus claimed that the “poor laws” of England of his time deprived the poor of any liberty and independence. He felt that the poor would have more self-respect and freedom if they could provide for themselves and their families through their own labor.
It was Malthus, not Darwin, who first mentioned a struggle for existence. In his 1798 screed, “An Essay on the Principle of Population,” he
wrote,
“Restless from present distress, flushed with the hope of fairer prospects, and animated with the spirit of hardy enterprise, these daring adventurers were likely to become formidable adversaries to all who opposed them. The peaceful inhabitants of the countries on which they rushed could not long withstand the energy of men acting under such powerful motives of exertion. And when they fell in with any tribes like their own, the contest was a struggle for existence, and they fought with a desperate courage, inspired by the rejection that death was the punishment of defeat and life the prize of victory.”
In the essay, Malthus basically argued that hardship limits population but abundance leads to population explosions. For this reason, feeding the poor is a bad idea, as it will encourage wanton reproduction and the survival of infants into adulthood. By helping the poor survive, they would then multiply and deplete the planet of all its resources. It is the wealthy, of course, who consume the most resources, but even at that, Malthus did not have quite the same view of some austerity minded people of the 21st century.
For one, Mathus wanted to protect the value of farm labor. He said,
“Every endeavour should be used to weaken and destroy all those institutions relating to corporations, apprenticeships, etc., which cause the labours of agriculture to be worse paid than the labours of trade and manufactures. For a country can never produce its proper quantity of food while these distinctions remain in favour of artisans. Such encouragements to agriculture would tend to furnish the market with an increasing quantity of healthy work, and at the same time, by augmenting the produce of the country, would raise the comparative price of labour and ameliorate the condition of the labourer.”
Efforts to drive down the wages of farm labor are, then, anti-Malthusian. He also did not believe in leaving the poor with no help for work and redemption. While he objected to the “poor laws” of his day, he did believe in a tax-supported programs to provide employment for the poor. Thus,
“County workhouses might be established, supported by rates upon the whole kingdom, and free for persons of all counties, and indeed of all nations. The fare should be hard, and those that were able obliged to work. It would be desirable that they should not be considered as comfortable asylums in all difficulties, but merely as places where severe distress might find some alleviation. A part of these houses might be separated, or others built for a most beneficial purpose, which has not been infrequently taken notice of, that of providing a place where any person, whether native or foreigner, might do a day’s work at all times and receive the market price for it.”
Public works projects, such as those put in place by FDR, can alleviate much suffering while also benefitting the public good through improved infrastructure and public service. Note that Malthus did not advocate putting poor people in prison and forcing them to work for free. Malthus did believe in treating the poor with respect and providing opportunities for honest employment for the betterment of society. Modern libertarians would do well to recognize the basic human desire for dignity and self-respect. When we help one another, we are free.
What is Bioethics? Environmental and Economic Justice
Like many people, Peter Singer was the first bioethicist to occupy any space in my consciousness. He first got my attention with his concern for animal welfare and calls for vegetarianism. I suppose he is best known for saying we should not eat animals but that it is sometimes acceptable to kill our babies, which many people find upside down, especially if they haven’t actually read all his arguments, and few of his critics seem to have read his arguments.
But Singer has also spent a great deal of effort offering suggestions on relieving the problems of globalization, wealth inequality, and further destruction of the planet. One can offer reasoned objections to his suggestions, of course, but his choice of topics and concerns helped define what bioethics was for me.
Singer’s concerns fit nicely with the term “bioethics” as originally conceived by Van Rensselaer Potter in 1970. Potter said bioethics should be “a new discipline that combines biological knowledge of human value systems.” Potter saw bioethics as a systematic attempt to ensure the survival of the planet and all the people on it. One of Potter’s goals was to eliminate “needless suffering among humankind as a whole.”
Unfortunately, by the middle of the 1970s, the term “bioethics” had already been co-opted by the medical establishment and applied primarily to medical ethics. Concerns for ensuring the well-being of humankind were replaced by concerns for patients and doctors, with a strong emphasis on patient autonomy. Today’s bioethicists tend to ignore problems that have nothing to do with healthcare or medical research, but millions of people in the world have no access to healthcare and so escape any attention from bioethicists at all, which is itself an injustice.
To be sure, bioethicists are still in the world working for justice and, in some notable cases, the survival of the planet, but those working on themes outside of healthcare or medical research are outsiders at best. (For a couple of examples, see Martha Nussbaum and Thomas Pogge.)
I will continue to argue that this is the wrong approach to bioethics. Potter’s and Singer’s concern for promoting the health of the earth and all its inhabitants is the only reasonable way to think of bioethics, and those who disagree are the ones who should defend their positions.
What are some of the issues we need to address? Just to get us started, we can look at environmental justice, war, climate change, worker’s rights, wealth inequality, access to water, human rights abuses, women’s equality, and children’s welfare. Too broad? The problems that threaten life and health are vast. Medical practice requires an enormous cadre of professional ethicists to develop policy and practice guidelines, of course, but bioethicists following the vision of Potter should be welcome at the table as well.
The ethics of eating talking plants
In a blog post on The Atlantic Wire, Sara Morrison writes,
“Just when moral vegetarians thought their meal of choice wasn’t sentient, it turns out that plants can totally talk to each other. Even weirder, they communicate through underground fungi. So mushrooms aren’t cool to eat, either. Sorry.”
Because that is how simple moral reasoning is. Morrison assumes, with no evidence, that moral vegetarians base their decisions on whether animals can communicate. This may be because others such as Descartes have denied that animals can have thought without language. Descartes further argued that without thought animals could no more experience suffering than a machine could. Perhaps to make a point, or not, he described some rather vivid scenes of vivisection.
But it is a mistake to think ethical vegetarians are motivated by Descartes’ thinking. We tend to think more along the lines of Jeremy Bentham, who famously said:
“Is it the faculty of reason, or, perhaps, the faculty of discourse? But a full-grown horse or dog is beyond comparison a more rational, as well as a more conversable animal, than an infant of a day, or a week, or even a month, old. But suppose the case were otherwise, what would it avail? the question is not, Can they reason? nor, Can they talk? but, Can they suffer?”
In response to the ethical vegetarian’s focus on suffering, some philosophers such as Daniel Dennett have shown that it is at least possible that animals can experience pain without the attendant suffering that vegetarians assume. It is possible that animals are automata that respond to pain without being aware of it, just as we may roll over in our sleep when we become uncomfortable (Dennett’s example). We can feel the pain and respond to it with no awareness whatsoever. (Interestingly, Dennett seems pretty sure dogs, and no other animals, may experience suffering in an otherwise uniquely human way.)
So, ethical vegetarians are stuck between those who claim that plant communication implies suffering that make moral demands on them and people who deny that clear expressions of pain are conclusive evidence that any given creature actually experiences suffering. For me, I’m quite content to assume that plants are not suffering until they express their suffering in a less ambiguous manner (or someone manages to measure it in a more convincing manner). At the same time, I’m content to assume animals with a nervous system similar to mine and pain expressions similar to mine are experiencing some kind of suffering that is enough to motivate some moral concern on my part.
At any rate, I can’t imagine how an indifference to the appearance of suffering can be something to go around bragging about. (And one final note: I really don’t understand vegetarians who are inexplicably eager to explain that they have no concerns whatsoever about the suffering of sentient beings but are only trying to lose weight or something.)
Bloomberg, human rights, and the ethics of soda
Recently, a New York court blocked New York Mayor Michael Bloomberg’s effort to limit the sale of sugary drinks of more than 16 ounces. The court and many individuals feel it is not up to the government to regulate the choices of individuals, even if those choices lead to death. And lead to death they do. A study at the Harvard School of Public Health claims that sugary drinks lead to 180,000 deaths worldwide each year, with 25,000 of those deaths in the US.
It isn’t at all clear whether limiting the size of drinks would reduce the disease burden, but I have to commend Michael Bloomberg for at least saying that the drinks are dangerous, which may help to raise awareness of the problem. The Harvard study links the drinks to the rise in diabetes, heart disease, and cancer. The beverage industry, of course, challenges the methodology of the study.
No one claims, however, that consuming large quantities of super-sweetened sodas is in any way healthful. People can choose to kill themselves with soda, but they should at least be aware of the danger. Perhaps warning labels, similar to those that appear on cigarettes, are in order. Smokers still choose a slow form of suicide, but they can’t claim they didn’t know what they were doing.
One problem with the large drinks, besides the harm, is the pricing structure. I’ve noticed that the largest drinks are often only slightly more expensive than the smaller sizes. Forcing retailers to sell the drinks on a per ounce basis might help achieve Michael Bloomberg’s objectives, though I’m sure this solution would not satisfy free-market libertarians, who are more concerned with private profit than public good.
But this focus on public health ignores a larger problem with the food we eat. As part of its Behind the Brands project, Oxfam recently released a briefing paper on food justice and the big 10 food and beverage companies (Associated British Foods, Coca Cola, Danone, General Mills, Kellogg, Mars, Mondelez, Nestlé, Pepsico and Unilever). The report notes:
“Today, a third of the world‟s population relies on small-scale farming for their livelihoods. And while agriculture today produces more than enough food to feed everyone on earth, a third of it is wasted; more than 1.4 billion people are overweight, and almost 900 million people go to bed hungry each night.”
The report goes on to say, “The vast majority of the hungry are the small-scale farmers and workers who supply nutritious food to 2 – 3 billion people worldwide, with up to 60 percent of farm laborers living in poverty.” The inexpensive food and drink we buy demands conditions that are often horrific for the people who farm and produce the food. Many of us buy drinks sweetened with real sugar to avoid the perceived harms of high-fructose corn syrup, but note that Coca-Cola is the world’s largest buyer of sugar cane, which is associated with rampant use of child labor and unconscionably low wages.
According to CNN, the International Labor Organization “estimates 2.4 million child workers are in the Philippines. Many of them, according to the ILO, are in rural areas working in fields and mines. The organization estimates 60% work in hazardous conditions.” According to Coca-Cola’s website, “A grant from The Coca-Cola Foundation funded the construction of a high school in Bukidnon, which has the country’s highest incidence of child labor and the highest number of school-aged children not working or attending school.” The idea is that the children who are in school will not be in the fields. Also, educated children will be empowered to seek and create better economic conditions and wages.
If efforts to educate children used in the supply chain for sugary drinks actually do reduce the amount of cheap (nearly free) labor, the price of sugary drinks is likely to rise, which may in turn reduce demand for the diabetes/heat disease-inducing drinks in the first place, achieving Mayor Bloomberg’s initial objectives. Will the drop in demand eliminate job prospects for the world’s farmers? The ethics of food, and drink, is complicated.