Stop infantilizing old people, please

R. Horton1 Comment

As I write this, I am 55 years old. Like most people my age, I like to think I am a “young 55” or that I look good “for my age.” As I get older, I think I have become a little more patient, more accepting, less doctrinaire, and, yes, sadder and wiser. However, I have not become more adorable, precious, charming, or sweet.

Although I am not yet extremely old, I’ve already noticed that younger people I hardly know sometimes refer to me as “sweetheart” or “sweetie.” This seems to be a particular problem in healthcare settings. Some call it “elderspeak,” which is characterized by treating older people more as children than as fully functioning adults (I personally feel this demeaning language is often inappropriate for children as well, but I will take one thing at a time). For some reason, when people talk to older patients, they tend to slow their speech, raise the volume, and sing their sentences. In addition, every statement seems to become a question and second person pronouns are replaced with first-person plural pronouns ( e.g., “you” becomes “we”). You can read more about this phenomenon here.  At a time when nursing home workers are sharing explicit photos and videos of older adults on social media, complaining about “sweetheart” seems almost quaint, but both the diminutive terms and the more extreme demeaning media rob patients of their dignity and personhood.

Other people seem to think they are honoring older adults by treating them as mascots. Many videos on social media feature adults who are “adorable” or “precious” dancing, singing, or doing other activities they have no doubt done for their entire lives. The videos are presented with the exact same attitude behind videos of kittens, puppies, and babies. Samuel Johnson once said, “A woman’s preaching is like a dog’s walking on his hind legs. It is not done well; but you are surprised to find it done at all.” Videos of the elderly seem to take the same attitude: it is amazing that older people might still do the things they love. If they make the attempt to engage in the activities that make them happy, the are “so cute.”

The consequence of assuming adults become children once again in later life can have serious consequences. For instance, healthcare providers often ignore the sexual health of older patients. As this article states, “prevailing misconceptions among healthcare providers regarding a lack of sexual activity in older adults contribute to making elders an extremely vulnerable population.” The result of this ignorance, is that STD rates among the elderly are increasing at an alarming rate. Although about 80 percent of adults aged 50 to 90 years old are sexually active, they are infrequently screened for STDs.

I am more concerned, though, about the basic harm of a society that treats its elders as mascots for amusement. As we age we lose the respect of our fellow beings and we lose our status as persons. For the most part, younger people don’t mean any harm, even if they are doing harm; they are acting out of ignorance. That being the case, I am here to help. The following are things you should know about your elders:

  1. They have and talk about sex. In a movie, it is always easy to get a good laugh by having an old person, especially an old woman, make any kind of statement that indicates she knows what sex is. Apparently, many young people believe that when you hit a certain age you become an innocent and naïve virgin, completely unaware of how people reproduce.
  2. They curse. This is related to the first point, but it slightly different. If you curse now, you will probably curse in 10 or 30 years. At what point do you think it should become funny or cute? Old people have the same right to words that everyone else has. Language is a human right.
  3. They still know how to do things. It isn’t amazing that someone who has danced since he was seven still likes to cut the rug when he is 80. Our abilities may diminish over time (some do and some don’t), but we don’t suddenly forget everything we’ve learned over a lifetime.
  4. They are still rational and intelligent. I realize we all suffer some cognitive decline as we age and some are affected by diseases that accelerate or accentuate that decline, but young people also suffer brain injury, disease, and other limitations on cognitive ability. Age is not a sufficient reason to believe someone is stupid.
  5. They’ve won the battles you are fighting. Somehow, your elders have survived. If you can manage the same, you should be honored, as you should honor them now. Any old person can tell you it isn’t easy growing old. Someone who has survived had the wits and strength to overcome many adversities. They could teach you a thing or two.
  6. They are persons. Here, I am using the word “persons” in a philosophical sense of someone who bears human dignity and value. It does not diminish as you age. If anyone has value, you do.

In case you haven’t seen any of the videos I described above, here is an example:
[youtube https://www.youtube.com/watch?v=R7Br3-5L6hM]

The Mirror: Reflecting on Reflection

R. Horton

—Whatever happened to that thing you wrote?

—Thing I wrote?

—You wrote something many years ago.mirror-800px

—I wrote many things many years ago.

—But this was a thing. Someone asked for it.

—Oh.

—A thing. For a movie?

—A movie? Yes. Or a play. Or something.

—What happened to it?

—I don’t know.

—Did they like it?

—Who?

—The people who asked you to write it.

—I don’t know. Someone said they did.

—Who said they did?

—I don’t remember.

—What was it about?

—About?

—Yes, what was the plot?

—Plot? It was words.

—But all writing is words. What did it mean?

—What do you mean what did it mean?

—What was it trying to say? What was the story?

—It didn’t mean anything. It was just words.

—But what was it about? Where was it set?

—It was just words. It wasn’t about anything.

—How can words not be about anything?

—Words aren’t about anything. They don’t mean anything.

—That’s not possible. Who were the characters?

—Characters? You don’t seem to understand.

—No, I don’t understand.

—It’s a puzzle.

—Puzzling, anyway.

—Were there people in it?

—What? People in what?

—The thing you wrote.

—It was words.

—Did someone speak the words?

—Someone could.

—Or not?

—Or not.

—What about images?

—What kind of images?

—Illustrations.

—Nothing to illustrate.

—To help readers understand.

—No one understands the meaning of words and images.

—But they must understand something.

—Why?

—Art and language are forms of communicating.

—So you say.

—Everyone believes it is true.

—Most people seem to.

—How else can we let people know what we are thinking?

—I don’t know what you are thinking.

—But you have an idea?

—You will never know.

 

 

Sparkle, Autonomy, and the Right to Die

R. Horton1 Comment

Recently a woman in the UK known only as C won the right to effectively end her life by refusing dialysis treatment. Owen Bowcott, writing for The Guardian described it as a “highly unusual judgment,” but, in making the decision, the judge said, ““This position reflects the value that society places on personal autonomy in matters of medical treatment and the very long established right of the patient to choose to accept or refuse medical treatment from his or her doctor.”

The judge is correct; the right to refuse treatment is one of the bedrock principles of medical ethics. In most medical decisions, autonomy trumps all other considerations, including efficacy of possible treatment. In other words, you are not obligated to accept treatment simply because it will prolong your life. This is the newnhamm-MultiColored-Sparkle-fixed-2400pxway things work in the world of medicine, but there could be other approaches.

Given the facts of this case, it seems a suicidal person sort of “lucks out” when an unrelated medical issue arises. Unlike C, not everyone seeking death is able to find a legal way out. Those who are so physically incapacitated that they cannot possibly end their lives without help often find too many roadblocks to death to ever carry it out. Even when healthy people try to commit suicide, the rest of us are obligated to prevent it when possible. If we find someone who has taken a drug overdose, for example, we try to save him or her. If someone is trying to jump off a bridge, we try to prevent it. And if someone asks for drugs to commit suicide, only a few places in the world allow them to be prescribed.

It is clear that we do not always respect the autonomy of suicidal individuals. Even in the case of C, the judge said, “My decision that C has capacity to decide whether or not to accept dialysis does not, and should not prevent her treating doctors from continuing to seek to engage with C in an effort to persuade her of the benefits of receiving life-saving treatment in accordance with their duty to C as their patient.” The judge seems to feel that the doctors ought to continue trying to save C, even while recognizing that she has the right to refuse treatment.

Clearly, the law in this case is built around autonomy, but perhaps it shouldn’t be. Autonomy assumes a rational and unimpaired person making a fully informed decision. The judge notes that C is fully functional and has no cognitive impairments. At the same time, though, C is facing a diagnosis of breast cancer and a severely damaged self-image. It isn’t clear that she may not modify her view with a little time and, perhaps, psychotherapy.

If her mental health is impaired, she may not be fully autonomous in the first place. If she isn’t, then perhaps she needs care more than freedom. An Ethics of Care would possible guide us to respect her wishes as well as her needs. A little more time may be needed to assess whether her decision, which is not reversible, is truly the decision she wants to make. With a little time and support, she may come to believe that sparkle is still possible for her.

I also think a focus on capabilities might be relevant. An ethics focused on capabilities would try to enable her to have a fulfilling life by maximizing the abilities she still has. Care and capabilities both emerged as feminist approaches to ethics and justice. While on the surface, this may not seem to be a feminist issue, but the judge also said, “It is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.”

It is clear that C has operated under rather sexist values for most of her life. That is her choice, to be sure, but it might be possible to find new values. Many who have experienced crippling injuries have sought suicide only to later find their lives are valuable and meaningful even without the activities and relationships they once held dear.

Book Review: The Experiment Must Continue by Melissa Graboyes

R. Horton

We all have a complicated relationship with medical research. We know that every effective treatment or therapy that exists was once an experimental treatment or therapy. We know that some drugs have been so effective that they eradicated various diseases completely, and we also know that someone had to be the first one to try all those new drugs. On the other hand, most new drugs don’t work out. Some are simply not effective, some are effective but have serious side effects that make them all but useless, and others turn out to be deadly.

Medical research is plagued with problems related to consent, coercion, therapeutic misconception, benefit, and access. All these problems exist Medical-Research-800pxin North America and Europe with both well educated, affluent populations and with so-called “vulnerable” populations.

Informed consent is an example. Virtually everyone agrees that patients who participate in medical research should know about and agree to their own participation. Ethics committees, lawyers, and bioethicists have gone to great pains to develop procedures for proper informed consent procedures. Sadly, too many people talk to their doctors about treatment options, hear about ongoing research, and sign consent forms without actually realizing they have agreed to participate in a medical experiment. Despite the best intentions of everyone involved, patients believe they are receiving treatment that is expected to help them (therapeutic misconception).

I sometimes use the HBO film adaptation of Margaret Edson’s play, W;t, in my classes. The main character in the play agrees to experimental treatment, is informed of the side effects and goals of the research, and then goes on to suffer tremendously for her decision. When I have my students write about the movie, more than half of them still believe the doctors were trying to cure the cancer of the main character. Despite all the frank discussions of the research, they still don’t understand that the protagonist was never expected to benefit from the treatments she was receiving. Furthermore, the character never seemed to fully realize that her participation was never expected to benefit her in any way.

If these kinds of misunderstandings happen between researchers and research participants from the same culture speaking the same language, the problems are sure to be compounded by cross-cultural communication. In her book, The Experiment Must Continue: Medical Research and Ethics in East Africa 1940 – 2014,Melissa Graboyes explores ethical challenges and lapses in numerous studies conducted in East Africa. Her book is a refreshing attempt to shed “conventional wisdom” about research in Africa.

For example, I think anyone who has studied research ethics has heard that African chiefs would sometimes provide consent for all the people in a village to participate in research projects. Graboyes says she could find no evidence that anyone in any of the locations under study ever recognized the right of anyone to give collective consent for a group of people. Further, many describe African research participants as “vulnerable” populations with little to no agency. In the sense that many people lack adequate medical care, they are vulnerable, but Graboyes challenges the notion that they lack agency and gives several examples of Africans responding actively and rationally to both exploitative research and beneficial research. In short, she shows that they are actually persons with wills, minds, autonomy, and awareness.

Another common theme for those studying research ethics is the use of coercion to get people to enroll in trials. Many wring their hands worrying over whether offering payment or gifts might unduly coerce potential participants whose desperate poverty might drive them to enroll. Those who did enroll, however, were more concerned about inadequate compensation than undue coercion. Participants realized that others would benefit from research carried out on their bodies or in their homes. In exchange for participating, they felt some reasonable benefit was due, whether it be in the form of cash, medicine, or health services.

One possible benefit, of course, is access to medicines researchers commonly advertise that participants will receive a new treatment at no charge. Many African participants assumed they were trading their blood for research and in turn would receive medicines that would benefit them. In some cases, participants did receive helpful medications, but those medicines were then withheld from them at the end of research, even if it proved to be effective. Researchers say it isn’t their responsibility to provide the medications, which may or may not be expensive, but leaving people with the knowledge that an effective treatment exists without making one available seems to me to be a particularly cruel kind of harm

In the United States, people also expect access to new medications. When people find they have a terminal illness, they will often (I want to say usually) demand to receive experimental medicines. In the 1980s, AIDS activists in the US demanded that experimental treatments be distributed to HIV-positive individuals, and demands for quick approval for experimental drugs have become routine. In this sense, medical research may be a victim of its own success. Most people in either America or Africa fail to appreciate the risk they take with unproven medicines.

Although many researchers view Africa as a fertile field for research (many describe Africans and “walking pathological museums) for the abundance of diseases present and for the relative low costs involved compared to research conducted in Europe and North American. Graboyes describes both successes and failures in East Africa, but the failures can be depressing. In some cases the research never got off the ground, in some it never produces usable results, and in some it made conditions much worse.

Is it unethical to conduct research in Africa? Graboyes doesn’t think it is necessarily unethical to conduct research in East Africa, but she does feel some of the research has been unethical, some simply misguided, and some poorly designed. Many Africans do not trust researchers, which is frustrating to researchers who feel they are on a noble quest to end disease, but many of them fail to realize how many researchers have told outright and deliberate lies in East Africa. People do not forget so easily.

I don’t want to give away too many details of the book, as it can become something of a page-turner. One last thing I will mention, though, is the fact that Graboyes was aware that she was another researcher visiting East Africa asking for cooperation. Although she wasn’t taking blood, spraying insecticides, or injecting treatments, she still needed to ensure that she was proceeding ethically and had the trust of the people she was interviewing. Her efforts are admirable but remind us that any reporting of facts is a matter of interpretation and may be subject to modification.

This book is admirable and compelling, especially for those interested in the ethics of international research. In addition, her insights might help to develop better ethical practices for domestic research, as many of the issues are the same.

Reid Ewing and the Failure of Autonomy in Bioethics

R. Horton3 Comments

Reid Ewing of Modern Family fame recently wrote publicly about his struggle with body dysmorphia in a personal essay on the Huffington Post. Ewing revealed that his dysmorphia led him to seek and receive several surgeries. He feels his surgeons should have recognized his mental illness and refused to perform surgery. He wrote, “Of the four doctors who worked on me, not one had mental health screenings in place for their patients, except for asking if I had a history of depression.”

The principle of autonomy is by far the most discussed principle of bioethics. Discussions typically focus on the rights of patients to refuse treatments, not to seek them. On either side, the issues can be thorny. If a depressed and suicidal patient refuses life-prolonging treatment, is it ethical to respect the patient’s autonomy or should mental health services be provided first? As in Ewing’s case, the ethical problem arises from the claim that the decision is driven by mental illness and not reason. If someone is mentally ill, they are not fully autonomous agents as they are not fully rational.

This is a problem with autonomy in general. Our ideas of autonomy come largely from Immanuel Kant, who claimed that all rational beings, operating under full autonomy, would choose the same universal moral laws. If someone thinks it is okay to kill or lie, the person is either not johnny-automatic-gloved-hand-with-scalpel-800pxrational or lacks a good will. How do we determine whether someone is rational? Usually, most of us assume people who agree with our decisions are rational and those who do not are not rational. If they are not rational, they are not autonomous, so it is ethical to intervene to care for and protect them.

Earlier this year, a woman named Jewel Shuping claimed a psychologist helped her blind herself. She says she has always suffered from Body Integrity Identity Disorder (although able-bodied, she identified as a person with a disability). Most doctors, understandably, refuse to help people damage their healthy bodies to become disabled, which can lead clients to desperate measures to destroy limbs or other body parts, sometimes possibly endangering others.

Jewel Shuping never named the psychologist who may have helped her, so it is impossible to check the story. It is possible to imagine, however, that some doctors would help someone with BIID in the hopes of preventing further damage to themselves or others. Shuping says she feels she should be living as a blind person, and she appreciates the help she received to become blind. In contrast, Ewing feels he should have undergone a mental health screening before he was able to obtain his surgery and that his wishes should not have been respected.

Plastic surgeons are often vilified as greedy and unscrupulous doctors who will destroy clients’ self-esteem only to profit from their self-loathing. On the other hand, these same plastic surgeons are hailed as heroes when they are able to restore beauty to someone who has been disfigured in an accident or by disease. Unfortunately, we do not have bright lines to separate needless surgery to enhance someone’s self image and restorative surgery to spare someone from a life of social isolation and shame. Some would argue the decision should not be up to the doctors in the first place but should be left in the autonomous hands of clients.

Many have similarly argued that doctors should refuse gender confirmation surgery to transgender men and women. As with BIID, many assume that transgender individuals are mentally ill and should see a mental health professional, not a surgeon. Transgender activists (and I) argue that transgender individuals need empowerment to live as the gender that best fits what they actually are. If surgery helps them along that path, they should have access.

All this leaves us with the question of when to respect autonomy and when to take the role of caregiver, which may involve a degree of paternalism (or maternalism for that matter). Is it more important for doctors who ensure the patient’s rights to seek whatever treatment they see fit, or is it more important to provide a caring and guiding hand to resolve underlying mental health issues before offering any treatment at all?

One of Ewing’s complaints is that he was offered plastic surgery on demand with no screening at all. The process for people seeking gender confirmation surgery, by contrast, is arduous. Before surgery, transgender people go through counseling and live as their true gender for an extended period of time. At the far end of the spectrum, people with BIID rarely find doctors willing to help them destroy parts of their bodies and resort to self-harm. These three cases are not the same, but make similar demands on the distinctions between respect for autonomy and a commitment to compassionate care.

It seems reasonable to accept Ewing’s claim that mental health screenings should be a part of body modification surgery, especially when someone has no obvious flaws that need to be repaired. In all these cases (dysmorphia, gender identity, and BIID), mental health support is necessary. In each case, patients describe depression, emotional turmoil, and, too often, thoughts or attempts of suicide. Mental health care does not require a violation of autonomy, but it may help a person’s autonomous decisions to form more clearly from deliberation and not desperation.

 

Tom Digby on Militarism, Sexuality, and Romance

R. Horton1 Comment

In a post on how men can be better feminist allies, Emma Cueto advises men to avoid the temptation to put men’s issues first. She sums up the problem of “toxic masculinity” by noting, “is not fun for anyone and often limits men’s choices in terms of interests or self-expression, and it means that many men are never really given the tools to properly deal with their own emotions.”  She goes on to say that men are not sexually assaulted at the same rate as women, are not victims of domestic violence as often as women, are not victims of pay disparities or sexual discrimination as often as women, and aren’t confronted by laws designed to control their bodies. She is right on all counts, but Tom Digby’s book, Love and War: How Militarism Shapes Sexuality and Romance , helps show why it is impossible to separate culturally programmed masculinity from sexual assault, reproductive regulation, domestic violence, and job discrimination and why feminists must deal with how sexism affects both men and women simultaneously.

His thesis is that militaristic societies establish values and goals that require men to cut off their feelings of care for others and for themselves, see women’s freedom as a threat, and rely on violence to solve their problems. In order to achieve military objectives, subject both boys and girls with intense cultural programming from birth to encourage strength in boys and passivity in girls. With this thesis, he flips the script from what many assume: that men are violent and cut off from their feelings by biological programming. Early in the book, he offers two pieces of evidence that this assumption is faulty. First, men and women in some societies do not show the differences that are so prevalent in militaristic societies. Second, he shows that men often fight against their own biology to retain the appearance of stoicism. Indeed, almost all men have been cruelly taunted for their failure to maintain their composure (choking back tears) even before reaching adolescence. If biology prevented boys from crying, no one would have to keeping telling boys not to cry. The conditioning is relentless and severe.

War dependent societies must maintain ample supplies of expendable men as well as childbearing women who will provide future generations of warriors. This requires shutting down empathy in men, glorifying risk and violence, and valuing women according to sexual availability and passivity. To the extent that maintaining near constant war was the goal, this model worked for centuries, but things have changed. I wish I could say we are no longer reliant on war, but that is sadly not driving the change. Digby points out that while war is still with us, the need for individual warriors who do one-on-one combat, relying on brute strength, has greatly diminished. Combat is now highly mechanized, and what physical differences may exist between men and women often offer no benefit to either side or may even give an advantage to women (he notes the case of jet fighters).

As a result, most men do not experience direct combat, or any kind of combat, in their lives. Our warriors must find other outlets for their masculinity. They may do it through aggressive sports, war games such as paintball, or even through violent video games. Digby points out that while women may be attracted to warriors, the guy who dominates video games doesn’t get quite the accolades of war combatants.

Another change is the material relationship between men and women. In the past, women were materially dependent on men and would comply with men’s wishes in order to avoid poverty. As women have entered the workforce, many are now the primary wage earners for their families. As women earn college degrees and professional credentials at higher rates than men, it is inevitable that men will become increasingly dependent on women for material support. These social changes leave our masculine warrior with an identity crisis. One option is for him to change his identity, which requires becoming more dependent and empathetic. This would be to become more “feminine” (a horror to the warrior). Or, the second option is for him to become more strident and militant, which may account for increased attacks against feminism and women these days.

When we observe the vitriol in attacks against feminist women online, graphic violence against women in video games and movies, and actual physical brutality and murder of women, it is easy to see the desperation of the warriors who refuse to go down without a fight. The fact that their opponents wish them no real harm seems to be of no consolation. It took me awhile to read this book because I assumed I would agree with it, and I did. I already knew that men were programmed to cut off their empathy, to expect women to be passive, to have the greatest disdain for “feminine” men, and so on. This book does bring a new analysis to these facts, though. It gives a new understanding of how things have gotten where they are and how they may be different.

I have only one minor quibble with one claim in the book. In chapter two, Digby quotes Sandra Bartky to explain the transactional nature of heterosexual relationships. He quotes Bartky as saying, “He shows his love for her by bringing home the bacon, she by securing for him a certain quality of nurturance and concern.” The claim is that men are emotionally unavailable or unsuited for empathy and emotional nurturance. On the other hand, women are expected to provide comfort and emotional support for men. I do think it is true that men are more likely to seek emotional support from women than from men, but I do not think this transaction is so readily accepted in heterosexual relationships.

I’ve spent quite a bit of time talking to both men and women in grief. Many men are so conditioned to “be strong” that they will never ask for support from the women in their lives for fear of appearing weak. Also, many feel they must suppress their emotional needs for the good of the family. Because they succeed in appearing strong, the women around them believe they are strong and do not need emotional support. As a result, men too often face grief and depression in complete isolation. When they finally crumble under the pressure, many will say, “I had no idea things were so bad.” This may help explain why men commit suicide at higher rates than women. Sadly, I’ve heard too many women say that they, also, do not feel supported by other women. Increasingly, at least in the United States, I feel grief is becoming a solitary activity for both men and women.

I hope we can all begin to support one another by offering each other protection, emotional support, material support, and just human kindness.

Suffragette, Slavery, and the Appropriation of Suffering

R. Horton1 Comment

Controversy erupted recently over a photo shoot in which the stars of the movie, Suffragette, wore t-shirts that said, “I’d rather be a rebel than a slave.” A group of white women wearing a shirt with a message comparing themselves to slaves was a problem to begin with, but people familiar with the fact that southern defenders of slavery in the US are known as Rebels only made things worse.

Defenders of the movie, the photo shoot, and the quote said the outrage was based on a misunderstanding of the quote, which comes from a speech by the British suffragette, Emmeline Pankhurst, rallying women to free themselves from the oppression of patriarchy. In the United States, abolitionists and suffragettes were sometimes, though not nearly always, the same people. The comparison of slavery to women’s oppression was noted by many, including former slave Frederick Douglas, who wrote, “In respect to political rights, we hold woman to be justly entitled to all we claim for man. We go farther, and express our conviction that all political rights which it is expedient for man to exercise, it is equally so for women.”

In the UK, people are less sensitive to comments about slavery and rebels. Some have suggested that the UK did not have slaves and that the quote is therefore not offensive. Time Out London, which published the photos, said in a statement: “Time Out published the original feature online and in print in the UK a week ago. The context of the photoshoot and the feature were absolutely clear to readers who read the piece. It has been read by at least half a million people in the UK and we have received no complaints.”

The UK does have a history with slavery, though. Unlike the US, Britain did not have a large workforce of slaves, but that doesn’t mean the UK had no involvement in slavery. Slavery was abolished in the UK in 1833 by the Slavery Abolition Act, which ended slavery throughout the British Empire with the exception of territories under control of the East India Company, Ceylon, and the island of Saint Helena. The exceptions were eliminated in 1843. In the US, President Lincoln issued the Emancipation Proclamation in 1863.

Having been neither a woman nor a slave, I hesitate to comment on the controversy of the use of the Emmeline Pankhurst quote, but it turns out that philosopher Elizabeth Spelman made an insightful and relevant commentary on the issue in her 1997 book, Fruits of Sorrow: Framing Our Attention to Suffering. In the first place, she points out that phrases such as “women and minorities” excludes and ignores the existence of minority women. Comparisons to slavery are a case in point. She says,  “Consider the talk about women being treated like slaves. Whenever we talk that way we are not only making clear that the ‘women’ we’re referring to aren’t themselves slaves; we’re making it impossible to talk about how the women who weren’t slaves treated those who were.” When a white woman suffragette declared her preference for rebellion over slavery, was she honoring the suffering of slave women or, indeed, setting herself apart from them?

Drawing on the work of Jean Fagan Yellins, Spelman continues, “The female slave is made to disappear from view. Although presumably it was the female slave’s experience that originally was the focus of concern, the other women’s experiences were made the focus.” Somehow, white women made use of the suffering of slaves without experiencing the actual realities of slavery, even if the oppression of white women was intolerable, it was not an experience shared with actual slave women.

When this relationship between white suffragettes and slaves is exposed an analyzed, of course white women will want to deny their privilege and insist that they were only honoring their sisters. They can say this with great honesty, because they are not aware of their privileged status. Further, Spelman says, “The deeper privilege goes, the less self-conscious people are of the extent to which their being who they are, in their own eyes as well as the eyes of others, is dependent upon the exploitation or degradation or disadvantage of others.”

When privilege is pointed out, it makes us uncomfortable. As a result, our reaction is motivated by shame. Self-awareness is necessary to effect change, but it is also painful. Spelman says, “Seeing oneself as deeply disfigured by privilege, and desiring to do something about it, may be impossible without feeling shame.” The shame provokes a defensive reaction, but it can also help to facilitate healing and solidarity–in some cases, anyway.

With the Emmeline Pankhurst quote used by the magazine, we can see the defensive reaction. Many people defended the quote as being taken out of context, as being somehow separate from slavery because it was British, or being a victim of PC culture gone mad. In the end, though, the outrage at the use of the quote helped spark a conversation about the suffragette movement, Britain’s role in slavery, and sensitivity to women whose experiences lie outside the realm of so-called “white feminism.”

Ethics of Grief: Profiting from the Pain of Others

R. Horton

Imagine you and a friend go to see a documentary (or even fictional film) about the plight of victims of famine, war, disease, or oppression, and you bawl uncontrollably throughout the film as your friend sits next to you unmoved and indifferent to everything happening on the screen. You think anyone who isn’t moved by the extreme suffering you’ve just seen must be some kind of monster (or a sociopath at the least). You feel, in short, that crying is more moral than just sitting there.

You will admit, of course, that your crying through the movie didn’t help the victims any and your friend’s indifference didn’t really hurt anyone. Still, it seems that a moral person should have feelings for those who are suffering, even if you can’t find any real benefit for these strong feelings for strangers who get no benefit from your tears, heartfelt as they are.

In fact, your friend might point out that you are getting all worked up for no reason, and it might be better to keep your emotions in check. Your wailing for these strangers won’t change anything for them, but it might impair your ability to attend to problems you can change. What good are you to your children, for example, if your mind is on the poor souls in some far corner of the world? You should get your head together, friend, and get on with the business of life.

But, you counter, if you learn to be indifferent and unmoved by the pain of strangers, you may become indifferent to the pain of others, including friends and, yes, your own children. You don’t want to become the kind of monster you now suspect your friend of being. You want to be the kind of person who is moved by the suffering of others. You may not be able to help in every situation, but you do not want to become callous and cold. You want to be a caring individual. It isn’t about what you can do but about what you are.

And now your friend points out that not only did you cry during the movie, but you seemed, in some sense, to enjoy it. In fact, you apparently went to the movie with the prior intention of being moved to tears. You chose the movie because it was described as “moving” and “emotionally riveting.” Will you be happy when your children fall ill because it will satisfy your need to “let it all out”? Perhaps you are the monster, after all?

You didn’t enjoy the pain, you object, but you enjoyed the high quality of the film and its ability to elicit the pain. It was beautiful in its ability to enlarge compassion and trigger a caring response. The film will help, if nothing else, audiences develop a greater sense of concern for others, even if it doesn’t affect everyone (with a sly and disapproving nod to your friend).

And your friend now points out that people had to suffer in order to expand compassion and develop a greater caring response, so the suffering of others is used as a means to your own ends. You are actually acting selfishly after all, and the film makers are also exploiting the suffering of these people in order to teach a moral lesson and even to make a profit and perhaps sit in the spotlight after receiving coveted awards. You can just imagine the director’s teary expressions of gratitude and exhortations for a more acts of compassion at the ceremony.

In 2012, comedian Anthony Griffith told the story of his daughter’s cancer in a moving performance for The Moth. The video quickly went viral. You can see the video here:

The video on YouTube now has more than 1.8 million views. It is almost impossible to watch the video without sobbing, and people shared it by promising that anyone watching should have some tissues on hand. For reasons that aren’t entirely clear, we enjoy experiencing his grief with him. It might be objected that we are emotional voyeurs watching a sort of grief porn. By watching, we are not helping his daughter, we are not preventing future cancer deaths, we are not improving medical care, and it isn’t clear how we might be improving ourselves.

Paradoxically, we simultaneously want to avoid our own pain but glom onto the pain of others. Watching the story enables us to experience the pain without having to actually experience the loss of child. Doing this while watching a fictional account of loss seems justifiable in many ways, but to seek out a chance to cry and experience this kind of pseudo-grief that is provided by the actual grief of another person certainly raises an ethical concern.

We might say that Anthony Griffith needed to talk about his loss, and we are providing him with an audience. We are doing him a great favor by listening. We are honoring his loss. And he may agree with us. In this case, he is using us to help him along his healing journey, but this doesn’t seem to be what is going on. We want to see and hear his story. We want to be part of his grief story without having to do any heavy lifting ourselves. We watch the video, feel emotional excitement, hug our loved ones because one never knows when they will be gone, and then we are done with it.

We might say that we want to hear the story because it is well written and well performed. Griffith is extremely talented as a story teller, and we appreciate his talent and courage to share such a personal story. When we watch the video, we are paying tribute to his writing and his acting. The only problem is that he really doesn’t seem to be acting. He has merely put his pain on view for the world. He is certainly talented, and the story is well-written, but most people will be moved by anyone’s story of a lost child. It is relatively easy to evoke strong emotions with a story of intense pain and grief.

It may be that we want to hear his story so we can prepare ourselves for the times our story might be the main event. Someday we will have to do the heavy lifting. If we can live through Griffith’s pain, maybe we can face our own. By experiencing Griffith’s grief, we see that we can also face it and live through it just as he has done. We finish the video feeling somehow more prepared.

Or we may be drawn to the stories of others because it provides an evolutionary advantage. By hearing stories of others, we develop compassion and care. Other than providing an audience, we may not be helping Griffith directly, but we may be better able to empathize with others in the future. We are preparing not only for how to face our own struggles but to help others through theirs. If this is true, then we are actually doing something noble and beneficial by watching such videos.

Or, maybe we are just seeking the thrill of an emotional roller coaster ride.

Comments are welcome below. I appreciate corrections to typos and so forth (randall@ethicsbeyondcompliance.com).

“When Clients are Grieving” CEU ethics workshop in Houston (Friday, December 4, 2015)

R. Horton

We are offering a workshop on the ethics of grief on Friday, Dec. 4, from 9 a.m. till noon. We will be exploring proper responses to grieving clients. Most therapists accept the dictum that “There is no wrong way to grieve,” but we will look at extreme cases such as homicide and self-destruction and search for the “bright line” between good and bad grief. We will then frightening2-800pxask whether “bad grief” is unethical or merely unhealthy. We will examine the ethical response to “bad grief” and explore whether men and women should respond to grief differently.

The workshop is open to anyone, but we offer 3 Continuing Education Units (CEUs) to Licensed Professional Counselors, Licensed Marriage and Family Therapists, and Licensed Clinical Social Workers.

The cost is $25.00.

For more information, write randall@ethicsbeyondcompliance.com

From Xu Mu to Donald Trump: Do We Need An Ethics Just For Women?

R. Horton

In the second GOP debate, candidates were asked an inconsequential question about what woman they would want to see on the $10 bill. Three mentioned family members who were caregivers and one mentioned Mother Theresa. Other candidates did mention women who were political leaders, but it is worth noting how difficult it is for some to imagine, even now, a great woman who is not caring for others. Rather, it is still hard for too many people to imagine that leading and fighting for justice and rights is a form of caring for women that is worthy of admiration.

The idea that women should be good, as women, but not in the same way that men might be good, is about as old as civilization. Men have placed women in an impossible bind forever. For striving to be the best person possible, they are often denounced, attacked, or even murdered for stepping above their station. In the seventh century BCE, Chinese poet and princess, Xu Mu found herself in a position where she felt she must defend her kingdom (Wei) against the Di people (see Barbara Bennett Peterson’s essay about dutiful daughters of ancient China here). She successfully rallied her brothers and friends from neighboring kingdoms to preserve their home.

A man in her position would simply luxuriate in the waves of honor and gratitude flowing over him, but Xu’s position was more complicated. She is remembered for her chinese poetaccomplishments, but she also faced the wrath of the men in her community. She recorded her mixed experiences and feeling in a poem, “Speeding Away”:

Harshly though you may judge me,
From my course I will not veer.
Compared to your limited vision,
Do I not see far and clear?

Harshly though you may judge me,
My steps you never can stay.
Compared to your limited vision,
Am I not wise in my way?

I’ve climbed the heights of A Qiu,
Gathered herbs on the slope alone.
All women are prone to sorrow,
Each follows a path of her own.
The people of Xu still blame me,
Such ignorance has never been known.

Out of necessity, she stepped out of the role of good wife, daughter, and mother to save her homeland only to be criticized, but she didn’t accept the criticism. She said, “O listen, ye lords and nobles, Blame not my stubbornness so,” but she was denied the opportunity to emerge as an unvarnished hero. If she had been a man, she would have been good, but she could not be considered a good woman without qualifications. Her society had two concepts of virtue: one for men, and one for women.

A couple of centuries later, Plato advocated for a single measure of virtue and goodness. He felt that the ideal form of the good was universal, so it wouldn’t make sense for some people to aim at one ideal and others at another ideal, as there can only be one ideal. Consequently, women and men should aim at the same ideal, and men, just by chance, seem to have an easier time getting close to it. In Plato’s Republic, women would be trained and educated in the manner of men in hopes of achieving their highest possibilities of human perfection. Women who succeeded in being the most like the best men would be the best women. Men who resembled women, on the other hand, were the worst of men. In Plato’s world, then, Xu Mu might be admired for embodying the virtues of men, but she may still be censured for failing in the virtues of womanhood.

Plato’s unusual conception of a single standard for virtue for men and women didn’t last long. His student, Aristotle, found insistence on a single standard for goodness unnatural and unfair. Men and women, being different, should strive for different ideals. A woman should be a good woman and a man should be a good man. To judge a woman on her ability to be like a “good man” would be as absurd as judging a musician on his ability to make good shoes. Women should do what is right and natural for them, he believed. Under Aristotle’s guidance, Xu Mu would do better to leave saving the kingdom to the men, who would be more rational and better prepared for war.

Those who feel women have different strengths than men will insist that they are not misogynistic. No, they love women for the things women do best. These men (and women) say that women have civilized men, make peace in families, and rear children for greatness. They love their mothers, wives, sisters, and daughters as they make it possible for men to achieve greatness in war, politics, business, science, and philosophy. For example. Ronald Reagan explained his high regard for women by saying, “If it wasn’t for women, us men would still be walking around in skin suits carrying clubs.”  The problem is that the things these men suppose women excel at doing are also denigrated by society precisely because women do them, which means that women are devalued as well. In the third century BCE, another Chinese poet, Fu Xuan, summed up the problem nicely:

How sad it is to be a woman!!
Nothing on earth is held so cheap.
Boys stand leaning at the door
Like Gods fallen out of Heaven.
Their hearts brave the Four Oceans,
The wind and dust of a thousand miles.
No one is glad when a girl is born:
By her the family sets no store.

By this measure, to be the best woman possible is still to be something inferior to even a mediocre man. Women may not attain the highest levels of virtue.

Upon reading the works of many men claiming that women are inferior at birth, Christine Pisan, wrote a rhetorical query to God in 1405 CE:

“Alas, God, why did You not let me be born in the world as a man, so that all my inclinations would be to serve You better, and so that I would not stray in anything and would be as perfect as a man is said to be? But since Your kindness has not been extended to me, then forgive my negligence in Your service, most fair Lord God, and may it not displease You, for the servant who receives fewer gifts from his lord is less obliged in his service.”

Trapped in a paradox, extreme virtue is demanded of women while it is simultaneously denied them. By asking God to resolve the paradox, Pisan brilliantly illustrates that it is men, not God, who created the paradox, for no God would be so irrational. The binary is not only absurd; it is impossible.

In 1694 CE, Mary Astell eschewed literary maneuvers and stated directly that men are to blame for the situation of women. In her Serious Proposal to the Ladies, she remarked, “That therefore Women are unprofitable to most, and a plague and dishonour to some Men is not much to be regretted on account of the Men, because ’tis the product of their own folly, in denying them the benefits of an ingenuous and liberal Education, the most effectual means to direct them into, and to secure their progress in the way of Vertue.”  She goes on to say, “For since God has given Women as well as Men intelligent Souls, why should they be forbidden to improve them?” Astell issued a call to arms for women. Many have responded, and continue to respond.

In the late 19th century, Mary Wollstonecraft repeated the call: “To account for, and excuse the tyranny of man, many ingenious arguments have been brought forward to prove, that the two sexes, in the acquirement of virtue, ought to aim at attaining a very different character: or, to speak explicitly, women are not allowed to have sufficient strength of mind to acquire what really deserves the name of virtue.”  Wollstonecraft argued that two standards of virtue only serve to cement the power of men over women. A single standard will liberate both.

Simply choosing between a singular or dual ethics does not resolve the problem of misogyny, masculine power, or the systematic devaluing of anything “feminine.” If we choose to embrace a single ethics, the default position is to embrace the ethics previously associated with “masculine” virtue. To do so, women must themselves then disparage “feminine” virtues, which will mean debasing the activities traditionally associated with women. Thus, both women and men engaged in such pursuits are permanent held in reduced stature.

On the other hand, to embrace a dual system of ethics is to preserve the status quo. The male system of ethics continues to be the good and noble ethics while the female ethics is valued only for its contributions to maintaining the power and worth of male activities.

A single ethics that values all virtues and activities that are, in fact, valuable demands a complete deconstruction of gender and power so that it can be replaced with a non-binary system that embraces and venerates all activities that aid human flourishing. If nurturing children is a good, then it is good for both men and women. Such a system can have no concept of “women’s work” or “men’s work.” The idea that activities or dispositions (caring, assertive, protective, sensitive) are “masculine” or “feminine” must become a foreign idea. This will require radical resistance. Xu Mu and others like her began this battle nearly 3,000 years ago. After watching the second GOP debate, I believe it may take another 3,000 years to finish the war.