Tuesday, December 10, 2013

Unethical Religious Directives

If the essential facts in this complaint are true (and there's no reason in sight to suspect that they might not be), a Catholic hospital in Michigan escaped by a tiny bit of luck from hosting (I'm not sure of a better term, maybe "watching" but certainly not "caring for") another Savita Halappanavar.

On Friday, Archbishop Joseph Kurtz, President of the defendant United States Conference of Catholic Bishops, issued a statement. It calls the lawsuit "misguided" and promises "to defend these principles in season and out" by "witness[ing] against a utilitarian calculus about the relative value of different human lives".

Notably, the statement makes no dispute of the facts, nor hints of an intention to dispute the facts at trial. It expresses no contrition. It makes no claim that perhaps these "principles" were carried 3 or 4 steps too far in plaintiff Tamesha Means' case.

These actions are morally reprehensible. The proffered reasoning is morally offensive. The caricature of a cold "utilitarian calculus" it claims to oppose is outrageously irrelevant to the core issue of personal autonomy. Even granting the Bishop Kurtz the entirety of "the universal and consistent teaching of the Catholic Church on defending the life of the unborn child" and "that all human life, both before and after birth, has inherent dignity", it remains no excuse whatsoever for nearly all of the complaint.

How does "inherent dignity" justify any of these things?
  • "MHP did not inform Plaintiff that in most cases, an amniotic fluid index of 3.4 at 18
    weeks of pregnancy, in the context of premature rupture of membranes, means that the fetus will either not be born alive or will be born alive and die very shortly thereafter."
  • "MHP did not inform Plaintiff about the serious risks to her health if she attempted to continue the pregnancy."
  •  "MHP did not raise or discuss with Plaintiff the option of terminating her pregnancy, despite the risks to her health of continuing the pregnancy, nor the fact that the fetus she was carrying had almost no chance of survival."
  • "Instead, MHP gave Plaintiff medication to reduce her pain and sent her home."
  • "MHP told Plaintiff to return on December 9, over a week later, for her regularly scheduled doctor’s appointment. This misled Plaintiff to believe there was a significant chance that the fetus would become viable and she w ould deliver a healthy baby."
  • "MHP did not give Plaintiff any other options for treatment. Upon questioning from Plaintiff, MHP informed her there was nothing else that could be done because Plaintiff was so early in her pregnancy."

How does "inherent dignity" get you there? To not informing someone about their health and healthcare? To deceiving a sick person about their healthcare? How does it get you to "directing" medical doctors to tell outright lies — that nothing else could be done — to their patients about the patient's health?

It doesn't get you there; it doesn't even put you in the same time zone. What does get you there, and what has been going on for far too long on this planet, is a complete lack of respect for women and for their agency.

If you really believed that the "inherent dignity" of this doomed and dying fetus required Ms. Means to take on enormous risks to her health, incredible pain, and a quite substantial risk of death, you would tell her that and argue your case. Maybe if you really believed it you would tell her that and lock her up or take other measures to prevent her from leaving. Maybe if you really believed it you would put her on some analogue of suicide watch. Not telling her is moral cowardice and the height of arrogance. Not telling her and sending her home to quite possibly die on her couch is reprehensible.

The story gets worse from there, if you can believe it.

She comes back the next day bleeding, in pain that she rated 10 out of 10, with a fever. They still didn't tell her that she was at risk, and released her again. "At the time MHP sent Plaintiff home, Plaintiff’s treating physician suspected she had chorioamnionitis, a significant bacterial infection that can cause serious damage to a woman’s health, including infertility and even death. However, MHP did not inform Plaintiff of this possible infection."

Luck saved Tamesha Means from her doctors, who had decided to release her for a third time, when "[w]hile Plaintiff was waiting to be discharged, she began to deliver and the feet exited her cervix. Plaintiff gave birth at approximately 12:13 a.m. on December 3, 2010. Because Plaintiff was only 18 weeks pregnant, the baby died after only about 2.5 hours. The birth was a breech delivery and extremely painful for Plaintiff. The placental pathology report indicates Plaintiff had acute chorioamnionitis and acute funistis at the time she gave birth. ... Chorioamnionitis or funisitis when untreated can result in infertility and have other permanent deleterious health effects for a pregnant woman."

We should call on the Catholic Church and the various entities under its umbrella to expeditiously divest themselves of all interests in and control over health care facilities or programs in the United States and around the world. I think they have some morally useful teachings, I think they do some good works in the world, I like their music and some of their hats, and I've given them some money in the past. I certainly respect everyone's right to free exercise of their chosen religion. No one should give them a nickel until this changes. This is a policy that is certain to lead to horrible painful death for other women, as the Irish version of the same policy did for Savita Halappanavar. (Ms. Halappanavar actually died two years after the events in this case, which in itself is damning evidence that the church sees no mistakes here and has no intention of learning from them.)

The stopped clock phenomenon may make a brief (as always) appearance when the bishop's statement says that "This lawsuit argues that it is legally 'negligent' for the Catholic bishops to proclaim this core teaching of our faith. Thus, the suit urges the government to punish that proclamation with civil liability, a clear violation of the First Amendment." Whether that defense is a defense hinges on the nature to which the "Ethical and Religious Directives for Catholic Health Care Services" (ERDs) are of a purely advisory nature; one would hope that they might be, but the Archbishop makes no statement to that effect, the title "Directives" opposes such a reading, and the document itself reads as institutional policy and not a mere "proclamation".

The extent to which this claim by Archbishop Kurtz is correct in this technical defense is exactly the extent to which the Ms. Means and the ACLU should also sue the more proximate decision makers: her doctors, the hospital, and whatever entities own and control the hospital and were responsible for disseminating the ERDs to the staff and for instructing them or leading them to believe that the ERDs were policy and not feel-good drivel.

Our legal system does not answer hypothetical questions, only questions arising from disputes that have already happened. When (not if) this policy kills again, as it did in Galway, we must not let the responsible parties claim ignorance. I applaud Ms. Means for fighting for her rights and by proxy for those of others similarly situated, instead of waiting for one of those others to die and for her family to raise these issues in a wrongful death suit. Let's hope it needn't and doesn't come to that, though I suspect that it will.

The legal question will be settled by the court. The answer to the moral question, in the meantime, is painfully clear. We should act on it before more women die. We should stop treating the perpetrators here with kid gloves. We should most definitely stop treating them as paragons of moral virtue, with special access to a mysterious and revealed morality.

Wednesday, July 10, 2013

War games

I was listening to The Sports Hub this afternoon while I was driving all over the Boston area.

They have a weekly segment where they ask 10 completely ridiculous questions of recurring guest Jermaine Wiggins.

Asked "Tic-tac-toe? Or Hangman?", Wiggins responded instantly and decisively (as is his way, it's why the segment is funny) that he preferred tic-tac-toe. Michael Felger pushed him on this, asking if he wasn't bored with tic-tac-toe because he could never lose. Wiggins maintained that it was still a good game because (paraphrasing) "even if you get the middle block, it doesn't mean you're going to win." He tried again but Wiggins wouldn't agree that the game was too simple, leading Felger to the joke of the day:

"Evidently you've never seen WarGames."

Wednesday, July 3, 2013

Shipping up to Boston

I was in a discussion today of the 2001 memorandum issued by Clear Channel advising radio stations not to play 165 songs that they deemed inappropriate in the immediate aftermath of the September 11th terrorist attacks. Among other things we discussed the myths that it originated with the government and that it banned relatively few and politically loaded songs.

If you look at the list, a lot of the songs are listed for connections that are quite tangential. I don't recall ever having heard this one, for example. And there's Mack the Knife, and Bennie and the Jets, and so forth.

But there are also a lot where you can see a stronger connection or lyrics with key phrases that are more likely to be triggering, and so you can kind of see the point of it. The thing is, I don't think there was much need for it, because I think for the most part the connections on the list are obvious surface level themes or lyrical references in the songs, something to which I think that local radio programmers could be trusted to show sensitivity on their own.

In the last few years, after The Departed and Jonathan Papelbon's famous jig, the Dropkick Murphys' song I'm Shipping Up to Boston became something of an anthem for the city, something celebratory, energetic, prideful, and ritually associated with the local religion.

I'm actually quite surprised that it seems to be strongly continuing in that role in the aftermath of the tragic and despicable marathon bombings, because of concerns like the ones Clear Channel was worried about. The song begins "I'm a sailor peg / And I've lost my leg", and the chorus is "I'm shipping up to Boston whoa / I'm shipping off...to find my wooden leg." Tragically at least 16 people lost one or more limbs in the atttack. But the song was still playing this role even very shortly after the attacks. I don't recall even hearing the subject of whether it was appropriate discussed, again to my surprise.

I'm just as surprised that The Mighty Mighty Bosstones song The Impression That I Get, which was at least locally quite popular when it was released in 1997, didn't enjoy a renaissance.

I'm not sure what the point is, or even if there is one, so I'm not going to summarize. If you figure it out leave a comment.

Good is dumb?

Friedrich Nietzche wrote in his 1886 book Beyond Good and Evil, from which I've only read a short excerpt and understood even less (emphasis in original):
Slave-morality is essentially the morality of utility. here is the seat of the origin of the famous antithesis "good" and "evil": power and dangerousness are assumed to reside in the evil, a certain dreadfulness, subtlety, and strength, which do not admit of being despised. According to slave-morality, therefore, the "evil" man arouses fear; according to master-morality it is precisely the "good" man who arouses fear and seeks to arouse it, while the bad man is regarded as the despicable being. The contrast attains its maximum value when, in accordance with the logical consequences of slave-morality, a shade of depreciation—it may be slight and well-intentioned—at last attaches itself to the "good" man of this morality; because according to the servile mode of thought, the good man must in any case be the safe man: he is good-natured, easily deceived, perhaps a little stupid, un bonhomme. Everywhere that slave-morality gains the ascendancy, language shows a tendency to approximate the significations of the words "good" and "stupid."
I think Dark Helmet captured some of this:

Leavers, takers, recessions, and the proverbial desert island

Marx and Engels wrote, radically, that capitalism is doomed to create a series of ever larger crises. It's a bit difficult to summarize, but I think this is the nut graf (with my emphasis):
Modern bourgeois society, with its relations of production, of exchange and of property, a society that has conjured up such gigantic means of production and of exchange, is like the sorcerer who is no longer able to control the powers of the nether world whom he has called up by his spells. For many a decade past, the history of industry and commerce is but the history of the revolt of modern productive forces against modern conditions of production, against the property relations that are the conditions for the existence of the bourgeois and of its rule. It is enough to mention the commercial crises that, by their periodical return, put the existence of the entire bourgeois society on its trial, each time more threateningly. In these crises, a great part not only of the existing products, but also of the previously created productive forces, are periodically destroyed. In these crises, there breaks out an epidemic that, in all earlier epochs, would have seemed an absurdity -- the epidemic of over-production. Society suddenly finds itself put back into a state of momentary barbarism; it appears as if a famine, a universal war of devastation, had cut off the supply of every means of subsistence; industry and commerce seem to be destroyed. And why? Because there is too much civilization, too much means of subsistence, too much industry, too much commerce. The productive forces at the disposal of society no longer tend to further the development of the conditions of bourgeois property; on the contrary, they have become too powerful for these conditions, by which they are fettered, and so soon as they overcome these fetters, they bring disorder into the whole of bourgeois society, endanger the existence of bourgeois property. The conditions of bourgeois society are too narrow to comprise the wealth created by them. And how does the bourgeoisie get over these crises? On the one hand, by enforced destruction of a mass of productive forces; on the other, by the conquest of new markets, and by the more thorough exploitation of the old ones. That is to say, by paving the way for more extensive and more destructive crises, and by diminishing the means whereby crises are prevented.
OK, that's a radical idea. Especially for 1848.

In some ways the 1848 situation has been ameliorated a bit, in that we have regulatory structures in place that attempt to limit the scope, frequency, and human cost of these crises. But it remains unclear whether those controls will put an upper bound on the cost of crisis or merely delay the rate of growth of those costs, and the most recent crisis has been far from encouraging in this regard. It's also unclear whether effective control is possible in principle but elusive in practice, or simply impossible.

But that's open to debate, and isn't exactly what I want to talk about.

Daniel Quinn's 1992 novel Ishmael expresses a similar critique of the structure of modern civilization, but far more radically. Quinn assigns most of the blame for the crises Marx and Engels were discussing, along with the larger slow-motion nexus of environmental crises, not to capitalism but to agriculture. Seriously. The implications are staggering.

You really should read the entire novelit's worth itbut I'm going to take the liberty of quoting at some length to summarize the connection I see here. (A note of caution: If you decide to do some further reading without starting from the beginning you should be aware that he develops a fair amount of jargon. Perhaps most importantly the people he calls "takers" are not the alleged and otherized 47%, but instead quite nearly all living humans. If you have access to the technical means of reading this blog you are nearly certain to belong to this category, as I do, and as does every acquaintance of mine that I can think of now.)

Here's a section of the dialectic in which the student summarizes the first half of the book (quotes and emphasis are in the original):
"Man was at last free of all those restraints that . . . . The limitations of the hunting-gathering life had kept man in check for three million years. With agriculture, those limitations vanished, and his rise was meteoric. Settlement gave rise to division of labor. Division of labor gave rise to technology. With the rise of technology came trade and commerce. With trade and commerce came mathematics and literacy and science, and all the rest. The whole thing was under way at last, and the rest, as they say, is history."
"Right," I said. "Okay. Man's destiny was to conquer and rule the world, and this is what he's done—almost. He hasn't quite made it, and it looks as though this may be his undoing. The problem is that man's conquest of the world has itself devastated the world. And in spite of all the mastery we've attained, we don't have enough mastery to stop devastating the world—or to repair the devastation we've already wrought. We've poured our poisons into the world as though it were a bottomless pit—and we go on pouring our poisons into the world. We've gobbled up irreplaceable resources as though they could never run out—and we go on gobbling them up. It's hard to imagine how the world could survive another century of this abuse, but nobody's really doing anything about it. It's a problem our children will have to solve, or their children.
"Only one thing can save us. We have to increase our mastery of the world. All this damage has come about through our conquest of the world, but we have to go on conquering it until our rule is absolute. Then, when we're in complete control, everything will be fine. We'll have fusion power. No pollution. We'll turn the rain on and off. We'll grow a bushel of wheat in a square centimeter. We'll turn the oceans into farms. We'll control the weather—no more hurricanes, no more tornadoes, no more droughts, no more untimely frosts. We'll make the clouds release their water over the land instead of dumping it uselessly into the oceans. All the life processes of this planet will be where they belong—where the gods meant them to be—in our hands. And we'll manipulate them the way a programmer manipulates a computer."
Phew. Like I said, a long excerpt. There's a lot to unpack here, but I think the outline of this idea has gotten a lot more cultural traction in the last two decades. These myths are still everywhere, but the idea that something is fundamentally yet subtly wrong is (or only seems?) a bit more in the open. Exactly what that something might be, of course, is as controversial and loaded as it ever was.

The Club of Rome's groundbreaking 1972 report The Limits to Growth got a very cold reception. One critic said its authors would "consign[] billions to permanent poverty." Almost two centuries earlier, Malthus got an even chillier reception for his Essay on the Principle of Population, he has a bad reputation in many circles to this day.

The driving force behind that reaction is the internalized utopian assumption that there must be a way out, a technical and regulatory solution that will allow the earth to provide 10 billion of us with a modern and comfortable standard of living. Interestingly, Engels and Marx themselves were apparently harsh critics of Malthus:
Engels called Malthus's hypothesis "...the crudest, most barbarous theory that ever existed, a system of despair which struck down all those beautiful phrases about love thy neighbour and world citizenship." Engels also predicted that science would solve the problem of an adequate food supply.
Quinn is asking us to look beyond that gut reaction and beyond the paralyzing depression that can come from closely examining the projected trajectory of our civilization and our planet.

The narrator's interlocutor sets them on a quest for fundamental principles in biology (more properly ecology, I think?) explaining which species can survive and thrive as long as the proper conditions continue, and which are doomed to extinction:
"Would you say that the law of gravity is about flight?"
I thought about that for a while and said, "It isn't about flight, but it's certainly relevant to flight, inasmuch as it applies to aircraft in the same way it applies to rocks. It makes no distinction between aircraft and rocks."
"Yes. That's well said. The law we're looking for here is much like that with respect to civilizations. It's not about civilizations, but it applies to civilizations in the same way that it applies to flocks of birds and herds of deer. It makes no distinction between human civilizations and beehives. It applies to all species without distinction. This is one reason why the law has remained undiscovered in your culture. According to Taker mythology, man is by definition a biological exception. Out of all the millions of species, only one is an end product. The world wasn't made to produce frogs or katydids or sharks or grasshoppers. It was made to produce man. Man therefore stands alone, unique and infinitely apart from all the rest."

"But the last of the gods' tricks [the first two being the falsity of geocentrism and of special creation] was the worst of all. Though the Takers don't know it yet, the gods did not exempt man from the law that governs the lives of grubs and ticks and shrimps and rabbits and mollusks and deer and lions and jellyfish. They did not exempt him from this law any more than they exempted him from the law of gravity, and this is going to be the bitterest blow of all to the Takers. To the gods' other dirty tricks, they could adjust. To this one, no adjustment is possible."
He goes on to construct an elaborate analogy between modern (in a very loose sense encompassing all of recorded history and going back at least in part to the neolithic revolution) civilization and the flight of an early experimental aircraft like this one (see 0:41 for a really appropriate example, and 2:07 for another, but feel free to watch the whole thing as a humor break):

As you can see and as the book points out, it's possible to run off a cliff and feel the "freedom of the air" without actually achieving flight, and until you hit the ground or see it coming it's possible to imagine feeling downright euphoric about your success and mastery over the world.

He suggests that a natural response, one we seem to have collectively made as Marx and Engels identified at the top of the post, to the slowly approaching ground is to "pedal harder." He discusses Malthus, and the utopian reaction to his ideas. He discusses the hope that we can be saved by improved agricultural methods or by the wide adoption of effective contraceptive techniques and rights, but dismisses those objections as ultimately ineffective.

Quinn's dialectic continues as a search into what humans have been doing differently for the last 10,000 years that has brought us to the brink of disaster so quickly. And he cleverly dismisses "human nature" as an explanation by pointing out both that the species has existed for a few million years and that isolated cultures continue to exist that show few or no signs of being on this path.

(As an aside, at this point in the story the teacher leaves our narrator wondering at the answer to this puzzle and sends him away. The narrator discusses his feelings about this dismissal in a way that I think has interesting parallels to psychotherapy that I might blog about at some later date; it's the end of chapter 7.)

You may have identified some of them, but the book eventually comes around to three things we do that we don't observe happening "in what [we] call the wild." If you think about them it is extremely difficult to come up with even nit-picky counterexamples, which is ordinarily a skill I have in abundance.
  1. We "exterminate [our] competitors."
  2. We "systematically destroy [our] competitors' food to make room for [our] own."
  3. We "deny [our] competitors access to food."(In a sense that may be less obvious, but that is well explained: "Bees will deny you access to what's inside their hive in the apple tree, but they won't deny you access to the apples.")
Ultimately the teacher summarizes the law as:
"You may compete to the full extent of your capabilities, but you may not hunt down your competitors or destroy their food or deny them access to food. In other words, you may compete but you may not wage war."
Which brings me around to the connection I wanted to explain. I think waging wars of a similar kind is at the root of the episodic crises Marx and Engels were complaining about. I think that an economic analogue of this (putative?) ecological law is at play. And so I think that Malthus and Engels were actually on different corners of the same page.

Unfortunately I don't think that "obeying" this economic law, even if it is possible to enforce, or perhaps even if everyone came to obey it voluntarily, can rescue us from the larger consequences of unwinding our over-consumption and our attack on biodiversity. It's another flavor of the utopian fantasy. But perhaps it can guide our thinking on how better to live in the civilization we have, while we have it?

If ten people are shipwrecked on an uninhabited island, at first they all have more work than they can handle. But if they eventually establish patterns of living, skills, and basic tools and infrastructure that allow them to survive more easily, what happens? Suppose that through such efficiencies they only need to do 90% of the work they originally did. Do nine work just as hard and let the tenth one starve as a punishment for idleness? I strongly suspect not, but that does seem to be what happens in our larger society. Why? (Labor specialization is a partial but not complete answer, I think. Is it avoidable without so disincentivizing work that the tools, skills, and infrastructure fall into disrepair?

Can studying this problem inform our difficult decisions about unwinding the growth that we need to unwind? Can it inform our attitudes toward confronting the problems? Toward distributing the material suffering and lessening the emotional suffering?

Monday, July 1, 2013

When you're right, you're right

It's getting more and more difficult to argue against this point from The Communist Manifesto:
The executive of the modern state is but a committee for managing the common affairs of the whole bourgeoisie.

Sunday, June 30, 2013

Why is industrial software so horrible?

I've just recently started using a line of industrial PCs from Beckhoff Automation. Their hardware is impressive, comprehensive, and modular, which is great.

But their software is as bad as everyone else's in the industry, and their documentation is worse.

For all the billions of dollars spent on industrial automation, you'd think someone could build a great programming language with clean semantics, intense static analysis, polished tools that don't hang when there are network hiccups, a nice standard library, and thorough documentation. Nope. No matter which vendor you pick you are lucky to get a C+ on even half of those goals with solid Fs for the rest.

It's really pretty strange.

Friday, June 28, 2013

Love and the practice of counting cards

In a previous session of the same class I wrote about in the last post, a discussion of an essay by bell hooks came around to brainstorming a list of movies about love.

One (of many) that the professor threw out was Jerry Maguire, which I agree is mostly about love. But Rain Man (which happens to be on TV right now) is a much better example in my opinion, if we are going to count Tom Cruise movies at all.

In fact I think that the whole movie is about Cruise's character learning this lesson:
A love ethic emphasizes the importance of service to others. Within the value system of the United States any task or job that is related to "service" is devalued. Service strengthens our capacity to know compassion and deepens our insight. To serve another I cannot see them as an object, I must see their subjecthood.

Wednesday, June 26, 2013

On the theology of eternal life

Today in philosophy class we were discussing Pascal's wager. Pascal took criticism for smuggling in the assumption that if god exists so does eternal life, and even posthumous reward or punishment.

The existence of a god doesn't seem to imply the existence of eternal life, I think that is fairly non-controversial.

Perhaps more interestingly, and certainly something that had never occurred to me before, is the question of whether the converse is true. Does the existence of eternal life imply the existence of a god or gods?

It seems there is a logically possible world where life could be eternal in a fully natural way, perhaps in line with the conventional concept of immortality. But is it also logically possible to have a world where souls exist and continue living after physical death, but in which there is no god? Or even one in which souls exist and can be resurrected or reborn but in which there is no god?