Friday, April 13, 2018

Review of Jeremy Sherman's, Neither Ghost Nor Machine: The Emergence and Nature of Selves


Jeremy Sherman, Neither Ghost Nor Machine: The Emergence and Nature of Selves (Columbia University Press: 2017)

Reviewed for Choice Magazine by Ronald F. White
 
In this book Jeremy Sherman, a former student of noted philosopher/scientist Terrence Deacon, explains and expands upon Deacon’s book Incomplete Nature: How Mind Emerged from Matter (2012).  While Sherman’s book is well-written and (for the most part) jargon-free, it is not suitable for students or the general public. Here are four reasons why: 1.) Sherman stipulates complex definitions for many common words; especially “selves” and “aims.” Then he addresses the nature and origins of both selves and aims, via evolutionary theory. That’s a lot. 2.) The title implies an alternative to Cartesian two-sided interactionism, often referred to as the “ghost in the machine hypothesis.” He suggests that his selves/aims model avoids the traditional mind-body problem by redefining “ghost” and “machine” in light of evolution. That’s a lot too! 3.) Much of this book also addresses the historically-puzzling concepts of teleological, teleonomic, and teleodynamics. That’s a lot. 4.) Sherman’s closing argument, attempts to carve out theoretical space for values, in a world of evolutionary facts, which is a lot and worthy of its own book. While we can all appreciate the effort behind this book, it is way too ambitious, and complex to recommend as a textbook in philosophy or evolutionary biology.                     

Thursday, February 22, 2018

Reading #10: Ethics of Reproductive Technologies

Introduction

In recent years many reproductive technologies have proven to be morally and/or legally controversial: abortion drugs, genetic testing and genetic engineering (for diseases, disabilities, or enhancement), embryonic stem cell research, fetal and/or infant sex change operations, reproductive cloning, and the artificial uterus. Most of these technologies are still in the developmental stage and will be used in conjunction with genetic engineering. There are three lines of argument: natural law (all reproductive technologies are morally unacceptable) libertarianism (all voluntary reproductive technologies are morally acceptable), and a variety of moderate views (some technologies are morally acceptable and some are not acceptable).

Natural Law.

In Health Care Ethics, the Natural Law Theory of Ethics is ultimately based on the idea that "life is a gift from God," and that "What is natural is good." After all, God is omnipotent, omniscient, omnipresent, and good. He created a universe imbued with purpose. Hence all biological systems are imbued with divine purpose: the purpose of eyes=to see, nose=smell, sex organs=make babies. Since the Middle Ages, the traditional view of the Roman Catholic Church has been that we all have a "duty to reproduce;" and that reproduction must be accomplished via sexual intercourse between married men and women.  Therefore the only acceptable reproductive technologies make sexual intercourse between husbands and wives more efficient. Any technology that replaces sexual intercourse is morally unacceptable. Any technology that deliberately interrupts that process including "artificial contraception" (condoms, birth control pills, and or abortion) is unacceptable. And any technology that enables humans to alter the outcome of that natural process, such choosing sex, eye color, height, weight. Intervention is permitted only cases where a fetal disease might be cured. In general, the Roman Catholic Church argues that most reproductive technologies are immoral and ought to be illegal.   

Libertarianism


Libertarians argue that individuals have a moral and/or legal right to access any technologies they choose, and that governments ought to neither force us to employ these technologies nor prevent us from employing them. In short, "anything goes." Among libertarians there is disagreement over the moral status for the fetuses at various stages of development, therefore not all libertarians defend the right to choose abortion. 

Moderate Views

There are many moderate views that fall midway between extreme conservative and extreme libertarian view. Some accept or reject these technologies based on social utility, and cite utility ratios reflecting costs and benefits as foundational. Some utilitarians embrace short-term utility, others embrace long-term utility... or "slippery slope" arguments.    

Issues

Let's take a look at a few contemporary issues: abortion drugs, genetic testing and/or engineering, cloning, artificial uterus.

Abortion drugs

Since the 1970s, the primary abortive technique in the United States has involve a surgical technique that removes the embryo or  fetus from the uterus. This technique has been relegated to specifically designed clinics that specialize in that technique. In recent years, most of these clinics have been regulated out of business. Therefore, if abortion survives this regulatory onslaught, it will no-doubt involve the use of abortifacient drugs. Many of these drugs walk a fine line between contraception and abortion. The most common contraceptive/abortive drugs prevent implantation of the zygote within the uterus. Issues include whether these drugs ought to legally require a prescription from  a physician (and/or why or why not?), whether these drugs ought to be sold "over (or under)-the counter" (and/or why or why not?),  age restrictions on purchaser, whether pharmacists and/or cashiers ought to refuse to sell these drugs for moral and/or religious reasons; and whether these drugs ought to be made available online. 

Genetic Testing and Engineering
 
Genetic testing of fetuses can serve both therapeutic and non-therapeutic purposes. There is also an overlap with Genetic Engineering... no only for existing fetuses, infants, and adults; but also for future humans or germ-line engineering.  Therapeutic testing is relatively non-controversial. It is often performed in order to treat existing fetuses that suffer from various genetic diseases and/or disabilities. Non-therapeutic testing may involve testing, not to cure a disease, but to enhance (via genetic engineering) the future life of that fetus or testing in order perform euthanasia on an fetus with a painful incurable or untreatable disease. Treatable diseases include some forms of Spina Bifida. Untreatable diseases include Tay-Sachs Disease. Enhancements might include testing for hair color, eye color, height, or sex. Genetic engineering for diseases and/or enhancements involving the germ-line, or future children is problematic, given that future generations cannot consent to research or treatment.    

Cloning

Cloning is a reproductive technology designed to create living things without the unification of ova and sperm. It usually involves the creation of an offspring genetically identical to the aspiring parent. Although no humans have been cloned (as of yet) many mammals have been cloned, especially in other countries; especially pets (usually dogs). There are two forms of human cloning: research cloning and reproductive cloning. The main arguments against reproductive cloning point to a "slippery slope" of potentially negative consequences. The moral status of clones in comparison to the original person has also drawn controversy.    


Artificial Uterus

Scientists have been developing an artificial uterus for many years. Many technologies already available in neonatal intensive care units are essentially late-term artificial uteruses; primarily respiratory, circulatory, and nutritive technologies. The goal is for NICUs to be able to nurture an embryo to an infant within an artificial environment. There are many arguments for and against their development. Most arguments against come from natural law theorists that argue that they represent a "slippery slope," into future where sexual intercourse and women carrying babies become obsolete, thus undermining human nature. Defenders argue that its the inevitable outcome of biomedical research designed to cure the "disease," of infertility.

Conclusions

In this course you may defend either Natural Law, Libertarianism and/or Utility; however, you MUST present arguments for/against. You many not simply invoke the authority of moral and/or religious experts.  
       

Wednesday, November 8, 2017

Andrew Pilsch, Transhumanism: Evolutionary Futurism and the Human Technologies of Utopia (University of Minnesota Press: 2017) Reviewed by: Ronald F. White, for Choice Magazine


This expensive book ($108) is intended to serve a small, but dedicated group of scholars engaged in research on “transhumanism;” a subject that enjoyed popularity in the 1980s and 1990s. Transhumanists are optimistic futurists who welcome recent scientific and technological advancements in: “neuroscience, neuropharmacology, life-extension, nanotechnology, artificial ultraintelligence,   and space habitation.” (p.1)  Most transhumanists are also devoted fans of science fiction and/or spiritualism. Philosophers have long-argued that the very concept of transhumanism is vague or vacuous and that there has always been (and always will be) both defenders and critics of present and future technology. Critics of transhumanism argue that unchecked, free-wheeling scientific and/or technological advancement threatens not only the future of humanity, but also the future of the entire planet. Therefore, they argue, government must play a role in controlling that advancement: Keep that genie in the bottle! For better or worse, this scholarly work is rife with “isms” that are offered in comparison and contrast to “transhumanism,” including: neoliberalism, futurism, utopianism, post-humanism, evolutionary utopianism, and xenofeminism. With 200 pages of scholarly text, it is fully documented with over 600 footnotes, citing mostly of books and journal articles published in the 1980s and 1990s. By all measures, this is a book intended for a rather narrow community of scholars. There is no obvious attempt to recruit new transhumanist scholars, no appeal to a popular audience, nor is it intended to serve as an undergraduate or graduate textbook.  

 

Tuesday, September 5, 2017

Health Care Ethics Textbook

1. What is Health Care?

2-6. What is Ethics?

7. Informed Consent in Health Care

8. Reproductive Ethics

9. Ethics of Dying

10. Allocation of Resources

12. Affordable Care Act

Sunday, September 3, 2017

Reading #8: Informed Consent in Health Care

In health care, the concept of "informed consent" has two primary applications: Informed Consent in Research and Informed Consent in Treatment.  In any Liberal Society these applications relate to the concept of "Human Agency," or the philosophical questions that underlie what kinds of persons can be held morally responsible for their actions.  There are two conditions: rationality and free will. In health care two questions dominate moral and legal debate. 1.) Was the research subject or patient given enough information to make a rational choice? and 2.) Once provided with this information, does the research subject or patient, have the ability to act "freely" on the basis of that information... in short, does that person possess free will.

There are many conditions that might impede a research subject/patient's ability to process information. First of all: much of the language associated with health care is highly technical and derived from Greek or Roman nomenclature, and therefore most of us do not understand what the researcher or physician is saying. And most researchers/physicians have not been trained in how explain medicine in laymen terms. Therefore, many research subjects/patients are vulnerable, and rely on third-party agents, usually nurses. The most vulnerable classes include: young children, persons suffering from mental diseases, persons with very low IQs, persons with little education, persons that do not speak English, and elderly patients suffering from varying degrees of dementia. In these cases, proxies, or other rational persons must make those rational decisions. But who... family or friends, physicians, lawyers, judges, or juries?  

There are also conditions that might impede a research subject or patient's ability to exercise free will, and consent to serve as a research subject or undergo costly, high-risk, medical treatments. Many potential research subjects/patients tend to defer these decisions to authorities who possess a Ph.D.  or an MD degree. Many research subjects/patients are vulnerable to outside interference because they are desperately seeking to avoid and/or remove pain and or disability. 

Informed consent has become an important moral/legal problem because researchers and physicians often have a stake in securing informed consent from prospective subjects/patients; and therefore may operate under a conflict of interest. Researchers need many research subjects in order to conduct clinical trials. Many researchers are college/university professors seeking tenure and promotion, researchers that are also pursuing lucrative patents for themselves or their respective corporation. Most physicians get paid for their services, and (like everyone else) needs to payoff student loans, feed, clothe, and shelter their families etc. Therefore, researchers and/or physicians might to tempted to misrepresent the known costs and benefits of serving as a  research subject or undergoing an expensive treatment. Sometimes these misrepresentations rise to the level of legal fraud. Sometimes these misrepresentations are paternalistic, and therefore serve the greater interests of the subject or patient, but sometimes these misrepresentations are predatory and serve, primarily the interests of the researcher or physician.  Research subjects may also be bribed into participation in a research project by offering either free health care or monetary reward. At what point does providing an incentive become bribery and/or economic predation (Kant)?    

Saturday, September 2, 2017

Reading #9: Reproductive Ethics

Introduction:

Questions concerning the moral and legal foundations of human reproduction are enormously complex. Some of the most important questions have become public issues that address the following: the moral/legal limits of reproductive assistance, the moral/legal limits on contraception, moral/legal limits on reproductive control by individuals, religious groups, and political regimes; and a cluster of issues that involve abortion. All five moral principles (utility, beneficence, non-maleficence, liberty, and justice) are often invoked in reproductive ethics.  

As an initial observation, let's all acknowledge that our individual and collective beliefs about human reproduction have been shaped by culture, religion, science, and politics. Today, all of these factors are also filtered through the media, especially social media.  

Reproductive Assistance and Control:

Since the 1970s, reproductive assistance has been shaped almost entirely by both "low tech" and "high tech" reproductive technologies. Low tech include simple procedure such as artificial insemination, that employ little more than a glorified turkey-baster; high tech, include in vitro fertilization, sperm injection, and cloning. 

Reproductive control includes who decides whether to have children, how many children, and on what basis might they decide, Hence "reproductive control" might include the use of contraception, the decision to continue a pregnancy, or abort a zygote, fetus, or infant, who decides and on what basis? 

Three Moral/Legal Perspectives

Reproductive ethics in the United States is most often reduced to two extreme views: the EXTREME LIBERAL POSITION (Liberty-Based): Anything goes, individuals decide whether to have kids, how to have kids, how many kids to have, and whether to terminate pregnancies at various stages of development. No laws are necessary. And the EXTREME CONSERVATIVE POSITION (Natural Law or Roman Catholic View).  

According to the Roman Catholic Church (via papal decrees), all sexual activity must take place within the "sanctity of marriage" between a male and a female via "natural" sexual intercourse." Three "sins" are to be avoided: sex outside of marriage (fornication) and sex outside of reproductive purpose via sexual intercourse (perversion), and abortion of a any fertilized ova, from zygote to birth. Thus, reproductive assistance within the church consists in making sexual intercourse more productive. Therefore, almost everything associated with In Vitro fertilization is regarded as immoral: donated ova and sperm, masturbation (to secure sperm), fertilization within a petri dish rather than within a uterus, and selective abortion in the case of multiple fertilized ova. Genetic testing, sex selection, gamete selection and storing frozen embryos are all regarded as an affront to "human dignity." In the case of blocked fallopian tubes, Roman Catholic fertility clinics may transfer those immobile embryos to the uterus. 

There are a variety of what we might call "MODERATE POSITIONS that fall midway between extreme liberalism and extreme conservatism. Most reflect intermediary views on the status of the fetus and/or utilitarian concerns with IVF. Many libertarians regard zygotes a "persons subject to moral concern," others identify personhood with various stages of fetal development, usually the developmental stages where fetuses can experience pain and pleasure. Others, argue that abortion of fetuses that will lead a short life of pain and suffering may be aborted at the earliest stages of development. Others, accept infanticide as well. Utilitarians might object to the cost of reproductive medicine in an "over-populated" world and/or the inability to regulate reproduction in a global context.   

Finally, it is important to distinguish between legality and morality. Libertarians tend to limit legal bans and mandates to major crimes such as murder, theft, and fraud. Many observe that fertility clinics commit fraud, when they "sell" IVF by overstating the likelihood that one or "cycles" of IVF will result in a "live birth," and that the cost of IVF is often obscured by charging patients per procedure, rather than per live birth. Many ultra conservative Roman Catholic scholars seek to legally ban IVF and abortion in all contexts, while others do not pursue legal bans and mandates for non-Catholics. Thus, many seek to distinguish between sins and crimes. 

Problematic Technologies    

In recent years several reproductive technologies have proven to be morally controversial: abortion drugs, genetic testing (for diseases, disabilities, and or sex), infant sex change operations, cloning, and the artificial uterus.