Monday, October 21, 2013

Went to med school to talk about ethics

I got to see the raging bias that interferes with the logic of doctors in regard to male circumcision first hand this weekend when I attended the annual Pitts Lectureship in Medical Ethics at the Medical University of South Carolina.  Among other debates, there was a debate on infant circumcision between Attorney for the Rights of the Child's Steven Svoboda, JD, and the AAP’s circumcision task force member Dr. Michael Brady.  Audience participation was encouraged after each debate, and at the all inclusive seminar that wrapped the conference.  Also present, Dr. Diekema of the same AAP task force fame (who, interestingly enough, gave a great talk on not turning away children/families who have not been vaccinated).  Eye opening in some regards, frightening and sad in others, the discussion made it clear that these people (the most argumentative pro-circers there) are incapable of accepting 4 things:

1.   The foreskin has function. Even when a few of the many functions were described in detail by someone who HAD one, their response was “you don’t know that”, and back to the beginning again with insisting there are no functions (or none that matter since we wear clothes). 

2.  Men WANT their foreskins.  A lot of emphasis was put on various surveys of newly circumcised men showing satisfaction, or anecdotes of men wanting circumcisions while serving in the armed forces.   Even though 99% of circumcisions are forced, and 99% or better of men in the world left intact from childhood die that way, or that thousands of men are going to the trouble of restoring their foreskins, it was still stated “men do not value their foreskin”.  No logic got through.  When it was pondered that breast bud removal could provide a gross benefit to society’s health, the objection was (of course) that women wouldn’t appreciate that when they got older, so, best to leave it for then.

3.   Boys have a right to their healthy bodies.  When the bad habit of assuming that the risk vs benefit analysis can apply to healthy body parts, even though it is clearly meant to guide a physician through evaluating NEEDED treatment, was challenged, the conversation ended up back at “it’s better”, an opinion.  Thanks Doc., that’s very respectful of you.  

4.  This culture (and they themselves) are biased in favor of circumcision.  It was said in several ways by more than one person that if you don't have a foreskin, and live in a culture that disregards its value, perhaps your vision might be skewed, preventing you from acknowledging points 1 - 3.  Interestingly enough, this wasn't denied, challenged, or defended in ANY way. It was almost like they were pretending they didn't hear it.

Disappointing, but all in all, not a shock.  God was only mentioned once, but validity of ritual, validity of culture, validity of tradition, validity of sheer numbers performed, and validity of proxy consent were all mentioned, even though those things have nothing to do with the ethical requirement in medicine to not interfere where interference is not needed.  

I do think that some people present actually “got it”.   The points were made and made well, biases were challenged with no logical or meaningful retort (other than continuing to argue in favor of circumcision) and I think it was pretty obvious to the people listening that the points and challenges were valid, which makes it all a success!

Thursday, June 6, 2013

Screw what your boss tells you to do

Dear all big business employees that have to work with customers:

            Don't you hate when customers get all belligerant and give you shit about things you can't change?  Don't you wish you could DO something about it?  Great news!  YOU CAN!  The key to not having pissed off customers isn’t giving them what they think is fair, that changes daily, and from person to person.  It's also not having the power to fix a problem after the fact, cause well, most employees have little control of the deal being made anyway.  The key is, in fact, managing their expectations. 

            The corporation that you are a slave to wants to give people high expectations in order to lure business, but has its true interests in the bottom line (profiting as much as possible).  It's called Bait and Switch, and it's pretty damn common.  Basically, this creates a set up for you getting to deal with a bunch of disgruntled patrons who expected to get more than they did (or to pay less than they get billed for, or.... etc.).  Corporations don’t care that this practice produces pissed off customers, because all the other big dogs do it too, and because YOU are the one who has to deal with their righteous indignation.  (Oh, they might read a couple letters here and there from people who take the time, but YOU get the snot and insults to the face.)

            The answer is FUCK CORPORATE and their bullshit policies. BE HONEST with your customers about what they can expect.  Think they might get caught in an "extra charge" trap?  TELL THEM!  They clearly want more than the deal they think they are buying?  SAY SOMETHING!  Don't just stand there while they sign off on 6 pages of fine print no one takes the time to read telling yourself that the surprise will be their fault.  Put in a little effort, and let them know what's up. They will be happier, and you will be the good guy. 


Thursday, March 14, 2013

"Don't say the word RETARDED"

The word "retard" is the new "black". There used to be a different term, (idiot & negro) then the new term (retard & black) was used to get rid of the less nice term, and eventually, because people who are rude are just GOING to be rude, and the INTENT gets married with the term, the new pc term is interpreted to be insulting, even though it's just a technical description.  Black is just a description of race, not an insult.  Retard means stunted, and it was around BEFORE people decided it was the new pc term for idiot.

It's 'lacking critical intellectual thought' to assign racism or debility intolerance to everyone who uses a word just because people who ARE like that use that word too.  Besides, any new term you choose to describe people WILL be used by rude people to be rude and intolerant, and eventually, your new word will be an "insult".  Say you pick “challenged” as your new ‘nice’ way to describe people whose mental growth is retarded.  Once it becomes common vernacular, rude people will just use the word challenged when they want to insult challenged people (though, more likely, when they want to insult non challenged people).  You can't win by policing the WORD people use, because you can’t take a person’s intent away.

This is especially important to recognize because, for some reason, people are suddenly not allowed to use the ‘not cool right now’ word for OTHER applicable things.  If you say “retarded” about some thing, idea, or circumstance you find to be stunted in intellect, or not matching your expectations of being well thought out, efficient, or productive, you’re interpreted as insulting challenged people, when you weren't even talking about them!  

The fact is, we have the right to find things to be personally undesirable.  Opinions are a right.  If having less mental capacity is undesirable, then that language is going to be automatic, and when I make a relationship with that word, and I use it to describe something that I find to be undesirable in the same manner, that does NOT mean that I hate people with lessened mental capacity or that I feel they deserve ridicule, disrespect, or any other bad treatment because of their situation; that would be retarded.

Now there's a subtle difference with other words and insults that I don’t want to be missed or misinterpreted.  Gay used to mean happy.  Then it meant homosexual, then, because it meant homosexual, and people are assholes, it started to mean ‘not cool’.  It never meant anything negative before the bigots got their hands on it.  If you use gay to mean not cool, you’re being insulting to people who still use the word gay as a valid description of their sexuality, but only if you meant it that way.  Plenty of people are just going with the flow of vernacular, and are not actually saying it’s not cool to be gay.  SO, saying “gay” to mean something bad CAN BE an insult, and saying retarded to mean retarded is JUST a description, unless someone is being mean TO a mentally challenged person.  It's the intent that makes it an insult, not the word.

Another subtle difference is that even though people have the right to have negative feelings about gayness, just as they have the right to have negative feelings about lessened mental capacity, there is an inappropriate moral judgment of other people's BEHAVIOR that comes with a negative association with homosexuality that does NOT accompany a negative association with a mental handicap.  No one is judging a handicapped person as being immoral or saying that they should not be that way because they are doing wrong.  In our zest for a world free of insults, we're forgetting to distinguish between an inappropriate moral judgment, and a simple recognition of an undesirable state.

In the end, think about what your words MEAN before you speak, and hear what the people you’re talking to MEAN instead of just the word. \ /,,

Wednesday, February 6, 2013

The validity of Belief

The Validity of Belief

Being a free autonomous being is more than just DOING what you want to do, it’s thinking for yourself, developing your own perspective, and ‘finding your truth’.  Your own truth is a very personal thing.  It’s more than just whether you prefer sunrise over sunset, how you feel about the complexity of personal relationships, or your best guess as to why we’re here.  It’s all of it.  All of the thoughts and feelings inside you.  All of your guesses about the unknown, wishes for what is, or will be, and even your fears.  Even the way you come to your conclusions, and how well you know yourself are part of it.  It’s a very specific color and shape of the world you live in, and it changes with you as you grow and learn. It’s what makes you YOU.

There’s no such thing as right or wrong when it comes to opinions or beliefs.  We are our thoughts, and we have a right to them.  Perhaps your belief system explains every single thing in the universe, or perhaps it mandates that you won’t guess at things not provable, or that you will reserve your certainty.  Even if you believe that we’re all just brains in jars living out a virtual reality… or you find the smell of skunk on the wind pleasing… or think that bank robbers are heroes… you can’t be wrong, not morally, not factually.   

No one’s ‘personal truth’ or ‘belief system’ is exactly the same as another’s because it has nothing to do with facts.  The facts that rule the world are the same for everyone.  The sun is hot and water conducts electricity.  Trees make oxygen and food sustains our life.  There’s what we know and can prove, and then there’s what we have to guess at.  That’s where our personal truths lie.  We’re all different beings who come to our conclusions through different experiences and reactions to those experiences.

There is a certain comfort, though, that comes when someone else has a similar belief to our own.  It makes us feel that our belief is valid.  With each person we meet who agrees with us, we’re that much more sure that somehow our belief is fact.  That really helps us deal with life if our belief is protecting us from fear or pain.  You can’t be alone when scores of other people validate your existence.

The problem with allowing the idea that our beliefs are validated when others agree, is that in order for one belief to be valid, all others must be invalid.  This goes against the nature of it being personal and having a right to it.  Once a belief system is “right” or considered to be fact, other perspectives lose the freedom to exist, even if only in the mind of the person who thinks their belief is right.  Sadly, the past is riddled with the right of alternative perspectives to exist being literally, and often tragically, denied.  That’s thought control, which translates into will control, and it’s not cool.  Humanity has struggled in recent years to break fee of the confines of enforced belief.  

Assuming that we all want to get along, and that we all want to be treated with respect, what we need to recognize is that the intrinsic nature of rights is that everyone has them.  The same is true for freedom of thought.  You don’t truly have it if your belief includes that others are undeserving of their belief, that they are wrong, or that it’s ok for you to tell someone else what to think.  If you can tell others what to believe, then others can tell you what to believe.  That changes the rule from freedom of thought, to “I’m right”.  The problem there is that everyone is an “I”, so that rule can’t possibly be applied.  Our rights must be respected universally, or there’s no way to keep them.

In order to grant freedom of thought to others, and enjoy it ourselves, we must maintain that beliefs are only valid to the individual.  One person’s love of coffee, no matter how strong, cannot make coffee better than tea to another.  One person’s belief that death is the end cannot make another’s belief that something else awaits them unreal.  We have to be brave and accept that the unknown exists; and while it is a beautiful and sometimes life changing experience to find our truth, recruiting others to ours, or agreeing with someone else’s truth cannot make it valid.  The validity of belief is based solely on the honesty of a person to his or herself. 

Having a belief system is a right of autonomy. Your will cannot belong to you if it is formed from the thoughts and perspective of someone else.  Thus, finding your truth is a right of autonomy as well.  If you never try a new food because others dislike it, then your preference doesn’t belong to you.  If you don’t go through a process of discarding pre-conceived notions, and asking yourself questions about the unknown, how can you know that the answers you hold are true for you?  

Because it is a matter of autonomy, no one should ever take the incredibly personal  experience of finding their truth from another.  It’s quite simply a violation of rights.  This kind of interference is difficult to achieve with an adult whose beliefs are already formed, especially one who is aware and deliberate about their belief system.  Most rights are easiest to deny to children.  This particular breach is common, and not well recognized in our society.  Denying autonomy of thought is done when we teach our children, as though it were fact, a pre-set belief, our own belief, or a known lie about something that is an opinion, or cannot be proven as fact.  

Young beings are impressionable, and trusting.  It’s a necessary part of their nature as it allows them to learn a great deal.  Unlike adults who can’t really be told what to think, children are vulnerable to thought conditioning.  If we are to have autonomy of thought as adults, we must have it when our core understanding of the world is forming. We must have it as children.  Finding our truth can take a lifetime, but not if we don’t have to struggle to let go of someone else’s to get there.

Early indoctrination is hard to let go of.  It colors our view of everything we see.  Many who were saturated as children with the beliefs of those who came before them never truly find their own.  Certain beliefs would never survive in today’s society that strives for equality and goodwill if it were not for teaching them to children.  There are children in the world who are certain that people they have never met deserve torture and death simply for being born a different race.  There are children out there that harass others with the threat of burning underground for eternity just for having normal biological urges.  This is how intolerance and hatred stay alive: those children simply grow up, and teach their children what they believe.  Not all passed on beliefs are negative, and even whether or not they are negative is opinion, and so, almost insignificant to the point.  The important part is that the ideas are not their own, and they can affect all other ideas for their entire life.  They have been denied the right to form their own thoughts and beliefs.  They are a living tomb of the will of people long dead.

As they grow, our children will form hopes and dreams for the future.  These are based on their perceptions of the world.  If we want what’s best for our children, we want them to know respect for their autonomy, and for their dreams to be realized.  To have that, what they hope for must be possible, and must belong to them alone; so, what we teach them must be facts and we must make the line between fact and belief known to them.  To do anything else is to risk that their desires will be inaccessible or misguided, or worse, to usurp their right to their own will and supplant it with someone else’s.