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Tufts OpenCourseware
Author: Ross S. Feldberg

1. Postings

Web Postings

Prior to most of the class discussion you will be required to post a comment. These postings should reflect your responses to the reading, the questions that arise as you read it, connections to other courses, notes on issues raised in current magazines, newspapers or TV, etc.

You will need to provide a comment on at least 12 of the 16-scheduled discussion sessions (if you comment on all 16, the lowest four scores will be dropped). There is no specific length requirement for these, but rather I will be looking for thoughtfulness of content.

For example, for a reading assignment you might use your posting to briefly address one or more of the following issues:

  1. What is the main thesis or argument of the reading?

  2. How does the author develop this thesis?

  3. What are there problems in the author's approach?

  4. What questions are you left with?

  5. What is your overall response to the argument?

  6. Are there any parallels to material you have worked with in other courses?

Below you will find several postings to give you an idea of what students have done. The postings were somewhat longer than in the past, but again, it is not the number of words that count, but the thought behind the words.

1.1. A student posting on the Ethics Readings

Looking at the Guantanamo Bay example, one can again refer to Russo's "Utilitarianism in a Nutshell" to gain a greater understanding of this issue. While act utilitarianism is flawed in its inability to predict indirect and long term effects, rule utilitarianism ascertains that in the end, the sum of all actions will produce the greatest good. The issue of long term effects must be considered in the critique of Russo's argument using Guantanamo Bay. While the immediate effect of keeping suspects imprisoned may be increased security for the public, what if, in the longer term, the effect is negative. What if more people become angry at the United States because the country violated the rights of a group of people, and even just one of these now-even-angrier people is encouraged by this anger to carry out a terrorist attack. In this case, it hold true that we are unable to predict the results of our actions and here, Russo's acknowledgement of the problem is violating the rights of a person or group is clear. In this way, deontology has a place, for is based on the inability to predict the future.

After reading the articles on utilitarianism and deontology, it appears that neither theory would work very well as a way of life. As pointed out by others, utilitarianism can lead to suffering of the minority for the benefit of the majority and a violation of the principles of justice. Deontology as well has flaws, rejecting compassion as an impetus for good will, despite the fact that compassion has enormous potential for encouraging great action and self-sacrifice, much larger than that which could be expected from good will based on duty. Ethics based on reason seems to deal with some of these problems. James Rachels' A Multiple-Strategies Utilitarianism concerns itself with virtues, motives and methods of decision-making in regards to both self-satisfaction and group welfare. This version of utilitarianism seems to reflect the complexity of matters in life and human nature. No situation is cut and dry, nor is any person able to act according to rules or feelings pressed upon them. By allowing each person to infuse his or her list of virtues and morals, and thus actions, with some of his or her "inclinations", there seems to be a greater chance that the individual in question would follow these virtues and morals, as they would come more naturally.

1.2. A student posting on Physician Assisted Suicide (PAS)

What I found to be the most intriguing insight from the readings was the idea that patients wishing to have the right to PAS did so because they wanted to achieve a sense of control. I, like Callahan, would have assumed that only people without a sense of hope would find suicide attractive. Perhaps, because I made some of the same assumptions as Callahan, I found his arguments to be more persuasive upon an initial reading. I read the Brock article first, agreeing with most all of his points and feeling that he outlined what I already believed to be a reasonable view of PAS. When I think of the issue, I assume that if the patient wants to die they will find a way with or without the help of a doctor, so why not make the process potentially easier on the families that survive them knowing they did not die a violent death. I think of the decision being the patient’s, and don’t really consider the implications their suicide would have on others, the manner in which Callahan addressed this point was thought provoking for me.

I think the most persuasive aspect of Callahan’s arguments was his discussion of the responsibility PAS would place on doctors. I agree with Callahan when he says, “As sensitive human beings, doctors should be prepared to respond to patients who ask why they must die or die in pain. But here the doctor and the patient are at the same level. The doctor may have no better answer to those old questions than anyone else and certainly no special insight from his training as a physician.” I wouldn’t be concerned that doctors would start aimlessly killing their patients, or pressuring their patients to kill themselves. Rather, I would be concerned that doctors would find themselves in a more vulnerable position. There are already many mal-practice suits today, and if a terminally ill patient’s family cannot resolve themselves to their relative’s wish to die, doctors may be confronted with further legal battles. The Oregon Death with Dignity Act does not require that a patient inform their family, simply gives them the opportunity to do so. This could lead to potential problems, as grieving families may not accept their qualified family member’s status as “competent.” Secondly, I would be concerned about the emotional toll a doctor participating in a suicide may undergo. The doctor already is faced with the fact that he cannot save his patient. Would instigating his patient's death only make him feel more impotent?

On a different note, I can’t help but question the desire to “control” death. None of us have control over death, with or without the onset of a terminal illness. In fact, despite our best attempts, we arguably don’t have control over many aspects of our experiences. I understand why patients might want to have PAS available in order to regain a sense of control, but I also understand why many might not actually act on it. I actually found it quite disturbing that Dr. Marcia Angell was quoted in the NY Times article as saying, “I am concerned that so few people are requesting it. It seems to me that more would do it. The purpose of the law is to be used, not to sit there on the books.” I really don’t think that it’s a bad sign if people aren’t committing suicide; in fact, I’d argue the contrary.

1.3. A student posting on Biology as Ideology

As someone interested in health and social inequalities, I found Lewontin's discussion of causes, effects, and agents to be particularly interesting. In chapter 3, Lewontin makes a critical distinction between causes of disease and agents of disease. He contends that agents of disease (i.e. asbestos fibers that lead to cancer), while of course the biological root of many infirmities, are given the chance to inflict illness only because of societal conditions that allow them to incubate and spread. He claims that: "Asbestos fibers and pesticides are the agents of disease and disability, but it is illusory to suppose that if we eliminate these particular irritants that the diseases will go away, for other similar irritants will take their place." As Lewontin sees it, the cause of disease and death among many populations has much less to do with the presence or absence of disease-causing bacteria and much more to do with living conditions and exposure to harmful environments; if one disease-causing agent is eradicated, another will be waiting in line to take its place.

This point of view stresses the need to step outside of biology when considering treatments for and prevention of disease. Consider the residents of a neighborhood in Chinatown. We can give every child in this neighborhood a vaccination against measles, hepatitis, and rubella, and then pat ourselves on the back for having been clever enough to outsmart these diseases and prevent them from occurring in this population. However, despite these vaccinations the children and adults of Chinatown still find themselves in a compromised position, as many suffer from asthma and other respiratory problems as a result of the neighborhood's proximity to a major interstate and the air pollution that ensues. So here we managed to win the battle against certain infectious diseases but the residents are still not healthy. Worse than that, they suffer from a disease that is equally curable and preventable. The problem here is that the "vaccine" against this type of ailment does not come in a vial or shot; it requires a much more complex shift in societal values. In order to eradicate asthma from this population, major steps must be made to improve the environment in which these citizens live by drastically reducing their exposure to harmful automotive emissions, as many of these residents do not have the financial means to move to a healthier location. Until this is accomplished, residents of Chinatown will continue to suffer the deleterious effects of an industrialized society whose dependence upon mass transportation continues to harm the environment and people in numerous ways. As Lewontin puts it:

"So long as efficiency, the maximization of profit from production, or the filling of centrally planned norms of production without reference to their means remain the motivating forces of productive enterprises the world over, so long as people are trapped by economic need or state regulation into production and consumption of certain things, then one pollutant will replace another."