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Ronald A. Lindsay - Future Bioethics
Posted: 30 August 2008 09:00 PM   [ Ignore ]
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Ronald A. Lindsay is a bioethicist, lawyer, and chief executive officer and senior research fellow of the Center for Inquiry.  He is also executive director of the Council for Secular Humanism.  For many years he practiced law in Washington, DC, and was an adjunct professor at Georgetown University and American University, where he taught jurisprudence and philosophy courses.  His new book is Future Bioethics: Overcoming Taboos, Myths, and Dogmas.

In this discussion with D.J. Grothe, Ronald Lindsay reframes the debates surrounding current controversies in bioethics. Carefully examining and dissecting claims made by many policy makers and ethicists on topics such as assistance in dying, genetic engineering, and embryonic stem cell research, bioethicist, Lindsay shows that all too often these claims are based on instinctive reactions, beliefs that lack factual support, and religious or ideological dogma. Through his insightful analysis, Lindsay demonstrates how to achieve pragmatic, progressive solutions to these controversies

http://www.pointofinquiry.org

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Posted: 31 August 2008 06:04 PM   [ Ignore ]   [ # 1 ]
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I love this show - it’s my sunday show lol

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Posted: 02 September 2008 03:48 AM   [ Ignore ]   [ # 2 ]
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This gentleman has crafted a logical and rational dissection of ethics without recourse to “deities”. Sounds like my kind of book. One question though, are any of the people who insist that ethics come from <religious book of your choice> going to read it?

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Posted: 02 September 2008 05:11 AM   [ Ignore ]   [ # 3 ]
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I finally got around to listening to this ep enroute to work today. A several points I found myself shouting at my iPod,
“DJ, ask him X!” and “Aw c’mon, DJ, you can’t let that stand, follow up on Y!” Which behavior generally means I enjoyed
the ep but felt DJ gave the guest too many softballs and free passes. A couple of areas where I felt DJ should have drilled
down:

1. early in the interview, Lindsey mentions that one very important input into his ideas for constructing ethics was “what most
people believe is moral and ethical” (don’t have the exact words in front of me, but that was the sense of it). This idea of
basing ethics on “majoritarianism” is not only silly, it is dangerous. Ethics are not politics, and the idea that “majority rules”
can be used to ground a valid ethical system (as opposed to a popular ethical system) is completely discredited.

2. I think Lindsey’s discussion on the whole idea of who/what is a “moral agent” was muddy and badly-conceived. It had a
strong taint of that whole Habermasian “open discourse among rational moral agents” naivete about it. I felt that when he
tried to defend his position that a first-trimester fetus was not a “moral agent” but a severely retarded or brain-damaged
adult was on the basis that the latter “have family ties and relationships”, I felt he did that important topic of
discussion no justice.

All told, not one of the better episodes (though I had enormous fun shouting at my iPod, which always wakes me up in the
morning ... wink

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Posted: 02 September 2008 07:27 AM   [ Ignore ]   [ # 4 ]
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I am glad that my interview allowed steveg144 the opportunity to become alert without excessive consumption of caffeine, but I am afraid he has misstated my views (perhaps I was not sufficiently precise in the interview—it is difficult to discuss moral theory in the space of a few minutes). Anyway, I do not subscribe to the view that what the majority thinks is morally right is morally right. That would be absurd. However, I do subscribe to common morality theory (other proponents of this theory include philosophers Bernard Gert and Tom Beauchamp), which holds that there are a few abstract norms that are shared across cultures. These include norms such as those prohibiting killing, stealing, deceit and the like. These norms are widely, if not universally, shared, because most people must follow these norms most of the time if we are to live together successfully—which to me seems the principal point of morality.
My understanding of morality as a practical enterprise, i.e., something that has objectives, is the crux of my moral theory. Viewing morality as something with a purpose is important if we are to achieve any measure of consensus about disputed ethical matters. Clearly, from the norms of common morality, which, as indicated, are both abstract and few in number, we cannot leap to normative conclusions about assisted dying, the regulation of human enhancement technology, and other issues in bioethics. To limit the range of morally acceptable policies on these matters (and I believe that is all we can realistically expect of a moral theory; the notion that some moral theory—yet to be discovered—will deliver the one right answer to our doorstep is just a fantasy), we need to explore the rationale for our proposed norms. For example, why do we prohibit killing and are our reasons for prohibiting killing inconsistent with allowing physicians to hasten the deaths of terminally ill patients?
The foregoing is just a sketch of my views, of course. As they say, for more detail and explanation, one will have to read the book. (Chapter 2 explains my method.)
Let me close by briefly commenting on the question of moral status, which relates to steveg 144’s second point. I do not recall using the term “moral agent” in the interview. It would be stange if I did because, in my view, moral agency is not the key to moral status, nor is rationality, sentience, or any of the other intrinsic properties that have been advanced as being sufficient conditions for moral status. These properties are not irrelevant to moral status, because they are important for how we interact with the beings that possess these properties, but moral status is also dependent on relational properties, including emotional bonds. With respect to the distinction between a fetus and a cognitively impaired adult, these relational properties are very important for moral status, if we accept, as I do, that morality is a practical enterprise. What is the point of forcing a woman to carry to term a child she does not want? How is the moral community benefited by that? On the other hand, there is some point to providing appropriate care to a cognitively impaired adult who has established relations with the community (especially when we consider that all of us have the potential to become cognitively impaired). The issue of moral status is discussed at some length in my concluding chapter.

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Posted: 02 September 2008 08:03 AM   [ Ignore ]   [ # 5 ]
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ronaldlindsay - 02 September 2008 07:27 AM

I am glad that my interview allowed steveg144 the opportunity to become alert without excessive consumption of caffeine

Ah, there’s your first mistake. My shouting behaviors are usually the direct result of excessive consumption of caffeine. wink

ronaldlindsay - 02 September 2008 07:27 AM

I do not subscribe to the view that what the majority thinks is morally right is morally right. That would be absurd. However, I do subscribe to common morality theory (other proponents of this theory include philosophers Bernard Gert and Tom Beauchamp), which holds that there are a few abstract norms that are shared across cultures. These include norms such as those prohibiting killing, stealing, deceit and the like. These norms are widely, if not universally, shared, because most people must follow these norms most of the time if we are to live together successfully—which to me seems the principal point of morality.

I may very well have heard (and then had my aging brain mangle) the “common morality theory” that you describe as a form of majoritarianism. If so, that’s my bad, my brain-fart. It was mentioned in passing
along with other inputs into moral decision-making, so it wasn’t something you strongly emphasized, as I recall. I wish DJ had slapped on the brakes and drilled down into that; it would have been a fascinating discussion.
I’d have a whole other set of issues with “common morality theory”; for one, it really just abstracts that whole “majority rules” concept from the level of the individual to the level of societies as a whole: “most societies have a prohibition against killing, therefore it is valid to use that” as opposed to “most people in a given society agree that killing is bad, therefore it is valid to use that.”  And “most societies” until very very recently (mostly thanks to the European Enlightenment, which to a large extent defined itself as going against the grain of what most societies believed was correct) have had prohibitions against suffering a witch to live, and that’s hardly an argument in favor of including witch-killing in one’s ethical outlook. Or do we just say “common modern, Western moral theory”, which creates a hierarchy in which one puts forward claims that a certain subset of all the societies in history and a subset of all the societies in the world today are the only ones whose common moral theories we should incorporate. I suspect that these sort of questions have the potential to force the “common moral theory” into such a high level of abstraction containing such a small number of common moral edicts, as to become almost useless for nuanced, day-to-day decision making. “Don’t kill people” doesn’t help with ethical decision-making when the larger ethical question at hand is “how does one define a ‘person’?” You can see where this can go (and I’m sure you’ve had the pleasure of going there more times than you want to count), but that’s maybe a discussion for a follow-on interview with DJ. I’d love to hear that conversation happen.

ronaldlindsay - 02 September 2008 07:27 AM

Let me close by briefly commenting on the question of moral status, which relates to steveg 144’s second point. I do not recall using the term “moral agent” in the interview. It would be stange if I did because, in my view, moral agency is not the key to moral status, nor is rationality, sentience, or any of the other intrinsic properties that have been advanced as being sufficient conditions for moral status. These properties are not irrelevant to moral status, because they are important for how we interact with the beings that possess these properties, but moral status is also dependent on relational properties, including emotional bonds. With respect to the distinction between a fetus and a cognitively impaired adult, these relational properties are very important for moral status, if we accept, as I do, that morality is a practical enterprise. What is the point of forcing a woman to carry to term a child she does not want? How is the moral community benefited by that? On the other hand, there is some point to providing appropriate care to a cognitively impaired adult who has established relations with the community (especially when we consider that all of us have the potential to become cognitively impaired). The issue of moral status is discussed at some length in my concluding chapter.

One could argue that either way. One could argue that if a woman should not be forced to carry to term a child she does not want, then why should a society be forced to “carry” a member of the society who will be a net drain on the resources of the society? As the father of a mentally-disabled adult, it’s not an argument I’d make, and I’d fight tooth and nail anyone who tried to advance it. But again I think we have that matter of just bumping something from one level of abstraction to another. On the personal level, what the woman “wants” trumps the fetus; but one would then be forced to consider that what the larger society “wants” trumps the cognitively-impaired adult. Like I said, it’s a repugnant argument to me, but there doesn’t seem to be anything in your methodology that would prevent one from drawing precisely this conclusion.

PS: sorry for putting the words “moral agent” in your mouth. I swear to dog I heard those exact words, late in the interview, but it was pretty noisy in the cab of my pickup, what with all the caffeine-fueled shouting and all. wink  I shall have to replay it at lunchtime today, see where the misunderstanding came from/.

All that being said, I still plan to buy your book; sounds like it will give me plenty to shout and rant about. :-D

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Posted: 02 September 2008 02:52 PM   [ Ignore ]   [ # 6 ]
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All I had to read was that you were going to buy the book.  I hereby adopt everything you say. 

No, seriously, you raise many interesting issues which are difficult to address via this post, especially in light of my keyboarding skills (if that is the correct word).  Perhaps DJ should have another show that focuses exclusively on the moral theory I advance in my book.  In any event, although it is certainly true that there has been disagreement among cultures about moral norms, I think if one surveys different cultures, both historically and in the present, one would be hard-pressed to find cultures that do not subscribe to the following norms as they affect recognized members of the moral community: Do not kill, do not cause pain or suffering, do not steal, keep your commitments, do not deceive, assist others in distress, and perhaps a few others.  If you know of such a culture, please let me know.  (Do not use Colin Turnbull’s example of the Ik, which has been discredited.)  If you think about it, widespread acceptance of these few core norms is to be expected once we recognize that, given certain perennial aspects of the human condition, such as vulnerability to disease, the elements, and predators (including other humans), and the inability of isolated humans to acquire or produce sufficient goods to satisfy their needs, cooperation for mutual advantage within a community is important for the functioning and the continued viability of that community.  Morality plays an important role in ensuring the continuation of this cooperation by praising or rewarding those who engage in cooperative activity and censoring or punishing those who do not.  Now, of course, the fact that all societies share these core norms does not, by itself, justify adherence to these norms.  But if we assume that the point of morality is to enable us to live together and to facillitate cooperative activity (and what is the point of morality otherwise?), then these norms are justified to the extent they promote those objectives.  And to me, these norms that I have mentioned do seem to promote these objectives.  Naturally, as you point out, these shared norms are so abstract that in many situations they may not provide the specific guidance that we seek.  Nonetheless, they provide a bedrock of agreement.  How we can arrive at the necessary level of specification is something I describe in the book.  Similarly, you are correct to point out that common morality theory cannot specify who is included within the scope of our moral norms, that is, who is a member of the moral community.  That has been a subject of intense disagreement across cultures. 

I may have more to say about these issues later in the week, but I am going to have to sign off now. 

Thank you for your contributions.  I have found this discussion interesting and worthwhile.

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Posted: 02 September 2008 03:55 PM   [ Ignore ]   [ # 7 ]
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ronaldlindsay - 02 September 2008 02:52 PM

All I had to read was that you were going to buy the book.  I hereby adopt everything you say. 

OK, now that was funny.  wink

ronaldlindsay - 02 September 2008 02:52 PM

No, seriously, you raise many interesting issues which are difficult to address via this post, especially in light of my keyboarding skills (if that is the correct word).  Perhaps DJ should have another show that focuses exclusively on the moral theory I advance in my book. 

I enthusiastically agree. This whole question of how we derive a viable ethical system without resort to supernaturalism is a subject that I can’t
get enough of. I often think that it is the question that humanism has to confront and resolve. When Dostoevsky said “If God is dead then
everything is permitted,” and Nietzsche said “God is dead!” the ethical “stuff” hit the fan. We humanists have to figure out ways to say “Yes,
God is dead, but no, everything is not permitted, and here’s why.” Otherwise we risk having the 21st century be a fast-forward replay of the
20th.

I’m really hoping DJ will tee up a follow-on episode to give you the breathing room to drill down on some of the issues we’ve poked at here.
DJ?

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Posted: 05 September 2008 11:56 PM   [ Ignore ]   [ # 8 ]
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I found something said by Mr. Lindsay to be somewhat troubling. One of his ethical claims near the end of the podcast is quite questionable, perhaps his own personal bias is showing through. The claim that a doctor or pharmacist who chooses to not perform a service or sell a product is somehow “forcing” their beliefs on others is insupportable. Patients are free to choose to go to other doctors or pharmacists, no force of any kind is being applied to them.

Is Wild Oats forcing their beliefs on me by not selling me Frosted Flakes? What about McDonalds not selling me a wheat germ shake? Should all stores end their “no shirt, no shoes, no service” policies because they force their beliefs on nudists? Or is it just that doctors are special, and once they decide to become doctors they must give up their own ethics and adopt Mr. Lindsay’s?

The relationship between the patient and the doctor is completely voluntary and either side has the right to end a transaction if they so choose, for whatever reason. Interfering with these voluntary transactions cannot be supported ethically. No one has a right to force another person to perform labour for them, we gave that up about 150 years ago.

There is no doubt that invoking “conscientious objector” status is a misguided attempt at an emotional appeal, it certainly doesn’t apply in this case. But I find it ironic that Mr. Lindsay says the label doesn’t apply because it only applies to those who are being forced to do something, yet that is exactly what he proposes.

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Posted: 06 September 2008 12:11 AM   [ Ignore ]   [ # 9 ]
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The problem with what the pharmacist was doing in forcing his morals upon those he is supposed to serve, is that not only was he refusing their prescriptions, but he would not tell them where they can go to get the prescription filled. Imagine if you substitute chemotherapy, and this particular pharmacist did not believe in chemotherapy as a treatment for cancer, endorsing latrile instead. Would you feel the same? To your (anticipated) reply that the examples are not comparable, how many lives do you think are destroyed by unwanted pregnancy, and you can start by counting the child. As an ICU nurse, I do not always believe in what I am doing, but I cannot, and refuse to, impose my values on my patients and their families as long as what they are doing is legal—i.e. I am obligated both legally and morally to report abuse of any kind. The morning after pill and birth control are still legal in this country. I have NEVER heard of a doctor or pharmacist refusing to supply a man with VIAGRA! Insurance companies that will not cover the morning after pill or birth control COVER VIAGRA! It appears to me to be a bit misogynistic.

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Posted: 06 September 2008 12:32 AM   [ Ignore ]   [ # 10 ]
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John Stewart of ‘The Daily Show’ made a great remark about this on his show tonight. Speaking with Newt Gingrich, he said, “so what Sarah Palin is saying is ‘Respect my rights to make decisions regarding my family’ and elect me so I will take away your abilities to make decisions regarding your family”. (It’s not exact, but that is the gist)

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Posted: 06 September 2008 01:08 AM   [ Ignore ]   [ # 11 ]
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asanta - 06 September 2008 12:11 AM

Imagine if you substitute chemotherapy, and this particular pharmacist did not believe in chemotherapy as a treatment for cancer, endorsing latrile instead. Would you feel the same? To your (anticipated) reply that the examples are not comparable, how many lives do you think are destroyed by unwanted pregnancy, and you can start by counting the child.

If you had said, “Imagine if you substitute chemotherapy, and this particular pharmacist did not believe in chemotherapy as a treatment for cancer and refused to sell chemotherapy drugs,” then, yes, I would feel exactly the same. But you added “endorsing latrile [sic] instead” which does indeed change the argument. In that case the pharmacist is taking an action that is fraudulent. We’re not talking about the pharmacists lying about the efficacy of any drugs, only refusing to sell them; a world of difference. Not only does the pharmacist have a right to not sell a drug, but they have a right to not provide any information about it either, as long as they’re honest about it.

I’m not defending their actions in any way, only defending their rights to make them (or not make them, as the case may be). Certainly doctors or pharmacists who do this should be exposed to public scrutiny and ostracised. But that wasn’t the suggestion, it was instead that they should be forced to sell the drugs.

asanta - 06 September 2008 12:11 AM

I cannot, and refuse to, impose my values on my patients and their families as long as what they are doing is legal.

But do you have a problem imposing your values on your pharmacist?

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Posted: 06 September 2008 01:29 AM   [ Ignore ]   [ # 12 ]
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I have a problem with the fact that MY DOCTOR can prescribe a LEGAL DRUG, for a condition that HE IS TREATING, and the Pharmacist will want to make a judgement to deny it to me based on his religious views. HE SHOULD NOT HAVE BECOME A PHARMACIST IF HIS RELIGION WAS GOING TO AFFECT HIS ABILITY TO DO HIS JOB EFFECTIVELY, or he should work in a capacity where he would have no patient contact.

Another example: You’re child is in a horrible accident and is bleeding to death. (S)he is brought to the emergency room on death’s door desperatly needing a blood transfusion for survival. The doctor immediately signs the paper work for untyped O- blood, 4 units to be delivered to the ED to try to save this child’s life. the nurse assigned to care for your child on this very busy Fri night is a Jehovah’s witness and stalls then refuses. Your child dies. You did not make the choice to withhold care, the nurse did. Even if you did decide to withhold the blood, the doctor would be on the phone with a judge to get an emergency order, because the law has determined that while the parent is a Jehovah’s witness, the child has not declared his beliefs. That being said, we do everything in our powers to respect the wishes of those with beliefs that are not the same as ours, to the extent it will not cause harm to the child(and I have seen some ‘wacky beliefs).

In the 1980s I worked with doctors that refused to order blood no matter how dire the situation because of their religion. The hospital went through the staff and fired them. They decided that it was not the doctor’s place to withhold proven treatment to patients. Nurses that I have worked with since recognize the difference between their beliefs and the rights and belief of their patients, and transfuse the blood.

Why is this pharmacist any different from the parents withholding medical treatment from their daughter while she died a miserable death from diabetic ketoacidosis? And I can guarantee you that it WAS miserable.

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Posted: 06 September 2008 04:35 AM   [ Ignore ]   [ # 13 ]
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asanta - 06 September 2008 01:29 AM

I have a problem with the fact that MY DOCTOR can prescribe a LEGAL DRUG, for a condition that HE IS TREATING, and the Pharmacist will want to make a judgement to deny it to me based on his religious views. HE SHOULD NOT HAVE BECOME A PHARMACIST IF HIS RELIGION WAS GOING TO AFFECT HIS ABILITY TO DO HIS JOB EFFECTIVELY, or he should work in a capacity where he would have no patient contact.

There’s a simple solution:  Get a different pharmacist.

asanta - 06 September 2008 01:29 AM

The hospital went through the staff and fired them.

Another simple solution.

asanta - 06 September 2008 01:29 AM

Why is this pharmacist any different from the parents withholding medical treatment from their daughter while she died a miserable death from diabetic ketoacidosis?

Are you accusing these pharmacists of kidnapping people and preventing their treatment? If not, then that’s the difference.

Bottom line:

You do not have a right to force another human being to perform labour for your benefit. What ethical framework do you have which allows you to think that you do?

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Posted: 06 September 2008 04:48 AM   [ Ignore ]   [ # 14 ]
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adamruth - 06 September 2008 04:35 AM

Are you accusing these pharmacists of kidnapping people and preventing their treatment? If not, then that’s the difference.
Bottom line:
You do not have a right to force another human being to perform labour for your benefit. What ethical framework do you have which allows you to think that you do?

If I remember correctly, and I’m sure I do, the pharmacist WOULD NOT RETURN THE SCRIPT SO THE PATIENT COULD GO ELSEWHERE. What ‘ethical’ frame work would this be????

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Posted: 06 September 2008 05:18 AM   [ Ignore ]   [ # 15 ]
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asanta - 06 September 2008 04:48 AM

If I remember correctly, and I’m sure I do, the pharmacist WOULD NOT RETURN THE SCRIPT SO THE PATIENT COULD GO ELSEWHERE. What ‘ethical’ frame work would this be????

Now that’s a valid complaint, because that’s theft. But that’s also a shift in argument.

The argument was that the pharmacist does not have the right to not fill the prescription. Do you agree that the pharmacist has no such right?

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