Overriding ignorance and respect for autonomy

by Dylan Popowicz

Last year, I found myself in the minority during a debate on the topic of personal autonomy*. In dispute was the following case:

A woman (let’s call her Mrs. Jones) has been diagnosed with cancer but refuses to believe what her doctor is telling her. A person with cancer, she believes, would not feel as well as she does; a person with cancer, according to her belief, would rapidly lose weight, whilst she has in fact gained a few pounds. According to her own prior experience with cancer (through word of mouth, film, etc.) it isn’t possible that she has cancer—thus, she refuses to take any medicine or follow any course of treatment.

This question followed:

Q1: Assuming that it is certainly true that Mrs. Jones has cancer, but that she doesn’t believe that she does after being proffered the appropriate evidence, would it be right for the doctor to secretly or forcefully administer treatment?

The class’ overwhelming response was that it would be immoral for the doctor to administer any drugs or medication without Mrs. Jones’ permission. The central principle of autonomy, our moral obligation to respect and protect an individual’s autonomy, had won out over any other (benevolence, nonmaleficence, etc.). Even with an important adjustment to the case, the majority opinion would not sway: it made little difference if we could imagine that the cancer could be treated by something as innocuous or unremarkable as a pill. The issue was not pain, or harm of any sort, but autonomy through and through.

It seemed to me that there was a world of difference between the autonomous choice of one holding a skewed relationship with reality, and the autonomous choice of one acting upon reflection of the facts. Of course, any such consideration was answered swiftly: but surely a part of one’s being autonomous is the ability to choose what one believes.

Now, I think that there is a profound philosophical problem at the root of such an untethered conceptualisation of autonomy. It seems peculiar to think that we could choose what we believe, but even if we could, it seems that our range of choice is limited to a certain educational conditioning. A way of teasing this issue out is to change the situation slightly: let us consider that the only reason that Mrs. Jones is denying the doctor’s assertion is due to her distrust of ‘people of colour’, and that the doctor is a black man. A new question could be (and was) asked:

Q2. Assuming that it is certainly true that Mrs. Jones has cancer, but that she doesn’t believe that she does due to the fact that she does not trust the opinion of any non-white person, would it be right for the doctor to secretly or forcefully administer treatment?

Let us assume that there is no other doctor available, no white authority to ask—either Mrs. Jones is treated by the black doctor, or she swiftly and painfully dies. Still, the majority of my class (though a tad fewer) argued that it would be immoral for the doctor to act against Mrs. Jones’ will. Even when I suggested that we certainly knew that Mrs. Jones would accept the treatment if she herself believed that she had cancer, the class still stood opposed to action—the relationship between belief and truth were not nearly as important as the the agent’s ‘choice’.

I’d like to suggest that a more robust conceptualisation of autonomy would take more into consideration than the childish assertion that action x is autonomous because subject y did it because she “wanted to”. I think we need to pay much more attention to how we conceive of agents and their relationship to the world, specifically when it comes to an agent’s epistemic position. An agent chooses based on certain epistemic considerations: we have beliefs or knowledge about the goals of our actions, what we are capable of doing, as well as the present state of affairs, or the point of action itself.

When it comes to these epistemic relationships, it seems difficult to disavow the important role other agents play.

Consider a colour-blind individual, let’s name him Calvin: I’d argue that it is not plausible that Calvin could come to properly understand his own optical deficiencies without the input of a non-colour-blind individual, or what I would like to refer to as an external perspective on his epistemic relationships (a mediating third element). In this situation, the latter individual would have what we could call an epistemic authority. Imagine the (fantastic) situation in which Calvin (who has trouble distinguishing between red and green) has come into contact with a deadly virus, and is sent by a doctor to get the “green” pills from a medical office, only to find that they are located next to a jar of “red” pills. Calvin, using what beliefs he has about the colours “red” and “green”, tragically grabs the wrong pills. Would we consider it a breach of a respect for autonomy if a second individual, let’s call her Claire, who was not colour blind, were to override Calvin’s choice, and make him take the other pills, even against his vehement objections? Remember, it isn’t that Claire is stopping Calvin from reaching a certain end or goal that he desires (the opposite in fact) but rather that she is exercising a certain authority over Calvin’s epistemic position, something that only a perspective from the outside can achieve.

If an autonomous being is taking a course of action towards a certain goal, but unbeknownst to itself, is mistaken in the course of an action’s relationship to the end, surely we can accept a certain sense of paternalism and epistemic authority whilst still leaving sufficient room for autonomy. It isn’t enough to think about an agent as simply ‘acting’ in a vacuum, or to analyse autonomy without making reference to an epistemic context. Ultimately—and I know a lot of readers will resist this on political grounds—I’m inclined to suggest that a full conception of a respect for autonomy would necessitate the need for certain paternalistic acts, based on the epistemic authority of those who know better than we.

* This discussion and debate took place in Prof. DiSilvestro’s Bioethics course in the summer of 2012. My thoughts on the matter are indebted to Dr. D.’s class.

Dylan Popowicz

Senior Undergraduate

Department of Philosophy

Sacramento State University

On the overemphasis of commonalities

by Dorcas Chung

Theology of religions is a branch of theology that attempts to make sense of other religions in the light of one’s own, by seeking a meaningful, authentic, and proper approach of one’s own religion towards others. For example, Joe may take an exclusivist approach to Religion X by emphasizing X’s distinctive and privileged access to Truth. Joe’s aim may be to show how other systems are false and misguided, with the intention of convincing other religious believers to replace their worldviews with Joe’s own. Jane, on the other hand, may view Religion X from the perspective of an inclusivist. While Jane recognizes X’s distinctive claims toward Truth, she does not completely reject the claims of other religions. Other religions may not access Truth with the kind of accuracy and privilege that X does; but they can nevertheless access some important aspects of it.

My interest is to explore yet another approach, called syncretism. Unlike exclusivism and inclusivism, syncretism makes no claim to a religion’s privilege or distinction. For example, as a syncretist Johanna may believe Religion X is only one among many religions with access to Truth. Johanna would thus make no attempt to convert those who belong to other religions, since no sincere religious worldview can be false or misguided. In effect, while other models narrow the scope of privileged access by varying levels, syncretism widens the scope.

Syncretism does seem attractive. Exclusivists can appear to be  imperialistic, dogmatic, and/or disrespectful. Inclusivists, perhaps ironically, turn out to be open to the same charge. The syncretic model, on the other hand, claims to avoid the aforementioned defects by de-emphasizing differences, emphasizing commonalities, and asserting that the commonalities are most essential and therefore most fundamental to any religious outlook. In this way, it appears to treat all faiths, and persons of all faiths, with equal respect and consideration, and to facilitate meaningful dialogue and solidarity to the greatest possible degree.

Syncretists typically argue that, while religions make divergent ideological claims, these claims have similar purposes and produce similar outcomes. Religious stories and concepts should therefore be understood only as meaningful metaphors rather than literal events. This is done to acknowledge the symbolic values and virtues of the metaphor, which can in turn be applied universally to other religious worldviews. There is an expressivist rather than a realist tendency here, in the sense that the syncretist wishes to discuss not what is true but what we all feel to be true. The syncretist believes that divergent religious claims are still taken seriously in this way, since the symbols and metaphors can point to common themes found in various respective religions. The syncretist believes these claims ought not be taken literally, because the differences between religions are actually insignificant and that placing undue emphasis on them can lead to unnecessary conflict.

But syncretism has a serious problem: an inordinate focus on commonalities can actually strip a religious belief system of its most distinctive, essential and robust elements. This is just because common characteristics may not be the most important or most fundamental aspects of a belief system. In referring to a position held by Hendrik Kraemer, Velli-Matti Kärkkäinen writes, “one cannot take individual features out of the context of a particular religion and, on the basis of these individual common features, posit a fundamental sameness of two (or more) religions.”[1] 

The point is easily seen if we think about different ethical systems. Consider the action of helping an old lady  to cross the street – found to be ethical from various theoretical positions. An egoist who believes fundamentally in self-interest may help the old lady because she believes a positive image of herself will help contribute to some future success. A utilitarian may take the same action; but do so because the action contributes to yielding the greatest happiness for the greatest number. A deontologist likewise acts the very same way, but out of a motive of duty for the old lady. Based on this, a moral syncretist might infer that there is a deep commonality between these ethical theories. But clearly it is wrong to claim that egoists, utilitarians, and deontologists all believe basically the same thing. If the foundations are differently rooted, they can and will inevitably lead towards divergent paths.

The syncretist also fails to recognize the importance of evaluating the roots from which symbolic values and virtues flow. She cannot say that a Christian, Hindu, and Daoist are all basically the same because they happen to endorse similar virtues or causes. Buddhism is not very Buddhist if it does not value impermanence and interdependency above all. Christianity is not very Christian if it does not insist that Jesus Christ is the Messiah.  Islam does not seem very Islamic if Muhammad is not necessarily Allah’s Prophet.

A further problem for syncretism is that some observed commonalities are in fact deeply problematic. The oppression of women, for example, is a phenomenon that is unfortunately found in most cultures and religions. Some religious sects even argue that these positions are rooted firmly in their faith.  The syncretist that chooses to disavow repugnant commonalities at least owes us an account of the basis upon which she chooses to do so. The syncretist who simply ignores the embarrassing commonalities is not ...well ...very syncretic.

It's interesting to note in closing that the problems of syncretism are similar to those of  the melting pot and salad bowl metaphors employed in multiculturalism. Opponents to the melting pot analogy argue that engaging with diversity means valuing, in addition to the commonalities, the differences between backgrounds, as well as the distinctiveness of respective backgrounds. A melting pot construal overemphasizes apparent commonalities; but underlying these commonalities are often the implicit predominant worldviews of a society. Thus, the overemphasis on commonalities can actually lead to less meaningful dialogue and undermine attempts at real cross-cultural understanding.

Dorcas Chung
Lecturer

Department of Philosophy

Sacramento State


[1] Veli-Matti Kärkkäinen, An Introduction to the Theology of Religions (Downer’s Grove: IVP Academic, 2003), 183.

Hostility to genetically modified organisms is lazy and misguided

by Scott Merlino

"Anything that is in the world when you’re born is normal and ordinary and is just a natural part of the way the world works. Anything that’s invented between when you’re fifteen and thirty-five is new and exciting and revolutionary and you can probably get a career in it. Anything invented after you’re thirty-five is against the natural order of things." - Douglas Adams, The Salmon of Doubt (2002)

Every week thousands of people protest genetically modified (GM) organisms, and not a few vandalize research sites where GM crops and animals are developed or tested. Many European countries and regions of Asia, Africa, South America, and Australia ban some or all GM products. Greenpeace, for example, has a zero-tolerance stance towards GM. However, co-founder of Greenpeace Patrick Moore now advocates ardently for GM crops for humanitarian reasons: GM remedies for dietary deficiencies save lives.

GM refers to any organism whose genotype has been altered and includes alteration by genetic engineering (GE) and non-genetic engineering methods. GE refers to changes in the genetic constitution of cells resulting from the introduction or elimination of specific genes via molecular biology (i.e., recombinant DNA) techniques. All GE is GM, but some GM is produced by GE and some GM is not.

GM corrects micronutrient deficiencies endemic where rice is a staple food. Vitamin A provides humans with an essential nutrient for vision, growth and reproduction; its deficiency is a public health problem in more than half of all countries, especially in Africa and South-East Asia. The World Health Organization finds that over 250 million people suffer from vitamin A deficiency and over 1 million die each year from it. Diets low in vitamin A produce over 300,000 irreversible cases of blindness annually, mainly in children, half of whom die within a year. Most of these people live in poverty, their diet is mainly a daily ration of rice. Lack of vitamin A also compromises immune system integrity and thus increases the risk of severe illness and even death from such common childhood infections as diarrhea and measles.

Wild rice grains contain a negligible amount of beta-carotene, a key metabolic vitamin A precursor. In the 1990s, molecular biologists Ingo Potrykus and Peter Beyer designed the “Golden Rice” cultivar by inserting two additional genes into the rice's DNA, thereby producing beta-carotene in the grain. The presence of beta-carotene, which makes kernels of corn bright yellow, also makes Golden Rice grains yellow. Beta-carotene derived from Golden Rice converts to vitamin A in humans.

If GM organisms such as Golden Rice can save human lives, then why are so many people upset? What exactly is it about GM rice or GM in general that people oppose? As many see it, GM is (a) unnatural, (b) untested, (c) unsafe, or (d) over-industrializes agriculture. This last concern is important, especially to proponents of sustainable agriculture, but it is not an objection to GM as such, it is an objection to when, how, and to what extent we should use GM cultivated crops. I won't address this issue here, but see this 2001 Economic Impacts of Genetically Modified Crops report. Each of the remaining three objections warrants serious consideration, because they are popular and thus undermine much that such technology offers. What interests me is both how weak each objection is and how little available evidence counts for (and against) each.

Suppose that someone accepts GM for crops such as Golden Rice but not for others. It is difficult, then, to sustain an objection to either GM or GE in general. To be sure, GM is mostly used so far to design into massively cultivated crops traits such as selective herbicide or insect resistance. Objecting to this use of GM or GE amounts to objecting to the specific traits produced, not the method by which such traits were produced. But if one objects to specific GM traits, then GM is not the problem, and we change the subject from whether GM is acceptable to when it is unacceptable. This is another conversation worth having, but it is a different issue. Again, either one objects to GM, in general, or specific GM traits. One need not reject GM, as a process, out of concern for any potential unintended, bad consequences of specific traits that GM (either GE or non-GE) produces. We don’t reject a whole technology simply because we because fear some of it products.

(a) Is GM unnatural? Yes, and so what? As I see it, one cannot oppose GM organisms produced by non-genetic engineering, since this amounts to a rejection of traditional/conventional agriculture, which was invented by our ancestors at least 10,000 years ago who cultivated plants and domesticated animals to suit their needs and wants. Cows, sheep, goats, pigs, sheep, horses, corn, wheat, rice, soybeans, and potatoes have all been genetically modified via selective breeding. We don't reject all or even most human agricultural manipulations of these species, so we don't reject all GM organisms. Of course, all GM is unnatural, but then all artificial selection is unnatural. Civilization depends upon artificial selection. We are living in and dealing with the consequences of human interventions (or expressions) of the natural order already. We innovate, observe consequences, and alter our ways so as to avoid the most demonstrably negative outcomes - this is nothing new.

What about genes moving from one species to another? Non-deliberate gene flow is possible when GM crops are grown in areas where interspecies contact occurs with non-GM crops or weedy species. It already happens in nature in wild populations, and in cultivated crop plants resulting from conventional selective breeding. However, rice species, and species, in general, with their different genotypes, have significant reproductive isolation, which makes them unlikely to hybridize with each other.

To be fair, there is something more specific to which many GM opponents object, namely genetic engineering (GE), which is a kind of GM. So, to call these GM techniques unnatural distinguishes molecular techniques from conventional plant and animal hybrid production methods such as outcrossing, crossbreeding, and inbreeding. GE is essentially biotechnology applied to genes. But we already accept such technologies in medicine. Since the 1990s, gene therapy researchers have been using "genes as medicine" in treatments for cystic fibrosis, diabetes, cancer, and even enhancing musculoskeletal tissue regeneration or inhibiting disease progression in brain disorders, stroke, and traumatic brain injury. Creating novel gene combinations in organisms is not without possible perils but this is a reason for careful design, controlled observations and tests, and above all vigilance. So many unfortunate people stand to benefit from such genetic engineering that it is inhumane and anti-science to block such innovations from fear alone.

(b) Is GM untested? No, even a superficial literature search reveals that GM products and consequences have been and continue to be subject to peer-reviewed, controlled, tests designed to reveal likely hazards to human health and the environment. People voicing this objection need to overcome their intellectual torpor and do their homework on this. I recommend starting with the 2004 National Academy of Sciences "Safety of Genetically Engineered Foods: Approaches to Assessing Unintended Health Effects," (2004). And the most recent 2013 systematic review of tests published in the Critical Review of Biotechnology concludes that “scientific research conducted so far detected no significant hazards directly connected with the use of genetically engineered crops.”

(c) Is GM unsafe? Possibly, but that a process or product is possibly unsafe is a good reason for us to proceed with caution, and never a rational reason to forego research, development and testing, especially when profound improvements in human health and welfare are demonstrable. It is quite difficult to prove that something is safe, especially when people disallow or destroy research facilities. But tests for actual unsafe consequences have been done (see above).

Further, when studies designed specifically to detect adverse effects find no statistically greater risks using GM, opponents overlook or deny these results. In the US, FDA approval requires that each new GM crop be tested. If a new protein (trait) has been added to the genome, the protein must be shown to be neither toxic nor allergenic. The European Union invests more than €300 million in research on the biosafety of GM organisms. After a decade of research its recent 2010 report (p.16) concluded "GMOs are not, per se, more risky than e.g. conventional plant breeding technologies."

Yes, some investigators conclude that some GM organisms are unsafe. But few published studies survive expert scrutiny. One spectacular case worth reviewing fully is the 2011 Seralini study alleging that herbicide-resistant corn caused cancer in rats. Its problematic experimental design and low statistical power provoked this 2012 European Food Safety Authority review.

By the way, one cannot assert consistently that GM is unsafe or dangerous and untested in the same breath, since the only way we may reliably show that any specific GM is a danger or unsafe is by testing under controlled conditions. If there is no such test, then there is no evidence that GM is either safe or unsafe. Speculation, anecdotes, and poorly designed studies that fail peer scrutiny will never satisfy burden of proof requirements even if they satisfy the lazy among us.


Scott Merlino
Senior Lecturer
Department of Philosophy
Sacramento State

Divine action

by David Corner

It is important to theistic religion that it conceives of God as being active in various ways. God creates the world, and human beings; he is also thought to perform miracles. On the usual picture, everything God does in the world is something that God causes to occur. But God is not normally conceived as being part of the natural world himself. He is supernatural. This means any event in the world that expresses God’s activity is understood to be the effect of a supernatural cause. Let us call this view- the view that God acts by supernaturally causing things to happen in the natural world- supernaturalism.

I have trouble getting a clear grasp on this idea of supernatural causation. I think I have a handle on the notion of a cause generally, though maybe I am fooling myself here. But for example, I think I understand the following claims:

• Sally caused her car to start by turning the key in the ignition.
• Sally caused Betty to get a sunburn by leaving the tanning bed on for too long.
• Sally caused the chandelier to fall by cutting the chain from which it was hanging.
• Sally caused the vinegar to foam up by putting baking soda in it.

All of these claims have something in common. First, they are all instances of what is called “event causation,” by which one event, a cause, brings about a second event, which is the effect. So for example, the event (1) represented by the key’s turning in the ignition of Sally’s car causes the event (2) of the car’s starting. But also: Sally is a human being, and so she has a body, which is a physical thing. And these kinds of causes fall under familiar principles: There are mechanical causes, electromagnetic causes, chemical causes and so forth. Furthermore, in these cases, the causal relationship exists between physical things that have physical properties, like mass, wavelength, charge, chemical valence, and so on.

But God is usually thought of as being able to cause things to occur without having a body. Furthermore, God is conceived to be all-powerful. So if God exists as theistic religion supposes he does, he could start a car, give Betty a sunburn, make a chandelier fall, or make vinegar foam up. How can he do all these things without a body? Remember, God is not a physical thing, and so he has no physical properties. He has no mass, no charge, no wavelength, no chemical valence.

A supernatural cause has, as far as I can tell, nothing in common with any other sort of cause. Thus it seems to me to be an empty notion. Why call this “causation” when it bears no resemblance at all to any other sort of cause? Suppose I told you that I had a pet bird called an Oolumph. You are interested; what sort of bird is this? You have never heard of such a thing. Does it have wings, feathers? Does it lay eggs? I inform you that it has nothing in common with any other birds with which you are familiar. You would be within your rights to ask me why I call it a bird.

I suppose we could say that supernatural causation is just its own kind of cause. (This would be like suggesting that the Oolumph is just its own kind of bird.) A particularly inviting possibility might be to deny that supernatural causation is a form of event causation. But thinking of God’s activity in causal terms invites confusion. For instance, theistic philosophers suppose that God created human beings- i.e. that he caused them to exist. But then they often suppose that this account of the origin of human beings competes with the account given by evolutionary biology, so that only one of these accounts can be correct. They seem inclined to suppose so because they think the word “cause” is univocal (i.e. means the same thing) in these two sentences:

• Human beings were created (i.e. were caused to exist) by God, and
• Human beings came about (i.e. were caused to exist) by evolutionary forces.

It seems to me that taking these two claims to be in competition with one another has been responsible for a great deal of trouble. If I insist that my Oolumph is its own kind of bird, I should not enter it in any bird shows.

The problem of divine agency that emerges here is a familiar one to philosophers. We encounter it in what is known as the problem of mind-body interaction, which arises in regard to a theory of mind known as substance dualism. It appears as though mind and body interact in various ways; the physical event of hitting my thumb with a hammer, for example, causes a mental event to occur, namely the sensation of pain. The mental event of my willing my arm to go up causes the physical event of my arm’s going up- or so the substance dualist supposes. But the substance dualist denies that the mind is a physical thing. How is this sort of causal interaction possible if the mind is not physical? Supernaturalism seems to be a variety of substance dualism.

All this talk of supernatural causation presents a serious problem for the view that God acts in the world- and by extension for theism generally. What to do?

One solution is to abandon theism. Science tells us everything we need to know about what happens in the world; there is no room for God. Or perhaps there is a God, but God never does anything. Obviously neither of these is a very attractive solution to the theist.

I think there is another solution. I don’t have the space to fully explain it here, but perhaps I can give some general indication of the direction that I think theism ought to take. The mistake that supernaturalism makes is in supposing that God can only act by being the cause of events in the natural world. It’s tempting to suppose this is true of agency generally- that anything an agent does, she does by causing something to occur. This is false.

Some time ago, a philosopher by the name of Arthur Danto noticed that some of the things we do are not things we cause to occur. He referred to these as “basic actions.” This notion received quite a bit of discussion from other philosophers, such as Donald Davidson, Alvin Goldman, and Jennifer Hornsby. Davidson refers to these as “primitive actions,” and says on p. 49 of his book, Essays on Action and Events, that “event causality cannot…be used to explain the relation between an agent and a primitive action.” Suppose that I move my fingers, thereby flipping a switch, which causes a light to go on. We would rightly say that I caused the light to go on, and that I caused the switch to be flipped. But I do not cause my fingers to move. I simply move them. This is a basic action on my part.

This means that we can speak of an agent as performing an action without making any references to causes.

We have seen that serious problems are implied by the view that God supernaturally causes anything to happen. But if God exists, we can say that God acts in the world in a basic sort of way. There are things that God “simply does,” in the same way that I move my fingers. These are not things that God causes to occur. I suggest that theists abandon talk of supernatural causes and speak instead in terms of basic divine action.

—

As a postscript, I regret to report that Arthur Danto died just a few days ago, on October 25th, 2013, and I would like to provide a link to his obituary in the New York Times. Though he wrote on many topics, he was best known for his work in the philosophy of art. I had the pleasure of conversing with him on a couple of very memorable occasions.


David Corner
Senior Lecturer
Department of Philosophy
Sacramento State