Alice Domurat Dreger's Blog

My work on trans issues

My research, writing, and speaking on sex and gender issues started with my Ph.D. dissertation work on the history of what happened to people with intersex conditions in the nineteenth and early-twentieth centuries. (During that period, these people were labeled “hermaphrodites.”) The medical and  social systems that deal with intersex – the systems on which a lot of my work has focused – also deal to a large extent with people who are or might be transgender, and as a result, I’ve been interested in the social and medical (mis)treatment of people who are transgender.

Sometimes people confront me with hateful things I have supposedly said about transgender people – things which I’ve never said. There are some posts out there that have my name and my byline and even my photo but have text that is not mine – in some cases, really disgusting, text. That is frustrating, but I’ve learned I can’t spend my whole life trying to stop false representations of me.

What I can do here is to point you to my actual work. Here are some examples:

“Really Changing Sex”: a 2006 post for the Hastings Center, arguing that doctors should not be the people in charge of saying who is what gender – that people should be allowed to decide that for themselves. Sport in Transition: Making Sport in Canada Responsible for Gender Inclusivity: a 2012 white paper I co-edited, pushing for inclusivity of trans athletes in sports. (I’ve also published four essays in the New York Times Sports section, arguing for allowing women with intersex conditions to compete as women without medical coercion.)“Gender Identity Disorder in Childhood: Inconclusive Advice to Parents”: a 2012 essay I wrote for the Hastings Center Report looking at some of the knowns and unknowns in terms of the evidence (including that childhood gender dysphoria that continues into adolescence is unlikely to disappear), counseling parents about how to put their children’s interests before their own. (Contact me if you’re not at an academic institution with a subscription and would like a copy.)Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born with DSD: A Resource for Medical Educators: a 2014 volume I co-edited with Andrew D. Hollenbach and Kristin L. Eckstrand for the American Association of Medical Colleges (AAMC) aimed at teaching future doctors to treat patients from sex and gender minority populations much better than many of their predecessors treated these populations.

Those are just some examples in terms of written texts over the years. I’ve picked ones that should be easily available to most interested people online.

If you’d like to hear a recent podcast in which I explain why I believe that transwomen athletes should be allowed to play as women, and in which I push back against the idea that there is a “problem” that more young people are seeking transitional interventions, have a listen to the Heterodorx podcast.

Finally, some people claim that I am “anti-transgender” because I believe that autogynephilia is a real human phenomenon and that it’s a legitimate way to be transgender. That’s just bizarre. It’s obviously real – plenty of people identify with it and describe the experiences – and I also cannot understand why some people think this is not a legitimate way to be transgender. It absolutely is a legitimate way to be transgender. If that’s how you got to your understanding of your gender identity (and sexuality), that is absolutely okay.

Want to know more about that? Check out this page, in which I conclude: “…while transgender people should be allowed to talk about how their sexualities matter to their gender identities, their self-declarations of gender identity should be all that matter to us in terms of their social gender identities.”

David Robert Grimes recently had the unenviable task of facing off against Andrew Wakefield on Irish radio. Dr. Grimes is a physicist who also functions as an advocate for science in the public realm. I very much respect his work.

Wakefield, on the other hand, is infamous for having falsely claimed that vaccines cause autism. (They don’t.) Investigative journalist Brian Deer showed Wakefield committed fraud in production of his dangerous claims, and Wakefield subsequently had his medical license revoked. But Wakefield is still at it.

My book, Galileo’s Middle Finger, includes the story of one of Wakefield’s supporters who also made false accusations about vaccines causing disease, so Wakefield’s doings very much remain an interest of mine. After his heavily-edited face off with Wakefield, Dr. Grimes and I got into a conversation about what one should do in such circumstances. Do you turn down the interview so as not to legitimize someone like Wakefield, or let him go unchallenged?

It’s a tough choice I’ve faced myself. There’s no easy answer, but I certainly respect what Dr. Grimes tried to do and I can very much relate to his visible frustration at Wakefield being given air time. (You can hear what aired here, by jumping to the 11-minute mark.)

That said, I do think it is important that we try to do a better job understanding why so many people are susceptible to false claims about vaccines, including conspiracy theories centered on alleged greed.

Many ordinary citizens and patients know—and are right to think about—the fact that vaccines are pushed in and by a medical industrial complex that is, particularly in the United States, rife with financial conflicts of interest, overtreatment, and iatrogenic harm from practices adopted without sufficient evidence.

Vaccines are produced and marketed by the same pharmaceutical companies that have been found, again and again, to engage in unethical and also illegal practices in pursuit of profits. And the fact is that many leaders in medicine, if not also in public health, have had deeply problematic relationships with big pharma; even the New England Journal of Medicine’s editors have lately been telling people to stop worrying their pretty little heads about conflict of interest disclosures and data transparency.

Vaccine exceptionalism—the attitude among many science and public health advocates, that approved and recommended vaccines are never to be questioned or doubted—is historically and politically naïve. Vaccine exceptionalism also ultimately feeds anti-vaccine campaigns by contributing to the sense among vaccine-worried parents that the “pro-vaccine” campaign isn’t really thoughtful or scientific.

I’ve written some about this in an article for New Statesman, so I’ll try to just recap here my position:

I care very much about vaccine public health programs and creating herd immunity for dangerous diseases. That’s why I cringe when I look at how the HPV and chickenpox vaccines came to be mandated in various states in the U.S.—namely through the purchase by pharma of Republican and Democratic politicians. That’s why I object to “ethicists” like Art Caplan taking money from vaccine makers and not revealing those payments while publishing essays arguing “it’s unethical not to be vaccinated” in the medical literature and the mainstream press. I really hate that our Centers for Disease Control, which set out vaccine public health policy, have a Foundation that explicitly takes money from vaccine makers, calling them “our partners.”

I wish none of this would happen, and that people in the public had every reason to feel they could completely trust that no one weighing in on vaccines had a financial interest to be “pro” or “anti.”

It’s time to recognize our responsibility to public health by recognizing that Wakefield’s side is not the only one to have effectively unmanaged and undisclosed financial conflicts of interest. Many of the people who are suspicious of vaccines, especially in the U.S., are not stupid. They know about how they and their loved ones have been screwed over by the medical industrial system that insists they need so many ineffective and unsafe drugs and screenings that do not actually help anyone but the profiteers in industry and pseudo-nonprofits, like our “non-profit” hospitals and some well-known “non-profit” cancer-fight organizations.

If we don't understand Wakefield as a symptom of legitimate suspicion among patients and parents, we will keep giving him fertile ground. It’s time we do something not only about Wakefield, but about the system of medical “science” that is causing the suspicion perpetuating his lies.

 

See my follow-up post providing a list for reporters of physicians, medical ethicists, etc. who can speak on vaccines and who have not taken funding from the vaccine industry.

 

Tags: once more

Since I’ve been asked about this on Twitter….

Today, my colleague Carl Elliott posted a short note at his blog that surprised me. By way of background, I have long supported Carl’s quest to bring justice to bear in the Markingson research ethics scandal; I’ve written essays on it, participated in leading a call for the external review, etc. I’ve long shared Carl’s disgust at how hard it has been to get justice in this case.

Anyway, Carl today posted this at his blog:

Forget Tuskegee. Forget Willowbrook and Holmesburg Prison. Pay no attention to the research subjects who died at Kano, Auckland Women's Hospital or the Fred Hutchinson Cancer Center. Never mind about Jesse Gelsinger, Ellen Roche, Nicole Wan, Tracy Johnson or Dan Markingson. According to Steven Pinker, "we already have ample safeguards for the safety and informed consent of patients and research subjects."  So bioethicists should just shut up about abuses and let smart people like him get on with their work.

I was surprised by reading this at Carl’s blog, because Steve Pinker has been extremely supportive of all my work, including on prenatal dexamethasone for CAH, which is unquestionably an ethics travesty where the rights of patients and research subjects are concerned. Indeed, before I mount what will be seen as something of a defense of Pinker, I should disclose that Steve Pinker has for many years been a key supporter of my work; most visibly, he supported my Guggenheim application and blurbed Galileo’s Middle Finger, the book that came out of my Guggenheim, the book where I tell the horror story of prenatal dexamethasone for CAH. (You can read the short version at the NYT review of my book.)

I guess I could even call Steve a friend, considering that he’s drunk my husband’s scotch and complimented our kid on having "extraordinary parents" after Steve learned from our son that we let him sleep in a refrigerator box with his two pet rats for six weeks when he was little. (I think “you have extraordinary parents” was meant as a compliment; he didn’t turn us into child protective services anyway.)

So to the point: Contrary to Carl’s post, Steve doesn’t actually say to forget any of those research ethics travesties. Nor does he say forget about those who were harmed.

What he does say—what is clearly the main point of the essay—is that so-called ethicists often predict terrible things will come out of new technologies, and they are often wrong. Most of his op-ed focuses on ethicists who try to stop the development of new technologies not out of concern for research subjects but out of concern that they will lead to “brave new worlds.”

As an historian of medicine and science, I’d have to agree that people have often been wrong about the supposed doom that will befall us when we achieve new biomedical technologies.

Carl truncated the one sentence about research subjects. Here’s what it says in full, with the part that was cut off now underlined:

"Of course, individuals must be protected from identifiable harm, but we already have ample safeguards for the safety and informed consent of patients and research subjects.”

So Steve is not suggesting rolling back safeguards, so far as I can see, although he doesn’t advocate having more, either—which some of us would advocate. (For my part, I’d advocate neither more nor less per se, but much more effective. I’m not sure how to get that.)

And Steve’s obviously factually wrong about there being ample safeguards, given what a lot of us, including Carl and I, have found—although I guess, in the end, that’s a judgment call based on what you see at a population level as acceptable risk to informed consent and safety. A lot of us (myself included) might set the acceptable level very, very low. Steve seems comfortable where it is. He might change his mind if he did the kind of work Carl and I do.

Anyway, I suggest folks read Steve Pinker's original op-ed for themselves. I rather wish he had not thrown in the issue of research subject protection with his main point—dire warnings about new technologies—as I think these issues are different and the point about research subject protection shouldn’t be in an essay that is mostly about the dire warning phenomenon. If Steve had written more about research subject protections, we could perhaps have a good argument on that point.

 

Postscript:

Steve Pinker sent the following to me on email and then at my request gave me permission to post:

Thanks, Alice, for the witty and welcome defense! We agree that human subject protections are not where they should be – there may be too little in some areas, but there surely are too many in others, as when they were used to persecute Mike Bailey and Beth Loftus, or, more parochially, when I have to formally request permission from a committee to change a single item in a questionnaire about irregular verbs. And many critics have pointed out that current IRB and privacy regulations are wreaking havoc with effective research and patient care (not least in the case of Jesse Gelsinger, who, it has been argued, was a victim of too much bioethical argumentation, not too little). So I’d stick with “ample,” though much of it is, as you’ve shown, misdirected.

Those interested in the Gelsinger case, including how he became "a victim of too much bioethics argumentation," may wish to see Carl's book, White Coat, Black Hat: Adventures on the Dark Side of Medicine.

Post-postscript:

My mate, Aron Sousa, read all this and said I could quote his response:

Nice essay. Pinker has been reading his own work about the better angles of our nature and thinks less about the individual outliers who are harmed. Dex is one of those system failures where everything that could go wrong has gone wrong: prenatal, off-label, intersex, fraudster, oil-rich donors, retrospective study design....

Those of you who know the story of dex from Galileo's Middle Finger will know what he means by all that--except maybe the "oil-rich donors" bit, which I left out of the story lest people think I had to be making it all up.

But Aron's main point is that Steve is thinking more about overall progress and "less about the individual outliers who are harmed." It's impossible for someone like Carl or me to do that, because after you spend years of your life tracking research harm in a particular case, you become pretty obsessed with "outlier" harm, and increasingly aware of how it may not be so rare.

Tags: once more

What’s a woman allowed to say?

That’s a question I wrestled with a lot while I was writing and revising my new book, Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science. Really ironic; so much of the book deals with struggles over who gets to say what gender means—and the whole book is written from the perspective of an unashamed feminist. So why worry about the question of what women are “allowed” to say?

Reality. That’s why my agent, my editors, and I worried about it. Because the reality is people would judge what I was saying not just by the words, but by the fact that my first name is “Alice.”

Reading a recent essay in the New York Times by Sheryl Sandberg and Adam Grant validated that fear. Sandberg and Grant reviewed Grant’s research findings as well as a new study by Yale University psychologist Victoria Brescoll—all of it arriving at the same conclusion: women get dinged for speaking up, while men get rewarded. This happens even at the level of the Senate floor.

I knew this even before this research came out. Most women who succeed in America know these unwritten rules. So I guess it is no surprise that I found myself, in dealing with Galileo’s Middle Finger, feeling like I had to de-feminize my voice over and over.

Taken out over the course of edits were several accounts of my breaking into tears (something I think we have nothing to be ashamed of), references to being a wife and mother, and quite a few lines that if I were a man would get me labeled “bold,” but as a woman would only get me labeled “shrill.”

Even when we reached the point of the book jacket, I found myself editing out my gender. The draft text for the jacket referred to “one woman’s eye-opening story.” I changed it to “one American’s eye-opening story.”

“How often,” I not-so-rhetorically asked the folks I was working with, “do women writing non-fiction books make the best-seller list?”

When they do, it’s often because they’re writing about being women. Exhibit A: Sandberg’s Leaning In. We're allowed to speak up if we stay in the women's parlor, talking about women's issues. . . .

Best to focus on my nationality, which is easily as relevant to this book as my gender. Still…

I have a fantasy—and that is that this book will succeed in being about being an American, and that then it will be read as a story about how women are real Americans, too—qua women.

We American women might even be able, someday, to have authentic voices that don’t get us punished.

In the meantime, you might understand why I’ve named this new blog—which is about my new book—Once More, with Feeling. Warning: some posts may get shrill.

 

 

Tags: once more

I’m a lot like Sheryl Sandberg, or at least her public persona. Ask anyone who knows me and they’ll tell you I’m a hard-driving, productive, leadership-prone woman who believes it is critically important for women to be confident, unashamed of their talents, and serious about careers they want. I have worked my ass off to achieve the c.v. I have, and I have enjoyed it.

But the truth is, I intentionally lean out of my career. A lot. I do this because there are only 24 hours in a day, and when I ask myself, “If I died tomorrow, what would I want people to remember me for?,” it isn’t anything I’ve published, any TV appearance I’ve made, or anything like that.

I’d like my son to remember, that almost every morning, I snuggled with him for 15 minutes before we finally got up together. I’d like him to remember that I had the door open and a hug ready for him when he ran home from the school bus, almost every day. I’d like him to remember that I took up the clarinet, and started lessons with him with his teacher, so we could play duets together and so that he could be my secondary teacher. I’d like him to remember all the after-school walks we took to the river. I’d like him to remember how happy I was when he had a snow day and could stay home with me.

I’d like my mate to remember all that, and to remember that I became a gardener, reluctantly at first, and that I did so because he loves planting but hates to weed. I’d like him to remember all the dinner parties with friends I arranged for us. I’d like him to remember the house concerts, like the one last night.

I’d like my neighbor to remember that when her beloved step-mom died, I dropped everything and ran over to her house, 100 feet away from my writing cottage. I’d like her to remember the times she helped me with my work and gave me the energy to continue.

I’d like my dad to remember that I scheduled a bunch of extra visits to help out him and mom, and that I made him Polish porkchops like his mother used to make. I’d like my mother to remember that I made her apple fritters.

I’d like my agent to remember the four hours we spent together talking about being wives and mothers and writers.

I’d like all the strangers who called me to talk about their medical traumas to remember that I took a few hours or a couple of days to listen to them and write down their histories for them.

I’d like my editor at Penguin to remember laughing when I told him that the local power company would probably pay him to give me my manuscript back, because as long as he was working on it, I’d keep working on my investigation of the power outage they bungled, because I felt like my town might benefit from that volunteer work from me.

I’d like my walking partner to remember our walks and all of the flowers and dogs we stopped to greet.

I’d like my late friend’s husband to remember that when his wife died, I came over to cry to pieces with him and their kids, and to help write her obit.

If I leaned into my career, I would not be doing all these things. I would not have time. I would be at work doing what my career path rewards.

So, when I take stock of what’s been important and meaningful in my life, well, it’s a lot of that stuff can’t ever show up on a c.v. In fact, it’s a lot of that stuff will necessarily get in the way of stuff that could otherwise show up on my c.v.

I leaned out starting a decade ago, in 2004. That’s when I quit my tenured position at Michigan State because I could not manage that job + motherhood + co-running the Intersex Society. When I asked myself what mattered, the job came up last. I was lucky; my spouse is a doctor and we live in a cheap town. I could quit. So I did.

My friends at Northwestern gave me a little job to keep my name in the game, and that has been hugely helpful to what I do in my work life. That it is part-time and long-distance has been even more hugely helpful to my home life.

Ironically, leaning out has given me a vastly more interesting career than I would have otherwise had. If I hadn’t leaned out, maybe I still would have gotten a Guggenheim. But I would never have researched the Bailey history and ended up on the path that took me to the Chagnon history, and I probably never would have ended up having the ability to do the prenatal dex work. So I also wouldn’t have a book coming out with Penguin that is about all of that work, the work that happened because I quit a full-time tenured job.

My university income sucks for my level of career. I have no benefits through Northwestern. I don’t have tenure or any chance of it at Northwestern, because I’m not on a tenure track job. I have a one-year renewable appointment that expires in 2017. The mate and I calculate that my leaning out has cost us, so far, about $750,000. Shocked?

Well, let me tell you what I do have:

I have is a fantastic relationship with the guy who has let me cost us $750,000, and I have an ability to support his work as a medical educator and physician. I have a libido. I have a strong relationship with my extended family. I have friends and neighbors who call me when they need me and help me when I call them. I have two triathlon “completion” medals and serious plans to do an Olympic-length triathlon this year. I have a contractor who enjoys muddling with me over lunch with a new plan for hours. I live in a neighborhood full of rainbow flags I helped put up, in a house now known as “the flower house” in town, because I’ve worked the garden so long with the mate. I have a friendship with a squirrel named Fred, and the other day, I had a northern flicker at my suet feeder, because I keep the feeders stocked every day, the birdbath cleaned and watered every day.

Best of all, I’ve got a kid who feels like he can tell me, as he did last year, “Maybe don’t go away so much?” to whom I can listen. (I cut back even more on my travel schedule, and have learned, as Sandberg would approve, to ask my talk hosts for more expensive flights that get me home much faster.) We are working on a Bach trio with our teacher. I’d like to get to the point where we can play “Si Tu Vois Ma Mere” together, before he goes to college.

I also have a dream that some day men will think, agonize, write, read, and talk about the work-life balance as much as we women do. But I’m not going to struggle to live their vision of “success” while I wait for them to try and understand mine.

Tags: One Foot InWork-Life Balance

This morning, Dan Ryan and I did a live radio interview on WKAR’s “Current State” with Mark Bashore. (Listen to it here.) Dan Ryan is the great guy from Lansing who took it upon himself to figure out who still needed power restoration during the huge Board of Water and Light (BWL) outage a couple of weeks ago, and to advocate for those without power. It was an honor to do the show with him. The work Jeff Pratt and I did to help people without power in East Lansing was explicitly modeled on Dan’s efforts.

Dan and I were supposed to be on the show after the BWL Board Chair, Sandy Zerkle, but she didn’t show up on time, so we went first. We resisted making jokes about BWL not showing up when you’re expecting them. After we finished, we ran into Zerkle in the green room. I introduced myself and Dan to Zerkle. Might as well--I figured she probably knew who I was; last night I spoke at the BWL hearing and she had tried to cut me off.

When it became clear she was going to be there for a few minutes with us, I thought to myself, “Do we talk about the weather, or what?” And then it occurred to me: Here Dan and I were with the chair of the power company we’ve been alternately criticizing and trying to help for two weeks. Why not seize the moment and speak truth to power--or at least speak truth to the power company?

So I started by observing to her that I thought last night’s meeting was a disaster for BWL. How so?, she asked defensively. I replied that having all of those employees get up and talk about how great their boss Peter Lark is just left folks like us feeling more stonewalled and not heard. The meeting was supposed to be for people like us to talk about what we’d been through, what went wrong, and how to fix it so it doesn’t happen again. Instead it turned into a “rah rah, this company is so great!” pep rally in which some of the employees criticized those of us who felt we’d been let down by BWL.

I observed to Zerkle that if Lark was qualified to do the job, last night wouldn’t have looked like that. After a few of the employees’ defenses of their boss, Lark should have cut off all the underlings’ testimonials and said, “Listen, I appreciate the team spirit of our folks, and you know my door is always open to talk to you, but now is not the time or place for this. We need to hear from our customers.” Instead, Lark let it go on and on and on, and on and on, a situation that looked self-serving, tone-deaf, and ultimately absent of compassion for people who had really suffered. How bad was it? Last night, the PR company BWL had hired tweeted that it had not been engaged in the design of the meeting. As I said on the radio, when your PR company is doing damage control because of embarrassment caused by their relationship with you, you have a really big PR problem.

Zerkle strongly disagreed with me saying Lark is qualified for the job. In fact, she got pretty belligerent, telling me I didn’t know what I was talking about. When I told her that I thought that with this attitude--nothing went wrong! we smell so sweet!--was just going to lead to East Lansing looking to change to a new power company, she asked me what choices I thought East Lansing had, and suggested we had no choice so I should shut up. Honestly it was like talking to an abusive boyfriend who tells you he doesn’t have to treat you well because he’s as good as you’ll ever get. I replied that, with that attitude, I was sure people of this town would be interested in looking to find out our options.

I told Zerkle that if they really wanted this so-called “independent” investigation to be trustworthy by people in East Lansing, it could not be another bunch of political appointees by the mayor of Lansing. To be trustworthy, it needed to have someone like Dan Ryan on it. I said to her bluntly, “You want me, and people like me, to trust this investigation? Put Dan on it.” Dan was standing right there; I had just introduced him. Zerkle replied that she didn’t know who this Dan guy was.

Facepalm. Seriously. This just shows you what a bubble Zerkle is living in, that she doesn’t know who Dan is. She then made some noise about how people on the investigation group had to have relevant backgrounds. Although Dan’s work during the outage alone would make him qualified, Dan pointed out to her he actually has a professional background in crisis management. (His success in this case was no accident.) She kind of huffed as if to say how dare we question her or dare to make recommendations to her.

By the time Mark Bashore walked in, Zerkle was pretty much yelling at me. She caught herself, obviously realizing how bad it must look. She fumbled an apology. To that, I replied that it was fine, I had become used to being told by BWL heads that we customers and critics are the problem. “I can take it,” I told her. “I’ve been taking it from you people for at least a week.” Go ahead, tell me off.

Clueless. Clueless, inept, self-defeating, embarrassing, and not inspiring of confidence.

I’m keeping my generator. Right now, though, I could heat my house from just the steam coming off the top of my head. You know why this bothers me so much? Because, as I told her, I actually want BWL to be my power company. I believe it is full of hard-working, smart people who are truly dedicated to this community. But the way to support those people is to do an honest, accurate accounting of what didn’t work--to recognize BWL was, for too long, lacking enough crews on the ground and had a non-functional outage reporting and tracking system, and that these deficiencies are most likely what turned an emergency into a disaster--and to fix these problems. Instead what we’ve got it Lark and Zerkle telling us they smell so sweet, everything was done optimally, and we should shut the heck up.

For those as disgusted with what happened last night as I am, listen: I asked around people I trust at BWL--there are several--and I can tell you, that parade of “rah rah” from the employees was not planned in a top-down fashion. The employees of BWL are good, hardworking people, and that means their feelings are genuinely (rightly) hurt by listening to customers who felt abandoned by BWL during the crisis. They saw last night as their chance to set the record straight. They chose to get up and talk about how great the company and their boss is. It backfired. And their bosses should have seen early it was backfiring and stopped it.

But last night’s meeting just turned into more proof that their bosses--in particular Lark and his boss, Zerkle--are not doing a very good job to support the men and women who do the real work of the company.

Some open advice to BWL and their new PR company:

Stop spending your energy on this “Saving Peter Lark” movie and start spending it on analyzing and fixing the broken parts of your system.

Stop referring to our pain and suffering as “discomfort,” like I had a corn on my big toe for nine days when, in fact, I was living in a 40-degree house for nine days, trying to keep it and my family and my neighbors from harm.

Say plainly what didn’t work, where you failed, and how harm was exacerbated by those failures.

Understand that good intentions don’t keep the lights on. We appreciate hearing about your good intentions, and we believe you, but we like to hear about your good intentions only in conjunction with an acknowledgement of what isn’t working.

Tell the truth about why you didn’t hire more crews earlier and how bad the outage reporting/tracking system was. Denying these problems will do you no good, as the truth will emerge. Concession is very grown-up.

Hire Dan Ryan to help with the analysis and public presentation of what went wrong. Even the most cynical of us trust Dan, and Dan has always been fair, honest, and careful (and not nearly as bitchy as me).

•Get a new Board Chair who actually knows how the company works, what her CEO’s contract says, and doesn’t yell at customers. If you can’t get a new one, tell her to stop talking in public. Make her go spend more time with her family or something. And send Lark to his office and tell him to put a “do not disturb” sign on the door for a while.

Find a few employees who are lower down in the chain to speak to the public--people who are real workers, who tell the truth, and who we feel we can trust.

Stop telling us this was a problem of communication. Saying this was a problem of communication is like saying the problem was Mother Nature. (You also need to stop saying that, by the way.) The problem was we went without power for ridiculously long periods of time when in all likelihood we didn’t have to. Better communication wasn’t going to make my ass warmer, stop my pipes from freezing, keep my child from getting depressed, or save us from generator-induced carbon monoxide poisoning. The problem was you left us without power for eight, nine, ten, eleven, and in some cases twelve or more days during very, very cold weather. Own it.

When you do these things, then I think we will all feel like the people who work for BWL and the people who rely on this company for their electrical power are being appropriately respected by those with political power.

 

For more on the outage, including reports and hotlinks, click here.

Recon suggests everybody in East Lansing is now restored to power, as of a couple of hours ago. Today marks 11 days since electrical power went out here--spectacularly in the case of our block, where a down wire arced for 30 minutes of sheer bright terror. (It lit up like a rocket launch every few seconds.) Our block first tried calling 911 over and over, but finding the lines jammed (“If this is an emergency, hang up and dial 911”), we then took to calling each other, frantically, up and down the block. (It really looked like two houses might be on fire.) It took the fire truck a full 15 minutes of nauseating electrical horror to arrive. The fire department left before the line stopped arcing; apparently they had to go to a house actually on fire.

Thanks to frigid temperatures and a power company with a computer system seemingly older than me, the initial trauma turned protracted. We went eight days without power, without central heat, living off a pathetic gas log, keeping our pipes from freezing by running the taps and putting pots full of hot water near the washer and dishwasher. We slept in the living room in sleeping bags, our pet rats caged (and so miserable), with hot water bottles around their basket to keep them from dying. The living room hovered around 57 degrees, except at night when we turned the fire down for safety. Most of the house was at about 42 degrees. On Day 8, I finally dissolved into tears. Seeing this, the mate found a way to connect a generator to the furnace. A friend with a PhD in electrical engineering explained to him how to do it. And added, “It’s not legal, but it’s safe.”

A few days before that, we had already started improvising. At home, where our neighbors took to simply coming into our house via the garage because there was no doorbell and we had insulated the front door and stopped using it, I was grinding coffee using a mortar and pestle and cooking simple meals using a headlamp. (Our gas stove worked, as did our water heater, which kept us from giving up the house.)

On Day 6, the mate and I decided to organize a protest at a local school, scheduled for the next day. He called it “Cold Pussy Riot.” Pays to have a background in media relations and a lot of local friends; we had about 150 people show up, most of them seven days without power at that point. I made about 25 signs for people to hold: “My pipes froze.” “I came to this protest and all I got was warmer.” “Empower the people.” And “Got pipes?” They were quickly snatched up and held high. The city manager tried to explain why he couldn’t call a state of emergency, and got heckled. (I didn’t heckle him. He’s a good guy, and he explained it wouldn’t bring more resources we needed, because what we needed were more crews.) After the protest, I took the signs back and left them on the front steps of the home of the head of our power company, a few blocks away, so that he might hear us. (He lives in a mansion that was restored to power in a couple of days. I found that pretty annoying.)

When a survey crew had yet to show up at our block a day later, Day 8, I woke up feeling depressed and sick. Tired of hearing (genuine) sympathy out of our city manager and police chief, who had had power restored to their homes, I walked our neighborhood, knocking on the door of every house without power, confirming loss of power, asking what heating source they were using, asking what they needed. (Most of them know me because I’m one of the neighborhood leaders.)

I then relayed our outage list to the city manager, city clerk, and police chief, and I told them what those in our neighborhood without power could use: firewood; hot showers at the community center; police/fire safety checks on generators (I saw several very close to houses); and PRINTED information distributed by officers including emergency info about warming centers, carbon monoxide poisoning, and how to report you’re still out. (A lot of good social media postings do for people eight days without power!)

By that afternoon, Day 8, the city clerk--still without power at her own house--delivered a cord of her own firewood nearby, and stood guard on it. We put the word out that it was available, and the clerk started arranging to get more wood. The police chief put together excellent printed information and police and fire officers started knocking, door to door, to do safety checks. They asked people with power to turn on their porch lights, and in the nights, went out scouting to see who was still out.

Day 9: I had breakfast and went to the “walk in” center set up by our power company at the community center 2 blocks from my house. I waited on line about two and a half hours. By the time I got to the front of the line, I had arranged to have seven neighbors walk up to the desk with me, to explain to “BWL Bob” (as I now call him) that we had 27 houses on one line that just needed what we thought was a simple fix. Why, we asked him, were trucks working on single houses when we had 27 families out on one circuit? He looked up our area and corrected us: it looked like 91 houses on that circuit. He said he’d try.

That evening, Day 9, a neighbor three blocks up from where we live (a guy who had been restored) personally found a crew from out of state and begged them to come to our out circuit. Word was until that day, BWL was not allowing very many outside crews to help us because they were afraid of people touching their stuff without a BWL person present. You know what, BWL? In emergency situations, I let people touch my stuff.

Anyway, the Illinois-based crew came because of that angel neighbor asking them to, and in about 45 minutes they had fixed the problem! Day 9, about 7 pm. As we had suspected might happen, the whole circuit of homes had been restored with 45 minutes, a couple of guys, one wire, and one fuse. I walked up and down the blocks that had been out, calling the cell phones of all my neighbors who had abandoned their homes and told them they could now come home. An SUV drove up while I was still on the street. The driver said, “Alice?” I couldn’t see and asked who it was. It was the police chief, here to ask if we were really restored. She was out personally checking to see who was still out, so that she could nag the power company.

That night, two nights ago now, I slept in my own bed for the first time since Solstice, and, first thing on Day 10, yesterday, New Year’s Eve, I started following the lead of Dan Ryan in Lansing (@BWLOutage) and Jeff Pratt in East Lansing (@ELansBWLOutage) and tried to work on getting other people restored. I made and brought a list of houses I had learned were still out to BWL Bob at the community center 2 blocks away. This list included a perfect stranger I’d just met that morning at the bagel place, a guy who I’d overheard telling the cashier he was still out of power. The mate, hearing same, looked at me and said, “Go get him.” I took his name, address, phone number, and kept track of his case until he was restored. That guy reported also two more houses to me on his block, and I worked them, too. So many of the houses still out were marked “on” in the BWL system.

Yesterday, I ended up sitting for several hours at the community center at the BWL help desk, working in person with BWL Bob, on email with the police chief, on Twitter with Jeff, and on the phone with my friends around town who at my request drove around checking various addresses for me, to see if there were crews or restoration or if we needed to report again. One commissioner of BWL, Dennis Louney, was there, too, and he actually gave me his personal contact info, as did BWL Bob. (The best bit was when Jeff -- whom I’d never met -- walked in and said, “Alice? I’m Jeff.” Turns out we both drive Chevy Volts.)

We kept at it, Jeff, me, the police chief, BWL Bob, and my network of East Lansing friends, working the list. When the Hillcrest Apartments came back online, I felt like a million bucks. When at 7:30 last night we drove by Whitehills Drive and confirmed restoration of those five blocks was actively happening--bliss! Then this morning, Jeff and I found a house only three blocks away from my home still without, Day 11. An older couple, in the cold. They had reported, and they’d been lost in the crappy BWL system. I called BWL Bob and promised the couple I’d stay on their case until they were restored. They were restored a couple of hours ago. Bob sounded so happy when I called to confirm it to him.

So what have I learned that other people might take from this?

Ask, very specifically, for what you need. After you say “I need power restored,” tell people in the meantime what you need: firewood, gas, a generator, childcare relief, a run to the drug store, whatever.

Keep asking until you get what you need.

Ask people who are suffering what they need. They usually know and will tell you if you knock on the door and ask.

Knock on the doors of strangers to ask them if they need help. No one begrudges you asking if they need help, even if you are a perfect stranger with no official capacity. (No one from the power company or the city seems to have done this until I asked the Police to do safety checks. The couple I talked to this morning said, “You are the first person here in 10 days.” WTF?)

Always assume midwesterners will not ask for help--they think it is impolite or something--so you have to bluntly ask them what they need. (There was one guy yesterday who “didn’t want to bother” me. I had to keep calling him to ask, “Do you have power?” He kept timidly saying no, and asking if I would please keep bugging BWL Bob for him. I kept pushing for him. When I finally called and he said “I HAVE POWER!” I was so happy, but I know he will never ask for help again.)

Ally with strangers. Find a Bob, find a Dan, find a Jeff, and work with them.

Say thank you constantly.

Show up in person.

Never assume the people in power know what they’re doing or will do what you would do if you had their power. You can wait a long time suffering, hoping they will read your mind. Instead, get in touch with them and give them your ideas.

People who are in public service because they love doing public service are really wonderful during crises.

Having a local press is incredibly important at times like this, even though reporters report only a fraction of what they should.

Help other people. The psych literature is right--it lifts your mood.

And what else?

The dishwasher can be used as a giant drying rack for dishes and laundry.

Laundry doesn’t dry if it’s 45 degrees in your house.

Wetter is colder.

There’s a reason people used hot water bottles before central heat came into existence.

Hair gel is an insulator.

Avoiding a cold toilet seat for long periods of time will just get you hemorrhoids.

•Even in extreme cold, old people and orchids can keep a long time if kept under lots of blankets.

If your house is 45 degrees and it’s 15 degrees outside, your house still feels unbearably cold when you come back in.

If you keep your pet rats in a cage for 8 days when they are used to a room where they can free-range, when you finally return them to “home,” they will bring you food offerings as thanks, or some kind of celebration meal, or something. It’s adorable.

Alcohol is a vaso-dilator, so it temporarily makes you feel warmer. Importantly, it also helps you not give a shit. Especially if you are drinking with good friends.

And finally, pick a place with truly great neighbors. And make sure one of them knows how to hotwire a furnace to a generator. It’s not legal, but it’s warm.

 

For more on the power outage (you want more?!), click here.

 

 

Tags: One Foot Inon advocating

We’re still missing a lot of undoubtedly relevant local history of what exactly happened at University Colorado Boulder with regard to Prof. Patti Adler’s “Deviance in U.S. Society” course. Here’s what we do know, and why this case really worries me:

Adler’s teaching at “CU” has recently been brought under extraordinary scrutiny because of a skit she’s been using as a teaching exercise for many years. The skit involves teaching assistants dressing up and acting in the characters of sex workers from various socioeconomic backgrounds. The exercise is apparently designed to help students understand the social, cultural, and psychological complexities of sex work: “to illustrate that status stratification occurs in various groups considered deviant by society” and to illustrate “the many types of prostitutes and how different they are--even within the broad category of prostitution,” according to an interview Adler gave to Inside Higher Ed.

The university administration is suggesting that, through this skit, Adler somehow violated the sexual harassment policy which prohibits “creating a hostile environment for their teaching assistants, or for their students attending the class.” The Provost has issued a statement saying that “University administrators heard from a number of concerned students about Professor Adler’s ‘prostitution’ skit, the way it was presented, and the environment it created for both students in the class and for teaching assistants. Student assistants made it clear to administrators that they felt there would be negative consequences for anyone who refused to participate in the skit.”

The administration apparently told Adler she couldn’t teach the course anymore, and offered her early retirement. (Message: get out.) According to a news report, Adler “told the class that she was being forced into retirement because the administration thought her lecture on prostitution degrading to women and offensive to some minority communities.” She told Insider Higher Ed that her dean informed here “there was ‘too much risk’ in having such a lecture in the ‘post-Penn State environment.’”

Of course, the CU administration is offering these sharp conclusions about sexual harassment while not providing numbers of complainants, details of the complaints, or names, because cases of alleged sexual harassment at universities--even when they are just about a class exercise--are treated in an ultra-clandestine fashion, allegedly to protect the alleged victims. Look, there are some really ugly cases of sexual harassment involving predation at universities; this doesn’t look like one of those. This looks like one of those cases where somebody was opening up a politically-incorrect conversation about sex, and somebody was made uncomfortable by that, and that somebody decided a sexual violation had therefore occurred. Because discomfort is harassment is reason for dismissal from one’s life work teaching.

As I’m reading about Adler, I’m thinking about some of the teaching exercises I’ve used over the years. I have, for example:

Shown and discussed photos of human genitals (including male-typical, female-typical, and intersex), asking students to discuss appearance and sexual sensation of human genitals.

Shown surgical training videos that document clitoral reduction surgeries on baby girls as well as medical examinations on little girls’ genitals.

Shown videos of a naked woman giving birth in a tub while her nearly-naked husband massages her and she moans rather erotically; close-ups show the woman’s vulva when the baby crowns and emerges.

Gotten up on a lab bench to demonstrate the difference between birth in the lithotomy position and birth in the squatting position, asking the students to picture me as a birthing woman so that they can understand the differences.

Had students take on various historical roles, including “sex worker” and “syphilis” (the microbe) and various ethnic and sexual identities, to explore how lives and diseases are culturally-shaped.

I’m not saying that absolutely anything Adler did to set up and enact this “prostitution skit” ought to be given a pass. But if it is the case that the first time a concern was raised about this skit, the course was taken away and Adler handed an early retirement package--well, we should all be very worried about what we’re teaching and how we’re teaching it, lest someone secretly make a harassment complaint or someone simply have the feeling “this might be too risky.”

And let’s face it: If we are not making our students uncomfortable sometimes, we are not doing our jobs. If we are going to have to worry all the time that we might offend some students’ sensibilities, we are not going to be able to teach in a way that actually matters. We’re not going to be able to teach about sex, gender, race, religion, or violence.

Are undergraduates and graduate students really such delicate flowers that they cannot be made uncomfortable sometimes, or asked, when made unreasonably uncomfortable, to raise the issue in a way that leads to productive dialogue and not automatic termination of classes or careers? Do we really have to protect the vulnerable by giving them all the power?

If Adler, in fact, led her TAs to feel pressured into dressing and acting in ways they didn’t want to take on, then she could have been told to stop using the TAs. Hire actors. Engage willing theatre students.

If someone felt Adler was being a prejudiced pig through this exercise, then they could call her out on it and have that discussion.

The answer here is not to compare this skit to the cover-up of child rape at Penn State(!), nor to do what Northwestern University has done--following media titillation but no complaints from students who attended an optional sexual demonstration--and shut down a human sexuality course completely.

One last note: Bizarrely, in the Adler case, a University Colorado Boulder university spokesperson has referred to the possible need for IRB approval for such “risky” teaching, in spite of the fact that IRBs are supposed to be for overseeing human subjects research, not teaching. This just seems final proof that IRBs are officially being viewed as all-purpose liability and PR shields for administrators, not for the protection of subjects of research.

The faculty at Boulder are holding a special meeting today on this situation, and several are speaking out. In a blog on the matter, CU Prof. Roger Pielke, Jr., asks the right questions: “Will I be at risk of losing my job if university officials don’t like how I teach [about sex, gender, race]? What if a student is ‘uncomfortable’ because of the material or exercises in the class?”

I hope that faculty around the U.S. will join Prof. Pielke and me in blogging on this topic.

 

 

Tags: One Foot InTeaching

This comes from personal experience and observations, but also my background in sex research. If you don’t believe in sex and gender differences, or in sex being important in the evolved and cultured human mind, please move along. This will only make you mad.

So you’re about to walk into some professional situation--a conference, a collaborative project, a mentorship, a contracted blog--in which you might end up being sexually attracted to or by the other party. What should you keep in mind?

Sex in humans often gets wrapped up with resource exchange, especially in women’s minds. As a consequence, when resource exchange is at play (as it often is in the professional realm) and the two parties could potentially be sexual partners, the situation may carry an erotic charge. One or more of the parties may view the situation as sexual. That doesn’t make it okay to solicit sex from or offer sex to the other party. But it does make a good reason to pick mentors who could never in a million years be your sex partner.

Women and men on average think about sex differently. Men, on average, are more comfortable with casual sex, and women, on average, are more likely to find sexual encounters to be meaningful, confusing, and complicated. Even when a man isn’t conscious that he’s sending a message “you can have this resource if we have sex,” a woman will often find herself (not unreasonably) reading that message onto a resource exchange conversation. All this means that, even if the two parties are the same gender, two parties can experience the same encounter very differently.

So don’t expect the other party to see the signals being passed the same way you do. If you’re worried the other party is misinterpreting what you are saying or signaling, be blunt and name it to avoid further confusion. If you don’t want to say “I”m not offering you sex,” because that would mean you’re naming sex, say with a serious face, “I just want to clarify what we are going to be doing together,” and name the professional activities you will engage in together. Do that as often as you have to.

Many reasonable, decent people have met their partners through work. Therefore, many of the people you meet in the professional arena will not think it is the case that romance or sexual relations should never emerge from professional encounters. Moreover, people don’t just remove all interest in sex and romance because they’ve walked through some double glass doors. So don’t assume they have. Insisting that people arrive at every professional endeavor with absolutely no potential interest in sex or romantic is asking people to be super-human.

That said, when you are walking into a professional situation, you should walk into it as a professional would, not as a cruiser would. To be clearer, it is critical that all people in professional and educational environments feel safe and not subject to cruising. Therefore, if there is any suggestion whatsoever that someone you might be interested in romantically or sexually is not interested in going there, you must absolutely back off, take a cold shower, and do everything to avoid becoming the source of unwanted attention or implicitly or explicitly punishing the other person because she or he doesn’t want that type of attention from you. Grow up or get out of the field. Classes, conferences, and job searches are not your personal OKCupid.

If you solicit romance or sex from a colleague, especially a junior colleague, and she or he accepts your solicitation, recognize that that may not mean s/he actually wants to accept. It may mean s/he feels s/he has to. Figure out a way to have a sober conversation about why this person is accepting. Coercive sex may be hot according to your genitals, but it’s only okay in reality as role play.

When, in the professional realm, one woman observes another woman engaged in a sexual relationship with a third colleague, even if it is a socially legitimate relationship, the observer may find that her unconscious sense of sexual competition is invoked. Consciously she may become aware the meritocracy is now playing out partly via sex. This may lead to her becoming angry at the other woman or to feel sexually and professionally inadequate. This situation sucks. Especially when it goes unprocessed, it often leads to women attacking each other.

If you are in a position of “mentorship” of any sort, take time daily to tell the juniors what a good job they are doing, how smart and talented they are. In order to stop our juniors from being vulnerable to predators, we must make sure that they don’t hear “you’re talented!” only when someone is using it to hit on them. We don’t want them feeling like they have to put out to receive praise, or that, when they receive praise, they have to put out.

Channeling my mom here: “You think you’re so special because he paid some attention to you, told you about his marital problems, made you feel desired by him? Well, let me tell you that whatever a man does, he’s done it with the last woman he was with, and he’ll do it with the next one, too. Ask yourself, if you were watching him act exactly this way towards the next woman, how would you feel? Like you had been with a gentleman who had now moved on, or that you’d been with a jerk with a smooth m.o.?”

Channeling my husband: Two drinks, and you won’t remember any of this.

 

 

Tags: One Foot Inadvice to grad studentsTeaching

“The SUPPORT defenders are going to be on the wrong side of history. And what’s shocking is that they don’t recognize that.”

I nodded in agreement to this email from Lois Shepherd of the University of Virginia. Lois had sent it a couple of days after we had met in Washington at the August 28th federal hearing convened in response to heated debate over the ethics of the large NIH-funded SUPPORT study of very premature babies. (The basics of the SUPPORT controversy are described here; the meeting transcripts and videos just became available here.)

The tense, day-long event in Washington had been organized by the federal Office for Human Research Protections (OHRP), and Lois and I were there, with like-minded representatives from the advocacy group Public Citizen, to encourage follow-through on enforcement following ORHP’s findings of inadequately informed consent in SUPPORT.  In our spoken remarks, we reiterated the conclusion of the New England Journal of Medicine letter we had organized with Ruth Macklin: OHRP had been right in its determination that SUPPORT consent forms lacked critical, required information. About half the study forms had led parents to believe that their baby would get the same care whether in or out of the study—an astonishing claim for a study that randomized very premature babies to various controlled research interventions in order to determine relative risk of those potentially life-saving interventions.

And yet, although history will likely find SUPPORT’s defenders wrong on the facts, that side appears to be winning the regulatory battle. Ordinarily OHRP doesn’t retract enforcement and hold a big public event to let critics lean on the agency charged with medical research ethics oversight, as happened here. But led by a number of prominent bioethicists—most notably John Lantos and Ben Wilfond—SUPPORT’s defenders have effectively forced OHRP into a corner. Indeed, under Lantos, Wilfond, et al., and in the name of biomedical progress, “Bioethics” is being employed via the SUPPORT controversy to deliberately reduce long-standing protections for subjects of medical research.

In Washington, presumably knowing they couldn’t really defend those obviously deficient consent forms, SUPPORT’s defenders collectively pushed a party line that went roughly like this: improvements in patient care through medical science require that we not scare potential enrollees out of studies by going into gruesome detail about risks, especially when clinical care itself is full of risks that doctors often fail to mention.

Some SUPPORT defenders even suggested that clinical care is somewhat “random”—because it isn’t based on enough good evidence, and because patients end up rather randomly in this or that clinic, each clinic idiosyncratic in its practices—ergo being allegedly “randomly” subjected to interventions in normal clinical care is essentially equivalent to being in a randomized controlled study of such interventions. Why require special consent for medical research, full of frightening discussions of risk, when medical clinics are such a mess in terms of science and consent? To do so would only risk slowing advancement in patient care!

I know. But keep breathing and stay with me.

Now, I realize that, as a federally-funded study, blessedly-free of pharma funding, SUPPORT would seem, at first glance, to have nothing to do with the recent back-and-forth at this website between Rob MacDougall and Carl Elliott about ethicists being paid by pharma. But I think, in fact, when you look at the MacDougall-Elliott exchange, and look at how the conversation about SUPPORT played out in Washington, you see clear parallels. You see that growing split I’ve pointed to within Bioethics, between defenders of the medical research industrial complex and us Impact Ethics types.

In case you missed it, two blog entries ago, Rob MacDougall made the argument that it’s perfectly okay for academic “ethicists” to function as “representatives” for pharma because, he says, everybody deserves a moral representative and “accepting all partial [i.e., biased] voices into bioethics debate” has inherent value.

One entry ago, Carl Elliott responded that there are some roles—like being a paid shill for corrupt corporations—that are fundamentally incompatible with being a decent scholar. If people like Glenn McGee want to work for companies like CellTex—or people like Art Caplan want to sell pharmaceutical companies “development of articles for peer-reviewed journals positioning the underlying issues”—then let’s at least not pretend these people are doing “bioethics” in any scholarly sense of the term. Real scholars don’t get paid to defend pre-ordained positions.

I don’t think it’s hard to see that what’s happened with SUPPORT is that the study’s apologists are functioning as paid representatives, not of pharma in this particular case but of the medical research industrial complex. Lantos, for example, works for a hospital that is part of the research network involving SUPPORT—a network Public Citizen has been asking the government to investigate following revelations over SUPPORT. Meanwhile, Wilfond is funded by the NIH.

And who is on the other side of Lantos et al., pushing for the rights of patient-subjects, now pushing against the NIH’s leaders who have been vigorously defending SUPPORT? Yeah, it’s us Impact Ethics types again.

So let’s go back to Lois’s implied question: How could the bioethicist defenders of SUPPORT not see they have the facts about the consent documents so wrong? To answer this, it helps to contrast MacDougall’s (industrial complex’s) and Elliott’s (Impact Ethics’) positions using a theological analogy.

MacDougall is hesitant to judge anybody’s acts as sinful, wanting instead to guess that perhaps we all have some reasonable motive in our souls for our deeds. The bioethicists who have functioned as SUPPORT apologists take a position much like MacDougall’s: they point to the good intentions of the researchers (and, by analogy, presumably themselves), to the importance of science, to the value of evidence-based medicine, and to a love of patients, especially babies. And what do they conclude, after this soul-searching? “We’re good people, with good values, and good souls.” All good.

Elliott, by comparison, is interested in acts when he judges good and evil. And when you look at acts, what can you do but conclude that OHRP was right about SUPPORT? Informed consent didn’t happen, no matter how nice you people are.

Needless to say, I’m with Elliott in terms of how we have to judge each other. As an historian (and Susan Reverby and I testified together for the hearing as historians), I grow weary of people trying to know and thus to judge people by motivation, when really all we can know is acts.

Besides, who gives a damn whether somebody is nice inside? Who cares if he loves science, patients, and babies? We ought to care about whether he shills for a corrupt industry, whether he accurately presents evidence in a case, whether he obtains informed consent. This is what patients and subjects would reasonably care about. Moreover, how on earth would you federally regulate a soul? Of course, maybe the fact that you can’t is part of the appeal of moving Bioethics towards judging souls rather than acts.

 

(originally posted at Impact Ethics September 11, 2013)