Take back control? Doctors as appointed fiduciaries
Cross-post from the Uehiro Centre's Practical Ethics blog
There’s a story that’s often told about the evolution of the doctor-patient relationship. Here’s how it goes: back in the bad old days, doctors were paternalists. They knew what was best, and the job of the patient was simply to do as they were told and hopefully get better. Then, in part because of abuses of power, and in part because of cultural changes, a new model emerged. This model cast patients not as passive recipients of instruction, but as active, autonomous agents, put in charge of their own medical decisions. The doctor-patient relationship was remodelled, from a paternalistic relationship (doctor looks after patient’s health) to a service relationship (doctor does what patient wants, within limits).
That story is almost certainly too simple to be true. But even histories that aren’t wholly accurate can come to influence our culture and expectations. And the dominant assumption between both patients and medical professionals seems to be that our relationship will be cast on what is sometimes called the “informative model” (Emmanuel and Emmanuel, 1992), where the medical role is simply to provide the patient with empirical information, such as information about likely risks and outcomes.
Outcome risk and status risk - Uncertainty for vegans
Here are two cases:
1. A trolley is hurtling towards a person on a track. You can divert the trolley so that it plummets over a cliff. You know that there is a small (but not vanishingly small) chance that there is a person in the trolley.
2. Eating plant food involves, indirectly, being complicit in the suffering of animals that are killed during harvest. You could reduce the amount of plant food you eat by eating insects like crickets. You know that there is a small (but not vanishingly small) chance that crickets have whatever feature(s), F, make things into persons. (For instance, crickets might feel pain and pleasure).
Bob Fischer (in his 2016 paper 'Bugging the strict vegan', ) wants us to accept that these two situations are equivalent. In both cases, we might say, you 'might kill someone who matters'. Since you clearly ought to divert the trolley, you ought to eat the insect.
Suffragettes and suffragists
There's been a lot of celebration in the UK news recently of the Suffragette movement, since it's 100 years since the 1918 Representation of the People Act, which granted the vote to (some) women.
Someone I know recently complained about the lack of focus in the associated discussion about the Suffragists. While I don't have the sufficient historical knowledge to offer a comprehensive distinction between the two groups, a rough division seems to be that while the 'ettes were prepared to engage in both violent and non-violent criminality to forward the cause, the 'ists wanted to do things within the letter of the law as it was.
The art of politicising a tragedy
Caveat: Since this is a blog, and not an article, I play loose with language by treating the left and right as two homogeneous groups. That's not accurate, but is hopefully not so inaccurate as to defeat my purposes.
America seems to be characterised increasingly by acts of gun violence. The response depends on features of the gunman. Typically, those on the left will use the opportunity to call for gun control. If the gunman is white, those on the right will offer thoughts and prayers, and perhaps say something about mental health. If he isn't, they'll say something about immigration, perhaps endorsing Trump's Muslim ban.
What follows, in any case, is that each side accuses the other of 'politicising a tragedy'. There have been screenshots on Twitter of people on both the right and the left reacting very differently to an episode of gun violence, depending on whether it supports their narrative. If it doesn't, opponents are reminded not to politicise a tragedy. If it does, a particular policy proposal is made.