On the subject

NB: In the following post I critique the workshop guidelines, for which I was partially directly responsible. I think at the time none of us realized how our new procedures would work in practice! ***

The attempt to keep us on all topic during the workshop was welcomed. The announcement of a topic would ordinarily be sufficient to justify the welcome, but there were contributions that seemed to be off-topic, and in response comments that suggested the apparently off-topic interventions were inappropriate. As a contributor of one or two of these off-topic contributions, I will offer two reasons why they were necessary in spite of the topic. There is a historical reason they are necessary and a formal reason. Moreover, such explanations were explicitly sanctioned by the instructions.

Historical reason

Historically the workshop has picked its topics without too much regard to past topics, except to avoid topics we have already covered. There would seem to be no principles for picking topics, other than that they be “bioethical” in the sense meant in the UNESCO Universal Declaration on Bioethics and Human Rights. 

Given the extraordinary philosophical distance between the Eastern traditions and the religions (Christianity and Islam), in theory and practice, there is an equally compelling need to address the grounds for communication between the two before comparing approaches to the posed ethical subjects. How can we speak of convergence unless we have established an agreed on means to communicate between the two? I will illustrate some of the issues in other responses [blog posts] to the workshop, but for now will refer you to work I did on this in response to the Hong Kong workshop here, here and here.

Rawls and many others after him have proposed procedural means for defining a common space in which agreement can be reached, but there are 2 problems with procedural approaches: they imply a base level of commonality, at least enough to identify the problem; and the stated goal of the workshop is to reach substantive convergence. I argue in my earlier analysis that there are virtually no substantive grounds unless the religions bracket their dependence on a strict, legalistic, unidirectional, unidimensional Augustinian theory of history. That theory of history supports scientific, positivist, materialist, physicalist universalism, as opposed to the looser and holistic universalism of Aristotle (kathalou). My approach is intended to speak to the religions because they both depend on this Augustinian world-view, and they both justify their jurisdictional approaches on it. Moreover, Augustinian history and its universalist consequences lead to a much narrower vision of reality, and that narrowness excludes so much it does not make sense to shoehorn the larger and more flexible visions of reality found in the East into the narrow confines of the religious west. We can see the extremely negative consequences of this in colonialism and all of its conceptual apparatus.

The notion that these kinds of arguments are best worked out in religious theory, sociology or anthropology conferences does not comprehend the broad scope of the workshop, nor the interdisciplinary nature of ethics in general. This is understandable, as one of the unexplored issues with the workshop is the difference between ethics and religion. Participants are to approach the ethical topic from within religious traditions. Well, the notion there are religions is seriously undertheorized for us at this point, and then the follow-on notion that religious perspectives on scientific acts are ethics and not theology is also undertheorized. Are we supposed to be doing ethics or theology? And these are only problems in the western traditions, since there are no religions in the east, and no distinction between ethics and religion. In other words, our conceptual remit is inherently very broad and interdisciplinary, and not very well articulated as a practical matter.Unsanctioned, as it were, attempts to address some of these lacunae must be tolerated and digested as part of the ongoing project.

Formal reason

Here are what the instructions for the participants said:

PAPER GUIDELINES
Recognized thought leaders from diverse religions and cultures will be invited to
analyze, write a paper and discuss about these bioethical questions and their
anthropological implications:

  1. using their religious and/or cultural authoritative texts and belief sources;
    2. organized around the workshop´s featured key questions
    3. within the global bioethics paradigm of human rights and duties, articulated by
    the Universal Declaration of Human Rights (1948) and the UNESCO
    Declaration on Bioethics and Human Rights (2005).
    4. engaging questions concerning potential bridge concepts as well as
    ‘problematic’ dissimilarities with suggestions on how they might be managed to
    keep the conversation focused with the aim of fostering convergence and
    cooperation

KEY QUESTIONS TO BE ADDRESSED BY THE PAPERS

  1. How does my cultural tradition take into account genetics and epigenetics?
    What is the understanding of neuroscientific developments?
    2. Can genetic and brain interventions, drugs, and devices beyond therapeutic
    use be applied that might alter a patient’s personality, identity, and/or
    behaviors?
    3. Are genes and the brain taken into account in order to explain human nature
    and behavior better? Why or why not?
    4. What is the relationship between DNA, brain, mind, and soul?
    5. How can genetic and neuroscientific research and their clinical applications be
    cultivated to benefit developing countries?

The instructions and questions confuse, under-specify and over-specify the topic. 

Confusion:

The questions are supposed to be “bioethical” questions. What if the tradition does not have a bioethics? What if the very concept is necessarily contested if the historical tradition is to be accounted for substantively?

Both the notions of religion and culture are western notions, and both are used in a scientific way (i.e., 19th century social sciences way). This is emphasized by the requirement that “anthropological” implications be taken into account.

The words “anthropological” and  “science” have quite different connotations for English and non-English speakers, especially Europeans, for whom the two words have meanings more associated with their etymological origins, whereas English speakers hear social science (anthropology) and positivist science concepts. If we are to move towards convergence, we must be sensitized to these kinds of linguistic issues.

Reference to “religious and/or cultural authoritative texts and belief sources” is entirely framed in western concepts. The eastern participant could just ignore the confusing prompt and look beneath the literal meaning, and that would be generally appreciated but in so doing that participant continues the western reification of the project. That reification is exactly what the project hopes to overcome in its broadest goals though, so “going along to get along” does not enable the more substantive dialogue being called for.

Under-and over-specification

The references to entities such as genes, brain, epigenetics, mind, body, drugs, devices, DNA, human nature, behavior, personality, identity, soul, clinic, and developing countries put the topic(s) into outer space, but mostly a western outer space. Anyone who has studied the sociology and anthropology of science is well aware of the socially constructed meaning of these terms, or at the very least that these terms are contested sites in and of themselves. On top of that, the distinction between technology and science has to be recognized. One of the things that happens in the global south and east is the adoption of technology with a simultaneous rejection of the science. In other words, science is recognized as the philosophy with which the understanding or meaning of the technology is framed. 

We solved some of this problem at the end of the workshop by deciding to make a few scientific articles available prior to the workshop so everyone can be on the same page about the actual technology/science.

The references to specific physicalist entities such as genes and the brain overspecify because they are too narrow, and overspecify because they are too broad. The philosophical meaning of the gene remains undefined. The reference will be read by most as a reference to a physical fact and nothing more. Yet others will read the reference as to a profound philosophical discourse between materialist/physicalist philosophies of life and more open textured, non-physicalist philosophies. Reference to the gene without a corresponding explanation of its relevance is an under-specification because the facticity of the gene overwhelms its philosophical dimension. Without context it is too specific. Reference to “mind and soul” over-specify because these terms are intended to refer to all possible non-physicalist, or potentially non-physicalist philosophical entities. These are English or western terms that have virtually little or no meaning in eastern philosophical traditions, most of which are so much more sophisticated than western Enlightenment “psychologies” or philosophies of the person, which is what the references are to, as to make them seem barbaric. The real western or religious bodies of thought that should be compared, once foundations for such comparison are established, are the theologies (or perhaps systematic philosophies such as Hegelianism). Consciousness, which is an English term not used for some reason, would have gone much further to enable a question for both east and west, as there are eastern cognates for consciousness, imo. “Mind and soul” are not robust enough, they are used as comprehensive terms but they do not reference enough conceptual territory to make them useful in an undertaking that seeks to bridge east and west.

The foregoing are reasons enough an eastern participant might feel compelled to address fundamental issues, rather than the specific questions. Moreover, there is explicit remit to address foundational questions in Paper Guidelines #4, which permits exploration of potential bridge concepts and their problematics with an eye to reaching some kind of common understanding. The first part of doing that certainly consists of identifying the differences and offering reasons and explanations for them.

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Prakash Desai 

It is with great sadness that we announce the loss of our colleague and friend Dr. Prakash Desai. He not only was an extraordinary physician and scholar, but he was a beloved father, grandfather, and friend. 

Prakash N. Desai was born and raised in India. He obtained his medical education at the Faculty of Medicine of the M.S. University of Baroda and completed his psychiatric residency at Northwestern University Medical School in Chicago, Illinois. His extensive work experience includes positions at the B. M. Institute in Ahmedabad, academic psychiatry, Community, Social and Cultural psychiatry, Director of Department of Mental Health and Developmental Disabilities of the State of Illinois, Veterans health care facility on the west side of Chicago, professorial appointment at the University of Illinois at Chicago, Director of Education for the University of Illinois Hospital, and associate member of the Committee of South Asian Studies at the University of Chicago. Among his many publications are Health and Medicine in the Hindu Tradition and Triumph and Tragedy: Psychohistorical Decisions of Mahatma Gandhi, several book chapters, and over a dozen papers in professional journals. He  received numerous awards for his work including the Oscar Pfeister Award, the George Tarjan Award and the Bruce Boyer Award. He was also actively involved in the governance of the American Psychiatric Association. 

Our most sincere condolences to his family. 

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First ‘three person baby’ born using new method

Yesterday it was published the following news:

“The five-month-old boy has the usual DNA from his mum and dad, plus a tiny bit of genetic code from a donor.

US doctors took the unprecedented step to ensure the baby boy would be free of a genetic condition that his Jordanian mother carries in her genes.

Experts say the move heralds a new era in medicine and could help other families with rare genetic conditions.

But they warn that rigorous checks of this new and controversial technology, called mitochondrial donation, are needed.

It’s not the first time scientists have created babies that have DNA from three people – that breakthrough began in the late 1990s – but it is an entirely new and significant method.” You can read the whole article here: 

http://www.bbc.com/news/health-37485263.

I am wondering what does your cultural/religious perspective thinks of these technologies? Is it ethical? What principles are at stake?  Please share!

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Neurobioethics, Human Rights and Justice.

By Alberto Garcia

With the objective to continue to foster a spirit of cooperation among our international and multicultural intellectual community , and to foster the bonds created over the years as a positive alternative to the strife and division that plagues all too many communities, this year we will have our Multiculturalism and Religion Workshop and Conference. This year’s meeting on “Bioethical Challenges in Neurogenomics from an Interreligious and Multicultural Perspective” will take place at the MD Anderson Cancer Center in Houston, Texas November 14-16, 2016.

From an integral and solidarian humanism, the person  is not just a conglomerate of cells, or a brain or a body; but a transcendent and relational being. These relations are the foundation of society. That is the reason that drives us to study the ethical limits and the relationship of neurogenomics and human rights.  Neurogenomics is a topic that brings to the table many questions, especially from a legal and humanitarian perspective. It is important that as bioethicists and leaders of our different traditions, we analyse the possible outcomes of this wonderful science so that we can enjoy its benefits and prevent the possible wrongdoings and violation to human rights.  Being cautious  in the ethical judgement in neurotechnologies will help to minimize the fear to the unknown, and to moderate the euphoria of the success of these technologies.
It is important to highlight also the law and its relationship with neurogenomics. This relationship is based on the fact that humans are in need of order to promote a positive interaction among communities.  Human relationships are based on reality – a truth- that should be rooted on an integral anthropological perspective. These rules should promote human flourishing that protect personal integrity and social structures from which communities are build in.  Truth should be paired with liberty because it is the free will (along with the responsibilities and consequences of making our own decisions)  that gives us a particular dignity. These freedom is questioned by some authors in neuroscience, arguing that it is the brain that rules the person and therefore there is not such a thing as free will. However, as stated in the beginning of these paper, humans are not just brains, but a body and soul. The brain, the psique, the soul are fundamental to each human being. These three realities can only exist with their inherited relationship with the body as a whole (corpus et anuma unum). This body-soul belongs to an ontological order that is superior than other organisms and that has a special value that we call dignity.  Liberty and autonomy should always be in harmony with justice. the perception of injustice is born as a natural feeling  when basic needs are neglected.
When studying the Universal Declaration of Human Rights, we can notice that there are some fundamental goods that  have been recognized as universal and therefore they need to be protected. Neurosciences and its neurotecnologies are outstanding tools to society when used with integrity and when life, truth, freedom and personal integrity and identity are protected.  Some of the rights to be protected in the development and usage of neurotechnologies are: Right of life; right of physical and psychological integrity; right of identity; right of privacy; right of freedom; right of social security; right of freedom of science; among others.All of these rights have their respective duty, and above all the main objective is to protect human dignity. During our next workshop I hope we engaged in a fruitful conversation in order to achieve a point of convergence that help us give light to the upcoming challenges of neurotechnologies.
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Case analysis

 An Ob/Gyn, has had many encounters with patients of various races, cultures, and religions, and these encounters have continued to mold his vision of healthcare within a pluralistic society throughout his long career.  One interesting encounter was with a young Chinese couple that was expecting a baby.  During the nine months of the pregnancy, all seemed to go smoothly.  The couple attended their regularly scheduled pre-natal visits, asked good questions, and generally followed his instructions.  When the expectant mother was at full term, he informed the couple that she needed to be admitted to the hospital because the baby was ready to be delivered. “No, bad luck… bad luck” they said.  “What do you mean, bad luck?” “Today’s date is bad luck; our child cannot be born today.”  He didn’t understand why they believed what they did; but nonetheless the couple left his office resolute on waiting at least until the following date to go to the hospital.  Unfortunately, the baby didn’t wait.  The expectant mother ended up delivering her child on the side of the road.  My father-in-law struggled to understand how this couple had seemed so reasonable to him, yet he failed to grasp why they had suddenly become obstinate when it came to the date of the delivery.  However, having lived through this experience, he learned to take a softer approach with patients and learned to have them communicate their expectations from an earlier point in time so as to not run into emergency situations like this in the future.

Modern societies are characterized by their plurality and multiculturalism where different religious and cultural convictions entail moral diversity. In many cases this leads to a confrontation of ideologies creating a confrontation between different believes. In health care, this clash is problematic because conceptual divergences surrounding the health of each social group lead to this confrontation, leaving the uncertainty of whether the religious/cultural conviction must prevail before the right of the person (Juarez & Chamorro 2003). How do we resolve fundamental cultural and religious differences about the foundations of medical morality? Is there a way to get to a compromise between human rights and cultural differences? (Marshall & Koeing, 2004).  How do we decide what is right and just? Is it possible to have social justice in a pluralistic world? 

This issue has been topic of our previous workshops. It has been questioned if it is possible to reconcile cultural diversity and human rights and duties, especially when cultural diversity is considered a universal value to be respected and promoted, and pluralism should be respected within a specific culture. Alberto Garcia argues that this reconciliation is possible using a realistic anthropology, based on an ontological reflection that supports a comprehensive and global vision about men and women, personhood, identity and liberty, beyond their cultural features and customs. With the aim of taking theory into practice, how would you apply Alberto’s method/theory in the presented case?

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Multiculturalism= Relativism?

Interesting essay:

TERRORISM IS NOT HATE by

Do you all think that multiculturalism necessarily leads to relativism?

 

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Scientists Slowly Reintroducing Small Group Of Normal, Well-Adjusted Humans Into Society

ITHACA, NY—In an ambitious attempt to revive a population long considered to be on the brink of extinction, scientists announced Friday they have slowly begun to reintroduce normal, well-adjusted human beings back into society.

According to officials at Cornell University …

http://www.theonion.com/article/scientists-slowly-reintroducing-small-group-normal-52632

 

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