Monday, May 19, 2008

Ethical Voyeurism and Selective Squeamishness

Watching the news last night, the inevitable harrowing scenes from the Irrawaddy Delta and Sechuan were abundantly on display. In China, we watched a dying man making a last phone call to his wife as he lay crushed under a huge block of concrete. In Burma, we saw a grief-stricken family watching as their patriarch died. What purpose does such footage serve? There is nothing we might be spurred to do about either situation which would be of any use - the earthquake response has been, apparently, efficient and concerted and there is little chance of anyone more being found alive, while in Burma the military junta (despite 'Lord' Malloch Brown's optimistic snap judgment) continues to prevent serious aid getting to where it's needed.
Is this intrusive footage anything more than a kind of 'humane', ethical voyeurism? The news crews' intrusiveness into private grief is apparently deemed quite permissible with people in faraway places who are 'not like us' - such footage of a homegrown disaster would not be shown. We are notably queasy - in a supposedly taboo-busting age - about showing death at all: witness the fuss over the Paul Watson documentary (which turned out to be fudged anyway).
And this squeamishness can have serious effects, as in the case of late abortions. Television is happy to show the most graphically grisly surgical operations, but there is a de facto blanket ban on late abortion footage, which therefore remains the preserve of the 'pro-life' organisations, who have, of course, plenty of it. The result is that the debate on late abortions takes place in a climate of ignorance - most of those taking part have never seen (and probably have no clear idea of) the 'procedure' they are discussing. Those who do know the reality are, it seems, refusing to carry on - i.e. the three-quarters of NHS doctors who won't perform late abortions. Brown has come out clearly against cutting the time limit on abortions - and, with a touching faith in the the words of interested scientists, has presented a vote to permit embryonic stem cell research and hybridisation as, quite simply, a vote for curing Alzheimer's, Parkinson's and cancer. This looks to me like a fine combination of ignorance and mendacious manipulation.

21 comments:

  1. Well spoken Nige. Why is it that scientists, whether in medicine or meteorology,amongst others, are always portrayed as being disinterested? Of these, medicine gets a phenomenally easy ride. The old 'cure for cancer, Alzheimer's and Parkinson's' has been trotted out for decades, but still works.

    The truth is that medicine hasn't had a major success since the defeat of polio in the fifties. The rest has been tinkering round the ages and lifestyle pharmacology linked to the particular desires and expectations of the 'boomers': Viagra; Prozac; etc., etc.. But we must still bow down before their omniscience.

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  2. 'Ages'. 'Edges'. Whatever.

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  3. Tumby WoodsideMay 19, 2008 1:33 pm

    Absolutely! My own particular favourite, which the news channels do seem happy enough to use in the home market, is: "And tell me, Mrs Buggins, how did you feel when you watched that bunch of youths chopping off your husband's head?"

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  4. I can't let that comment pass, Recusant. I don't consider any of the new breast cancer treatments to be 'lifestyle' pharmacology. They save lives, end of story.

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  5. Sophie's right. There are also now much better (less invasive) tests for detecting prostate cancer. It's really just a matter of where you look in medicine -- some things really work, other things they still haven't figured out.

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  6. By the way, Nige, is a "Voyeursim" a virtual voyeur?

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  7. Sophie & Susan

    I agree that there have been positive developments in the treatment of various conditions, cancer included. My point is though that, no matter that survival rates have increased (but still pretty marginally) we are absolutely nowhere nearer 'curing' cancer or any other major class of diseases than we were in the fifties.

    Yes, the improvements have saved lives, an unequivocally good thing, but we are still waiting for the 'breakthrough' we have been endlessly promised by medical science and I, for one, class the present lobbying for the HEF Bill in the same class as those previous promises. The price they ask, for the unlikeliness of a gorund-breaking return is too high.

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  8. Thanks Susan - I'm a bit wordblind today - had already corrected it from 'Voyerusim', but didn't quite complete the job...

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  9. Thanks Nige, very well said. the dangerous part is that we are so sure of our rationality, yet almost entirely driven by sentiment. Our genius is in being able to rationalise our sentiments in endless ways--Hume started it I think ('Reason is, and ought only to be the slave of the passions'). Likewise our blind adherence whatever anyone in white coat says is quite stunning--I don't think any priests ever had that power. But the worst part is the complete convicion of our rationality.

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  10. Looking for cures may be looking for the wrong thing. A lot of pesky ailments can now be put into remission or slowed to the point where the patient can lead a more or less OK life for a reasonably full span. There may well never be outright cures for some things, in an organism whose cells age and which depends on oxygen (and which is entirely prey to random events, too). But often we don't want to face such notions, so we go along with the "miracle cure" routine whereas slow but steady progress may be the better route.

    Also, surgical techniques seem to have improved out of all recognition, whether simple ops for cataracts, new joints for the arthritic or the amazing keyhole stuff. Not long ago, if the illness didn't get you then the operation surely would.

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  11. Likewise our blind adherence whatever anyone in white coat says is quite stunning--I don't think any priests ever had that power.

    Surely you jest, Chris. For hundreds of years in Christian societies they most certainly did, just as monks did in Buddhist societies and imams in Islamic societies. While there remain pockets of blind adherence to whatever priests or monks say in various societies, the challenge of the twenty-first century, and the source of much conflict around the globe, is the Islamic world coming to terms with the fallibility of its religious leaders, their increasing inability to control access to alternative sources of information, and the resultant threat to social stability and political power within those societies.

    I agree that, for many, the men donning white coats are like priests, whose utterances on a host of issues, medical & environmental, are to be accepted without question. The fact that they so often end up doing u-turns has not diminished the ardor for a new priest class, conversant in secret rituals and sacred texts incomprehensible to the masses.

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  12. I am deadly serious, in that it is something that we ought to take seriously. The very fact that people find this proposition quite incredible should be a major warning. I don't think people have become any less intrinsically inclined to follow what they are told. What I do notice is that everyone seems to be convinced that we are intrinsically better than those living in non-industrial countries and better than our ancestors.

    I see our modern intellectual landscape littered with metaphysical assumptions that are being heavily pushed by science. try to engage an intellectual in a thoughtful discussion and a very uncomfortable feeling will rapidly descend. People don't want to go monkeying around there thank you very much, and would much rather just stick with what the men in white coats are telling them.

    Remember village witch doctors, etc., get their power by mastering something. With this power they start asserting their authority in areas that they are not at all competent in. It is only too easy for scientists to do that today.

    Only today I have written an piece, Why I am not an Atheist, reflecting on the total irrationality of a certain kind of atheist, yet they see themselves as models of rationality (it was prompted by Peter Singer's Cif article, Good God?). I think this kind of thing is legion today.

    I think you will find that the problem with Islam is not theological but political. When all other means of opposition get closed down it becomes too easy to use the Church or Mosque as a rallying place, and thence the religion itself gets hijacked. The underlying point of over-reifying things too much (fundamentalism if you like) is rife everywhere, in the industrial world as much as outside it.

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  13. Just on the political aspect; It seems that Gordon wants to be back in opposition benches. And much like the dem's in the USA, where a boot would have won this time, each and every twinky ideology is dusted off and defended to the death.
    I will not be very shocked if Macain wins.

    Vincent

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  14. Recusant wrote at May 19, 2008 10:29 AM: "The truth is that medicine hasn't had a major success since the defeat of polio in the fifties."

    Wikipedia gives here plots of life expectancy over time, from 1950 to the present, and for various regions of the world (of different levels of development).

    I doubt there is any better indication of medical success (and its application) than life expectancy. So, for me, those graphs with top ranking (North America, Europe and Oceania) indicate clearly that Recusant is talking through his hat.

    Medicine marches ever forward, as does the rest of technology: almost invariably to our overall benefit.

    Best regards

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  15. Concerning abortion, over the years I have had many discussions on this. The most interesting ones are with women.

    The horror of back-street abortions, and the contingent female mortality etc, should not be forgotten.

    For me, the issue is clearly one of steering between two evils.

    However, killing people is almost always best avoided (and a foetus is a person: actual or nascent). Therefore we should all avoid abortions, as much as is practical.

    Though I am but a mere man, I have never quite understood why, in almost every circumstance, an 'abortion of choice' cannot be undertaken within 12 to 16 weeks of conception. This is on both recognition of the fact of pregnancy and on making the decision to terminate. [Note: many other countries have just such a limit; thereafter sound medical reason is required (though I read that the interpretation of 'sound' is somewhat variable).]

    Returning to Nige's main posting, I personally struggle to see how these videos of the gory process of late abortion should actually form a needful contribution to the decision process. If they were, surely we would all be clamouring to witness murder (or an avoidable industrial fatality) before deciding such things are wrong.

    Best regards

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  16. Nigel Sedgwick

    I think you will find that engineers have had a deal more to do with increased life expectancy than doctors. Clean water. Sewage disposal. Refrigeration. Rapid transportation. Aseptic packaging. The list is endless.

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  17. And Nigel, "the horror of back street abortions" is part of the great mythology. Who do you think was performing them in over 90% of cases? That's right, doctors and midwifes.

    As for the maternal mortality rates, the last figures put together by the Royal Society of Obs & Gyn (an organisation in favour of David Steel's original Abortion Bill)for 1964, put the death rate at just under 46 for 36,000(calculated) abortions. A figure that compared very favourably to the maternal death rate for full term pregnancies at the time.

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  18. Good post Nige and excellent comments Recusant. Embanking the Thames probably saved more Londoners than anything done by medics.

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  19. This World Health organisation briefing paper (13 pages) on 'unsafe abortion' begins: "Ending the silent pandemic of unsafe abortion is an urgent public-health and human-rights imperative. As with other more visible global-health issues, this scourge threatens women throughout the developing world. Every year, about 19–20 million abortions are done by individuals without the requisite skills, or in environments below minimum medical standards, or both. Nearly all unsafe abortions (97%) are in developing countries. An estimated 68 000 women die as a result, and millions more have complications, many permanent. Important causes of death include haemorrhage, infection, and poisoning."

    There is a briefer article on Wikipedia.

    The above is an average of 367 maternal deaths per 100,000 unsafe abortions. Though I am sure that developed world death rates from unsafe abortions are (and were) much better than the equivalent worldwide average for any particular time-period, I am not at all convinved that these death rates ever were trivially unimportant, are now, or that returning to backstreet abortions would be a good idea. However, I would be interested in reconsidering that on the basis of up-to-date (and historical) information of the comparative death rates for legal and unsafe abortions in the developed world (rather than just bold assertion).

    Recusant's quoted 1964 figures for the legal abortion death rate being no higher than the maternal death rate from normal pregnancies was, undoubtedly, useful information for the abortion debate back in 1964: equivalent up-to-date figures might also be useful for the current debate. I don't, however, see their relevance on this current disagreement between him and me which, at least as I understand it, is whether legal abortion in hospital is to be preferred to the other sort.

    Best regards

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  20. But Nigel the jurisdiction whose laws we are discussing is the UK, not Burundi or any other jurisdiction. I'm sure you will find a much higher rate of food poisoning there as well, but it is not relevant.

    For a necessary comparison as regards the hyperbole attached to the phrase you used, 'back street abortions', you would also need the maternal death rate for pregnancies carried to term in developing countries.

    Having said which the WHO does not have a great track record for the disinterestedness of its position or statistics.

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  21. Likewise our blind adherence whatever anyone in white coat says is quite stunning--I don't think any priests ever had that power.

    I wouldn't credit much power to the white coat. People will choose their own authority figures. That sounds like an oxymoron, but in a democracy that's how authority works. If you want legalized abortion, you invest scientists who promote the benefits of abortion with moral authority.

    We've democratized science. The global warming debate is a sure sign of that. People have voted for a massive comeuppance for western techno-capitalist civilization for all its sins, and have vested the non-consensus consensus of scientists with the authority to execute its judgment.

    I don't know why so many people say that Europe has lost its religious faith. Europe is the most guilt-driven society on the planet.

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