Tuesday, October 13, 2009

Teaching Woes

So I'm teaching two sections of medical ethics this semester. And it's pretty interesting, a lively debate where lives are actually potentially on the line makes for more rigorous thinking. And it's much more interesting now that we're done doing things like confidentiality, truth-telling and the like.

See, I thought, sweet, I'll do medical ethics while there's this health care debate raging around us and we'll make the class interesting and topical! And, because I cannot help but be a political philosopher we'll look at issues like race and gender and poverty and medicine. Awesome pants!

So we're starting in on that section, with a general topic of "is health a right?," and I did anticipate there being some disagreement, some healthy and full engagement with the topic. And in one section, I have that.

The other, however.

Interestingly, both classes identified rights as something to which you are entitled. Which is interesting. As is the common desire to think of rights within a purely political nature. Which is also interesting. The difference between the classes is that one class was able to move into a thinking about human rights, outside of political rights, and the other class wasn't.

Really, the only right they could identify, human or political, was the right of self-determination. I had to give this second class the idea that we have a human (or even political) right to not be killed unjustly. I agree that the right of self-determination is an important right, one from which one can redress much injustice. However, the right to not be killed unjustly is a right that is important to be able to say, just like the right to bodily integrity or to be treated equally.

The last two I had people fight me on. Indeed I had people fight me on the right to not be killed unjustly. In fairness, the last they argued against because people are killed unjustly. And other cultures don't recognize it.

And there I am. Standing at a whiteboard. Uncertain as to how to move forward. I had expected disagreement about whether or not there is a right to health, and whether or not if that right did exist one could or should enforce it. I did not expect to have to explain, again, that when doing an ethics class we have to argue from a semi-universal standpoint. That, in fact, it was perfectly ok to make an argument that people have rights.

Interestingly, the most vehement proponents of choice were also the ones that are the most anti-choice. You know. You have the right to choice up until you have the right to choose whether or not to bring a pregnancy to term. Even though we can't think immediately of a right to life.

There is a problem here. A deep one, an unsettling one. It was chilling to face a class of relatively young people who don't think that the right to be treated equally is a human right. It is terrifying to be so confronted by isolation. These kids do not think that they are embedded in community. They don't think that society can have structures that are unjust. They believe they are radically free and are unconstrained or unprivileged by virtue of luck and birth.

I don't know what to do. If they're still relativists, still proto-Randians, what sort of conversation can we have about the intersection of racial and sexual injustice and how they ought to behave in a medical setting? These are nursing students. These are students who will become doctors. And a significant number of them reject empathy. And it's terrifying.


  1. This reminds me of a Phil of Law class I taught where we did the classic utilitarian train example and I had one family fall asleep on the railroad tracks. My students jumped on it --- "It's their fault that they're there, so you don't need to worry about their protection?" The same class later defended a date rapist b/c the woman could have used her cel phone (it was a case from the 80s...).

    Here's my honest suggestion though: I'd say, ok, if you want to defend the position that people don't have rights to be protected from unjust killing or to health, fine --- from that position, it would make sense to argue against universal health coverage. But why aren't Republicans and conservative commentators making that argument (and show examples of how they're not). Why are they instead arguing that it will be an inefficient way to cover people or else will take away health coverage from the upper-middle class? Why, in other words, do most of them posit a right to health?

  2. Ouch! wish I had some handy, witty advice, but I'm fresh out. Can you just shake them?

  3. censorship rules...

  4. Anonyymous, you might want to get your head out of your ass and explain your position--appeal to the people which is implicit in your phrase (and in this case is even more fallacious than it is in regular discourse b/c you have NO awareness of your audience) will simply not work.

  5. And that's Anonymous with one 'y'. But I'm sure you knew who I was referring to (sense and reference are not at odds here).

  6. Wow.....you actually made me think.

  7. Well, forgive me but I've been forcefed Fox News for the past 24 hours (thanks Dad!) So if my view is jaded and mean, ignore it.
    My Father has been a nurse for some odd 40 years and I believe it is a necessity for his empathy to be turned off and on like a switch, and he can; its truly frightening.

    I can remember him taking me to school the day we had to dissect a frog "you just need to step away from yourself, watch from above." I think ya have to be able to do that to be a good medical professional.

  8. If the first question is "Do you have a right to health", then if you answer yes, how exactly do you define health? The government would be expected to protect your health then, so NHC comes in. But for most people, health is a result of diet and lifestyle. So does the government force people to eat certain ways and live certain ways? While not disagreeing with the idea of a right to health...at some theoretical point the government enforcement of that right conflicts with the right to freedom. So whether it is a right or not, the argument of government protection of that right that people have is probably not the best one to use. As far as the students who generally felt that it was ok for people to not be treated equally, this is not surprising to me, and I'll tell you why. While a great deal of the population believes in equal treatment under the law, there is also a large portion that believes in unequal treatment for one reason or another. Such as much of the nation's stance against homosexuality, or the portion of the black community which feels that there should be government reparations paid to black people for what has happened in the past. Or perhaps the tense relations between much of the Jewish and Muslim communities created by the situation in Israel.