Saturday, August 28, 2010

On Paternalism, Murder, and Genocide

Most people don't think of paternalism and murder as compatible. The same could be said for paternalism and genocide. The fact of the matter is that there's nothing incompatible about the concepts.

Paternalism is an attitude. Murder and genocide are actions. They're completely different things.

To commit paternalistic murder, all you have to do is to kill someone because you believe they're better off dead -- to kill them "for their own good". To commit paternalistic genocide, you simply have to generalize this to a demographic group.

It's a sad commentary on the state of things in the world of disability that we have to seriously worry about this intersection.

Friday, August 27, 2010

I Always Want to Be Right (And You Should, Too)

I always want to be right. When I say this, I don't mean that I want to win arguments. That's not being right -- that's having other people tell you you're right. I mean that I want my beliefs to reflect reality. I want all of my beliefs to reflect reality -- if not perfectly, then at least as fully and completely as possible.

I do not want to believe I can fly when I can't. The practical consequences of this are perhaps best described by the term "splat".

I do not want to believe that a cure for cancer works when it doesn't. The practical consequences of this are paid in wasted money and unnecessary side effects. By the same token, however, I don't want to believe that a cure doesn't work when it does. The practical consequences of this are commonly referred to as "dying in horrific agony". Selecting an effective (and helpful) treatment or cure is one of the hardest -- and most important -- parts of medicine.

I do not want reality to conform to my existing beliefs. That idea -- the foolish wishing for what I tend to derisively call "magic god powers" -- may make for a nice fantasy on occasion, but is usually a waste of time. I want my beliefs to conform to reality. I want to believe what is true, not for reality to follow from what I believe.

I do not want others to sit back and say nothing when I express an inaccurate belief. If they do so, I lose the opportunity to correct my beliefs. I fully understand that the price of being right is admitting that you have been wrong. I accept and eagerly pay this price. Metaphorical humble pie may taste awful, but it's very good for you.

I do not want others to hold back in debate. I want to hear the best, most valid arguments that the people I'm debating can put forth -- and I want them to support these arguments as well as they can. I, in turn, will do the same. I will hold my position with the best arguments I can come up with (as the circumstances allow) in hopes of drawing out the best, most thorough counterarguments possible. If I did otherwise, I would deprive myself of evidence and reasoning that could help me develop a better, more informed view of the issue we're debating. If I "win", so be it. If I "lose", so be it. Either way, I'll be using the reasoning and evidence to reevaluate my position... and will very often change it.

Of course, this changing isn't always obvious. I usually reevaluate my position after the debate... and I often play "devil's advocate", offering forth arguments that I don't really believe (but can't easily counter) in order to draw out a precious -- and useful -- counterargument.

I don't want to reach premature final judgment... and my beliefs tend to be more probability estimates regarding the possibility of something being true than actual beliefs that something is true. Truly wanting to be right means being comfortable with the limitations of one's knowledge.

And, in the end, as I reflect on my attitudes and my desire to be right... I can't help but think that the world would be a better place if more people desired to be right, too.

Thursday, August 5, 2010

"Words to the Wise"

As I write this, I am sitting in a computer lab with a copy of Thomas Szasz's "Words to the Wise". It's an utterly fascinating collection of quotes and sound-bites on a wide-ranging collection of topics by one of the most controversial authors in the field of clinical psychology. Some of the quotes I agree with; others I don't. All, however, are thoughts worth considering. Despite the format, it's one of the most thought-provoking books I've seen in a long time.

Ten of the quotes more relevant to today's autism issues:

If a person ingests a drug prohibited by legislators and claims that it makes him feel better, that proves that he's an addict.

If he ingests a drug prescribed by psychiatrists and claims that it makes him feel better, that proves that mental illness is a biomedical disease.

When and why do we say that a behavior is caused rather than willed?

We say that chemicals in the brain cause depression and suicide; but we don't say that chemicals in the ovaries or testicles cause lust and marriage.

The child cannot match the adult in most accomplishments. Hence, we reward him for effort as well as achievement. Yet, the child must learn that what counts in life is not effort but achievement. The child over-rewarded for effort may grow up to seek approval for trying instead of for succeeding. This dooms him to failure. If he succeeds, he succeeds only at trying hard. If he fails, he fails miserably.

When a woman finds having a fetus in her body annoying, she can abort it by taking an abortifacient drug or having a surgical abortion.

When a woman finds having a child in her home annoying, she can abort his persona by having a child psychiatrist give him a chemical straitjacket.

Diagnoses are not diseases.
Diagnoses are names, human fabrications.
Diseases are phenomena, facts of nature.

Demonstrable bodily lesion is the gold standard of medical diagnosis. Without practical convertability into gold, the value of paper money rests only on faith. Without conceptual convertability into bodily lesion, the diagnosis of disease rests only on faith.

A patient with cancer says: "If I had refused my surgeon's suggestion that I have my tumor removed, the cancer would have killed me."
A patient with depression says: "If my psychiatrist had let me refuse the electroshock treatment he recommended, I would have killed myself."
The difference between these two sentences sums up the difference between bodily illness and mental illness.

Three principal rules of conduct:

1. The Golden Rule: Do onto others as you want them to do unto you.

2. The Rule of Respect: Do unto others as they want you to do unto them.

3. The Rule of Paternalism: Do unto others as you in your superior wisdom know ought to be done unto them in their own best interests.

Formerly, debasing the Other by calling him a "nigger" was considered politically correct: the speaker was viewed as a protector of the race or nation from those bent on defiling it.
Today, debasing the Other by calling him "sick" is considered politically correct: the speaker is viewed as a protector of the debased person's best mental health interests and of the nation from a danger to the public health.
Replacing the former rhetoric by the latter is considered moral progress.

Today, everyone claims to be working for the patient's best interests. No wonder the patient is in deep trouble.

Note that I selected these quotes based on relevance, not agreement. I don't, as a matter of fact, agree with a lot of Szasz's thinking. This said, he's an incredibly thought-provoking author. In this blog post, I'm not going to take a stance on any of these. Instead, I'm going to give an "assignment" of sorts to each of my readers.

Read these quotes. Think about them. What does each of them mean? What do they imply? Is this statement -- or implication -- accurate? Is Szasz right or wrong? Why?

Then post an explanation here, answering at least one of these questions for at least one of these quotes. Feel free to do so anonymously or pseudonymously. I don't care about that (although I will delete SPAM posts or personal attacks). If you aren't the first to reply to this, also reply to at least one of the previous replies.

My own replies here will be mostly playing "devil's advocate", issuing responses also intended to make people think and facilitating discussion. Unless I state specifically that a position is my own personal belief, please don't think that it is. I will likely issue arguments against your position even if I agree with it.

The point, after all, is to get people thinking about this sort of thing.

In addition to the obvious, this exercise should give you a pretty good idea of why I highly reccommend this book. It has nothing to do with agreement (although I strongly agree with both the contents and sentiments of many of the quotes, this cannot be said about many others). It has everything to do with the way the book makes you think.

Oh, and it's a treasure mine for anyone who wants quotes for articles, the beginnings of book chapters, and the like. Lots of grade-A quotes here... which is the entire point of the book.

Edit: Added a link.