Latest / Health Ethics Podcast / Art & the opposing viewpoint: Towards logical reasoning and civil discourse

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Art & the opposing viewpoint: Towards logical reasoning and civil discourse · Health Ethics Podcast

0:09
Speaker 1: Welcome to Health Ethics, a series of conversations with leading
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Speaker 1: experts about ethical considerations associated with health and healthcare, both
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Speaker 1: locally and globally. I am Brian Pilkington, Professor of Bioethics
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Speaker 1: in the Department of Medical Sciences at the Hackensack Meridan
0:24
Speaker 1: School of Medicine. This series, like its predecessor, which focused
0:29
Speaker 1: on the COVID nineteen pandemic, relies on the idea that
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Speaker 1: challenging ethical issues are best addressed by folks from diverse
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Speaker 1: backgrounds practically reasoning together, and complements the Health Ethics series
0:41
Speaker 1: with its panel of leading experts from medicine, nursing, politics, economics,
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Speaker 1: philosophy and the law. Thank you and enjoy the episode.
0:58
Speaker 1: In this episode, I speak with Caitlin Puccio about philosophy,
1:02
Speaker 1: art and bioethics. Caitlyn Puccio is a lawyer and bioethicist
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Speaker 1: and the director of the Art and Bioethics Initiative at
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Speaker 1: the UNESCO Chair in Bioethics and Human Rights in Rome.
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Speaker 1: Her work focuses on the implementation of logical reasoning and
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Speaker 1: civil discourse to analyze policy issues in the bioethics space.
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Speaker 1: She was previously teaching Associate for Law and Bioethics at
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Speaker 1: Columbia University's Master's Program in Bioethics, and has lectured at
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Speaker 1: universities globally, including the NYU School of Law, Fordham Law,
1:34
Speaker 1: and Louis School of Law in Rome, as well as
1:37
Speaker 1: EIDM in Madrid. Her writing has appeared in publications such
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Speaker 1: as Psychology Today and The Fashion Law, and she has
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Speaker 1: contributed her analysis of a broad spectrum of policy issues
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Speaker 1: to Vogue Business, The Business of Fashion, Fox Business newsweeknd more.
1:54
Speaker 1: Caitlyn has appeared as an on air expert on OutKick
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Speaker 1: discussing issue choose such as transgender participation in sports, and
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Speaker 1: is the author of five books. Caitlin, thank you so
2:07
Speaker 1: much for joining me today.
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Speaker 2: Thank you for the invite.
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Speaker 1: So we want to think a bit in today's podcast
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Speaker 1: about bioethics and also connections to art and connections to philosophy,
2:18
Speaker 1: and so let's jump in with a question more sort
2:21
Speaker 1: of inside baseball for bioethics, folks. For those who think
2:26
Speaker 1: about bioethics really as a field that deals with challenging
2:29
Speaker 1: clinical ethics cases right as opposed to the breadth of
2:33
Speaker 1: bioethics can you help those folks understand more sort of
2:38
Speaker 1: the other aspects of bioethics.
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Speaker 2: Yeah, I would say that's absolutely right.
2:42
Speaker 3: That's a lot also what we think of from a
2:47
Speaker 3: US perspective about what bioethics is, right, it's not necessarily
2:51
Speaker 3: that way in Europe, where there is this kind of
2:56
Speaker 3: idea that it's also a branch of philosophy rather than
2:59
Speaker 3: just a piece of medicine. So, of course when we
3:02
Speaker 3: think of bioethics, we think of applying it to things
3:05
Speaker 3: like medical aid and dying for example.
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Speaker 2: Yes, that's one of the obvious.
3:11
Speaker 3: Aspects of it, but we also have things like trans
3:16
Speaker 3: women in sports. Right, it's not just the medicine side
3:20
Speaker 3: of transgender issues, but it's the social side of it. Also,
3:24
Speaker 3: what I deal with is sort of the technology side.
3:28
Speaker 3: We have artificial intelligence, and because I come from a
3:30
Speaker 3: fashion background, my focus there is AI potentially replacing models
3:37
Speaker 3: on the runway or in magazines or something like that.
3:40
Speaker 3: So there's it is, as you said, way more broad
3:45
Speaker 3: than just clinical ethics cases.
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Speaker 2: Of course, it's very important.
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Speaker 3: But if you kind of break down the word bioethics, right,
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Speaker 3: it's life ethics. And when you think of you know,
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Speaker 3: how are we going to apply ethics to these life issues?
4:00
Speaker 1: Well?
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Speaker 2: What are these life issues?
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Speaker 3: And there are many, so I would also say, though
4:06
Speaker 3: just one point here, I'm also a lawyer, and the
4:12
Speaker 3: law and ethics don't always one hundred percent overlap. So
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Speaker 3: even if we have laws on the books that deal
4:22
Speaker 3: with these ethical issues, as bioethicists, we can still have
4:26
Speaker 3: conversations about the ethics of that law. Some laws may
4:31
Speaker 3: lead to unethical outcomes, and not all ethics is codified
4:35
Speaker 3: as law, right, so we can still have these conversations
4:41
Speaker 3: on a more meta level, which is the way. It's
4:44
Speaker 3: the more philosophical kind of level.
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Speaker 1: That's great and I think really helpful for folks and
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Speaker 1: lines up with what people who listen to the podcast
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Speaker 1: regularly might have bumped into in terms of the importance
4:54
Speaker 1: of bioethics as a subdiscipline of philosophy. It sounds like
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Speaker 1: we're on the same page on that, though many many
5:01
Speaker 1: people disagree. I want to push you now or ask
5:05
Speaker 1: a bit about sort of how philosophy and how art
5:08
Speaker 1: inform the account of bioethics that you just started to sketch,
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Speaker 1: and I do so noting that you're the director of
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Speaker 1: UNESCO's Art and Bioethics Initiative. So please, I mean pull
5:18
Speaker 1: an international examples. Rely on your background and thinking about fashion,
5:22
Speaker 1: artificial intelligence, but what about philosophy and art informs how
5:26
Speaker 1: you think about bioethics.
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Speaker 3: Yeah. So I come from a philosophy background.
5:32
Speaker 2: I study philosophy at.
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Speaker 3: NYU, but I also come from a film background, and
5:38
Speaker 3: what I did as a film producer was I always
5:40
Speaker 3: tried to tell stories or write stories that did question
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Speaker 3: some of these things that we question as bioethicists now
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Speaker 3: and as the director now of the Art and Bioethics
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Speaker 3: Initiative that UNESCO. First of all, it's the UNESCO Chair
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Speaker 3: in Bioethics and Human Rights.
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Speaker 2: So what does a UNESCO chair.
6:00
Speaker 3: Where It's just to be super clear as a lawyer,
6:05
Speaker 3: it's essentially a team of people. We have a group
6:09
Speaker 3: of people in where I am as in Rome, that
6:13
Speaker 3: are part of a higher education or research institution that
6:18
Speaker 3: our partner with UNESCO to develop projects to advance knowledge
6:23
Speaker 3: in some area. So what I specifically do there as
6:28
Speaker 3: the director of the Art and Bioethics Initiative is try
6:31
Speaker 3: to bring the idea and the concepts behind bioethics to
6:37
Speaker 3: a broader audience via the various forms of art. A
6:41
Speaker 3: lot of times we get stuck in the academic space
6:46
Speaker 3: and we wind up either writing for other academics or
6:50
Speaker 3: just speaking to other academics, and it can be very insular,
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Speaker 3: and these ideas they really affect everyone.
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Speaker 2: So it's.
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Speaker 3: It would be nice to be able to speak to
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Speaker 3: a broader audience and to encourage people to think about
7:08
Speaker 3: some of these issues that we're working through kind of
7:11
Speaker 3: in the background, but just present these questions and ideas
7:17
Speaker 3: to the general public in a way where they can
7:21
Speaker 3: explore for themselves what does this concept mean to them.
7:26
Speaker 3: We talked a little bit about medical aid and dying.
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Speaker 3: I mentioned it in the beginning. So for example, if
7:31
Speaker 3: we have a documentary film or even just a narrative
7:35
Speaker 3: film on someone's journey through this whole process, that can
7:44
Speaker 3: open up a lot of doors for questioning, for personal exploration,
7:50
Speaker 3: for your perspectives, and it brings bioethics outside of this
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Speaker 3: tiny sphere of academia, and it's not only for only
8:03
Speaker 3: Americans or only Europeans, because it can be disseminated worldwide,
8:10
Speaker 3: and then these perspectives come into play, these different perspectives.
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Speaker 3: So that's really the kind of in a nutshell, the
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Speaker 3: ultimate goal and how art and bioethics mixes a little bit.
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Speaker 1: I appreciate the aim sort of how you nicely connected
8:26
Speaker 1: both in the sort of early discussions so that the
8:32
Speaker 1: social in this answer as well the social features and
8:35
Speaker 1: how bioethics can sort of be brought to broader audiences.
8:39
Speaker 1: Philosophy and arts seems like excellent areas to do that.
8:44
Speaker 1: Continuing with sort of and you can help me not
8:47
Speaker 1: be too much in the academic sphere given want you
8:49
Speaker 1: just laid out. But one of the common concepts that
8:55
Speaker 1: I think is a bioethics concept that has a greater
8:59
Speaker 1: appeal global then maybe in the US. So with your
9:02
Speaker 1: UNESCO director had on or director of the chair, those
9:06
Speaker 1: good clarification as well. With that hat on, do you
9:11
Speaker 1: think about do you do any work on the concept
9:13
Speaker 1: of dignity in light of what the un and UNESCO
9:16
Speaker 1: have done. So some philosophers recently in some bioethicists Nancy
9:20
Speaker 1: Jecker at all have that recent ish paper and a
9:22
Speaker 1: job it's really about war, right, But this sort of
9:26
Speaker 1: layout dignity and the usual claims about the kinds of
9:29
Speaker 1: things folks need to maintain dignity. One of them is play,
9:33
Speaker 1: which I think might touch on some of the considerations
9:36
Speaker 1: of philosophy and art that you mentioned. Lots of folks
9:39
Speaker 1: think that dignity has esthetic elements. As the director of
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Speaker 1: the Art and Philosophy initiative, does dignity come across Do
9:48
Speaker 1: you think about dignity, Does it help you conceptualize things?
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Speaker 1: Or is the old school bioethics and autonomy kind of
9:54
Speaker 1: move Is that better?
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Speaker 3: Yeah, this is a really interesting point that you bring
10:00
Speaker 3: up here, because in the United States our concept of
10:04
Speaker 3: bioethics is very focused, of course on autonomy. We have
10:08
Speaker 3: these four pillars essentially of bioethics, right, and they have
10:13
Speaker 3: that as well in Europe. But one of the pillars
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Speaker 3: is actually dignity, which we don't specifically state as one
10:21
Speaker 3: of the four principles of bioethics in our US version.
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Speaker 3: It's implied, it's in there, it's kind of written into
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Speaker 3: other principles, but it's not specifically listed as one of
10:36
Speaker 3: the four principles of bioethics as it is in Europe.
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Speaker 3: So this is a really interesting point in how we
10:42
Speaker 3: can kind of share perspectives and learn from other people
10:47
Speaker 3: outside of our little world in the United States, which
10:52
Speaker 3: it's of course we want to talk to other Americans
10:55
Speaker 3: as well, but we do want to broaden our perspective.
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Speaker 3: So the concept of dignity, I would say, if we
11:04
Speaker 3: boil it down to a very basic definition, and this
11:08
Speaker 3: is maybe not the only definition, but one of the definitions,
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Speaker 3: you can think of it as respecting others in social contexts.
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Speaker 2: So what do I mean by that?
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Speaker 3: We are talking a lot about in the United States.
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Speaker 3: A lot of these social issues. They're bioethical issues. They're
11:26
Speaker 3: highly emotional. For example, transgender rights is like that, highly
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Speaker 3: emotional social issues, very different perspectives on what we should
11:38
Speaker 3: do and how we should talk about them, and so
11:45
Speaker 3: bioethical policy issues essentially are social policy issues in a
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Speaker 3: lot of instances. So dignity, if we think about it
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Speaker 3: as at its core respecting the perspective of others, then
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Speaker 3: we can start to have conversations with others in a
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Speaker 3: civilized fashion about these social issues. And the way we
12:08
Speaker 3: were kind of layering things on now the way to
12:11
Speaker 3: bring art into this is that if we have these conversations,
12:15
Speaker 3: we're limited by language. Our English language can be very
12:20
Speaker 3: ambiguous at times. So some ways that we can kind
12:26
Speaker 3: of have these conversations without being limited by language is
12:29
Speaker 3: via art.
12:31
Speaker 2: Now, what do we show through art?
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Speaker 3: We see the artist's perspective, and we apply our perspective
12:38
Speaker 3: to try to understand the artist's perspective. So it's a
12:41
Speaker 3: little bit sicklical, it's a little bit meta at some stages,
12:45
Speaker 3: but that is kind of how I would say, it's
12:48
Speaker 3: all intertwined. But at a fundamental level, if we do
12:54
Speaker 3: want to have these conversations about highly emotional, bioethical social
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Speaker 3: issue whose we do need to think about, what is dignity?
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Speaker 3: And am I respecting dignity? Am I respecting this person's dignity?
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Speaker 3: At really kind of exploring that, even if it's not
13:14
Speaker 3: laid out as one of our bioethical principles in the United.
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Speaker 1: States, that's really helpful. I mean both the international perspective,
13:21
Speaker 1: and I want to get to your work on civil
13:23
Speaker 1: discourse too, because I think that's relevant here. But before
13:26
Speaker 1: I do, the role that art can play in sort
13:29
Speaker 1: of actualizing considerations of respect for dignity or just helping
13:34
Speaker 1: folks through these when there are deep disagreements around social
13:38
Speaker 1: issues which we can think of as bioethical policy issues, right,
13:42
Speaker 1: And you and I can do sort of academic bioethics
13:44
Speaker 1: stuff all day, but I think you helpfully point to
13:47
Speaker 1: the lived experiences of different folks and navigating those tensions
13:53
Speaker 1: is challenging. So before we do civil discourse, any particular
13:56
Speaker 1: examples of how art can be useful, See how it
14:00
Speaker 1: can be I see the artists perspective, and I think
14:02
Speaker 1: that maybe that metaphor of the artist is really helpful
14:07
Speaker 1: and understanding how different folks could view a situation or
14:11
Speaker 1: understand even you know, a murky concept like dignity. Well,
14:16
Speaker 1: do you use art when you teach this sort of thing?
14:19
Speaker 1: Is there a good painting? Is there a useful song?
14:23
Speaker 1: Is there an excellent fashion piece? Help me here teaching
14:29
Speaker 1: to sort of work through?
14:31
Speaker 3: Yeah? I would say that art is a useful launch
14:36
Speaker 3: pad for a discussion. And the helpful thing about art
14:40
Speaker 3: is that you can look at a piece and then
14:43
Speaker 3: have a conversation about the piece, whether it's it could
14:48
Speaker 3: be something in fashion. You could go to a fashion
14:51
Speaker 3: museum or what I mean. I look at fashion as
14:53
Speaker 3: art as well, but I mean you could look at
14:58
Speaker 3: any kind of art piece and then and you're having
15:00
Speaker 3: a conversation about what that piece is saying, and it
15:04
Speaker 3: provides this helpful distance from.
15:07
Speaker 2: That highly emotional.
15:10
Speaker 3: Topic because you're having a discussion then a little bit
15:13
Speaker 3: of a step removed from this is what I think,
15:17
Speaker 3: and I'm going to yell my conclusions at you, and
15:19
Speaker 3: it's going to get really angry, and then we're going
15:21
Speaker 3: to have we're going to have to stop the conversation
15:23
Speaker 3: because we're not getting anywhere.
15:25
Speaker 2: Art is it. It's kind of a catalyst for having
15:30
Speaker 2: these discussions.
15:31
Speaker 3: But looking at it from the outside, now, what I
15:34
Speaker 3: do usually when I.
15:35
Speaker 2: Teach is I focus a lot on.
15:41
Speaker 3: Being very specific in the words that are used and
15:45
Speaker 3: trying to fully understand at least what the other person
15:50
Speaker 3: is saying. Even if you cannot fully understand their experience.
15:54
Speaker 3: I could be I could have grown up in the
15:57
Speaker 3: same household as my siblings and had the same type
16:02
Speaker 3: of upbringing and the same everything, and I still might
16:04
Speaker 3: not know exactly what it's like to be my sibling
16:08
Speaker 3: because we are different people. Now, there are different degrees
16:12
Speaker 3: of this of these differences and not being able to
16:16
Speaker 3: understand the experiences of other people, but we can try
16:21
Speaker 3: at least even if I can't walk in your shoes,
16:25
Speaker 3: I can try to understand what it's like to walk
16:28
Speaker 3: in your shoes, or at least try to understand.
16:32
Speaker 2: How it feels for you to walk in those shoes.
16:36
Speaker 3: The way I do this is maybe kind of kind
16:40
Speaker 3: of annoying to some people, but I will ask the
16:43
Speaker 3: same question in a variety of ways to try to
16:47
Speaker 3: make sure that I'm fully understanding the responses that I'm given,
16:51
Speaker 3: or I will restate the answers that I'm given. I'll say, okay,
16:55
Speaker 3: so let me try. Let me tell you how I
17:00
Speaker 3: understand this. So what you just said is X, Y,
17:03
Speaker 3: and Z, and they'll say yeah, but also on point X,
17:09
Speaker 3: I meant this, And that conversation, that kind of restatement
17:13
Speaker 3: of what you think you've understood helps the other person
17:17
Speaker 3: fill in the blanks and helps you get a little
17:20
Speaker 3: bit closer to understanding their perspective, even if it's not
17:27
Speaker 3: being in their shoes. Right, there's a difference between empathy
17:30
Speaker 3: and sympathy, okay, and sometimes we just cannot cross the
17:33
Speaker 3: line because we are different humans, but we can at
17:39
Speaker 3: least try to understand the thought process.
17:42
Speaker 2: And again this bringing it back to.
17:44
Speaker 3: Art, this is one of those ways where we can
17:48
Speaker 3: use art as a buffer to have these conversations, to
17:52
Speaker 3: try to understand the other person, but keep a little
17:56
Speaker 3: bit of a distance from that heavily emotional you just
18:00
Speaker 3: don't understand me type of type of speak.
18:03
Speaker 1: And thanks for saving me as I rambled through the question.
18:06
Speaker 1: That's really helpful. And I think for our bioethics colleagues
18:09
Speaker 1: tuning in, they'll be able to see some of you
18:13
Speaker 1: a version of that kind of practice in the sort
18:16
Speaker 1: of talkback model and informed consent right to really understand,
18:20
Speaker 1: right as we teach medical students and physicians to really
18:23
Speaker 1: understand what a patient's saying, restating. And for those who
18:26
Speaker 1: do clinical ethics consultation, our clinical ethics colleagues, I'm sure
18:31
Speaker 1: will already be a fan of the role of art.
18:34
Speaker 1: And I know lots of folks use interpretations of artistic
18:38
Speaker 1: pieces as ways of helping with diagnostic skills, right, So
18:42
Speaker 1: the sort of critical distance, and then you might pick
18:45
Speaker 1: up things that you or hone skills that then you
18:47
Speaker 1: can use in other other spaces. So that's that's really helpful.
18:53
Speaker 1: I think you've made a good case for it. Now
18:56
Speaker 1: before we jump into some sort of other world and
18:58
Speaker 1: international things. Let me push you a little bit more
19:01
Speaker 1: on civil discourse. So this is an area of studying
19:04
Speaker 1: area of your work, and I think you've already laid
19:07
Speaker 1: out some of what's important in civil discourse when we
19:10
Speaker 1: have radical disagreements, or just the idea that even if
19:14
Speaker 1: you lived and grew up in the same household as someone,
19:17
Speaker 1: you're not that person. You don't have the experience the
19:19
Speaker 1: sort of sympathy empathy distinction which I am sympathetic to
19:25
Speaker 1: take a step back for folks who are less familiar
19:28
Speaker 1: with considerations of civil discourse, and we can sort of
19:31
Speaker 1: broadly frame this in what's going on in the world,
19:33
Speaker 1: and I'll push on that too, But what does civil discourse?
19:37
Speaker 1: When does it apply? When should it apply? If you've
19:40
Speaker 1: got to put your lawyer hat on and understand, that's
19:42
Speaker 1: good too, But help us start thinking about civil discourse
19:46
Speaker 1: in this age.
19:48
Speaker 3: I would say that civil discourse can be explained by
19:53
Speaker 3: very simply by just thinking of it as civilized discussion,
19:57
Speaker 3: which seems like it's a base.
20:00
Speaker 2: But we have lost a lot of.
20:02
Speaker 3: That in our current highly polarized, highly emotional world. So
20:07
Speaker 3: who does it apply to and when and how it should.
20:13
Speaker 3: It should apply to every conversation you have, whether it's
20:17
Speaker 3: a political discussion or just a conversation about I mean
20:20
Speaker 3: the you know, the weather or whatever.
20:22
Speaker 2: I mean, it's just if you if you.
20:25
Speaker 3: Are actually listening to the person with whom you are
20:29
Speaker 3: speaking and able to respond having actively listened, that is
20:34
Speaker 3: kind of a first step to civil discourse.
20:38
Speaker 2: I think it's actually.
20:39
Speaker 3: Something that we should in a sense be teaching. We
20:44
Speaker 3: don't need courses necessarily on civil discourse, but I think
20:48
Speaker 3: it needs to be built into some of the curricula
20:53
Speaker 3: that we see in universities, especially in bioethics or law.
20:59
Speaker 3: I mean, we have to be so clear about our
21:03
Speaker 3: own arguments as lawyers, and I think it would be
21:08
Speaker 3: very helpful if we actually had this name, you know,
21:11
Speaker 3: civil discourse, to have kind of a conversation about having
21:16
Speaker 3: this conversation. Right.
21:17
Speaker 2: It's again we're in that metal world.
21:19
Speaker 3: But I think that the way to start thinking of
21:23
Speaker 3: civil discourse is logical reasoning. So if we are having
21:29
Speaker 3: a discussion and we think of arguments as when you
21:32
Speaker 3: say it's a logical argument, we're not saying argument in
21:36
Speaker 3: the negative sense. It's actually just a walk logically through
21:42
Speaker 3: an idea leading to a conclusion, and that conclusion is
21:46
Speaker 3: your opinion, right, But when we hear people present their opinions,
21:51
Speaker 3: a lot of times it's conclusions without laying out those steps.
21:58
Speaker 3: Those you have the logical premisses that then lead you
22:01
Speaker 3: to the conclusion.
22:02
Speaker 2: That's what we need to see more of.
22:04
Speaker 3: We need to see the actual logical argument laid out,
22:08
Speaker 3: because that's the only way to really engage in these conversations.
22:12
Speaker 3: We know that there are and there are a lot
22:15
Speaker 3: of people in the middle, of course, but there are
22:17
Speaker 3: we see right now, two sides, very opposite opposing viewpoints
22:23
Speaker 3: to a lot of these social issues, and we keep
22:26
Speaker 3: hearing the conclusions, and what we need to hear is
22:30
Speaker 3: the actual argument that leads to those conclusions. Because what
22:35
Speaker 3: this does is then it allows us to actually have
22:38
Speaker 3: the conversation to try to understand the other perspective instead
22:41
Speaker 3: of just saying, oh, they're just I can't believe they
22:44
Speaker 3: think that, how could they?
22:45
Speaker 2: That's impot I mean, it's just ridiculous.
22:47
Speaker 3: Try to understand the logical reasoning behind that, and then
22:52
Speaker 3: it might be I oftentimes find that it's not actually
22:56
Speaker 3: the conclusion that we are so far apart on it's
23:01
Speaker 3: one of the premises that we disagree on. So if
23:05
Speaker 3: you have a logical argument, then you can point to
23:08
Speaker 3: premise too and say, oh no, that's you can't rely
23:12
Speaker 3: on that because that's not true. And that's the discussion
23:15
Speaker 3: that you then have. Because right now it seems in
23:18
Speaker 3: the world that we're stuck in conclusion land and that's
23:22
Speaker 3: why we haven't really made a whole lot of progress
23:24
Speaker 3: on some of these social issues.
23:26
Speaker 1: That's helpful we should have a third person on the
23:29
Speaker 1: podcast who sort of doesn't buy in the philosophical approaches
23:32
Speaker 1: at all. Because from a lawyer's perspective, from a philosopher's perspective,
23:35
Speaker 1: I can't talk about the former. I can say a
23:37
Speaker 1: little bit about the latter that sounds exactly right. And
23:40
Speaker 1: instances where folks might be talking past each other, it's
23:43
Speaker 1: not that they really disagree about the conclusions, as you said,
23:47
Speaker 1: it's that there's a different way of you know, it's
23:50
Speaker 1: the premise to problem. And for folks to listen to
23:53
Speaker 1: the podcast, you're called doctor Jeff boss Camp, the infectious
23:57
Speaker 1: disease pediatrician, was on a couple of weeks ago and
24:00
Speaker 1: sort of was making a very very strong case for
24:03
Speaker 1: the importance vaccinating children, especially with the measles outbreak and
24:07
Speaker 1: sort of looking concerns about future whooping cough outbreaks and others,
24:11
Speaker 1: and doctor boss Camp helpfully pointed out that it's not
24:14
Speaker 1: as though folks who are not getting their children vaccinated
24:19
Speaker 1: don't love their children, right, It's a different way. It's
24:22
Speaker 1: due to misinformation, disinformation and other sorts of historical challenges
24:29
Speaker 1: that some one might right, and so folks are going
24:30
Speaker 1: for the same conclusion, right, protect the kids. It's just well, yeah, yeah,
24:37
Speaker 1: it's a little bit more complicated and there's a lot
24:40
Speaker 1: more folks agree on. So this move for civil discourse
24:44
Speaker 1: and thinking about civil discourse, both as you said earlier,
24:47
Speaker 1: of the clarity and language and the sort of attention
24:49
Speaker 1: that you laid out in the previous answer about thinking
24:52
Speaker 1: and really understanding the experiences of folks. I mean, this
24:55
Speaker 1: seems like a roadmap potentially to resolving deep disagreement. And
25:01
Speaker 1: maybe I'm curious what you think on this, and then
25:03
Speaker 1: we'll get you on to a bigger topic ut whether folks,
25:06
Speaker 1: you suggested civil discourse maybe is something that could be
25:09
Speaker 1: taught in certain ways in law school and undergraduates. Any
25:12
Speaker 1: thought on medical school, do you think future physicians should
25:15
Speaker 1: be studying civil discourse?
25:18
Speaker 3: I would hope the ideal world for me would be
25:22
Speaker 3: that by the time they get to medical school, it's
25:24
Speaker 3: already part of their I mean, it's already there.
25:29
Speaker 2: They don't need to be taught anymore.
25:30
Speaker 3: But since we're we're kind of here and maybe starting
25:34
Speaker 3: a little bit from scratch. Yes, I do think that
25:37
Speaker 3: in any conversation that you know, look at this, what
25:41
Speaker 3: do you think of this? Then always probe that it. Again,
25:44
Speaker 3: it doesn't need to be Okay, this is a civil
25:47
Speaker 3: discourse class and we're going to go through you know,
25:50
Speaker 3: here's a roadmap for how you're supposed to analyze an argument.
25:54
Speaker 2: It's just kind of a part of it.
25:57
Speaker 3: Again, I think it should be really a part of
26:00
Speaker 3: our everyday life. We just have to get back to
26:03
Speaker 3: the idea that I mean, this used to be school
26:06
Speaker 3: in general. Right, You would have in a classroom that's
26:09
Speaker 3: you would have a discussion and it would be okay,
26:11
Speaker 3: well what do you think of this? And someone over
26:14
Speaker 3: here might think something different, and you started to have
26:16
Speaker 3: a conversation about that, and you respected the other person's perspective.
26:21
Speaker 3: And you asked questions, and I think that's just a
26:24
Speaker 3: natural part of learning.
26:26
Speaker 2: At any level.
26:28
Speaker 3: I think the thing that we need to start with
26:32
Speaker 3: is just getting back to, you know, let's remind ourselves
26:36
Speaker 3: of what logical reasoning is. Some people, I mean, we
26:39
Speaker 3: could even get into some people might say that, well,
26:42
Speaker 3: logic is man made. So but there are some things
26:45
Speaker 3: that we just need to accept in order to be
26:48
Speaker 3: able to proceed. So we say, okay, we understand that logic.
26:52
Speaker 3: You know, man made logic might have its limitations, but
26:55
Speaker 3: that's what we have to work with right now. So
26:58
Speaker 3: that's the framework within which we're going to work. But yeah,
27:02
Speaker 3: I mean in summit's it should just be a part
27:07
Speaker 3: of any time you make a statement, you should be.
27:11
Speaker 2: Able to back it up.
27:13
Speaker 1: For medical students, at least in undergraduate medical education, to
27:16
Speaker 1: be doing a bit more philosophy, both for these kinds
27:19
Speaker 1: of reasons, right clarity of thought, and also to help
27:23
Speaker 1: future physicians when they're interacting with patients with sort of
27:28
Speaker 1: very different values, very different conceptions, very different understandings of
27:32
Speaker 1: the basic facts of medical science. I think it would
27:36
Speaker 1: be useful there. And you, well, we should get on
27:39
Speaker 1: other things. But you offered. I think is one of
27:42
Speaker 1: the main objections to this kind of view, right, which
27:45
Speaker 1: is that, well, what if someone comes in with a
27:47
Speaker 1: different logic. So, I mean, at some point and this
27:51
Speaker 1: is not a philosophy seminar, and we can accept that
27:54
Speaker 1: facts are valuated in all of that, but at some
27:57
Speaker 1: point you have to start somewhere, and that's a challenge.
28:00
Speaker 1: They don't put it in the same way that you did,
28:02
Speaker 1: but that's a challenge that physicians who are you know,
28:06
Speaker 1: bump into our medical educators raise when they see out
28:10
Speaker 1: of HHS sort of claims about vaccines that just don't
28:15
Speaker 1: fit basic medical science, when they see claims about certain
28:20
Speaker 1: kinds of research being required that just doesn't fit the field,
28:26
Speaker 1: and things which there are no ways other than to
28:28
Speaker 1: say that they're fALS or they they're red herrings. So
28:31
Speaker 1: that's maybe that's the bigger question, which is, well, do
28:37
Speaker 1: you want to jump in on that or I'll give
28:38
Speaker 1: you the.
28:38
Speaker 3: Yeah, it is, You're right, you do have to start somewhere,
28:41
Speaker 3: and I would say yes, you can have those meta
28:44
Speaker 3: conversations about should we accept Boolean logic or you know,
28:50
Speaker 3: a different should we accept that the English language is
28:53
Speaker 3: the language that we're going to communicate in and you know,
28:57
Speaker 3: should we accept that there are going to be some ambiguities,
29:02
Speaker 3: and I mean, you have to start with something.
29:06
Speaker 2: And if you don't want to accept.
29:08
Speaker 3: Logical reasoning in the way that most of the United
29:13
Speaker 3: States has accepted logical reasoning, again, why it's not to
29:17
Speaker 3: say that that's wrong. It's not to say that, you know,
29:21
Speaker 3: maybe someone does come up with something they realize or
29:24
Speaker 3: they discover something that goes against everything.
29:27
Speaker 2: I mean, we've seen this in history and it.
29:29
Speaker 3: Turns out that everything was wrong and we have to
29:31
Speaker 3: kind of fix it. Okay, So it's we can't just
29:34
Speaker 3: jump straight to well, that's just going against everything that
29:37
Speaker 3: we know. But we do need to question, well, why
29:42
Speaker 3: are you saying that when we have all of this
29:46
Speaker 3: what appears to be.
29:50
Speaker 2: Verified information to go on.
29:53
Speaker 3: This is a big question in the I'll bring us
29:57
Speaker 3: back to the example of transgender issues. It's a big
30:00
Speaker 3: question about you know, chromosomal biology. And there's differences in
30:06
Speaker 3: opinions within the medical community about what we can even
30:10
Speaker 3: call biology at this point, right, So we do there
30:14
Speaker 3: are layers to these conversations. But if you want to
30:19
Speaker 3: create some kind of policy, we do have to have
30:23
Speaker 3: a starting point. We can have these philosophical discussions all
30:26
Speaker 3: day long and never come to a conclusion. But when
30:29
Speaker 3: we're dealing with these ethical issues, medical ethics, anything like that,
30:34
Speaker 3: we actually need to create policy. So we do have
30:36
Speaker 3: to come to some kind of conclusion. That doesn't mean
30:39
Speaker 3: that it's once we have a policy in place that
30:42
Speaker 3: it's not worth continuing to have the discussion over. But
30:47
Speaker 3: we cannot get so in our own way that we
30:51
Speaker 3: can't even agree on a starting point. We have to
30:53
Speaker 3: agree on a starting point and then say, Okay, maybe
30:57
Speaker 3: this isn't perfect, but we're both going to except that
31:00
Speaker 3: this is what we know right now, and without undoing
31:05
Speaker 3: the entire universe of knowledge, we're going to have to
31:09
Speaker 3: move on and have this conversation.
31:11
Speaker 1: That's I mean, that sounds exactly right, and I appreciate
31:15
Speaker 1: the you know, sort of leaving open the possibility for revision.
31:18
Speaker 1: So it's challenging to throw everything out that experts with
31:23
Speaker 1: relevant credentials and experience have sort of helped us awry
31:27
Speaker 1: that right yet still right in the image of Galileo
31:30
Speaker 1: walking back, if it where's the balca in the Jaesu
31:32
Speaker 1: or something? Right? So there are huge shifts we realized
31:36
Speaker 1: we were thinking about we sort of probably we're thinking
31:38
Speaker 1: about this in the wrong way, or even have a
31:40
Speaker 1: little sort of Cunian paradigm shifts. You need to leave
31:43
Speaker 1: open that space. But as you've said, you have to
31:46
Speaker 1: start somewhere. And the complications with some of these bodies
31:49
Speaker 1: of knowledge, how we're thinking about them in new ways,
31:52
Speaker 1: you still have to start somewhere. And it's I mean,
31:54
Speaker 1: the power of this answer, right is in the import
31:56
Speaker 1: for for everyone, right, for every day folks. We can
32:01
Speaker 1: do philosophy and bioethics all day, but at some point
32:04
Speaker 1: the policies impact real people. So let me I want
32:08
Speaker 1: to sort of move a little bit but saying sort
32:12
Speaker 1: of the same vein of what's going on broadly in
32:13
Speaker 1: the world, giving your international role, your working bioethics, and
32:18
Speaker 1: sort of help the audience and folks listen to this.
32:21
Speaker 1: We're fortunate folks listen to this podcast from all over.
32:23
Speaker 1: We have lots of medical students who listen to lots
32:26
Speaker 1: of folks in the US. From your international perspective, how
32:32
Speaker 1: I mean this is a big or your own perspective
32:34
Speaker 1: embedded within an international community. How are folks viewing the
32:39
Speaker 1: US's engagement in wars. Research cuts cuts to aid a
32:44
Speaker 1: lot of topics which may seem like they're outside of bioethics.
32:48
Speaker 1: So you did, I think, a really nice job highlighting
32:50
Speaker 1: the importance of bioethics for broader social considerations. But these
32:53
Speaker 1: are the articles at the top of leading bioethics journals.
32:56
Speaker 1: These are the topics people are thinking about. So with
32:58
Speaker 1: that law intro, how do you have I mean, and
33:03
Speaker 1: as you know, in terms of UNESCO and it's sort
33:06
Speaker 1: of educational arm of the UN, how are you and
33:09
Speaker 1: how are your colleagues thinking about these things?
33:11
Speaker 3: Yeah, this is as you said, it's a very big question.
33:16
Speaker 3: I'll take it in pieces here. So what I've noticed
33:21
Speaker 3: in the US I alluded to this before. In the
33:24
Speaker 3: US it's a little bit more concrete, I would say,
33:27
Speaker 3: And in Europe the bioethics in general can be viewed
33:33
Speaker 3: from a more philosophical perspective. But what I have noticed
33:37
Speaker 3: in the US, and this is not everywhere, this is
33:40
Speaker 3: a generalization. There's a lot of consensus among bioethicists right
33:46
Speaker 3: now in the United States. And this is kind of
33:48
Speaker 3: bioethicists in specific places within the United states and that consensus.
33:54
Speaker 3: If you read what they're putting out as committees or
33:58
Speaker 3: whatever it is, there is is a very overt political stance. Now,
34:04
Speaker 3: of course, these are political issues that we're dealing with
34:08
Speaker 3: as bioethicists, but this also goes back to having those
34:14
Speaker 3: sort of non agendered conversations and realizing, Okay, so I
34:20
Speaker 3: might have my own personal viewpoint on this this particular issue,
34:25
Speaker 3: but if I'm analyzing it from an outside bioethics perspective,
34:31
Speaker 3: I need to check those emotions. I need to keep
34:35
Speaker 3: them in check. I need to make sure that I'm
34:36
Speaker 3: not letting them cloud my logical argument.
34:40
Speaker 2: And what I'm going to do is also rely on.
34:42
Speaker 3: The other bioethicists in the room, and the other you know,
34:47
Speaker 3: medical professionals in the room and everyone. I mean, there's
34:49
Speaker 3: a lot of people who talk about these things. I'm
34:52
Speaker 3: going to rely on them to also help keep me
34:55
Speaker 3: in check by questioning my logical reasoning. That's why we
34:59
Speaker 3: have these conversations. And I think that because once we
35:03
Speaker 3: start having so much consensus, we have to question that
35:08
Speaker 3: because when when these are there's such divisive issues, and
35:12
Speaker 3: if everyone has the same viewpoint, are we really talking
35:16
Speaker 3: to a broad enough group of people, because what the
35:20
Speaker 3: consensus does then is it piles on UH and it
35:25
Speaker 3: leaves others who are who have opposing perspectives not free
35:31
Speaker 3: to contribute their own ideas because now think of just
35:35
Speaker 3: as on a practical level, the career path for a
35:39
Speaker 3: bioethicist is not very straightforward in the United States. It's
35:43
Speaker 3: kind of a new It's not a new field, right,
35:45
Speaker 3: We've we've had bioethics, it's just it's more popular now,
35:48
Speaker 3: but it's still you still it's a small community, and
35:53
Speaker 3: you're still dealing with the issues of networking, and your
35:58
Speaker 3: jobs are going to come from maybe people you know,
36:01
Speaker 3: and you maybe because there aren't so many options, you
36:05
Speaker 3: might still be a little bit.
36:06
Speaker 2: Afraid to be the voice of opposition.
36:10
Speaker 3: This is one of those problems that it's it's kind
36:13
Speaker 3: of this this wave of the politics are and the
36:18
Speaker 3: political questions are so emotional and so charged right now
36:23
Speaker 3: that it really is kind of overwhelming. We really need
36:28
Speaker 3: to make sure that we are talking with a variety
36:32
Speaker 3: of people. And this is where I think some of
36:35
Speaker 3: the you know, look at what we're doing in Europe,
36:37
Speaker 3: because they come from they bring a very different perspective
36:41
Speaker 3: what a lot of people don't realize, or they may
36:44
Speaker 3: just they may know and just forget or not think
36:47
Speaker 3: of it. When we when we are talking about issues
36:49
Speaker 3: like surrogacy, for example, we kind of in some ways
36:52
Speaker 3: in the United States take these things for granted, and
36:56
Speaker 3: some of it's become kind of normalized in some places.
37:00
Speaker 3: If you look at Europe, particularly Italy, surrogacy is not
37:06
Speaker 3: so much accepted. I will I will say, I'll put
37:08
Speaker 3: it that way. But so it's I mean, the perspective
37:13
Speaker 3: we kind of think we've accepted things and we think, oh, well,
37:16
Speaker 3: this is just normal, and we stop the questioning of
37:20
Speaker 3: it because it's just we've accepted it as part of
37:22
Speaker 3: our daily life.
37:24
Speaker 2: It's just it is what it is.
37:25
Speaker 3: But not always so we really need to seek out
37:28
Speaker 3: if we're seeing this consensus, we need to seek out
37:32
Speaker 3: the opposing viewpoint to either shore up our own argument
37:37
Speaker 3: or to really poke holes in our argument and then say, okay,
37:41
Speaker 3: so this is this is the point that we're missing,
37:44
Speaker 3: or this is the point where I looked at this
37:46
Speaker 3: subjectively instead of objectively. And this is again it goes
37:50
Speaker 3: to logical reasoning and civil discourse. Have those conversations where
37:54
Speaker 3: you don't have an agenda. You just want to hear
37:57
Speaker 3: from the other person. You don't want to tell them
37:59
Speaker 3: anything necessarily. You're not there to sell your ideas. You're
38:05
Speaker 3: there to listen actively. And I think this is one
38:12
Speaker 3: of the things that is important in my work with
38:15
Speaker 3: the UNESCO Chair in bioethics is getting those, as I
38:20
Speaker 3: said earlier, getting that variety of perspectives and doing it
38:24
Speaker 3: in a way where language is really not an issue.
38:26
Speaker 3: If I want to talk to someone who doesn't speak
38:28
Speaker 3: English and I don't speak their language, how can I
38:31
Speaker 3: do that? We can convene over art in some way, right,
38:36
Speaker 3: there are other ways of communicating and seeing responses, you know,
38:40
Speaker 3: body reactions, facial expressions, things like this.
38:45
Speaker 2: It may not be the ideal, but it's at least
38:48
Speaker 2: some place to.
38:49
Speaker 1: Start useful advice for future physicians and think about the
38:52
Speaker 1: importance of logic. And also, I mean, I think a
38:54
Speaker 1: nice or a helpful way to think about empathetic engagements
38:59
Speaker 1: with patients right coming there, and you know, sort of
39:01
Speaker 1: starting by listening. I see where it's sort of just
39:04
Speaker 1: about out of time. Kaitlyn, thank you so much for
39:07
Speaker 1: being here. I'll give you one more question on the
39:09
Speaker 1: way out, but the philosophy, the art, sort of considerations
39:12
Speaker 1: for bioethics international. I mean, there's just there's so much here.
39:15
Speaker 1: I will pest you in another time to get you
39:17
Speaker 1: back on. But for our listeners who enjoyed this, who
39:21
Speaker 1: learned something, who were interested in more, what's next for you?
39:24
Speaker 1: Is there a new book, a new class, new project.
39:27
Speaker 1: What can we appoint the listeners to who want to
39:30
Speaker 1: hear more?
39:31
Speaker 2: Yeah, all of that.
39:33
Speaker 3: Yes, I will be teaching at a variety of universities
39:38
Speaker 3: and institutes, but more available things that are more available
39:43
Speaker 3: to the public would be I'll be doing more speaking
39:48
Speaker 3: engagements in New York and the DC area. I will
39:54
Speaker 3: also be doing some things online. Unfortunately I can't quite
39:57
Speaker 3: announce specifically anything right now, but I can point you
40:00
Speaker 3: to my website.
40:01
Speaker 2: Caitlinpuccio dot com for updates.
40:03
Speaker 3: And I am also writing a book, which so the
40:07
Speaker 3: next time I come on maybe I'll have some info
40:11
Speaker 3: on where you can buy the book. But for now,
40:14
Speaker 3: it's an exploration on ethics policy in sports and fashion.
40:21
Speaker 3: And I will leave you with just one final thought,
40:24
Speaker 3: because I think this is important. You mentioned that a
40:26
Speaker 3: lot of medical students listen to this podcast, and I
40:29
Speaker 3: wanted to leave them with something just in case they
40:32
Speaker 3: can't make any of my talks.
40:34
Speaker 2: I would say that even.
40:35
Speaker 3: If you, as a medical student, are pursuing bioethics, either
40:40
Speaker 3: as an addition or something like that to complement your studies,
40:45
Speaker 3: even if you go through and get your PhD, as
40:49
Speaker 3: a bioethicist, I would always say, consider what makes you,
40:55
Speaker 3: as a physician more qualified than your patients or your
40:59
Speaker 3: colleagues to analyze ethical issues in a clinical ethics setting.
41:04
Speaker 3: And I would say that the real benefit of having
41:08
Speaker 3: a bioethics background is not necessarily that you're more qualified,
41:12
Speaker 3: or you have more letters after.
41:13
Speaker 2: Your name or anything like that.
41:16
Speaker 3: It's that it's the discipline thought process in analyzing these issues,
41:23
Speaker 3: and that I will be speaking more about that and
41:26
Speaker 3: civil discourse in my upcoming talks, and I think that's
41:30
Speaker 3: a key takeaway for medical students.
41:33
Speaker 1: That's great, that's great. On a perfect note to end
41:36
Speaker 1: on Caitlin, thank you so much.
41:38
Speaker 2: Thank You.
41:38
Speaker 1: Series is a production of the Health Ethics Lab, and
41:41
Speaker 1: I am grateful to colleagues in the Department of Medical Sciences,
41:44
Speaker 1: the IHS Library, and the Hackensack brity in the School
41:47
Speaker 1: of Medicine for making this collaboration possible. To learn more
41:51
Speaker 1: about our work or to engage with the series content,
41:53
Speaker 1: reach out to me Brian Pilkington at Brian dot Pilkington
41:57
Speaker 1: at HMHM