Nicomachean

10.09.12

Randy Cohen’s Three Favorite Ethicist Columns

The current public-radio host and former writer of the popular New York Times Magazine advice column shares three of his favorite posts, collected in the book Be Good.

A year and a half after leaving The New York Times Magazine, where he wrote the popular Ethicist column for about a dozen years, Randy Cohen says he’s not thinking about or reading his successor, Chuck Klosterman. “There’s nothing to be gained from following your ex around,” Cohen said. He’s busy with his new public-radio show, Person Place Thing, where interview subjects talk about a person, a place, and a thing important to them. Cohen will be talking to comedian and Daily Show correspondent John Hodgman at the 92YTribeca Wednesday night.

Many of Cohen’s Ethicist columns are collected in Be Good: How to Navigate the Ethics of Everything. Here are Cohen’s three favorites, with a brief explanation why:

1. Racist Patient

I like this one because it’s a clash of two goods. I admire that the physician is repulsed by the demand, but I liked it that he also allowed for the patient’s worth as a human being. He believed in doing what he could for the patient. It was admirable to wrestle with that, to put aside his own feelings, to seriously to consider this ridiculous request.

I am an anesthesiologist at a metropolitan hospital. A patient scheduled for an operation one day requested a female anesthesiologist, a request we were inclined to honor. When the anesthesiologist’s name was given to the patient, she wondered if the anesthesiologist was African American. When told that she was, the patient demanded a white anesthesiologist. It was 7:00 a.m., too early to contact hospital lawyers or the ethics board. What should we have done?

—D. W., Houston

I admire your inclination to put a patient at ease, but such requests are not exempt from moral scrutiny. If a patient told you she would be more emotionally prepared for surgery if she could go out to the hospital parking lot and drive over a couple of puppies, you would not lend her your car. Similarly, you should have rejected her racist request, explaining that your hospital does not consider race when making assignments. (If it did, the hospital could face legal claims from rejected anesthesiologists.)

You were wrong even to grant her request for a woman anesthesiologist. We rightly consent to some such demands but not to all and not unthinkingly. Most of us would accommodate a woman’s desire for a female gynecologist, deferring to the patient’s sexual modesty. (Although I hope that this customary justification, too, will pass away as we advance toward true gender equality.) But few would honor her request for a female clerk in the hospital gift shop. Because an anesthesiologist’s task does not intrude on sexual modesty, it was illegitimate to make sex a factor here. Surely other members of the surgical team were men but were not subject to patient veto.

UPDATE: Despite finding the patient’s request objectionable, the doctors granted it.

This column received some dispiriting responses when it first appeared, among them several emails from women asserting that a surgery patient’s being unclothed is in itself sufficient reason to preclude a male physician’s attending her. And not all came from religious fundamentalists, or at least from those who made overt references to faith. It would be lamentable indeed if such prudery moved us to a two-tiered, gender-segregated system of medical care.

Video screenshot

Even more alarming were the emails that dragged affirmative action into this discussion. Neither those readers nor the patient had the slightest idea if that African-American anesthesiologist had entered school via affirmative action or gotten a leg up as the son of an alum or was a child genius who completed med school at age 2. For all anybody knew, the replacement she demanded was an old white guy who, not having to vie with women or African Americans for a spot in med school, was less skilled. In any event, affirmative-action students tend to graduate at the same rate as their classmates and go on to lives of equal accomplishment.

2. Fur Is Murmurred

This was a challenging new wrinkle on a familiar question. The solution at first looked a lot like hypocrisy.

Cleaning out the closets of the house we inherited from my husband’s great aunt, we found several fur coats. It didn’t seem right to stuff them in the Goodwill bag, so we kept them. I would never buy a new fur, but is it wrong to wear an old one I didn’t pay for, as a parody of fashion-conscious women who do? (Does parody count if I’m the only one who knows it’s parody?) If it’s wrong to wear the furs, what should I do with them?

—Hattie Fletcher, Pittsburgh

You certainly should not wear a new fur. A case can be made for some exploitation of animals—as food or in important medical research—when there is no meaningful alternative, and when their suffering is minimized. But there is no justification for harming animals to produce something as frivolous as a fur coat. An old fur, however, is a different matter, although not for the reasons you offer.

It’s insignificant that the fur was a gift; the animals in pain don’t care who pays the bill. And you are rightly wary of the parody defense, too easily invoked by those who, for example, construct a racist parade float and when criticized say it’s satire. How does an ordinary fur suddenly become a parody of itself? Are the words “I Am Heartless and Vain” shaved into the back? Now a coat made of live weasels or raw beef …

A more persuasive rationale for keeping the fur is that an attic coat can be grandfathered in (great aunted in?). It already exists, you do no good by tossing it in the trash; you do no obvious harm by wearing it. Except this harm—appearing in fur announces that doing so is acceptable. You are voting with your feet (if the coat is much too long for you). Your wearing the great-aunt’s fur does not injure any animals, but it does injure us, it coarsens our sensibilities as it declares our values.

Thus, if we concede the moral high ground to the Fur Is Murder (or at least Wanton Cruelty) crowd, you may not wear any new fur, but you may use—discreetly, privately—an old fur, a found fur. Make it into fur socks or a bathroom rug or an unseen lining for a cloth coat—utility without propaganda. If everyone follows that rule, the fur trade withers.

UPDATE: When this column first ran, I invited readers to suggest other uses for this old fur; more than five hundred people did. The most frequent idea by far was to make that old fur into a teddy bear—a collectible, a fond memento of the great aunt, a toy kids love. Several websites list seamstresses who perform these coat-to-bear conversions professionally. This seems to meet my criteria for fur reuse—utility without propaganda—but does convey an odd message to the child cuddling that former coat (and former mink). Perhaps that’s why I’m uneasy, this smacks too much of taxidermy. My objection may be aesthetic not moral, but I can’t help wondering what materials these hobbyists would use to construct a baby doll.

The next most popular idea was to give old fur coats to the homeless, an altruistic act to be sure. However, if wearing fur endorses its use, then even the poor should not wear them. There is no shortage of wool or down or Thinsulate coats to be donated. And there is something redolent of crumbs-from-the-rich-man’s table about dressing legions of the desperately poor in ermine. (Although it may well deglamorize fur to distribute it to poor folks.)

Surprisingly, such gifts are acceptable to PETA; that organization has itself sent fur coats to earthquake victims in Iran and refugees in Afghanistan. Those who are put off by the thought of a war victim huddled in my imaginary Aunt Minna’s fox stole may be comforted to know that PETA also uses old fur coats in educational displays and for animal bedding. This last use is similarly endorsed by the Humane Society of the United States, which sends old furs to licensed wildlife rescuers who make nesting materials out of them for orphaned and injured animals.

Other oft-submitted suggestions: donate that old fur to a local theater company; make it into a pillow or fur throw; give it to a science teacher for static electricity lab work.

3. Adderall

It’s exhilarating to be wrong. It gives you a fresh way to see the question.

A friend and I will soon take the LSAT. His father, a psychiatrist, gave him Adderall to help him take the test. I asked my friend if he could share some with me, and he said that would be unethical. Is it? Isn’t his dad’s giving him the Adderall unethical?

—Name withheld, Austin, TX

Medical ethics does forbid a psychiatrist to prescribe drugs to a close family member, but there is no druggie’s code that bars his son from sharing ill-gotten pills. The more important question: is it ethical to use Adderall and the like not in response to some malady but to boost academic performance?

For you to take what some call “study drugs” may violate the law, endanger your health, and if those pills are ineffectual, waste your money, but doing so does not offend ethics, at least in some classrooms. If there were a safe, legal, and effective pill that let you learn French in a day, you’d be mad (fou!) to shun it. You do not forswear studying by electric light because Lincoln relied on his fireplace. You need not reject a learning aid merely because it comes in convenient chemical form. Many a student uses coffee to gain extra study hours.

Performance-enhancing drugs might give their users an unfair advantage over their unpilled peers. But academe does not exist on a level playing field. Deans, test-givers, and students themselves routinely accept greater inequities. Few who attend magnificent universities see this as an unethical edge over students at more modest colleges. Some students have parents who are lawyers, but nobody forbids those parents to help their kids learn. The equal-access problem would be solved if the health center handed out free Adderall to all. Until that utopia arrives, it might be heartening to realize that most students have easy, albeit illegal, access to these drugs.

Some foes of these drugs call them academic steroids, arguing that, as on the football field, those who decline to take them—and thus avoid the attendant health risks—cannot compete with those who do. Arguments supporting the use of such drugs would be more persuasive if a university were essentially a contest for grades; it is not.

Here is a more potent moral argument against these drugs: they undermine education itself and not just the drug-taker. This was what my daughter asserted when she was a student at a small liberal arts college. These are not so much study drugs as cramming drugs. They make you more adept at amassing facts but no more able to deeply engage with, for example, art or history. Also pernicious, by relying on rote memorization, you arrive at class unable to fully participate in the discussions that are central to learning, and thus fail in your duty to your fellow students, to your professors, to the academic community you voluntarily joined.

She’s right. And so I must amend my conclusion, there is no ethical barrier to taking such drugs in classes that rely on individual work—math, Latin—but you may not take them in classes where you are expected to interact with your fellow students—political science, literature. But to prep for the LSATs? Go nuts.

UPDATE: The letter writer acquired Adderall from someone other than her friend, but she didn’t like it—“it made me nervous”—and stopped taking it long before the LSAT.

From Be Good by Randy Cohen. Copyright © 2012 by Randy Cohen. Reprinted by permission of Chronicle Books.