Tuesday, August 30, 2011

Information and Metaphysical Conclusions

I was struck by Kyle's post on Friday "Abortion, Rational Decision-Making, and Informed Consent", but it took me a while thinking it over to come to an explanation of exactly what I find wrong about it. Kyle is addressing the issue of "informed consent" laws which require a woman seeking an abortion to view an ultrasound of her baby or read an explanation of fetal development at the stage of pregnancy her child is at. He is concerned, however, that such laws miss the real moral point:
Catarina Dutilh Novaes explains her worry about some new laws requiring physicians to show a woman an ultrasound of the fetus and describe its status, organs and present activity before performing an abortion. She writes: “It does not take a lot of brain power to realize that what is construed here as ‘informed decision’ is in fact yet another maneuver to prevent abortions from taking place by ‘anthropomorphizing’ the fetus” and “it is of striking cruelty to submit a woman to this additional layer of emotional charge at such a difficult moment.” She’s right, I suspect, about the underlying motivation behind the laws and the suffering their practice would impose. If the legislators and activists pushing these laws recognize the suffering they may inflict, they clearly see it as justified, weighing, as they do, the vital status of the nascent life as greater than the emotional status of the expectant mother.
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There’s something to this. The information the physician is legally required to communicate by these new laws informs in a very limited way: it doesn’t provide evidence of personhood or a right to life or any such metaphysical or moral reality. The sight and description of the fetus may give the appearance of a human life worthy of respect, but, as pro-lifers note, appearance is not indicative of moral worth. An embryo doesn’t look like a human being, but that appearance doesn’t signify anything moral or metaphysical about it.

The woman, for having this information, is not in any better position to make a rational, ethical decision. It may cause her to “see” the nascent life as human, but it doesn’t offer her a rational basis for such a perception. Her consent is no more informed after seeing and hearing the physical status of the life within her, and so these new “informed consent” laws don’t achieve what they are supposedly designed to do.

There are places conducive to informing people about the nascent life’s stages of development and about what exactly, scientifically speaking, abortion does to that life. A high school health class, for example. There, the scientific information about the unborn life and abortion can be more thoroughly considered, and once fully understood, serve in other settings as a reference point for metaphysical and moral considerations. Consent to abortion should be informed, but the information these new laws require to be communicated does not on its own result in informed consent or provide an additional basis for a rational, ethical decision. Why? Because, by itself, appearance is not ethically relevant and can also be misleading.
Now on the basic point, I agree with Kyle: appearance is not moral worth. A person is not worthy of human dignity simply because someone looks at him or her and sees similarity. To say that would be to suggest the converse: that when someone looks at another and sees simply "other" he is justified in not treating that person with human dignity. For instance, one could imagine (though I think it is the far less likely option) a situation in which a woman is leaning against abortion because she thinks that the child inside her will look "just like a baby", she sees a fuzzy ultrasound of something that still looks like a tadpole on an umbilical cord, and she thinks, "Oh, that's all? It must not be a baby yet. I'll abort."  Clearly, in this case, the information would have led to the wrong conclusion.  An appearance of similarity or dissimilarity does not a person make.

At the same time, the suggestion that informed consent laws are a bad idea just rubs me the wrong way, not just from a pragmatic point of view but from a moral one, and when I have this kind of conflict between instinct and reason, I tend to poke at the issue until I come up with a reason why it is that the apparently reasonable explanation seems wrong to me.

Having gone through this poking exercise, I realized that the issue is that Kyle's argument seems to imply that there are two sets of information -- information which relates to personhood, and information which relates to other qualities (appearance, sound, texture, etc.) -- and that informed consent laws are problematic because they require that people be provided with the latter type of information (information about appearance) when the relevant question is one of personhood, and thus only information relating to whether the being in question is a person would be applicable to the decision being made.

This seems reasonable for a moment until you try to think what information is actually in the first set, the set of information which relates to personhood. And here lies the paradox: there is none.

As beings who are both physical and rational, we understand the metaphysical concept of "person", but the inputs which we can receive from the outside world (things which we might be informed of as "facts" via "informed consent") are all sensory inputs. We reach the conclusion metaphysical, "This other being is a person, just as I am a person," based on sensory information, not metaphysical information.

Famously, in the movie Juno the main character is persuaded not to have an abortion when her pro-life classmate tells her that her baby has fingernails. This detail is what humanizes the baby in Juno's mind and causes her to decide not to abort the baby. Responding to this example, Kyle says:
The scene in Juno shows the effectiveness of giving a description of the fetus in order to humanize it, and it’s good that she chose to keep the baby, but she didn’t exactly make an informed ethical decision. Whether or not her baby had fingernails is irrelevant to the morality of abortion. It doesn’t follow that because the baby had fingernails that it was a human being with a right to life that the law should protect, but acting as though this information about fingernails led to “informed consent” implies that it does.
At the literal level, of course, the attribute "having fingernails" is not something that makes a being a person. We would not say, "Man is an animal with fingernails." Nor, if a human being through some genetic deformity was born without fingernails would be conclude that that member of our species was not a "person" because he lacked fingernails.

And yet, it is invariably through these surface level details that information comes into our minds and allows us, eventually, to form enough of an understanding of something that we are able to form metaphysical conclusions about it.

Picture, if you will, that at this moment I were to head down to the local coffee shop, and there I found Kyle sitting at a table with a banana.

"Darwin," Kyle informs me. "This banana is actually a person. It's an intelligent space alien."

My first reaction, after ordering a triple espresso, would doubtless to be respond, "It doesn't look like an alien. It looks like a banana."

My statement would have been about appearance, and yet, it would be completely normal for me to form the metaphysical conclusion that the banana was not a person based on this appearance combined with my experience of other similarly looking fruits. If a moment later, the thing-that-looked-like-a-banana were to rise in the air and trace in glowing letters a refutation of Derrida's claim that apartheid in South Africa was a consequence of phonetic writing which, "by isolating and hypostasizing being, ... corrupts it into a quasi-ontological segregation" -- I would rapidly revise my conclusions since this would be behavior far more in keeping with my experience of persons than with my experience of bananas.

The fact is that we will invariably reach the metaphysical conclusion "this is a person" based on a grouping of non-metaphysical sensory inputs. A materialist approach would to be say that this means that metaphysical conclusions never follow from "the data" and thus should be abandoned. Since there is no specific, observable characteristic which I can say "this is what makes something a person", this approach would reject personhood as a useful concept.

I would argue, instead, that it is precisely because we are beings able to perceive metaphysical realities through our sense of reason that we are able to take in a number of pieces of sensory "information" about something outside of ourselves and use those pieces of information to reach a metaphysical conclusion. In the case of deciding whether the unborn child is a "person" in the moral sense, pieces of information which might be key would be: member of our species (human), has unique DNA different from mother than father, heart is beating, eyes have formed, moves spontaneously, etc. None of these pieces of information is metaphysical in import, and yet, from the combination of them all, many people would form the conclusion that the creature in question is "a human being".

Further, there is simply a visceral reaction to seeing someone. Recall the New York Times piece on "twin reduction" that was going around a few weeks ago:
One of Stone’s patients, a New York woman, was certain that she wanted to reduce from twins to a singleton. Her husband yielded because she would be the one carrying the pregnancy and would stay at home to raise them. They came up with a compromise. “I asked not to see any of the ultrasounds,” he said. “I didn’t want to have that image, the image of two. I didn’t want to torture myself. And I didn’t go in for the procedure either, because less is more for me.” His wife was relieved that her husband remained in the waiting room; she, too, didn’t want to deal with his feelings.
Kyle's is right in saying that appearance itself is not evidence of personhood, but he is wrong in saying that this means that an ultrasound would not form a piece of "information" which would lead to a more "informed consent" in regards to abortion. In the end, no piece of information is in and of itself evidence of personhood. And yet, it is through these incomplete clues, these pieces of information which do not themselves indicate personhood, that we know that anyone at all is a person -- indeed, that anyone at all exists.

14 comments:

  1. I definitely agree with your basic argument, but I want to point out something that bothered me about Kyle's post, and tagentially about yours. With the examples of "looks like a baby" and "has fingernails", I think it's quite obvious this is information in support of the personhood of the fetus. To complain that something (someone) that doesn't look like a baby, or doesn't have fingernails, may still be a person doesn't change this. To say that it does seems to me to be a case of denying the antecedent, or, relatedly, confusing necessary and sufficient conditions. We could certainly say "a living thing that looks like a baby is a person" without implying that not "looking like a baby" implies non-personhood - looking like a baby could easily be a sufficient but not necessary condition of personhood. Or, in logical terms, this is not a valid syllogism:
    Major Premise: If an organism looks like a baby, it's a person.
    Minor Premise: The embryo is an organism that does not look like a baby.
    Conclusion: The embryo is not a person.

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  2. David,

    Good point.

    That "looks like a baby" or "has fingernails" might spur one to taken on the belief that a baby is "a person", it's clearly invalid to slip these around the other way. (Though it's a fallacy that people indulge in frequently.)

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  3. I think Kyle is also missing an essential point, that is often missed on both sides of the discussion, that there is a huge body of people who aren't strictly "the fetus is a baby when it takes a breath" or "the embryo is a baby at conception" but are "the fetus is a baby when it has a heartbeat, organs, some other feature I identify". However they formed their metaphysical/ontological conclusion, the dividing line for *identifying* these characteristics are sense data. The informed consent part is not to have them reevaluate their entire metaphysical view in the OR, but inform them: this is where your fetus is currently at, how does this fit with your metaphysics?

    It seems like straightforward informed consent. People are informed about the size of their tumors and the dosages of their drugs, why shouldn't they be informed of the size and condition of their fetus?

    It seems like the guilt would be minimized this way, regardless of your choice.

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  4. I think the problem Kyle has is that she doesn't want anyone to think about the fetus at all.
    Most, even pro-choicers, intuit that any abortion kills . . . something. Ultrasound destroys the "it's just a bunch of cells" lie.

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  5. Dubitor,

    To be clear:

    - Kyle is male.
    - Kyle has been quite clear on multiple occasions that he believes that life begins at conception and that abortion is wrong.

    I think what he is attempting here is a misguided exercise in clear argumentation or fairness of some sort -- trying to encourage people to do the right thing for the right reasons rather than for the wrong reasons -- though clearly I think he's misguided in making this argument, and thus the post.

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  6. "I looked at what I am going to pay someone to remove" or "I am informed the basic facts about what is going to be removed" are both states which result in a more informed choice than lack of either one-- especially in these days of "clump of cells" and "fertilized egg" descriptions.

    It's far from being perfectly informed, but it's a start.

    Heck, I knew-- very intimately-- that a fetal animal is a living member of that species, and it's an absolute "duh" statement that a human is a person, but seeing my daughter for the first time still struck me. I could have rattled off a list of statistics, and seeing her little hand keeping the tech from getting a good face shot was still amazing.

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  7. Conclusion: Poetic understanding, and the intuiting of part to whole, are underesteemed among today's logicians and rationalists.

    It doesn't matter whether it's
    "fingernails" or "the same bloodtype as my little brother". It's really about the imagination seizing upon tiny elements of likeness to create sympathy. Elements which appeal to the senses are helpful to the imagination, which is why poets and artists generally do appeal to sense imagery. But it's really about what's invisible to the eye; the eye of the heart is opened by the eye of imagery.

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  8. Elements of unlikeness would be equally helpful. "This is the only redhead in your family", for example, would probably be an excellent imagination-opener.

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  9. As always, Darwin, I appreciate the feedback and critique. So as not to have the same discussion in several locations (I've responded a little at TAC), I'll limit myself here summarizing my complaint about the new additions to the informed consent laws.

    I’m all for ultrasounds before abortions being available and encouraged, and even publicly funded, but because they don’t necessarily achieve “informed consent,” could potentially achieve the opposite, potentially give the implication that looking human means being human, and because they can inflict psychological suffering (upon someone who’s already psychologically suffering), I’d rather not see them enforced by law with no exemptions. These ultrasounds can be helpful but also potentially harmful, and so I think it's best to use them, encourage them, but not legally require them.

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  10. Kyle,

    I've mostly responded to your more extensive comments at TAC, but I want to respond briefly to this comment because I think your summary actually brings what may be the key issue here into a bit more clarity. I'll repost at TAC to prevent fragmentation.

    Your first three points:
    because they don’t necessarily achieve “informed consent,” could potentially achieve the opposite, potentially give the implication that looking human means being human,
    strike me as very weak, because given a post-enlightenment (much less post-modern) understanding of sensation versus understanding this would essentially be an argument against every communicating anything to anyone even in the attempt to save an innocent person from suffering or death. (For instance, one could use the same argument to suggest concealing evidence that might keep an innocent person from being convicted of a capital crime: evidence is never unambiguous, it might be taken wrong by the jury, and it might give the mistaken impression that if this one piece of evidence were not convincing, then the accused was certainly guilty.)

    Thus, I can't help thinking that it is your last concern that is in fact the primary concern here: because they can inflict psychological suffering (upon someone who’s already psychologically suffering)

    This would fit both with your laudable capacity for empathy and with the quoted piece which serves as your jumping-off point in the post. It also underlines a weakness which I think we would agree it is important for pro-lifers to avoid: that of acting as if the only person worth worrying about is the unborn child and ignoring the concerns of the mother.

    At the same time, it seems to me that in this case you're applying a post-abortive mentality to the point in time before an abortion has occurred.

    Yes, a woman on the verge of having an abortion may well be suffering psychological pain, and showing her an ultrasound which makes more clear the gravity of what she is considering may make that pain more severe, but it seems to me that this needs to be weighed against that fact that at this point the pain which is realization may have the effect of helping her avoid the greater, longer pain and guilt of having caused the death of her child.

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  11. [continued...]
    God does not want us to suffer, and yet there are experiences which bring to us, naturally, suffering. When you put your hand on a hot stove burner, you feel pain because your body is trying to tell your brain, "Stop doing this!" When we experience pain as we do or prepare to do some evil action, this is a way in which all of nature attempts to scream out at us -- to stop us before we are forever someone who has done what we are about to do.

    I was struck by this strongly recently reading Bloodlands. There's a passage that quotes a letter that an Austrian policeman, sent to Belarus with the occupation forces in 1941, wrote home to his wife:
    "During the first try, my hand trembled a bit as I shot, but one gets used to it. By the tenth try I aimed calmly and shot surely at the many women, children and infants. I kept in mind that I have two infants at home, whom these hoards would treat just the same, if not worse." [I'm not going to quote the rest -- I don't want to give readers nightmares. This is from page 205.]

    You can hear there, in that long dead person's voice, the suffering. And then he overcomes the suffering, and you feel the icy touch of damnation setting in.

    If I could, by some means, reach back and require some extra moment of looking on his potential victims, some greater suffering, such that he would not fire those ten shots and acquire that familiarity -- become the person who had done those acts -- I would. Suffering of that kind, to that end, is the suffering of light breaking through darkness -- the suffering that saves us from ourselves.

    It is a false compassion to help people hide from themselves the horror of an act they may quickly do, and spend the rest of their lives regretting.

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  12. Kyle: On the psychological suffering: I think it can be taken both ways, though. Say, a woman, coming in for an abortion has little knowledge of embryology. She has an abortion because she imagines she is getting rid of a clump of cells. Later on, she voluntarily gets pregnant and sees ultrasounds of her new baby (and the tech informs her: here are the toes, here is the beating heart, etc). This causes her stress for an event the past which she has no way of influencing the outcome, and would have made a different choice had the information been presented to her. I think it is psychologically more difficult to deal with this pain later than before the decision is made. Unless we plan to have the woman *never* look at another ultrasound after her abortion, it seems to creating a situation with *more* psychological harm than less.

    Now, the other case is of a woman that even given this information would still decide on an abortion. Would the information be traumatic for her? Maybe, maybe not -- some pro-choicers are pretty informed on embryology and just don't consider it a human being or deserving of rights. They wouldn't be impressed by "your fetus has a heart" anymore than if someone told them "the cow we ate last night had a heart." OTOH, another woman might have such external pressures that they might need to consent to the abortion regardless of what is revealed in the ultrasound. This will be more traumatizing for her -- true. But she will feel that she is making a decision with more information, and will not feel lied to later down the line. The emotional baggage is all there in front of her, and she can start dealing with it the day after the abortion, instead of coming back to it years down the line, having every birth of future children tainted by the idea that she was lied to, etc.

    I think the idea of "amortizing" the possible psychological pain of the abortion to a future time when the woman is pregnant with a wanted baby is needlessly cruel and patronizing.

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  13. Ah, but here's the problem.

    What the "law" wants is for the mother to see she is ending a human life.

    The "law" should not allow her to end a human life.

    The contradiction will diminish any effect the informed consent laws have. They are basically saying, "We will not criminalize a serious wrong to another human being, but we want to criminalize you not seeing that you are doing it."

    If we allow a woman to kill a fetus or embryo it's a little odd to try to force her to know what she's doing when she does so. I realize the law is not one body, it comes from as many directions as there are legislators, but this is still a distorting focus.

    Now, a law that says an abortion practitioner must offer the information, clearly and openly and without prejudice -- that makes sense. The woman has the right to know what she's doing. But in a world where she's allowed to do it, she probably also has the right to remain in ignorance of the consequences of her actions if she so chooses.

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  14. Philosophical difference-- legality isn't morality, basically.

    It's no more of a mind-blower than the difference in the law between those who drink and drive (without hitting anyone) and those who drag their children across the road, getting one killed and another injured. (and endangering everyone else on that road)

    (I don't see how on earth one can justify "she's been punished enough" for a willful endangerment that killed ones child, while wanted to head-hunt for a willful endangerment that did not harm anyone. Subject is on my mind because of that poorly reported "hit and run victim's mother faces longer jail time than drunk driver" story. The legal maximum for what she was charged with was longer than the time he actually served.)

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