Can You Handle the Truth?

For a while, I thought motorcyclists looked menacing – many ride behind dark sunglasses on machines with modified mufflers, scaring the daylights out of others nearby.  I wondered if they were high while cruising on their monstrous noisemakers.  But it turns out that the most doped up hog was a cyclist.  He was so famous that there was literally a stamp (of approval) on his work uniform, and millions proudly paid to wear bracelets practically with his name on it.

Going from being worshipped (or thinking of himself) as a demi-god to being called a “pathological liar,” a “bully,” and a “manipulator” must hurt more than crashes, surgeries, and chemotherapies.  I couldn’t care less about this guy who made a living riding a bike.  Cheating was (literally) in his blood.  But still, should we take the moral high ground in wagging our fingers?   We have a professional sports system where one can win or lose millions in prizes and endorsement revenue, and sponsors could reap even higher returns on their investment when their athletes win.   With corporations cashing in from fans’ cheering, cheating on the massive scale and cover up can be expected.   Could we have handled the truth?

It also turns out that – gasp – lying is very common among mere mortals. Maybe that’s why the former head of the International Cycling Agency's anti-doping foundation said that if the cyclist were simply a “single, one-off liar,” or a “drug cheat,” he might have deserved a second chance after appropriate sanctions.  In one study, participants engaged in a recorded conversation with another stranger for 10 minutes.   Looking at the footage later, participants were amazed of the little lies that came out. In just 10 minutes, they told an average of 3 false things. 

Most people don’t start out cheating in egregious ways.  When we can cheat just a little bit, we may rationalize it.  But this grey zone can get us in trouble.  After we take one dishonest step, we become a slightly different person. And then we take another step, and another step. We gradually rationalize what we would once have considered to be unacceptable dishonesty.

We shut little kids’ mouths when they tell embarrassing truths, and they quickly learn that lying can get them out of trouble.  Adults insist that sometimes we need to lie for altruistic or utilitarian reasons.  My undergrad students would all say that they would lie to the Nazis to protect the Jews hiding in the cellar.  

Sure, philosophers are great at coming up with thought experiments to prove a point.  But the line between altruistic lies and self-serving lies isn’t all that clear in most cases.  I doubt that any lies I’ve ever told was necessary to save another person’s life.  Their ego, perhaps.  Or more likely, my own ego.  We are prone to fudge the truth and excuse our embellishments.  We hear what we want to hear, and we shun those who have the courage to tell the truth.  We even need protections for whistleblowers.  (If we were all willing to hear and investigate the truth, there wouldn’t be such a thing as whistleblowers.) 

So before we wag our fingers again, we may need to stop putting others in situations where they think they have to lie to us, or excuse our deceptions as simply white lies.  We benefit from a system where we can trust others, but that also demands that we all fulfill our responsibility in showing that we can handle and would deliver nothing but the truth.  

Image Sources:

Ponocchio’s bike; I’d lie less

 

The Status of the Loonie

No, I’m not talking about the value of the Canadian dollar (over parity!), but the American National Rifle Association’s (NRA) call for a national registry of the mentally ill after the Newtown shooting.   Resisting requests for stricter gun control, Wayne Lapierre from the NRA blamed gun violence on the inability of the National Instant Check System to “screen out one of those lunatics”.

The political battle on gun control has been debated extensively in recent weeks.   This brief post will focus on the simplistic clustering of people of various forms and levels of mental illness and the derogatory casting of these people as “lunatics” who require special monitoring.  Lapierre talked of “an unknown number of genuine monsters - people so deranged, so evil, so possessed by voices and driven by demons that no sane person can possibly ever comprehend them.”

Many people may doubt that they can ever comprehend Lapierre, who wants to put armed guards in schools.  (Columbine had armed guards.)  While I cringe at the ignorant slur, my concern is not about being politically correct.  My worry is that the demonization of a diverse group of people as deranged criminals-in-waiting may further discriminate and marginalize those in need of mental health services, and also lead to ineffective violence-prevention strategies.

Some point out that quite a few mass shooters in the last few years were mentally ill, even though the Newtown shooter’s alleged Asperger’s syndrome is a developmental disorder rather than mental illness, and it is not associated with violence.  Moreover, most people with exactly the same profiles as mass shooters do not commit violent crimes.  Making people with mental illness scapegoats ignore that mental illness describes a very broad range of conditions, ranging from depression, post-traumatic stress disorder, phobias, eating disorder, schizophrenia, border-line personality disorder, and more.  (Just imagine calling the survivors of the Newtown shooting, who may now suffer from PTSD, lunatics.) The type, intensity and duration of symptoms vary among people, but it is noteworthy that people with mental illness are more often victims of violence rather than perpetrators.   Patients with severe mental illness commit 5% of violent crimes, with the risks being higher for patients with schizophrenia and bipolar when other non-clinical or socio-environmental factors are at play.  So, most crimes are not committed by people with mental illness.  In fact, people with no mental disorder who abuse alcohol or drugs are reportedly nearly seven times as likely as those without substance abuse to commit violent acts.  Why don’t we return to prohibition? 

And while we are at it, why not also ban franchise sports, as riots often break out after soccer matches or hockey tournaments?  Things have been so much calmer in Vancouver during the NHL lockout.  Now we may need to brace ourselves once again…

Most homicides are carried out by outwardly normal people with access to deadly weapons in the grip of rage.  Certainly, mental health is a multi-dimensional public health issue, and we need to help families, schools, and the general public recognize potential signs of increasing disturbance and to provide access to treatments for those who experience such disturbance.  However, stigmatization and demonization most likely would discourage those who can benefit from seeking help.  It would also conveniently neglect the roles we all play in the culture of violence.  

A reader of an earlier blogpost said we should solve the world’s problems and move on.  So my questions for you are: how might we change the culture of violence?  And what would be some plausible ways to promote better understanding and treatment of people with mental illness?

Image Sources: Lunacy, Prohibition, Vancouver Riot

Did I Make the List?

Many of us live on lists, even when some of them don’t serve us well. The holidays brought out countless wish lists and shopping lists. Those addicted to the busy trap are proud of their never-ending to-do lists. Under the pressure of publish or peril, some of us in the academia love counting and recounting items on our publication and citation lists. And a few years ago there was a movie about bucket lists.

In recent years, however, instead of placing objects or goals on lists, we have been increasingly putting people on undisclosed lists. After 9/11, there have been concerns that the US government has expanded surveillance on anyone in the world, even people who are just passing through, or communicating everyday matters. People of certain religious affiliations, ethnic backgrounds, countries of birth, or political ideologies have filled various watch lists – some reportedly even got questioned or detained by the National Securities Agency (NSA) and the Federal Bureau of Investigation (FBI) without proper legal representation. While one list that I like when flying is the upgrade list (which I rarely get on – sigh), the no-fly list is probably the more populated one, even if less popular and largely impossible to get off.

In this watch-list culture, perhaps it should be no surprise that the American National Rifle Association (NRA) wanted a national database of “lunatics”. Sure, it’s ironic, as the group has always fought against a gun registry. Many who have been horrified by the recent Newtown tragedy and shocked by the group’s subsequent responses may wonder if the NRA members themselves would qualify for their desired list.

I will save the issues of lumping people with various forms and severities of mental illness together into one list and calling them “lunatics” for a later post. And many have already reported on various good reasons to have stricter domestic gun control and global arms trade, and to ensure that certain people do not handle or own firearms. What is worth noting here is that, while some are appalled by NRA’s potentially discriminatory suggestion, most states already require or authorize the use of mental health records for firearm background check, lapses in reporting notwithstanding.

The culture of violence and war in the US and around the world certainly requires change. As I ponder on that for another post, I wonder if people knew that the aforementioned health-record lists are already being shared, and if we were not aware of that, why it might be the case. Should we have such a list, and if so, who do you think should be on this list? What criteria do you think we should use to place people on the list, and what type of information should we include on each person? Are you concerned about privacy implications or misuse of information? Or do you trust that the government or parties with access to such data would only collect and use this information in appropriate ways? How would you balance the rights and limits to privacy? Or do you think that this list only affects people with mental illness, and if we don’t (think we) have one, we have nothing to worry about anyway? What about other lists that you may or may not even know about?

Image Sources:

The List; No-Fly List; Health Records Hacker

Disagreeing, in Private

“…It seems that some who say they are anti-consumerist are simply CHEAP! They don’t want to spend money on others. Then they turn around and tell you that they are anti-materialistic, and make it sound like they are better people than you…”, a friend wrote in an email after reading my last blog entry. The day prior, another friend wrote me about the same entry, commenting that gifting isn’t necessarily a materialistic thing. She enjoys “seeing the anticipation and excitement” in her kids’ faces when they rip apart the wrapping paper to find their favourite toys.

These are exactly the types of diverse responses that I would like to elicit and get the dialogue going. Interestingly, some friends who seemed to agree with me “liked” my post or put their comments on my Facebook page, whereas those who disagreed or questioned my position did it in a more private manner.

As I pondered over this, another friend encouraged me to blog about this. As a bioethicist, I’m often called upon to address the most distressing ethical dilemmas at the bedside. Many ethics consults are prompted by disagreements about what to do in a particular situation, such as whether we should remove life support for a patient in minimally conscious state, or use anti-psychotic drugs on patients and long-term care residents who allegedly display aggressive behaviour.

My friends weren’t looking for anonymity – they emailed me from their personal accounts. So I am curious: why may people be reluctant to air even thoughtful disagreements in public, especially when anonymous posting is an option? Is it because we worry that public disagreements are often seen as conflicts?

If people agreed all the time, I would be out of a job. And my goal for starting a blog about ethical issues in our daily lives certainly isn't to get agreements – my purpose is to engage in reflection and dialogues with others. So as many of us anticipate the excited faces of our loved ones opening presents we chose for them, do you think there is a difference between anti-consumerism and being cheap? And would you be willing to agree or disagree with me, in public? :)

Image Sources:

Agree to Disagree

Dialogue

Shop Till the End of Time

“Are you ready for the holidays?”, multiple people asked me in the last few days.

I tried, if getting ready means buying gifts and hoping that the world wouldn’t end before we show these special people how much we spent on them. The day after Black Friday, I was in a mall – a revelation that may shock those close to me.  It was, to use a friend’s favourite term, a ‘gong show’ there.

While consumerism was certainly in full display, was love in the (stale) air?  

A recent movie about how the characters were (not) preparing for the end of the world raised a question that people often ponder about but rarely act on: how would I live my remaining days if I knew the end was coming?  How would we show those we care about that we love them?  While the death rate for us mortal beings has always been 100% (!), when or how we will die is never quite certain, raising ethical and political questions about how we should prevent accidents, test genetic anomalies for life-restricting conditions, treat patients with various illnesses, and more.  I suppose having the whole world ending is different from you being the only one dying – with the former, you don’t need to worry about how your death may affect your loved ones.  But either way, is buying more presents the best way to show love while we are still around?  

Don't get me wrong.  I appreciate all the thoughts and efforts behind every gift people gave me.  I've also spent hours shopping for or making gifts for those I love.  But the gift of time is perhaps the scarcest and most treasured.  Its rarity is not surprising, given how many of us are addicted to the busy trap – me included.  But increasing consumption and the use of social media have not brought people closer to each other than simpler times.  If anything, the unrealistic expectations on what consumer goods can do in terms of relationships and happiness may have made people more stressed out and more isolated than ever.  

Oh, how far I have strayed since getting my undergraduate degree in marketing :).

Last week, on a day when I had to run back and forth between sites, I confirmed with our intra-hospital shuttle driver my return time.  When I stepped back into the van a couple hours later, he had a dark chocolate bar waiting for me.  He knew I often had to skip lunch to attend various meetings and consultations, and he picked it up for me while on his break.  That was only a few days after he gave me another snack so I had something to eat while rushing between meetings across facilities.  He kept emphasizing the low monetary value of the chocolate bar, but it was perhaps the most valuable gift I received on a hectic day when I lacked the same care and generosity that he exhibited.  

On the weekend, to celebrate our lives together, a friend gathered a few of us for a delicious home-cooked dinner.  We shared stories about our hopes and dreams, concerns about the state of affairs and atrocities in the world, the oddities of human relationships, and endless laughter.  No one was worried about the Mayan calendar myths taking us away from each other any time soon, but we were all living in the moment and treasuring each other’s company.  

And with their gifts of time and love, I am now ready for the holidays.

Image Sources:

(1) Black Friday

(2) Barbara Krueger, Untitled (I Shop, therefore I am), 1987

(3) Puppets of Consumerism