Informed Consent, Compelled Speech, and Promises to Pay Leigh E. Rich Abstract Book chapter for the edited volume The Twenty-First Century and Its Discontents examining legal and bioethical issues of informed consent, using examples from medical television dramas, philosopher Jürgen Habermas’ work on communicative action, and physician compelled speech laws. Ideally, informed consent is achieved […]
The bureaucratization of dehumanization is nothing new. Examples can be found in many eras and places and during both wartime and peace. Modern warfare, however, has meant innovations in the techniques of killing as well as the “framing” of those being killed, whether accomplished by separating the act through distance or technology or training soldiers (and the public) to “see” the enemy differently. The U.K. anthology series Black Mirror revisits this question in an episode titled “Men Against Fire,” a direct reference to S.L.A. Marshall’s controversial 1947 book of the same name, Men Against Fire: The Problem of Battle Command. Marshall observed the battlefield as a lonely and traumatic place and portrayed this isolation—and an individual’s moral upbringing—for soldiers’ hesitancy to fire on an enemy, even when ordered or in danger of losing their own lives. What was needed, according to Marshall, were “well-trained foot soldiers” freed from such burdens. While bureaucratic techniques that dehumanize or obscure the Other can be particularly “useful” in war, they are perhaps more insidious beyond the bounds of war. Primary examples include Jim Crow and eugenics, with reverberations of both still felt today. Examining the Black Mirror episode, not in relation to war or Marshall but when men are not “against fire,” sheds light on why health disparities and other inequities persist and the need for movements like Black Lives Matter or new waves of feminism. In civil society, the “problem of battle command” has been understood by certain policymakers and powerbrokers as a hesitancy to limit safety nets (“entitlements”) or reproductive and civil freedoms of the “undeserving” in the name of protecting the financial and corporeal health of the social body. Viewing “Men Against Fire” through examples such as eugenic thinking reveals how discriminatory rhetoric against poor, minority, and other stigmatized populations has lingered during peacetime through the twentieth and into the twenty-first century. Unlike Marshall’s conclusion, the answer to ending such policies and practices is rooted not in overcoming a sense of morality but engaging in it.
A common theme in detective stories is the introduction of an archenemy—often a serial killer who rivals the protagonist in intelligence and cunning but clearly lacks a moral center. This “two sides of the same coin” trope heightens the suspense in the storyline not only because the hero and the villain stand toe-to-toe (or brain-to-brain), especially in the final face-off, but also because the constructed symmetry suggests that there is but a fragile line between “genius” and “evil genius.” In the television series Hannibal, FBI consultant Will Graham and the cannibalistic psychiatrist Hannibal Lecter seem on the surface to fit these roles. Upon closer inspection, however, the two characters share little in common: While the latter is a medically-trained psychopath, impeccably poised but devoid of compassion, the former’s talent for catching killers stems from his “remarkably vivid imagination” and rare capacity for “[p]ure empathy.” This empathetic understanding, a combination of rational and emotive deduction, enables Graham to “see” what the FBI’s behavioral and forensic scientists cannot: a contextualized and embodied view of another’s actions rather than a reconstructed and technologized myopia of the “evidence that counts.” Interestingly, it also allows him to recognize each killer as human, not as some wholly distinct and monstrous “other.” In this way, it is instead the members of the FBI’s Behavioral Science Unit—inculcated with a “professional distance” that tends to transform all subjects into objects—that are “just like” Lecter. Thus, rather than merely another round of rivalry between hero and antihero, Hannibal calls into question the “objective distance” of professionalism and emphasizes that “genius” (revelation) is rooted not just in reason but also in emotional and subjective experience, exploring cultural fears of the fuzzy postmodern constructions of science and the self. While empathy poses certain real risks (from which Will Graham and the rest of us are not immune), Graham’s character and the Hannibal television program suggest that, rather than undermining understandings of the world or ourselves, an empathetic approach to discovery is more authentic and ethical because it leads to greater recognition of oneself and others—and who we are in relation with others (identity as co-constructed)—as well as greater capacity to take responsibility for our actions.
The twofold task in working out the question of American medicine By Leigh E. Rich and Jack Simmons “To the things themselves!” — Martin Heidegger, Sein und Zeit, 1927 “How can I tell what’s real and what’s not?” — Dr. Gregory House, “No Reason,” episode no. 224, May 23, 2006 In 1927, Martin Heidegger published […]