Syllabus 2025

(stay tuned)

[The syllabus is subject to revision. Always consult the "Next" section in the upper right corner of our Home Page, for recent changes and other announcements.]

PHILOSOPHY 3345 Bioethics                                                                                

Spring 2025

4:20-5:45 pm, JUB 204

Dr. Phil Oliver, phil.oliver@mtsu.edu - 898-2050, 898-2907 (philosophy dept.), 525-7865.

OFFICE HOURS: TTh 11-12:30 & by appointment, MWF 4-5 by appt. via Zoom. James Union Building 300 (but check the message board on my door on "nice" days and at lunchtime, or maybe call first ). I answer emails mostly during office hours, never on weekends. Best way to secure a quick response: call or come in during office hours.

• Bioethics: The Basics (Campbell) ”...the word ‘bioethics’ just means the ethics of life…”

• Beyond Bioethics (Obasogie) “Bioethics’ traditional emphasis on individual interests such as doctor-patient relationships, informed consent, and personal autonomy is minimally helpful in confronting the social and political challenges posed by new human biotechnologies…”

• The Premonition (Lewis) "The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society..."

• WHAT WE OWE THE FUTURE (MacAskill) "argues for longtermism: that positively influencing the distant future is our time’s key moral priority. It’s not enough to reverse climate change or avert a pandemic. We must ensure that civilization would rebound if it collapsed; counter the end of moral progress; and prepare for a planet where the smartest beings are digital. If we make wise choices now, our grandchildren will thrive, knowing we did everything we could to give them a world full of justice, hope and beauty"... 

• THE CODE BREAKER: Jennifer Doudna, Gene Editing, and the Future of the Human Race (Isaacson) "we are entering a life-science revolution... Should we use our new evolution-hacking powers to make us less susceptible to viruses? ...Should we allow parents, if they can afford it, to enhance the height or muscles or IQ of their kids? After helping to discover CRISPR, Doudna became a leader in wrestling with these moral issues..."

• Each student will also choose and report on additional relevant texts pertaining to pandemics, public health, or some other issue the course raises, thus enabling us to extend our study of the field by “crowd-sourcing” many more of the crucial issues it raises.

==

IMPORTANT DATES Spring 2025

• Jan 21 – Classes Begin

• Feb 4 -- Select midterm report presentation topic & date

• Feb 13 --  Mid-term report presentations begin

• Mar 6 – Exam 1

• Mar 10-15 – Spring Break – No Classes

• Mar 31 – Select final report presentation topic & date

• Apr 1 – Final report presentations begin

• Apr 29 – Our Last Day of Class. Exam 2

• May 2  -- Final report blog post (final draft) due. Post earlier for feedback

• May 8  – Last Day of Term

• May 10  – Commencement (Days and Times TBD), Official Fall Graduation Date

• May 11  – Deadline for Submission of Final Grades, 11:59 p.m.

* Deadlines. Due dates are firm. Extensions are possible in the event of illness or some other unavoidable or extraordinary circumstance, but must first be authorized by me. jpo

JAN

21. Introductions. Post your response to these questions, interpreted any way you like: Who are you? Why are you here? What do you think Philosophy has to do with Bioethics? What ethical/philosophical issues related to the pandemic occur to you? Do you have an easily-summarized personal philosophy? (Maybe something short like Charlie Brown's sister Sally's?--"No!")

23 What is Bioethics? (Basics 1); Premonition Intro/prologue/1

28 Moral Theories (Basics 2); Premonition Premonition 2

30 Perspectives (Basics 3); Premonition 3

FEB

4 Clinical Ethics (Basics 4); Premonition 4 Select midterm report presentation topic & date: indicate your 1st and 2d choices for date and topic in the comments space below midterm report presentations.

6 Research (Basics 5); Premonition 5

11 Justice (Basics 6); Premonition 6; Assign midterm report topics 

13 Beyond Bioethics Foreword, Introduction, 1; Premonition 7. Midterm report presentations begin.

18 Beyond 2-3; Premonition 8 Midterm report presentations begin.

20  Beyond 4-6; Premonition 9

25 Beyond 7-8; Premonition 10 

27 Beyond 9-12; Premonition 11/epilogue

MAR

4 Beyond 13-15; Codebreaker Intro & Part One-The Origins of Life

6 EXAM 1

SPRING BREAK

18 Beyond 16-17; Codebreaker Part Two-CRISPR

20 Beyond 18-20; Codebreaker Part Three-Gene Editing

25 Beyond 21-22; Codebreaker Parts Four and Five-CRISPR in Action, Public Scientist

27 Beyond 23-27; Codebreaker Part Six-CRISPR Babies. Select final report presentation topic & date

APR

1 Beyond 28-31; Codebreaker Parts Seven, Eight-The Moral Questions, Dispatches from the Front. Final report presentations begin.

3 Beyond 32-34; Codebreaker Part Nine-Coronavirus.

8 Beyond 35-36; Future Part I-The Long View

10 Beyond 37-39; Future Part II-Trajectory Changes

15 Beyond 40-42; Future Part III-Safeguarding Civilisation

17 Beyond 43-50 Future Part IV-Assessing the End of the World

22 Beyond 51-54; Future Part V-Taking Action.

24 Final report presentations conclude

29  Last class. Exam 2 (NOTE: Exam 2  is not a "final exam," it is the exam covering material since Exam 1.)

MAY

2 Final blogposts due (post early draft for constructive feedback)

EXAMS. Two objective-format exams based on daily questions, each worth up to 25 points.

REPORTS. Midterm presentation), final presentation & related blog post (1,000+ words minimum). Worth up to 25 points each. Indicate your topic/date preferences in comments below "Report Presentations" post.

PARTICIPATION. Participation includes attendance, your full and attentive presence in class, and posts, comments (etc.) to our Bioethics site prior to each class. No points formally allotted, but steady participation earns strong consideration for a higher final grade. Hypothetically, for instance: say you earned a total of 88 points (of a possible 100) on the exams and reports. If you did not participate consistently and well, your course grade would be B+. If you did, it would be A. In other words, strong participation earns you EXTRA CREDIT. (So please don't ask, at the end of the semester, how to get it. This is how: participate.)

==

SCORECARDS. Because your professor is a baseball fan, we'll track participation with baseball scorecards adapted to the purpose. Come to class to get on 1st base. Post a pertinent comment or question for discussion prior to class to advance to 2d base. Same to move to 3d. To come home, post a pertinent research discovery, something we wouldn't have known from the day's assigned reading.

==

"Solvitur ambulando"... the art of walking

A NOTE ON THE BLOG POST FORMAT: final report blog posts should include appropriately-bloggish content: not just words, but also images, links, videos where relevant, etc.

==

Watch this space for updated info on the university's and our department's FREE tutoring service... and learn how to study, get help with understanding difficult course material,  receive better test grades, or simply improve your grade point average.  Tutoring is available in study skills and learning strategies that includes sessions on time management, notetaking, when and where to study, and memory principles.  Tutoring is also available in over 200 courses including biology, history, computer information systems, physics, math, psychology, chemistry, economics, recording industry, and many more.  The central location for tutoring is the Tutoring Spot, located in Walker Library, but is also conducted at various other campus sites.  For available tutoring opportunities, visit http://mtsu.edu/studentsuccess/tutoring.php#on .  For questions, call the Tutoring  Spot at 615-904-8014.

Dr. Cornelia Wills

Director of Student Success

Middle Tennessee State University

P. O. Box 500

Murfreesboro, TN 37132

Telephone:  615-898-5025

http://mtsu.edu/studentsuccess/index.php

==

Title IX

Students who believe they have been harassed, discriminated against or been the victim of sexual assault, dating violence, domestic violence or stalking should contact a Title IX/Deputy Coordinator at 615-898-2185 or 615-898- 2750 for assistance or review MTSU’s Title IX website for resources. http://www.mtsu.edu/titleix/

==

Writing Center

The Margaret H. Ordoubadian University Writing Center serves all MTSU students, from freshmen to PhD candidates, on writing from any discipline, and in any genre. [website...] We have a brand new  digital class visit, a brief introduction to the UWC, which can be embedded in any D2L shell for your students.  

Tutoring sessions begin August 24th, and this semester, students will have two choices for online writing support: ​

• ​Live Chat: students to use their mic and camera and meet tutors in real time to work on a shared document; 

• Document Drop: students upload their text and assignment sheet, identify specific feedback needs, and receive tutor feedback through email. 

​We also support writers through course-specific or assignment-specific workshops. The UWC administrative team has worked closely with faculty in diverse programs and departments, such as Biology, Anthropology, and Professional Studies, to create workshops and writing support for students in those courses. Please email Erica Cirillo-McCarthy, Director of the UWC, at erica.cirillo-mccarthy@mtsu.edu if you are interested in talking about ways the UWC can support writers in your class.  

Childhood Vaccination Rates Were Falling Even Before the Rise of R.F.K. Jr.

The declines began with the pandemic, well before routine vaccines became part of the national political conversation.

After years of holding steady, American vaccination rates against once-common childhood diseases have been dropping.

Nationwide, the rate of kindergartners with complete records for the measles vaccine declined from around 95 percent before the pandemic to under 93 percent last year, according to the Centers for Disease Control and Prevention. Immunization rates against polio, whooping cough and chickenpox fell similarly.

Average rates remain high, but those national figures mask far more precipitous drops in some states, counties and school districts.

In those areas, falling vaccination rates are creating new pockets of students no longer protected by herd immunity, the range considered high enough to stop an outbreak. For a community, an outbreak can be extremely disruptive. For children, measles and other once-common childhood diseases can lead to hospitalization and life-threatening complications...

https://www.nytimes.com/interactive/2025/01/13/upshot/vaccination-rates.html?smid=em-share

Ariel Dempsey

I discovered her, and this video, here:

 "...My favorite work in American philosophy is the twelve-volume collection of The Correspondence of William James. For me his landmark publications, The Principles of Psychology, The Varieties of Religious Experience, and Pragmatism etc., are like the studio photographs of his era; they preserve one moment in his thinking, carefully staged and curated for public viewing; but his letters are more akin to home movies, less polished and professional but also more revealing. Owing to their frequency and intimacy, they capture James’s philosophy in motion and, crucially, in context; the juxtapositions of his comments and ideas are frequently gossipy, humorous, and mundane but at the same time arrestingly profound.

In place of recommended reading, I’d like to propose some recommended viewing! I recently watched this video of a talk by James scholar Ariel Dempsey. She’s a medic and dancer who is currently carrying out research for her PhD on James’s ideas about living with uncertainty, with the aim of enriching medical approaches to end-of-life care. (Her focus on the difficulties of coping with uncertainty also, I’d suggest, has practical applications within the field of mental health more generally.)

She performs some of her own choreography as part of her presentation, and this type of embodied philosophical enactment is appealing on many levels, not least its valuable public engagement potential. In his essay on the “The Gospel of Relaxation,” James himself began unpacking the links between emotion, body and gesture, and his embedding of emotion and feeling into the project of philosophy is well known. It seems to me that there is much to be gained, in practice and pedagogy, from moving beyond text and brain-based conceptions of philosophy and into a realm of whole-body thinking." 

--Emma Sutton

https://american-philosophy.org/i-am-an-american-philosopher-emma-sutton/

And see her TEDTalk:

...

The World Is Falling Apart. Should I Scrap My Plans to Have Kids?

A hundred years ago, you would have been bringing a child into a country where perhaps a majority of people lived around or below the poverty line, where, as W.E.B. Du Bois wrote in 1926, "we continually have mobs fighting and doing unutterable things because at bottom, men are afraid of being unable to earn a respectable living," where stepping on a tack could prove fatal, where environmental regulation as we understand it hardly existed, where segregation was widely entrenched and reproductive rights were scarcely to be found. In the meantime, Stalin was consolidating his power in the U.S.S.R., Mussolini was eliminating forces of opposition in Italy and Hitler was rebuilding the Nazi Party in Germany. Still, people had kids, and so here you are, able to look back in horror at the way things used to be...

The Ethicist

https://www.nytimes.com/2024/12/20/magazine/family-planning-uncertain-times-ethics.html?smid=nytcore-ios-share&referringSource=articleShare

Next time

Covid-19 is responsible for the deaths of millions of people around the world, but researchers fear the next global outbreak could be even worse, making it vital that we start preparing for that unknown pathogen now.

https://www.threads.net/@newscientist/post/DEXOnaVum_h?xmt=AQGzLx4-rCVIP-LEZG3L6GbSXXHHbiNql5AZAMJY3EauUw

Mind cure

"...mind cure and the crop of pseudoscientific interventions that materialized contemporaneously (“hydropathies, diet fads, homeopathies, mesmerisms, hypnotisms”) were “acceptable neither to science nor to church,” as Meyer writes. Their unacceptability was precisely the point. Neurotics were tired of contending with a liberal Protestantism that called suffering congregants to feats of manly self-discipline, and they were no less tired of an impotent medical establishment bent on dismissing their problems as fictions.

Many doctors in the 1860s and ’70s were staunch materialists, unwilling to countenance the existence of diseases that left no detectable traces. Others understood “nervous disorders” as regrettable but inevitable by-products of modernity and its ceaseless exhaustions. In his 1881 treatise, American Nervousness, pioneering neurologist George Beard anticipated much of the self-help dialectic to come, identifying society as the problem and proposing personal improvement as the solution. “Confronted by an imbalance between two terms”—the self and civilization—“one could modify one or the other, or both,” writes Meyer. But not for a moment did [Beard] mean to be attacking civilization. He drew no romantic inferences. He had no political or social therapies to propose. In effect, Beard assumed that “modern civilization” was what it was; nothing was to be done about it.

In this tacit isolation of therapy from society, of health from politics, he was offering nineteenth-century individualism one of the major lines upon which it could fall back in its twentieth-century retreat. If neither physicians nor pastors could heal nervous people, patients would have to seek alternative sources of aid or learn to heal themselves. Paradoxically, they did both, often simultaneously. They discovered alternative sources of aid in mind cure—which promptly counseled them to fix themselves. The crankish cure-alls that flourished at the end of the century were an ingenious way to split the difference between their two nemeses, science and organized religion: mind cure and its brethren were precursors of the now-common claim to being “not religious but spiritual,” for they, too, straddled the growing schism between enchantment and Enlightenment, cloaking the consolations of religion in the sober mantle of scientific respectability. Here at last was that precious thing, license to believe in miracles without stanching the tides of Progress."

Everything is Too Small: https://a.co/fHaOfaQ

How to Repair the Planet? One Answer Might Be Hiding in Plain Sight.

We tend to look at environmental problems in isolation. A holistic approach would be more effective, a new report says.

Sometimes, human needs can make problems like climate change and biodiversity collapse seem insurmountable. The world still relies on fossil fuels that are dangerously heating the planet. People need to eat, but agriculture is a top driver of biodiversity loss.

But what if we're looking at those problems the wrong way? What if we tackled them as a whole, instead of individually?

A landmark assessment, commissioned by 147 countries and made public on Tuesday, offers the most comprehensive answer to date, examining the sometimes dizzying interconnections among biodiversity, climate change, food, water and health.

"Our current approaches to dealing with these crises have tended to be fragmented or siloed," said Paula Harrison, a co-chair of the assessment and an environmental scientist who focuses on land and water modeling at the UK Center for Ecology & Hydrology, a research organization. "That's led to inefficiencies and has often been counterproductive."
...

https://www.nytimes.com/2024/12/17/climate/biodiversity-climate-change-interconnections.html?unlocked_article_code=1.iE4.d22K.DrhnJ6y0rYq2&smid=em-share

The Gilded Age of Medicine Is Here

"...2024 was arguably the year that the mortal dangers of corporate medicine finally became undeniable and inescapable. A study published in JAMA found that, after hospitals were acquired by private-equity firms, Medicare patients were more likely to suffer falls and contract bloodstream infections; another study found that if private equity acquired a nursing home its residents became eleven per cent more likely to die. Although private-equity firms often argue that they infuse hospitals with capital, a recent analysis found that hospital assets tend to decrease after acquisition. Yet P.E. now oversees nearly a third of staffing in U.S. emergency departments and owns more than four hundred and fifty hospitals. In some of them, patients were "forced to sleep in hallways, and doctors who spoke out were threatened with termination," according to Jonathan Jones, a former president of the American Academy of Emergency Medicine.

Erin Fuse Brown, a professor at the Brown University School of Public Health, told me that private-equity firms have learned that they "don't have to make things better or make them more efficient. You can just change one small thing and make a ton more money." They are hardly the only corporations to learn this lesson. Increasingly, health insurers, private hospitals, and even nonprofits are behaving as though they aim first to extract revenue, and only second to care for people. Patients often are viewed less as humans in need of care than consumers who generate profit.

In 1873, Mark Twain co-wrote the novel "The Gilded Age: A Tale of Today," which satirized an era that was marked by inequality, greed, and moral decay but was painted in a veneer of abundance and progress. Industrialists made fortunes in oil, steel, and shipping even as millions suffered poverty and exploitation. Today, health care is where the money is. New technologies and treatments sustain the impression that patients have never been healthier, but corporations and conglomerates wield immense power at the expense of the people they're meant to serve. Welcome to the Gilded Age of medicine..."

https://www.newyorker.com/culture/2024-in-review/the-gilded-age-of-medicine-is-here

English heritage

That ubiquitous internet attribution to Ben Franklin of the line that beer is proof that God loves us is surely apocryphal.

"His (London) colleagues nicknamed him the Water-American because he refused to partake in the ubiquitous beer drinking: a pint before breakfast, with breakfast, after breakfast, with the midday meal, at six, and a last one before bed. (Franklin preferred Madeira.) Franklin also prided himself on healthy habits…"

— The Bookshop: A History of the American Bookstore by Evan Friss

Nobelists vs. rfk jr.

More than 75 Nobel Prize winners signed a letter urging senators not to confirm Robert F. Kennedy Jr. to lead the Department of Health and Human Services. The letter marks the first time in recent memory that Nobel laureates have banded together against a cabinet choice. https://nyti.ms/3ZVGD0t

https://www.threads.net/@nytimes/post/DDYfLHMJfBP?xmt=AQGz_JVaAzyTLs1rr8ONwjp0eyswfDQbK_U4lh0Gh7_Ruw

Atul Gawande on living longer/better

  

Atul Gawande, the assistant administrator for global health at the U.S. Agency for International Development, talks about how to live longer and better, with the New Yorker staff writer Dhruv Khullar.

Gawande's Being Mortal is excellent. He talked about it at Google:

 

Back in '25

 Returning Spring 2025

PHIL 3345, BIOETHICS 

T/Th 4:20 PM, James Union Building (JUB) 202

3 credit hours. Explores ethical issues arising from the practice of medical therapeutics, from the development of new biomedical technologies, and more largely from reflections on life’s meaning and prospects in the face of changing modalities of intervention fostered particularly by the various life sciences. Dr. Oliver

Supporting the philosophical study of bioethics, bio-medical ethics, biotechnology, and the future of life, at Middle Tennessee State University and beyond... "Keep your health, your splendid health. It is better than all the truths under the firmament." William James --Course blogsite, http://bioethjpo.blogspot.com/

TEXTS include-

• BIOETHICS: THE BASICS (Campbell) ”the word ‘bioethics’ just means the ethics of life”... 

• BEYOND BIOETHICS (Obasogie) “Bioethics’ traditional emphasis on individual interests such as doctor-patient relationships, informed consent, and personal autonomy is minimally helpful in confronting the social and political challenges posed by new human biotechnologies”... 

• THE PREMONITION (Lewis) "The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society"...

• THE CODE BREAKER: Jennifer Doudna, Gene Editing, and the Future of the Human Race (Isaacson) "we are entering a life-science revolution... Should we use our new evolution-hacking powers to make us less susceptible to viruses? ...Should we allow parents, if they can afford it, to enhance the height or muscles or IQ of their kids? After helping to discover CRISPR, Doudna became a leader in wrestling with these moral issues..." 

• WHAT WE OWE THE FUTURE (MacAskill) "argues for longtermism: that positively influencing the distant future is our time’s key moral priority. It’s not enough to reverse climate change or avert a pandemic. We must ensure that civilization would rebound if it collapsed; counter the end of moral progress; and prepare for a planet where the smartest beings are digital. If we make wise choices now, our grandchildren will thrive, knowing we did everything we could to give them a world full of justice, hope and beauty"...

For more info: phil.oliver@mtsu.edu

If My Dying Daughter Could Face Her Mortality, Why Couldn’t the Rest of Us?

… Recently, a friend of Orli's gave me a tremendous gift: the knowledge that Orli had tried to prepare herself. Four months before her death, Orli texted this friend to say she knew she would not survive. She believed she had two years left. "I'm going to die," she wrote. "But doesn't everyone? I just will die a little sooner than most. This is a great opportunity for me actually. Everyone's focused on the time they have left. They forgot to live."

That she could face what we could not is not entirely unusual. Some psychologists have pushed for allowing teens and young adults a role in determining not only the course of their care but also in how they live their days, and how they die. This population, I learned, has a strong sense of their own trajectory; they are known for trying to protect the emotional well-being of their caregivers.

Indeed, after she died, I found out that Orli had worried most about what would happen to us — Hana, Ian and me — if she were to leave. I offered her no reassurance. I didn't know these were her fears. I learned of them too late.

She and Ian spoke about death more than I did — what happens, where do we go, is there something more, will we ever see each other again? I wish I had been in those conversations. Still, I am comforted that they took place.

Everyone, even children, deserves the opportunity to sit with these questions at the end of life. It's not impossible. But to do so requires us to recognize: It's not sadness we should fear. It's regret.

https://www.nytimes.com/2024/11/25/opinion/children-cancer-grief.html?smid=nytcore-ios-share&referringSource=articleShare

Ethical theory

"This fall, I've been teaching Intro Ethics for the first time in years. It's a strange assignment, as though the students were previously feral and my task was to begin their moral education, age 18 to 22. Presumably, most were introduced to ethics already by their primary caregivers. At least, I hope they were.
There are difficult questions about what to teach in such a class and how. I once wrote about the risks of Intro Ethics, echoing Annette Baier's "Theory and Reflective Practices." "The obvious trouble with our contemporary attempts to use moral theory to guide action," she wrote, "is the lack of agreement on which theory to apply."
…
Kieran Setiya
https://open.substack.com/pub/ksetiya/p/intro-ethics?r=35ogp&utm_medium=ios

the ultimate thanks-giving

"I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure."

When the poetic neurologist Oliver Sacks learned that he was dying, he wrote something almost unbearably beautiful about the measure of living — the ultimate thanks-giving:

https://mailchi.mp/themarginalian/oliver-sacks-gratitude

A crisis of crises

"..,Crisis can be a powerful catalyst for shaping policy and improving society. But just like any such tool, it can be misused as easily as used.

If that lesson isn't new, it's very much worth reviewing now. The United States is in what can only be described as an epoch of crisis. There is no quarter of American life that has not been claimed by the term, from the planet (climate) to the Republic (democracy, migration, housing) to the deepest chambers of the human heart (loneliness, despair). In the future, if we survive that long, historians will marvel at either our capacity to endure so much hardship at once or our ability to label so many disparate problems with the same graying word. In the meantime, officials and policymakers — and, yes, journalists — ought to consider how they employ this term and why, and whether it's having the desired effect..."

https://www.nytimes.com/2024/11/21/opinion/public-health-crisis-america.html?smid=nytcore-ios-share&referringSource=articleShare

Problematic

The Road to Wisdom: On Truth, Science, Faith, and Trust By Francis S. Collins

“A recent cross-sectional study in two states, Ohio and Florida,37 showed that the rate of death in those states was strongly associated with political party affiliation—after May 2021, when vaccines were freely available to all adults, the death rate for Republican voters was 43 percent higher than for Democratic voters. The long echo of the negative public response to COVID-19 has led to greater resistance to all forms of vaccination, putting children at risk for diseases like measles and polio that had almost been eradicated in the developed world. This may be the most consequential example of distrust of science in modern history. This circumstance is utterly contrary to the way a person or a nation should respond to a threatening pandemic: political party should be set aside in favor of clearheaded and objective assessment of the facts. But with our current separation into divisive tribal communities, the opportunity for thoughtful considerations of options—for achieving wisdom—has mostly been lost. The consequences have been truly tragic.” ― Francis S. Collins, The Road to Wisdom: On Truth, Science, Faith, and Trust

A.I. Chatbots Defeated Doctors at Diagnosing Illness

A small study found ChatGPT outdid human physicians when assessing medical case histories, even when those doctors were using a chatbot.

Dr. Adam Rodman, an expert in internal medicine at Beth Israel Deaconess Medical Center in Boston, confidently expected that chatbots built to use artificial intelligence would help doctors diagnose illnesses.

He was wrong.

Instead, in a study Dr. Rodman helped design, doctors who were given ChatGPT-4 along with conventional resources did only slightly better than doctors who did not have access to the bot. And, to the researchers' surprise, ChatGPT alone outperformed the doctors.

"I was shocked," Dr. Rodman said.

The chatbot, from the company OpenAI, scored an average of 90 percent when diagnosing a medical condition from a case report and explaining its reasoning. Doctors randomly assigned to use the chatbot got an average score of 76 percent. Those randomly assigned not to use it had an average score of 74 percent.

The study showed more than just the chatbot's superior performance.

It unveiled doctors' sometimes unwavering belief in a diagnosis they made, even when a chatbot potentially suggests a better one... nyt

==

Readers respond https://www.nytimes.com/2024/12/01/opinion/ai-doctors-diagnosis.html?smid=nytcore-ios-share&referringSource=articleShare

health misinformation and political polarization

"I taught a course at Vanderbilt University on health misinformation and political polarization in 2022. My syllabus & readings are available on my website and unfortunately still highly relevant today. "

www.matthewfacciani.com/teaching MisinfoResearch

“If it kills me”

Clever dramatically-convergent portrayal of environmental activism & bioethics (long Covid, depression, mental illness), with a side of British humor…

https://www.bbc.co.uk/sounds/play/m0024w9s?partner=uk.co.bbc&origin=share-mobile

AI as philosophers' stone?

As American civic life has become increasingly shaped by algorithms, trust in government has plummeted. Is there any turning back?

"...In “The Techno-Optimist Manifesto,” posted last October, Marc Andreessen, the venture capitalist and notable Trump-Vance supporter, delivered a delusional account of human history as the triumph of the “techno-capital machine” over the constraints of nature. “We had a problem of isolation, so we invented the Internet,” Andreessen proclaimed, preposterously. The solution is at hand: “We believe Artificial Intelligence is our alchemy, our Philosopher’s Stone—we are literally making sand think.” This September, OpenAI’s Sam Altman posted an essay in which he argued that generative A.I. is “the most consequential fact about all of history so far,” and that humanity is on the cusp of solving every problem. “There are a lot of details we still have to figure out,” Altman wrote, unironically, “but it’s a mistake to get distracted by any particular challenge.” The following month, not to be outdone, Dario Amodei, the C.E.O. of Anthropic, a rival of OpenAI, published a blog post called “Machines of Loving Grace: How AI Could Transform the World for the Better,” in which he predicted that A.I. could lead, in five to ten years, to “the defeat of most diseases, the growth in biological and cognitive freedom, the lifting of billions of people out of poverty to share in the new technologies, a renaissance of liberal democracy and human rights”—developments that will happen so fast and be so overwhelming that many of us will be “literally moved to tears.” Someone will be crying. That much is true.

Having built an information infrastructure that classifies and divides humans and drives them to ideological extremes, these same people and corporations are now building machines that purport to undo the very damage they have caused, much in the same way that geoengineering schemes seek to address catastrophic climate by using the very logic and tools that created the problem. In a study funded in part by M.I.T.’s Generative AI Initiative and published in Science this fall, conspiracy-minded Americans were subjected to long exchanges with a deprogramming chatbot. “The treatment reduced participants’ belief in their chosen conspiracy theory by 20% on average,” the researchers concluded. They don’t seem to have bothered to establish control groups who might, for instance, have been asked to read articles and books, or—seemingly beyond the realm of imagination—converse with another human..." Jill Lepore

Best American Science and Nature Writing

 2021...2023...

Jennifer Doudna on gene-editing

The biochemist Jennifer Doudna—who won the Nobel Prize in Chemistry, in 2020—reveals a few books that she thinks best equip one to understand the promise and potential peril of the gene-editing revolution.

https://www.threads.net/@newyorkermag/post/DBM4Oo3hAiz?xmt=AQGzR8uWJUxEKH34B6UaClaVdllgDJY1CdCOjOFZ8mbw9Q

A teaching hospital

110425_a15729_g2048 JPEG Image · 340 KB

I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine.

As a young, idealistic medical student in the 2000s, I thought my future job as a doctor would always be safe from artificial intelligence.

At the time it was already clear that machines would eventually outperform humans at the technical side of medicine. Whenever I searched Google with a list of symptoms from a rare disease, for example, the same abstruse answer that I was struggling to memorize for exams reliably appeared within the first few results.

But I was certain that the other side of practicing medicine, the human side, would keep my job safe. This side requires compassion, empathy and clear communication between doctor and patient. As long as patients were still composed of flesh and blood, I figured, their doctors would need to be, too. The one thing I would always have over A.I. was my bedside manner.

When ChatGPT and other large language models appeared, however, I saw my job security go out the window...

https://www.nytimes.com/2024/10/05/opinion/ai-chatgpt-medicine-doctor.html?smid=nytcore-ios-share&referringSource=articleShare

Medical Gaslighting

By Ilana Jacqueline
Narrated by Lori Prince

Listen on Audible:
https://www.audible.com/pd/B0DFMX44S4?source_code=ASSORAP0511160006&share_location=pdp

How the World Eats

 @julianbaggini: https://www.instagram.com/reel/DAiKccAovql/?utm_source=ig_web_button_share_sheet&igsh=M2M0Y2JmOTAyOA==

Anti-Aging Enthusiasts Are Taking a Pill to Extend Their Lives. Will It Work?

…

"Let's see, taking something that's risky, that's going to have no benefits?" Dr. Dillin said. "I'll pass."

https://www.nytimes.com/2024/09/24/well/live/rapamycin-aging-longevity-benefits-risks.html?smid=nytcore-ios-share&referringSource=articleShare

Climate & health

The climate crisis is a health crisis.

The most effective action to slow and reverse ClimateChange is transitioning to renewable energy and moving away from fossil fuels.

Learn more 🔗bit.ly/3TFVSXs #UNGA79

Something’s Poisoning America’s Land. Farmers Fear ‘Forever’ Chemicals.

For decades, farmers across America have been encouraged by the federal government to spread municipal sewage on millions of acres of farmland as fertilizer. It was rich in nutrients, and it helped keep the sludge out of landfills.

But a growing body of research shows that this black sludge, made from the sewage that flows from homes and factories, can contain heavy concentrations of chemicals thought to increase the risk of certain types of cancer and to cause birth defects and developmental delays in children.

Known as "forever chemicals" because of their longevity, these toxic contaminants are now being detected, sometimes at high levels, on farmland across the country, including in Texas, Maine, Michigan, New York and Tennessee. In some cases the chemicals are suspected of sickening or killing livestock and are turning up in produce. Farmers are beginning to fear for their own health.

The national scale of farmland contamination by these chemicals — which are used in everything from microwave popcorn bags and firefighting gear to nonstick pans and stain-resistant carpets — is only now starting to become apparent. There are now lawsuits against providers of the fertilizer, as well as against the Environmental Protection Agency, alleging that the agency failed to regulate the chemicals, known as PFAS…

https://www.nytimes.com/2024/08/31/climate/pfas-fertilizer-sludge-farm.html?smid=nytcore-ios-share&referringSource=articleShare

No, Lyme disease is not an escaped military bioweapon, despite what conspiracy theorists say - The Washington Post

https://www.washingtonpost.com/health/no-lyme-diease-is-not-an-escaped-military-bioweapon-despite-what-conspiracy-theorists-say/2019/08/09/5bbd85fa-afe4-11e9-8e77-03b30bc29f64_story.html

No, Lyme disease is not an escaped military bioweapon, despite what conspiracy theorists say theconversation.com

Reasonable expectations (for a centenarian)

Maria Branyas Morera, World's Oldest Person, Dies at 117

Ms. Morera, who cultivated a following on social media as "Super Catalan Grandma," died peacefully in her sleep, her family said.

...Like many supercentenarians, Ms. Morera became the subject of scientific fascination. Her habits and lifestyle — and genetic makeup — have been studied in the hopes of understanding her longevity.

"What do you expect from life?" a doctor once asked her while retrieving blood samples for study, according to El País.

Ms. Morera, unmoved, answered simply: "Death."

https://www.nytimes.com/2024/08/20/world/europe/worlds-oldest-person-maria-branyas-dead.html?smid=em-share

We’re Applying Lessons From Covid to Bird Flu. That’s Not Good.

…Undeniably, the country is in a different place regarding the risks from Covid than it was two or three or four years ago, and it is perfectly justifiable that many Americans are less interested in hearing about Covid than they were then. Perhaps it is also natural to not want to hear about public health matters at all — the previous years were difficult and painful, after all. But to believe that means we should pass laws discouraging individuals from taking precautions, or to choose not to pursue surveillance measures to actually track the progress of a new disease threat, is a deeply pathological response to an experience of pandemic trauma, and one that implies it is more problematic to remind those around us of ongoing health risks than to take action to limit them. We seem to have memory-holed not just the suffering of Covid-19 but also the initial burst of inspiring if imperfect solidarity it produced, preferring instead to embrace the "bipartisan" indifference our pandemic tribalism ultimately yielded to. Thankfully, bird flu isn't making us pay for it — yet.

David Wallace-Wells

https://www.nytimes.com/2024/08/07/opinion/bird-flu-covid.html?smid=nytcore-ios-share&referringSource=articleShare

A Prescription for Physicians: Listen to the Patient’s Story

In "Telltale Hearts," a new memoir, Dr. Dean-David Schillinger traces the links between narrative and well-being.

...One of the chief complaints about physicians these days is that they don't have enough time and they don't really listen. So Dr. Schillinger, a primary care physician at Zuckerberg San Francisco General Hospital and Trauma Center, has written a book about the importance of patients' stories. He writes of the power of narrative to build trust that cuts through the barriers that often separate doctors and patients to ultimately improve care.

"What has increasingly been lost as we advance in our technologies, using electronic health records that make us look at the computer and not at the patient, and becoming more constrained from a time perspective, is the most important and common medical procedure — the medical interview," Dr. Schillinger said told The New York Times.

"A lot of people think that's the doctor peppering the patient with questions, but that's not really how it should go," he added. "It really should be about eliciting the patient's perspective on the experience and their social context."

Science is paramount, he said, but the patient's story is an essential complement. "It's when we separate the two that we get in trouble," Dr. Schillinger said. The book is about what he thinks of as "the alchemy of science and story."
...
https://www.nytimes.com/2024/08/03/health/schillinger-telltale-heart.html?smid=em-share