Justice Everywhere

a blog about philosophy in public affairs

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How The God Committee gets Organ Allocation and Xenotransplantation Wrong and Why it Matters

This is a guest post by Kailyn Price and Jacob Zionts. It discusses their thinking on some of the ethical dilemmas faced by organ transplant committees through the lens of The God Committee.

(Note: this post contains spoilers)


It is 2021 and Dr. Jordan Taylor (played by Julia Stiles) sighs relievedly as she sees the genetically modified pig heart that she has just transplanted into the chest of a baboon beat and come back to life. The apparently successful operation serves as the climax to Austin Stark’s The God Committee, a fast-paced medical drama that grapples with the ethics of transplant committees, xenotransplantation (cross-species transplantation), and benefit calculations.

Despite the achievement, the scene is haunted by Dr. Taylor and her transplant committee’s decision a decade earlier to accept a bribe from a suspiciously wealthy man whose adult son desperately needed a heart. Prior to learning of the twenty- something’s condition and prospect of a bribe, the committee had been coalescing around a decision between two other candidates: 1) a middle-aged Black man who struggled with bipolar disorder but is also a loving father of three daughters, and 2) a curmudgeonly 70-year-old white woman who demeans her nurses, has little extant family, and seems ambivalent about receiving the heart. The bribe required the committee to ignore the son’s typically disqualifying drug use and deprioritize the other candidates but, ultimately, funded the research that culminated in the pig-to-baboon heart transplant and enabled the hospital to care for more patients.

The God Committee wants its audience to walk away thinking that the ends justified the means—that the hard-nosed consequentialism of the committee and their willingness to shoo aside the more deontological and virtue-oriented constraints of standard bioethics were necessary to secure the greater good. But we don’t think that’s the right message to take home. In this post, we will explicate and reject both of the committee’s reasons for accepting the bribe: (1) saving the hospital and (2) securing xenotransplantation funding. In the end, we argue that (1) accepting the bribe undermines the committee’s ability to act in the best interest of the hospital’s patients; and (2) the film’s narrow focus on xenotransplantation occludes the upstream causes of heart failure that are imminently targetable with status quo technologies and, critically, have the upshot of positively interacting with the demands of racial, environmental, and animal justice.

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Allowing fossil-fuel advertising is harmful and irresponsible

John Kenneth Galbraith, in his classic The Affluent Society (1952) formulated a powerful argument he called the “dependence effect.” In a nutshell, the idea is that capitalist societies create wants in individuals in order to then satisfy them. Perhaps the central tool in this process is advertising. Galbraith suggested that the additional wants generated through advertising might not even lead to additional welfare. People’s level of preference satisfaction before being exposed to advertising can be just as high as after the exposure. Viewed from his angle, advertising is wasteful from a societal perspective, because the costs involved do not generate any tangible benefits. The reason firms engage in it is solely to secure more market share than their competitors.

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Self-control and socio-economic disadvantage: trickier than it seems

In social psychology, there is a small industry for articles reporting positive correlations between measures of self-control and various measures of socio-economic status and achievement. For example, Tangney, Baumeister and Boone (2008) found that self-control, measured on a self-report scale they devised, is correlated with better grades, somatic and mental health, and stable social relationships such as marriage. Moffitt et al. (2011) conducted a longitudinal study that followed children who had participated in the Mischel “marshmallow tests” to the age of 32 years old, and found childhood performance in that delayed gratification assignment to be correlated with measures of health and economic success, interpersonal adjustment, and  with criminal justice outcomes, even after controlling for childhood socio-economic factors.

Studies like these have been widely publicised, and the message in popular science media often leads with the idea that self-control is a stable trait that some have, some don’t. The ones who were dealt a losing hand in self-control got a losing hand overall, ending up with poor health, poverty, unstable relationships, and crime not out of ill will, but because they simply can’t hold it together. In short, the causal arrow goes from poor self-control to socioeconomic disadvantage.

This line of thinking has received plenty of criticism. Some have pointed out that the studies have been designed from a perspective assuming a middle-class lifestyle, and that self-control may not be as adaptive for people from all backgrounds.

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An interview with Albert Dzur (Beyond the Ivory Tower series)

This is the latest interview in our Beyond the Ivory Tower series, a conversation between Lisa Herzog and Albert Dzur

Albert Dzur is Distinguished Research Professor at Bowling Green State University, where his work focuses on citizen participation and power-sharing in criminal justice, healthcare, public administration and education. 

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Putting a Price on War

This is a guest post by Stanislas Richard. Stan is a research fellow at the Dr. Rachelle Bascara Foundation and is visiting at the Central European University. The post discusses his thoughts on the role of enticements to desert could play in war.


Should we pay soldiers to desert? Should we, for instance, give financial incentives to the Russian soldiers currently invading Ukraine to lay down arms? And what role should such Enticements to Desert (ED) play in peacekeeping and de-escalation policy? This post sketches some answers to these questions.

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Should we deprioritize grades? Or not grade at all?

 

A snippet of a 19th century report card

If you have any experience teaching, you likely have experience grading. Grades are often considered an important part of teaching, for example because they are thought to motivate students. However, while grading, ranking and classifying has become the norm in many places (a development which only really kicked off in the late 19th century), many teachers are trying to move away from crude metrics. Some even go as far as doing away with grades completely. For this post in our series on teaching philosophy, Justice Everywhere spoke to Dr Marcus Schultz-Bergin (Cleveland State University), about his attempts to deprioritize grading and his experience with going completely gradeless in one Philosophy of Law course. He has detailed his experience on his blog, and a version of his reflections on gradeless teaching has also been published in a new book about “ungrading”.

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matches standing upright, some burnt others intact

Fatigue and the need for a social energy policy

This month we are publishing a series of posts on the topic of fatigue. Two years after the outbreak of the Covid-19 pandemic, constant fatigue characterises the lives of too many of us. Here we think about some of the political and social consequences of fatigue. In this first final post Zsuzsanna Chappell writes about the political consequences of physical fatigue.


Fatigue is semi-invisible; it fades into the background of a life we take for granted. Yet both its social and individual consequences are far-reaching, making it exactly the kind of topic that social and political philosophers can and should engage with. This is because persistent fatigue not only saps individual quality of life, but also helps to maintain existing patterns of marginalisation and exclusion.

The biggest obstacle to organising a series of blog posts on fatigue has been fatigue itself. Some of those who have offered to write posts have had to bow out, with one potential contributor signed off work with burnout. Others have told me ruefully that they think the topic is important, but that they are too tired or overwhelmed to write anything. I am finishing this post a week late, still exhausted by recovering from a covid infection. This is what makes fatigue such an invidious and little discussed problem. We simply do not have the energy to talk or write about it. The positive response to my suggestion for this blog series is not the only encouraging sign that fatigue might yet to be taken seriously as a political and philosophical problem. Just as I was finishing this essay, Jonathan White published his own essay on Aeon highlighting the injustice of sleep inequality.

Letters spelling "happy burnout" next to half-eaten cake

In our society fatigue is fetishised and individualised. Certain form of fatigue, for example overwork in professional jobs, is held up as an ideal, a measure of hard work and success. For a while, using make-up to draw under-eye circles became fashionable, as if even those who were not yet sufficiently exhausted (or their skin did not show it) also appealed to classic signs of fatigue as a badge of honour. The source of fatigue appears to lie in individual choices not in social structures: the choice to take a job, the choice to have a baby, a choice to stay up late, and so on. Solutions to fatigue are also individualised: practice sleep hygiene, change your life, take vitamin supplements, eat a balanced diet. Just as in the case of loneliness or healthism (the idea that individuals are primarily responsible for their own health), this is a misleading picture of our world. We are of course able to make meaningful changes to our lives, and not binge watching tv series until late at night may be one. But this ignores the deeper patterns that lead to true fatigue as opposed to temporary tiredness.

Work patterns out of synch with our needs for sleep can lead to what Jonathan White calls circadian injustice. This is especially evident in the case of people who work night shifts or work at irregular, unpredictable times. Poor sleep is also linked to an increased likelihood of self-harm and suicidal thinking. Overwork and a lack of sleep have made meth a workers’ drug in parts of Europe, enabling people to get through grueling 18-hour shifts on building sites or as cleaners. This is a cycle documentary film-maker Barbora Benesova portrays movingly in her short film about Lenka, a Czech woman who relies on drugs to be able to both work and care for her elderly parents and their small farm. “[I]t was clear to me that she wasn’t just choosing to stay on meth because it was a comfort in a lonely and isolated life, but because it was central to it. She carried a lot of responsibility and relied on meth to get by on barely any sleep.”

Physical fatigue also characterises many chronic illnesses and disabilities. The phenomenology of this kind of persistent fatigue is hard to grasp for those who have not experienced it, making it all to easy to dismiss. This fatigue stems from a mixture of low energy, a need for meticulous planning to work around everyday obstacles, the constant uncertainties surrounding managing one’s condition (am I in enough pain or depressed enough to take another pill or see a doctor?) and more often than not, poor sleep. The spoon theory is frequently used to explain the daily struggle it takes to balance one’s energy. It illustrates visually how we all start our day with only a limited amount of energy (spoons) and every activity costs a set amount of energy (spoons). Some people have so many spoons they have some left over at the end of the day. Many others, living with disabilities or chronic illness, need to carefully calculate how they will use their available energy.

As useful as it is, the spoon theory remains largely individualistic. It is up to the individual to decide how they will use their spoons. But is this likely when outside demands crop up all the time without notice? (The “fork theory” works better for these.) Why is it so rarely acknowledged that managing all those spoons costs a spoon itself, thus leading to an even greater deficit of spoons compared to able-bodied people? And why is it that people always only use up their spoons, they are rarely given any by those who have more than enough themselves?Recommendations for managing energy often include things like moderate exercise or mindfulness meditation. Meanwhile, after over 150 years of persistent lack of benefit, NICE have finally abandoned graded exercise as one of their clinical recommendations for chronic fatigue syndrome. Just as not binge watching tv until the early hours of the morning, these individualistic solutions only offer marginal benefits. Thus, while the “spoons” framework acknowledges that some people cannot get as much done in a day as others, it ignores the fact that care and support from others could lead to greater empowerment and flourishing.

While the extra mental load and emotional labour experienced by women is now frequently acknowledged, that of other marginalised groups is still too often neglected. The need for managing every penny for people living in poverty. The need to consider whether a racist comment is worth fighting. The need for disabled people to endlessly plan ahead. (Will there be step-free access?) The research fatigue experienced by small populations of marginalised people who are called on over and over again to report on their experience in studies.

In a political culture that relies on individuals to exercise their political rights, fatigue will reinforce existing patterns of privilege. Because fatigued people will not have the energy for protest, activism or democratic deliberation. While this applies both to those who have to work long hours for low wages just to make ends meet and professionals for whom long hours have become the cultural norm, the impact on these two groups could not be more different. That is because most people who work in professional, high status jobs do not need to do the political work to make their views heard. Our social and political organisation is for the most part already weighted in their favour – in other words, they are already holders of social privilege. Politicians, bureaucrats and other influential people are likely to be more like them socially, thus representing them better in political life. Those on the other end of the spectrum, living a reality of poverty and low-paid, low-status jobs, do not benefit from the same social privileges. Political organisation in order to overcome marginalisation is beyond their reach due to a lack of time and a lack of energy.

matches standing upright, some burnt others intactThe picture is just as bleak when it come to other marginalised groups. Political activism often presents an unaffordable cost. Yet, it does even more than that. It exacerbates the costs of information overload: those who are already tired will be less able to sort through the torrent of information available, making it easier to arrive at poorly reasoned conclusions. A lack of energy for meaningful political deliberation might lead people to either withdraw or engage in poor quality slanging matches on social media. After which it is even easier to dismiss the points of view of those (exhausted) people.

All this should illustrate the urgency of another, social energy policy. It is not enough to think about green energy and gas pipelines. We also need to make sure that everyone in our society has the energy both for personal flourishing and for social and political participation. This kind of energy policy asks us to see how we can care for and help others, not only as individuals, but more importantly through creating social structures that allow everyone to lead a sustainable life.


Photos by Nataliya Vaitkevich

How to kill a democracy in 10 easy steps (spoiler alert: exhaust your citizens)

This month we will be publishing a series of posts on the topic of fatigue. Two years after the outbreak of the Covid-19 pandemic, constant fatigue characterises the lives of too many of us. Here we think about some of the political and social consequences of fatigue. In this first post, Lisa Herzog writes about the dangers of fatigue for democracy.


How to kill a democracy in 10 easy steps
(spoiler alert: exhaust your citizens)

1) Make sure people work hard, so that there is time for little else in their lives. For the poor, that’s simple: low wages mean more hours. For the rich, make sure people desperate seek status. Let them think that to be respectable, they need to have an expensive house, an expensive car, that fancy holiday far away. By the way: don’t allow long holidays. It helps if people think that their God dislikes idleness. Time spent working is time not spent on politics!

2) Deny childcare. In fact, deny any form of support, for any form of care! It’s better for children to be with their mothers, isn’t it? Make childcare so expensive that people understand that. And for the elderly, it’s so much better if they are looked after by family members! Make sure any affordable homes for the elderly are just gross – put them in ugly concrete buildings with leaking roofs, somewhere near motorways. Time spent caring for children and the elderly is time not spent protesting.

3) Make all forms as complicated as possible. No matter whether it’s taxes or health insurance or an application for a driving license. You can rely on businesses to help you with this: let them include pages and pages to prevent liability. Keep people anxious about making mistakes in forms, so they will spend more time on them – that’s time they won’t spend calling their representatives!

4) Divide people into ideological camps early on. Make education competitive, so that people internalize that competitive gaze onto others that undermines solidarity. Keep them busy with competitive bickering in all areas of life, to the point of exhaustion. That will distract them from any questions of how the system should change!

5) Provide distraction. Endless, inexhaustible distraction, of the kind that makes people spend their free time in that strange zone where you can switch off from work, but not really relax. You wouldn’t want people to come to work truly rested and with fresh ideas, let alone an urge to ask deeper questions, would you? If you give them too much time to think, they just realize how shitty their working conditions are. You friends, the business owners, wouldn’t like that!

6) Abolish all institutions to which people could turn for help. Even better: convince them that it’s shameful to turn to them. Consumer associations, tenants’ associations, unions – those are socialist institutions, for losers not winners! Winners fight only for themselves! Don’t tell them that fighting only for themselves will just leave them more exhausted. For you, it means: divide and conquer!

7) You can do more to divide and conquer. Reduce social contact at work. Or better, abolish the workplace. Give people gig work, or home office (didn’t they want that “flexibility” all along?). They won’t trust colleagues whom they only know as little heads on screens. And they will be too tired to socialize with them anyway.

8) Destroy any habits of serious reading of news. Isn’t it much easier to just swipe through a “feed”? Reading a newspaper while having two coffees in the morning? Make sure the commute is too long to allow that, and that trains and subways are so crammed that nobody in their right mind would dare to unfold a real, paper newspaper. Also, if the news continues to be bad, that’s good for you. Your citizens get tired of reading the same old crap all the time. At some point they’ll just stop. Good for you!

9) Tell people protest is clicking on a link. Discourage any form of more sustained protest or engagement. Make sure that followers of social movements will be quickly exhausted, by following steps 1)-8) above. If followers are exhausted, so will be the leaders. It’s just too hard to keep going, isn’t it?

10) Always remember: exhausted citizens are submissive citizens. Or no citizens at all – at some point of sleep deprivation, they turn into subjects. That’s when you know you’ve won.


Essay by  Lisa Herzog

Brain stew for dinner: information overload and daily burnout as the new normal?

This month we will be publishing a series of posts on the topic of fatigue. Two years after the outbreak of the Covid-19 pandemic, constant fatigue characterises the lives of too many of us. Here we think about some of the political and social consequences of fatigue. In this first post, Elisa Piras writes about the dangers of information overload.


I’m having trouble trying to sleep / I’m counting sheep but running out (…)
My eyes feel like they’re gonna bleed / Dried up and bulging out my skull / My mouth is dry, my face is numb (…)
My mind is set on overdrive / The clock is laughing in my face / A crooked spine, my senses dulled (…)
Green Day, Brain Stew (1995)

Painting of woman with head bent forward, in a despairing position

Egon Schiele: Sitzendes Mädchen mit herabgebeugtem Kopf, 1911

If there is a word for describing the continuous tension that we experience in our daily life because of our compulsive need of information, it is probably overload. In a large and hyperconnected world, we are at the same time information seekers, producers and transmitters: we are informative hubs, constantly sharing messages with other hubs, because of our work, education, leisure activities. Like Don Quixote, the average person spends way too many hours engrossed in intellectual activities, absorbing the most different notions, analysing a wide array of data, messaging with a number of interlocutors. Some of us do so while moving between different languages and crossing several networks. Unlike Don Quixote’s, the world we live in is not an imaginary or evanescent one; quite to the contrary, the information waves that we ride and that sometimes overwhelm us bring elements of reality to our attention and put a strain on our cognitive, communicative and social skills.

When reality becomes especially pressing – for instance, in particularly intense work periods, or when major media events, like a pandemics or an escalating war, unfold – we can experience a malaise that Wurman (1989) has described as information anxiety, the condition of stress caused by the perceived gap between data and knowledge, which we feel when we are not able to extract what we need or want from the available information. Analysing work-induced stress manifestations among managers, Lewis (1990) observed the existence of the so-called information fatigue syndrome, whose symptoms are psychophysical: unrest and irritability, anxiety and self-doubt, insomnia, confusion and frustration, forgetfulness, frequent stomach pains and headaches. Since our access to information is often physically mediated by screens or earphones/earbuds, these symptoms might be accompanied by those revealing technostress: brain fog, sore eyes, neck and spine pain.

Overwhelming waves of information cause the condition we know as information overload or infoxication, which “occurs when decision-makers face a level of information that is greater than their information processing capacity”; this situation causes a decisional paralysis (Roetzel 2019). Sure, the problem of obtaining and processing just the adequate amount of information which allows people to make good choices is not a new one. However, nowadays data smog and info-noise appear to be especially challenging, not only for managers, but for a wider group of people, including adolescents. Moreover, according to a recent report, 59.5% of the world population uses the Internet and the pandemic has boosted the number of social media users, which has reached 4.2 billion as of January 2021. Smart working, online teaching and learning, socialising in the metaverse – something that 30 years ago could be possible only in cyberpunk sci-fi novels – have become widespread activities during the last two years and the smartphone really is this age’s devotional object, as techno-apocalyptic philosopher Byung-Chul Han (2014) maintains.

Woman in red blouse lying on her front, one hand covering her nose

Egon Schiele: Liegendes Mädchen mit roter Bluse

As a rich literature shows, our capacity to make decisions is hampered by information overload. Even under normal conditions, our decisions tend to be less rational and intelligible than we believe them to be, because of the characteristics of the problems at stake such as undecidability and/or of the so-called opacity of consciousness, i.e. the difficulty with grasping the cognitive processes behind our choices. This is especially so when we consider collective decisions which have to be adopted under conditions of information disorder. Rumours, i.e. false or manipulated information, contribute to make our collective decisional processes – in the family, at work, in political arenas – more complicated and make dialogue more difficult, fostering opinion polarisation and undermining the chances of reaching an agreement and developing mutual trust.

When information overload is not a momentary blackout but becomes a daily condition, our normality changes and we feel protracted fatigue and exhaustion. Writing, reading, listening, discussing become exhausting tasks and we feel like we are falling into a Green-Day-dystopia. We risk becoming prey to neuronal illnesses like depression and burnout syndrome. Information is the key to our societies and it helps us to shed light on reality, but as Byung-Chul Han (2015) warns us, its overly intense glow can blind us and eventually plunge us into darkness, turning us into insomniac and depressed hyperconnected yet socially isolated ghosts. Knowing that we are exposed to such a risk is the necessary precondition to start searching for viable solutions, alternative to the “heresy” of radically disconnecting ourselves from the digital world and choosing a life sheltered from the blinding light of information.


essay by Elisa Piras


Why We Can’t Have It All When It Comes to the Future of Work

This is a guest post by Deryn Thomas, PhD Student in Philosophy, Benjamin Sachs, Senior Lecturer, and Alexander Douglas, Senior Lecturer, at University of St. Andrews. It discusses their recent research on a future with fair work for all and some of the trade-offs it involves. 


Two years into a world turned upside down by lockdowns, travel restrictions, and viral mutations, the way people work and make a living has changed dramatically. New challenges are being presented by rising childcare costs, increases in automation, the digitisation of the workplace, and the gig economy. So we need to ask: how do we make the future of work better for everyone?

At the Future of Work and Income Research Network, we’ve been thinking hard about this problem. As part of these efforts, we recently participated in a consultation for the Scottish Government on its Fair Work Goals, set to be implemented by 2025. The consultation document and stated goals offer an optimistic vision for the future of work in Scotland. But it risks being too idealistic: many of the stated goals conflict with each other.

We noticed at least four sets of incompatible goals. As it stands, the documents say nothing about how these compromises will be decided. But we think this leaves out an important step in the process. Therefore, we offer some reflections from philosophy about how to weigh up the values at stake.  In the end, we think that decisions like these need to be made in the context of a national conversation about the trade-offs surrounding work.

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