B09: Tutorial 6 – Summary

  • Administrative reminders:
    • Participation reflections #2 due end of day
    • Will hold office hours once the midterms are returned (to be scheduled) to discuss grades and any issues etc
    • Will hold office hours (to be scheduled) to talk about the essay when it’s released. If you want to talk about the essay in tutorials, you should email me questions so I can prepare responses
    • There is a philosophy essay clinic (link under news on main tutorial page) which you may want to sign up for, for free help with your essay drafts, outlines, etc
    • C will post some lectures they’ve given elsewhere for those who have asked about other questions around bioethics we’re not covering in this course
  • Gave summary of the last lecture (over two weeks ago!)
  • C brought two handouts as choices, but each tutorial only covered one (Abby) copied below. The other (Henri) may come up in other tutorials and is not copied here as we didn’t cover it.
    • Abby is a 64 year-old married woman, with a nine-year history of Multiple Sclerosis (MS). She was hospitalized two years ago following multiple falls caused by balance issues, onset with the progression of MS and lesions to her pons and cerebrum. She has also seen some decline in memory, and she has better days and worse days, but seems not to have any further cognitive impairments or history of depression. In the past year, she has developed difficulties with a number of motor functions, and her caretaking team feels that she may need to be placed on a feeding tube soon to assure adequate nourishment.  They ask Abby about this—explaining the nature of the procedure and its consequences—and in the morning she agrees to the procedure. However, in the evening (before the tube has been placed), Abby seems confused about her decision to have the feeding tube placed. She tells the team she doesn’t want it in. They revisit the question in the morning after, when the patient seems more lucid again. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure. What would Buchanon and Brock, Freedman, and Misak say about this case? Should we, all things considered, move forward with the procedure and insert the feeding tube? Would your argument differ if Abby was 24 years-old?  
    • What are some barriers to granting or obtaining informed consent? What roles does informed consent play in settings like critical care medicine or emergency departments? Should the standards of informed consent be different when the person consenting is not the current patient (such as a surrogate decision maker or an advance care plan or directive)? Do the standards and expectations for informed consent in medicine match the standards of informed consent we use in other parts of our lives? How, why, or why not?

B09: Self-Reflection 1 – Brief Collective Feedback

The first self-reflections were generally very well done, and helped me get to know more about your learning and engaging styles. Because these were due before we first had a chance to talk about styles of reasoning and argumentation, I tried in general to be more lenient on the support needed for answers to move up to the 10/10 range. We will hope to see a little more support for the next ones, as we begin to develop more skills in critical explanation or support, but if you ever do not understand why you did or did not meet the goal you expected, feel free to reach out!

I do not have too many collective comments, both because people who submitted generally got 8 or 10 out of 10, and because the answers varied greatly. But there are a few things worth briefly repeating that map onto the last tutorial, or which repeat things that were available on the Participation Questions and Answers handout available from the beginning of the term (click here to check it out if you hadn’t before).

  • Specificity and/or examples: Recall from the first tutorial that part of the goal of the self-reflections was to work at articulating and supporting our answers in order to convince other people where possible. (See also the Participation Questions and Answers handout) .Providing a more critical level of support or explanation for our answers was part of the evaluation for scoring, but also is meant to help us develop skills toward writing our paper. One way of strengthening our answers would be to add clearer specific details, or to provide examples. It was common to say something like “I participated in group discussions by speaking up. This has not changed because…”. It would help our answers to give more detail about how we spoke up or what we tried to contribute. Did we contribute by sharing something we learned from the textbook about utilitarianism and relating that to the context of disclosure? Or by drawing on lived experience to describe another way of understanding health as also spiritual? Did we ask a clarifying question about what someone meant by a term we hadn’t heard of? Other answers might have mentioned conversations with friends or family members, or people in groupchat: What did we talk about? Where did the conversation go? What did we learn, if anything, from talking with others? More specific details or examples of how and what we contributed would lend more support to the claims we express. We discussed more strategies around this in the most recent tutorial before reading week.
  • Explaining non-answers: As I mentioned in the first tutorial, it’s definitely okay not to have answers to questions for a variety of reasons, and that will not by itself prevent us from accessing full scores. To move from a 6/10 to a possible 8/10, our reflections would have to tell us there is no answer rather than leaving the question blank. To move from an 8/10 to a 10/10, our answer would have to explain why we don’t have a direct answer to the question this week. On the participation handout from the first tutorial, for example, says “It’s okay for an answer to say ‘I don’t know if I have a good answer to this, this week, because…’, or ‘I actually don’t think this is a helpful question this week, because…'”, but in each of these cases there is a “because” claim that supports the response given. And as it says in the Participation Questions and Answers handout, “The main goal we should be aimed at is convincing someone that the answer we gave is true, right, or otherwise convincing. Ideally, anyone reading your answer should be inclined to believe it. If there is no available evidence, that’s totally okay! For full marks, you could try to explain why there is not or cannot be evidence, and why someone should accept your answers without. The goal overall is to try to support our claims in case someone might disbelieve us, and this will help as practice for when we write our term papers.” There was no consistency between different people as to which questions was hard to answer or irrelevant to people more generally, so the next reflection will keep all the same questions as planned.
  • Concrete plans: Some of our answers to questions about how we could improve said things like participating more, or supporting others more, but did not explain how we would try to do that. In some cases where we did not know how to support others, we didn’t discuss how we might try to learn how to support others. For answers around how we might improve, it would be helpful to have more concrete action plans. What are specific ways I can make steps toward doing better next time? “Participate more” doesn’t always give us the tools to make progress.
  • Building for next time: For the next reflections, keep up the level of self-critical reflection we saw in your first early answers. Many of us gave answers about how we thought we could improve on our own engagement or support for others. Did we succeed? Did we manage to follow any of those steps we outlined? Did we realize they were unreasonable or otherwise not well suited for us? In our next answers, it will help to reflect more on what changes we did or didn’t make, and why not. Are we just comfortable participating how we were? Is it too much work to change? And for all of these, why? There are more tools and resources available to us for next time (more tutorials done, more opportunities to change or interrogate our practices, more opportunities to ask the TA questions about participation, more opportunities to learn about support and reasoning, and so on). Make use of these!
  • Barriers: Most of the barriers people communicated have hopefully already been better accommodated or dismantled in the last few weeks (things like familiarity, switching up groups, getting further into the course, and so on). I am committed to addressing barriers as they arise or persist over the term. One of the most commonly cited barriers (over 87% of responses!) was ourselves and fears of coming across as badly informed, as not critical, as unprepared, and so on. Those answers almost always said those barriers were just our own to address, but I hope in letting you know that nearly nine out of every ten people who responded felt the same way, it helps in trying to overcome those mental blocks. We’re not alone. We’re all learning with and from each others. And I look forward to more of that over the course.

As always, if you have further questions, you can always email me and/or discuss in office hours or arranged meetings. As mentioned in first tutorials, if a question is too much to answer by email, I’ll suggest we meet in person, but there’s no reason not to try asking by email! These first reflections were very interesting and helpful to read and learn from, and I look forward to your next reflections as well!

B09: Tutorial 5 – Summary

  • (As mentioned before, if anyone wants to volunteer to do summaries, that will help them get posted sooner than my looking for free time! Shoot me an email).
  • As announced last week, participation reflection grades will be returned by the 18th. The next submission window has been pushed back to accommodate the later-than-planned return. Feedback will be posted on the week of the 19th through C’s website.
  • C will have office hours on the Monday the 26th after the break, in room 101 of the Philosophy Portable, from 11.30am to 1.30pm (the professor has cancelled tutorials that week). Come with your thoughts and questions!
  • C began with a summary of content as usual. They then shared thoughts why philosophy is not “more subjective” than other disciplines, and how in almost every discipline there isn’t a right answer, just “better” answers and methodologies. So too, there are better answers and methodologies in philosophy (styles of argumentation, supported conclusions, etc). We spent the remainder of tutorial thinking about philosophical methodologies a little bit by thinking about how philosophers usually think about argumentation. See below.
  • Handout:
    • Side one: Practice questions (these are NOT from the midterm question set, because I cannot give concrete advice on questions that could show up on the midterm). We did not cover these in tutorial in detail.
      • These are not questions from the midterm study sheet. The boxes are not a suggestion of answer length. This is just a handout to make us start thinking about answers and support.
      • Why is moral disagreement a problem for cultural relativism?
      • What is paternalism? Is this a problem for Rossian principleism?
      • Consider the claim ‘most people believe it is permissible to screen embryos for disabilities.’ Is this an example of the descriptive sense of morality or the normative sense of morality?
      • Reflect: What are our answers missing? What do other people have that we don’t? How could we improve our answers? If we didn’t know the answers, what strategies should we take to look for them?
    • Side two: We spent tutorial on this side of the handout, talking through how philosophers usually think about argumentation, and the language they sometimes use to talk about them. These are not strict rules. We don’t need to know technical terms unless they’re in the slides. They’re just ways of helping us to start thinking about argumentation.
      • Arguments are usually evaluated based on (i) how convincing the individual claims are, and (ii) how well the claims support their conclusion. (Premise, Conclusion; Deductive, Valid, Sound; Inductive, Strong, Cogent.) Generally: think of content and structure; convincing and supportive claims. Truth and likelihood is a property of claims, premises, conclusions, not arguments. Logic and Rhetoric are two of the main disciplines that study argumentation.
      • Assume our reader doesn’t already agree with the things we believe. Give them reasons to accept what we have to say. Not everything is obvious to everyone.
      • Language is important: there are debates over how we should understand words. Remember tutorial two: “health”. Be careful with technical terms; avoid synonyms.
      • Some possible ways of objecting: invalid; unsound; counterexamples; counter-evidence; insufficient evidence; too narrow in scope; entails undesirable or unacceptable consequences; showing how alternative theories or arguments are more desirable; demonstrate impracticality; violates methodological, ethical, or social norms; and so on.
      • Some possible ways of supporting: demonstrations of application, importance, practicality; examples, data, arguments for premises; objecting to arguments against premises or entailments; showing how other alternatives are less desirable; moral or social reasons to accept claims; and so on.
      • We don’t always have to write or defend what we believe, especially when we don’t have strong evidence or reasons for our beliefs (these are assignments not confessions)
      • Midterm: feel free to underline important things; use I, me, my; etc.

B09: Tutorial 4 – Summary

  • Thanks for your patience waiting for this summary. Again, I welcome volunteers to send me their own versions of tutorial summaries (a style of participating), as I am not always free to write them up until several days later, and may not always be able to go into depth.
  • News and reminders (most of these already posted on main page).
    • Strike updates
    • Office hour updates
    • C will take longer to return self-reflections due to personal/health circumstances, as disclosed in more detail in tutorial. They will be returned within two weeks nonetheless.
  • I introduced three terms that are not required knowledge in this course unless they pop up in slides at some point, but common and important to nursing ethics, and moral lives more broadly. Oversimplified, these are:
    • Moral distress: occurs when we strongly believe or know what the right thing to do is, and yet are unable to do that thing, typically due to institutional rules or other power structures constraining our choice
    • Moral fatigue: occurs as a result of ongoing moral distress and moral residue. Physical, mental, emotional.
    • Moral residue: the “residue” left from engaging in moral deliberation and decision making, often as results of moral distress, from learning more about how we should have acted, etc.
  • Discussion followup: Does principleism or casuistry give us any better guidance on what Dr. Bell should do? Have your answers changed since last week? Why/why not?
  • Discussion:
    • Version One: X-men: William and Marcy Stryker want to have a baby but are unable to get pregnant through PIV intercourse due blocked fallopian tubes. They want a baby to be similar and related to them, so they undertake a course of in vitro fertilization. The Strykers are offered pre-implantation genetic diagnosis, and during the screening process physicians identify that the embryonic DNA has an X-gene on chromosome 23, known to yield proteins that variously change chemistry throughout the body and cause mutations. Types of mutations differ drastically between individuals with no known cause of phenotypical differences, but mutation is associated with social isolation, physical and mental differences, and persistent stigma and lack of social support. William believes that the possible child overall would not have a future worth valuing, and that they are unfit to raise a mutant, and he suggests rejecting the embryo. Marcy opposes his decision, claiming that his valuation of mutants is couched in ableism and discrimination, and that she would do her best to care for, nurture, and love the possible child. Is it permissible to reject the embryo? (see also: X-2 the movie)
    • Version two: Trisomy 21: Similar set up but the embryo has an extra copy of chromosome 21 under contemporary social contexts of ableist discrimination.
    • Version three: Colourism: Similar set up but the embryo of mixed race parentage will have darker pigmented skin under contemporary social contexts of white supremacism (Possible example of colourist discrimination in the new Black Lightning TV series)

384: Brief Collective Feedback on Reading Response 1

This is an online copy of the handout posted to our lecture Blackboard, for PHL384 (Spring 2018), as a backup in case of any issues accessing Blackboard.

“Steinbock outlines several philosophical perspectives on the moral status
of human embryos. Which perspective do you find most convincing and why?”

Note: Not everything that impacted individual reading response scores is reflected in these comments, and not everything that is commented on here is something that affected any grades. Rather, the goal of these comments is to identify some ways that we can collectively improve more generally, both in our engagement with readings and with our future writing assignments in this course. Not everything here will be relevant every time, but I’ve tried to make the recommendations quite general so we can think about them over time. If you have further questions, you are definitely welcome to reach out and to ask them in TA office hours. The Philosophy Essay Clinic is also a great place to get assistance in planning and writing for philosophy courses. (info here: http://philosophy.utoronto.ca/st-george/undergraduate-at-st-george/philosophy-essay-clinic/ )

Brief feedback:

  1. Explanation: Sometimes, the answers we gave focused on explaining the view we thought was most convincing, but did not also explain why we found it the most convincing. Similarly, sometimes we picked one view and showed what it specifically says about the status of an embryo, but didn’t explain why we should prefer that view (is it because it comes to a conclusion we should think is right? If so, we can explain why that conclusion seems right). When thinking of how to describe why we find a view convincing, it can be helpful to assume that our audience has already read the view (either they did the reading too, or, in our longer writing assignments, because we’ve explained it to them), but that they still are not convinced by it. Re-stating the view won’t necessarily change things. What could we do to make someone more likely to agree with us?
  2. Focus: Sometimes, our answers focused only on fetuses or therapeutic induced abortions, and didn’t make any mention of embryos, or explain why that view is most convincing for embryos in particular. In the future, it can be helpful to make a list of the key terms in questions or prompts, and use those to guide our reading when we’re preparing our answers, to make sure we are working within the scope of the question.
  3. Formatting: In some cases, while we demonstrated good engagement with the questions, we didn’t follow the assignment instructions. Sometimes our answers were over the word limit, or were not otherwise formatted and submitted according to instructions. It is important to follow the word limit in particular for at least two main reasons: (i) part of the challenge and goal of our assignments in this course is to practice concise writing and clarity; and (ii) it is an initial principle of fairness, for writing and for evaluating assignments, that all students are being provided the same resources and word limit. In the future, it could be helpful to make a little checklist of the things our assignments should complete, including the questions we need to answer and the formats in which to answer them (C. does this in their own writing submissions to make sure they don’t miss things!).
  4. Accuracy/clarity: In some cases, Author’s names were misspelled, or they were referred to by the wrong pronouns. While this is important as a matter of care for other people, it could also be confusing at times to whom we were referring when the pronouns or names did not line up. And sometimes we confused the names of positions or views. For example: in the first paragraph of “The Person View”, it says that there are two distinct senses of ‘human being’: a biological or genetic sense, and a moral sense. Some of our answers called the moral sense a ‘genetic’ sense, or used other misleading terms. Finally, sometimes we misused words that have technical meanings in arguments (like ‘thus’, which is meant to indicate a conclusion or an implication), and this made it harder to follow the line of thought. In the future, we should be careful in how we represent the views in our readings, and upcoming TA office hours will be good opportunities for getting help with this for assignments, as well as the department’s essay clinic (link above).
  5. Arguing by objection: One style of argumentation that a lot of our answers shared, was to argue in favour of a view by explaining objections to the other views that were covered in the text (example, arguing in favour of the interest view by stating objections to the biological humanity view, personhood view, and FLO view). A stronger version of this style of arguing would also show why the view we prefer doesn’t suffer from the same sorts of objections. It would also help in future writing assignments, when arguing this way, not only to explain the objection but to explain why that objection is convincing. TA office hours and the Philosophy Essay Clinic are both good resources for getting feedback on styles of arguing for future writing assignments.
  6. Arguing by belief: Sometimes when we explained why we found a view most convincing, we said it was because it aligned with our beliefs, such as saying that we believe that embryos have some moral status and that a certain view fit this belief best. However, this can sometimes look like saying that we find a view most convincing just because we believe it, but doesn’t give other people reasons for believing it too. In the future, a stronger version of this argument would try to show other people why they should also find the view convincing, and we cannot always assume they share our beliefs. So, we might give a reason why we hold that initial belief, and then show how that initial reason connects to the view. If our goal in future writing assignments is to write a compelling argument, then we will want to make sure we are also writing for people who don’t share in our beliefs already.

If there are any errors or omissions, or if you have other questions or concerns about this assessment and feedback, please don’t hesitate to contact me using the address listed on the Blackboard syllabus.

B09: Tutorial 3 – Brief Summary

  • Administrative items and reminders (attendance, emails, using prof’s office hours for lecture-related questions, TA office hours survey, self-reflection submission window closing)
  • Gave a brief overview of Thursday’s material
    • Click here to see what was written on the board (this will be uploaded shortly: the blackboard doesn’t translate well in images, so I will re-draw the diagrams and take a clearer photo to upload).
  • Discussion handout: Case analysis
    • Purpose: Get us thinking about different ethical theories in action. Get us thinking about cases, the issues we face in thinking through scenarios, and possible conflicts in principles and theories. Get us thinking about different relationships and responsibilities and the messiness of bioethics and health practices.
    • Case: Ash, a fourteen year-old, had developed acute lymphoblastic leukemia some years ago, but treatment had resulted in a complete remission. Recently, she had relapsed and again was placed under treatment. Dr. Bell is called in to oversee her care while her usual attending doctor is out of town. Before he enters the room, Ash’s mother (and legal decision maker) tells him that Ash did not know of the leukemia diagnosis: she wasn’t told when she was younger and hadn’t been told after the relapse. Ash’s father had died from lung cancer, and her aunt died from breast cancer, and the mother fears it would be too upsetting for Ash to know of her diagnosis. She tells Dr. Bell not to tell Ash, and to say that it was an unusual anemia. Ash’s regular care team had been complying with the mother’s wishes so far. Dr. Bell isn’t sure what to do. [case adapted from “The Protective Parent” by Dr. Paul Griner: Accessed January 13, 2018 from http://ihi.org/education/IHIOpenScool/resources/Pages/Activities/TheProtectiveParent.aspx]
    • Open Reflection: What should Dr. Bell do? What might a utilitarian say? What might a Kantian say? What might a Virtue Ethicist say? What do you think? What information do we have, or need, that seems relevant to making a decision? And for all these answers: Why that answer?
  • Groupwork and end of tutorial debriefing, we explored how each of the theories can yield multiple interpretations or results (applications of the objections we considered in class), as well as differences between theories, and between theories and our own intuitions. We concluded by looking over some of the details of the case, and pointing out what may be relevant information, what could be distracting, what information we do and do not have.
  • Some of the end goals were to (i) show us why and how moral philosophy tries to refine ethical theories, (ii) see what theories (and objections) look like in regular lives and not just unlikely thought experiments, (iii) explore the conflicts between theories and begin thinking about principleism or casuistry for next week, and (iv) get us thinking with and about  just generally recognize the messiness of bioethics and medicine, the limits of our knowledges, and begin reflecting on information and relevant information.

B09: ‘Help me get to know you’ form: C’s Answers

When filling in your help me get to know you forms in tutorials or online, a few of you asked questions about me in return, and I feel it’s only fair to answer them back! Here’s some of my answers to the questions on the form, and to the questions you all asked.

What name would you like us to call you in this course? I prefer to go by C (pronounced just like the letter, or ‘sea’). If you’re uncomfortable with that for some reason, you can also call me by my legal name, Charles. I’m not a big fan of it though.

What pronouns would you like us to use for you? I go by they/them/their pronouns. I try to be understanding when people don’t use these when referring to me, as I know that those who come from other cultures or languages that don’t have gender-neutral pronouns may have less experience with this. I just ask that you try your best.

What made you interested in taking this course? I am not required to be a TA in my department, but I love teaching and learning from and with students, and I love the practical potential for bioethics, so I applied to TA this course. I think that medicine and health are places where questions about “right” or “wrong” can be especially important, because the risks of physical, social, and cultural harm are greater than in many other areas of philosophy or moral theory. Many of the people I hang out with, live with, study with, and grow with have experienced a lot of harm or exclusion from medical health systems, and I think it is important to bring these perspectives into the ways we learn and think about bioethics. In general: bioethics pervades my life and research, and I love teaching and learning with students.

What are your intended majors/minors, if any? I did my undergraduate degree at the downtown U of T campus, where I formally completed a specialist in philosophy, a major in psychology, and a minor in bioethics (less formally, a triple-major between the three). In my current PhD program, I will (hopefully!) receive a degree in Philosophy, and a notation for the Collaborative Specialization in Bioethics organized by the Joint Centre for Bioethics.

Have you taken any philosophy or ethics courses so far? If so, which ones? I was a philosophy specialist in my undergraduate degree, so I took many courses downtown. Here’s a rough list:

  • 100 (A) level: Intro to philosophy.
  • 200 (B) level: Probability and inductive logic; Modern symbolic logic; Knowledge and reality; Persons minds and bodies; Introduction to ethics; 17th-18th Century Philosophy; Environmental Ethics; Bioethics; Ancient philosophy.
  • 300 (C) level: Intermediate logic; Epistemology; Issues in the Philosophy of Mind; Metaphysics; Wittgenstein; Philosophy of Language; Ethics and mental health; Issues in environmental ethics.
  • 400 (D) level: Advanced philosophy (the “Socrates Project”); Seminar in applied ethics (focused on climate and water ethics); Seminar in philosophy (focused on Hume’s problem of induction); Seminar in philosophy of science (focused on thought experiments); Independent study on social media and personal identity; Independent study on narrative identity in dementia; Independent study on silence and teaching philosophy.
  • Graduate: Narrative and value; Aristotle on friendship; Theoretical approaches to bioethics; New approaches to classical Daoism; Social epistemology; Seminar on semantic vagueness; Philosophy of medicine; Philosophy and teaching; Reading course on feminist philosophy; Confucianism; Reading course on Peirce, silence, and disability.

What is something you’re most excited for in this course or tutorials? Every time I TA in bioethics, I learn a lot from the experiences, feedback, knowledge, ideas, and questions of students. I’ve already learned a lot with your answers to these questions, and I’m very much looking forward to learning with and from you in the rest of our time together.

What is something you’re most worried about for this course or tutorials? Lots of students mentioned the strike here. While I’m a little worried about a possible strike too, I am confident from previous experience that we can reduce its impact our learning community by early and transparent communication. I am a little worried (and excited!) about how the new participation guidelines will work out for the first time, how many people will choose to/be able to attend tutorials, etc. But I am also committed to doing the best I can to be flexible and responsive to changing those guidelines based on how they seem to work for us over the term.

Is there anything we should know about your learning style or how you best engage in course communities? I often do a lot of work preparing for tutorials because I have physical and cognitive disabilities that can make it hard to rely on memory, or to always be standing or moving around. Some weeks I might read more from notes I prepare in advance than speak from recollection, or might have to sit or lay down for a while. I have never yet handed student work back late, and work hard to make sure I can provide the best learning community and environment possible without disruption.

Other questions (from you!):

  • Do I have any pets? Very unfortunately, I’m very allergic to a lot of animals that we can legally keep as pets (and lots of other things too). Fortunately, several of my friends are fosters for cats or dogs (housing and taking care of them until adoption), or have other pets of their own, so I have regular access to animals whenever my immune system can handle it! (And when I can’t, there’s always the internet).
  • Where did you go before grad school? I was an undergraduate student on the downtown campus at the University of Toronto. I did not do a masters program.
  • What do you want to do after you graduate? Job markets are increasingly tough, but eventually, down the line, I’d like to be involved in teaching. Ideally in a philosophy, bioethics / health humanities, or disability studies program (in that order). But I’d also like to be involved in some version of consulting: some of the most valuable moments in my life have been the ability to help individuals and organizations based on my research and learning. Before all that, though, I’ll probably try to get a masters in health sciences, which would help me access some more skills in applied research and practice and improve my position for teaching and/or consultancy jobs. But that’s all a long-ways-away!
  • What is a Vanier scholar? Being a Vanier scholar just means that my research is supported by a Vanier Canada Graduate Scholarship (click for information). It is a national award competition run annually. Listing it on my website is a for-better-or-for-worse institutional norm, and a way of being transparent about financial support and possible conflicts of interest my research receives.
  • Have you been a TA for this course or related before? Yuppers! I was a TA for PHLB09 in 2015 and 2016. I’ve also been a TA for introductory bioethics courses on other campuses multiple times (PHL281 at UTSG and PHL283 at UTM), and I’ve been a TA for many of the 300-level (same as C-level) bioethics courses downtown, such as ethics of death and dying, ethics of genetics and reproduction, ethics and medical research. I’ve also been the TA for the introduction to ethics twice downtown, and have run the philosophy essay clinic there.
  • How can I succeed in this course when there are no ‘right’ answers in philosophy? There are often no ‘right’ answers in most fields, including many scientific research programs. Results are subject to dispute in interpretation, studies are subject to dispute in their methodologies or theoretical frameworks. Rather than coming up with right answers, we seek to come up with better answers: answers established through a better (research) methodology, theories that better fit forms of evidence, equations that properly derive from axioms, and so on. (and of course, even axioms are subject to dispute, and competing axiomatic systems or competing theoretical frameworks seek to show their better fit). The same is true of philosophy: there are better and worse ways to argue, there are axioms to follow (the study of ‘logic’ is the study of argumentative structures and systems, for example), there are different kinds of evidence we seek to fit (observation, intuition, consistency, etc), different methodologies and approaches, different theoretical frameworks, and so on. Philosophy is not distinct in not having clear right answers. Rather, it fits many other disciplines and fields of study in trying to derive better answers to questions posed (and: better ways of asking questions/forming hypotheses and research programs). Assignments may be evaluated on things like strength, coherence, clarity of reasoning, use of evidence and support, consistent and coherent use of theories and concepts, and overall methodological rigor. As we progress into this course, we will develop tools and familiarity with styles of reasoning.

I’ll update this page as appropriate if I missed questions (or more arise)


B09: Tutorial 2 – Brief Summary

In future weeks, summaries will be less detailed as you have more opportunities to form connections with peers in the class and develop resources together (and my ability to type things out each week will differ). As a reminder, collaborative note taking and study groups are things I consider toward styles of participation and engagement.

Outline for tutorials:

  • Admin things
    • Light sensitivity: some have written to me that they are light sensitive or otherwise find the room too bright. Unfortunately, there is only one switch in the room and it controls all the lights, so my plan to have only some lights on (or designate lower light areas of the room) is unsuccessful. If you have suggestions on how we can manage this, please let me know
    • Strike: monitor front page for updates as I get them.
    • Readings: there is a lot of content in many of the chapters we’ve had assigned, and not all of it is required for this course. My suggestion: try skimming the assigned material before lecture, and then use the lecture and slides to inform your focus for a closer and more careful reading of the most important parts of the texts. This will help you manage time better, and get a better sense of what to focus on, and will usually help answer some of your questions about the slides (since what’s written on the slides are usually briefer forms of what is also said in the text)
    • Assignments: Lots of questions about assignments: I don’t have info about these yet. Once I do we’ll start developing resources. Ask the prof for any questions in the meanwhile.
    • Office hours: I’ll send out a survey later this week now that I have access to your email addresses, to decide when/how to hold office hours.
  • Summary: I provided a brief summary of Thursday’s lecture/content.
  • Discussion sheets: The following sub-bullets include the text from the discussion sheets.
    • This sheet is meant to guide and prompt discussion together. You don’t need to hand it in if you don’t want. You don’t need to write all answers. You can use it to fidget, doodle, read your thoughts from, whatever. You can write on the back, sides, extra paper, wherever. C has extra pens if you need to borrow one.
    • Today’s questions focus on about what “health” could mean. The questions are broad to encourage different ways of thinking and understanding and approaching the questions. This will support and complicate our readings and conversations over the term, and will set us on the path toward our final course topic: what is disease? Biomedical ethics is applied ethics, so this also helps us explore the context of application for the theories we will learn in the next few weeks.
    • #1 Reflect: What does the word or idea of “health” mean to you? (Or: what is your relationship to the idea of health?)
    • #2 Evaluate: The World Health Organization (WHO) has defined human health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Is this different from your own thoughts on what health is? Are there any issues with the WHO account?
    • #3 Connect: What could thinking about how to understand “health” teach us about how we should think or act in medicine, public or global health, or bioethics? About what is “right” or “wrong” to do?
  • Closing remarks: We wrapped up from small group discussions with opportunities for class-wide comments. C then offered some closing comments around the WHO definition to get us thinking further, drawing from broader critical health conversations that have been had. Some rough examples of things mentioned include:
    • Is health a state, or also a process or activity? Something we have or do?
    • What does “well-being” mean? How is this any different from just saying “health” again? (Physical health, mental health, social health).
    • Can anyone ever have complete well-being, enough to be healthy on this definition? Consider: most people have had Chickenpox (vericella), which is a strand of Herpes (varicella zoster virus or VSV). VSV remains in our systems and can re-emerge as shingles (herpes zoster). If more people have herpes (and cold sores are also often caused by herpes strands like HSV1 and HSV2) and a majority of people have other persistent viral infections (most people have or will have one of more than 170 strands of human papillomavirus (HPV), which can be communicated through sexual interactions and pregnancy), then are any of us ever fully healthy? What about those of old age whose bodies are variously deteriorating? Or those with congenital (means present at birth) or chronic (ongoing or lifelong) illnesses, disorders, disabilities, or diseases?
    • Can this translate to policy and action? How can this inform healthcare?
    • What about other aspects of things that seem to inform health, like environmental well-being, spiritual well-being? What about wealth and social and material capital? (Think of Chemical Valley in Ontario, of correlations between “fertility” and air pollution, of the cost of healthcare in Canada and abroad, of spiritual understandings of the self within and beyond Western Judeo-Christian theologies…)
    • [mentions of racism, sexism, ableism (and slur mention), violence, medical abuse, sexual assault] What does “social well-being” mean in relation to social norms, when norms of what social well-being might look like are often informed by systems of domination or oppression? For example, the ways that enslaved people’s low-energy or attempts to escape were medicalized as drapetomania or dysaesthesia aethiopica against social norms (to be “treated” or “cured” with whippings); how Black political protestors were diagnosed with schizophrenia in Ionia Michigan (or вялотекущая шизофрения or slow progressive schizophrenia for political dissenters in Russia) because of their potentially “violent” ideas or actions; how women’s dissent against patriarchal home and political systems was often medicalized as hysteria to be treated with institutional sexual assault and confinement (and how the term is still used as a pejorative adjective today); how those with learning disabilities and developmental disorders were diagnosed as morons, imbeciles, idiots, (later replaced with mental retardation after those original terms were deemed too awful and stigmatized, despite our willingness to still use them today) and how this posed grounds for involuntary sterilization (including in Canada until only a few decades ago)?
    • And how do we reconcile these worries about how vague definitions can enable medical violence, with the feeling that maybe we can’t actually be fully healthy under oppression (both metaphorically as human health and personal flourishing, and literally due to social determinants of health like stigmatization, risk of violence and abuse, microaggressions, socioeconomic determinants of health)?
    • Where do we fit things like intergenerational trauma’s impacts on health in this definition?
    • Should we think of “healthy” or “standards of health” as different for different places and cultures? What does this mean when we think of global or international health, and international aid initiatives and international medical research ethics? Whose “healthy” should we abide by? Whose norms of diagnoses?
    • How does health as normal or desirable inform the ways we think about those with less access to health resources, those with congenital and chronic conditions, living as disabled or disfigured? What kinds of health and treatments are prioritized here?
    • (How) does this treat humans as distinct from other kinds of things or creatures?
    • A few other quotes I shared: (may be rephrased from original)
      • Rene Leriche (~1936): Health is “life lived in the silence of the organs”
      • HansGeorg Gadamer (~1993): “Health is not something that is revealed through investigation but rather something that manifests itself precisely by virtue of escaping our attention [… It] belongs to that miraculous capacity we have to forget ourselves”
      • Eli Clare (2017): Lots of good discussions in his book Brilliant Imperfection that challenges, complicates, and explores the idea of “cure” and the “normal”
      • Robert Crawford (1980): Credited with coining the term “healthism”, which is used to describe ideologies around health as morally good, desirable, a personal responsibility, and focuses on the roles of individuals’ responsibilities for health behaviours in ways that obscure broader systems’ impacts on the ability or desirability to pursue those activities (the term is found most often in academic fat studies and disability studies, and used differently by different people)

B09: Short Tutorial Handout

Click here to return to main tutorial page

This is the online version of the short handout given out in our first tutorial titled “Short Tutorial Handout”. If you see any errors please free to let me know. This handout will be expanded into a longer handout in the first few weeks of class, to better represent the ways we elaborate on these points in tutorial, and the different feedback we express.

Revision history:

  • 11/01/2018 Original handout posted.
  • Any revisions will be noted here.

PHLB09: Short Tutorial Handout
For students registered in C’s tutorials, 2018

About your TA

  • You can just call me “C” (preferred) or “Charles”. My pronouns are they/them. This is my fifth time being a TA for bioethics. I am a PhD student in the Department of Philosophy and Joint Centre for Bioethics researching relationships between silence, exclusion, oppression, and resistance in the contexts of health and epistemology. I am always happy to talk about bioethics.
  • Please email me at cdf.uoft@gmail.com with the course code in your subject line. I try to reply within two business days, and you are welcome to email me again if I’m slow to reply: I think it is helpful and not at all rude. You can use my utoronto email address but I might be slower to reply there. If I cannot answer your question over email, I may suggest we arrange to discuss in person. You’re always welcome to try asking me things rather than assume the answer is ‘no’. We can arrange other ways of communicating as needs arise.
  • My office hours will be announced later in the term, and I will tend to have more around deadlines or when assignments are returned. You can always contact me to try and book an appointment.

Accessibility and inclusivity

  • I believe that access is a fundamental right
  • I understand “accessibility” very broadly, and acknowledge that many disabilities and illnesses are non-linear or imperceptible, that not everyone has the same relationship with the English language, that barriers to access rooted in oppressive social structures exist, that personal life can interfere without warning, and that I will never be able to fully anticipate all needs.
  • I respect that our needs can differ over time, and that new needs can arise, and that accessibility is a dynamic process, not a single event or action
  • I respect that not all accommodation needs can be “documented”, that not everybody is or can be registered with AccessAbility, and that not everybody has equal access to the means to have their needs “officially” recognized.
  • If you ever feel that you are not being included in tutorials, that your needs aren’t met, please contact me so we can navigate possible changes together.
  • All handouts and other resources for our tutorials will be posted and updated online at https://cdf.so/B09. I will try to make digital resources available in print too, including large format. Please let me know if there are alternative formats that would help make materials accessible to you.

About tutorials

  • The readings are where we go to try and learn. The lectures are where we go to better understand and make connections. Tutorials are where we go to further discuss, explore, challenge, and disrupt our beliefs and understandings, and to practice and develop our philosophical skills and engagements.
  • Ultimately: tutorials are our space to engage with the course in the ways we need to. They are flexible to what we need. We will strive to adopt tutorials to our needs, interests, and feedback.
  • Proposed daily outline:
    • We will start by passing around an attendance sheet, while C gives a very brief summary of the previous lecture to make sure everyone has some access to the content, even if they missed class or readings.
    • We will ask if we have any questions, clarifications, or things needing discussion around the topics or other course issues.
    • We will then pass around discussion sheets with prompts or case-studies, based on student emails sent to C, and current assignments or topics.
    • We will have a moment to think about the questions, and then join small discussion groups to discuss thoughts and questions about them, while the TA moves between groups answering questions, adding feedback and ideas, and mediating conflicts.
    • We may end with a class-wide discussion, by combining groups, or by continuing as we are, depending on our needs.
  • We will change this schedule based on our changing wants, interests, and needs.

Here are a few things to keep in mind when we are together

  • Nobody should feel forced to speak up (and C will never “cold-call” students), but we should always try to create room for others to engage and be heard. We should encourage respectful and compassionate engagement while leaving room for authentic feelings and reactions. Respect should be a tool for opening up communication and possibilities, not a tool for silencing or for closing opportunities for expression.
  • We all have different relationships to course topics, themes, and examples, and different people can have different experiences of going through the same things. We should avoid making assumptions about people’s experiences and identities.
  • We are meeting and studying on Indigenous lands, while Indigenous health issues, crises, and perspectives continue to be ignored or undervalued in healthcare systems, bioethics, and philosophy. This needs to be challenged and disrupted.
  • Philosophy and bioethics have a long history of prioritizing certain voices and people over others, and have actively and passively excluded other voices, people, experiences, and ways of knowing. These histories need to be challenged and disrupted.
  • Barriers to access do not only include disability, but also things like poverty, multilingualism, mental health, experiences of violence and oppression, access to housing and food, family and personal issues. We cannot always identify what lives people are living and when. Maybe they are sitting next to us. Maybe they are also us.
  • We are encouraged to prioritize our health, safety, and wellbeing, and we can skip or leave during a tutorial without explanation as we need. We are also welcome to show up to tutorials unprepared.
  • Some of us may speak quickly or slowly, and may use words or phrases we are not familiar with. We should acknowledge that people have different relationships with the languages used in this course, and should feel also comfortable asking what something means or to hear something said again.
  • We should feel free to stretch, move around, use computers and phones, eat or drink, as long as we also try to reduce the ways we may be disruptive to others.

If anything isn’t working for anyone, or if I have missed something important, please try to let me know so we can work together to change and address it.

B09: Why isn’t our tutorial “green friendly”?

Here’s a quick aside.

A question I sometimes get in tutorials is “Why isn’t our tutorial ‘green friendly’?”

By “green friendly” tutorials, we usually mean those that do not have any print materials (such as textbooks, handouts), where the course materials are largely online, and where assessments are submitted online. In some cases, it can also include courses that only use single-spacing and double-sided printing.

With human-caused climate change spiraling further out of control, and with global deforestation and inadequate recycling practices, many of us are inclined to think that going “green” is the morally right thing to do. This is relevant to bioethics not only as a course but also as a methodology and field of study: environmental changes can directly impact health outcomes. So there is good reason, I agree, to think that we should aim to “go green”. That is to say:

I am generally and genuinely interested in working to protect the environment and limit my environmental impact. But as our TA, I am also critically interested in making sure our learning community is as inclusive and accessible as we can make it.

And too often, “green” initiatives are not as inclusive as we might believe. In particular, they tend to exclude many people who are disabled and poor, among others. When green initiatives focus on individual or group actions, we can sometimes ignore the different social realities and personal contexts where actions happen, and also how those contexts can impact who is able to participate in those actions and how.

Not everyone has access, or regular access, or equal access to technology and digital materials. Some people do not have computers or smart phones, or share them with others, and sometimes our electronics get lost/broken/stolen. Not everyone can afford home internet and may be more dependent on the wifi on campus or in public places. Not everyone can easily read from a screen, or from a screen for extended periods of time. Libraries and places where people can access computers have limited hours of operation, and may be overbooked or physically inaccessible.

And on the other hand: not everyone can afford textbooks, can easily read print materials, or read print materials for an extended period of time, or read handouts that are only single-spaced. Sometimes our handouts, books, and notes get lost/unreadable/stolen. Sometimes we can’t afford to print things we find online. Books and binders can be too heavy to carry, and not everyone can physically take handwritten notes. If we choose only one or the other, technology or print, we will usually exclude certain people.

My goal for tutorials will be to provide multiple paths to accessing our handouts, blog posts and updates (like this one), and any other material I post or share online or in tutorial. This means I will be willing to print anything I post online if you need, and that I will post anything I handout in person online as well.

If you need anything in alternative formats (such as if any resources can’t be read by your screen-readers, or you need audio, or larger print handouts) let me know, and I will do the best I can to make sure everything is available to you.

At the same time, I will strive to limit printing to cases where it is needed, and I will avoid printing longer handouts unless requested (and I genuinely welcome those requests!). I will aim to print on recycled paper when I have access to it. I will avoid uploading .pdf files and images which can take more energy to store and load unless requested (we often forget that electronics require power, as does hosting and accessing the internet, and that this is a form of energy consumption too).