He's Done a Course

Back in my days editing the JME blog, we used to get the occasional unsolicited post sent to us.  Almost always, they went unpublished; this was overwhelmingly because they weren't very good.  The one person who did sometimes get his unsolicited work published was the ethicist-turned-barrister Daniel Sokol.  There was a number of reasons why we were a little more forgiving of him: he was someone we knew, and a reasonably well-known person in the field - he had a fairly regular column in the BMJ; his submissions, while sometimes a bit self-congratulatory, were often fairly inconsequential - but they were by the same token pretty harmless, so could tide us over during those periods when we had little to say of our own; and, finally, if we did reject his submissions, we could more or less guaratee that they'd appear on the BMJ's own blog anyway, so there wasn't much point our trying to act as gatekeeper.

A post by him appeared on the JME blog a few days ago, detailing the help he had been able to give a doctor, one Tarek Seda, who had found himself in professional trouble and facing a hearing from the Medical Practitioners' Tribunal Service in 2019.  This post purported to be a brief account by Dr Seda of how Sokol was tremendously helpful, andit was supplemented by an account by Sokol himself of how Sokol was... er... tremendously helpful.

Now, I do not know whose idea the post was - in the comments, Sokol writes that

[a]fter the outcome of the MPTS hearing, Dr Seda selflessly asked how he could help other doctors in a similar situation.   One suggestion was to write an article, giving a dual perspective on the process of ethics remediation: the doctor’s and the ethicist’s.   This blog is the product of that idea.

This tells us little about whose idea the post was, although I do have my suspicions - and I'll come back to that in a moment.  But it will not have escaped anyone's attention that the post as a whole does come across rather as an advertorial.  Evidence for this can be produced from the final sentence of the post proper, and the supplementary text that follows it:

Tracing Apps: Precaution and Paranoia

It's a little over a year since I last blogged anything.  Partly that's because I had other things on my mind, and nothing struck me as being the kind of topic about which I had much to say.  And then Covid-19 came along, and I still didn't have anything to say.

Gratuitous virus image!  Yay!

I think that a lot of people don't have much to say about it; but that doesn't seem to have stopped them saying it anyway.  There's been a lot of nonsense.  And there's also been a lot of stuff that isn't nonsense, but that is nonetheless trivial, as people find an excuse to make their rather quotidian thoughts about consent or resource allocation or whatever relevant by sticking "... in the Time of Coronavirus" at the end of the title and bunging it off to a journal.  Hey-ho.  The REF's coming.  What do you expect?

The upshot is that I've been ignoring most of the CV-19 stuff; but every now and again, something catches my eye - such as this piece by Deena Davis on the Hastings Center blog: "Before We Turn to Digital Contact Tracing for Covid, Remember Surveillance in the Sixties", the conclusion of which is that "for me, digital contact tracing [through phone apps] is a bridge too far".

Why would this be?  The concern articulated has to do with the misuse of data.  Once you're being traced, who knows what'll happen to the data generated?  There are precedents for things happening with it that one might not welcome:

Do you remember when we discovered that Uber’s passenger app not only traced you to your destination, but continued to trace where you went after you exited the car?

And so the worry is that by installing a tracing app, one would potentially be handing over vast amounts of information to the government, which might use it for sinister ends.  For example, it might allow information to be gathered about immigration lawyers having met clients - presumably, not something that one would want to see.  Correspondingly, we might see other instances of governments prying into personal lives.  And this is at the root of the reason not to install the app.

In order to place such an app on my phone I would have to believe at least the following things: that the promised anonymity would be respected, that the government would not get hold of it, and that it would not be used to trace contacts for other reasons, e.g., to discover an immigration lawyer’s clients.
[W]e would need important safeguards against mission creep, whereby the surveillance app did not de-activate just because the pandemic was over. Perhaps the government discovers a new use for it; perhaps we kind of get used to it, the way we are used to the idea that our E-ZPass keeps a record of every toll booth we have gone through and our grocery store loyalty card keeps a record of the foods we buy.  [Ryan] Calo [has] noted that “clear, explicit rules are critical,” but what point are rules if the government clandestinely subverts them?

Well, OK.  But it's one thing to raise concerns about what a government might do nefariously with data gathered through a tracing app - quite another to take those concerns as settling matters.  For one thing, we have to ask ourselves whether governments actually would do that.  Perhaps they would.  Perhaps not.  It's notable that Davis doesn't really go beyond the "But what if..." stage of argument.  But that's a really cheap move.  We need to know more about the likelihood of this or that outcome.  ("But what if my writing this blog inspires a white supremacist murder?"  Well, I suppose there is a non-zero chance that it could, somehow.  But it's not likely.  It's not a reason not to write it.  The example is hyperbolic, but I hope it gets the point across.)

Let's stick with the immigration lawyer example.  It strikes me that there's a number of problems with this.  The first is that people who are concerned about deportation are likely to be among those least likely to download any kind of track-and-trace app to begin with.  And so - assuming I've understood the technology correctly and it'll be required for two phones to have it installed and active for it to work - there won't be a particular concern there.  Even if I've misunderstood the technology, anyone who is particularly worried would be able simply to turn their phone off for a bit, or leave it at home, or something like that.  This does undermine the efficacy of the app, for sure - and I'll come back to that point in a moment.  (The qualifier would have to do with instances in which apps are installed automatically, like U2 albums.  But if that's the case, there's nothing special about CV-19 apps, because presumably governments could install such apps anyway, and much more surreptitiously.)

In the meantime, it's also worth noting that there are rules about legal privilege that militate against the government making use of data gathered from such an app.  And while I'm not sure how powerful this point is - it's not obvious that there'd be a way to distinguish reliably between a lawyer and a client meeting in the office (which would be privileged) and their meeting in Starbuck's half an hour later (which wouldn't), the principle applies; and, of course, it people are bumping into each other in the coffee shop, then this is a "civilian" interaction anyway, so whether people are immigrants or lawyers would be neither here nor there.  They could easily be just people who happened to be close by at a given point.

"Ah, yes," the response might go, "It's true that the government would be in trouble if it subverted the rules on legal privilege; but so what?  By then it's too late.  And as Davis says, what point are rules if the government subverts them?"  And, superficially, this has a certain attraction as an argument - except for two considerations.  First, it militates against having rules on anything: if you've decided that they won't stop nefarious behaviour, you might as well not have them; and if you don't have the rules, then there's nothing about which to complain.  sequitur, second, that though the rules might not stop people determined to be bastards, their being there does give you a way to resist that bastardy.  That's an important point of principle.  So, for example, if you're an immigrant who's facing deportation because of the rule-breaking way an app was used, you'd have grounds for that deportation decision to be overturned or suspended, because there was (in effect) a due process violation.  Now, admittedly, it might be that when push comes to shove, this makes no practical difference.  But, as indicated, the point of principle would stand, and at the very least it would improve the prospects of other immigrants in a similar situation.

But a point that's more important than any of that is, I think, this: that the reason for having the app is important.  Davis doesn't say much about that, concentrating instead on the reasons to be suspicious of it.  But the examples she offers are examples of institutions using data for what we can take to be bad reasons.  It is prima facie undesirable for Uber to scrape data for commercial reasons.  It is prima facie undesirable for governments to try to sidestep legal norms when it comes to things like immigration (or anything else).  There does not seem to be a particularly compelling, or even good - by which I mean morally defensible - reason for either of those things to happen.

An app for exposure to CV-19 is different.  The underlying reason for that seems to be prima facie decent.  So even if there are reasons con as well, matters are different from how they appear in the examples offered.  We can't make sense of the desirability or otherwise of installing the app unless we give a full account of the reasons pro and con.  It might even be that we find the reasons for a CV-19 app unconvincing all told.  Nevertheless, there is a qualitative difference between it and the other examples Davis offers, precisely because there is a weighty moral reason for a CV-19 app that there isn't in other cases.

And this is where I go back to the point about lawyers switching off their phones for a while.  There is a reason not to.  But maybe, if the government is untrustworthy enough, there is a reason to do that.

If there are no particularly good reasons to install the app, then don't install it.  If the positive reasons not to are great, then don't install it.  But slightly vague appeals to the risk of state surveillance don't seem to me to carry much weight.

Feeling my Age

My last post here was a reply to a paper by Joona Räsänen in the Journal of Medical Ethics that had argued that there was a case for allowing people to change their legal ages.  I... wasn't convinced.  And, encouraged by people on Facebook, I submitted a slightly tweaked version of the reply to the JME; it's now published, and available here.  I was not the only critic - and it's notable that the criticisms that have been published raise very similar points.  For his part, Räsänen has provided a reply to some of the criticisms.

Readers: it's not convincing.  I'll be brief.

"Iain Brassington and William Simkulet both raise the following objection against legal age change," he says, paraphrasing us thus:

Ageism is not a reason to allow age change but a reason to require that age is not asked while recruiting employees.  Age change should not, therefore, be allowed because there is an easier way to solve the problem of discrimination: restricting access to one’s birthdate.

OK.  That seems like a reasonable précis, and it attracts a twofold response from him.  First, if recruiters are allowed to ask but applicants allowed to withhold age, that is a sign that there is something to hide, and so it would not solve the problem.  This is possibly correct, as far as it goes - but that's a symptom of ageism, and so it's not quite clear where we should go next.

The second option, Räsänen continues,

is to prohibit everyone from revealing their ages in job applications to ensure that no-one can be discriminated against because of age.

(This is the position towards which I lean, by the way.)  But, he objects,

[t]his option might reduce discrimination but the cost is too high. Age is an important part of people’s identities. If we do not allow people to reveal their ages to others, we are committing a serious moral wrong because we are restricting their freedom on something that matters to them greatly.

I have real problems with this.  Bluntly, I don't know what it means, and I can't even speculate about what it's supposed to mean.  What are we supposed to make about a claim that "age is an important part of people's identities"?  What work is being done by "identity"?  Indeed, is any work being done by it at all?  In what sense is age important to whatever it is that "identity" is supposed to mean?

In it for the Money

Something I'd never realised about my job was that I've been missing out on the chance to turn into a cash-machine.

In the grand scheme of things, academic pay isn't bad... once you get established.  The problem is that getting established isn't easy: I was 30 before I'd ever earned enough to pay income tax, and it's got harder since then to get a foot on the career ladder.  Taking into account the level of student debt that new entrants'll've accrued, which are far higher than people of my cohort would have had, and the way that they're expected to have a portfolio of publications even before getting a job, I'm glad I'm not looking for a first job now.  Still, the point stands that, once you've got a foot on the ladder, the average academic salary is comfortably more than the average salary.  All the same: a bit more income on the side would never be a bad thing, would it?

Considerablay richer than yeow.

Daniel Sokol, writing on the JME blog, thinks that it should be possible to monetise medical ethics, and offers advice on how to do so.  Well, he might be offering advice.  He might simply be looking to tell the world that he's doing nicely, and tacking an advert for his book on at the end.  It's hard to know.  Anyway: he's got some suggestions.

I'm not going to rehearse what they are point by point, because that'd be tedious.  The gist is that there're thousands of pounds to be made if you happen to make the right moves.  But one wonders quite what planet he's on with the figures he quotes, and about the character that'd be required to make the moves that he recommends.

A Limited Defence of Toby Young

(Originally posted as a two-parter at the other place, here and here.  Admittedly, events have moved on a bit since yesterday, but the point about eugenics stands.)

The response to Toby Young's appointment to the new Office for Students has covered the whole range from "He's not the best person for the job" to "He's the worst person for the job".  Some of the reasons offered have to do with unsavoury comments about women; some have to do with his general lack of qualification.  Writing in The Times, Janice Turner is - I think - balanced in her assessment of his qualities, but still finds him to be (to say the least) wanting.  But the thing that's of interest to me here, on what is a bioethics-related blog, is one of the other sources of controversy: his public support for (a kind of) eugenics.  The mere fact that he could be associated with eugenics has had some people in paroxysms.  Taken more or less at random here's a tweet from Vince Cable:

Theresa May stood by Toby Young when she should be firing him. This is a man who has a record of misogyny and backs eugenics. His appointment shows poor judgement and, as May admitted, a lack of due diligence. It seems all you need to survive is be a friend of Boris Johnson #Marr

— Vince Cable (@vincecable) January 7, 2018

Note that "backs eugenics" is offered as being a reason in itself to object to Young's appointment.  Cable is not, by a long way, the only person to make this sort of comment.

Is it justified, though?  Well, the article that's generated the ire is this one, called "The Fall of the Meritocracy", published in 2015 in Quadrant.  It's a long piece, and the eugenics bit only comes about 80% of the way through, and for that reason I'll only home in on a few details.  But it is worth looking in a bit more depth at some of those details.  I think that what he's arguing is, in many ways, fairly unremarkable.  It's mistaken in important ways, too; I'll come to those in the next post.  But whatever problems there are with the piece do not flow from the use of the "E-word".  And so, to the greatest extent possible, I'll try to talk about it without mentioning eugenics.