Monday, November 26, 2012

Right and Wrong: All In Our Brains?

When I was teaching an engineering ethics module for a few semesters, one of the first things I asked the students to do was to spend five minutes writing an answer to this question: “How do you tell the difference between right and wrong conduct?”  The responses usually fell into three categories.

Many people would say that they rely on what amounts to intuition, a “gut feeling” that a course of action is right or wrong.  Nearly as popular was the response that they look to how other people would act in similar circumstances.  Very rarely, a student would say that he relies on religious guidelines such as the Ten Commandments or the Quran.  These results are consistent with a claim by neuroscientist Josh Greene that many of our moral decisions are guided, if not determined, by the way our brains are wired.  But we can rise above our instinctive moral habits by consciously thinking about our ethical dilemmas and applying reason to them.

An article in Discover magazine outlines the research Greene and others have done with sophisticated brain imaging techniques such as fMRI (functional magnetic resonance imagining), which indicates spots in the brain that get more active when the mind is engaged in certain activities.  Greene finds that routine ethical choices such as whether to get up in the morning are handled by lower-level parts of the brain that we share with other less-developed animals.  But when he poses hard ethical dilemmas to people, it is clear that the more sophisticated reasoning areas of the brain go to work to deal with reasoning about probabilities, for example, as well as the parts that control simpler instinctive actions.

One of the ethical dilemmas Greene uses is a form of the “trolley problem” conceived by some philosophers as a test of our ethical reasoning abilities.  As Philippa  Foot posed the problem in 1967, you are asked to assume that you are the driver of a tram or trolley that is out of control, and the only choice of action you have is which track to follow at an upcoming switch.  There is one man working on the section of track following one branch of the switch, and five men on the other branch.  Which branch do you choose, given that someone is going to be killed either way?

Greene has found that these and similar hard-choice ethical problems cause the brain to light up in objectively different ways than it does when a simpler question is posed such as, “Is it right to kill an innocent person?”  Whether or not these findings make a difference in how you approach ethical decision-making depends on things that go much deeper than Greene’s experiments with brain analysis.

But first, let me agree with Greene when he says that the world’s increasing complexity means that we often have to take more thought than we are used to when making ethical decisions.  One reason I favor formal instruction in engineering ethics is that the typical gut-reaction or peer-pressure methods of ethical decision-making that many students use coming into an ethics class, are not adequate when the students find themselves dealing after graduation with complex organizations, multiple parties affected by engineering decisions, and complicated technology that can be used in a huge number of different ways.  Instinct is a poor guide in such situations, and that is why I encourage students to learn basic steps of ethical analysis so that they are at least prepared to think about such situations with at least as much brain power as they would use to solve a technical problem.  This is a novel idea to most of them, but it’s necessary in today’s complex engineering world.

That being said, I believe Greene, and many others who take a materialist view of the human person, are leaving out an essential fact about moral reasoning and the brain.  The reigning assumption made by most neuroscientists is that the self-conscious thing we call the mind is simply a superficial effect of what is really going on in the brain.  Once we figure out how the brain works, they believe, we will also understand how the mind works.  While it is important to study the brain, I am convinced that the mind is a non-material entity which uses the brain, but is not reducible to the brain.  And I also believe we cannot base moral decisions upon pure reason, because reason always has to start somewhere.  And where you start has an immense influence on where you end up.

As a Christian supernaturalist, I maintain that God has put into every rational person’s heart a copy, if you will, of the natural laws of morality.  This is largely, but not exclusively, what Greene and other neuroscientists would refer to as instinctive moral inclinations, and they would trace them back to the brain structures they claim were devised by evolution to cope with the simpler days our ancestors lived in.  (If they really think ancient times were simpler, try living in the jungle by your wits for a week and see how simple it is.)  God has also made man the one rational animal, giving him the ability to reason and think, and God intends us to use our minds to make the best possible ethical decisions in keeping with what we know about God and His revealed truth.  This is a very different approach to ethics from the secular neuroscience view, but I am trying to make vividly clear what the differences are in our respective foundational beliefs.

So both Greene and I think there are moral decisions that can be made instinctively, and those that require higher thought processes.  But what those higher thought processes use, and the assumptions they start from, are very different in the two cases.  I applaud Greene for the insights he and his fellow scientists have obtained about how the mind uses the brain to reach moral decisions.  But I radically disagree with him about what the outcomes of some of those decisions should be, and about the very nature of the mind itself.

Sources:  The Discovery magazine online version of the article on Josh Greene’s research can be found in the July-August 2011 edition at  I also referred to the Wikipedia article on “Trolley problem.” 

Monday, November 19, 2012

Million-Dollar Surgical Robots: Worth the Cost?

The other day, a friend of mine had emergency surgery for a strangulated hernia.  While I have not pressed him for details (he’s still recovering), it’s possible that the surgeons used robotic surgery aids during the operation.  Believe it or not, there are ethical questions one can ask about such devices, and because they involve highly engineered robotic systems, I think it’s appropriate to discuss the question of whether these gizmos are worth the money they cost in a blog about engineering ethics.

Before we go any farther, I should make clear that we are not talking about replacing surgeons with robots.  (The surgeons wouldn’t stand for it, for one thing.)  A live human surgeon is always in control.  In the case of robotic laparoscopic surgery, for example, three small incisions are made to allow the insertion of a camera and operating tools.  The surgeon sits at a control console a few feet away from the patient, watches the camera field of view on a display console, and manipulates the tools remotely.  Obviously, such surgery requires special training, but many surgeons say they can do a better job with robotic aids once they have mastered the techniques involved.  An endoscopic camera can give a better view than you could get by standing above the patient and looking through an old-fashioned open-wound type of incision, which is much larger than the laparoscopic type used in most robotic operations.  It’s also easier to do finely-calibrated motions with the robotic instruments, because one’s hand motions get scaled down to allow better control of the tools.  A new million-dollar robotic surgery system recently described in the New York Times reduces the number of laparoscopic incisions from three to one.  Patients undergoing operations with this kind of robot for gallbladder removal (the only type for which this particular unit is approved by the U. S. Food and Drug Administration, or FDA) can go home with only one small incision, which can be near the navel and practically invisible.

It appears that most surgeons are generally in favor of robotic surgery—what about the patients?  Other things being equal, fewer, smaller incisions would be better.  But what about the cost?  Here is where things get complicated.

According to the Times article, one use of the million-dollar robot can add up to $60,000 to a surgical bill, depending on what auxiliary equipment a hospital already has.  Under the present fee-for-service model, if insurance companies approve, the patient can have the surgery and may not even notice the extra charge on the bill.  But if people had to pay directly out of pocket for their operations, I wonder how many folks would shell out an extra $60,000 to wind up with only one abdominal scar instead of three?  Maybe a few bathing-suit supermodels could justify the expense, but what about the rest of us?

This is a hypothetical question, because not many people pay for operations out of pocket.  Very poor people have Medicaid in many cases and most employed people (not all) have health insurance.  In the U. S., we are looking at a large change in how medical care is funded, with the gradual rollout of what even the President himself now terms Obamacare.  Without going into details, the net effect of this law will be to require more people to have health insurance and to extend governmental control of the system with regard to what interventions will and will not be paid for.  It is far from clear that Obamacare will have the net effect of making robotic surgery more accessible.

Expensive robotic surgery systems are just one specific example of a trend that has been going on for decades:  the soaring sophistication and cost of modern medical care.  Perhaps because U. S. health care is more free-market-oriented than in many other countries, this trend has been more noticeable here than elsewhere.  Although one might expect the U. S. to be more friendly to costly healthcare innovations than nationalized-medicine countries such as Canada, it turns out that the firm making the million-dollar robot is based in Toronto.  One reason for that may be that the FDA runs one of the more restrictive regulatory operations compared to many other countries.  It is very difficult, expensive, and risky to get drugs or other medical interventions approved in this country.  A good bit of the million-dollar price tag for the robot machinery goes to pay off expenses for getting the thing approved.  No one wants to go back to the bad old days when any quack could set up shop as a doctor and inflict wanton harm upon uninformed patients, but there is a lot of evidence that the FDA has gone too far in the other direction of making it too hard to get innovative medical advances approved.

From an engineering point of view, robotic surgery seems to be a basically beneficent kind of technology.  If it leads to fewer complications, faster surgery, and more rapid recovery, it might even be shown to pay for itself compared to the old-fashioned open-wound method, simply on the basis of efficiency.  Unfortunately, the medical profession is still learning how to measure its own performance in quantitative ways, and so it is hard even to obtain reliable data on such cost-saving possibilities.  This is where industrial engineers can help, but only if the medical community asks for assistance.

Industrial engineers are the efficiency experts of engineering.  They look at any process and find ways to measure how resources are used, what the goals are, and how the process can be made more efficient.  Up to now, applying industrial engineering principles to medicine has been somewhat of a novelty.  But if we as a nation are serious about doing something with regard to the rising costs of health care, I see a great future role for industrial engineering in the evaluation and comparison of medical procedures.  The tricky part will be to apply these techniques intelligently, and not in a one-size-fits-all way that will simply centralize control in Washington without making anything better.

My best wishes to my friend for his rapid recovery, and for the betterment of the nation’s health care system in general.  I for one hope robots will be a part of it.

Sources:  The New York Times article “When Robotic Surgery Leaves Just a Scratch” appeared in the online edition on Nov. 17, 2012 at 

Monday, November 12, 2012

A Purely Nominal Problem

My father didn’t like to spend money when he didn’t have to, so when my mother expressed a wish for an automatic dishwasher, one day he showed up with an old portable unit that some friends of ours got rid of when they bought a newer model.  It was a big floor-model box on rollers, and you ran one hose to the kitchen sink and another to the sink drain and plugged it into a wall outlet.  It worked fine for a few weeks.  Then one day it refused to drain.  We opened the door and saw all this dirty dishwater, so we bailed it out and I volunteered to fix it.  Because I was cheaper than calling a repairman, my father agreed to let me tear into the thing.  After a lot of gross and messy work, I found the problem:  a toothpick had lodged between the drain pump impeller and the housing.  That little toothpick had jammed the pump, and as a result the whole washer couldn’t drain.

I learned several things from that experience (not the least of which was to avoid appliance repair as a future career).  But the most important one was that fairly small, common, almost unnoticeable things can have big negative effects.  And the things don’t need to be physical ones at all.  In fact, immaterial things can make a lot more difference than any physical object, especially if they are so widespread that you don’t notice them, like fish who don’t realize it’s water that they’re swimming in.  The little thing I’d like to draw your attention to is nominalism.

The word “nominal” is often used by engineers to mean “typical” or “according to the specifications.”  But its original meaning is “relating to names.”  Nominalism is a philosophical position first proposed by William of Ockham (~1288 A. D. - ~1348).  Until he came along, most philosophers thought the word “apple,” for example, referred to a real and essential, though immaterial, “appleness” that is shared by all things properly called apples.  However, William of Ockham claimed that there was no such thing as appleness—the essence of what it is to be an apple.  Instead, “apple” is just a name for certain kinds of objects that we, in our human wisdom, have decided to call apples.  In other words, he denied that there are any universals—that is, essences of things.  There’s just a lot of round red fruits out there that, for convenience, we have decided to group under the name of “apple,” but in reality, all apples are different individuals and there is nothing more to the word than the sum of all things called apples.

After William of Ockham proposed nominalism, the other philosophers had to think of a name to call themselves, and the term they chose was “realists.”  A realist, in this technical sense, thinks that there is indeed a universal concept, objective and independent of our minds, which in English is denoted by the word “apple.”  These concepts, which the moderate realist Aristotle called essences, are as objectively real as a bank account.  A bank account is not a material thing, though there may be material records of it.  A bank account is a non-material concept, and so are the concepts of “apple,” “tree,” “horse,” and “man.”

Unless you are aware of this historical controversy, as a typical 21st-century person you probably think and act as a nominalist most of the time.  For example, if you agree with the words of the 1992 U. S. Supreme Court decision in Planned Parenthood vs. Casey that “At the heart of liberty is the right to define one's own concept of existence, of meaning, of the universe, and of the mystery of human life,” you are a nominalist, because defining is what a nominalist does.  First comes the name, then come the items to be grouped under that name.  But the namer is always in charge, and things can be arbitrarily regrouped by the namer to suit one’s convenience.  As the philosopher Richard Weaver has pointed out, an important consequence of nominalism is that “if words no longer correspond to objective realities, it seems no great wrong to take liberties with words.”  So, for example, the genocide of Jews by Nazi Germany in World War II is euphemized to “the final solution.”

Engineers are perhaps less apt to fall into the grosser errors of nominalism, because we have frequent encounters with objective reality.  If a computer chip you design doesn’t work, calling it by a different name isn’t going to make it start working.  But even the way engineers use logic has been affected by nominalism.  The digital logic that all digital computers use is based on symbolic logic devised by George Boole, a nineteenth-century mathematician whose hope was to reduce all logic to symbols.  The trouble is, symbolic logic assumes that nominalism is true, and throws out a great deal of material that traditional Aristotelian logic relied on, including the notion that understanding is a uniquely human power essential to right thinking.  But if everybody uses nominalist logic that can be expressed by Boole’s “boolean algebra,” we have reduced our thought processes to those that can be done by computers.  This is an important source of the idea put forth by artificial intelligence proponents that the brain is really nothing more than an advanced wet computer.  If we can’t make computers act like humans, we’ll reduce humans to the point that they act like computers.

Let’s hope that doesn’t happen.  Regular readers of this blog may have noted that I try to approach philosophical matters from an Aristotelian perspective that moves from the real, objective world to the world of thoughts.  Nominalism tempts us to do the opposite:  to define things the way we want them to be, and then look for pieces of reality that fit our preconceived notions.  I think engineers of all people should be aware of the dangers of nominalism.  Realism is more than just being practical; it means realizing that there is more to the world than we can possibly understand or control, and the proper attitude toward nature is one of humility.  Otherwise, like that toothpick in the dishwasher, nominalism can throw a whole culture out of whack.

Sources:  The quotation by Richard Weaver is from his 1948 book Ideas Have Consequences (Univ. of Chicago Press), p. 7.  I was inspired to write about nominalism and realism by reading one of the few logic textbooks in print which employ realist Aristotelian logic rather than symbolic logic as its basis:  Peter Kreeft’s Socratic Logic (South Bend, Indiana:  St. Augustine’s Press, 2004).

Monday, November 05, 2012

Technology and Democracy—Too Much Information?

Here in the U. S. we are in the last three days of the 2012 election season.  At stake is the Presidency, hundreds of seats in the U. S. Congress, and thousands of state and local races.  Our question for today is this:  have advances in technology made democracy as it is practiced in the U. S. better or worse?

That question immediately leads to another:  by what standard are we to judge improvements in democracy?  Unlike technical concepts such as ideal 100% efficiency, it’s hard to imagine what an ideal democracy would look like.  Just imagining ideal people running it doesn’t do any good.  It was James Madison who pointed out, “If men were angels, no government would be necessary.”  So to my mind, at least, an ideal democracy would allow real fallible people to govern themselves to the best of their abilities.

That being said, we must distinguish between direct democracy and representative democracy.  An old-fashioned New England town meeting where the citizens simply represent themselves is a direct democracy, but obviously such a method gets impractical as the size of the political entity becomes larger than a few thousand people.  So what we are discussing is an ideal representative democracy:  one in which people elect representatives periodically to embody their interests and judgments in the operation of government.

In such a situation, we can assess how accurately the elected representatives really mirror the inclinations of their constituents, and how effective this representation is in running the government.  By this standard, technological advances have helped matters in some ways, but have led to big distortions and injustices in other ways.

The good news is that, for example, ballot-counting is a lot faster, and probably more accurate overall, with electronic voting machines and computer networks to handle the math and presentation of election returns.  Electronic news media allows interested parties to learn a great deal of more diverse information than was provided in the old days when there were at most two or three TV networks, as many radio networks, and a couple of daily newspapers in most major media outlets, but no Internet or social media.

What about the negatives?  One serious problem I have seen is the way that computer-intensive calculations have been employed in demographic analyses to gerrymander U. S. House of Representatives districts.  “Gerrymandering” is a term that comes from an odd-shaped Massachusetts congressional district drawn by Governor Elbridge Gerry to benefit his political party in 1812.  The odd shape basically divided his opponents’ constituents and united his own, but one resulting district looked like a salamander and was satirized in a political cartoon that labeled it a “gerrymander.”  The term caught on as a way of criticizing the drawing of voting districts so as to favor one party or another.

Unfortunately, gerrymandering has become a way of life, and it is a routine thing for the party in power in a state to take advantage of every U. S. Census to push the gerrymandering art to new highs.  With computer-intensive analysis of election returns, this process has become one that often guarantees the outcome of an election in a given district.  One adverse consequence is a complete reversal of the original intent of the Founders as to the different purposes of the House of Representatives and the Senate.

Senators, with their revolving six-year terms, were intended to be a steady, long-term, stabilizing influence on government, while representatives, all of whom are elected every two years, were meant to reflect rapidly changing constituent opinion.  The gerrymandering of House districts has turned this intention on its head.  With computer-aided gerrymandering, many representatives enjoy fifteen, twenty, and even thirty-year tenures in their House seats.  But because Senators by law are elected from an entire state (and so far, no one has seriously contemplated gerrymandering state borders yet), they are the ones who can be turned out after a single term, and often are.

I haven’t even mentioned such things as targeted campaign ads aimed at specific demographic groups, the overwhelming power of electronic media and its crippling expense that leads to the exclusion of all but the best-funded candidates (which means that no one without rich friends or wealthy corporations on their side can do much of anything nationally), and the handing over of Congressional authority to unelected bureaucrats, which while not directly aided by technological advances, seems to have become more popular as technology has advanced.  And there are now instant polls conducted daily if not more frequently, with dozens of places online to see the poll results almost minute by minute—or instantly in the case of those public-opinion meters displayed on some TV channels during the Presidential debates.  Just about the only thing that hasn’t changed is the formal mechanism of voting and what it means.

The optimist in me says not to worry too much—perhaps the modern voter really takes advantage of the superabundance of information and delivers a more informed decision than those in the past whose media sources were so much more limited.  But the pessimist in me thinks that technologized democracy tends to pander to the worst and the simplest arguments and procedures:  mass-media scare tactics, reducing voters to a single demographic characteristic (e. g. poor, black, Hispanic, working class, etc.) and manipulating voters based on that characteristic, and other techniques that tend to remove power as a practical matter from the average non-politician citizen, and concentrate it into the hands of the few elite who operate the handles of the analysis and publicity machines.

I recently read a book that pointed out many of these flaws and recommended some radical changes that might move the situation back closer to where it was a few decades ago.  Arnold Kling’s Unchecked and Unbalanced is primarily an analysis of the 2008 financial crisis, but along the way he shows how un-representative our U. S. government has become.  One main takeaway from the book is the fact that while the current system of constituting the House and Senate was set up back when the population was only a few million, it has not undergone any basic change since that time, and now our population is more than 300 million.  In order to get back to the point that a single congressperson represents about the same number of people that he or she did in 1800, say, we would have to have perhaps 5,350 of them rather than the 535 that we do now.  As things are, there is simply too much power and money concentrated in the hands of too few people, and the great mass of voters go largely unrepresented.

Largely, but not completely.  It still means something to vote, and I hope all of my U. S. readers with that privilege will go out and exercise it on Tuesday.  And we will all have to abide by the outcome, so you better vote wisely.

Sources:  Arnold Kling’s book Unchecked and unbalanced : how the discrepancy between knowledge and power caused the financial crisis and threatens democracy was published by Rowman & Littlefield in 2010.  I found the James Madison quote from one of his Federalist Papers at, and used the Wikipedia articles describing “U. S. population”, “democracy”, “gerrymander,” and “republic.”