Is sexual orientation analogous to race?

The argument I've most often seen for why sexual orientation is analogous to race is because both are not "choices": just as we cannot choose our race, so likewise we cannot choose our sexual orientation.

1. On the face of it, this conflicts with the work of LGBT scholars like Lisa Diamond. For example, see her book Sexual Fluidity: Understanding Women's Love and Desire.

Along the same lines, see Edward Stein's The Mismeasure of Desire: The Science, Theory, and Ethics of Sexual Orientation.

2. There's also empirical evidence of former homosexuals choosing to become heterosexuals (e.g. here).

3. We don't choose how attractive or ugly we are, how tall or short we are, among many other traits and characteristics. Does this mean physical attractiveness and height are analogous to sexual orientation? If so, then shouldn't we legislate laws protecting ugly people and short people from discrimination by the film industry, the National Basketball Association, and so forth?

4. As Jeremy Pierce has pointed out in his A Realist Metaphysics of Race, there are various positions on what race is. Does race exist at all? Is race primarily a "natural kind" where "because of the genetic similarity, members of a race share the same range of moral traits, behavioral dispositions, and emotional dispositions"? Is race primarily a social construct? Etc. Thus, we'd have to first come to an agreement about what race is before we can make an argument from analogy regarding race and sexual orientation.

5. Perhaps LGBT advocates wish to tweak the argument so it's more like sexual orientation is sometimes but not usually a choice. If so, then it's no longer analogous to race if we take race to be what we are immutably born with.

Also, if so, then as Steve Hays has brought up in the past, people can be addicted to drugs, alcohol, smoking, gambling, pornography, etc. Many believe they can't always choose contrary to their addiction. Many can't help but sometimes or oftentimes indulge their addiction. Given this, I'd be happy to conclude LGBT sexual orientation is analogous to addiction.

July effect

Political correctness run amok?

I just saw this article about a physician (anesthesiologist) who "trashes a sedated patient - and it ends up costing her":

1. It wasn't only the anesthesiologist who did this. It was several people in the surgical team including another physician - i.e. the gastroenterologist.

2. True, this was rude talk by the surgical team including physicians. It also shows their lack of judgment.

3. That said, I wonder why the gastroenterologist (let alone other medical staff) wasn't likewise penalized since he too made similar remarks about the patient? Instead, he was "dismissed from the case." I guess he has a really good lawyer!

4. Or, maybe more likely, he was the patient's personal physician, has a good rapport with his patient, and apologized to the patient. Whereas most patients have no idea who their anesthesiologist is. It's probably easier for most people to sue an anonymous person than someone the person knows.

5. I don't buy the explanation in the article that the patient recorded the conversation "to capture the instructions his doctor would give him after the procedure." That's because the instructions are hardly instructions at all. The instructions before a procedure would be something like: just close your eyes, breathe in the anesthetic, and fall asleep. The instructions after a procedure would be something like: open your eyes, relax, rest. Why would anyone need to record these sorts of instructions?

6. I could be mistaken, but I thought legally people (including patients and physicians) are prohibited from recording conversations without obtaining written informed consent.

Indeed, the patient wasn't even part of the conversation, yet he recorded it presumably without other parties' informed consent. This sounds amiss to me, but then again I'm no lawyer.

The article notes Virginia (where this incident occurred) is a "'one-party consent' state, meaning that only one person involved in a conversation need agree to the recording." But would any of the doctors or nurses agreed to have the conversation recorded?

Or is this somehow suggesting only the patient needs to "consent" to his own recording? If so, then this seems quite unfair to the people being recorded! (I'm looking at you, NSA! Just kidding.)

7. By the way, putting legality aside, I'm not suggesting it's always unethical to secretly record a conversation. It could be the patient had a justifiable reason to secretly record the conversation. Although the article doesn't tell what the reason would be in this case.

However, imagine how the media would've liked to see this play out if a doctor was caught secretly recording a patient, even if the doctor had a justifiable reason to do so.

8. All that said, the patient was awarded $500k and the doctor lost her job. Granted, I don't know how the law works, but this seems to be out of proportion to the remarks made and "distress" caused to the patient. I would've instead expected at most something like a few thousand dollars, free counseling sessions for the patient, maybe the state medical board reprimanding the physicians.

9. I suppose the main lesson is doctors always need to tread very carefully. Always watch what they say and do. Always be on guard. Never say stuff like a patient is fat and needs to lose weight, in case it comes back to haunt the doctor! In short, be afraid to speak your mind, otherwise risk getting sued. I suppose this is the price of living in a society which kowtows to political correctness. Where coarse and inappropriate talk may be mistaken for slander or defamation. Where surveillance is ubiquitous.

Todd Howard

Roof and Suboxone

I've read reports indicating the mass murderer Dylann Roof "may" have been on Suboxone. He may not have been, but let's say he was or is on Suboxone. If so, to my knowledge:

1. Suboxone is primarily used to treat people with opioid addiction. Addiction to opioids like morphine or heroin. Basically, Suboxone reduces the craving for opioids and it reduces withdrawal symptoms.

2. Suboxone is a fairly mild and safe drug (unlike say methadone which is a standard treatment for addiction to opioids like heroin and which needs to be very closely monitored).

In fact, Suboxone isn't generally even used as initial treatment to come off of opioid addiction, although perhaps it can be, but rather it's normally used to maintain the treatment once the initial treatment is successful.

Not to mention Suboxone isn't strong or powerful enough to be used in people who need high maintenance doses. It's generally used in people who require mild to maybe moderate maintenance doses.

3. I think there are basically two possibilities: the Suboxone was working, or the Suboxone wasn't working.

a. If the Suboxone was working, then I can't see how Roof's use of Suboxone would make him less culpable. If anything, if the Suboxone is working, then Dylann should feel more settled or stable in mind. More like a normal person.

b. If the Suboxone wasn't working, or not working well enough, then there could be side effects. However, even still, the side effects are not normally mind-altering effects.

The main side effects are mainly constipation, upset stomach, nausea and vomiting, lower blood pressure, headaches, dizziness, sleepiness or drowsiness, mild agitation.

Also, Suboxone itself can be addictive, but certainly far less addictive than the opioids it's meant to counter (e.g. morphine, heroin).

4. However, Suboxone is not a street drug, I don't think. Junkies would prefer something much stronger like heroin. Suboxone is relatively expensive for the average person (was Roof insured?) and requires a prescription. How would Roof have acquired Suboxone in the first place?

To catch a predator

(Background: See Richard Carrier's recent announcement that he is polyamorous, etc.)

Doctor Who

(Source: Alice X. Zhang.)

Anesthesia

A colony of bacteria

Richard Dawkins once claimed in "The Richard Dimbleby Lecture: Science, Delusion and the Appetite for Wonder (1996):

For the first half of geological time our ancestors were bacteria. Most creatures still are bacteria, and each one of our trillions of cells is a colony of bacteria.

Hm, "each one of our trillions of cells is a colony of bacteria"? Sorry, I couldn't leave this glaringly inept bit unchallenged. I'll try to keep it short and only say a couple of things for now:

1. What does Dawkins mean by "each one"?

   a. For starters, "each one" of our cells is a single cell, not a "colony" of cells (let alone bacterial cells). But maybe Dawkins simply expressed himself poorly here.

   b. Or does Dawkins mean all the constituent parts of a cell within a single cell are themselves "a colony of bacteria"? If so, then that's just dumb. Are the constituent parts of a bacterial cell likewise "a colony of bacteria" within a single bacterial cell such that we have an infinite regress of "colonies of bacteria"? It's turtles (or bacteria) all the way down!

2. By the phrase "each one of our trillions of cells," I presume Dawkins is referring to a group of the same type of cells within the human body. Say brain cells like neurons. But how are neurons equivalent to "a colony of bacteria"?

   a. Does Dawkins mean neurons are literally "a colony of bacteria" residing in our brains? If so, there are several problems. For one, it fails to distinguish between self and non-self. If neurons are indeed "a colony of bacteria" in humans, then wouldn't we expect our immune system to recognize them as such and deal with them accordingly? (Or are they like gut flora, which if so would raise other issues which would appear to contradict established medical science?)

   b. Does Dawkins mean evolutionarily speaking neurons originated from "a colony of bacteria"? If so, that's a pretty big ask. And of course there are many arguments against neo-Darwinian theory as a whole (such as from the ID community).

As an aside, if we are "a colony of bacteria," does that make the Earth a Petri dish (or at least the appearance of a Petri dish)? :-)

Ectopic pregnancy

For what it's worth, if anything, here are some of my thoughts on the topic of ectopic pregnancy:

1. Keep in mind I'm a mere med student, not a physician, let alone an OB/GYN. I'm open to correction on the medical science and other related data.

2. The vast majority of ectopic pregnancies are tubal ectopic pregnancies. Specifically, 95-98% of all ectopic pregnancies are tubal ectopic pregnancies. This simply means they're in one of the Fallopian aka uterine tubes.

   Other types of ectopic pregnancies are far less common (e.g. ovarian, cervical, abdominal).

3. My understanding is if an ectopic pregnancy occurs (e.g. the embryo implants in one of the uterine tubes), then there are basically two possibilities:

   a. The pregnancy will end in miscarriage.

   b. The baby will grow too big and rupture the uterine tube. This may in turn damage adjacent organs. Worse, the rupture could likewise cause the mother to hemorrhage to death.

4. If ectopic pregnancy is discovered early on, and doctors think (a) is most likely, then doctors will attempt what's called "expectant management." This means the doctors will closely monitor the mother and hope the pregnancy will naturally resolve itself in a miscarriage. That way, nothing much needs to be done by the medical team, and the health outcomes for the mother are probably best (e.g. she'll still likely be fertile).

   But if (b) is more likely, then medical (in the form of an abortifacient drug i.e. methotrexate) and/or surgical intervention is needed. It could be a medical emergency depending on how close to rupturing it is.

5. A few possible if currently perhaps unrealistic pro-life options:

   All these assume the baby in the ectopic pregnancy is developing normally or at least not developing too abnormally. This may be a pretty big assumption though. It's quite possible the baby won't be developing normally. Not getting enough blood and nutrients from the mother and so on since it's not implanted in the mother's womb but outside it (by definition).

   a. A potential option is to surgically transplant the embryo from the uterine tube (or wherever else it is) to the uterus aka womb.

   However, at least to my knowledge, medical science isn't advanced enough to do this let alone do this safely.

   Maybe someday in the future.

   b. Another possible option is to allow the ectopic pregnancy to grow and develop as much as possible, and then to surgically remove the baby as a preemie.

   However, this is highly unrealistic in a tubal ectopic pregnancy. The diameter of the uterine tube is approximately half an inch or thereabouts (about 1.25 cm). While the uterine tube is extensible to some degree (depending on several factors), the bottom line is if the baby grows too much bigger than the diameter of the uterine tube, then it could rupture the tube, and put the mother's life at risk. The baby would already be about half an inch at around 6 weeks. By 8 weeks or so, the baby would have doubled this size. At this point, or not too much beyond this point, it's possible the uterine tube could be at grave danger of rupturing. But to remove the baby at even 10-12 weeks would mean it'd die.

   Currently the earliest we've been able to save babies is around 20 weeks, give or take. And that's extremely rare. Most don't make it.

   But maybe future medical technology will make this a viable option.

   c. In the vast majority of ectopic pregnancies (i.e. tubal ectopic pregnancies), unfortunately it seems the best option is either to allow the ectopic pregnancy to naturally end i.e. miscarriage, or to intervene and abort. This is where some philosophers and ethicists justify the abortion by the doctrine of double effect. But in a small percentage of ectopic pregnancies, it may be possible to save the baby and/or mother. Basically, my understanding is these are in general only realistic in abdominal ectopic pregnancies, although there may be some cases where it's happened in other types of ectopic pregnancies.

   If the ectopic pregnancy is in the abdomen, then there might be more room as well as sufficient blood supply (depending on where in the abdomen the baby is) for the baby to grow and develop and with some luck make it to 20+ weeks, and thus we could hope to remove the premature baby such that neonatologists have a fighting chance to work their magic and rescue the baby. Although even 20+ week old babies are still at huge risk of dying. (A full-term pregnancy is at least about 37 weeks.)

   But even still there's absolutely no guarantee both baby and mother won't die. I think it'd be best to look at abdominal ectopic pregnancies on a case by case basis and see what, if anything, can be done to save both, or one (if not both).

   Here is a list of some successful ectopic pregnancies. But note the vast majority of them (if not all of them) are abdominal ectopic pregnancies, not tubal ectopic pregnancies (which again constitute the vast majority of all ectopic pregnancies - i.e. 95-98%).