D. T. Max’s article, The Public Shaming Pandemic, talks on multiple stories ranging from Covid-19 victims to racist actions and our society using the internet to publicly shame others for their actions and circumstances. Shaming is not a new idea, as it has long been an accepted moral behavioral correction tool. Shaming is inherently not meant to be truly harmful, but instead is meant to correct negative moral behavior. Additionally, care ethics tell us how we should act in decision making and morality by using a relational approach to ethics and differs from many other approaches because of its consideration of emotions. It relies heavily on relationships among people, particularly individual relationships. Therefore, shaming is most effective when it comes from a close individual relationship, such as a parent or another individual that is respected.
The internet is a very powerful tool that has allowed for connections among people across the world at a much larger scale than was ever possible before. This is great for the spreading of information until it isn’t. It is just as easy for false information to be spread as it is for information that is reliable, and shocking hearsay tends to spread the fastest. Additionally, there is a certain amount of desensitization that comes with interacting behind a computer screen. It doesn’t feel as if a relationship is being formed- it is just you and your screen.
“Cancel culture”, which has become very popular on social media, is one recent way shaming has evolved to fit into our increasingly online society. Unfortunately, this form of shaming is much more permanent and detrimental overall. What was once meant to be a moral behavioral corrector has now become a platform for widespread rejection of a person often based off a single action. In my opinion, cancel culture is not really an effective method of shaming. As it is not a personal relationship, many do not care what random Facebook or Tiktok users are saying about them. Additionally, while often the shaming is warranted, if an individual is “cancelled”, does the reprimand they receive really do anything for them if they as an individual are no longer accepted by society?
In Ed Yong’s Anatomy of An American Failure, Yong explores the actions and implications of the American government. If the American government were said to be holding a position of paternalism over the American people, it is safe to say that it did not end up being for the best interest of said American people. While it is not my place to speak for the motivations of the Trump Administration as I do not know them, it is plausible to assume that part of the reason that they withheld information about just how wide the spread of COVID-19 really was in late January to early February was to preserve peace and not cause mass panic. This ended up backfiring, as this withholding of information and encouragement that everything was under control just emboldened those who doubted the legitimacy of the virus. It is my opinion that there were also much less noble reasons at play such as financial obligations and infrastructure shortcomings, but I do think that the paternalistic viewpoint of the Trump Administration thinking it was in the best interest of the American public was part of it.
The same can be said for the Trump Administration’s stance on masks, and how it changed throughout the spring. At first, they were adamant that masks, especially N-95’s, were not necessary to be wearing in public. While this is obviously not true, one could argue that the reason the Trump Administration said this was because they were trying to preserve what was left in the stockpiles across America that were a non-negotiable necessity for those at the frontline of the battle against COVID-19. Again, the Trump Administration withheld vital information that led to more deaths and higher spread among the public and looking through a paternalistic lens they did this thinking they were helping most of the American public. I would like to point out that this was before issues such as this became partisan.
In general, the infrastructure of the national stockpile and ability for the Public Health systems to handle mass influxes of patients was extremely lacking. As many things are, these changes and shortcomings were mainly tied to financial obligations. The defunding and expulsion of existing measures in place meant to safeguard against pandemics exactly like this one was mainly to allocate more money to other areas that were found to be more relevant or financially beneficial to the government. How would our nation look now if we had not had an administration withholding vital information and an infrastructure to support us?
In the third part of “The Immortal Life of Henrietta Lacks”, Skloot works with Henrietta Lack’s family to find out what really happened with the HeLa cells. As in the first two parts, abuse of power and informed consent, as well as racism plays prevalent roles in the story.
While it is obviously highly immoral at the individual level for a doctor to violate laws of informed consent and essentially steal property through the loophole of fine print on a legal document, I think that this issue is an overall systemic problem. Moore v Regents of the University of California is a prime example of where priorities lie for not only the doctors but also the American Government. John Moore, a patient who had his spleen removed, unknowingly signed his right to his cells away on a consent form. Due to the cells high antibody count it was extremely coveted by scientists and the patent to the cells sold for billions of dollars. When Moore took it to court, even knowing the cells were obtained through violation of informed consent, the court sided with the scientists ruling that once a cell is taken from the body it is no longer that individual’s property. The courts had one motivation: prevent de-motivation of researchers and companies, as well as maintain continued scientific discovery. As this example points out, the government cares more about monetary gain then the individual rights of its citizens.
Monetary gain over the wellbeing of society is again highlighted by the continued poverty of the Lacks family. The HeLa cells brought large monetary gain to multiple corporations, however Deborah who had significant health issues was unable to receive reliable medical treatment even though it was her mother’s cells that have brought wealth and scientific achievement to those who could help her. The fact that it took so many years for the Lacks to find out what was going on with Henrietta’s cells shows just how little the doctors care about Henrietta or her family past what they can do to maintain their research goals. The family was not contacted until they were asking for blood samples to fix the “contamination problem”, nor did the scientists care to have more information on Henrietta or her family past what it could do to make their research articles on HeLa have more “character”. With it so engrained in our society, will we ever be able to reform the blatant disregard of racism and human rights by our society in pursuit of monetary gain?
Skloot’s The Immortal Life of Henrietta Lacks tells the story of a 31-year-old African American woman who was treated for an aggressive form of cervical cancer in 1951 which she died of a year later. While performing her first radiation treatment, the doctors also took a sample of her cancerous cells which became the first human “immortal cells” known as “HeLa” which were a key part of the advancement of many medical treatments including chemotherapy and the polio vaccine. Skloot begins the book by talking about Henrietta’s childhood and life as a young adult, where she lived in impoverished circumstances and was obviously not able to receive convenient and consistent medical treatment. At the time, Johns Hopkins was one of the only hospitals in the Baltimore area that had a “colored” wing where they would treat black patients.
The morality of the doctor’s treatment of Lacks is heavily scrutinized, as no informed consent was given by Lacks. From a legal standpoint, the doctors received all the consent they needed to perform the cell biopsy, as she did sign a form stating her consent for the doctors to “perform any operative procedures…that they may deem necessary” (Skloot 77). However, she was never informed what exact procedures were going to be performed and why, which goes against all criteria of informed consent. Additionally, she was never told the procedures would make her infertile. Not only is this permanent and important information regarding her procedure, but she also stated she would not have gone through with the procedure if she had known this was a consequence. This is one of the main reasons why informed consent is so important. She lost the ability to do something she loved -having children- which would have been preventable had she received all the information. One might argue that this is besides the point considering she may have died even quicker without the radiation. However, a patient, regardless of the outcome, should have the right to make a decision about their body regardless of the consequences either way.
One quote that really stood out to me was Grey calling himself “the world’s most famous vulture, feeding on human specimens almost constantly” (Skloot 76). I don’t believe that Grey saw anything wrong with getting his samples without consent, especially when he viewed it as a sort of “payment” for treating the patients in the public wards such as the colored ward at Johns Hopkins. This highlights the racial issues within healthcare at the time. Grey may have been willing to treat people of color, but he saw no issue with taking from them personal property such as cells without their consent.
Faden and Beauchamp differentiate two definitions of Informed consent. In their entry “The Concept of Informed Consent”, they label these two definitions into different senses. The first sense, labeled Sense1, distinguishes informed consent as being “active authorization” by the patient. This is to be differentiated from agreeing or submitting to an authoritative figure, in which Faden gives an interesting example; A child submitting to a punishment such as a spanking from an authoritative figure, like a parent, and the child giving an active directive to do so of their own autonomy are distinct. Sense1 can be defined as a patient of their own autonomy who has substantial understanding of the procedure intentionally authorizing a professional to perform said procedure. Katz views informed consent and shared decision-making between patient and doctor as synonymous, to which Faden Beauchamp do not agree. They view shared decision-making to be manipulative and under the Sense1 definition, a shared decision does not need to be reached for a patient to exercise autonomous authorization.
Conversely, the second sense, labeled Sense2, is defined as effective consent, or obtainment of procedures that satisfy rules and requirements of institutional practice. In other words, the informed consent that was valid in sense1 is only valid in sense2 if they meet the requirements -often of social or legal design- of that said practice. The example Faden gives is a 19-year-old giving authorized consent to a kidney transplant. This meets the definition of informed consent in Sense1, however because the law states the legal age of consent to surgery is 21, the decision is not valid under Sense2. Adequate consent in Sense1 does not always equal adequate consent in Sense2 and vice versa. Faden and Beauchamp rest on the idea that the justification behind obtaining informed consent is in deference to autonomy. While Sense2 is “morally acceptable” even when it differs significantly from Sense1, it can veer away from the absolute necessity for authoritative autonomy and therefore prove problematic in terms of morality.