Life as an Extreme Sport

Category: Academics

Classes and coursework.

Allopoietic Orientalism and Excluded Autopoietics

2004, Academics, CHID 390, Summer 04, University of Washington

An old paper added, just in case I’m called out to prove the paper behind the excessive title exists, in a conversation over on Crooked Timber…

Allopoietic Orientalism and Excluded Autopoietics

Said’s conception of Orientalism is one of “flexible positional superiority, which puts the Westerner in a whole series of possible relationships with the Orient without ever losing the relative upper hand” (7). He sees the dominant discourse of the Occident creating the identity of the Orient, with the Orient (for a series of reasons that would please Jared Diamond) unable to escape from this hegemonic form of identity creation. Chakrabarty belongs to the “postcolonial project of subaltern studies” (1). This group of scholars is primarily focused on rethinking and rewriting Indian history, removing the Orient from the shadow of the Occident. In fact, these scholars pull a maneuver similar to what Stephen Greenblatt, in Marvelous Possessions, highlights Mandeville as doing. Mandeville shifted his history from the Dome of the Rock, the center of the world, to the outer edges of the sphere. Likewise, Chakrabarty, Spivak, and others shift from the “elite” center of Orientalism to the margins of the subaltern.

The problem with this subaltern take is that it is a reaction to the Orientalism Said describes, and in being a reaction ends up simply trying to co-opt the same Cartesian binary model of the power/knowledge dichotomy Orientalism and colonialism operates under. The focus on flipping who has the power in this dichotomous relationship ignores the inherent flaw in the concept of the relationship itself, which is that in any situation where you set up a Self and an Other, you are automatically excluding all that does not fall into either definition. I believe that Chakrabarty, et all, would attempt to argue that the focus of subaltern studies is the space between Self and Other, but that narrow space between the two is still excluding everything that falls outside. What is this outside, this excluded? In terms of Orientalism vs. Occidentalism, it can be those Muslims who live outside the immediate area defined as the Orient by Said (the Levant, Persia and India), such as the Maghreb and sub-Saharan Africans who are Muslim and face the same prejudices of exoticism. It can be those in China who were also under the British colonial power, the pirates of the Barbary Coast, or the Barbary Coast itself. The point being, as excluded, it is something that can and often has an effect on the scenario being described, but is not itself being described.

It becomes useful to think of what both Said and Chakrabarty are talking about in terms of allopoetic systems, an other-made system that imposes form on it from the outside. Orientalism is allopoietic; it is a system of describing and interacting with the Orient created and imposed by the Occident. Likewise, the field of subaltern studies is an effort to co-opt and reframe this allopoetic system in a manner that, while rejecting a Western-dominated history, is still defined by it. (After all, they are opting to specifically reject something for another.) The problem with Said, Chakrabarty and allopoietic systems is that it’s a process; there is a beginning and an end. To take it from the abstract, it’s like an easy-bake oven; raw dough goes in, cookies come out. This allopoietic model doesn’t allow for a system of feedback, or anything except the raw dough and the oven.

If we switch instead to an autopoietic system, we break out of the model of Cartesian dualism and can begin to embrace a feedback system that allows for inclusion of the excluded third. Autopoietic systems are self-creating systems; crudely put, they are interactive systems that continually produce and maintain themselves and the bits and pieces that form their relationships. If we then reframe Orientalism and Occidentalism into an autopoietic system, they are two systems in a dynamic together that, while feedbacking to one another to continue their relationship, are also open to the feedback and input of unacknowledged forces. These forces can be the weather that determines the tea production, the demand for batik in the Caribbean, or the very language used to describe and translate the news. Autopoietic systems allow for temporary binary situations to exist, often nested within one another, while still allowing for an inclusive, non-binary system to encompass the whole.

Both Said and Chakrabarty are operating within the Foucaudian power/knowledge dichotomy and ignoring everything that falls outside the realm of the (British, French, and to a lesser degree German) Occident and the (Levant, Persia and Indian) Orient. Ignoring the excluded third of everything else is a way of seeing the world in terms of clashing allopoietic processes, rather than nested autopoietic systems that allow for temporary binary situations to exist while still creating an inclusive system that encompasses the whole. Which is, perhaps, simply a fancy way of saying that it’s turtles, all the way down.

Citations and References
Said, Edward. “Introduction” to Orientalism
Chakrabarty, Dipesh.
Maturana, Humberto R. and Francisco J. Varela

[The Daily] – The Right to Life

2006, Academics, The Daily, University of Washington

The Right to Life
2006-07-05

So here’s a question for you to mull over: When were you old enough to make your own decisions?

Chances are you were pretty young when you figured out you didn’t like the taste of broccoli. And you probably weren’t old enough the first time getting drunk sounded like a good idea.

Now ask yourself this: At what age were you old enough to make your own medical decisions?

You were probably old enough to know what you wanted or didn’t want, medically speaking, before you turned 18. Probably even before 16 or 14, although it gets murkier the younger you go. Some kids are a lot more capable of that sort of thinking than others.

I doubt anyone thinks they were young children when they were able to make their own medical decisions. Since the concept requires speech, infants are ruled out.

This means in the case of infants and anyone else who hasn’t reached that nebulous age of “old enough,” someone else — a parent or legal guardian — is making their medical decisions.

This is how it should be, right?

Or is it?

Consider that by the time someone is in his or her teens, doctors will start asking for assent, if not consent, from the teenager. That is, they’re asking to sound out the patient’s feelings on treatment, aside from the feelings of the parent.

While legally the patient cannot give consent (unless, as in some states, it’s for issues related to sexual health), the patient can assent to treatment. Or they can disagree, in which case the doctor has to decide how to navigate the suddenly rough waters.

While you’d think doctors would want to avoid situations that could place them between patient and parent, the reason they do ask for assent is because — as I’m sure we’ve all experienced firsthand — children do not always follow parents in belief.

For most of us, we deviate from our parents’ beliefs in simple ways. PC vs. Mac, Democrat or Republican, science fiction or not.

But sometimes the apple falls pretty far from the tree, and children end up disagreeing with their parents about more serious, weighty things, like religion.

Religion has typically been the reason you would find a parent in court, arguing that he/she had the right to determine a child’s medical treatment. Parents who believe only in prayer, or who refuse blood or other life-saving treatments for any number of reasons, typically justify their decisions through religion.

That changed in Seattle last week when a 9-month-old baby was smuggled from Children’s Hospital by his mother, who wanted to pursue naturopathic treatments instead of allowing the surgical implantation of a shunt that would allow him to receive dialysis for his failing kidneys.

One Amber Alert and two days later, the mother was in jail and the child back at Children’s. Friday morning, a judge granted Child Protective Services custody, and permission for the surgery the mother so strongly opposed.

Not surprisingly, this case has privacy advocates up in arms, insisting that the government has overstepped its authority, and that parental rights are what matter.

In this case, the legal logic is similar to that used in religious cases, and it’s one I have a hard time finding any ethical fault with.

A child should be allowed to live to the point of making their own choice on whether or not to receive medical treatment, and until that age, you default to the assumption of doing whatever it takes to live.

[The Daily] – Biological Incubators

2006, Academics, Bioethics, The Daily, University of Washington

Biological Incubators
2006-06-21

Susan Anne Catherine Torres and Cristina Doe were born 10 months apart, in August 2005 and June 2006, respectively.

Sadly, Susan Torres passed away six weeks after birth. Yet these two girls are connected to one another through a very unusual circumstance: Both babies were born to braindead women.

According to Dr. Winston Campbell of the University of Connecticut Health Center, there are approximately a dozen cases of braindead women completing gestation to the point of delivering a viable fetus in the medical literature.

Further research in the journal of Obstetrical and Gynecological Survey shows another 15 cases of pregnant women in persistent vegetative states remaining on life support to deliver.

While there are few cases in the literature, this is largely because technology has only recently advanced to the point of making this a possible practice.

The idea of leaving a woman on life support to gestate a fetus is a highly contentious issue. There are those who believe all pregnant women should be kept on life support until delivery is possible. There are those who believe it’s up to individual families to make the decision. Then there are those who see a slippery slope of forced pregnancy and believe if a woman is dead she should be allowed to die, regardless of pregnancy.

These positions are all very self-explanatory, and a few years back, this columnist would have been firmly in the camp of “she’s dead — let her die.”

The idea of a woman being kept alive as a fleshy incubator horrified me — it was like a dystopic nightmare come to life. Women die, but their bodies are kept alive to gestate. What’s next — taking that dead woman, hooking her up to life support and then impregnating her?

In the meantime, I’ve realized that this is a non causa pro causa fallacy, the slippery slope at its worst. It’s saying that if A happens, by a gradual and continual process, B, C, D and eventually Z will happen. Z of course is a horribly bad thing, and since it should not happen, A shouldn’t either.

In reality, there is a strong line drawn between the A of keeping a pregnant woman alive a handful of months to deliver a desired fetus, and the dystopic possibilities inherent in Z.

That strong line is biology. It seems the body can maintain a pregnancy while it is braindead for somewhere around 3-4 months. While it’s long enough to attempt to bring a fetus to viability, it’s not long enough to create a pregnancy from scratch.

These days, I fall in the middle ground: I believe it’s a decision that should be made between family, doctors, friends and religious figures — the important people in the individual woman’s life.

That it be a personal decision, not a political or legislated one, is key. There is currently legislation in 27 states that allow doctors, lawyers and hospitals to override the wishes of the pregnant woman or her family. These pregnancy clauses mandate that every attempt should be made to save the life of a fetus, including keeping the woman alive on life support beyond the wishes of her family and friends.

This is where our concerns should be. It shouldn’t be with people who opt to keep their loved ones alive in order to have a piece of them continue to live in the form of a child.

Nor should it be with the people who believe that heroic measures should not be attempted, and mother and fetus should be allowed to die as nature dictated.

Our concern should be with the people who are taking these decisions out of the hands of those immediately affected and placing them in the clinical hands of the disinterested and uninvolved.

This decision, whether or not to attempt a medical miracle to bring a life into the world, is a private one, not a matter of public policy.

[The Daily] – Medicine or Miracle?

2006, Academics, Bioethics, House MD, Pop Culture, The Daily, University of Washington

Medicine or Miracle?
2006-05-30

A recent episode of the television show House titled “House vs. God” dealt with the idea of faith healing, something that comes up a lot these days in medical journals.

What is the power of prayer? Does faith healing work? Can miracles happen?

As many are aware, there have been multiple studies that attempt to look at these subjects, the strongest being that of the effect prayer has on people.

Unfortunately, even the people running these studies will tell you they are not well designed, and potentially flawed.

This came to light recently when one of the most comprehensive studies on the power of prayer showed that prayer for post-operative cardiac patients actually appeared to have a slightly detrimental effect on the patient.

Perhaps this is a reflection of my interdisciplinary training, but I think the much more interesting questions to ask are why miracles can’t happen and prayer can’t heal.

Some would say that it’s because there is no higher power, deity or God, but do we need such a being to exist for prayers and miracles to work?

After all, couldn’t you argue that a miracle is just that which we don’t understand?

You could quite often say the same thing about our medicine. The typical example is a cell phone in the rain forest, although I’d argue there’s an awful lot of technology and medicine that might as well be (and probably is) “magic” based on how well we understand it.

There is simply the belief, the faith that it will work, because someone is being told it will work.

How is that so different than hearing a faith healer tell you the same?

Of course, we of the rational, medical type say we have medicine. We can take the time to understand how technology works. We can figure it out and we can do the math.

But we cannot and do not fully understand how the body works; we keep finding new things.Miracles keep being rationalized and understood, filed away into things to learn and knowledge to distill.

If we have learned one thing, it’s that the body is an amazing thing.

In the episode of House I refer to, the patient — a young teenage boy — hears the voice of God, and believes God wants him to be a faith healer. Dr. House takes the case on after the boy collapses in the middle of a church meeting, and eventually discovers the boy has a tumor in a certain part of his brain, the result being that he experiences hallucinations — hallucinations he believes to be the voice of God.

Who is to say that the power of the placebo effect isn’t enough to help some people?

After all, we know scientifically and medically that positive thinking does positively affect our health, including helping us recover from illness.

Does it even have to be a placebo? We understand so little of how the brain works, is it so genuinely inconceivable that there are still processes left we don’t understand?

We don’t want to entertain the notion that something can be both real and invisible, quantifiable yet mystical, so it gets filed away as faith-healing fakery and fraud.

But in 10 years, perhaps it will have a Latin name and a textbook, diagnosis and belief, some way to reconcile disbelief and faith (or evidence).

That’s the way knowledge goes: a part of life for both miracle and medicine.

Why should we limit our view of the world to that science we already understand, instead of enjoying the magic and mystery behind those things we don’t?

[The Daily] – Expecting the layman to be a doctor

...and everything else, Academics, The Daily, University of Washington

Expecting the layman to be a doctor
2006-05-24

You’re in the doctor’s office, and she’s just handed you a form to read. While you’re scanning over the form, she starts to explain it to you. It’s your consent-for-surgery form and it’s telling you what the surgical procedure is, what the goal of surgery is, and what the risks are — from common side effects to rare complications.

This sounds simple and is common sense. It is, in fact, a required step all hospitals must go through in order to maintain accreditation. So what’s the problem with informed consent?

Often, the problem is in what your doctor does. For example, do you understand the following?

“A neurolytic sympathetic blockade of the right stellate ganglion nerve bundle with bupivacaine and a corticosteroid.

“Potential complications include injection into the vertebral artery, phrenic and superior laryngeal nerve block and rarely, intrathecal injection.”

Chances are good that, unless you have a strong medical background or have been subjected to a similar procedure to the above, you have little idea of what that meant.

Yet, it tells you the procedure, the risks and potential for complications. It gives information necessary to make an informed decision. Or does it?

After all, if you can’t understand what is being said, you can’t really make an informed decision.

The problem is, many see doctors as people in a position of authority. Doctors have knowledge, based on their education. Because of this, patients trust what doctors say needs to be done; this is often blind faith.

Or, at least uninformed faith.

According to Art Caplan, director of the Center for Bioethics at the University of Pennsylvania, “The informed consent process has become more of a shield than a doorway,” which protects the doctor and hospital from malpractice instead of empowering the patient to understand his or her treatment.

There are two major problems interfering with the notion of true informed consent: reading comprehension and education/medical knowledge.

The first is very simple: Informed-consent forms, those that you read and often sign before anything from a vaccine to a surgical procedure, are, according to the e-journal of the Association of Medical Directors of Information Systems (TIR), written in college-level language.

The average American adult reads and comprehends at approximately an eighth-grade level.

Writing for an eighth-grade comprehension level does not have to mean dumbing things down.

TIR gives an example of how this can be achieved. Instead of saying: “Adhering to treatment recommendations is often fraught with difficulties, for families have a multitude of scheduling commitments, and may also be highly insecure about their abilities,” doctors and their consent forms can say, “Families often find it hard to follow treatment recommendations. They are short of time. They may also doubt their skills.”

The same information is conveyed, but the second phrasing is much more accessible.

Accessibility leads directly to the second major issue with informed consent: Your average layman is not a doctor, and should not be expected to understand medical treatments, procedures and options.

Many physicians take the notion of informed consent to mean they should provide the patient with all treatment options and potential risks, then allow the patient to make the decision on his or her own.

So long as the physician is explains each treatment option in comprehensive terms and there is no coercion, there should be no problem with the provider giving opinions on the treatment.

In fact, this should be the encouraged norm.

Informed consent stems from a noble idea: That the patient, not the physician, should be making the decisions important to the his or her life.

Unfortunately, the information overload ends up bringing us right back to the position we were originally trying to get away from: The paternalistic doctor making decisions for the welfare and well-being of the patient.