Monthly Archives: April 2020

notes on the social role of science: 1. the example of fetal ultrasounds

We reflect on–and we argue about–the point at which human beings become persons with rights, how (if at all) gender relates to biological differences, the degree to which people are interdependent versus free, the rights of disabled persons, and the roles of mothers and other parents.

Meanwhile, we are surrounded and supported by tools and technologies that obtain data and information to guide decisions and judgments. Methods for obtaining and analyzing data have high prestige. But methods for reflecting on moral and metaphysical issues attract widespread skepticism, except among people who are deeply committed to particular moral/metaphysical views (often, religions).

In this context, we have a tool–fetal ultrasound imagining–that purports to peer into the womb and provide data about the developing organism, including its viability and its genitalia, as well as the prospective mother’s health. People may suspect that this scientific tool will shed light on personhood, sex, disability, and motherhood, not to mention such specifically contested questions as abortion and gender attribution.

The tool is used in specific, culturally resonant ways. Often prospective parents go into the medical facility together. The prospective mother is prepared and treated as a patient–in a blue gown, and so on. The room where the procedure is conducted is private, separated by a closed door from the waiting room. A large, precise, moving image appears on a screen. The parent or parents are asked whether they want to know whether the child is/will be a boy or a girl, which determines whether they are shown the genital area. At least some pregnant women report that the image compels everyone’s attention to the fetus and negates the woman, since she is literally made invisible (Barad 1998). Prospective parents of “normal” or “healthy” children are congratulated and offered good wishes. They can take still photos or even videos home with them.

If we ask “What is a fetal ultrasound session?” (as Clifford Geertz asked, “What is a Balinese cockfight?“) we might consider several answers:

  1. “A fetal ultrasound (sonogram) is an imaging technique that uses sound waves to produce images of a fetus in the uterus. Fetal ultrasound images can help your health care provider evaluate your baby’s growth and development and monitor your pregnancy. In some cases, fetal ultrasound is used to evaluate possible problems or help confirm a diagnosis” (The Mayo Clinic). Note: “your baby” as a description of the object. Not “the baby,” not “the fetus,” not “you.”
  2. An apparatus that uses a piezoelectric transducer, a crystal that both receives and produces ultrasound waves in complex interactions with the mother, the fetus, the computer, the video screen, and the viewers (Barad 1998).
  3. A “bonding scan” also known as a “recreational” or keepsake” ultrasound, meant to produce pictures or videos to save and share with friends and family or even with the child later on (per LiveScience.com, which does not endorse such uses).
  4. An application of SONAR technology, invented to detect and destroy enemy submarines (Barad 1998)
  5. One of the events to expect when you are expecting. A moment to anticipate, celebrate, and share.
  6. A ritual that encourages prospective parent(s) to: 1. bond as couples and begin bonding with their child, with whom they will form a nuclear family, 2. bring the fetus to term because is already moving and kicking, 3. avoid behaviors, such as alcohol consumption, that might harm the fetus, 4. encourage them to begin to begin thinking and talking about it as a “boy” or a “girl,” who will have an appropriate name, pronouns, etc., 5. allow them to announce the pregnancy to a larger audience, thus enhancing their social capital, 6. reinforce the authority of credentialed medical professionals in white coats, and 7. produce revenue for the clinic.

Karen Barad wrote a brilliant 1998 article* that explored much of this terrain. I would respectfully dissent from part of her analysis, only because I am trying to work out a view that better fits my sense of the problematic power of science.

Inter alia, Barad raises epistemological doubts about the image that we see on the screen. We are not “peer[ing] innocently at the fetus,” but using an elaborate apparatus that produces an image as a result of complex interactions that can be changed by altering the apparatus. It is a mistake to think that the referent, when we talk about this image, is “the fetus.” The referent is a “phenomenon that is constituted by the inter-action of the apparatus and the object.” Barad cites Niels Bohr’s epistemology in opposition to the older, “Newtonian framework” in which observation was the “benign facilitator of discovery, a transparent and undistorting lens passively gazing at the world.”

I completely agree that looking inside the torso of a pregnant woman is not innocent or automatically benign. Whether to do it, how to design the procedure and the larger event, and what conclusions to draw are moral and political choices that should be critically assessed. Fetal ultrasound could be banned, discouraged, publicly funded, or required. The image could be seen only by a professional who would give written results to the pregnant woman alone. Or it could be done only by the pregnant woman, who would decide whether to share any information with anyone, including a physician. It could be re-designed so that the woman was depicted in the image along with the fetus, or in many other ways.

A fetal ultrasound event is a social phenomenon that reflects and reproduces power. There is a risk that it will block critical deliberation about issues like abortion and gender by claiming to present natural facts just as they are. To quote Bruno Latour, science can “render ordinary political life impotent through the threat of an incontestable nature” (Latour, 2004, p. 10).

Yet I do believe that we are looking at the fetus. In fact, it is precisely because the technology allows us to actually peer into the woman’s body that it is invasive.

When you see a car coming down the road, you may not actually look at the object that matters. Your brain interprets a reflection on the back of your retina, which may reflect the image on a convex mirror, which distorts reality by showing objects smaller than they would appear if seen directly. But you’d better not pull out into the road if there’s a car coming. The mirror is an excellent device for looking around corners, which is why we use it.

We are in a world of tools that we use effectively for a variety of reasons. In the Philosophical Investigations, Wittgenstein encourages us to see representations as tools that we can use for many purposes. A blueprint can provide instructions to a builder or ideas for a heist, or it can decorate a wall. There is nothing tricky about its metaphysical status. A picture does nothing mysterious inside us that needs analysis (Philosophical Investigations, 188). Whether the visual experience of an image is authentic is not an interesting question (190). The question is what uses we make of an object, including using it to represent a different object. For instance, to see a painting as a portrait of someone is to use it in a certain way. “Now when I say, ‘We consider a portrait to be human’ – when and for how long do we do this? Whenever we see it at all (and don’t see it as something else)” (199).

Likewise, when we are presented with a moving image from inside a pregnant woman, we can see it as a person, or as a boy, or as a fetus, or as a medical problem. Science has no legitimate right to tell us which way to see it. However, the ritual of a fetal sonogram event–conducted by people in white coats with scientific degrees–probably does determine how we will see it. The ultrasound technology really works; the question is whether and how we should use it.

Sources: Karen Barad, “Getting Real: Technoscientific Practices and the Materialization of Reality,” Differences: A Journal of Feminist Cultural Studies 10, no. 2 (1998): 87-91; Bruno Latour, Politics of Nature: How to Bring the Sciences into Democracy, trans. Catherine Porter (Cambridge, MA: Harvard, 2004); Wittgenstein, Philosophical Investigations, German text (1953), my translations.

See also: what does a Balinese cockfight have to do with public policy analysis?; issues in the philosophy of social science; science, democracy, and civic life; is science republican (with a little r)?; nature includes our inner lives; some thoughts on natural law; is all truth scientific truth?; decoding institutions; media literacy and the social discovery of reality

new minor: Entrepreneurship for Social Impact in Civic Studies

We’re launching a new minor within the Civic Studies program. It complements the Civic Studies Major and the existing minor, which is called Peace & Justice Studies. I anticipate that these two minors will draw students with different interests, thereby promoting intellectual diversity and debate. We’re thinking about adding even more minors over time. One prospect is a minor in Interfaith Civic Studies, or something along those lines.

The Entrepreneurship for Social Impact minor requires six courses, including Intro to Civic Studies (which I regularly reach) and the Innovative Social Enterprise course offered through the Tufts Entrepreneurship Center. The remaining four courses include two from the approved Civic Studies list and two from the approved Entrepreneurship course list.

New Civic Engagement Section of the American Political Science Association

The APSA has approved a new section on Civic Engagement. In the proposal for this section, we noted that “APSA has been dedicated to civics education and the task of stimulating civic engagement since its inception in 1903.” However, there had not been “an organized section” for “political scientists who specialize in teaching and/or research in civic engagement.”

We said that our purposes would include:

  • To promote the teaching of and scholarship in civic engagement through sponsorship of civics education and civic research panels and/or short courses.
  • To facilitate the development of faculty in this field through mentoring.
  • To publicize new research and share pedagogical experiences through a newsletter and/or journal.

With APSA’s approval, we are now in business and we invite political scientists to join the section. For APSA members, the cost is minimal ($5 per year). After you log in to apsanet.org, click on your name and you will go to your own profile. “Add section” will be one of the options. That will bring up a list of sections you can join. Ours is the second from the bottom on the list. Or you can do so by adding it the next time you renew your registration. 

We welcome scholars working with diverse methodological backgrounds and in diverse institutional settings including research-intensive universities, teaching-intensive colleges and universities, HBSUs and HSIs, community colleges, and in the nonprofit sector.

We have been given two panels at the APSA annual meeting in September. Please look for those in the program and help us out by attending, if you can. Also, we are planning to hold a business meeting and a reception at the annual meeting.  They should be listed in the program or we will advertise them separately. Please join us for those events. The business meeting will be our first as an organized section and we would appreciate your input on the governance of this new section.

The co-chairs are Elizabeth Bennion and Richard Davis. I am the Vice-Chair, and Malliga Ochs is the Treasurer.

why the relatively good US numbers for COVID-19 mortality?

Major news sources are reporting that the USA has had the most cumulative COVID-19 deaths. That is a meaningless statistic, since our population is, for example, seven times larger than Spain’s. On a per capita basis, the US is reporting far fewer cumulative deaths than ten major OECD countries.

(My analysis of data from Our World in Data.)

One objection is that we are experiencing the pandemic later than Spain and Italy, and our per-capita cumulative rate will grow to meet theirs. However, assuming we peak (as expected) early this week, then we should not converge with Italy and Spain.

For a more precise comparison, here are per-capita cumulative deaths on the 30th day after each country saw its deaths reach one in ten million.

(I have consulted Kevin Drum’s daily updates to find Day 30 for each country. Several nations have not yet reached Day 30 and are not shown.)

The ratios are, indeed, smaller in this second graph than in the first. For example, on April 10, Spain had almost six times more cumulative deaths per capita than the USA that same day. If you compare the two countries on their respective Day-30’s, which happened weeks apart, the ratio is just 4.8-to-one. Still, the gap is unlikely to close much further, which means that Spain’s outcome will be four or five times worse than ours.

Another objection is that national aggregates are misleading because health outcomes in the USA are badly unequal by race. If per capita mortality for African Americans and Native Americans were shown separately, those numbers might look much worse. Then again, white Americans would then look even more fortunate in international comparison.

The same goes for regional breakdowns. On its own, New York City would look bad, but removing New York would make the national statistics look even better.

A third objection is that these statistics are inaccurate. No doubt, some COVID-19 deaths are not being appropriately counted. However, I am using deaths instead of diagnoses, because mortality statistics are generally considered pretty reliable and comparable across countries. Also, the epi-curves in these countries are rising smoothly in the expected ways.

A fourth objection is that we have only considered the first wave. If the pandemic revives in a second wave, all bets are off. I would say that it is wise to prepare for a second wave, but the only data we can discuss come from the current phase. It’s worth trying to analyze what it means.

Assuming that these statistics are fairly accurate, there doesn’t seem to be a meaningful relationship between COVID-19 mortality and the size of a welfare state (% of GDP spent on social welfare). The correlation would be positive (more spending goes with higher mortality), but the scatterplot is diffuse.

Nor is there a correlation between COVID mortality and health expenditures per capita, adjusted for purchasing power.

The preliminary evidence suggests that public policy, political leadership, and the social contract matter much less in this pandemic than I would have thought. I think we must look elsewhere for explanations of the variance in COVID-19 deaths.

Some differences in national outcomes may be due to social and geographical factors, such as the median age of populations, population density, or the frequency of living together in intergenerational households. I suspect a major variable is the timing of the onset of the disease. By the time the pandemic was starting its rise in the USA, many Americans had already become alarmed by the news from Italy and Spain; we self-isolated pretty rigorously. Like Iran, Italy and Spain didn’t have the benefit of as much warning. Meanwhile Taiwan and South Korea did better because they had previously experienced SARS.

This analysis is preliminary and amateurish and could easily change. That said, it challenges my own ideological priors. I would have assumed that Donald Trump would make things worse here than in other countries, and that our lack of health coverage would set us up for failure. It is always worth challenging your own ideological premises when conflicting evidence arises.

It’s also important to prepare for a summer and fall in which anti-Trump forces will try to blame the US situation on him, and the most cogent defense will be that the US is actually faring better than most social democracies. I don’t expect Trump to present his defense with any discipline, but his critics should be ready for it.

effects on civil society will be mediated by the economy

How will the current pandemic affect civic engagement? We certainly cannot know, but I would offer the following hypotheses:

People’s voluntary behaviors, values, and preferences will not change very much. If you can, you will snap back to pre-COVID habits and beliefs as soon as possible. However, the economic turmoil caused by the shutdown will destroy many nonprofit associations, newspapers, and businesses that are integrated into community life (such as cafes and barber shops). In the short term, not only will that destruction harm many people, but it will suppress civic life, since most people engage in and because of organizations. In the longer term, there will be space for civic innovation and growth, and maybe younger and more diverse leadership will emerge. However, civic organizations–particularly, local newspapers–that already have fragile business models may never be replaced.

Although it’s a century old, our best model for predicting the pandemic’s effects is the great influenza pandemic of 1918. In many parts of the world, its effects are impossible to disentangle from the impact of World War I, the Russian Revolution, and the collapse of empires. However, the US was peripheral to those matters and lost less than 1/20th of one percent of our population in the Great War. Changes that occurred between 1918 and 1920 can be plausibly attributed to the pandemic, which killed 650,000 out of 103 million Americans (equivalent to about 2 million deaths today).

Graphs from Robert Putnam’s Bowling Alone show no significant or lasting impact on civil society. Deep trends–industrialization, urbanization, the Great Migration–were ongoing, and so were trends in civic life. For instance, the early 1900s was the era when Americans constructed national organizations with local chapters, and their growth proceeded unabated through 1918.

Putnam also presents trends for membership in professional associations and unions, the rate of playing card games, the number of police officers per capita, and telephone ownership. These rates do not all smoothly rise in the early 1900s, but none seems to bend around 1918.

One possible exception is the rate of founding of major membership organizations, which was lower in the 1920s than in the 1910s:

Putnam lists the actual associations by their date of founding. None were launched in 1918, but three came into being in 1919. I see little evidence that the pandemic affected associations, unless it caused a delay in foundings during the actual year of the flu. In 1920, Warren Harding won election on the promise of a “return to normalcy”–poor grammar but a pretty accurate prediction.

However, the civic life that Americans built in the early 1900s depended on small contributions, dues, or subscriptions (in the case of newspapers) from many ordinary people. As long as they had jobs, they could support the associations. Organizations seemed to have weathered any short-term loss of income.

In contrast, today’s civil society is heavily dependent on philanthropy from foundations and wealthy individuals and contracts with governments. Many 21st century nonprofits basically run as businesses with a small number of investors and lots of constituents who do not pay for their services. A market meltdown could easily kill them off. In an international survey conducted from March 24-26, 68% of nonprofits already report a decline in contributions.

I worry especially about the metropolitan daily newspaper, because I believe it was an interesting hybrid invented between 1890 and 1920. Newspapers were often very profitable thanks to advertising and wide reach. At their peak, they attracted more than 80% of households by providing a basket of goods–sports, classified ads, comics. Meanwhile, they served a civic function by presenting important news on the front page. They did not invest in reporting because it maximized their profits but because professional reporters and editors–“the press”–exercised some influence over the owners of newspapers. The resulting combination was valuable but vulnerable and already in steep decline by 2010. If the recession now kills the last surviving metropolitan daily newspapers, there is no reason to think that any functional equivalent will replace them.

See also: new research on “civic deserts”; The “civic state of the union”; Bowling Alone after (almost) 20 years; and the hollowing out of US democracy.