International Society for History, Philosophy, and Social Studies of Biology

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THURSDAY, JULY 9  /  11:00 - 12:30  /  DS-M280
Individual papers
Biomedical Ethics and Non-human empathy

A matter of national dignity? Tuberculosis, North Korean defectors, and the politics of disease management

Kyuri Kim (Korea Advanced Institute of Science and Technology, Korea); Buhm Soon Park (Korea Advanced Institute of Science and Technology, Korea)

To date, historians have studied the sociocultural meanings of tuberculosis and their relationship with society, such as romanticization, stigmatization or exclusion of patients and related groups. This research argues that tuberculosis in South Korea gained meaning by being translated into politico-economic terms, and demonstrates the politicization of tuberculosis management in the late twentieth century through discourse analysis of policy papers, research publications, media reports and interviews. Tuberculosis has been largely understood under the rubric of economic development and closely tied to the country’s identity and dignity. Until the 1990s, tuberculosis was considered an obstacle to economic development, which provided justification and motivation for rigorous policies targeting the entire population. Tuberculosis is no longer as rampant but still maintains a constant presence in South Korea, with unprecedentedly high prevalence rates despite the economic advancement. Tuberculosis has thus been described as ‘unfitting,’ and more common among specific marginalized populations—or risk groups. In the late 1990s, the number of North Korean defectors (NKDs) entering South Korea increased exponentially, and a new socially marginalized group at high risk of tuberculosis had emerged. Extra vigilance and care in detection and treatment of tuberculosis among NKDs was institutionalized, but also resulting in the othering and blaming of North Korean public health system and the defectors for importing tuberculosis across the border. Coupled with the long-standing economic frame of understanding tuberculosis as a disease of poverty, the matter of tuberculosis prevalence among NKDs became a medium for demonstrating the capabilities and superiority of the South Korean regime over its northern counterpart. This case of tuberculosis in South Korea shows that disease lies at the intersection of both exclusion and inclusion of Others in society, and that of sociocultural and geopolitical contexts, and is mobilized for the preservation and promotion of national dignity.

A Study in nature: STS reflections on the Tuskegee syphilis study

Margaret Curnutte** (Baylor College of Medicine, United States)

The history of the Tuskegee Syphilis Study is fairly well known. In 1932 the US Public Health Service (USPHS) initiated an experiment in Macon County, Alabama, to determine the natural course of untreated syphilis in black males. The study continued for forty years, well after it was known in the early 1950s that penicillin could be used to treat syphilis. While the ethical implications of this case have been discussed in great detail, in this paper I would like to draw attention to the significance of how the study was defined. From its inception, the USPHS called the Tuskegee Study a classic “study in nature,” rather than an experiment. This paper first explores the historical origins of the terminology, “study in nature,” locating its origins with Francis Bacon’s distinction between natural experiments, which become studies in nature, and contrived experiments, which are controlled experiments in a laboratory or clinical setting. Second, this paper addresses the significance of this dichotomy, in particular for the Tuskegee Study, from a science and technology studies (STS) perspective. STS scholars, like Latour and Jasanoff, have shown that the notions of nature and politics were developed over centuries in such a way as to make any synthesis of the two terms impossible. The consequence was the separation of (scientific) facts from (social) values. Recent scholarship has shown that natural and social orders are produced at one and the same time, or co-produced. In light of these STS insights I argue that the historical terminology used to characterize the Tuskegee syphilis study reflects important historical boundary-work. The description of the case as a “study in nature” separated the collection of observed “value-neutral” scientific facts from the social and political context that allowed for such a study.

In defense of bottom-up approaches to animal empathy

Félix Aubé Beaudoin (Université Laval, Canada)

Frans de Waal’s “Russian doll model” is a prominent example of a bottom-up approach to animal empathy. As the name of the model suggests, de Waal sees empathy as a multilayered phenomenon. He maintains that “cognitive” forms of empathy (e.g. empathic perspective-taking) are built out of simpler and phylogenetically more ancient ones (e.g. emotional contagion). Two important objections are sometimes made against such approaches. First, they overestimate the role played by lower-order mechanisms, especially in humans. Second, they offer explanations of altruistic behavior in non-human animals that are too “mentalistic”. I will address both objections. Drawing on recent work on contagious yawning and autistic spectrum disorder, I will suggest that deficits in lower-order mechanisms disrupt empathetic responses all the way up to the “cognitive level”, even in humans. Bottom-up approaches, therefore, are probably right to insist on the key role played by such mechanisms. The second objection draws attention to a general problem with the attribution of mental states (e.g. beliefs, metacognition, phenomenal consciousness, empathy, etc.) to non-human animals. Possible explanations of a given behavior can range from more behavioristic to more “mentalistic” ones, and it can be very hard to tell which type of explanation is preferable. In some cases, the evidence is compatible with both. I will review some of the evidence on altruistic behavior in non-human animals, both anecdotal and from controlled experiments, and argue that many examples of such behavior are best explained in “mentalistic” terms. In other words, it is quite plausible that some animals – especially non-human primates – are able to act on the basis of an understanding of a conspecific’s situation, goals, etc. It is also plausible to think that such acts are sometimes motivated by a concern for the welfare of others, rather than by purely egoistic motives.