JBI Dialogues
JBI Dialogues
Articles from the JBI archives Ep 3 (Finale): Anniversary collection picks w/ current joint editor-in-chief Dr Michael Ashby
What is truth-telling and is it always the best way? How might dignity help us think about the morality of kidney sales? What does the 2018 Thailand cave dive rescue teach us about medical informed consent and virtue?
These are just some of the questions explored in the JBI articles chosen by current joint editor-in-chief, Dr Michael Ashby, for the journal’s 20th anniversary collection.
Michael is a palliative care and pain clinician, a self-confessed ‘dabbler’ in philosophy, and joint editor-in-chief at the JBI for nearly a decade.
In addition to some cracker reflections on these JBI articles, Michael peels back the ‘editorial curtain’, and we talk about things like:
- The impacts of the recent US election and Trump’s USA, and the trickle down effects into Australia and NZ
- Political “contagion” and mimicry
- The need for logic and the ‘realness’ of subjectivity
- A Freudian psychoanalysis of bioethics and
- Trying the ‘pub test’ on your piece bioethics research.
This is also a great pod episode if you’re newer to the JBI and publishing/reading bioethics as Michael gives a bit of insight into what kinds of scholarship the JBI publishes.
Enjoy!
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0:00 - Introduction
5:20 - Reflections on 20 years of the JBI and the recent US election
18:56 - on truth and reconciliation
22:50 - on autonomy and patient values in Poland
29:30 - on open disclosure in New Zealand
34:33 - on the morality of kidney sales
38:50 - on the ethical considerations of anaesthetist involved in the 2018 Thailand cave dive rescue
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JBI Archives 20th Anniversary - Open Access Collection
Micheal's complete editorial 'Twigs of Evidence'
Select Papers (in order of mention):
Lingis, A. Truth in Reconciliation. Bioethical Inquiry 8, 239–243 (2011). https://doi.org/10.1007/s11673-011-9306-2
Olchowska-Kotala, A., Strządała, A. & Barański, J. Patients’ Values and Desire for Autonomy: An Empirical Study from Poland. Bioethical Inquiry 20, 409–419 (2023). https://doi.org/10.1007/s11673-023-10241-y
McLennan, S., Moore, J. New Zealand District Health Boards’ Open Disclosure Policies: A Qualitative Review. Bioethical Inquiry 16, 35–44 (2019). https://doi.org/10.1007/s11673-018-9894-1
Reese, A., Pies, I. The Morality of Kidney Sales: When Caring for the Seller’s Dignity Has Moral Costs. Bioethical Inquiry 20, 139–152 (2023). https://doi.org/10.1007/s11673-023-10231-0
Irwin, M.A. The Thailand Cave Rescue: General Anaesthesia in Unique Circumstances Presents Ethical Challenges for the Rescue Team. Bioethical Inquiry 19, 265–271 (2022). https://doi.org/10.1007/s11673-022-10168-w
Music by Lidérc via Pixabay
Hosted, produced and edited by Sara Attinger
Transcribed by Microsoft Word automatic transcription.
This transcript has not been edited and may contain errors.
Transcript:
00:00:00 Speaker 1
This podcast is being recorded on the unseeded lands of the peoples of the call in nations. We wish to acknowledge them as traditional owners and we pay our respects to their elders, past and present.
00:00:16 Speaker 1
Welcome. You're listening to the JBI dialogues. Hi, I'm Sara Attinger, digital and content editor at the Journal of Bioethical Enquiry. This year, for Jbi, turns 20 to celebrate this milestone, the Jbi is pulling out select papers from the archives and releasing them as a special anniversary collection.
00:00:36 Speaker 1
Editors past and present were invited to nominate papers published during their tenures and to share their reasons for their choices.
00:00:44 Speaker 1
On this episode, we are joined by one of our current joint editors in Chief, also a medical specialist in palliative care and pain medicine, and a professor of medical ethics and deaf studies. It is, of course, Michael Ashby. Welcome, Michael.
00:00:59 Speaker 2
Good morning.
00:01:01 Speaker 1
Thank you for joining us today to talk about the 20th anniversary collection. To get us started, could you tell us a little bit about how you came to find yourself at the jbi?
00:01:12 Speaker 2
Thank you, Sir. That's I guess that's that's a challenge in its own right.
00:01:19 Speaker 2
I often hear people talk about planning their lives and having 1-2 and five year plans. Most of my life and most of my career has been a kind of opportunistic and things have arisen and.
00:01:33 Speaker 2
Certainly my involvement with the journal is very much like that.
00:01:38 Speaker 2
So I've been involved with the editorial team in one form or another, form or another.
00:01:43 Speaker 2
Since about 2010.
00:01:47 Speaker 2
And it really happened when Paul rang me up one day, Paul Komessaroff and asked if I was interested in joining the team.
00:01:55 Speaker 2
Which I was, to be honest, I was. I was surprised and very honoured because.
00:02:02 Speaker 2
Paul and Ian and some of the other founders of the journal a decade earlier are heavy hitters in both medicine, but also very much in in ethics and bioethics.
00:02:12 Speaker 2
Six. My involvement in the bioethics happen because.
00:02:19 Speaker 2
I was appointed as the first medical director of palliative care at the Royal Adelaide Hospital and the Mary Potter Hospice in Adelaide in 1989. After training as a radiation oncologist in the UK and taking more and more interest in pain and palliative care.
00:02:36 Speaker 2
And at that time, there wasn't really a specialty in that. There was no formal training.
00:02:41 Speaker 2
So I I went into into the pioneering days, if you like, in Australia of of of the palliative care.
00:02:49 Speaker 2
And immediately at that time in South Australia, there was an emerging euthanasia debate.
00:02:55 Speaker 2
And there was a Select Committee of the Parliament of South Australia.
00:03:01 Speaker 2
There was a very influential former Health minister, Jennifer Cashmore.
00:03:06 Speaker 2
Whose husband was a prominent journalist and very good friends with Mark Oliphant, the former governor and nuclear physicist.
00:03:14 Speaker 2
And they've been talking, you know, publicly about euthanasia and the distinction between palliative care and end of life care. And I got involved in looking at causation, death, causation and so-called causal neutrality that palliative care was saying neither hastening nor prolonging the dying process.
00:03:34 Speaker 2
And I wrote a very prolonged and unusual MD degree thesis in.
00:03:40 Speaker 2
Delayed and got involved in I guess the the early days of the euthanasia debate and the medical legal aspects. So I started attending some conferences and at one of them I must have bumped into Paul.
00:03:55 Speaker 2
And he very kindly called me into the fold, where I've remained ever since.
00:04:03 Speaker 2
So my main interest is in end of life ethics and I would stress that apart from doing the.
00:04:12 Speaker 2
The.
00:04:13 Speaker 2
Intensive Monash bioethics course.
00:04:17 Speaker 2
Up in the chalet, in where is it? I forget the place now up in the Victorian Alps. Apart from doing that with Helga Coos and Peter Singer.
00:04:27 Speaker 2
I don't. I don't have a formal training and I don't certainly do not have.
00:04:32 Speaker 2
A philosophical background. I I dabble in it. I probably misunderstand half of it.
00:04:39 Speaker 2
So I'm not a general bioethicist by any stretch of the imagination.
00:04:44 Speaker 2
There used to be a lovely slide that showed basically some sperm and a tombstone and it basically said bioethics either did one or the other.
00:04:53
You're.
00:04:53 Speaker 2
Either end beginning of life or end of life. There seem to be.
00:04:58 Speaker 2
Controversies, if you like.
00:05:01 Speaker 1
You probably wouldn't be the first person to be wondering on by on your merry way when someone sort of pulls you in to to a world of fire ethics.
00:05:11 Speaker 1
How was your own engagement with bioethics changed over the past 20 years or so, or even just in the time that you've been with the jbi?
00:05:21 Speaker 2
You know, look, if you'd asked me this question even a year ago, I'd probably have a different answer today.
00:05:28 Speaker 2
And I'll I'll I'll try not to get distracted by the editorial I've just been writing.
00:05:36 Speaker 2
Committee, which I show it to the group and basically make sure that they're not too unhappy with what I'm saying, but it's very much a personal view. I mean, I think after the recent US election, I feel like I suddenly have just, you know.
00:05:51 Speaker 2
A penny has dropped to realise that.
00:05:55 Speaker 2
Progressive politics in the world is actually on the run. It's in big trouble. They're they're they're in a lot of countries now. The empire is really striking back, you know, toxic masculinity and leadership and.
00:06:07 Speaker 2
That's that's not a good thing at all. And I think the other thing too is that.
00:06:15 Speaker 2
People are very, very mistrustful of experts and academies and academics, so I think I've I've written a message to the field that I think we probably need to rethink how we engage with the public.
00:06:28 Speaker 2
And I would have to say that.
00:06:33 Speaker 2
When I read some of the papers, they're very worthy. The scholarly. Sometimes they are so kind of arcane and obscure.
00:06:45 Speaker 2
And frankly.
00:06:47 Speaker 2
Look, I'll just. I'll just put it out there. When when you realise that in bioethics there's a thing called a natalism, a pronatalism versus anti natalism struggle. And I think I'd just love to serve that up to JD Vance and see what he'd say. But I can tell you what, it wouldn't be pretty.
00:07:05 Speaker 2
So I think the problem is that we are conducting now.
00:07:09 Speaker 2
A long conversation which in which we I hope.
00:07:15 Speaker 2
Have core values that we share.
00:07:19 Speaker 2
None.
00:07:20 Speaker 2
But how we actually honour those values and act them out in public policy and the law and in daily lives in the delivery of health services and the conduct of biology, the way we treat animals, all these things that the journalists concerned with.
00:07:36 Speaker 2
I think we have to realise that we're flying very, very far apart from a large part of our electorates, which are declaring themselves now, so I'm sure we'd all say that we're.
00:07:49 Speaker 2
Small D Democrat.
00:07:53 Speaker 2
That we believe in the democratic process. The democratic process is delivering some outcomes that basically I think most people in the field would be very worried.
00:08:05 Speaker 2
And so that's the problem.
00:08:08 Speaker 2
Democracy is a winner takes all. Not necessarily good to minorities and a lot of what we publish is about minorities.
00:08:15 Speaker 2
And I I think to be honest, probably the progressive world is going to have to have a very long, hard look at how it engages with people who disagree with it, because we're getting some very disturbing trends. So that's why I'm at at the moment and I suppose.
00:08:30 Speaker 2
I there's that terrible term woke, which is like the the original empty signifier that you could just dump in everything you don't like.
00:08:38 Speaker 2
But I do think that.
00:08:42 Speaker 2
In some areas we've overshot somewhat and we're really just rather than taking people with us, we're actually annoying them.
00:08:50 Speaker 2
And what they actually do when they go to the ballot box where they don't have to worry about being cancelled or anything else is they barely vote the way they feel. And I think that's to be honest, there's a there's a lot to me, if I'm I'm quite interested in Freudian views of the world. I don't buy all of his Canon by any means. I don't even understand it all.
00:09:09 Speaker 2
But this idea, as somebody said to me recently, why does Donald Trump succeed so well? The answer because he understands your lizard brain better than you do. And I think there's a lot of there's a lot of that stuff going on that I think the field needs to be aware of.
00:09:20
Hmm.
00:09:29 Speaker 2
And so I I I suppose I've I've changed a bit in the sense that I'm actually saying to people, do you really want to talk like that? Do you really think that's the best way to?
00:09:41 Speaker 2
Progress this debate and the values that you hold.
00:09:47 Speaker 2
I suppose the other the other reason I I've always been fascinated by bioethics is that I'm intrinsically contrary. And you know, if if, if, if the prevailing wind is one way, I'm very likely to go the other way.
00:10:01 Speaker 2
It's my nature. I don't think I'm the only person in bioses like that, to be honest.
00:10:08 Speaker 2
Yeah. So that's been a little bit my journey very recently just it's almost like a light bulb goes on to think actually you know the values that I thought the kind of bottom lines that were in public life suddenly realise actually.
00:10:24 Speaker 2
Those bottom lines are looking pretty fragile. They're they're actually under threat. I suppose most of all, I I have to say that for women's reproductive rights. I'm. I'm not only worried in the US for not.
00:10:28
Mm.
00:10:38 Speaker 2
You know, I mean, I guess one of the things I've put in the editorial is that we actually don't live in America. We are not. We are we, we have to be careful how we speak for them and say why they voted the way they did. So and and in Australia, we've been doing that massively over the last few weeks.
00:10:55 Speaker 2
But but I do I do very much worry for for women in America. But I also worry here that there are forces in Australia and in all of the countries that we mainly publish, you know the.
00:11:10 Speaker 2
The United Kingdom, New Zealand.
00:11:12 Speaker 2
And in a lot of these countries, the there are, there are people who are definitely out there to undermine gay rights, reproductive freedom, abortion fed all these things.
00:11:27 Speaker 2
They they they have long term agendas to undermine and to damage these things, preferably to get rid of them so.
00:11:34 Speaker 2
And I do think particularly the assault on women's rights is very, very troubling indeed.
00:11:40 Speaker 1
Yeah, and. And you're at, you know, where where where not the USI mean we're both here in Australia and yeah it is it is important that we that we don't speak as you sort of said for for the US in the way that they have voted in the election just in the last.
00:11:57 Speaker 2
Just as we would resent people coming into this country and doing the same thing. So we're, by all means comment, but we just have to be restrained ourselves a little bit and and sort of.
00:12:09 Speaker 2
Just check ourselves and remember that we are talking about another country in a way that we probably wouldn't welcome here.
00:12:17 Speaker 2
But I do think there's also an international contagion with reaction. I think we'll see, if you look at Europe now.
00:12:22
Yes.
00:12:26 Speaker 2
The the the politics are quite frightening. I mean, I, I, I spent three years at school in France as a boy, lived in France and Belgium on the border there. So I'm, you know, very, very fond of France and all things French.
00:12:42 Speaker 2
Yeah, I think the chances of a National Front president next time around are actually really quite high. Sadly, have to say there is real risk and I think contango here, we've got an election coming up here in Australia next year. And I really do think that the right will be very much emboldened by what's happened and there.
00:12:48
Mm.
00:12:58 Speaker 2
A kind of.
00:12:59 Speaker 2
Of mimicry contagion. That, that that is seeping in. And we've already seen it, you know, in the Queensland election I was up there in Brisbane when that actually happened. And I know I spoke to several women there at the VAD conference who said, you know, you can see what's happening now with.
00:13:14 Speaker 2
Proposals from some candidates to to revise abortion laws to make it more difficult.
00:13:21 Speaker 2
We look at country hospitals in New South Wales that we will find actually do not allow termination of pregnancy, they don't do it. This is absolutely extraordinary and I don't think it should be should be allowed.
00:13:36
Mm hmm.
00:13:36 Speaker 2
But but it is. It's incredible.
00:13:39 Speaker 1
And as much as mimicry, I think there's also the spreading of of of fear on all sides.
00:13:46 Speaker 2
Yes.
00:13:48 Speaker 1
That's the sort of sense I get about at least some of the reporting in the last couple of weeks about the state of abortion rights and access in Australia.
00:13:58 Speaker 1
That there's a lot of concern when there's any sort of perceived or real instance of those rights being minimised in some way.
00:14:10 Speaker 2
Yeah, no, absolutely it is. It is troubling and I think you're right to the term, the, the word fear is and that's where my Freudian sort of stuff kicks in. But when you have fear.
00:14:24 Speaker 2
What happens? Fight and flight that. That's that's all of us are subject to that. And when you get into fight and flight.
00:14:36 Speaker 2
You get into splitting so there's goodies and baddies, and once you get into splitting, that's when things become really adversarial.
00:14:39 Speaker 1
Mm hmm mm.
00:14:45 Speaker 1
Mm.
00:14:46 Speaker 2
And so it's really hard to do good kind of consensus and compromise work when people have have defaulted into that splitting, you know, and and then of course, in politics, people exploit that, you know, they understand it really well.
00:15:03 Speaker 2
And say, well, they had the big bubbles in town, but don't worry, I'm your leader. I I I will banish the big bad wolf. I'll fight him or it or her or whatever. I'll, I'll. I'll defend you from it. So I'll build a wall to keep Mexicans out, for instance. Yeah. That's classic splitting behaviour. So vote for me.
00:15:22 Speaker 2
I'll. I'll protect you or, you know, immigrants have taken your jobs, so don't worry. I'll lock them out. And then your employment will be safe. These are classic splittings, and I think we're seeing a lot of that around the world.
00:15:35 Speaker 2
World and obviously in the bioethical world, that is very much what we are not wanting to see.
00:15:45 Speaker 1
See as the role for bioethics is it is there something that bioethics can contribute, or or is it even just a matter of avoiding some of the the pitfalls that?
00:16:00 Speaker 1
Seem to be fracturing conversations and debates and communications between different views.
00:16:07 Speaker 2
Well, look, I think one of the key things in all of this is to say.
00:16:11 Speaker 2
It's perfectly OK to have an in house academic literature and conversation, so if you're a pure mathematician, you publish an A pure maths journal. None of us. The rest of us would read it, and if we did, we wouldn't understand a word. That's fine, we don't. We don't to give them a hard time for that.
00:16:29 Speaker 2
And similarly in philosophy, most of philosophy is unintelligible to as one of my philosophy friends in Adelaide, Brian Stoffel, dear friend.
00:16:37 Speaker 2
And as you said, if you haven't been through it with the drum Sergeant major, you know, through the basics, then yeah, yeah, it will be difficult for you to read the stuff. Not so you shouldn't. But you're going to struggle because, you know, we spent three or four years going through the basics and trying to to, to, to, to, to, to understand that.
00:16:55 Speaker 2
So it's perfectly OK to do that, and some of bioethics, to be honest, is a bit like that you read.
00:16:59 Speaker 2
And.
00:17:00 Speaker 2
Think that's so mean. If I took that to my local pub, so I just want to read you his paper that I've just seen, you know, and people just say, what on Earth is that? That's that's that's that's nonsense.
00:17:11 Speaker 2
Nonsense in the sense it doesn't make sense to us.
00:17:16 Speaker 2
So it's OK to do that and to say that there's an internal conversation where hopefully complex ideas are tested out and.
00:17:27 Speaker 2
And explored and developed that. That's fine. It's OK to do that. But I I I think most of the people I know in bioethics I'd be interested in your views here.
00:17:39 Speaker 2
I'm engaging in the field.
00:17:42 Speaker 2
There's also a sense that what you're discussing you want to action in the world you actually want to see stuff happen as a result.
00:17:51 Speaker 2
Of good debate and rigorous exploration of ideas and and implementation in policy and law. So there's an applied bit to bioethics.
00:18:04 Speaker 2
And in particular, you know getting.
00:18:07 Speaker 2
Broad consensus about values.
00:18:11 Speaker 2
But as Ronald Dworkin, the late American jurist and jurisprudence scholar, he said, look, we all agree that life is sacred. I think we can all pretty well agree on that as an ethical value, but we had just had different ways of honouring that sacredness.
00:18:28 Speaker 2
And I think that that therein lies the key. But most of what we publish is something that you probably comes from the world, has a kind of an action in a real world dimension to it. And that's where I think we need to be prepared for the pub test.
00:18:45 Speaker 2
At the end of the day, you need to be able to take it out there to people who do not function in this environment and be able to talk to them about it. Otherwise there's no point why? Why would you?
00:18:57 Speaker 2
In my first choice for this anniversary edition, I picked a paper by Alfonso Lingus.
00:19:06 Speaker 2
And what he's a prominent US thinker.
00:19:11 Speaker 2
Particularly in the human rights area.
00:19:14 Speaker 2
And he had a look at the truth and Reconciliation Commission in South Africa, which I had always.
00:19:22 Speaker 2
Assumed to be a pretty damn good way of dealing with in a horrendous history.
00:19:28 Speaker 2
Which you could see very little way out of, to be honest. The whole apartheid struggle really tricky. So I thought, yeah, that, you know, I remember Bishop Desmond Tutu and interviews and and articles and review stuff about the truth and Reconciliation Commission.
00:19:45 Speaker 2
Where the victims of torture, trauma, etcetera, would would, would, would, would talk in the Commission would often face their their tormentor.
00:19:59 Speaker 2
And.
00:20:00 Speaker 2
And I guess from a therapeutic background, I sort of thought that was good and he's come along and said, well, I'm not so sure.
00:20:12 Speaker 2
Truth is contestable. You're re traumatising people now. I don't think that he's a psychologist or psychoanalyst, so you know we very much believe. I believe in the talking therapies that talking stuff through is a good idea, however.
00:20:27 Speaker 2
He in that article.
00:20:31 Speaker 2
In 2011.
00:20:34 Speaker 2
He calls that into quest. That's a battle of personal opinion. I think it was a very it was a challenging article and you know, it's when you see that kind of constructive.
00:20:46 Speaker 2
Questioning. So I think it's really useful. So I had thought that the truth and Reconciliation Commission was basically an inherently good thing. Somebody comes and said well, wait a minute, maybe.
00:20:58 Speaker 2
Maybe maybe you need to at least ask some questions of it.
00:21:03 Speaker 2
And the author then goes on to look at the United Nations Cambodia Court.
00:21:11 Speaker 2
For the horrendous years there of the Pol Pot era so-called Pol Pot.
00:21:19 Speaker 2
And the incredible cruelty.
00:21:23 Speaker 2
And because he's questioning that what I call actualization, so one of the theories from a guy called William Walden, who's an American psychologist who specialises in death studies, he was the one who said.
00:21:38 Speaker 2
Because in the old and now somewhat abandoned kubleros view of grief and loss and trauma is that when you, when something really bad happens to you, the first thing is you go into disbelief. I think there's certainly some truth in that.
00:21:53 Speaker 2
And rolled that, warden said. Basically, what you need to do is actually face and actualize the truth.
00:22:00 Speaker 2
And that's why we recommend people to see bodies after death where possible. But it's actually can be a very useful thing in coming to terms with the process.
00:22:11 Speaker 2
And he actually says in this, you know, I'm not sure that going back and sort of looking at the gore of it all is a good idea.
00:22:19 Speaker 2
So it's a. So that was the first paper that I came across as I went through the old editions of the journal.
00:22:24
Yeah, yeah.
00:22:26 Speaker 1
In your you say this in your editorial. That's that. What struck you about the Lingus article is is that it made you question long held assumptions. So you've already talked about one of the articles that you've chosen for the anniversary collection of five.
00:22:44 Speaker 1
Could you tell us a bit about the other articles that you've chosen for the anniversary collection?
00:22:49 Speaker 2
Yes, for sure. I I actually felt that the we have a feature categories, editorials, reviews, commentaries and recent developments.
00:23:00 Speaker 2
But the bulk of the so-called research articles are basically opinion pieces which are primarily polemical, qualitative, or quantitative studies, so-called empirical bioethics, bioethics, and.
00:23:15 Speaker 2
So.
00:23:18 Speaker 2
As we were saying before.
00:23:22 Speaker 2
I I I struggled with the idea of producing 3 or 4 articles.
00:23:27 Speaker 2
Because my I immediately defaulted to some kind of idea that was a competition to pick the best in inverted commas, and when you look at hundreds of articles.
00:23:34
Mm.
00:23:38 Speaker 2
Over a 20 year period that the journal has published.
00:23:44 Speaker 2
In very diverse.
00:23:48 Speaker 2
Academic.
00:23:51 Speaker 2
Location subjects, methodologies that that clears a probably is kind of an impossible task, so there there's a lot of subjectivity involved. But then in bioethics there's a truckload of subjectivity and and of course one thing we don't want to do is.
00:24:08 Speaker 2
Have the subject of masquerade as objective, so look, I just went back and I I just flicked through old copies and looked online at some of the editions I've been involved with.
00:24:19 Speaker 2
And and I came up with some studies that were kind of emblematic.
00:24:23 Speaker 2
And.
00:24:24 Speaker 2
Little bit of a spread so that the next the next one after.
00:24:30 Speaker 2
Oh, and the last thing with Alberta Lingus is that there is a Russian saying that says that history can be unpredictable. And I think what that means is that it's really important to recognise that the uses we put history.
00:24:45 Speaker 2
Change with time and are.
00:24:47
To.
00:24:47 Speaker 2
Quote a current term weaponized by.
00:24:50 Speaker 2
People in all kinds of contests, not the least in political and actual conflict, so that that's also interesting, that the uses to which we put history. But look, the next the next category was empirical, an empirical quantitative study and it was actually one from Poland.
00:25:09
Where?
00:25:12 Speaker 2
It raises the issue.
00:25:14 Speaker 2
That you know, you feel like mine in medicine, which is predominantly empirical.
00:25:22 Speaker 2
People really more comfortable with that kind of work, you know, they're they're really interested in how many people think this.
00:25:32 Speaker 2
And how do we measure this, that and the other thing?
00:25:36 Speaker 2
And of course, the the thing about bioethics is that just because a lot of people think something doesn't make it right, just as a law can be unethical. So we have questions of kind of alignment of.
00:25:40
Just.
00:25:51 Speaker 2
Of values.
00:25:53 Speaker 2
And principles and and then what actually?
00:25:57 Speaker 2
So and so these Polish authors.
00:26:03 Speaker 2
Were looking at values of. I think it was a group of patients from memory in a healthcare context and looking at how younger people and older people differed with regard to their desire for autonomy.
00:26:19 Speaker 2
And the values that they held.
00:26:20 Speaker 2
And into SQL start, surprise surprise, to the younger people were not so attached to traditional order and values well, but. But anyway, at least it gave some some some data to those kind of explorations.
00:26:36 Speaker 2
I concluded that it's difficult to analyse the nature of autonomy.
00:26:40 Speaker 2
Yeah, autonomy is one of the bioethics wore 100 nil like there are no competitors.
00:26:46 Speaker 2
Which of course is back to the sort of JS mill concepts of you know. Basically you can do what you like, provide you don't upset other people and harm other people which you know I think is a.
00:27:00 Speaker 2
Something I certainly.
00:27:03 Speaker 2
Agree with by and large, but I've just said it's difficult to analyse the nature of autonomy with perhaps recognise it when we see it. But explaining why a concept we hang on to so much is so important to us can sometimes elude us.
00:27:20 Speaker 1
And yeah, it's quite it's quite a tricky thing to.
00:27:24 Speaker 1
In down in just mere words, written, written, or spoken. But as you say, we kind of know it when we say it, or at least we think we do.
00:27:31 Speaker 2
Yeah, that that, that's right. And if you work in medicine as I do, you will know. Yes, we have 1. The autonomy war. When you, if there ever was one. But I guess there was because the other the other, the other end of the spectrum is totalitarianism. And we definitely don't.
00:27:48 Speaker 2
But the the way that health practitioners talk about autonomy.
00:27:55 Speaker 2
You know it's sometimes.
00:27:58 Speaker 2
Quite.
00:28:00 Speaker 2
Hard to understand.
00:28:03 Speaker 2
Or rather, it's quite extreme and.
00:28:08 Speaker 2
How we can contribute to or detract from a person's autonomy?
00:28:15 Speaker 2
Sometimes the arguments are not very good.
00:28:19 Speaker 2
And we'll come later on to an example where autonomy probably had to take a second seat.
00:28:26 Speaker 2
So I think the important thing to remember is it's not absolute value.
00:28:31 Speaker 2
That you know that in the sense that it doesn't always rule completely, but obviously in issues in terms of medicine and consent and informed consent, clearly quite rightly, it's very well embedded now in the system.
00:28:47 Speaker 2
Sometimes to the point where even if a person wants a more personal, paternalistic, what we call paternalistic approach, they can't get it because, oh, no, don't you know, you know, don't, don't, don't ask me for advice here. I've given you the options. Now you need to choose.
00:29:03 Speaker 2
And often quite important, what I do is to, you know, if I look at what I do say in finances or something like that, I've got my views about what I want to do with my resources, but I'm going to talk to my financial advisor, and I'm actually going to say to him.
00:29:17 Speaker 2
At the end of the day, yeah, OK, this is what I think I wanted to do, but what do you think? I actually really want to hear what you think. I want to know what your opinion is. I might not. I might not take it, but I want to know it.
00:29:30 Speaker 2
So that the next catheter I came to was an empirical qualitative review and this was an example where bioethics scholars can actually take something like in this instance it was open disclosure policies.
00:29:43 Speaker 2
In hospitals in New Zealand or in health services.
00:29:47 Speaker 2
And this is something I've had quite a lot of involved with in my day job as a clinical director. Open disclosure when when things go wrong.
00:29:57 Speaker 2
And they looked at the open disclosure policies in New Zealand nationally, and they'd be fairly early adopters of these. But because there was no national kind of roll out of it, different health boards had.
00:30:11 Speaker 2
Had different.
00:30:15 Speaker 2
Subtly different.
00:30:17 Speaker 2
Changes.
00:30:20 Speaker 2
In the way that they articulated the policy and implemented it.
00:30:26 Speaker 1
So that one was actually from that. That paper was from 2019, so it's it's been around for about 5 years now and sort of being a paper that speaks directly to so more more directly to your clinical or your disciplinary world in the clinical world.
00:30:44 Speaker 1
Have you have you seen that have much of an impact?
00:30:49 Speaker 1
In practise.
00:30:53 Speaker 2
I'm not sure that the paper necessarily.
00:30:58 Speaker 2
I think sorry. I think the paper is probably mirroring something that's happening out there, regardless of whether people have read the policies or not. And I think what what we're now seeing certainly in Australian.
00:31:13 Speaker 2
Healthcare providers is that they're wanting to train all their staff in open disclosure because there are a lot of mistakes made.
00:31:22 Speaker 2
For instance, one of the things is as a health worker that you cannot do is admit liability.
00:31:29 Speaker 2
You cannot do that because you are working for an insured entity and insurance. You are not allowed to. It is not legal to admit liability on behalf of the organisation until they've done the proper inquiry.
00:31:44 Speaker 2
But in open disclosure, what we do want to do is make sure that from the word go, people told the truth about what happened. So you can imagine it's quite a fine line there, but and. And so when I was doing it and I think you know, all of my colleagues were very clear.
00:31:53
Mm.
00:32:00 Speaker 2
That the truth must be told right from the word go. But that's it's easy then to lapse into liability, and that's what you can't do.
00:32:12 Speaker 2
So I guess we know that historically in health systems.
00:32:18 Speaker 2
There was.
00:32:21 Speaker 2
A tendency wasn't across the board, but there was too much covering up but went on.
00:32:28 Speaker 2
And so patience, and often families of people who died.
00:32:35 Speaker 2
Were not given the whole truth, and often it would come out years later in legal proceedings.
00:32:40 Speaker 2
So now I I think the systems have all accepted.
00:32:45 Speaker 2
That it's best for everybody to tell the truth.
00:32:49 Speaker 2
And the whole truth, as it's known right from the word go. And so we have these meetings with families particularly, and we try and explain to them in a compassionate way what's happened and and not to close off a liability discussion. One of the things in, you know, that I, I I would do. I would have to do as part of my process is to is to indicate.
00:33:10 Speaker 2
Without wanting to encourage people to say that they are at liberty to take this further, including to law if need be.
00:33:17 Speaker 2
And that that is their entitlement.
00:33:21 Speaker 2
And what was interesting in this paper too was that.
00:33:26 Speaker 2
They they noted that there needs to be an open disclosure meeting. We'll certainly some people along who've got expertise in this and they'll coach you.
00:33:35 Speaker 2
And that's I think that's pretty well what we we did at the royal when I was there.
00:33:40 Speaker 2
Because it's very hard for, particularly for more junior staff and this is the other thing you shouldn't be letting your junior staff do it. You need to make sure senior people, senior decision makers, are involved.
00:33:51 Speaker 2
It's one of the hardest things that I've been involved in. You know, I talk to people about their own death and dying every day. That's what I do. I'd say this is actually harder because there's a sense of, you know, blame, you know, somebody's to blame as causation involved. And it's often unclear.
00:33:51 Speaker 1
Yeah.
00:34:07 Speaker 2
And you often get a lot of anger and sometimes it's justified. And to be honest, and other times it's misplaced. But you can understand why. So it's really tricky.
00:34:18 Speaker 2
So yes, it was, and basically what they're saying is we've got all these policies, you know, how do they match up and and surely in a sense this is something where we should really have one voice makes sense, doesn't it?
00:34:32 Speaker 1
And the last few articles that you've chosen feature ethical analysis. Could you tell us a little bit more about those?
00:34:39 Speaker 2
Yeah. So this is where you don't necessarily generate new data.
00:34:44 Speaker 2
Or analyse existing data in some kind of quantitative or qualitative way, but where you actually in a sense, do I suppose what you call a philosophical exercise and the article I chose was the morality of kidney cells.
00:35:01 Speaker 2
And often these articles, when they're right, written by specialists in the in the field, they're quite hard to access and understand for people who are not in that part of the Academy. But this one was was very.
00:35:19 Speaker 2
Very accessible, very readable.
00:35:23 Speaker 2
They tackled the question using an ethical argument based on balancing the relative dignity of donors and recipients and differentiating between individual human and social dignity. Now I must admit.
00:35:39 Speaker 2
I probably after I thought about it.
00:35:42 Speaker 2
I probably struggled a little bit with that because.
00:35:46 Speaker 2
There's a whole industry in medicine that's picked up on dignity as something that's all, almost medically.
00:35:55 Speaker 2
And I I just, I just can't really quite understand the link between the word and the concept and some kind of will treat your dignity. We need to and there's actually.
00:36:09 Speaker 2
Some work in the palliative care field that I've always struggled with about dignity promoting.
00:36:15 Speaker 2
Therapy and you sort of think well, yes, we certainly want to promote dignity. But but the trouble is it's a really complicated concept.
00:36:26 Speaker 2
And I actually don't think this article.
00:36:30 Speaker 2
Necessarily teases that issue in a way it kind of it displayed that issue to me, but the discussion was basically should we have a market for kidneys, you know, on the one hand, if you really need one, somebody's prepared to sell one, why not?
00:36:46 Speaker 2
It goes into the whole issue of altruistic donation. I must admit it's something I cannot begin to understand. Maybe because I'm such a self centred person, but the idea that I would go in and and and let a surgeon slash open my side, remove one of my kidneys and give it to a stranger is just.
00:37:05 Speaker 2
Very weird.
00:37:09 Speaker 2
And so.
00:37:11 Speaker 2
It trailed those ideas around.
00:37:14 Speaker 2
And I just said the use of dignity is an endpoint for comparison is interesting.
00:37:18 Speaker 2
As it appears to be a surrogate for general health and well-being.
00:37:21 Speaker 2
The OR the risk of introducing, I've said more contested ground, quality of life, which of course then you get into all kinds of subjectivity.
00:37:33 Speaker 1
Yeah, yeah. Interesting.
00:37:34 Speaker 2
So I thought it was a really interesting.
00:37:38 Speaker 2
Way of tackling the morality of whether people should pay for kidneys or not.
00:37:44 Speaker 2
Which by and large I think probably.
00:37:48 Speaker 2
Isn't a very good idea. The idea that somebody is poor and they think, oh, you know, I'll be able to get a, you know, get a bit of money for one of my kidneys. You know, it's it's a bit like I was going to say it's a bit like selling public assets. You know, once they've gone, they're gone. You know, it's very fine.
00:38:07 Speaker 1
Yeah.
00:38:07 Speaker 2
It's so yeah, I I and I'm pleased to see that the author's actually concluded it wasn't a very good idea and blanket prohibition prohibition probably is a good thing.
00:38:17 Speaker 1
It it's it sounds like a a good example of that kind of ethical analysis that that sort of describes a a situation that we can all sort of imagine and just takes a particular lens to it.
00:38:32 Speaker 1
And and sort of shakes it and and sees what what falls out.
00:38:37 Speaker 2
Yes.
00:38:38 Speaker 1
And yes, but not the first ethical paper to to start with a very clear disclaimer statement at the beginning.
00:38:49 Speaker 1
And the last article you've chosen is about the the Thai cave rescue, and we were sort of alluding to this earlier when we were discussing perhaps the the limits or or the the edges of autonomy.
00:38:55 Speaker 2
Yes.
00:39:07 Speaker 2
Yes. And I I guess when you think.
00:39:11 Speaker 2
When you twirl that around in your mind.
00:39:15 Speaker 2
It really comes down to trust.
00:39:18 Speaker 2
So.
00:39:21 Speaker 2
Most of health, quite rightly, is based on informed consent, which itself is a contestable and complex thing because you know what is, what is informed for one person might not be to another, and the standard of information given.
00:39:38 Speaker 2
And comprehension of it are quite hard to test, but nonetheless, quite rightly, if you're going to let.
00:39:45 Speaker 2
A stranger? Slice open your body and take an organ out, or you know, do something to your body.
00:39:53 Speaker 2
Then you you have a both an ethical and a legal right to have the full information about the pluses and minuses of doing that, and you'll say so to do it is, is kind of sacrosanct, absolutely.
00:40:08 Speaker 2
But that doesn't.
00:40:11 Speaker 2
Extend to emergency medicine.
00:40:15 Speaker 2
And there is a thing called therapeutic privilege, where consent is not required because if you delay for consent, you die. Basically it's as simple as that, so.
00:40:27 Speaker 2
But the article.
00:40:30 Speaker 2
By Irwin in 2022 is an analysis of the issues at stake in the 2018 Thai Cave Rescue Rescue, where a group of.
00:40:42 Speaker 2
Soccer players, boys.
00:40:45 Speaker 2
I think all of them under 18, I think that's right.
00:40:50 Speaker 2
We're trapped in a cave because of rapid flood water.
00:40:56 Speaker 2
Rises.
00:40:58 Speaker 2
And.
00:41:00 Speaker 2
The advice from the experts was that unfortunately the water would not recede before the boys died.
00:41:10 Speaker 2
And so they needed to be rescued. And this type of rescue is as difficult as it gets, though there's probably nothing on the planet would be more difficult than an underwater cave rescue.
00:41:24 Speaker 2
Involving a number of boys, young, young people.
00:41:31 Speaker 2
Who I'm have to say, they displayed incredible courage.
00:41:36 Speaker 2
Most of us in that situation would have would have probably died of fight a long time ago. Was it quite incredible that.
00:41:45 Speaker 2
But what was interesting about it was, and the reason I chose it is that as I was doing this, I was.
00:41:52 Speaker 2
A guest at Government House in Adelaide at a reception for the professional Association for palliative care doctors and parents.
00:42:01 Speaker 2
For their 20th anniversary in in Adelaide and the Lieutenant governor who was posting the event, happened to be Doctor Richard Harris, who's the anaesthetist, the Australian anaesthetist, who was the the Co mastermind? If you like of the whole operation.
00:42:21 Speaker 2
And I I had a conversation with him and his wife and. And then when I went back and saw this story, I thought I've I've got to choose this article.
00:42:29 Speaker 2
Because The thing is that full informed consent to those boys would have terrified them.
00:42:38 Speaker 2
And although there was time here, it was a meticulously planned operation, so it wasn't something that was done on the spur of the.
00:42:46 Speaker 2
But at the end of the day, you had to take a decision as an anaesthetist, whether you were going to anaesthetize fit and healthy.
00:42:54 Speaker 2
Young people and then in an anesthetised state, swim with them out of a flooded cave.
00:43:03 Speaker 2
I mean that is just mind boggling. Imagine if you're the table having an anaesthetic in the hospital, I said, oh, by the way, now we're just going to go under underwater for two or three kilometres and you know they will come back the other side. But they did it and they saved them. And.
00:43:18 Speaker 2
You know the the ethics of that are you could say, well, you know, there was a chance of death for each of them, of course, not insubstantial.
00:43:28 Speaker 2
There were huge risks of death and brain damage and hypoxia. God knows what.
00:43:33 Speaker 2
But it's an example of where you just basically had to trust the guy who's running it and virtue really virtue and technical skill really mattered.
00:43:44 Speaker 1
Mm.
00:43:46 Speaker 2
So I learned bioethics. We very rightly get very carried away with all of the issues about informed consent and we give people a hard time for any slight violations thereof.
00:44:02 Speaker 2
In the final analysis.
00:44:05 Speaker 2
Particularly when you go for surgery, you know you're in the hands of people.
00:44:10 Speaker 2
Who? You know, there has to be some trust that you've picked a person who's got the skills and the knowledge to be doing what they're doing, who explain it to you in an honest way about what their experiences and what the data show.
00:44:24 Speaker 2
And beyond that, if you're in the emergency room, there isn't time for debate often.
00:44:24 Speaker 1
In your.
00:44:34 Speaker 1
So what I think you're you're sort of the five articles that you've pulled together for the anniversary collection really nicely demonstrate various.
00:44:45 Speaker 1
Ways of approaching bioethics scholarship and just hearing you talk about the those articles now and and the breadth and the depth.
00:44:57
It.
00:44:58 Speaker 1
Reminds us what? What a rich, what? A rich area buyback fix is and and can be. One thing I did want to ask you actually in your editorial, you and you and you alluded to this earlier. You you talk about the jbi.
00:45:16 Speaker 1
Resting its case on on logic and science, but also at the same time, I'm sort of endeavouring into the subjective world to sort of understand.
00:45:27 Speaker 1
Human behaviour and the the wider world and and inquiry.
00:45:32 Speaker 1
And I'm I'm wondering having having been joint editor in Chief for a number of years now at the jbi, do you think that you understand more or or less about the world?
00:45:43 Speaker 2
Oh, look, without doubt it's been a great privilege to to be asked to read all of these things and.
00:45:51 Speaker 2
It would be incredibly arrogant of me to suggest anything else. Yes, absolutely.
00:45:57 Speaker 2
It's informed me on on so many levels and I think one of the things that all me and particularly and the founders have been very clear about, is they wanted a really diverse multidisciplinary.
00:46:12 Speaker 2
Exploration of bioethical issues and I I completely support that and I think when I when I first got interested in ethics, I went on that that weekend intensive.
00:46:27 Speaker 2
And that Buffalo was in Victoria at the shallow there.
00:46:30 Speaker 2
Health occurs and Peter Seyer, both of them, extremely able people very, very good brains.
00:46:39 Speaker 2
And I I think I I I didn't realise it had a title, but you know I'm, I I I'm surprisingly resistant to the dangers of impostor syndrome.
00:46:54 Speaker 2
To to my disadvantage. You know, I think I've I've often blundered into things.
00:47:01 Speaker 2
Pretending I know what's going on and.
00:47:03 Speaker 2
Later on on.
00:47:06 Speaker 2
But I think the thing about that weekend was I came away really quite informed, but also this sense of of of imposter syndrome, that really the bright people in this were the philosophers.
00:47:21 Speaker 2
And one really had to listen to them because they had the the kind of secrets of ethics. And what's you know.
00:47:28 Speaker 2
What's right or wrong?
00:47:31 Speaker 2
And and how you justify that rightness and wrongness. And there's still no doubt that that we need those people who've rigorously studied philosophy and philosophical ethics, that I I wouldn't walk away from that. It's important.
00:47:47 Speaker 2
The fact that most of us.
00:47:49 Speaker 2
Have the difficulty for certainly I have difficulty in following some of the more difficult arguments and when my colleague Paul Komisarov says that he does indeed read the tract, Tartus by Wittgenstein. You know, I pick it up and dip into it and and probably misunderstand.
00:48:07 Speaker 2
Whatever I take out of it, but.
00:48:11 Speaker 2
I think the refreshing thing of encountering the journal is really finding people like Paul and Ian and one's colleagues on in, and the writers say no, that actually somebody, you know, this is about all of our lives and deaths and births and.
00:48:29 Speaker 2
The way we treat the environment and animals and all the rest of it. So we've all got something to say and.
00:48:36 Speaker 2
You know, it doesn't have to be in philosophical language, obviously. What we have to say has to be truthful and logical up to a point. But the problem is I, you know, as as as we come to a close, I I guess the big thing I put out there from my explorations into the Freudian world, which similarly to philosophy I I have, you know, I probably get the wrong.
00:48:57 Speaker 2
Often than not, but.
00:48:59 Speaker 2
The really big insight into this is.
00:49:01 Speaker 2
And I put the coalition packs to you as the interviewer. How much of your lives do you think are actually logical? Because my view is actually most of what we do is not logical. Most of our behaviours are not logical. Most of our choices are not logical.
00:49:17 Speaker 2
They're much more nuanced.
00:49:20 Speaker 2
And I think it's Freud's idea that we've basically got the ego, which is kind of the personality and the action in the world you've got the.
00:49:30 Speaker 2
You've got the.
00:49:32 Speaker 2
Which is the primitive animal kind of instinctual.
00:49:38 Speaker 2
Element of the brain and therefore of our behaviours. And then you've got the superego, which obviously the bioethics inhabits, you know, this, this, this conscience, that kind of beats you up for doing the wrong thing. I think these are actually, I think it's a very plausible way of talking about the world. I'm not saying it's a scientific fact. I'm just saying it's a really good way.
00:49:59 Speaker 2
Due to talk of the world, so the so really bioethics is in this constant battle in a sense. Obviously the ego is always getting in the way, but it's almost like this battle between the Eid, you know, between human nature and how we really want the world to be.
00:50:17 Speaker 2
And I think that.
00:50:21 Speaker 2
That that whilst our argumentation and our scholarship and our writing needs to follow rules so we can understand each other, we need to be able to.
00:50:32 Speaker 2
In particular, you know the thing I did take from victim Stein's whole idea of context and language.
00:50:38 Speaker 2
You know, a lot of what we do in bioethics is teasing out language and trying to find common symbols and metaphors that that we could actually agree on.
00:50:51 Speaker 2
The rules of engagement, if you like.
00:50:55 Speaker 2
That's very important, but.
00:50:59 Speaker 2
For people who think that human behaviour can solely be viewed to logical tools and through science, oh, no, no, no, no, definitely not. I don't hold that view at all. I think that that we spend more time in the subjective.
00:51:15 Speaker 2
Than we're even aware of.
00:51:18 Speaker 1
Because in our field there is a lot as you sort of say, there's a lot of subjectivity to negotiate.
00:51:25 Speaker 1
Which is is part of the difficulty, but also the the value of bioethics and thinking I was thinking about what you were saying earlier about about the place of logic. I keep bringing myself back to this question of.
00:51:40 Speaker 1
What? What? What role or what need does logic fulfil or what what need are we seeking to fulfil with logic? What does it? What does it bring us and?
00:51:53 Speaker 2
Yeah, that's a very interesting question.
00:51:57 Speaker 2
And I go back to John Ralston's full the he was a Canadian, I guess philosopher, public intellectual if you like.
00:52:11 Speaker 2
Who visited Australia a few times? He read a book called Voltaire's ******** and one of he was basically saying is.
00:52:18 Speaker 2
Everything in the Enlightenment was going along swimmingly well until along came the Jesuits, who started a process of that led to corporatization. So everything we do gets turned into a business.
00:52:33 Speaker 2
And.
00:52:37 Speaker 2
And you know everything is, he said, was vandalised by science and business. So subjectivity is kind of pushed aside. Everything is objective, logical, positive, decisive, decisive.
00:52:50 Speaker 2
And and and ultimately. Then you develop a bureaucracy which has reinforcing kind of behaviours, and this is actually not good because the world isn't really like that, but we're and but. But the key thing, the echoes of what you're saying, he said, why do we do this?
00:53:08 Speaker 2
And he says well.
00:53:09 Speaker 2
Because it gives us childlike certainty.
00:53:12 Speaker 1
MMM.
00:53:13 Speaker 2
Yeah. And it's back to this business.
00:53:17 Speaker 2
The Medal of decline thing where she basically says the two sort of states that we have 1 is what she calls the schizoid state, which is that we start off and this is this is a psychoanalytical kind of a view of the world, which is what she was.
00:53:35 Speaker 2
To say we start off separating from the mother.
00:53:39 Speaker 2
Who has to totally look after us to start?
00:53:42 Speaker 2
With and so we expect to have all our needs met and then gradually as things progress, the mother detaches from you and we don't like that.
00:53:54 Speaker 2
And so we see the world then as good and bad. And this is a bad thing that, you know, my mother's not there. Every time I cry and all the rest of it. So that's her theory of psychic development. And she says basically what happens is that normal maturation as you come to a thing, terrible terms. But anyway, that's psychoanalysis for you. They like, they like to be obscure, I think.
00:54:14 Speaker 2
In some ways, she talks about the depressive position where you.
00:54:19 Speaker 2
Say aha, OK, the world's like that. It's got good and bad in it. I'm not always going to get all my needs met and I have to just get used to that because that's life and she she calls that the psychic maturation. But what she says is when we're threatened, we go back to.
00:54:34 Speaker 2
To the fight and flight the splitting.
00:54:39 Speaker 2
And So what? What Wilson Saul was saying, I think is that.
00:54:44 Speaker 2
The world is full of uncertainty. It's messy, it's contradictory. It's contradictory.
00:54:50 Speaker 2
Umm.
00:54:52 Speaker 2
But.
00:54:54 Speaker 2
This very logical positive business related ******** objective kind of view of the world does is it actually boxes everything up nice and neatly.
00:55:06 Speaker 2
And it tidies up the world, and therefore we feel less anxious.
00:55:11 Speaker 2
So in a way, it's cure for anxiety.
00:55:14 Speaker 2
About the uncertainty, including the fact that we really don't know for sure whether we're going to be alive tomorrow or not. None of us do so. So I think I very much enjoyed Ralston's store stock because he sort of indicated to us that there's a whole structure in the modern world of the corporation.
00:55:32 Speaker 2
There's public and private. One might add, where there's all kinds of self reinforcing.
00:55:39
I.
00:55:40 Speaker 2
Behaviours and rules and regulations.
00:55:44 Speaker 2
But it's actually a very poor response to the totality of the human condition, which is that more messy, sort of subjective, see and and and things like you said. Well, if we employed objectivity, there'd be no reproduction.
00:56:01 Speaker 2
You know, how do we deal with our attractions as well as our hatreds, all those things.
00:56:08 Speaker 2
And so I think in a way that's my long winded answer to the question you pose, which is to say that logic makes us feel comfortable because it tidies up a world that is very messy.
00:56:24 Speaker 1
Yeah, wow. Couldn't have said it better myself.
00:56:30 Speaker 1
Yeah, I actually I have. So I have so many thoughts, but unfortunately I probably need to just wrap up the episode because I will get kicked out of the booth.
00:56:40 Speaker 1
But man, I could keep talking about this.
00:56:43 Speaker 2
And also it circles back to what I was saying in this new editorial that, you know, we've got Elon Musk about to decimate the federal public service in America. I feel very sorry for them. But again, it's this idea just bringing the master spy. Click, click, click or automaton and you just sack a whole lot of people.
00:57:04 Speaker 2
Will be better, you know, cheapest, you know.
00:57:06 Speaker 2
It's it's, it's an energy and it we we we need we need to be organised definitely we need organisations we can have too much of it. Just like you have too little society. You can have too much.
00:57:19 Speaker 2
So yes, I'm sure we could go on. But but we mustn't thank you very much for.
00:57:26 Speaker 2
For for having me.
00:57:28 Speaker 2
But for engaging in this discussion.
00:57:30 Speaker 1
And so, thanks so much Michael, for your time and for, yeah, speaking a little bit more about your, your choices of the articles. I know it was a really difficult process and just hearing you talk about them all, I have no doubt.
00:57:45 Speaker 1
It was really, really difficult. Thank you again, Michael. So much for participating and and sharing your insights with us here on the wire dialogues.
00:57:56 Speaker 1
And to those listening, thank you very much for joining.
00:57:59 Speaker 1
You can check out Michael's full editorial as well as the articles that were mentioned today up on the JB is website and I will link them all in the show notes below. You can read those.
00:58:13 Speaker 1
Articles from the Archives for free for a limited time and stay tuned for our next episode. Thank you so much. Take care.