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2020 Michigan High School Ethics Bowl Case Studies

This year's Ethics Bowl, with a ever-growing number of schools and student teams, is packed with real world cases, with real thinking, in real time, about the topics of literary anonymity to the ethics of the Ethics Bowl itself.

Unlike other Regional Bowls, most Michigan Bowl case studies are written by community members, all of whom are working in Michigan or have a longstanding Michigan affiliation. The Michigan Bowl also has a fine editing team: several philosopher coaches from the University of Michigan Department of Philosophy Outreach Program. 

As always, each case is accompanied by study questions to fire up the neurons and jumpstart discussions. And don't forget to take a look at the author bios - you may share some interests with the case writers, or you might meet them on Bowl Day. Several of the case writers come to the Bowl to learn about what you think, and to hear your arguments about their own as well as all the other case studies. 

Case 1: Uterus Transplants

Medical teams in the United States and Sweden are working to make uterus transplantation operations possible. If approved, these procedures would allow women without a uterus to become pregnant and give birth (a woman might lack a uterus for a variety of reasons: e.g., she was born without one or had it removed because of damage).  There are approximately 50,000 women in the US that could be candidates for the uterine transplants. Whether or not they will be able to undergo the procedure, however, is unclear since the procedure is rather controversial. 

Proponents note that the inability to become pregnant and give birth is a source of significant sadness and frustration for many women. So the possibility of a procedure that could allow them to carry their child to term is very exciting. In fact, these transplants would likely bring a better option for many who are unable to become pregnant. Unlike adoption, uterine transplants would give women the opportunity to have a child using their own eggs and their partner’s sperm. And while surrogacy can provide this benefit, some find surrogacy morally objectionable and it’s also prohibited by some religions. Most significantly, perhaps, uterine transplants would provide the women who receive them with the chance for the special—even transformative—experience of carrying their own child to term. As one woman explained, “I crave that experience. I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”

Detractors put forward a variety of concerns. For one, in addition to the risks that come with any major surgical procedure, uterine transplants—like any live organ transplant—require the recipient to take powerful anti-rejection drugs. But these drugs carry serious negative side-effects like increased cancer rates and kidney damage. The anti-rejection drugs are also associated with more complications during birth and smaller, lower weight babies. In addition to these concerns, some have also questioned whether performing these procedures (especially since adoption and surrogacy are available to many) is a good use of our healthcare resources—the money and energy being devoted to performing these procedures would be better spent elsewhere.

Study Questions:

  1. Should women, who otherwise are incapable of conceiving their own biological child, have the right to undergo uterus transplants?
  2. Is it morally permissible to undergo a uterus transplant even given the associated health risks to the future-offspring? What, if any, amount of risk should be tolerated? Explain.
  3. Let us imagine making uterus transplants accessible would deter people from both adoptions services and surrogacy. Would this lead to a morally better or morally worse state of affairs than the status quo?

Author Bio: Charlie Kurth is an Associate Professor in the Philosophy Department at Western Michigan University. His research focuses on issues at the intersection of ethical theory, moral psychology, and the philosophy of emotion. Charlie’s book, The Anxious Mind: An Investigation into the Varieties and Virtues of Anxiety, was recently published by MIT Press, and he has articles in journals like Ethics, Philosophy of Science, Mind & Language, Behavioral & Brain Sciences, and Philosophical Studies. He regularly teaches biomedical ethics and he has received awards for his graduate teaching and mentoring. 

Case 2: Gene Testing

Stacey is a first-time mom taking her ten-year-old daughter, Emma, to the pediatrician for Emma’s annual physical.  Emma appears to be perfectly healthy, but Stacey wants to talk to the pediatrician about ordering some genetic tests for the girl. 

Emma’s paternal grandmother was only 60 years old when she passed away from Alzheimer’s disease last year.  Given how young she was, the doctors determined that the grandmother had early onset familial Alzheimer’s disease (eFAD).  This specific type of Alzheimer’s disease is marked by symptoms that appear much earlier than in other types of Alzheimer’s disease, and it is also hereditary.  This means that individuals with affected family members are much more likely to be diagnosed with the disease themselves, compared to individuals with no family history of the disease.  Like other forms of Alzheimer’s disease, there is no cure for eFAD.

Since Stacey is not a blood relative of Emma’s grandmother, she is not worried about getting eFAD herself.  However, she is concerned that Emma will develop the disease and wants to get her genetically tested to find out. 

The pediatrician is not quite sure what to do when he hears Stacey’s concerns.  He knows that the Committee on Bioethics of the American Academy of Pediatrics currently advises pediatricians not to genetically test children for conditions that onset in adulthood.  They advise that this kind of genetic testing “should be deferred until adulthood or until an adolescent interested in testing has developed mature decision-making capacities.”  As symptoms of eFAD typically begin when a person is between 30-50 years old, it is categorized as an adult-onset condition which means that, per the guidelines, he should not order the tests.

However, the pediatrician also knows that parents can bypass the guidelines and still request genetic testing for their children, especially when a genetic disease is known to be present in their family.  Since this possibility is present in Emma’s case, the pediatrician could be justified in ordering the tests.

Study Questions:

  1. Does Stacey have the right to make this decision on behalf of her daughter? Or should she instead wait for her daughter to be old enough to make this decision (of ordering the tests) for herself?
  2. If Emma gets tested, does Stacey have to tell her daughter about the results right away or can she wait until Emma is older?  At what age is Emma “mature” enough to decide for herself if she wants to get tested or find out the results?
  3. Should the pediatrician order the tests?  Are there certain diseases or circumstances that would warrant a different outcome?
  4. Given the hereditary component of eFAD, would Stacey or the pediatrician be obligated to tell other family members about the genetic tests so that the other family members can also get tested?

Sources:

https://www.alzforum.org/early-onset-familial-ad/overview/what-early-ons...

https://pediatrics.aappublications.org/content/129/1/163

Author Bio: Madeline DeMarco is a master’s student studying health behavior and health education with a focus on public health genetics at the University of Michigan School of Public Health.  She also completed her undergraduate degree at the University of Michigan with a dual major in biology and Spanish. Through the School of Public Health, Madeline volunteers her time to work with the Detroit Food Policy Council as well as Project Healthy Schools.  Madeline also works as a graduate student instructor for the University of Michigan Marching Band. In her free time, Madeline enjoys running, cooking, and playing with dogs.

Case 3: The Ethics of the Ethics Bowl

Stephanie is a Philosophy professor setting up a High School Ethics Bowl in a small college town. She sees Ethics Bowl as a rare opportunity to make philosophical skills and ideas accessible to young people. It is particularly important to Stephanie that she widen access to these academic skills by working with schools that have relatively fewer resources. But Stephanie does not want to be exclusive, particularly in the early years of the Bowl. So she allows any school interested in participating to join the program.

As the months go by, and Stephanie visits each of the schools participating, it becomes clear to her that the students at different schools have widely varying levels of background literacy and cultural capital. She hears from a student at one school that their father is a lawyer, from another that their father is a farmer, and from another that their father just went to prison. The students are working toward very different academic goals — though they all want to go to college, they are applying to very different colleges, and some schools’ students are all first-gen while others come from families who all have advanced degrees — and the teachers describe very different challenges to Stephanie, from dealing with pushy parents to trying to find ways to incentivize attendance in the lead-up to standardized tests. The different levels of financial investment that each school enjoys are evident from the huge variation that Stephanie sees in their building upkeep.

Stephanie does her best to arrange coaching at each school in a way that meets the students where they’re at. But they are at very different places, with some reaping the benefits of participation in well-oiled Debate teams, and others just beginning to approach moral and political questions through their work on Ethics Bowl. When it comes to preparing for the Bowl, some schools are able to devote a lot more time to the case studies than others, as some students have multiple jobs and turbulent home lives that make it difficult to get regular practices in. Stephanie sees the impact that these different starting positions and different opportunities for preparation throughout the year have on the students’ performances in the Bowl. Each team has one or two motormouths who are able to talk for at least three minutes of their presentation time. But some of these students are making their answers up on the spot, having had insufficient time to get to grips with ethical theory, fully analyze each case study, and settle on a group “stance” on the case in advance. And, predictably, the students at schools with more resources wear fancier clothing to the Bowl, sit up straighter, smile more, and deploy more four- syllable words.

Stephanie’s Ethics Bowl judges are no fools, and so they do not award points to the fancy schools just because they look fancy. But Stephanie notices that the schools with more resources do tend to pick up more points, on the whole, than the schools with fewer resources. She worries that her judges might be affected by implicit bias, particularly when she hears them using words like “spirited” and “passionate” in their feedback to the schools with lower resources and “sharp” and “polished” in their feedback to the schools with more resources. Nonetheless, Stephanie also knows that the schools who are doing better are probably just giving better presentations, according to the Ethics Bowl scoring criteria — their presentations are probably more “clear and systematic”, which is one of three scoring criteria for the presentation section, and their training in critical thinking probably enables them to give more careful and well-reasoned on-the-spot responses to the judges’ questions, which are worth a full half of a presenting team’s points. Stephanie feels as though she can’t do much about this. Moreover, she isn’t even sure whether any sort of injustice is occurring; if one school’s presentation is better, then shouldn’t it be that school that wins?

However, when Stephanie travels to UNC Chapel Hill for the National High School Ethics Bowl, her unease increases. Of the dozens of schools in attendance, only three are state-funded. Most students have the slick presentation style and cute outfits of the more well-resourced schools that Stephanie works with, and, as the rounds progress, her stereotype fits the remaining students more and more perfectly. Moreover, some of the teams say things that strike Stephanie as somewhat ignorant. For example, during a round on felon disenfranchisement, one team refers to prison as a “time out” and a “bubble”, while the other team sincerely suggests that felons should be given voting rights equivalent to two-thirds of a regular vote. Stephanie tries to voice her concerns to the Director of the Parr Center for Ethics, who runs the National Bowl, but she leaves with the impression that he isn’t really listening to her.

Over the summer, as Stephanie begins to prepare for the second year of her Bowl, she isn’t sure what — if anything — she should do differently. It feels odd to her for an ethics competition to be reflecting and replicating background social inequalities. But she doubts that there’s much that she can do to prevent this sort of thing from happening at her Bowl.

Study Questions:

  1. What, if anything, is morally required of Stephanie under her circumstances?
  2. If a well-resourced school scores higher than a poorly-resourced school in an Ethics Bowl round, but the well-resourced school did give a better presentation according to Ethics Bowl criteria, has any injustice occurred?
  3. In what ways might it be possible for Stephanie to minimize some of the disparities between relatively well- and relatively poorly-resourced schools in the Bowl? What about Ethics Bowl judges? The Director of the Parr Center and other high-level Ethics Bowl officials?

Author Bio: Zoë Johnson King completed her PhD in Philosophy at Michigan from 2013 to 2018. During this time, she co-founded the Michigan High School Ethics Bowl in her first year, and co-organized it the other four years. She specializes in Ethics, Metaethics, Epistemology, Decision Theory, and Philosophy of Law. She is currently an Assistant Professor and Bersoff Faculty Fellow at New York University, and will be moving to the University of Southern California in Summer 2020.

Case 4: Pelvic Exams Under Sedation

You are a young woman undergoing a procedure to remove a fibroid from your uterus. The procedure will be done at a teaching hospital where you have never been a patient before. You understand that at this institution, unlike your local hospital, learners of different levels may participate in and observe your operation including medical students, residents, and fellows. While you are waiting in the pre-operative unit for the procedure to start, many of these individuals introduce themselves to you. You don’t remember all of their names, but you do remember a somewhat nervous medical student telling you he will be “scrubbing in” on your procedure.

You are completely sedated for the procedure. You wake up outside of the operating room in the anesthesia recovery unit. You are told the procedure went well.

A few weeks later, you are having brunch with a close friend who is a surgical technician. She has participated in many operations just like the fibroid removal you had. Out of curiosity, you ask her what medical students may do in the operating room. She says that frequently students suture incisions. As she continues to describe what happens in the operating room after the patient has been sedated, you learn that a pelvic exam is common practice before the start of a gynecological procedure. You’ve had pelvic exams with your family doctor before and recall that it involves the provider inserting their fingers into the vagina. It dawns on you that the medical student, in addition to all the other physicians participating in the procedure, may have performed a pelvic exam on you while you were sedated. You do not know for sure what happened and no one informed you otherwise.

Study Questions:

  1. Is it ethical for the medical student to perform a pelvic exam on a sedated patient under conditions such as those described in this scenario? If not, are there ways in which the scenario could be changed such that performing the exam is ethically permissible?
  2. As a doctor-in-training who does not yet have a medical license, what “professional” obligations does the medical student have to the patient in this situation?
  3. Medical students often perform other procedures such as suturing or intubation while patients are under sedation without having consented the patient beforehand. Is a pelvic exam any different from these other procedures? If so, why?
  4. Does the need for training future physicians morally require some adjustment in how patients are treated in a clinical setting? Do patients who seek medical attention at a teaching hospital implicitly accept this condition? Should it be made more explicit?

Author Bio: Samantha Chao is a fourth year medical student at the University of Michigan. She is currently completing a pre-doctoral fellowship in clinical ethics sponsored by the Center of Bioethics & Social Sciences in Medicine. The fellowship involves working on the Ethics Consultation Service at Michigan Medicine to help patients and providers work through real-time, healthcare-related ethical dilemmas. Samantha graduated from Carleton College in 2016 with majors in English and Chemistry. This year, she will be applying for residency in Emergency Medicine.

Case 5: Peacekeepers and Protection During Genocide in Rwanda

Background:  In 1994, over the course of a little more than three months, approximately 800,000 Rwandans were murdered by their fellow citizens.  Since most of the victims were Tutsi and most of the perpetrators were Hutu, the episode has become known as the Genocide against the Tutsi in Rwanda, and it stands as one of the greatest human tragedies of modern times.  It also represents an ethical catastrophe on several levels:

  • First, and most obviously, hundreds of thousands of Rwandans breached ethical norms by participating in the genocide: killing, taking actions that lead to killings (like participating in roadblocks, cordons, or patrols), raping, and/or stealing the property of victims.
  • Second, the organizers of the genocide used institutions and power structures not for the common good, but to encourage, incentivize, and mobilize killing.
  • Third, people not directly involved in either of the preceding sets of ethical breaches decided not to come to the assistance of those being victimized. Rwandans and non-Rwandans alike stood by when some action might have saved lives.

This case involves the very last of these scenarios,  in which a group of non-Rwandans fails to protect Rwandan Tutsis from persecution. As is often the case in by-standing scenarios, what in retrospect appears to have been a severe moral failure involved a more complicated calculus in the moment.  Consider, for example, Rwandan bystanders whose choice of whether or not to take ethical action was made in the face of threats against them if they acted to protect potential victims.

Case:  A contingent of United Nations peacekeepers had been stationed at the ETO Technical School on the outskirts of Kigali, Rwanda’s capital, when the genocidal violence began on April 6, 1994.  By April 9th, over 2000 Tutsis had congregated at the school, seeking and gaining the expected protection of the peacekeepers there.  But on the 9th, with mass killing (of Rwandans by Rwandans) breaking out throughout the country, several European countries initiated an operation to evacuate their expatriates.  Unsure of the security requirements of doing so, a contingent of several hundred French, Belgian, and Italian soldiers flew in and asked the United Nations for the assistance of their peacekeeping troops as well.  Over the course of two days, several hundred aid workers, missionaries, and business people were successfully ferried to the national airport in Kigali, with no casualties sustained among either the rescued or the rescuers.

However, when the UN troops left the ETO Technical School on April 11, in part to participate in the evacuation operation, they abandoned the Tutsis who had sought refuge there.  Reportedly, within minutes of the peacekeepers’ departure, Hutu militias closed in on the school grounds and detained the Tutsis.  Later that day, the captive Tutsis were forced to march to a more remote location, where they were almost all slaughtered.

In retrospect, it is clear that the effort undertaken to save – and there is no reason not to highlight the racial element of it – a few whites (who may not have been in grave danger at any rate) came at the cost of the deaths of over 2000 Rwandans.  No one would make that ethical choice if it were framed as such from the outset.  However, there were mitigating circumstances that clouded the ethical calculation at the time, including whether the evacuating expatriates might be in greater danger than they actually were, and whether it was known that the abandoned Tutsis were in as great a risk as they were. 

Moreover, the peacekeepers themselves fell within a military chain of command, meaning the commander of the ETO contingent took orders from someone at the UN’s Kigali headquarters, who in turn took orders from someone in New York.  While it is recognized the soldiers have an affirmative duty to resist following orders to commit a war crime or other illegal act, it is not clear in this case that being called away constituted such a situation.  Reportedly, some of the peacekeepers at the site recognized or could have predicted the consequences of the UN contingent’s departure.  But what recourse did they have to resist their orders? 

We might also ask whether peacekeepers themselves require a different standard for evaluating risks of exposure to harm than is the case for military forces engaged in adversarial combat against one another. Perhaps most importantly, what sort of guidelines for peacekeepers might lead to a better ethical result in similar situations in the future?

Study Questions:

  1. Is it reasonable to argue that the (white) Europeans who were in Rwanda had some special claim to be evacuated or did their choosing to go to Rwanda imply an agreement to be subject to the same dangers as anyone else living in the country, citizen or not?
  2. Should someone have resisted the order to help evacuate the expatriates and abandon the Rwandan Tutsis? If so, who had that responsibility? Does it include an individual UN soldier?
  3. Can the peacekeepers reasonably argue that unlike military forces engaged in adversarial combat, they did not choose to expose themselves to the risks of war and that it was therefore ethically permissible for them to reduce risks to themselves in spite of the greater danger it caused the Tutsis hoping for their protection?
  4. If the UN peacekeepers, based on their knowledge on the ground that arguably was greater than that of the UN’s higher command, felt confident that most of the Tutsis would be killed if they were abandoned, would following orders to abandon the Tutsis constitute a moral crime?

Resources:

African Rights. "Left to Die. At ETO And Nyanza. The Stories of Rwandese Civilians Abandoned by UN Troops on 11 April 1994." (2001).

Paolo Tripodi. "When Peacekeepers Fail Thousands are Going to Die. The ETO in Rwanda: A Story of Deception: Report from the Field." Small Wars & Insurgencies 17, no. 2 (2006): 221-236.

For a description of the evacuation force from the definitive history of the Rwandan genocide, Human Rights Watch’s Leave None to Tell the Story (1999), see here: https://www.hrw.org/reports/1999/rwanda/Geno15-8-01.htm#P88_24569.  The episode is briefly covered in Samantha Power’s award-winning Atlantic Monthly article, in the context of a scathing indictment of American indifference and inaction towards the genocide (“Bystanders to Genocide” Atlantic Monthly 288, no. 2 (2001): 84-108, online here: https://www.theatlantic.com/magazine/archive/2001/09/bystanders-to-genoc...)

It has also been portrayed in film. Beyond the Gates (dir. Michael Caton-Jones, 2005) offers a fictionalized version of the events.  The documentary Ghosts of Rwanda (dir. Greg Barker, 2004) provides a glimpse of the expat evacuation, including the searing episode Power describes in her article.

For more context on the UN’s involvement in Rwanda in 1994, see Michael Barnett’s article, "The UN Security Council, indifference, and genocide in Rwanda” (Cultural Anthropology 12.4 (1997): 551-578), which provides an insider’s perspective of the bureaucratic ethical framework in which UN decision-making took place.  He focuses on the decision two weeks after the ETO incident, to evacuate most of the UN peacekeeping force itself, in the midst of the genocide (available here: https://home.gwu.edu/~barnett/publications.htm); he covers these same issues at much greater length in a book, Eyewitness to a Genocide (Cornell U. Press, 2002)).

Author Bio: David J. Simon is the director of Yale University’s Genocide Studies Program. Additionally, he is a senior lecturer in the Political Science department at Yale, where he focuses on the political challenges after mass atrocities and the possibilities of developing within societies a greater level of resilience to mass atrocity threats.  He has also served as a consultant to the UN office on Genocide Prevention. David graduated from Ann Arbor Greenhills School in 1987. 

Case 6: My Sister's Keeper

You are a pediatric cancer doctor who has been asked to evaluate Ricky, a 4-year-old boy, as a bone marrow donor for his older sister. Ricky’s sister, who is 9 years old, has sickle cell disease. She has experienced many complications of the disease, which causes significant pain, and has been admitted to the hospital because of it multiple times. Bone marrow transplant is a relatively new curative treatment for sickle cell disease that has shown some promise in small research studies. All of the sister’s relatives have been tested, and Ricky is the only relative who is a genetic match. Because they are children, medical decisions for both Ricky and his sister are made by their parents. Your job is to evaluate whether Ricky would be an appropriate bone marrow donor for his sister; more specifically, whether the benefits of donation would outweigh the risks to him undergoing the bone marrow harvest procedure.

To harvest stem cells from a donor’s bone marrow, the donor is sedated under general anesthesia and a needle is inserted into the bone. Generally, exposing young pediatric patients to anesthesia carries greater risk than exposing an adolescent or adult patient to anesthesia. The range of risks is broad, ranging from mild complications after the procedure (such as vomiting or needing extra oxygen to breathe) to quite severe, including death in very rare cases. Repeated exposure to anesthesia in young children is increasingly recognized as having potential to permanently alter brain development.

Furthermore, Ricky is much smaller in size than his 9-year-old sister. In order for the bone marrow transplant to work, enough cells need to be harvested from Ricky to be transplanted into his sister. The transplant team believes they will have to perform two harvest procedures on Ricky in order to obtain a sufficient amount of cells. This means twice the exposure to anesthesia and a likely hospitalization for Ricky to recover after the procedure. The transplant team is also considering offering a medication to Ricky to increase the number of stem cells in his bone marrow at the time of collection to improve the chances of harvesting an adequate sample. This medication often causes a significant amount of bone pain. Additionally, there have been cases in which the use of the medication has resulted in complications when used in patients who carry the sickle cell trait. Ricky is a sickle cell trait carrier.

Study Questions:

  1. How is this case different from a case where Ricky and/or his parents want him to donate bone marrow to a stranger?
  2. How should one respect the autonomy and bodily integrity of a young child who is not his own medical decision-maker?
  3. Does the fact that the parents must make a decision for both of their children in this case introduce any problems? For example, is there a chance that the parents won’t be unbiased decision makers?
  4. Is it ethically permissible to move forward with the stem cell harvest procedure(s)? If not, under what conditions could the procedure(s) be permissible?

Author Bio: Samantha Chao is a fourth year medical student at the University of Michigan. She is currently completing a pre-doctoral fellowship in clinical ethics sponsored by the U-M Center of Bioethics & Social Sciences in Medicine. The fellowship involves working on the Ethics Consultation Service at Michigan Medicine to help patients and providers work through real-time, healthcare-related ethical dilemmas. Samantha graduated from Carleton College in 2016 with majors in English and Chemistry. This year, she will be applying for residency in Emergency Medicine.

Case 7: Copycat

A staff member, Amber, has prepared an educational PowerPoint presentation to be used at the organization for which she works.  This PowerPoint contains facts and figures that will be used both for the education of the staff in the organization and also for marketing purposes.  It is a clever presentation that engages the viewer easily and has been well received.

Jane, a colleague of Amber’s, has seen the presentation and has asked Amber if she can use it for a presentation that she is doing.  Amber agrees and sends her the PowerPoint.

Later she learns that Jane has actually used the PowerPoint as a major part of an education module for obtaining her online Master’s degree. She even hears from another colleague that Jane claimed sole authorship and development for this.

Amber feels disappointed and feels that what Jane did wasn’t right.  But she realizes that she did give her permission and actually forwarded it to her.  The information and format was not copyrighted, and Amber feels that, although she personally developed it, the property actually belongs to the organization for which they work.

Study Questions:

  1. Did Jane do anything wrong? (For example, did she lie to Amber, or almost lie? Did she plagiarize, or almost plagiarize?)
  2. What, if anything, should Amber do? Confront Jane? Report the incident to Jane’s school or to their employer?
  3. Who owns this PowerPoint presentation?

Sources:

The Royal Society, “Plagiarism, copyright and intellectual property” https://royalsociety.org/journals/ethics-policies/plagiarism-copyright-ip/
Deb Gearhart, “Ethics in Distance Education: Developing Ethical Policies” http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.594.4947&rep=re...

Case 8: Drive Me Crazy

Arthur is a senior citizen who has lived alone with his dog for about 10 years since the death of his wife. He has managed quite well on his own, finding joy in simple pleasures like shopping, visiting friends, and taking his dog to the dog park. Arthur often joins his adult children for holidays and family events. Over the course of about a year, Arthur’s children start to worry that he may be getting dementia. They notice that Arthur, who was always so focused and alert, is starting to forget more things and frequently needs reminders. Arthur is very sensitive when his family members point out any memory issues and becomes quite argumentative, stating that he knows people with dementia and that nothing like that is happening to him. Still, at his children’s request, Arthur reluctantly agrees to allow his physician to run a few tests for signs of cognitive decline. The physician notes that Arthur does show some very early signs of dementia. 

Arthur’s family becomes concerned about his ability to drive.  Though he has not had any recent accidents or traffic violations,  his children recall that he did park in a ‘no parking zone’ at a recent family get-together. After soliciting input from neighbors to see what they think about his driving, the family then decides to report Arthur to the MDV (Michigan Department of Motor Vehicles) via an anonymous “Request for Driver Evaluation” (OC-88). When Arthur receives the information by mail that he will have to be evaluated for fitness to drive, he is appalled and asks all of his various family members if they submitted this request.  They all deny doing so.  He also asks his physician (the original law Public Act 354 and Act 355 allows doctors to alert the Secretary of State if the doctor or optometrist thinks a patient’s medical condition makes that person unsafe behind the wheel) and the doctor states that she did not submit the request.

Arthur studies for the test online for several weeks and is even able to pass a practice test. But when he goes to take the exam at the Secretary of State, he fails and his license is revoked.  Arthur is very upset at this outcome, as he fears he will lose his independence. Soon after, his family arranges for his car to be sold. Without his car, Arthur makes fewer trips to the store, to his friends’ homes, and to the dog park, because the bus schedule is sporadic and he does not want to burden his children by asking for rides.

Study Questions:

  1. Did Arthur’s family have an obligation to be honest with him when they reported him?
  2. Could it be considered age discrimination to request a driver evaluation for a senior citizen who has no record of accidents or traffic violations?
  3. If it is the case that Arthur’s driving could have endangered others, does public safety outweigh the independence and personal fulfillment Arthur gained by driving?

Case 9: Good Grief!

A grief counselor, Janet (licensed as MSW, LPC) was working with a family where the wife had a terminal diagnosis, and death was expected within a few months.  The family consisted of the patient, her husband of 25 years, and 2 adult children who lived in different states.  The patient died as expected and Janet followed up with the husband and adult children by phone.  The children declined any further calls but accepted the suggestions Janet offered for grief groups and counselors in the areas in which they lived.  The husband of the patient agreed to join a group that was being facilitated by Janet, and also participated in several phone call counseling sessions. He received counseling support for a period of about a year, then stopped attending Janet’s group. He did experience profound loneliness after his wife’s death, but seemed to be adjusting by the end of the year.

Several months later, Janet ran into the husband (Mr. X) at a community art fair. They chatted briefly and found that they had similar taste in art.  Mr. X asked Janet to join him for coffee, and she said yes.  After they got coffee, Mr. X asked her if she wanted to go to the movies with him the following week, and she accepted this invitation as well.

At the movie theater, Mr. X and Janet ran into another staff member from the organization for which Janet worked.  This other staff member recognized Mr. X as the bereaved husband who had been in Janet’s counseling group just a few months before. This staff member felt uneasy and tried to gauge whether Janet had just run into Mr. X by chance, but it became clear from the conversation that they had come together and that this was more like a ‘date.’

The staff member mentioned her observation to Janet’s supervisor the following week. Janet was then called into her supervisor’s office and was asked to explain the situation.

Study Questions:

  1. Did Janet violate any ethical obligations she had to Mr. X as his former counselor? Did she compromise her professional integrity?
  2. Would the situation be different if Janet had been a volunteer rather than a professional licensed counselor?
  3. Was the other staff member acting ethically when she reported what she saw to the supervisor?
  4. What (if any) repercussions should come to Janet?

Sources:

The National Association of Social Workers (NASW) Code of Ethics.
Counseling Ethics for the 21st Century: A Case-Based Guide to Virtuous Practice. Elliot D. Cohen and Gale Spieler Cohen. Sage Publications 2018.

Case 10: Repatriation

There is much discussion of repatriation of art, especially when it was  stolen from native lands or bought at unfair prices during colonization.

There are several popular examples, including the South African request for the return of the bones of Saartjie Baartman, taken in 1810 to England and France and exhibited in a demeaning fashion that exemplified racism.  They were returned in 2002 at Nelson Mandela’s request.

The Greeks have requested that the Elgin Marbles be returned to them from England, and are still awaiting repatriation of them.

Native Americans have requested bones to be returned to them from museums in the United States, including the Museum of Anthropology at the University of Michigan, which did comply with the request.

It would seem the appropriate ethical principle is clear--return the pieces of art to the rightful owner.  But critics argue  that some ‘rightful owners’ may not be equipped to care for and preserve the artworks in a way that will preserve their enjoyment for the future.

Is it ethical for a nation or organization to keep possession of works of art because they believe that the owner will not take appropriate care of them? 

Along similar lines, there is controversy over the US National Monument at Mount Rushmore, which is located in the Black Hills, land sacred to a number of Native American tribes. The Lakota and others say that Mount Rushmore isn’t just a piece of art that they dislike, but one that has been forcibly installed in their own sacred space.

What are appropriate ethical responses to the idea of repatriation?  In particular, what would be an ethical response to Mount Rushmore? Would it be more ethical not to visit this monument?

Study Questions:

  1. Is it ethical to display a piece of art in one’s home that is made of ivory that was obtained prior to the ban on ivory exports?
  2. What are the ethical principles involved in the issue of repatriation of art?
  3. How does repatriation work when the art is not a physical piece, but rather music or writings?

Sources:

 Heritage, Culture and Politics in the Postcolony by Daniel Herwitz.

Back to Where They Once Belonged: Proponents of African Artworks Take Issue with the Past--and Present and Future www.artnews.com.

Case 11: Greatest Shows on Earth?

Ringling Bros. and Barnum & Bailey Circus ended its 146 year run in May of 2017. Their reasons for closing included low attendance, high operating costs, and costly legal battles - particularly with animal rights groups.

Animal rights issues have gained traction in recent years. Individual activists and animal rights groups have fought against many instances of animal exploitation, including the use of elephants in circus acts and recreational hunting on African safaris, to name a few. In many cases, the groups have found success: we have seen increased public outcry against recreational hunting, the closing of many circus animal acts, and a greater awareness of and concern for endangered species. Even zoos have begun to rethink their principles of animal management; for example, the Detroit zoo ended its popular chimpanzee show in 1982.

In the face of increased awareness about animal rights, some people have begun to question whether zoos in general are ethical. The Detroit Zoo, for example, contains  2,400 animals from 235 species. The Detroit Zoo was originally founded to help care for a group of animals abandoned by a bankrupt circus in 1883. Today, they see education  - teaching people to help animals - as an important part of their mission. They run green literacy and community action initiatives, and they have a stated focus on animal welfare.

Nevertheless, PETA (People for the Ethical Treatment of Animals) argues that zoos are prisons, and that they actually hurt conservation efforts instead of helping them. They believe that, despite the Detroit Zoo’s educational and advocacy efforts, the entertainment of people cannot justify taking animals from their native habitats and keeping them captive.

So, in the face of increased sensitivity for animal rights, how should we feel about zoos in general? Are zoos ethical?

Study Questions:

  1. Can zoos be justified in keeping animals captive?
  2. If, as an individual, you think zoos are not ethical,  is it immoral for you to visit a zoo?
  3. The Detroit Zoo employs 261 full time employees, in addition to over 1,000 volunteers. It attracts 1.5 million visitors each year. Should we be worried about the economic ramifications of closing zoos?
  4. Are the educational initiatives, and the opportunity for children and adults to learn about animals they wouldn’t otherwise get the chance to see, enough to justify the preservation of zoos? 

Sources:

  1. Humane Ethics and Animal Rights. Michael W. Fox.  https://animalstudiesrepository.org/acwp_awap/14/
  2. Detroit Zoo Website.  detroitzoo.org

Author Bio of Cases 7-11: Teri Turner retired from full time employment in 2017 after an interesting career in nursing that has involved both international and local connections. Her education at U-M (BSN & MS) took her to China in 1981 to study the health care system and she ended up working in the Middle East for most of the 80’s and then returned to Ann Arbor and began working in Hospice & Palliative Care where she has been for 27 years. She is certified in Hospice & Palliative Care by the Hospice & Palliative Care Credentialing Center.  Her international work has given her a great focus on the importance of culture in the delivery of health care and also in the arena of Ethics.

She has served on the Ethics Committees for Saint Joseph Mercy Hospital and for Arbor Hospice & Hospice of Michigan and currently is a consultant for Angela Hospice, co-chairing their Ethics Committee. She also serves as a founding board member of the Children’s Palliative Care Coalition of Michigan and is currently vice president of that board.  She is a guest lecturer on Hospice and Palliative Care at U-M Schools of Social Work, Pharmacy and Public Health and has also lectured internationally in Japan and Malawi.

She came to A2Ethics via the Big Ethical Question Slam, leading a team from Arbor Hospice for several years and that team managed to win the Philosopher’s Hat and the first International Competition. She has also been involved with the High School Ethics Bowl, providing a case scenario and also as a judge.  She joined the Board of A2Ethics in September of 2018. Teri is also a member of the American Society for Bioethics and Humanities.

She is currently a Docent at UMMA. She has also always been involved in music and continues to be involved in church choirs and sings each year with the Monroe Community Chorale in their annual performance of the Messiah.

Case 12: Music and the Me Too Movement

Ethical dilemmas frequently arise in the performing arts, and often receive much public attention. Yet ethical issues within the realm of classical music composition are not so commonly discussed. One example of a contemporary dilemma in this area involved composers who write music that acknowledges personal traumas experienced by other people, or acts of violence, hatred, and intolerance against a specific group. The best-known example may be American composer John Corigliano’s Symphony No. 1, first performed in 1990, which is a memorial to victims of the AIDS epidemic. Corigliano himself is a member of the LGBTQ community, and though he did not have AIDS, his Symphony was inspired by the friends he lost. 

A more contemporary case involves another composer who has written a work recognizing others’ personal trauma: experiences from the “Me Too” movement. As the composer describes the work in her own words:

“The “Me Too” movement gave birth to my composition, Our Time: Me Too for carillon (bells in a bell tower), dedicated to Michigan State University gymnasts and survivors of sexual abuse worldwide. A time-honored tradition of respect is to encode the letters of someone’s name in a musical alphabet. As this composition unfolded, the letters coded from “Me Too” formed a haunting musical alliance as a mantra that recurs in accents from every continent. Unlike in times past, these voices chanting “Me Too” will no longer remain silent or encapsulated.

Survivors worldwide, including MSU gymnasts, have expressed gratitude that this piece is being performed. It acknowledges their trauma and opens up discussions avoided too long."

Study Questions:

  1. Does whether a composer (or other artist) has experienced the relevant trauma themselves impact whether they can or should deal with that topic in their art?
  2. Is writing about trauma or violence morally different from other topics? Are there any extra factors that composers working with this material ought to consider? 
  3. When composing about trauma and acts of violence, should a composer depict the crime in the score? Why, when or why not? Without that depiction, is the story truthfully told? Does this change if the memorial comes through a different medium (say, film, journalism, medical reports, art, or poetry)?
  4. When a composer (or other artist) writes a piece based on the suffering of others, should that composer be paid for the composition (i.e. should they offer it for sale), or should they offer it for free?

Author Bio: Grammy-nominated performer Dr. Pamela Ruiter-Feenstra thrives as improvisation expert, international concert and recording artist, and award-winning composer, conductor, pedagogue, and author. A passionate advocate for marginalized populations, Ruiter-Feenstra’s newest improvisations, compositions, hymn texts, and concertatos focus on social justice themes and collaborations.  As a 2017–2019 recipient of a Ronald Barnes Scholarship grant from the Guild of Carillonneurs in North America, she interviewed individuals from Arab and Muslim, African American, Jewish, and Latina/o communities. Inspired by their voices and life stories, she composed four pieces in a collection entitled Belonging: A Carillon Call to Care for All.  Her Liturgy Live organ set features world music themes. She composed Our Time: Me Too and Enough is Enough: Never Again Sketches to ring out against violence, marginalization, and injustice and to lift up the voices of survivors. Our Time: Me Too is featured in Michigan State University’s Museum exhibit, “Finding Our Voices: Sister Survivors Speak.” About her work, Ruiter-Feenstra says, “In my compositions, books, plays, and poems, my goal is to lift up the voices of those who have been silenced or marginalized, and to create awareness of and discussions about the injustices of how they have been mistreated. Leaning into difficult conversations opens up constant opportunities to grow more humane and compassionate as I connect with incredible people whose stories are different than my own. It’s a vulnerable and frequently uncomfortable place. I don’t know how others will respond and I’m constantly reminded of how I don’t know what I don’t know. But this is a vital way I can learn, and thank goodness, there are generous people on the journey who are willing to teach me.”

Case 13: Ethics in the WNBA

Players in the WNBA lack many of the benefits their male counterparts in the NBA have despite being governed by the same organization. In addition to being paid less than their male counterparts, WNBA players face inequality in revenue sharing, insurance and other benefits, training resources, travel, and facilities. In interviews, the commissioner of the NBA, Adam Silver, who also co-authored the business plan to launch the WNBA, cites revenues as the reason for such disparity: because the WNBA generates less revenue than the NBA, its payers are paid less. However, even when we take into account the difference in revenue between the two leagues it’s clear that WNBA players should be paid more. Right now, the average salary for a WNBA player is $71,635, and the average salary for an NBA player is $6,388,007. Moreover, coaches in the WNBA, who are primarily male, are paid less than NBA coaches, but make six to ten times more than the best paid WNBA player, which is the reverse of what happens in the NBA.

The benefits of both NBA and WNBA players are governed by a Collective Bargaining Agreement (CBA) that is negotiated between the league and their respective players’ union. In a historic negotiation in 1983, the NBA developed a revenue-sharing plan that afforded the players 53% of gross revenues comprised “of preseason, regular-season and playoff gate receipts and income from network, local and cable television, and from radio.” WNBA players, as of the 2019 season, have only negotiated access to revenue sharing of ticket sales and it’s estimated they receive less than 25% of gross basketball related income. Part of the reason why revenues are estimated and thus uncertain is the lack of access to WNBA finances. WNBA players do not have the same audit and visibility privileges as their male counterparts in the NBA. This right is also governed by their respective CBAs.

Study Questions:

  1. Does the WNBA have an obligation to pay its players the same revenue percentage as it does NBA players?
  2. To what extent does the NBA have an obligation to provide its female players with the same benefits (e.g. chartered travel, training resources, and facilities) as it does its male players?
  3. Given the Collective Bargaining Agreements between the NBA and their male athletes, are they negotiating in good faith if they don’t afford their female athletes the same benefits?

Author Bio: Robert Haddad lives in New Jersey and is a 1998 Sport Management and Communications department graduate from the School of Kinesiology at the University of Michigan, where he was also the Chair of the Alumni Society from 2012-2015.  He currently works in business development for SocialFlow, a social media technology company that creates publishing software for publishers and media companies (like the New York Times, BBC and The Wall Street Journal) to improve and centralize distribution of their content to platforms such as Facebook and Twitter.  Prior to his current career, Robert spent 16 years at Major League Baseball Productions as a Director of Documentaries and head of their field production department. He won an Emmy Award for his involvement on the Showtime series, "The Franchise: A Season with the San Francisco Giants" in 2011 and directed seven consecutive World Series Films from 2008-2014.

Case 14: Rules for JUUL

In schools across the country, small devices resembling USB flash drives live in the pockets, lockers, and backpacks of students. This new accessory delivers the same levels of nicotine as a standard cigarette with flavors like creme, mint, cucumber, and mango. Since 2017, JUUL Labs has dominated the e-cigarette industry with its slim, metallic, and simple design. The mission stated on the JUUL Labs website is to “improve the lives of the world’s one billion adult smokers by eliminating cigarettes.” The company founders used product design and innovation to make JUUL devices a more attractive alternative to cigarette smoking and the other bulky e-cigarettes and vaporizers on the market. 

A major goal for many clinicians, policymakers, and researchers is finding new ways to encourage current cigarette smokers to quit combustible tobacco. Even with significant reductions in the U.S. over the last 50 years, cigarette smoking remains the leading cause of preventable death. E-cigarette use does not involve tar or carbon monoxide, two of the byproducts of cigarette smoking strongly linked to cancer, chronic disease, and shortened life expectancy. Still, many experts are unsure about the safety of e-cigarette use. While researchers have some data supporting the claim that e-cigarettes are safer than traditional cigarettes, little data is available on long-term use. The public is also concerned about the intentions of companies like JUUL Labs. JUUL is the preferred e-cigarette for underage users. Previous advertising for JUUL products on social media platforms has featured young, smiling models with bright backdrops. Some argue that JUUL device features are particularly well-suited for younger generations, pointing to features like flavored e-liquids and charging JUUL devices via USB outlet.

JUUL Labs has restated its mission in response to the popularity of their devices among teenagers, along with public attempts to change their image. JUUL Labs shut down their Facebook and Instagram accounts, and current advertising campaigns exclusively feature former cigarette smokers who switched to JUUL devices. Additionally, JUUL Labs recently named Dr. Mark Rubenstein, a former University of California researcher, as their executive medical officer. Rubenstein’s research career has largely focused on the effects of nicotine on the adolescent brain.

Steps forward regarding regulation for JUUL Labs and their products are unclear. Experts are concerned that the initial generation of underage interest will not disappear with a new medical perspective and marketing campaign. Conversely, proponents of e-cigarettes do not want to eliminate a safer alternative to traditional cigarettes. Major uncertainty lies in the relationship between government regulation, public health concerns, and company interests for the future of the e-cigarette industry.

Study Questions:

  1. Is it morally wrong for JUUL Labs to market its products in a way that makes them appealing to underage users?
  2. Although JUUL Labs claims that its mission is to provide a healthier alternative to people who already smoke, its products are frequently purchased by people who have never smoked before. Does JUUL have an obligation to prevent its products from being used in a way that goes against its mission?
  3. Suppose that it is shown that e-cigarettes like JUUL do not have significant long-term side effects. If it is nevertheless the case that e-cigarettes are a gateway for people to start using conventional cigarettes or other drugs, should e-cigarettes be strictly regulated?

Sources:

https://www.nytimes.com/2018/08/27/science/juul-vaping-teen-marketing.html

https://news.gallup.com/poll/109048/us-smoking-rate-still-coming-down.aspx

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobac...

https://www.npr.org/sections/health-shots/2019/08/20/752553108/cigarette...

https://en.wikipedia.org/wiki/Safety_of_electronic_cigarettes

https://www.health.harvard.edu/blog/electronic-cigarettes-good-news-bad-...

https://www.juul.com/

https://www.latimes.com/business/story/2019-07-20/assignment-juul-hires-...

Author Bio: Kate Leary is a coordinator and project manager at the U-M Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center). She graduated from the University of Michigan in 2017 with a B.S. in Philosophy. While at Michigan, she was a member of the U-M Ethics Bowl team. Kate has stayed involved with the Ann Arbor ethics community since graduation by serving as a judge for the Michigan High School Ethics Bowl and describing one of her favorite cases on A2Ethics’ The Most Compelling Case podcast series. Currently, Kate spends most of her time supporting a team of substance use researchers, working towards French fluency, and learning to cook and eat locally.

Case 15: Art & Context

In 2018, Poetry Magazine and The Nation – two prestigious poetry publications – each published a poem that generated a great deal of controversy. Poetry Magazine published a poem by an English poet that contained symbolism known to be associated with the Nazi Party. The Nation published a poem about being homeless, written in an approximation of African American Vernacular English (AAVE, or “black vernacular”) by a well-to-do white poet. 


The standard for most journals when evaluating poems or fiction submitted for publication is to look at the work submitted, and only the work submitted, ignoring any biographical information about the writer. In fact, many journals ask for a cover sheet with that information that can be separated from the submission so that the work can be read anonymously. This is considered the most neutral possible way to evaluate writing. Plenty of critics, however, suggest that this way of evaluating writing is not actually neutral at all, both because it doesn’t address the evaluators’ unconscious biases and because once the writing is published, it will never be free of context; it will always and only be read in relationship to the world around it. Criticism of Poetry Magazine and The Nation for their publishing decisions focused on this, suggesting that they have a responsibility to consider context before making final decisions. Critics pointed out that the poet published in Poetry Magazine had previously published a poem entitled “Elegy to the Young Hitler” and that the poet published in The Nation clearly had very little familiarity with AAVE and was relying heavily on stereotypes.


The journals took two different routes in responding to criticism. Poetry Magazine published an essay by the poet, giving him the opportunity to explain the symbolism in his work. The poet claimed that the symbolism was not meant to be fascist and that he was working with other, more obscure meanings of the words. He said that he understood why it would be read that way but that he had proceeded because he knew it wasn’t what he meant. The Nation, by contrast, published a statement from its poetry editors apologizing for publishing the poem in AAVE, stating that the editors “hold ourselves responsible for the ways in which the work we select is received.” Both responses also met with criticism. Some believed that Poetry Magazine was now relying too much on context by giving the writer the opportunity to explain himself, an opportunity they have not extended to other poets they publish. Others believed that The Nation was refusing to protect free speech or stand by their editorial decisions by issuing an apology and that editors should not be responsible for how they work they publish is read by the public. 

Study Questions:

  1. What responsibility, if any, do editors and publishers have to consider the context in which a given creative work has been written? Does this extend to cases of outright bigotry (if, for example, the poem in Poetry Magazine had called for genocide or the poem in The Nation used racial slurs)?
  2. Once an outlet has decided to publish a piece of writing, what is an appropriate response to reader criticism? Should publishers always stand by their editorial decisions? Is there only one appropriate response, or are there multiple appropriate responses dependent on context?
  3. Both Poetry Magazine and The Nation, while based in the U.S., are privately owned media outlets and are not required lawfully to adhere to the First Amendment; they are free to reject speech they don’t like. Neither, however, professes any ethical or moral guidelines to which submitted work must adhere. On the other hand, their evaluation processes are not transparent, and it is possible that some of their evaluators are already rejecting submitted work for moral reasons. How much freedom should evaluators of creative writing have to decide what they think should and shouldn’t be published?  

Author Bio: Fiona Chamness is writer and musician from Ann Arbor, Michigan. She attended Ann Arbor Greenhills High School, where she was mentored by the late Big Ethical Question Slam and Ethics Bowl enthusiast, Spanish literature teacher Lisa Ortiz, and participated in the VOLUME Youth Poetry Project at the Neutral Zone, Ann Arbor's teen center. Her poetry is published or forthcoming in PANK, Blood Lotus Journal, the Bear River Review, Radius Lit, Muzzle Magazine, Midwestern Gothic, HEArt, Nailed, VINYL, the Beloit Poetry Journal, Prairie Schooner, the Indiana Review, and ANMLY, as well as in several anthologies and in the poetry collection Feral Citizens, co-authored with Aimée Lê. She was the recipient of the Beloit Poetry Journal's Chad Walsh Prize in 2014. She also writes and performs as a solo musician and with queer feminist punk band Cutting Room Floor. She is currently an MFA candidate in Creative Writing at Rutgers University, Newark.