By David Hunter

I recently finished reading Galileo’s Middle Finger by Alice Dreger a medical historian and ethicist (although she may deny the title) and since I found it both thought provoking, terrifying and inspiring I thought I would share a few thoughts and hopefully convince you to read it, since I think some of its content is a must read for bioethicists and people who view themselves as in some way trying to make the world a better place.

The book tells two stories, a fascinating detailed personal description of the various ethical battles Dreger has found herself embroiled in (somewhat naively at the beginning of her career as a medical historian who just deals with the dead as far as she was concerned) and a meta-story of what she has learnt across those battles in regards to the role of research, activism, evidence, justice, equality and science.

I can’t do justice to her historical accounts (Go and Read the Book), but they focus frequently on how ideology gets in the way of good thinking – as well as how easy it is for modern media to be abused to damage people’s careers and lives for championing unpopular ideas. I have been fortunate enough to not experience this directly myself, apart from on this blog as part of the fallout from the paper that shall not be named, nonetheless what she describes is terrible, and it issues a call to arms for all of us, to defend people’s right to pursue controversial hypothesis and evidence.

But here in any case I mostly want to discuss the second meta-story. Dreger makes a case consistently that good quality activism and scholarship go hand in hand since they follow the evidence, rather than being stuck on the ideology.

The biggest lesson was, you can’t take shortcuts to make the world a better place – each time an idea becomes more important than the evidence behind the idea, the argument for its importance, disaster happens in the debate as Dreger documents.

As an interesting juxtaposition I happened to also reread Angus Dawson’s piece in Bioethics – The future of bioethics, three dogmas and a cup of hemlock where Dawson makes a compelling case that much of medical ethics has become an ideology – of autonomy worship often without evidence or argument given. He argues in response that bioethics needs to return to its roots, a socratic tradition of critical self reflection where we put the strongest criticism on those views we hold dearest.

I think Dawson is right, if we don’t become more self critical as a discipline we are likely to help perpetuate the disasters that Dreger describes rather than help resolve them.