{"id":3928,"date":"2020-07-21T13:15:07","date_gmt":"2020-07-21T12:15:07","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=3928"},"modified":"2020-07-21T13:15:07","modified_gmt":"2020-07-21T12:15:07","slug":"solidarity-and-similarity-what-kind-of-we-are-we-and-why-does-it-matter","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/21\/solidarity-and-similarity-what-kind-of-we-are-we-and-why-does-it-matter\/","title":{"rendered":"Solidarity and similarity: what kind of \u201cwe\u201d are we, and why does it matter?"},"content":{"rendered":"

By Avery Kolers.<\/p>\n

Think of a time when you were trying to flex a rarely used muscle: say, learning to raise one eyebrow. In the moment, the action isn\u2019t hard to do in the sense of being costly or requiring strength you don\u2019t have, it\u2019s hard to do because you don\u2019t know how to isolate that muscle and send it the required electrical impulse.<\/p>\n

In other words, in the moment, working a rarely used muscle is not so much about physical exertion as it is a feat of proprioception<\/em> \u2013 attending to how we perceive ourselves from the inside.<\/p>\n

Both scholars and activists discussing solidarity \u2013 whether on Covid-19 restrictions<\/a>, Black Lives Matter<\/a>, or other issues \u2013 focus a lot on the kinds of demands solidarity can make: from simply wearing a mask, to accepting the loss of your business; from donating money, to calling elected officials, to risking arrest. I am interested here in a different kind of demand that solidarity can make, namely, this demand for proprioception. Solidarity requires those of us who are privileged to perceive ourselves, and our broader \u2018comfort zone\u2019 of institutions and acquaintances, in unfamiliar and often unwelcome ways.<\/p>\n

In their ground-breaking work on the subject, Barbara Prainsack and Alena Buyx<\/a> characterize solidarity in biomedical contexts as \u201can enacted commitment to carry \u2018costs\u2019 \u2026 to assist others with whom a person or persons recognise similarity in a relevant respect.\u201d<\/p>\n

I agree that solidarity is about action; it\u2019s about doing things, not just believing or supporting or sympathizing. But I question Prainsack and Buyx\u2019s requirement of similarity.<\/p>\n

Solidarity does not respond<\/em> to similarity, but creates<\/em> it. That is, the similarity is not antecedent<\/em>, but rather, an achievement or commitment: deciding to throw our lot in with someone. Just as saying \u201cI promise\u201d does not describe<\/em> a moral relation but establishes<\/em> one, so the solidary agent\u2019s statement \u201cwe are in this together\u201d does not observe a reality but makes one. Instances of solidarity should therefore be morally evaluated less based on what we do than that on who we\u2019ve decided to throw our lot in with, and why.<\/p>\n

This is how solidarity becomes proprioceptively demanding.<\/p>\n

Professionals who ascend the career ladder tend to inhabit \u2013 for lack of a better term \u2013 a comfort zone where we can see others and be seen as individuals, because antecedent similarities are taken for granted. Outside this comfort zone our interactions are much more transactional; there, we engage with others as avatars of social roles \u2013 people we know by job or location rather than by name. It is our everyday behaviour that sets, and polices, the boundaries of this comfort zone. Those who inhabit positions of power and prestige can normally expect others to accept the boundaries of their comfort zone and to defer to them rather than pull them out of it.<\/p>\n

Those in positions of power and prestige need to learn to see themselves and their comfort zones as built on unjust structures and located within social and political struggles. They need to learn to throw their lot in with those who seek to break down the boundaries of comfort zones that are built on injustice. The actions required to do this need not demand much by way of physical exertion or cost. But they are often proprioceptively demanding because they require attending to how we perceive ourselves, and instead seeing ourselves \u2018from below\u2019; recognizing that, to others who lack our privileges, we are avatars of social roles. Consequently, actions that seem, from the inside, like perfectly reasonable responses to highly individual contexts, may be revealed as structurally determined and politically retrograde when viewed from below.<\/p>\n

So what does all this have to do with biomedicine? The power and prestige of the medical profession, buttressed by physicians\u2019 associations, make it easy for physicians to recognize similarities with other physicians, especially when faced with demanding patients, desperate families, or political pressure. In turn, the social structures that support physicians\u2019 power and prestige ensure that most patients approach physicians in a deferential manner, accommodating physicians\u2019 manners and schedules rather than demanding to be accommodated in these ways, and most politicians approach physicians\u2019 associations in ways that seek consensus rather than lay down the law.<\/p>\n

In this context, the \u2018solidarity\u2019 of physicians \u2013 their willingness to carry costs for one another on the basis of perceived similarity \u2013 too often spurs physicians to morally dubious or politically retrograde action, such as microaggressions<\/a>, larger-scale prejudice<\/a>, or at a political level, opposition<\/a> to expanded<\/a> rights to health care<\/a>.<\/p>\n

If solidarity is to be of any use for bioethics, it should help physicians and health system administrators build the proprioceptive capacities that enable them to see themselves from below, and to break out of patterns of action that reinforce their power and privilege relative to patients, support staff, and those without access to adequate care.<\/p>\n

 <\/p>\n

Paper title: What Can Solidarity Do for Bioethics?<\/a><\/p>\n

Author(s): Avery Kolers<\/p>\n

Affiliations: Department of Philosophy, University of Louisville<\/p>\n

Competing interests: none<\/p>\n

Social media accounts of post author(s): twitter: @avery_kolers<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

By Avery Kolers. Think of a time when you were trying to flex a rarely used muscle: say, learning to raise one eyebrow. In the moment, the action isn\u2019t hard to do in the sense of being costly or requiring strength you don\u2019t have, it\u2019s hard to do because you don\u2019t know how to isolate […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3928","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nSolidarity and similarity: what kind of \u201cwe\u201d are we, and why does it matter? - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2020\/07\/21\/solidarity-and-similarity-what-kind-of-we-are-we-and-why-does-it-matter\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Solidarity and similarity: what kind of \u201cwe\u201d are we, and why does it matter? - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Avery Kolers. 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