The Bicameral Mind

Time to unwrap the Jeremiad again, I’m afraid; I’m getting tired of this. Really tired. I know it’s an American thing, but stop it will you? Or can you? Every time there’s a bicameral shift it tears the fabric a little more and unravels what I want to believe about your country. Yes, I’m Canadian and watching with unvetted eyes I guess, and yet sometimes it is good to hear from the other side of the mirror. To listen to the indrawn breath and pause to look around. Sometimes acumen travels in disguise: the dusty traveller leaning on the fence, the unwashed face of Vishnu. Wisdom does not always wear a flag.

One of the things I’m referring to, of course, is the perpetually probationary status in the United States of both family planning and pregnancy termination. Women’s rights seem contingent upon the prevailing ideology, their status as stable as the government in power -guaranteed only conditionally, and as changeable as the pen that underwrites them.

As a non-combatant, I suppose I should only listen with firmly closed lips; perhaps the border should be a closed curtain so I cannot see through. And maybe I should apologize for being so critical, but when is this vacillation going to stop? I accept that there are valid differences of opinion, and that any decision is inevitably temporally adjudicated. Times change, and so do populations and their ethnic and cultural compositions. It’s happening to us all. But surely the answer isn’t to retreat behind the doors and barricade the walls.

And defunding organizations that seek to address the issues of involuntary overpopulation would seem unduly parochial and even internationally misunderstood. It is the special duty of an enlightened nation to accept that there are many roads and many destinations. It has, it seems to me, the burden of reasonable neutrality, grounded observation, and judicious guidance.

The issue, I think, should be one of choice not fiat. Conscience, not doctrine. To offer alternatives is not to coerce, nor to prejudice the selection; it is surely to achieve the goal for which the options were offered in the first place. Not all things are equally acceptable; not all choices are politically or culturally permissible, to be sure. So a variety of solutions might have a greater likelihood of admissibility. A greater possibility of success.

Several years ago, I travelled to the States to attend a gynaecological convention and discovered that not only was pregnancy termination still an inflammable topic for many delegates, but even the provision of Family Planning counselling for whoever requested it. I found this hard to understand, especially at a meeting of specialists in the field.

I remember questioning one of the doctors I met there and she rolled her eyes at my Canadian naïveté. “Do you remember that fable of Aesop called ‘the Belly and the Members’?” Now I felt really naïve because I had to shake my head.

She seemed surprised. “Well,” she said, after interrogating my face for a moment to make sure I wasn’t kidding her. “The version my daddy told me when I was young went something like this. One day, after carrying the body through a long day of heavy work, the feet complained that they seemed to be the only ones in the body who had to work. Of course the hands argued with them that they were the ones who should complain -the feet may have carried the body, but they had to carry and even balance the load. The only thing they could agree on, after a long argument, was that although the four of them worked all day, in the end it was the stomach who got all the food.

“So, they devised a plan. The feet refused to walk to the stove, and the hands refused to pick up any food.”  The doctor smiled at this point and pierced me with her eyes. “And you can guess what happened after a while… They all got weak and finally had to agree to work together. Only the stomach could give them the strength they needed.”

She giggled at the end and touched my arm playfully. “I can’t believe you didn’t know that one, doctor.”

I hate it when a colleague calls me ‘doctor’, but I let it pass. “And I take it the fable is telling us that we all have to work together, no matter that we’re different? And that we can all have different opinions?”

Her expression changed and a puzzled look crept onto her face. “Never thought of that, actually… My daddy said it meant that we all have our jobs, but need someone –something- watching over us to give us strength and direction… Reminding us of what we should do. He said the Stomach was our Conscience… But I think he really meant the President… Or maybe the Lord…” She shook her head in apparent disbelief at my interpretation. I blinked, because it didn’t make sense to me. I wondered if she’d remembered it wrong.

“You must have similar fables even up there in Canada…” I could tell she was trying to understand my confusion. Transcend boundaries.

“Well,” I started, just like she had, “I do remember one about chopsticks…” She smiled at my multiracial example –so Canadian. “It was something one of my Chinese patients told me after giving me a little gift for delivering her baby. She said her father had told her this when she was a child.

“’There was an old man,’ she said, ‘who was close to death, and worried about what would happen after he died. He decided to ask the wise village elder if he knew what it would be like in Hell. The elder smiled and told him to imagine a large room filled with people. ‘They are all thin and hungry,’ he said ‘even though there is food everywhere.’

“’Then why are they so thin,’ the old man asked?

“’Because their chopsticks are each ten feet long,’ was the answer.

“The old man thought about it for a minute. ‘And Heaven,’ he asked, ‘What’s it like in Heaven, then?’

“The elder laughed. ‘Imagine another large room. There is food everywhere, but the people are fat and happy in spite of their ten foot long chopsticks…’

“The old man was puzzled. ‘But… I don’t understand.’

“The elder smiled and put his arm around the old man. ‘In Heaven, they feed each other…’”

Perhaps, I thought, after watching my colleague’s reaction, perhaps there is something more profoundly different about our two countries than simply the colour of our mailboxes…

The Dark Night of the Canadian Soul

I hesitate to refer to the 16th century mystic Spanish poet St. John of the Cross’ dark night of the soul, but I am troubled by the political process in which I feel engulfed. Swallowed… And yes, powerless. And it’s not so much that I disagree with the ideology expressed or dislike the personalities of the leaders and their approach to solving what they feel are the problems confronting the country (according to their polls) –that is politics and universal. If it were only that, it would then become merely a matter of taste or confirmation bias that determined my vote. I might feel disappointed if I didn’t get my choice of government, but not angry.

But I feel angry now –already. Or is it helpless? I find myself powerless to change what appears to be happening around me. Mutating around me as I watch. Party after party seems to be willing to debase itself for votes, pandering to the fearful in one population and the ignorant in another. It is not a principled approach and it does not provide equality for all –or even most.

It seems to me that in a democracy –especially one that espouses multiculturalism as does Canada- it is the rule of law that must be equitable: laws that apply to all -and equally, no matter whether it is a small minority whose ethnic or geographic culture pulls it in an awkward direction, or an elsewhere-maligned religious group who chooses to dress differently from our current norm. Democracy –at least as I imagine it- is not simply the rule of the majority; intrinsic to it is an obligation to protect the minorities within it because it is the right thing to do. And because the law applies to everyone –even minorities.

The rights of all should not be subject to arbitrary or capricious revision without exhaustive and careful consultation from all those who might be affected. It should not be so much a majority decision, as an examined and consensus-driven decision. One side should not be pitted against another. As in international relations, the ideal would be for all sides to talk to each other. Communicate. And while a decision need not be unanimous, it should at least meet with the general approval of every side. Polling –no matter how cleverly conceived- canvasses only those who are polled…

But you wonder why I am angered and not simply disappointed at the political process? I seems as if I can no longer vote for the principles I hold important. Perhaps I have retrospective falsification of my memory, but I can’t remember as much divisiveness in federal politics before -as much negative advertising, as much pretended obsequiousness and crawling for power. As much casting aside of principles in a desperate grab for control. I am appalled that we, as a nation, must tolerate this fawning pretense of servility. Appealing to the lowest common denominator may seem fair to some, but it is certainly not the way to run a country for all.

I blame the current government for acceding to those who would divide the country to satisfy their agenda. I blame the political system for allowing those who stumble first past the post (FPTP) to be elected even if they have not earned the majority of votes. And I blame us all –you and me- for not demanding a more representative way of electing the government. As much as I dislike using quotes from Wikipedia, one of their summaries does seem to illustrate my frustration with FPTP: Wasted votes are votes cast for losing candidates or votes cast for winning candidates in excess of the number required for victory. For example, in the UK general election of 2005, 52% of votes were cast for losing candidates and 18% were excess votes – a total of 70% wasted votes. This is perhaps the most fundamental criticism of FPTP, that a large majority of votes may play no part in determining the outcome. This “winner-takes-all” system may be one of the reasons why “voter participation tends to be lower in countries with FPTP than elsewhere.”

In other words, in Canada, I have no option but to attempt to vote strategically -and for someone with whom I do not necessarily agree- simply to make sure that the one I disagree with even more, does not get elected. If I vote on principle, or electoral platform, my vote may be wasted.

So why do I vote? Perhaps because the devil I know may well be worse than the devil I don’t… Help me St. John of the Cross, because I find it truly dark out there.

 

The Justice of Justice

Okay, I’m Canadian; I do not understand the objection to universal health care south of the border. And I certainly don’t know how a society that purports to believe in equal opportunity for all could be so resistant to accepting the inalienable right of every person to access affordable medical treatment, the right to a personal choice as to whether or not to become -or stay- pregnant; and, so long as it does no harm to anyone else, the right to make a decision about what to do with their own bodies. Isn’t that part of the Life, Liberty and pursuit of Happiness in the U.S. Declaration of Independence?

Each person has the right to choose a path for herself. That does not mean that others have to make the same choice –or even agree with it. But they should respect the right to do so. Live and let live; not judge and punish. Life –society- is far too complex; there are too many interactions, too many competing values (each one held and defended by someone) – too much going on for there to be just one direction, just one answer that is forever correct no matter the circumstances.

We all have ideas that we embrace and cherish. Often, one of the hardest things to do is read contrary opinions; we –most of at any rate- are subject to a confirmation bias. That is we tend to read or watch only those things that confirm our opinions. We do not frequently seek to explore those that contradict. We do not usually parse them to discover if there is a way they might be compatible with our own. If the contrary opinion expressed is about a strongly held belief we certainly do not examine it as closely as we might an article commenting on a foreign war atrocity. And religion seems to inhabit an entirely different Magisterium where compromise is considered a form of moral compromise and is anathema. Unacceptable. Wrong.

For what it’s worth, I think the answer to opposing values does not lie in denying them to the point of anger but rather in examining them to discover why they are held, and what benefits might obtain by considering them. Incorporating them, Compromising with them. In fact, it seems to me that even being willing to assess them is a step in the right direction.

What started me thinking about this was a BBC report of a recent 5-4 decision by the U.S. Supreme Court which “found that some corporations can hold religious objections that exempt them from a legal requirement that companies with 50 or more employees offer a health insurance plan that pays for contraception at no charge to the worker or pay a fine.”

 http://www.bbc.com/news/28093756

One has to assume that the Supreme Court is impartial and that its judgements are delivered only after a dispassionate consideration of all the relevant details of the case in point. The fact that all three female justices disagreed with five of their male colleagues does give one pause for thought, however. Is it a coincidence unrelated to the judgement on what can certainly be seen as a comment on the value of a woman’s rights, a woman’s choice -or something else?

But one has to be careful in evaluating the judgment. It’s not really an issue of increasing the difficulty for a woman to obtain contraception, nor even that it should be paid for by a company. Fortunately there are some foresightful provisions that the White House thought to include that may mitigate the ruling –the BBC once again: As the court noted, the Obama administration has already devised a mechanism under which workers of non-profit organisations that object to the contraception mandate could keep coverage without the organisation having to pay for it.

So then, what’s the big deal about the Supreme Court ruling? Well, The decision marks the first time the Supreme Court has found a profit-seeking business can hold religious views under federal law, analysts say. In other words, it suggests that religious beliefs trump individual rights -women’s rights in this case. And no doubt it is the thin edge of a wedge for further disruptive –not to mention religious- challenges.

In a dissent she read aloud from the bench, Justice Ruth Bader Ginsburg called the decision “potentially sweeping” because it minimizes the government’s interest in uniform compliance with laws affecting the workplace. “And it discounts the disadvantages religion-based opt-outs impose on others, in particular, employees who do not share their employer’s religious beliefs.”

And don’t think this is an attitude peculiar to America; Canada is not exempt:

http://www.calgaryherald.com/health/Calgary+doctor+refuses+prescribe+birth+control+over+moral+beliefs/9978442/story.html

We are all subject to our own biases; it’s just when they interfere with the rights of others that I worry.

The internet has exposed us all to a plethora of competing viewpoints. Of course, if we don’t agree we can just read the first sentence, make a judgment, and then move on to another. Or if we’re so inclined, we could even take the time to comment on it. But those ideas with which we disagree require some examination to refute online or the rebuttal seems fatuous. Ill considered. Unrealistic. And it will have little effect. Some of us don’t care, of course: anonymity is a seductive drug. That’s what cyber-bullying is all about: not changing opinions, merely inflaming them. Freedom to speak -or write- is not really freedom unless it makes sense. Connects in some meaningful way. Justifies… I suspect that most of us would not make the same vapid and vituperative comments if our names were appended and we knew that others were judging us. Or if we could be held accountable in the courts, for that matter.

This time Shakespeare (Coriolanus speaking to a group of mutinous citizens): What’s the matter you dissentious rogues, that, rubbing the poor itch of your opinion, make yourselves scabs? I’m not sure that I’ve entirely escaped a confirmation bias here, of course –I’ll have to examine my position- but I think he’s on to something…

 

 

 

 

 

Mother-Baby Units in Prisons

Mothers keeping their babies while in prison -a great idea? I have to admit that I hadn’t thought much about it until the Media publicized a case being considered by the British Columbia Supreme Court. A mother-baby program was cancelled at a regional institute in 2008 and the contention is that this not only violated an infant’s right to a mother’s care, but discriminated against the mother as well. There is also a Federal facility in the area however; it is still open, also offers a mother-baby program, and is theoretically available to those who meet the criteria.

This was not an across-the-board right for all female prisoners who were mothers, it must be noted; it was supposedly available only to those who were serving terms of less than two years, and was for those where it was judged the baby would not be at risk. The regional officials felt that there were safety concerns apparently.

Mother-baby programs in prisons are not new, and certainly not a uniquely Canadian compassionate innovation. In fact the Bedford Hills Correctional Facility for Women (a maximum security prison in New York) first opened a prison nursery in 1901 and there are similar programs in other U.S. states as well as in Europe.

Although criteria for acceptance seem to vary depending on region -in some, for example, the woman has to be pregnant when sentenced, as opposed to already having a newborn child- many of the principles seem roughly similar: the baby is eligible to stay with the mother for a year to eighteen months (presumably because of some developmental data that suggest any benefits to the child that derive from being with the mother after that are offset by the detrimental effects of being in an institution); there must be no threat to the child either because of the mother or the surroundings; the mother is required to attend parenting classes of one sort or another; and she must be serving a relatively short sentence usually.

Of course after the eighteen months, if the mother is still in prison, the baby is then taken away -either to relatives, or foster care. In a way, this is a two edged sword, isn’t it? Bonding occurs and then it is severed with probable consequences for both parties. So what are we to conclude? Do the benefits of the close mothering outweigh the subsequent schism? Are there data that substantiate its worth?

What few studies I have been able to find seem conflicted on the effects of the units. The hope, of course, is that they will reduce the likelihood of the mother re-offending; that by showing understanding and compassion, she will be convinced to change the way she apprehends the world. Unfortunately the units do not improve the environment into which she will be released, nor alter the conditions that led to her crime in the first place. But we need to take one manageable step at a time. To be sure, many things need to change, but punishment per se rarely extinguishes a behaviour as quickly as reward. For that matter, allowing a new mother to stay with her baby is not a reward, it is what a just and empathetic society should facilitate! We are what we do.

Most centers are adamant that the process exists not so much for the mothers as for the babies who, as Mark Thompson, governor of the Eastwood Park Unit (one of 8 units in the 13 women’s jails in the UK) says “Have not done anything wrong and who deserve to have a good start in life.” In that unit at least, women are taught parenting skills; they’re taught how to cook; they’re supported in breast (or bottle) feeding, shown how to change diapers and sterilize bottles and even how to play with their babies…

Clearly the opportunity to learn many of these skills might not have been accessed had they not been in prison. And yet, balance that with the thought that a prison might not be able to offer other things for the baby that are necessary for it’s development. The Prison Service leaflet from that same British unit advises the mother “Your baby will miss having contact with normal daily life, such as family, traffic, shops, parks and animals.” Socialization, in other words. This is mentioned, even though in that unit the staff apparently take the babies out to parks and supermarkets, etc. as an attempt to normalize things. Wow!

I suppose my interest in this -apart from being an obstetrician and a father- is in examining what we hope to accomplish in our penal system. Is the aim of incarceration merely Retributive Justice -revenge by another name? In other words, the woman committed a crime and doesn’t deserve to have her baby with her! (There are letters and online comments to that effect.) Is it public safety -keeping them off the streets (out of sight, out of mind)? And if the latter, one has to wonder why anyone would be jailed for a victimless crime like, say, a drug offense, or petty theft. If it is a non-violent offense, is the right place for them really behind bars? And for that matter, what about all the so called ‘white-collar crimes” that are clogging the cells? Surely there are other, better uses for the public purse.

I have always treasured the notion that where incarceration is necessary, rather than hardening the inmates against whatever system put them there and teaching them how to avoid getting caught the next time, it would incorporate some attempt at rehabilitation: education, retraining, and re-motivating. Teaching normal and acceptable life-skills to a captive audience would seem to be an obvious benefit not only to them but to society at large -an obvious opportunity.

And I don’t think I’m being unduly naïve in intuiting that being able to keep their babies with them must be a highly motivating factor for most mothers. Motivating and humane. To waste an opportunity that might potentially benefit everybody -mother, baby, and society- is in itself a crime.