"Selling" Ourselves: The Ethics of Self-Marketing

Do we inevitably do ourselves an injustice when we try to “sell”¹ ourselves? Can there ever truly be an ethics of marketing or “selling” ourselves? Is the phrase “the ethics of self-marketing” an oxymoron?

      Is it ever morally right for us to place a price tag on, or assign a monetary value to, ourselves? When we “sell” or market ourselves, do we inevitably risk demeaning and devaluing ourselves? By putting a monetary value on our time, labor, skills, and abilities and expecting to be financially compensated for them, are we thereby confirming the justness and appropriateness of their monetary valuation?

      When we market or “sell” ourselves, we may be offering to provide others (in exchange for their money, assistance, approval, or sponsorship) a variety of things, such as our labor, skills, expertise, advice, ideas, experience, personal services, personal endorsement, personal spokesmanship, or personal image rights.

      We may try to “sell” or market ourselves in a variety of ways. For example, we may try to "sell" ourselves by telling others about ourselves, by talking with them, by listening to them, by developing personal relationships with them, by building friendships and partnerships with them, by trying to respond to their interests and concerns, by engaging them in our own interests and concerns, by educating them, by entertaining them, and by trying to inspire them.

      Methods of self-marketing may include handing out business cards, mailing out brochures, sending out emails, creating a website, blogging, writing magazine or journal articles, writing books, giving talks, conducting seminars, creating online videos (e.g. on YouTube, Veoh, or Vimeo), using social media (such as Twitter, Facebook, Google+, and LinkedIn), appearing as a guest on a radio talk show, becoming a professional coach or mentor, becoming a professional consultant, becoming a member of a professional society, and doing volunteer work for a nonprofit organization.

      Self-marketing may also include “personal branding” (e.g. Donna Karan Fragrances, Martha Stewart Home Decor, Hilton Hotels, and Oprah Magazine), “self-packaging” (e.g. developing a signature style or creating a look) and “image management” (e.g. personal, social, professional, and political image management)

      The ethics of self-marketing may presuppose that there is an external market governing transactions between buyers and sellers, and that there are market rules regarding buyer and seller behavior. Violations of marketing ethics may therefore trigger external (market-imposed) as well as internal (self-imposed) sanctions.

      “Selling” or marketing ourselves may consist of demonstrating our aptitude, ability, knowledge, competence, trustworthiness, and reliability to others. It may also consist of making others aware of, or making others believe in, our merit and value.

      “Selling” ourselves may also consist of promoting our ideas and demonstrating their meaningfulness, significance, and relevance. It may also consist of demonstrating the value of our physical, mental, social, or professional traits and assets. It may therefore be a kind of performance that can be judged according to ethical as well as aesthetic criteria.

      In order to properly investigate the ethics of self-marketing, we may need to recognize that there is an art (including a visual, auditory, and performing art), as well as a science (including a cognitive, behavioral, and social psychology) of self-marketing.

      The ethics of self-marketing may define not only our duties to ourselves (including the duty not to surrender or compromise our own human dignity and moral integrity), but also our duties to others (including the duty not to make intentionally false or deceptive claims about ourselves).

      Our duties to ourselves may include the duty not to “sell” or market ourselves in a manner that is harmful to our physical and mental well-being. Thus, we may have a duty not to “sell” or market ourselves in a manner that is harmful to our sense of self-worth and self-respect.

      Our duties to others may also include the duty not to “sell” or market ourselves as something we are not. Thus, we may have the duty not to exaggerate or embellish our personal accomplishments. We may have the duty not to misrepresent the level of our technical expertise, practical knowledge, and professional training. We may have the duty not to intentionally create false impressions about our educational, academic, or professional backgrounds. There may be moral limits as to how we market ourselves, and as to what we say about ourselves.

      We also have the duty not to accept bribes or unethical inducements for “selling” ourselves and for selling our time, labor, services, personal companionship, personal property, or privacy.

      The ethics of self-marketing also demand that we not participate in illegal markets, including markets in illegal drugs, markets in illegal weapons, markets in smuggled goods, and markets in stolen or pirated goods.

      We have the duty not to sell our knowledge, expertise, skills, services, etc. to unlawful or criminal enterprises. We also have the duty not to let ourselves become the knowing or unknowing instruments of corrupt business or political interests.

      If there are ethical ways for us to “sell” ourselves, then how do we avoid selling ourselves short? How do we avoid misjudging our value to others? If we “sell” ourselves to others, then we may need to be mindful of, and try to avoid, “underselling” or “overselling” ourselves.

      “Selling” or marketing ourselves may be a part of ordinary work skills. A teacher, counselor, attorney, architect, engineer, or professional speaker may have to “sell” herself in some way to her students, clients, customers, or audience in order to be recognized as a reliable and credible authority in her field of training or expertise. A salesperson, shopkeeper, vendor, broker, or entrepreneur may also have to “sell” herself in some way to a prospective client or customer in order for that client or customer to consider buying a product from her or using her professional services. If a marketer or vendor fails to “sell” herself properly, then the prospective customer may consider buying the same product or the same services from some other marketer or vendor.

      One reason that we may fail to get a job promotion or be recognized for our job performance is that we may fail to “sell” ourselves properly to a supervisor or employer. We may fail to make an impression on a supervisor or employer or make her aware of our value and importance to the organization we are working for.

      We may also sell ourselves short by failing to "sell" ourselves tactfully and effectively. We may fail to identify and personally connect with our prospective employers, clients, customers, or audience. We may fail to develop a strategy for reaching, appealing to, and mobilizing a particular market sector, customer base, readership, viewing audience, or listening audience. We may fail to utilize a variety of methods in order to develop a marketing platform and communications network. We may fail to recognize our own strengths and virtues, and may fail to make others aware of how those strengths and virtues could be helpful or useful to them.

      Some of the disadvantages of selling ourselves short are that we may miss out on opportunities (personal, social, professional, and financial) that we would otherwise have had, and we may reinforce negative feelings that we have about ourselves. We may also promote negative images that we have of ourselves. We may also subject ourselves to mistreatment or abuse if we feel that we don’t deserve to be treated any better. We may try to find various reasons to continue dysfunctional or unsatisfying personal relationships. We may also accept being told that we are inferior and undeserving.

      Some other disadvantages of selling ourselves short are that we may settle for a lower level of financial compensation than we deserve for having fulfilled a professional obligation, and we may settle for less recognition than we deserve for having performed a particular service. We may even settle for being discriminated against and being denied privileges that have, under similar conditions, been granted to others.

      On the other hand, the ethics of self-marketing require that we not demand excessive reward or excessive compensation for providing our goods and services. We have a duty not to make false and deceptive claims about our skills, expertise, professional background, and work history. We have a duty not to claim intellectual property rights over intellectual property that does not rightfully belong to us.

      In order to comply with an ethics of self-marketing, we must also avoid “selling out” (compromising our moral principles for the sake of personal reward or financial gain). We must avoid making a Faustian bargain with a supposed benefactor by sacrificing our moral principles and “selling” ourselves to that supposed benefactor in return for temporary personal gain (in the form of power, fame, or success). We must also avoid taking unfair advantage of others for the sake of our own personal gain.

      Techniques for “selling” or “packaging” ourselves may include wearing particular styles of clothing (“dressing for success”), grooming ourselves in a particular manner, trying to make a good first impression, being relaxed and outgoing, being courteous and friendly, establishing eye contact with whomever we are talking to, trying to be considerate and kind, and trying to appear calm, assured, confident, knowledgeable, and competent.

      The ethics of selling ourselves (or of selling various parts of ourselves) may also apply to such practices as paid blood donation, paid bone marrow donation, paid sperm or egg donation, paid hair donation, paid organ donation, paid breast milk donation, paid surrogacy, paid participation in scientific research trials, paid companion services, paid escort services, paid sex work (such as stripping, lap dancing, adult film performing, and prostitution), and selling ourselves into bonded labor or slavery.

      A moral question raised by the selling of our bodies or body parts is whether we have the moral right to sell them, even though no one other than ourselves has the moral right to claim ownership of them. How can it be morally wrong for us to voluntarily sell our own bodies or body parts, if we are not harming anyone else by doing so? Those who affirm that it is indeed morally wrong to sell our own bodies or body parts may argue that it is inherently harmful to our own moral or psychological well-being. They may also argue that our own bodies or body parts cannot rightfully be regarded as buyable or sellable commodities. They may also argue that by claiming the right to sell our own bodies or body parts, we are contributing to the development of markets in bodies or body parts, and thus to human trafficking.

      Arguments against legalization of the selling of body organs or body parts include (1) that it is morally wrong, (2) that it is a violation of human dignity, (3) that it treats body organs or parts as if they were commodities, (4) that it promotes an inequitable system of organ distribution, with access to available organs granted to those who can afford to pay, and access to available organs denied to those who cannot afford to pay, (5) that it promotes a system of organ distribution in which the wealthy will be the recipients and the poor will be the donors, treating the poor as sources of organs to be distributed to the wealthy,² (6) that it might not alleviate the present shortage of available donor organs, since donations might decrease if selling were allowed,³ and (7) that it might lead to the kidnapping and murder of children and adults in order to harvest their organs.⁴

      Arguments for legalization of the selling of body organs or body parts include (1) that legalized selling of body organs might help to alleviate the present shortage of available donor organs for medical patients who need organ transplantation, (2) that voluntary donation of body organs allows the donors to help those in need, (3) that legalized selling of body organs might encourage more people to donate their organs, and (4) that human beings should have the right to treat their bodies as they desire and should be able to voluntarily sell their own body organs or body parts if they are not harming anyone by doing so,

      Arguments for legalization of prostitution include (1) that prostitution is a “victimless crime,” (2) that legalization would reduce health risks for sex workers by requiring them to be tested regularly for sexually transmitted diseases (STD’s), (3) that it would reduce violence against women, by providing safer environments for sex workers, (4) that it would enable greater regulation of the sex trade, in order to prevent human trafficking, (5) that it would prevent child prostitution, (6) that it would save law enforcement resources, (7) that it would be a source of tax revenue, and (8) that it would allow sex workers to obtain labor rights, such as minimum wage, health care rights, safety rights, and protection from discrimination.⁵

      Arguments against the legalization of prostitution include (1) that prostitution is morally wrong, (2) that it is inherently dehumanizing, (3) that it promotes the abuse and exploitation of women, (4) that it promotes the victimization of children, (5) that it promotes human trafficking, (6) that it promotes the spread of sexually transmitted diseases, (7) that legalization does not protect sex workers from exploitation, and (8) that it promotes the spread of prostitution.
      Perhaps the two most basic requirements of self-marketing ethics are (1) that we have the right to market or sell whatever we are marketing or selling, and (2) that we do so in a truthful, honest, and socially responsible manner. Thus, the ethics of self-marketing informs us of the duty to engage in ethical advertising  and promotional practices, regardless of what kind of marketing strategy we are employing (e.g. mass marketing, multi-segment marketing, targeted marketing, or niche marketing).

      Self-marketing ethics also include an ethics of self-disclosure, i.e. an ethics governing the nature, kind, and amount of personal data we release to others in our “selling” of ourselves. To the extent that release of our personal data affects the well-being of others, we have an ethical duty not to unnecessarily harm, offend, trouble, or inconvenience them by unnecessarily releasing such data. We also have an ethical duty not to be selfishly attention-seeking and exhibitionistic in our self-promotion or self-marketing. We also have an ethical and legal duty not to engage in such acts as breaching the peace, creating a public nuisance, infringing on the privacy rights of others, and using public resources, property, or communications without proper authorization.

      In some cases, we may have to “sell” ourselves to ourselves (convince ourselves of our own merit and value). We may also have to “sell” ourselves on the act of “selling” ourselves (convince ourselves that we are doing the right thing by “selling” ourselves to others). Self-marketing may therefore in some cases involve marketing ourselves to ourselves as well as to others.

FOOTNOTES

¹The word “sell” is here placed in quotation marks to distinguish the metaphorical from the literal sense of selling. We often try to “sell” ourselves to others in everyday life by trying to convince others of our intelligence, sophistication, resourcefulness, attractiveness, sense of humor, and other admirable qualities, but this metaphorical sense of selling is to be distinguished from the literal sense of selling that is exemplified by the selling of human beings into bondage or slavery, the sex trade, and the selling of human body organs or body parts.

²Debra Satz, Why Some Things Should Not Be for Sale: The Moral Limits of Markets (Oxford: Oxford University Press, 2010), p. 198.

³C.J. Dougherty, “Body Futures: The Case Against Marketing Human Organs,” in Health Progress, Volume 68, Number 5, June 1987, p. 51.

⁴R.R. Kishore, “Human Organs, Scarcities, and Sale: Morality Revisited, in Journal of Medical Ethics, Vol. 41. 2005, p. 362.

⁵Erin Fuchs, “7 Reasons Why America Should Legalize Prostitution,” in Business Insider, No. 13, 2013, online at http://www.businessinsider.com/why-america-should-legalize-prostitution-2013-11.

The Thinkable and the Unthinkable

The term “unthinkable” may be used in a variety of ways. It may, for example, be used to refer to that which is unimaginable, inconceivable, unquantifiable, unidentifiable, or indefinable. It may also be used to refer to that which is virtually impossible or almost completely out of the question (presupposing that there is indeed a corresponding question that may be formulated by thought).

      When we say that something is “unthinkable,” we may in some cases mean merely that we consider it to be very improbable or highly unlikely. For that thing to become actual reality may therefore be for it to be taken as an example of the "unthinkable" becoming thinkable.

      The “unthinkable” may also in some cases be merely that which is considered to be socially inappropriate for, or forbidden within, a given setting or context. The "unthinkable" within a given setting or context may be that which is barred or prohibited for a given person, group, network, or community. The occurrence of that which has previously been considered "unthinkable" may thus in some cases be perceived as disruptive, disturbing, unseemly, appalling, or shocking.

      The “unthinkable” may also sometimes be a specific thought content, idea, or concept that is forbidden and that we are told, taught, or ordered not to think about. It may also be that which it is illicit or impermissible to think about. To “think the unthinkable” may therefore be to disobey moral, religious, social, legal, or governmental dictates and to violate conventional norms. The “thinker of the unthinkable” may in some cases be a kind of ground breaker, innovator, or visionary, and in other cases a kind of law breaker, apostate, heretic, or revolutionary.

      A given mode of speech, thought, or conduct may be made "unthinkable" by a given moral, religious, social, or professional code or by a given religious, social class, political, or cultural ideology. For a given code or ideology to gain power or become predominant within a society may be for the thinkable to become "unthinkable" or for the "unthinkable" to become thinkable. The thinkable within a given code or ideology may be "unthinkable" within a different code or ideology.

      Under an authoritarian system of government, the “unthinkable” may also be that which has been declared by the state to be beyond the limits of the thinkable or sayable. To “think the unthinkable” or “say the unsayable” may therefore be to risk censure or incur punishment for having transgressed the limits of the sayable or thinkable. The thinkable may be a realm that is governed by the state and that is enforced by means of thought control.¹

      The “unthinkable” may also in some cases be merely that which we have been too shortsighted or careless to think about. We may in some cases describe a situation or event as “unthinkable” merely because we have been too thoughtless to conceive of its possibility.

      Some examples of events that are often described as “unthinkable” include natural disasters, environmental catastrophes, devastating industrial accidents, worldwide disease epidemics, stock market crashes, sudden collapses of government, mass shootings,² terrorist attacks,³ war crimes, and other acts of violence and destruction.

      The “ungraspability” or “unthinkability” of some facts, events, or situations may also be expressed by colloquial expressions such as “I don’t get that” or “I can’t quite get my head around that.”

      Thus, it may be important to distinguish between the literally unthinkable and the figuratively unthinkable, as well as between the unthinkable in theory and the unthinkable in practice. It may also be important to recognize and delineate those situations and contexts in which the unthinkable can become thinkable and the thinkable can become unthinkable.

      To say that something is literally unthinkable is to say that there are boundaries or limits to what we can think, and that there are boundaries or limits beyond which we cannot think of, or think about, something. What then are those boundaries or limits? How may we delimit or demarcate the domains of the thinkable and the unthinkable? May such domains overlap?

      If there are limits beyond which we cannot think, can we ever know or recognize those limits? If we were able to know or recognize those limits, then would we perhaps also have to be able to know or recognize not only the thinkable, but also the unthinkable? Thus, Wittgenstein, in the Tractatus, says that in order to draw a limit to thinking, we would have to think what cannot be thought.⁴

      To say there are limits to what we can think may also be to say there are limits to what we can conceive of, imagine, hope for, desire, trust in, be disappointed by, be angered by, agree with, disagree with, believe, disbelieve, remember, forget, know, talk about, dream about, and understand.

      The literally unthinkable may be that which transcends words or concepts, and that which exceeds or surpasses the limits of thought. But if there are limits to the thinkable, are there also limits to the unthinkable?

      The thinkable is all that can be thought, including all that has been thought, all that is being thought, and all that has not been but will be thought. On the other hand, the unthinkable is all that cannot be thought, including all that is not being thought (because it is incapable of being thought), and all that has not been and never will be thought (because it is incapable of being thought).

      To think about something may be to make it an object of thought. The unthinkable may therefore be that which cannot be made an object of thought. To be able to distinguish between the thinkable and the unthinkable we may also need to be able to distinguish between what can and cannot be made an object of thought.

      Some important questions to be considered include: Are the limits of language the same as the limits of thought? Can language express everything that can be thought? Are there limits to the expressive capacity of language? Can pure intuition transcend the limits of deliberative thought? Are there things that can be recognized or known purely intuitively and that transcend our ability to think deliberatively about them?

 FOOTNOTES

¹Noam Chomsky, “The Bounds of Thinkable Thought,” in The Progressive, Vol. 49, Issue10 (Oct. 1985), pp. 28-31.

²Todd Zwillich, “Stop Saying Mass Shootings Are ‘Unthinkable,’” June 24, 2015, at http://www.thetakeaway.org/story/stop-saying-mass-shootings-are-unthinkable/

³Phil Rosenthal, “9/11 attacks unthinkable, not unimaginable, as events prior show,” Chicago Tribune, Sept. 11, 2011, at http://articles.chicagotribune.com/2011-09-11/business/ct-biz-0911-phil-20110911_1_economy-contraction-federal-agency

⁴Ludwig Wittgenstein, Tractatus Logico-Philosophicus [1922] (Mineola, Dover Publications, 1999), p. 27.      


Listen to radio news correspondent Todd Zwillich explain why we should "Stop Saying Mass Shootings are 'Unthinkable'"

When Should We Trust Our Intuitions?

What is the most accurate and reliable way for us to recognize those situations in which our intuitions are correct, well founded, and trustworthy? When should we rely on more preconscious and automatic, as opposed to more conscious and deliberative, modes of thinking? What kinds of situations are best approached intuitively rather than analytically?

      Intuitions may sometimes be referred to as “instincts,” but they should be distinguished from the latter, insofar as intuitions may be defined as “immediate apprehensions” or “direct perceptions, independent of any reasoning process,” while instincts may be defined as “natural or innate impulses or inclinations” or “inborn tendencies to action common to a given biological species.”¹

      Intuitions should also be distinguished from “hunches,” “suspicions,” or “gut feelings.” A hunch or suspicion may, in contrast to an intuition, involve deductive reasoning, while a gut feeling may be more generalized and nonspecific and more like an inclination or disposition than an intuition.

      Even the most committed intuitionism may recognize that in some cases deliberative decision-making may provide some advantages over intuitive decision-making. Intuition may not be the best means of making all judgments. Some cases of decision-making may require thorough consideration and thoughtful deliberation.

      In what kinds of situations then should we rely on our intuitions? Perhaps we can examine the suitability or unsuitability of proposals such as the following for assessing the reliability of cognitive, sensory, and mixed intuitions.

      (1) We should trust our intuitions when the rightness or wrongness of actions is self-evident.

      However, it may be argued that whatever appears to be self-evident to one person may not be self-evident to another person. People may have varying opinions about the nature of self-evidence. There may be controversy about whether any actions are self-evidently right or wrong, that is to say, right or wrong without any demonstration of their rightness or wrongness, just as there may be controversy about whether any actions are intuitively right or wrong, that is to say, right or wrong without any regard for, or consideration of, their motives or consequences.

      (2) We should trust our intuitions when we recognize that we may be receiving misinformation about a situation and that such misinformation may not serve as an adequate and proper foundation for making appropriate deliberative judgments about that situation.

      However, the possible unreliability of deliberative decision-making in such a situation does not guarantee the reliability of intuitive decision-making in that situation.

      (3) We should trust our intuitions when we are compelled to do so by time constraints that hinder our being able to make decisions more deliberatively.

      However, even this modest proposal for assessing the reliability of intuitions does not indicate that we should not subsequently reexamine and review our intuitions or that we should not subject them to further scrutiny when time permits.

      (4) We should rely on our intuitions when we are confronted by situations that demand immediate action as opposed to deliberative thought. The readiness and spontaneity provided by intuitive decision-making may be more appropriate to situations demanding immediate action than the reserve and formality provided by careful analysis and painstaking deliberation.

      However, this proposal is subject to the same limitations as (3).

      (5) We should trust our intuitions when we are presented with the alternative of trusting the intuitions of someone else whom we regard as less informed or less capable of making rational, fair, unbiased, and impartial judgments about the situation at hand. 

      However, it may be argued that both our intuitions and the intuitions of whomever we regard as untrustworthy may be mistaken. Both of us may be acting intuitively under a veil of ignorance of which we are unaware.

      However, a counter-argument to this might be that even if our intuitions are mistaken, if we rely on own intuitions rather than those of someone else whom we regard as untrustworthy, we may at least be able to take comfort in the fact that we made our own mistakes of judgment, rather than having repeated someone else's mistakes of judgment.

      (6) We should trust our intuitions when we know by previous experience (and therefore have sufficient evidence) that our intuitions are reliable and trustworthy in situations similar to the present one.

      However, the general or overall reliability of our intuitions in situations similar to the present one does not guarantee their reliability in every such situation. Each situation may present unforeseen challenges to our ability to make correct, appropriate, and reliable intuitive judgments.

      In some cases, we may find that our intuitions are dead wrong. Further examination may reveal that what we intuitively thought was true is unquestionably false. We may find that in acting intuitively we were simply being naïve, overconfident, rash, or imprudent.

      Although intuitive judgments may often be profitably reexamined, to insist that every intuitive judgment undergo rigorous scrutiny and deliberative reevaluation may in some cases amount to a kind of moral, aesthetic, or epistemic obtuseness. To deny that any propositions are obvious or self-evident may in some cases be merely to be obstinate, devious, or willfully blind.

      Since intuitive judgments may require less effort on the part of the evaluator than deliberative judgments, it may perhaps be easier to make correct or incorrect intuitive judgments than to make correct or incorrect deliberative judgments.

      To trust our intuitions in some cases is not to deny that they may be aided by deliberative thinking. Intuitive thinking and deliberative thinking are not mutually exclusive. Indeed, they may be combined to produce morally, aesthetically, and epistemically reliable judgments. They may also augment and supplement each other.

FOOTNOTES

¹The Random House College Dictionary (New York: Random House, 1980).

Some Teachings of the Dao De Jing

The Dao eludes naming and namelessness. It cannot be conveyed by means of language. It transcends all attempts to formulate or conceptualize it. It cannot be spoken or thought. It cannot be seen, heard, or touched. It is a gate to ephemerality and durability, to impermanence and permanence, to transitoriness and eternity. It is the origin of all things, and the source of all mysteries (stanza 1).

      The Dao is neither a name nor a part of speech. Words or names cannot articulate or describe it. It is light within light, and darkness within darkness. Its presence is found in its absence, and its absence in its presence. 
      Inclusivity rather than exclusivity seems to belong to the Dao, but the former does not depend on the latter. The Dao is a doing and not-doing that does not need to, and cannot, be verbalized. Indeed, it transcends speech and verbalization (stanza 2).

      The Dao is not a construct, nor is it a way of acting on constructs. It is not to be found by searching for wisdom and knowledge. But to be wise and knowing is to follow the Dao and to be guided by it.

      The Dao is not a sign, nor is it a signifier of truth or meaning. It is rather a way of acting and not acting. It endures forever, because it is uncreated. It cannot be destroyed, because it does not destroy. It cannot be resisted, because it does not resist. By yielding to resistance, it overcomes resistance.

      Acting according to the Dao is not a way of seeking fame or making money. It is not a way of accumulating unnecessary things (stanza 9). It is also not a way of seeking admiration or recognition. Rather, it is a way of being gentle and kind, true and just, reliable and competent, selfless and trustworthy, compassionate and understanding (stanza 8).

      To act according to the Dao is to act virtuously, but not to strive for mere virtuosity. When virtues are actualized, mere virtuosities disappear. Thus, the Dao is elusive and indefinable (stanzas 21, 32). It transcends all boundaries of perception or knowledge, and it surpasses all limits of perceptibility or knowability.

      Forgetting or remembering does not lead to the Dao. Once remembered, the Dao is forgotten, and once forgotten, it is remembered. Following the Dao is not an act of intellect or mind. It is a way (or more accurately, The Way) of acting effortlessly and virtuously, as manifested by compliance with natural law and non-resistance to the ceaseless flow of events in the universe (stanza 28).

      To follow the Dao is to find that softness can overcome hardness, that gentleness can overcome roughness, that temperance can overcome intemperance, and that tolerance can overcome intolerance (stanza 43).

      In acting according to the Dao, less and less acting on constructs is done, until no acting on constructs is done, and thus everything that is in accordance with the Dao is done, and nothing that is in accordance with the Dao is left undone (stanza 48).

      Acting according to the Dao is not acting unnecessarily. It is also acting by not acting, and doing by not doing. It is also decreasing by increasing, and increasing by decreasing. It is also losing by gaining, and gaining by losing (stanza 63).

      Acting according to the Dao is also responding to harshness by offering mildness, responding to roughness by offering gentleness, responding to unkindness by offering kindness, and responding to enmity by offering friendship.

      To act according to the Dao is to avoid doing too little by doing too much, and to avoid doing too much by doing too little (stanza 75). It is to recognize the mutual dependence between acting and not acting, doing and not doing, rising and falling, gaining and losing.

      It is also to promote forgiveness rather than retribution, mercy rather than punishment, impartiality rather than partiality, and empathy rather than resentment (stanza 79). 

REFERENCES

Lao Tsu. Tao Te Ching. Translated by Gia-Fu Feng and Jane English, (New York: Random House, 1972).
Laozi. Tao Te Ching: On the Art of Harmony. Translated by Chad Hansen, (London: Duncan Baird Publishers,  2009.

Keping Wang. Reading the Dao: A Thematic Inquiry. New York: Continuum, 2011.


Some of my further thoughts about the Dao De Jing can be found here.

Medical Indications as Epistemic Justifications

A medical indication to perform a particular test or administer a particular treatment may be a medical reason to perform that test or administer that treatment. Stedman’s Medical Dictionary (2005) defines a medical indication as “the basis or rationale for using a particular treatment or diagnostic test,” and says that it “may be furnished by a knowledge of the cause (causal indication), by the symptoms present (symptomatic indication), or by the nature of the disease (specific indication).”¹

      A medical indication may also be a situation or condition in which a particular test or treatment is advised or recommended, based on the available scientific evidence. For example, according to the Physicians’ Desk Reference (2015), the indications for prescription of an albuterol inhaler include “Treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease,” and “Prevention of exercise-induced bronchospasm in patients 4 years of age and older.”²

      A medical indication may also be an evidence-based justification for a particular test or treatment. The strength of the indication may depend on the strength of the available scientific evidence for that indication.

      Factors affecting the indication for a particular test or treatment include not only the nature of the particular disease process under consideration, but also the potential benefits and efficacy of treatment, the age of the patient, the overall condition of the patient, the personal desires and preferences of the patient, the potential side-effects and burdens of treatment for the patient, the costs of treatment, the availability of treatment, and the projected goals of treatment.

      A medical non-indication for the performance of a particular test or administration of a particular treatment is an absence or lack of indication to perform that test or administer that treatment. Reasons that medical tests or treatments may not be indicated include: the non-health-threatening nature of some medical conditions, the lack of treatment efficacy with regard to some medical conditions, the potential side-effects of some treatments, the potential financial burdens of some treatments, and the personal desires of some patients not to undergo arduous tests and treatment.

      A medical contraindication to a particular test or treatment is a medical reason not to perform that test or treatment (because the test or treatment may be injurious or harmful to the patient). A contraindication may be described as relative or absolute. A relative contraindication to a test or treatment may sometimes be outweighed by the potential benefits of that test or treatment if the potential benefits are significant and the risk of harm is very low, but an absolute contraindication to a test or treatment is never outweighed by the potential benefits of that test or treatment (because of the severity and magnitude of the potential harms that the test or treatment may cause to the patient)

      What then is the relation between medical indications and epistemic justifications? To say that a particular test or treatment is medically indicated is to make an epistemic claim regarding the appropriateness, correctness, and advisability of that test or treatment. If we make such a claim, then we may have an epistemic duty to justify it by thoroughly examining all the available evidence for and against it. In order to be epistemically justified in saying that a particular test or treatment is medically indicated, we must have sufficient epistemic grounds for saying so.

      Let’s consider the following propositions (where the letter “T” stands for a medical test or treatment) as a method of investigating the role and function of medical indications as epistemic justifications:

1.     If T is medically indicated, then it is medically (and epistemically, and ethically) justified.

2.     If T is medically indicated, then there are good medical reasons for it that sufficiently outweigh any possible or actual reasons against it.

3.     If T is medically indicated, then there is sufficient scientific evidence in favor of it, and there is insufficient scientific evidence against it.

4.     If T is medically indicated, then there is sufficient scientific evidence of its benefit, safety, and efficacy.

5.     The proposition P that a particular test or treatment T is medically indicated is epistemically justified if there is sufficient scientific evidence in favor of the truth of P.

      The above propositions may all have their corresponding negations.  Thus, if T is not medically indicated, then it is not medically (and not epistemically, and not ethically) justified, and so on.

      To what extent may medical indications differ from epistemic justifications? Medical indications may be more than epistemic justifications, insofar as they may be not only epistemic, but also ethical (and practical) in nature. They may be not only situations or conditions in which particular tests or treatments are said to be appropriate or advisable, but also parameters and guidelines for performing tests and prescribing treatments.

      Medical indications may also differ from epistemic justifications insofar as in some cases an argument can be made that a test or treatment may be epistemically (and ethically) justified without clearly being medically indicated (its justification may not be apparent at first glance and may only be apparent on later examination). A test or treatment that was not clearly indicated at first glance may turn out to have an unanticipated beneficial effect. However, such a possibility may still not provide sufficient grounds for the argument that the performance of non-indicated tests or treatments can in some cases be medically justified. The justifiability of a medical test or treatment may in fact depend on the strength, clarity, and sufficiency of the indications for that test or treatment. Tests or treatments that have weak, unclear, or insufficient indications may be medically (and epistemically, and ethically) compromised by their weak, unclear, or insufficient justification.

      Non-indication, or lack of indication, for a test or treatment may in some cases be a contraindication to that test or treatment, insofar as that test or treatment may pose unnecessary risks to the patient and may expose the patient to unnecessary harms. Non-indicated tests or treatments may also cause unnecessary financial expenses for patients, for third-party payers, and for a whole healthcare system.

      Medical indications may constitute reasons to perform particular tests, procedures, or treatments, based on our knowledge of the potential benefits, safety, and efficacy of those tests, procedures, and treatments, and based on our knowledge of the natural history of the disease processes under consideration. Medical indications may also affirm the usefulness, appropriateness, and rationality of particular tests, procedures, and treatments within the context of particular medical illnesses, disease processes, and conditions.

FOOTNOTES

¹Stedman’s Medical Dictionary for the Health Professions and Nursing, Fifth Edition, edited by Thomas Lathrop Stedman (Baltimore: Lippincott Williams & Wilkins, 2005), p. 735.

²PDR, LLC “Full Prescribing Information, ProAir HFA (albuterol sulfate),” 2015, at http://www.pdr.net/full-prescribing-information/proair-hfa?druglabelid=569.