You teach and research bioethics, and you work with health organizations to promote ethical outcomes in health care; what led you to this focus in your work? 

I’ve been interested in ethical issues since high school, which is what drew me to philosophy. However, a lot of philosophy, even the ethics stuff, isn’t directly applicable to real-world problems. I didn’t find out about clinical ethics until I was doing my PhD, but it immediately struck me as a good fit for my skills and interests. Additionally, health care is constantly changing as the population changes and new technologies are created, so we aren’t running out of issues to work on! 

You write a SubStack newsletter called “Value Judgments” where you examine a variety of health care related topics with an ethics lens and often challenge some of the common concerns about Canada’s assisted dying law.  Is evaluating the ethics of a subject like assisted dying, or its common slippery slope argument, different from negating mis- and disinformation? Can you explain your method when you write these topics? 

Some of what I do is addressing misinformation by correcting claims that are verifiably untrue, such as false claims about Canada’s MAID laws. My main approach, however, is to assess arguments. An argument can be mistaken because it rests on a false empirical claim, but, most often, the success of an argument about MAID comes down to values and reasons. I named my newsletter “Value Judgments” because I believe that empirical facts on their own can’t determine how physicians should act or what our health care system should be, including for MAID. We have to make value judgments, so I’m interested in what those judgements are, who gets to make them, and what to do when people disagree.   

Why is creating this type of content important to you?  

It’s partly that MAID is a high-water mark for patient autonomy, which I care a lot about. For over a century, people have been arguing that patients themselves, not physicians or the government, should be making decisions about how they get to live and even whether they continue living. MAID is an important achievement in that much larger fight. 

A thing that interests me about MAID is that the objections people make to it often start with premises I share. For example, Canada’s lack of housing affordability and long wait times for health care services are both serious issues that need to be addressed, and they’re also both reasons people give when they object to MAID. I think applying those issues to MAID is a mistake, but I’m drawn to these arguments because the mistake isn’t believing something empirically false, like climate change doesn’t exist. Instead, I think they’re making a mistake in reasoning from the genuine issue, like lack of affordable housing, to their conclusion that this is connected to MAID. As a philosopher, I’m in the business of making and assessing arguments, so I have something to offer.   

At DWDC, we share your content regularly with our supporters. We know it helps people critically evaluate controversial topics like assisted dying. What do you think is the most important thing someone can do to critically evaluate a topic? 

The first thing is to be open to withholding judgment when there isn’t enough information. Every so often, there’s a news story about what happened to a person who had MAID. The problem is that these are always one-sided. Health care providers aren’t allowed to discuss the details, so we only ever hear from the patient’s family. As a clinical ethicist, I’ve been on the inside of situations that have made the news, so I know that there’s usually more to the story than what gets reported. This isn’t to say that patients and families are always mistaken. Mistakes happen and health care providers sometimes do the wrong thing. But I treat those stories with lower weight unless we hear from all sides. 

The second thing is to stress-test our own views by asking questions such as “how confident should I be of this conclusion?” and “what would it take for me to change my mind?” 

Finally, since we all have blind spots, it’s good to expose ourselves to views we don’t share. For MAID, that means reading arguments against MAID with an open mind.    

We’re seeing mis- and disinformation more frequently in the media, from professionals and experts, and even in research; what’s your advice to identify it and combat it?  

We all need to be selective about our media consumption. I avoid media that isn’t fact-checked, so I stay away from almost all daily news, even from more-reputable places. People can also do something called ‘prebunking,’ which involves reading up on common misinformation tactics. For MAID, the use of anecdotes is a common example. “Here’s this bad thing that happened to someone, so we need to stop MAID!” The problem is that we can’t verify if the thing actually happened to the person. And, even if it did, we shouldn’t make policy decisions based on one story. 

Maybe the one I write about the most is the interpretation of data. Whenever new MAID data gets released, there’s a flurry of takes making a big deal about the number of MAID deaths: the numbers are too high, or they must be evidence of something sinister. The response is to recognize that interpreting data always involves value judgments. Sometimes they’re justified, but other times they’re questionable.