In May, I had the opportunity to visit with Dr. L. Syd M Johnson, a philosopher, bioethicist, neuroethicist, and professor in the Center for Bioethics and Humanities at Upstate Medical University in New York. Dr. Johnson is a former film critic, and today she is a member of the National Institutes of Health BRAIN Initiative Neuroethics Working Group and an associate editor for the journal Neuroethics. Dr. Johnson teaches students and colleagues alike about the law, population health, and healthcare ethics.
Her current research in neuroethics focuses on ethical issues related to brain injuries, including sport-related neurotrauma, brain death, and disorders of consciousness. Her work is situated at the intersection of ethics, medicine, and law, and she has published on disorders of consciousness, sport-related concussion and Chronic Traumatic Encephalopathy, reproductive ethics, research ethics, and animal ethics. Her interest in all things with brains/minds includes every kind of critter, zombies, and robots.
We originally visited in the midst of the coronavirus pandemic before the killing of George Floyd and the subsequent uprisings following his death. After Mr. Floyd’s death, I circled back to Dr. Johnson to ask her what opportunities she sees in education to advance ethics, including racial justice, within healthcare.
HF: Tell me about your everyday work, including how it’s changed with the coronavirus pandemic.
SJ: It seems like I am busier than ever these days. There are two major differences in my everyday work. One is that I don’t have to commute into the office anymore. That is, honestly, a benefit. That travel time was not very useful. Before this started, I was already trying to cut back on the number of days I drove in to the office. The other change is that my kids are home. My teenager can look after herself, but my fourth grader needs help structuring her days and her online schoolwork. The frequent interruptions and distractions make it difficult to do anything that requires sustained attention. I’m trying to work like a bee—flitting from one flower to the next, but with a destination and an objective to move towards.
I’m working on a few collaborative projects right now, and between those and work-related meetings, it seems I’m spending a lot of time on video conference calls, just like everyone else.
HF: How did you become interested in brains?
SJ: In graduate school, I was interested in philosophy of mind and consciousness, and also bioethics. I had a postdoc in neuroethics immediately after graduating, so that got me to thinking more about brains, and brain-related issues. I got interested in the specific issues I work on—disorders of consciousness and sport-related concussion—because there were a lot of interesting developments happening in those areas at the time.
HF: What do you see as our most significant cognitive strengths and limitations, as human beings?
SJ: The most significant cognitive strength of humans is our empathy—our capacity to think about what matters to someone else, to imagine ourselves standing in someone else’s shoes, to feel. It’s a basic capacity that drives us to create and consume art and literature and film, to help others, to keep the world going. Unfortunately, limitations in our empathy are our greatest weakness. We try to carve the world and its creatures (including our fellow humans) into manageable, familiar spheres—the things we decide we have the ability, the means, the bandwidth, and the desire to care about. The challenge is doing that—doing what is practically necessary—while remembering that things outside those spheres are still things worth caring about. It’s easier to turn them into things towards which we have apathy or antipathy.
HF: Tell me about how ethics has weaved its way through your life and career, including how you came to include nonhuman beings among your concerns.
SJ: When I was a kid, my family used to go camping and fishing in eastern Washington. When I was about 12, I was out in the rowboat fishing by myself, and I guess I was right above a school of perch. I would drop my fishing line in the water and immediately hook a fish. This went on and on, but after a while, I started to feel bad about it. I felt like it was unfair, that I was taking advantage of the fish because they didn’t know I was dangerous. That was the last time I went fishing. It would still be quite a while before I stopped eating fish or other animals, but when I did, I went vegan overnight. That was 1986, when I was in college, and it was in the middle of a cross-country road trip. I got pretty hungry for the rest of that trip!
Many months later, I read a book called Radical Vegetarianism by Mark Braunstein, and I learned the world “vegan.” Mark lived not far from me in Providence, Rhode Island, and he was nice enough to meet with me. I was introduced to the local animal rights group—the Rhode Island Animal Rights Coalition—and spent several years working with them before I moved to New York. We had two claims to fame—in 1987 we successfully lobbied the Cambridge, MA city council to ban the LD-50 Acute Toxicity Test and the Draize Eye-Irritancy Test in Cambridge, and we were infiltrated by an FBI agent who investigated us for several months. She got to witness us doing things like dress up in dog suits to protest the use of dogs in medical device marketing. We must have been a pretty weird and boring assignment for her. We never, ever did anything illegal. We engaged in activism-by-theatre and activism-by-annoyance. But I suppose that somewhere in the FBI archives there is a file on me, with a photo of me as Dr. Dog, dressed in a dog suit.
My interest in animal advocacy and animal rights was for a long time something I was philosophically interested in, but I didn’t see a clear contribution that I could make. I worked on it a little, at the margins of my scholarship, usually in conference presentations or in blog publications. I always found ways to work it into the ethics courses I was teaching. But people started asking me to write things—papers, book chapters, blogs, some amicus briefs for legal cases, and eventually a book. Now, it’s a pretty significant part of my scholarly work.
HF: What are you working on now?
SJ: I just finished an edited book called Neuroethics and Nonhuman Animals, which I’m quite proud of. It’s the first book to explicitly consider how neuroethics and animal ethics should be in conversation, and how the extensive animal ethics literature—which has for a long time been marginalized and siloed even in philosophy—can inform our approach to neuroethical issues related to both humans and nonhumans.
Right now, I’m working on my next book, and it’s a project I’ve been working on for years. It’s on disorders of consciousness, and how medical and scientific uncertainty about those disorders should prompt a change in our ethical thinking about them and our approach to other bioethical and neuroethical concerns. I’ve just been working on a chapter on moral status and personhood, where I can really incorporate animal rights and animal ethics thinking—because it’s the same issue, whether we are talking about humans with disabilities, humans with brain injuries, or nonhuman animals. In particular, I’m thinking about how consciousness is often thought to be a criterion for moral status or personhood. I think consciousness might be enough (or sufficient, in philosopher-speak) but it isn’t necessary for moral status. I suspect there are a lot of sufficient conditions for mattering morally, but none that are necessary.
HF: Commonly, I ask about what gives people hope. It would be interesting to hear from you what gives you hope, and what you think of hope as a neurological construct.
SJ: In the midst of this pandemic, one of the things that gives me hope is that we have shown ourselves to be flexible enough to change. We stopped driving and flying and going out. We found workarounds. Wildlife and other nonhuman animals emerged to fill the spaces we left empty. The air and water got cleaner. This year, I suspect, will buy us just a little bit of time to address climate change. Obviously, all of this has had pretty profound effects on human lives, but I hope that we can come out the other side of this with the recognition that we can respond to great challenges and do the things we must do to have a positive impact on the world.
HF: A follow-up question…since we last spoke, George Floyd was killed by police, sparking nationwide and international protests. His death and the killing of other Black people by police has also raised the level of public consciousness about how to better address structural racism and its effects on education, healthcare, and justice. What opportunities in education do you see now to better advance ethics, including racial justice, within healthcare?
SJ: It feels like we are on the verge of a momentous change in public consciousness. I really hope so. And coming in the midst of the pandemic, when attention was already turning to the devastating effects of structural racism on the health of Black people, Indigenous persons, and other people of color, it’s extraordinary to see a clear picture emerging amidst all the tumult. My experience with my students has been that once you lay out all the pieces, tell them the history, show them the effects, they can connect the dots and understand clearly how structural racism and injustice affect health for Black people, Indigenous persons, and other people of color. In my experience, they are astonished to learn about these things. When I taught my students about Black infant and maternal mortality in the US this past spring, they were aghast. So, future healthcare workers and doctors are ready to lead, and they are ahead of their teachers, but they need the information. The challenge, in my view, is to get health faculty onboard, to get them to recognize their moral and pedagogical responsibility to teach about the effects of racism and injustice.
Photo by Denise Rego Bass.