Gender Disparity: Paycheck Fairness Act is not enough

Before I start, let me say that I support any effort to address wage inequality and I believe strongly in the right to equal pay for equal work. If the Paycheck Fairness Act helps to bring more equity to the workplace, I’m all for it, but it will not eliminate wage disparities between men and women on its own.

Republicans are wont to point out that women make less than men not because of discrimination but because of lifestyle choices. (Read a fuller discussion of this in The Guardian.) Their argument centers on the fact that it is possible to pay every woman in any given job the same wage as every man in a similar job and still end up with wage disparity because more women are in lower-paying jobs. To Republicans, this means sexual discrimination is not a problem (everyone should just choose to be a petroleum engineer or investment banker, right?), but for the rest of us it means that sexism is a pernicious problem that will not easily be solved with a piece of legislation.

First, we might ask why the jobs more women choose pay less than the jobs more men choose. One proposed answer is that men choose jobs that are riskier and require a more “masculine” personality. Women, it is assumed, will choose safer and less demanding jobs. Another answer is that women gravitate toward jobs that require fewer hours (they need to get home to the kids, you know?). And another is that women choose jobs that require less training.

According to the 2013 Physician Compensation Report, male doctors earn 30 percent more than female doctors. The report explains the disparity thus: “There are fewer women in some of the higher-paying specialties. For example, in orthopedics, only 9 percent of the survey respondents were women, whereas in pediatrics, 53 percent of survey respondents were women.”

Interestingly, the lowest paid specialty in medicine is now HIV/Infectious Diseases, which also happens to be the specialty with the second highest rate of overall satisfaction (just behind dermatology). The other low-paying specialties are family medicine, diabetes/endocrinology, and internal medicine. Other high-paying specialties, after orthopedics, are cardiology, radiology, gastroenterology, and urology.

While I can’t see that the risk of treating infectious diseases is lower than the risk of practicing urology, I do see that the lower-paid specialties focus more on care and concern and require human interaction. (It still may be true that women are more risk-averse, which may be why they are safer doctors.) It seems to me that we value technical expertise over human and care and concern in most fields. At least we are more willing to pay for technical expertise and less willing to pay for the care and concern that we will all need.

Teachers work hard and take many risks but will never earn as much as petroleum engineers. Ah, but petroleum engineers fatten the bottom line for their employers, you say. Let them try to survive without teachers to get them there. Let all the hard-working risk takers make it through life without the people who cared for them and helped them become successful. And men have always said this, haven’t they? We have clichés such as “Behind every successful man is a woman.” And women have done their work, largely, for free—because they had no other choice. So the work women have done is devalued (though prized in way) and undercompensated. If fewer people were willing to do “women’s work,” the price of such work may indeed rise, but I don’t see this happening any time soon.

And men sometimes choose work that may be seen as “feminized.” When they do, men also earn less because their work is undervalued, too. If the work were not undervalued, I aver that more men would choose different careers. After successful careers in industry, some men choose to leave their jobs for more “meaningful” work after middle age. The work people describe as “meaningful” or “rewarding” is almost always related to either caring relationships or creative enterprises; these are the activities that make life seem worthwhile.

Because these activities bring so much personal satisfaction, people are willing to do them for less pay. If petroleum engineering did not pay so well, I’m sure some people would still choose it as a profession, but many people choose it now only because it pays well and not because it enriches their lives in any other way. Many men are starting to reject the idea that they must choose careers based on how well they pay. Some men in the men’s movement reject being treated as “success objects.” Nonetheless, I think women are more likely than men to feel free to choose careers based on satisfaction rather than remuneration, and men are more likely than women to feel they must choose a career that pays well. There are many, many exceptions, of course, but not enough to close the pay gap between men and women.

So, what should we do to address the problem of wage disparity? First, stop devaluing “feminine” work. Recognize the true value of education and care. Second,  stop treating men as “success objects.” Remove the stigma from rejecting a high-powered career for a more rewarding and meaningful life. Finally, make it possible to find a balance between a career that pays well and a meaningful life. Some women may pass up high-paying professions because they do not want to neglect their family relationships or similar concerns. At the same time, some men neglect relationships and personally rewarding work because they feel obligated to earn as much as possible. Men and women would both behave differently if it were possible to enter any career without having to sacrifice family relationships, volunteer opportunities, and creative outlets. Another world truly is possible.

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Doctors, Patients and Bad Bedside Manners

ethicsbeyondcompliance:

Protecting the rights of patients will come from patients first. The more stories patients share of their experiences, the more prepared all patients and prospective patients will be to face their interactions with healthcare providers.

Originally posted on womenscancerconnection:

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In a support group that I facilitate, we recently were discussing our relationships with our doctors. So many of the women have had bad experiences, especially, with their surgeons. Now, this may be true in all of cancerland, but in the case of ovarian cancer, it is especially true. So many women report that their original diagnosis was put off because of doctors who were not listening to them, or taking their symptoms seriously. Also, many of the doctors did not do the proper testing and/or did not refer to the proper specialist (a gynecologist or gynecologic oncologist).

But even after they were finally diagnosed, their experiences with doctors weren’t always the best. Women have told me over the years that their surgeons (usually gynecologic oncologists) are sometimes very negative and doom and gloom. One woman, Lee, told me her doctor said “You’re like a plane going down”. Several others…

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Is there a wrong way to grieve?

Over the past few months, I’ve written of several philosophers of the ancient past who taught that grief should not overwhelm us before themselves becoming overwhelmed by grief. Stoic philosophers taught that we should understand that death is nothing to fear or mourn, if only we can have the proper understanding, but the emotion of grief trumps rational explanations every time. I would conclude, then, that we should not attempt to suppress or diminish our grief but should let it unfold naturally and grieve for as long as necessary. Criticizing the grief of others seems counterproductive at best.

But this left me wondering whether there is a wrong way to grieve. What obligations can the bereaved have to others? Obligations to the dead? Does grief suspend normal obligations?

Like the rest of the world, I don’t know what caused Spc. Ivan Lopez to go on a shooting rampage at Ft. Hood. He certainly had experienced a great deal of stress in his life and had good reason to experience problems with mental health. According to a CNN article by Ray Sanchez, Lopez’s father said the recent deaths of his mother and grandmother, medical treatment, and changes related to transfer of military installations “surely affected his condition.” Grief often becomes unmanageable when it is combined with other complications, obstacles, and challenges. We do well not to ignore the impact of grief on those around us. We are part of a community, and the health of the community deals in part on how well we respond to grief.

For an example from fiction, I’m reminded of “A Rose for Emily” by William Faulkner. Emily has much to grieve for: When she loses her father, she loses a loved one but also status, wealth, predictability, and honor. She responds by simply refusing to acknowledge her loss. In the beginning she denies that her father is even dead. Eventually, she relents and permits him to be buried, but continues her life as if nothing has changed. Her neighbors go along out of pity, not respect. As you probably remember, Emily eventually takes a lover from out of town, kills him, and sleeps with his body for the rest of her life.

Emily’s neighbors had tried to offer condolences to her when her father died, but she denied his death. After his death, the neighbors reacted to her with a mix of compassion, respect, suspicion, and disgust, but they also lacked the will to intervene as Emily continually pushed them away. They left Emily with her privacy and, as much as possible, a little dignity, which only led her to more extreme and destructive measures.

If I say that Emily grieved unethically, you may say that grieving wasn’t the core problem; rather, she was refusing to accept change. But grief is always a reaction to change, and all change is annihilation. The bereaved will often say the whole world changed, and that is exactly what has happened. Emily’s world changed, but she refused to accept either her father’s death or her change in fortune. By killing her lover, she tried to preserve a moment forever. Emily’s response to grief was understandable but not excusable. Then again, perhaps her neighbors did not respond ethically to Emily’s grief. The neighbors did reach out to Emily, even with follow-up visits, but failed to intervene more forcefully. Are they obligated to take matters into their own hands?

I recently had the opportunity to hear author Cheryl Strayed speak on her latest book, Wild, which is about Strayed’s own response to her mother’s death. Strayed is a talented and courageous writer and proficient speaker. As she talked about her grief journey, she only lost her composure once. She said that after her mother’s death she became the kind of daughter her mother would not have wanted her to be. She described her adultery, promiscuity, and substance abuse through tears that evaporated as she moved on to discuss how she began to manage her grief more positively (ethically?).

I ask whether there is an ethical way to grieve. We can see that people, overcome by grief, behave in ways that are certainly unethical in most contexts, but we may have such compassion for the bereaved that we soften our judgment of them. “What she did was wrong,” we may say, “But I can see why she did it. I might have reacted the same way.” But this may be true anytime someone acts unethically. In the exact same situation, I may have acted as Bernie Madoff acted. In fact, we have all acted in unethical ways. We had our reasons (grief, exhaustion, addiction, depression, or whatever), but our actions were unethical.

So what helps people behave more ethically? Jean-Paul Sartre, the famous Existentialist philosopher, says that with each of our actions we choose “the good.” He doesn’t mean we always make good choices, but given our options, we choose the one we thought was best, which means we write our ethical values for public view by the actions we choose. In this environment, other people become our hell. Nothing is more damaging to us than being trapped by the others’ perceptions of us.

When we choose an action, we are choosing the one that seems best to us at the time. The problem is that some of us have run out of good ideas for what to do. We often explain ourselves, rightly, by saying, “I didn’t know what to do!” If we had more ideas, we would have more choices and could make better decisions. Sartre claimed we have absolute freedom, but really we can increase our freedom by increasing the number of actions we have in our consciousness. Sartre saw others as our judge, jury, and executioner, but they can also become our community.

It is Sartre’s companion and lover who had a broader vision for existentialist ethics. Simone de Beauvoir was able to see the positive importance of others in our lives. Beauvoir declares “freedom can be achieved only through the freedom of others.” If we want to be free, we must seek our freedom through the freedom of our community, and our freedom grows out of our love. Beauvoir says, “If we do not love life on our own account and through others, it is futile to seek to justify it in any way.” Without valuing others, our life truly loses meaning, and we will lose all hope.

When I was in China, I once thanked someone for helping me with a problem, and she responded, beautifully, “When we help each other, we are free.” Indeed, it is the only way for us to become free. And it is the only way for us to have more good ideas of what we can do.

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Why I hate Steak and BJ Day

On March 14, I learned of a new holiday known as Steak and BJ Day. Known as a humorous response to Valentine’s Day, the idea behind Steak and BJ Day is that women get all the attention on Valentine’s Day (men spend about twice as much as women) and there should be day for men to get what they enjoy, which is, obvious to the creators and celebrants of this day, steaks and blow jobs. It’s just a joke. It’s all in fun. If you don’t like it, don’t participate.

Many women seem to feel this is a fair way to compensate men for being so generous on Valentine’s Day, apparently having no qualms describing their romantic relationships as blatant prostitution. (“After all the trouble he went to for Valentine’s Day, I owe him something. Teehee.”) If people want to live their lives exchanging gifts for sexual favors and cooking services, I have no problem with it, so long as everyone knows what is going on and feels comfortable commodifying relationships. I have a different problem with this holiday.

Steak and BJ Day is based on a crude masculine stereotype that is inoffensive to men who live for their next steak and treat of oral sexual gratification. All men are supposed to want this. Any man who doesn’t love and know how to prepare steak, in fact, should turn in his man card, according to this web site.  Again, it is just a joke. If you don’t love steak, you are just a girl. Hilarious. I mean, who would want to be a girl? It isn’t meant to offend anyone. Any man who objects to this stereotype is himself at risk of being told he is too sensitive or not a “real man” or a “typical man.” People who are less kind will tell him he is a sissy, wimp, girl, or any number of nastier anti-gay slurs.

So, men who don’t want these things should turn in their man cards (see this site for an uproariously funny rendition of this ). “Turn in your man card” is the functional equivalent of “you throw like a girl.” As much as people insist this is all just a joke, the consequences of masculine stereotypes are severe. Children who fail to express their gender in expected ways are more likely to be bullied and abused and suffer from depression and PTSD (see a study on the risk here). You may have heard what happened to a boy who liked My Little Pony. Further, anti-gay attacks are typically in reaction not to sexual activity but to perceived non-conformity to gender stereotypes (a 1982 study by Joseph Harry found that “effeminate” men are twice as likely to be victims of gay bashing than gender conforming men), which means gay-bashing victims include many heterosexuals or children with no obvious sexual orientation or identity at all.

This bias against unmanly men is nothing new. Through an essay by Elizabeth V. Spelman, I found a passage in Plato‘s Republic describing what kinds of men would be inappropriate for a decent society:

We will not then allow our charges, whom we expect to prove good men, being men, to play the parts of women and imitate a woman young or old wrangling with her husband, defying heaven, loudly boasting, fortunate in her own conceit, or involved in misfortune and possessed by grief and lamentation—still less a woman that is sick, in love, or in labor.

People sometimes want to credit Plato with an early form of feminism, because he felt women should be trained in the mode of men. Like many today, he felt it was quite admirable for women to strive to “achieve” masculine traits. Men being the highest form of human perfection, Plato thought it made sense for women to strive for the masculine ideal. The man who would follow the lead of women, however, would be lowering himself below his station and be pathetic at best. His view persists as we encourage girls in sports, mathematics, and leadership, but forbid boys from nurturing, crying, creativity, and careers related to care and empathy. It seems odd to me that eating meat is considered particularly masculine, but vegetarian men are portrayed as being the least manly of all. The hatred and devaluation of “feminine” men is an extension of the oppression of women. Feminist philosopher Jean Grimshaw points out that the conception of a feminine ideal depends on “the sort of polarization between ‘masculine’ and ‘feminine’ which has itself been so closely related to the subordination of women.”

The hatred of “effeminate” men is an extension of the devaluing of the feminine, but it leads to violence and oppression of both men and women. In order to be free, we must assign equal value to all human activities and emotional dispositions. Leadership and assertiveness have their value, but we will not last long in a society devoid of nurturing, care, and concern. Another feminist philosopher, Genevieve Lloyd, puts it this way:

If the full range of human activities–both the nurturing tasks traditionally associated with the private domain and the activities which have hitherto occupied public space–were freely available to all, the exploration of sexual difference would be less fraught with the dangers of perpetuating norms and stereotypes that mutilated men and women alike.

I added the emphasis on the word “mutilated,” because I am grateful to her for using such strong language to describe accurately what sexist stereotypes have done to us. I often hear women struggle to describe how sexism hurts men. Some say it discourages men from working hard or from caring for others, but they miss the fact that sexism destroys men from the inside out. Very few men escape childhood without having their masculinity questioned and challenged. And too many men have responded violently to a woman who has taunted them with, “If you were a real man, you’d . . . !” The constant demand that a boy or man prove his resilience, indifference to pain and fear, and lack of compassion rends men from their humanity. Those who resist are often trampled under foot and left with depression, addiction, anxiety, and self-loathing. Too often, it ends in self-destruction through addiction, isolation, or suicide.

You may be thinking I take things a little too seriously. No one would kill himself over Steak and BJ Day. I agree, but I am asking you to consider the good of masculine stereotypes, and I tell you they serve no purpose and provide no benefit. The cumulative effect of such stereotypes is to prevent men from being whole and to destroy those who are uninterested or unable to fulfill the social expectations such stereotypes are designed to enforce.

For the love of humanity, please free us all.

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The Joshua Hardy Case: Lessons Yet to Learn

ethicsbeyondcompliance:

When you have few options, clinical trials often seem like the best hope, but experimental treatments often offer little hope of therapeutic benefit.

Originally posted on MSU Bioethics:

Bioethics-in-the-News-logo This post is a part of our Bioethics in the News series. For more information, click here.

By Hannah Giunta

Earlier this month, major news outlets reported the story of 7-year-old Josh Hardy, a current end-stage cancer patient at St. Jude Children’s Research Hospital. Hardy has faced and overcome cancer four times after first being diagnosed with rhabdoid tumors of his kidneys when he was only nine months old. After treatment for his kidney cancer, he relapsed, and cancer was again found first in his thalamus and then in his lung. In November 2013, Josh was diagnosed with myelodysplastic syndrome and required a bone marrow transplant. The weakening of his immune system caused him to come down with a particularly vicious case of adenovirus, and current antivirals have failed to control that infection. After approved drugs failed, Hardy’s doctors suggested that the experimental agent brincidofovir might offer the…

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What Obamacare has done for me

When I first met my wife in 2007, she told me she was about to quit her job of 27 years in the oil and gas industry to pursue a career in family therapy. Quitting her job meant giving up her employer-provided insurance, so she went on COBRA for 18 months. By that time, she was in graduate school and was able to get student insurance. When she graduated, however, she was unable to get insurance on her own as she had pre-existing conditions that precluded purchasing insurance on the open market.

I was following a similar path. When we first met, I was working on my PhD while also teaching full time. In 2011, I was beginning my dissertation and my college, facing budget cuts, was offering a payoff to anyone willing to resign. By this time, my wife was on my insurance, and I hesitated to give up my benefits, but we eventually decided I would resign and take student insurance for both of us.

From there, I was playing a delicate balancing act. I knew the healthcare exchanges mandated by the Affordable Care Act (Obamacare) were supposed to become available in January 2014. I pressed forward with my dissertation without wanting to graduate before the exchanges were available. I found that I could stay on the student insurance for six months past my graduation date. I defended my dissertation in March 2013, but did not turn in final paperwork in time for spring graduation, meaning that I would have to enroll in the summer. I graduated in August and was able to keep the student insurance for my wife and myself until February 2014.

Thankfully, the exchanges did go into effect by the beginning of 2014, and we were both able to purchase insurance for ourselves. The cost of the insurance was about the same as the price for the student insurance, but it is a much better insurance plan. I am extremely grateful for the Affordable Care Act (ACA), which made this possible.

But the ACA is even better than I realized. I now teach part time for two colleges. Under the ACA, I can join rejoin the Teacher Retirement System of Texas and purchase health insurance along with disability insurance, accidental death and dismemberment insurance, and life insurance for myself and my wife. Further, the teaching I am now doing applies to my years of service in the Teacher Retirement Service, which means my retirement account is growing and will become available to me sooner.

I am not happy with all of President Obama’s policies by any means, and ultimately I would like to see the US adopt a single-payer model for healthcare, but Obamacare is a step in the right direction. Without Obamacare, my wife and I would have joined the millions of working Americans who have no health insurance or access to affordable healthcare.

So, thanks, Obama.

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Oil spill shuts down 65 miles of the Mississippi river

Originally posted on Climate Connections:

By Katie Valentine, February 24, 2014. Source: Climate Progress
In this aerial photo, river traffic is halted along the Mississippi River between New Orleans and Vacherie, La., due to a barge leaking oil in St. James Parish, La., Sunday, Feb. 23, 2014.  Photo: AP PHOTO/GERALD HERBERT

In this aerial photo, river traffic is halted along the Mississippi River between New Orleans and Vacherie, La., due to a barge leaking oil in St. James Parish, La., Sunday, Feb. 23, 2014. Photo: AP PHOTO/GERALD HERBERT

An oil spill has shut down 65 miles of the Mississippi River in New Orleans, as authorities work to clean up the oil.

The spill occurred on Saturday when a barge carrying oil crashed into a tugboat between Baton Rouge and New Orleans. Authorities closed the stretch of river on Sunday and still can’t say exactly how much oil was spilled, though a light sheen of oil is being reported. No injuries were reported from the crash.

In St. Charles Parish, public drinking water intakes along the Mississippi were closed as a precaution, but a news release Sunday assured the public that the water…

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