NHSEB 2021-2022 Regionals Cases Initial Thoughts—Full Set

1: The Social (Experiment) Network – Facebook could direct its algorithms to encourage outbreaks of collaboration, civility and purposefulness. Instead, it distracts users with triviality, spreads misinformation and sows anger, all in the service of maximizing ad revenue. Running comparatively innocuous experiments (of course attitudes are contagious… was an experiment really needed?) is low on the platform’s list of sins. More appropriate targets for analysis could be a) whether a wise person should allow themselves to be distracted and manipulated by social media at all, b) whether Facebook usage, like other habit-forming vices, should be limited to users over 18 or 21, or c) whether Facebook should accept lower ad revenues in exchange for using its power to uplift rather than devolve humanity.

2: Trust the Science – Since we rely on the media to make important healthcare decisions (Should I wear a mask? Which mask? Where? Should I get a shot? Which shot? When?), outlets have an obligation to present information in a nuanced, contextualized fashion. However, as the case notes, “even the most reputable media still rely on gaining consumers through attention-grabbing headlines and engaging content,” meaning that outlets have a financial incentive to sensationalize, which too often leaves us scared, divided and confused as to whom to trust. With the power to inspire vaccine enthusiasm or hesitance, virus precautions or disregard, responsibility falls on news producers to present information in a way that empowers sober, fact-based, compassionate decision-making.

3: Boy, Bye: Or, On the Ethics of Ghosting – It would be kind for Imani to send her online connections a brief goodbye. But given that their relationships are new, superficial and 100% digital, she has no strong obligation to do so. Risk of being “ghosted” is taken for granted in the online dating culture, especially in the early stages. And so none of her aspiring love interests would likely be hurt too terribly if she simply disappeared.

4: Suffering in the Wild – Our obligation to ease the suffering of wild animals is strongest for species and populations most impacted by human activity (through habitat destruction, ecosystem disruption, poaching), and our permission to intervene in the natural order strongest to the extent changes are reversible, modest and planned. Gene editing without careful consideration of the long-term impacts would be reckless, whereas relocating animals to a more accommodating habitat could be fine. Vaccinations would be somewhere in between, and the elimination of all carnivores, through extinction or gene modification, is an interesting possibility deserving additional reflection. (If we could modify the natural order such that mice, deer and salmon died of old age rather than owl, coyote or grizzly attack, and if we could avoid or curb overpopulation, wouldn’t that be a happier world? Maybe keep carnivores that eat mice…)

5: Predictive Policing – So long as proactive crime-prevention is positive (helping the unemployed find work, the homeless find shelter, the addicted receive rehabilitation assistance) and genuinely encouraging (as opposed to demeaning or belittling), it sounds like a win-win, similar to programs that proactively reach out to patients statistically at risk of suicide. Citizens contacted by “life support officers” in a coach-like fashion (if that’s indeed their approach), should welcome the support, and the state’s interest in their success could turn around an otherwise unhappy and destructive life trajectory.

6: AppleScare – Apple’s strategy of converting known problematic images into numbers, then scanning phones for those numbers (rather than downloading, viewing or otherwise accessing users’ personal images) is a reasonable compromise between respecting user privacy and deterring child abuse. A similar strategy might be devised for anti-terrorism and other legitimate purposes.

7: 23 & Memaw – (After a little reflection, I flipped my stance on this one, so be sure to give it time to marinate.) Since everyone seems to have hated Nancy’s grandfather (who turns out wasn’t her mother’s biological father after all), Nancy should tell her mother what she discovered through genetic testing, assuming she has good reason to think it will do more to fill her mother with joy as opposed to resentment or anger. Whatever the case, the impact on her mother should be the primary driver of Nancy’s decision – given that the man died before she was born, and the fact that her mother is in poor health, Nancy’s personal curiosity shouldn’t weigh as heavily.

8: Art with an Asterisk— Imagine that [insert the worst villain you can imagine] were secretly a master sculptor, and their work discovered after their death. Surely we could marvel at the magnificence of and skill behind the art while still denouncing the person’s behavior. However, we should be sensitive to living victims, ensure that our appreciation of the art isn’t confused with appreciation for the person, and that its display doesn’t enrich the artist unless they’ve repented, been reformed and forgiven. Bottom line: art stands on its own.

9: Priorities, Priorities – Analogous scenario: two patients are in need of a liver transplant, the first due to alcoholism, the second due to a congenital condition. Since the first drank excessively knowing that this could harm their liver, if there’s only one liver to allocate, all else equal, the patient in need through no fault of their own should be prioritized (though if there’s an abundance of livers, everyone gets one). Similarly, absent mitigating circumstances and all else equal, COVID-19 patients who chose to not take reasonable precautions to prevent severe illness (who go unvaccinated, who gather with large groups indoors for frivolous reasons such as entertainment, who choose not to properly wear an effective mask) should be de-prioritized for ICU beds (though if there’s an abundance of beds, everyone gets one). Mitigating circumstances might include the patient’s age (and amount of life left to live), chances of recovery (would ICU care even help?), and responsibilities (a mother of five young children, a surgeon with rare, in-demand skills, an ethics bowl blogger – kidding!). However, to the extent a patient’s behavior was reasonable in light of their education and access to information (imagine a person lacking basic investigative skills, surrounded by anti-vax family and friends, and awash in anti-vax propaganda), they are less to blame because based on their info, inferences and social pressures, going unvaccinated and maskless may have been the reasonable, healthy choice, and therefore their prioritization would be partially redeemed. (Note the connection between this case and case 2: Trust the Science.)

10: Are You My Mother? – All else equal, while genetic parents should receive custody (or partial custody as in the second case), the birth mother (essentially the surrogate mother, lacking genetic connection) deserves substantial compensation from the clinic that caused the error, not only to amend for the heartbreak of losing a child with whom she’s no doubt bonded, but also for the extreme burden of gestating (changing the woman emotionally and physically forever), and to give all fertility clinics strong financial incentive to prevent similar errors.

11: Just The Facts – Avoiding the appearance of biased reporting is essential to serious news outlets’ credibility. Of course, some outlets don’t care – Fox intentionally positions itself as pro-conservative, MSNBC as pro-liberal, RT as a pro-Russia. But for sources claiming disinterested presentation of objective facts, there’s nothing wrong with reassigning reporters when their background or history suggests a possible bias. Analogous situation: helping organize the Los Angeles HSEB, I once had a judge rush into the hallway to tell me she knew a member of a team whom had just sat down. Solution: I swapped that judge with a judge in another room – not because the first was incapable of judging the teams fairly, but to avoid even the appearance of favoritism, to proactively defend the legitimacy of the outcome. News outlets desiring similar credibility with their readers/listeners/viewers may swap reporters for similar reasons.

12: Paralympic Pay Parity – Paralympic competitors are usually missing a limb due to circumstances beyond their control (congenital, accidental), and so since they didn’t do anything to deserve their physical state, paying them less is in some sense unfair. However, public interest in the Olympics (indicated by viewership and merchandise sales) and the higher revenue the heightened interest generates suggest a higher perceived value and make more funds available for distribution. Therefore, since the public seems to care more about and spend more on the Olympics, paying Olympians more is legit.

13: Fake Views – As deepfake tech becomes more pervasive, the global “truth crisis” will accelerate and expand, undermining trust and certainty, and destabilizing societies. To offset this impact, producers should include disclaimers when deepfake tech is used for acceptable reasons (for example, to dramatically portray a true event), and news sources should vet and only release received footage once confirmed genuine and/or include warning labels such as, “Possible Deepfake – event not yet confirmed.”

14: Familial Obligations – Amir should simply disclose his situation. Any satisfaction his mother might enjoy by believing he is financially successful is being overridden by her and the rest of his Lebanese family’s disappointment, jealousy and spite, caused by their false impression that he’s wealthy and has forgotten about them. Assuming they’ve been good to him, he does have an obligation to help his sister and mother. Why? If it weren’t for their support and love, he wouldn’t be the person he is, and therefore should repay them with care and support in turn, at least as he’s able (though his primary obligations would indeed be to his dependent child with the pressing, expensive medical need, due to the child’s vulnerability and the fact that Amir helped bring the child into existence).

15: All Eyes on You – Physical surveillance on school grounds is one thing, but students’ private lives should be shielded from intrusion. It’s belittling and demeaning enough to be monitored and overseen during the school day, treated in many cases more like an inmate to be controlled than a person to be nurtured. Giving students space to be themselves after school (and in some cases to make a few mistakes) is part of growing up, preparing them to become responsible members of free society. Schools should therefore minimize monitoring of all non-official and after-hours student activity, and clearly disclose which communications and activities are being surveilled.