This second episode of the Philosophy Bakes Bread radio show and podcast features an interview with Dr. Bill Myers of the Birmingham Southern College in Birmingham, AL, on the topic of the “Ethics of Dentistry.” It has surprisingly little to do with stealing gold teeth.
Listen for our “You Tell Me!” questions and for some jokes in one of our concluding segments, called “Philosophunnies.” Reach out to us on Facebook @PhilosophyBakesBread and on Twitter @PhilosophyBB; email us at firstname.lastname@example.org; or call and record a voicemail that we play on the show, at 859.257.1849. Philosophy Bakes Bread is a production of the Society of Philosophers in America (SOPHIA). Check us out online at PhilosophyBakesBread.com and check out SOPHIA at PhilosophersInAmerica.com.
(1 hr 9 mins)
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- In this episode, we referred to two books that are great for people who want to learn more philosophy and just want fun introductions that don’t require much background. One mentioned was Plato and a Platypus Walk into a Bar, by Thomas Cathcart and Daniel Klein. The same authors also published Aristotle and an Aardvark Go to Washington. The other book mentioned on the show was Sophie’s World, by Jostein Gaarder and translated by Paulette Moller.
Transcribed by Katlin Dellis, published May 4, 2017, episode aired on January 22, 2017.
For those interested, here’s how to cite this transcript or episode for academic or professional purposes (for page #s, use the Adobe PDF file‘s pagination):
Weber, Eric Thomas, Anthony Cashio, and Bill Myers, “The Ethics of Dentistry,” Philosophy Bakes Bread, Transcribed by Katlin Dennis, WRFL Lexington 88.1 FM, Lexington, KY, January 22, 2017.
Announcer: This podcast is brought to you by WRFL, radio free Lexington. Find us online at wrfl.fm. Catch us on your FM radio while you’re in Central Kentucky at 88.1 FM, all the way to the left. Thank you for listening, and please be sure to subscribe.
Dr. Weber: Welcome folks to WRFL Lexington this is Dr.Thomas weber; you’re listening to 88.1 radio. I’m at the University of Kentucky, live in the studio. In a moment you’ll hear Dr. Cashio of the University of Virginia at Wise join me for episode two of Philosophy Bakes Bread: food for thought about life and leadership, a production of the Society of Philosophers in America. The show airs each Monday at 2 pm at the University of Lexington in Kentucky for the spring semester of 2016-2017. If you’re out of town or across the globe you can stream the show live at WRFL.FM/STREAM. Today as we air this episode it is Martin Luther King Jr. Day. Cohost Dr. Cashio and I both teach from kings writings. Most people don’t realize how much influence some philosophers like Josiah Royce had on king. In fact, when in an interview, King was asked about his “desert island” book, excluding scripture, he answered that his desert island book would be Plato’s Republic—true story. Last but not least, the name Socrates came up in King’s famous letter from a Birmingham jail. Here is your chance to win a free Sophia t-shirt, the first time we’ve done this! I’ll make this a contest via email only, so if you’re driving don’t enter [laughs], or stop. Just be careful if you’re typing. You can email your answer to email@example.com. The first person to send me the right answer at that address will win a free t-shirt. So here’s the question: How many times did Martin Luther King mention Socrates name in the Letter from a Birmingham Jail? Again, email me with the correct answer at philosophy firstname.lastname@example.org. For those of you wondering, we got the name Philosophy Bakes Bread from an old saying that ‘philosophy bakes no bread.’ John Cleese replied to that in a recording produced for the sentinel celebration of the American philosophical association meeting in the year 2000. Here is a clip from that:
It’s been said that philosophy bakes no bread. And you may think it hard to figure out just what philosophy is good for. Is it just argument, speculation, or a required course in college? Here’s a thought: philosophy is fun, like skiing down a sheer cliff or singing a difficult song. Philosophy can fill you with the edgy excitement that makes being a human wonderful. Don’t believe it? – I suggest you seek out a philosopher and find out just what you’re missing, because philosophy may bake no bread, but the thoughts it provides could make the meal of life more satisfying.
So, there’s john Cleese. Philosophy doesn’t bake bread, said the old saying, and our show is intended to reject that idea- that philosophy does in fact, bake bread. So, we aim to buck that misleading outlook. Today’s episode is episode two on the ethics of dentistry with Bill . Surprisingly, the topic has nothing to do with stealing gold and teeth. Before we get there, I would like to make sure we give you our intro music
Dr. Weber: All right; so Dr. Bill Myers is professor and chair of the department of philosophy at Birmingham Southern College in Alabama and is adjunct associate professor in the University Of Alabama Birmingham School Of Dentistry. Bill is also a long time leader in the Society for the Advancement of American Philosophy. He earned his PhD at the University of Texas at Austin and has published articles and edited a book on what is known as process philosophy. Given an interesting opportunity, Bill has taught on ethics and dentistry at University of Alabama’s School of Dentistry; we’ll come to focus on that fact in a moment. At Birmingham Southern College, he has taught courses on ethics, logic, American philosophy, environmental ethics, religious ethics, and ethics in managerial choice.
Dr. Cashio: On today’s show we are very fortunate to be welcomed by Dr. Bill Myers; hi, Bill!
Dr. Bill Myers: Hi Anthony, hi Eric.
Dr. Cashio: Bill is here to talk about the ethics of dentistry. Dr. Myers is a professor of philosophy at Birmingham Southern College where I was an alma mater and had the opportunity to take many courses with Bill, but none on the ethics of dentistry. Learned a lot—
Dr. Weber: You were an alumnus I think and it was your alma mater but I know what you mean
Dr. Cashio: …exactly, thank you Eric.
Dr. Cashio: So Bill, this first section is called know thyself. We invite you to tell us a little about yourself. Who you are, how did you get into philosophy? Maybe about what philosophy interests you? What is it about the ethics of dentistry that engages you?
Dr. Myers: There is a lot there Anthony…where should I start?
Dr. Weber: Start with the know thyself part; tell us about yourself and how you got into all this stuff
Dr. Bill: Dental ethics or philosophy?
Dr. Weber: Let’s start with philosophy.
Dr. Myers: Believe it or not, when I was a senior in high school I took a humanities course and the first twelve weeks of that course was the history of philosophy and I fell in love with it. The backstory to this is that I was originally planning on going to Baylor University on the track of being a Baptist preacher. Instead, I went to visit a local state school in Arkansas, Central State Arkansas, and I met the philosopher there and he was from an honors college and he convinced me I needed to go there instead, so I did. I fell in philosophy and never turned back. The only major I ever had, the only thing I’d ever done in college- so it sort of is my life, obsession wise.
Dr. Weber: Would you say that person corrupted the young?
Dr. Myers: Yes, corrupting the youth and corrupting young minds for a living, one of them being Cashio.
Dr. Cashio: Yes, corrupt.
Dr. Weber: So, how did that study of ethics of philosophy sort of… what is it about that that hooked you? We want to know about you and how philosophy can come to be of interest. This person, how did he convince you? What did he do? What is it about all of this?
Dr. Bill Myers: I’ve always been one to ask why- my entire life. When my fourth grade teacher told us that everything in the world was made of matter I said, “No it’s not,” and I questioned, it’s just my nature. I think I was a philosopher by temperament- so I have no other choice but to do this.
Dr. Cashio: What did your teacher say?
Dr. Bill Myers: Well the science book says- well I said are you kidding me? My shirt, my chair, the light, the sun? Everything is made of the same stuff? She said, “yes,” I said, “no!” We disagreed;I still disagree.
Dr. Weber: Do you think people who are attracted to the “why” question are good candidates for philosophy?
Dr. Bill Myers: Sure, that seems like a very good way introduce that. One of the ways of dealing with that is dealing with all of the answers of that- joining the conversation of the philosophers of the millennia.
Dr. Cashio: So Bill, I had the opportunity to take many of your classes in my time at Birmingham Southern- I was corrupted by your influence. How do you think your teaching encourages your students to go out into the world and to be engaged philosophically? Do you see that playing out in a number of different ways or do you think it’s just a general academic interest?
Dr. Bill Myers: Well, I hope it does. One of the things I encourage in my classroom is an open atmosphere. I try to encourage that not just in the classroom, but in life in general, to be open to questions and new ideas. One of my highest marks on my teaching evaluations is “open to questions,” so maybe if I can encourage and foster that, maybe I’ve helped some mind to open.
Dr. Weber: Very nice. Bill! I have a question for you that is maybe more for our listeners who are maybe not terribly acquainted with philosophy about corrupting people with philosophy. Somebody who is listening to this may be troubled if they don’t know why we’re joking around, but your average person might not know why we are referring to this. Can you give a little background to people who don’t know about philosophy or haven’t heard much yet about these corruptions and allay their fears that we are trying to corrupt people?
Dr. Myers: Well, of course. In ancient Athens, Socrates was accused of corrupting the youth because one of the things– philosophy is kind of dangerous. Questioning the status quo can be threatening but also incredibly important because if we never question the status quo we will never make progress. If we never questioned the status quo women would not be voting, Africans would still be enslaved. The progress we’ve made has come out of the people who question—the gadflies. Those who, like Socrates, corrupted the youth, as they say. When you do that, you cut against the establishment and the establishment needs to be questioned.
Dr. Weber: What is this gadfly? I think that’s an important metaphor.
Dr. Myers: It’s the horsefly that bites you that you can’t get off.
Dr. Weber: Who wants a gadfly? Why would anyone want a gadfly?
Dr. Myers: Sometimes people need to be goaded! Life goads us and moves us.
Dr. Weber: Ahh…
Dr. Cashio: Have you ever been bitten by a horsefly Eric?
Dr. Weber: I really hope to never be, at least literally speaking. The metaphor I was thinking of is, and you’ve mentioned already is: think of the mind as a horse. And that it’s so easy to sit comfortably, but when the horse is stung in the rear by the gadfly it gets the mind racing. And so the philosopher’s gadfly provokes us- it may not be comfortable. Have you ,you’re in a very conservative place in Birmingham, have you found people getting upset about either philosophy and what you do, or anything in your area when you ask provocative questions?
Dr. Myers: Not too often. A brief anecdote: early on, my second or third year here, a local NBC affiliate aired this two piece mini-series on Noah’s Ark. A lot of the local people got upset because it wasn’t biblically accurate. A local reporter asked me on TV If I thought it was important that a story retelling be biblically accurate. In my reply, I said, “Well you know, when you’re retelling the myth the important thing is not that it be biblically accurate but that it be an interesting retelling.” Unfortunately, it wasn’t a very interesting retelling and my referring to Noah’s Ark as a myth ruffled some feathers. The president was called; the secretary was called.
Dr. Weber: What do you mean by something being a myth, when you say that?
Dr. Myers: By myth? Well, this is mythic. These are the stories that the three monotheistic religions tell. This is their rallying cry. They’re not intended to be history, but they’re meaning makers.
Dr. Cashio: Would you make a distinction between a myth and a legend?
Dr. Myers: I wouldn’t make that distinction the way our high school English teachers make it. A high school English teacher would say that legends have some basis in history while myths are completely false. No, myths aren’t completely false, they’re true-they convey truth, they’re just not history.
Dr. Weber: Interesting. So the popular show, Mythbusters, they would often bust myths but sometimes the myths we all heard about turned out to be true.
Dr. Myers: Yeah, the disparaging of myth that we do in our culture is something I lament. We should celebrate myth, not debase it.
Dr. Weber: So we’ve been talking with Bill, Dr. Bill, of Birmingham Southern College and it’s been a pleasure talking to you Bill, thanks so much. We will come back after a short break and ask bill about a course he’s been teaching recently, a subject matter he’s been teaching: the ethics of dentistry. There are a lot of people who’ve thought and talked about medical ethics, but the ethics of dentistry is a specialized area so it’s particular and interesting and is another place in which we can ask the question about how, if it does, make a difference in the world. So thanks for listening, we’ll be back shortly.
Dr. Weber: This is Dr. Eric Weber back in the studio for Philosophy Bakes Bread, 88.1 WFLR Lexington. We did, in fact, get a message from somebody who gave a guess to our question- our t-shirt giveaway for the Society of Philosophers in America (SOPHIA). We have a, I think, a pretty sweet t-shirt and it’s available to the first person who emails us. My cohost Anthony Cashio- we do these pre-recordings, but he texted me and said, “Why don’t you open it up to twitter,’ and I said to myself, “ok let’s open it up to twitter.” We are on twitter @philosophybb or you can email us at email@example.com. Tweet us @philosophybb, or email us at firstname.lastname@example.org with your answer to this question. ‘Tred” emailed us and he gave a good guess, but it was a little bit off. The question: how many times did MLK mention Socrates by name in the Letter from a Birmingham Jail? The first person to email us with the correct answer or to send us a tweet, we’ll try and confirm who was first with the correct answer. The first will get a free Sophia t-shirt. One last time our email is email@example.com, and our twitter account is @philosophybb. You just heard from Dr. Bill Myers in our section called ‘know thyself.’ Before that, we had said that we hadn’t yet received any comments from listeners because the first episode hadn’t aired yet. In each episode we ask listeners for questions, comments, and what they think about the questions we raise. This episode with Bill was pre-recorded before our first episode aired and is now airing as our second episode. The good news is that we did, in fact, receive some listener feedback after that first show. So I’m adding this in: I wanted to give a big shout out to Devon Beach who kindly tweeted to us on our Philosophy Bakes Bread twitter account: @philosophybb caught the show on WRFL today can’t wait to listen every week. That’s awesome, thank you Devon! Another listener called in with a question, which Anthony and I met up to talk about. Here is what You Tell Me segments will sound like as we get into the swing of answering your questions and much needed praise.
Dr. Cashio: At the beginning of each segment we hope to open with a bit called “You Tell Me.” Before each episode ends we ask you to send us your questions, comments, as well as thoughts about a specific question or set of questions we raised earlier episodes. Hey Eric.
Dr. Weber: Yo.
Dr. Cashio: Do we have any calls, questions, lots of praise about our conversation last time? We talked about Plato’s theory of the cave and how to think about it in this post-fact world? Any ideas? Questions?
Dr. Weber: [laughter] Thanks for asking. We did get some callers actually. There’s one that stood out, the fellow didn’t want to be named but he was happy to have his question mentioned. We were talking about getting at reality and the fact that when you think about learning- it’s like this idea we discussed about Plato’s cave, and you’re looking at shadows on the wall. We need the help of experts who have had their eyes turned to the light and so forth- we were talking about the allegory of the cave and how it’s still relevant today and therefore it’s so important for experts who have seen the light of truth outside the cave to come back in and help us out, you and me, who are stuck in the cave still, arguing about falsehoods instead of the real deal. This guy called in and said, “Well, look, you’re talking about, let’s say, doctors who need to talk about people who are wrong about vaccinations. What do you do when experts disagree?”
Dr. Cashio: What do you do when experts disagree? This is a very hard question I think. What do you think? Do you have any ideas on this, Eric?
Dr. Weber: Experts disagree all the time on things, so you could ask what do we do? We continue to do more studies in science, we look into things further. Now, there is an important distinction to make, however. So think, for instance, about the theory of evolution. Can you find someone with a PhD in something scientific who denies the theory of evolution? You can probably find one or two, or three, maybe ten, I don’t know how many. You can definitely find people who want to say something negative about the theory of evolution, but the notion that the theory of evolution is controversial because you can find one or two people who disagree with it, is not quite what I think of when I consider controversy.
Dr. Eric Weber: Compare thoughts about what we ought to do about climate change with whether or not the climate is changing. There is no doubt that the climate is changing- the science is empirical, it is fact. What we ought to do about that and how we should think about its causes and so forth are more complicated, although the ladder is vastly more subtle than it used to be. What we ought to do is, it’s interesting, there are a lot of different things we might do about it. There’s controversy about that- there’s not much settled science. There are times when experts disagree. It may be that everybody seems to understand that evolution is the way to understand the development of Homo sapiens but there was a time when everybody thought differently and Charles Darwin was this weirdo who needed to get his foot in the door. Agassiz? The famous scientist was at Harvard, he was the anti-evolution guy. So, what do you do when experts disagree? You disseminate your information and seek confirmations from others. The thing is, when people started looking at what Darwin said, all over the place they found confirmations.
I did a search many years ago for one of my classes on the topic of confirmations of evolution. I found hundreds of thousands in one major scientific outlet, I think SCIENCE the major scientific journal. There were hundreds of thousands of published confirmations of evolutionary theory. If evolutionary theory was right then this and that would be the case, so you investigate and find out that it was a decent prediction. When you have people who disagree, you do more science. You think about truth not just as something that you may or may not have immediately but rather something like a long run. Picture as Charles purse would say. We should think about truth as what would be agreed upon at the end of an infinite inquiry. So, do you want to be devil’s advocate and push back?
Dr. Cashio: I was just thinking, are we going to be two experts disagreeing? Is that what you’re suggesting? I think you’re right. Part of being an expert is knowing when and how to disagree. When you’re talking about scientific inquiry, I think this is a very good example, from the caller’s question it also seemed he was interested in the example of doctors disagreeing. Always get a second opinion? But, at a certain point, the evidence will play itself out. What if it’s something that experts come to a consensus about?
Dr. Weber: Right.
Dr. Cashio: Or even claim to be an expert on something like morality or religion. This seems to be outside of what can be empirically tested. What do you do then? Do you give into confirmation bias and give into what someone you like says?
Dr. Weber: Well when you think about the public policy world we have these conflicts and so there are some things about which you may just never be able to get full agreement about. What do you do? You think about principles for how to address those moments of conflict. You try to agree on procedures. Those procedures may not be so hard to agree upon. Ultimately when you’ve got judges, and there are judges who disagree, who is the higher judge? At the end of the line we need some final deciding body. When it comes to judges, that’s the Supreme Court. Even they, of course, are held accountable in a sense in as far as congress can amend the constitution and all of the judgements of the courts won’t remain in stone insofar as the laws can change. You come up with mechanisms and ways of doing things, checks on power, and that’s for sort of the really grey stuff. When it comes to the sciences it is amazing, some of the subject matter is just difficult and complex and there can be so many different answers. When it comes to something, for instance, like if the average global temperature is going up, there are people who are going to reject that even though it is clearly unequivocally established as things can be.
Dr. Cashio: When dealing with this question, one trap not to fall into is to think that because experts disagree that there is no expertise.
Dr. Weber: That’s a good point.
Dr. Cashio: To say, “Well because professor A says this and professor Weber says this, then neither of them can be correct and therefore there is no truth. I can also be an expert.” I see this happen a lot and it can also be a danger. Just because experts disagree agree does not mean there is not some expertise to be had.
Dr. Weber: What form does it take? More inquiry, more study. We are never done, until we can’t do it anymore I suppose. There is an end date on my life but not necessarily on humanity. [Laughter].
Dr. Cashio: Be dogged in the pursuit of truth.
Dr. Weber: If you’ve got other questions or comments or thoughts or totally disagree with what you’ve just heard, let us know.
Dr. Weber: So here’s that segment on the ethics of dentistry that I promised you.
Dr. Cashio: Welcome back to philosophy bakes bread. This is Dr. Cashio and Dr. Weber, and we are here today talking with Dr. Bill Myers. Our topic for today is going to be on the ethics of dentistry and I am eager to hear what Dr. Myers has to say. Now, Bill, when I was a student at Birmingham Southern College I took a lot of classes with you in philosophy of religion, modern philosophy, American philosophy, but you never offered a class in dental ethics. When did you start teaching classes in dental ethics, how did you become interested?
Dr. Myers: Well Birmingham Southern College does not have a dental program. So, I did not teach that as a part of my job here. In January of 2008 I received an email from a dean over at the dental school asking if I would like to consult on a course on dental ethics. I replied, “Well, I know something about bioethics so I’d be happy to point you some directions.” He said, “No, by consult I mean design and teach this course.” And at first I was taken aback. When he told me the hourly rate it piqued my interests, let’s just say. So, I designed a course to begin digging into it and discovered a treasure trove of issues. So, every July since 2008 I have taught a five week course on dental ethics. It is the first ethics class that incoming dental classes take and we meet twice a week for three hours for five weeks. It has been very rewarding for me in very many ways- I’ve learned a lot.
Dr. Cashio: Wow.
Dr. Weber: Bill, so this person came to you with interest? My guess is that there is some sort of professional requirement and reason for the person asking you?
Dr. Myers: The University of Alabama is a big university here in town. They have a medical school, a dental school, and they revamped their curriculum when ethics began to bubble up in the dental world. So, they revised their curriculum to include an ethics course. They couldn’t get the philosophers to do it for them-they began branching out and someone found and contacted me. This has been a very happy sort of relationship that we’ve had. So, they asked me and I was just, I guess, the lucky one they caught.
Dr. Weber: So I think this idea is fascinating that ethical issues bubbled up in the dental field. Can you tell us about that? What kind of ethical issues bubbled up?
Dr. Myers: When accreditation issues began to come up there was accusations about dentistry. The accreditation agencies were seeing dentists doing horrible things, so ethics became a necessity. We were probably the second or third dental school in the nation that had a dedicated course on dental ethics. Now, I think, there’s probably about a dozen, twelve or fifteen, of them. So we were very early on in that and the course I designed was the second or third in the nation- so we were cutting edge at that time
Dr. Cashio: When you say dentists were doing horrible things at the time, what do you mean? What were they doing? [laughing]
Dr. Weber: Were they taking peoples teeth and selling them to someone else?
Dr. Myers: No. Primarily, the big theme was pushing professionalism. One of the biggest classes, the biggest course sections I do: is dentistry a profession or is it a fancy craft- a high tech trade? In other words, I paint this picture of dentistry as a dental clinic as being a Jiffy Lube. They want to sell you your stuff. You come in, they want to to sell you product and maximize their profits, they’re trying to sell you everything they can to get you spend all of your money with them. I paint this really ugly picture of the dentist as the shoe salesman, and I say ok, is that what we want? The assumption at those schools is that dentistry is a profession where patients come first with a service orientation as the primary profit motive. One of the mantras the dean says is, “take care of your patients and the profits will come.”
Dr. Weber: Interesting. So this is sort of getting at the issue of whether or not the people who sell you stuff have an obligation, with respect to your interests.
Dr. Myers: – Is there a feud here, or a relationship?
Dr. Weber: There is a related question that came up in a business ethics course I was teaching this semester where the folks on Wall Street were shooing mortgages. They were the financial experts you’d go to, to consult with and get your needs filled, and they were doing what makes them the most money- not what was best for you; in so many cases that led to the economic collapse. It’s interesting because most people don’t think about business as a profession and yet, my goodness, I wish they did and that they had standards like that. It’s interesting that I would’ve expected most people to think the same about dentists, but it sounds like what you’re saying is there had been a trend in which people were thinking more like Wall Street than as though they’re engaged in a profession
Dr. Myers: Yes, there was a front line documentary called Dollars for Dentists that paints this picture of dentistry very, very strongly. These chains that go up, corporate chains, not run by dentists, maximizing Medicaid and doing crowns when they don’t need them, so there’s a lot of ground that we’re trying to make up.
Dr. Cashio: I’ve always suspected I had to get extra fillings from the dentist
Dr. Weber: So they were giving people crowns that they didn’t need and they were billing Medicaid for it?
Dr. Myers: Yes, a simple filling would’ve done. Instead, they crown the tooth because that makes you more money.
Dr. Weber: And that makes not only the patient the person engaged in this potentially consensual agreement, but actually you and I and everyone else contributing in tax dollars are paying for something unnecessary that could be supporting something else.
Dr. Myers: Exactly.
Dr. Weber: That does become a deep ethical issue. Now, that’s interesting…I’m going to hope to not step too hard on Anthony’s toes. You brought up a point earlier that was very interesting. There is a long tradition, perhaps because of, well, predating abortion. There is sort of a rich history of medical ethics in the profession of philosophy and you’re talking about the ethics of dentistry, which can be thought of as perhaps a subset, perhaps it’s something quite different? I wonder if you’d, for our listeners, explain to us a little bit about ethics and how medical ethics fits into that, and how do we think of the relationship of ethics of dentistry into relation to all of that?
Dr. Myers: Absolutely. Let me just sort of paint the big picture of ethics just very briefly. Ethics is…there’s 3 basic approaches to ethics. Those grounded in the good of outcomes, those grounded in duty and doing the right thing, those grounded in virtue and some aspect thereof. Those three factors and morals, they interplay, and these are sort of the independent factors involved in morals. Well, bioethics has played upon this and they had these virtues, beneficence, autonomy, and justice. Justice, autonomy, and beneficence are the big three virtues in bioethics. Autonomy refers to the right of the individual to self-control. Beneficence refers to the good of the individual or greater good for society, and justice to doing the right thing providing the proper care and that sort of thing. So dentistry embodies the ethical boards. They use the foundation of bioethics themselves, but they apply them towards dentistry. Now, the one thing about dental ethics is that we don’t have to deal with death and dying issues. So, I don’t cover euthanasia in my class. I don’t cover abortion in my class. However, we do significant issues about autonomy and informed consent, for example. Informed consent is a huge issue in dentistry; how much they have to tell you, how much you need to know to make an informed decision, are you co-deciscion makers or is the dentist driving your treatment plan? That sort of thing. So, the issues that are in bioethics, as long as you’re not dealing with death and dying, the same ones there are also in dentistry
Dr. Weber: Interesting. So would you say that, when you need to teach dentists matters you can just teach them bioethics? Or can you tell us a little more about what’s unique about dentistry?
Dr. Myers: Well yeah, I mean. We do basic bioethics. Our core units, after professionalism, we do a section on autonomy and informed consent, the right to refusal of treatment; we do a section on the confidentiality of medical information, that’s one of the core virtues going back to Hippocrates. A big one in dentistry is truth telling, non-disclosure or disclosure of medical error- making the distinction between bad outcomes and bad work. When a dentist drills in and drops something in the cavity and leaves it there, the dentist makes a mistake, what obligation do they have to tell you about that even if it’s not necessarily something that’s going to be bad? Should they tell you when they screw up? Those issues of disclosure about medical mistakes- that’s a big one.
Dr. Weber: Definitely.
Dr. Myers: In addition, another thing that we do in our class is a lot of medical ethics in medical schools teach the doctor patient relationship, and they do that very well. What they don’t do, is they don’t teach the doctor-nurse relationship, the doctor-clinic relationship. So we wrap up our course with a section on issues in medical management, we talk about employee-employer relationships, we talk about sexual harassment, whistleblowing, racial harassment and all of those issues also. It turns out that there are a lot of doctors that are wonderful to their patients but they treat their staff like crap.
Dr. Weber: I won’t go into details but there was a medical professional, I’ll be vague, who treated his nurses as if they were little girls and it made me so uncomfortable to see
Dr. Cashio: Awkward.
Dr. Weber: It was awkward, exactly.
Dr. Myers: So, it’s not just about ethics between doctor patient, but it’s also ethics about how you run a clinic. By the way, the field of bioethics is grossly neglected.
Dr. Cashio: I’m curious, Bill. how do the students respond? Like at the beginning of the semester, what is their general attitude coming in having to take a philosophy class right off the bat?
Dr. Myers: They all come in thinking, “Look, I just want to be a dentist,” and by the end of the second day they have discovered there is a huge variety of issues. They’re shocked at the number of issues that they will be facing as dentists in their everyday practice. So, to answer your question on two levels: one of them is there they’re surprised the ethical complexities in dentistry, but secondly yeah, it’s a real philosophy class and science trained people don’t necessarily care for that. I make them do three major writing assignments and there’s a lot of complaining about subjective grading.
Dr. Cashio: You’re evil.
Dr. Myers: Yes, absolutely. But overall, the course is very successful and very popular.
Dr. Weber: Well there’s people who don’t like to think about the difficult kind of questions that involve answers that are complex or that seem to have grey areas and so forth but as Aristotle said, “You shouldn’t expect more specificity than what the subject matter allows.” It’s the world that’s complicated, it isn’t your class that’s causing the problem.
Dr. Myers: That’s why I’ll say, “Welcome to dentistry.”
Dr. Weber: That’s a great moment to say we’ll be right back after a little break with Dr. Bill Myers. This is Dr. Eric Weber and I’m here with cohost Dr. Anthony Cashio. We’ll talk a bit more in the next segment about the ethics of dentistry.
Dr. Weber: Hey folks, this is Eric Weber here live in the studio. I wanted to let you know we have received some a response to our question today for the free t-shirt giveaway.. if you can get the right answer, but we haven’t yet received the correct answer. I’m going to give you a couple more ways to get in touch with us as well as a little hint but one more time, here’s the question that we are asking you. If you get it right we will send you a free t-shirt—to the first person who answers and gets it right. The question is: how many times did MLK mention Socrates by name in a Letter from a Birmingham Jail? The first person to email me or tweet at me or tell us on Facebook with the right answer will win a SOPHIA t-shirt. So here’s how you can get ahold of us: you can send us an email at firstname.lastname@example.org, you can tweet us @philosophybb, and we are also on Facebook. If you search Philosophy Bakes Bread you’ll find us on Facebook. Email us, tweet us, or Facebook us the correct answer- if you’re the first person you’ll win a free SOPHIA t-shirt. Here’s the little hint I wanted to give you: Letter from a Birmingham Jail is online and it can be text searched [laughter], so there’s a little hint about how one might be able to find the answer if you don’t know. One last time: how many times did MLK mention Socrates by name in the Letter from a Birmingham Jail? It’s an important letter, an important piece of American history which is of course why I bring it up, and I would like you all to be thinking about it. So have a look if you have to, tweet at us, email us, send us a message on Facebook if you have to. We are coming back here with everyday ethical challenges at the dentist’s office with Dr. Bill Myers and my cohost, Dr. Cashio on Philosophy Bakes Bread.
Dr. Cashio: Welcome back! You’re listening to Philosophy Bakes Bread. This is Dr. Cashio. I’m here with Dr. Weber and Dr. Myers, our guest. We’ve been discussing dental ethics: the ethics of dentistry in the last section. Bill!
Dr. Myers: Yes?
Dr. Cashio: Quick question for you. You mentioned that there are a lot of different issues that, by the second day of class, dental students are concerned about. What are some issues that a dentist, in their practice, might encounter? Maybe they’re listening to us talk right now.. they’re drilling into someone’s tooth and they’re hearing us talk and they think, “yeah, these are the kinds of issues I encounter every day in the dentist’s office.”
Dr. Myers: Let’s start sort of light. A patient comes in and the dentist knows clearly what is the best treatment for this patient. However, the patient can afford this, but doesn’t want to go that route. They want to do something else. This is a conflict between autonomy and beneficence. The dentist, as a professional, knows what the ideal and best path for this patient is, but the patient also is the autonomous person who is authorizing this procedure. So the conflict between autonomy and beneficence is the core conflict that dentists will see.
Dr. Weber: Let me ask you to define some terms for our listeners, Bill.
Dr. Myers: Autonomy is the right to decision, the basic right to self-governance that we all have. And beneficence is grounded in utilitarian thinking- that’s the greater good. Beneficence is the oldest virtues in bioethics. It is the doctor knows best, the doctor has your best interest in mind, therefore you should do what the doctor wants. Autonomy is a relatively more recent concern that people will say that they have a right to choose their path through a procedure.
Dr. Cashio: The tension here is between the dentist saying “I know what’s really best for you,” and the patient saying, “I know you’re probably right but I don’t want to do it anyway.”
Dr. Weber: I should be able to decide for myself what I want.
Dr. Myers: Exactly. That is the fundamental conflict. So patient autonomy is one of what to do with a recalcitrant patient, the noncompliant patient. Do you treat a patient who you know won’t do follow-up care? These are issues that the dentist will face every day. Let me go over another issue that dentists face. Someone who is, say a specialist. They place me in endodontics, which is root canal doctors. My department teaches trained dentists how to do root canals. If you’re an endodontist, and someone comes in regularly and the work that they get from their regular dentist is subpar, what do you do with that? Well, dentistry is a self-regulating profession.so dental boards consist of dentists who make the boards and make these decisions. Do you report a colleague who is doing subpar work? This is one of the most troubling things, and a lot of dentists will tell you that you can never really have enough evidence to do that. Some will say they were willing to try to report subpar work, so this is a huge issue in dentistry.
Dr. Cashio: I imagine that’s a big issue a lot of people can relate to even outside of dentistry. You have a teacher who is doing subpar teaching- what do you do about it?
Dr. Weber: I actually had a contractor who poured some concrete for me at a prior house. He did an awful job, and I was trying to figure out: can it be salvaged? What should I think about this? I had another contractor explain to me what this guy had done wrong, and we’d have to have it totally redone. Having the courage, and knowing when to speak up and say, ‘ this person has done me wrong,’ because you can ruin someone’s livelihood.
Dr. Myers: Exactly. Their ADA code says you should never speak ill of a colleagues work.
Dr. Weber: Woah.
Dr. Myers: Your job is to inform the patient of their present oral health status. You’re not supposed to say, “Oh my god who did that?” That’s against the rules.
Dr. Myers: What’s allowed is telling them their current state and how to improve their current state.
Dr. Cashio: So I mentioned that I have more fillings than I think I needed at one point. I asked a dentist, “did I need these fillings?” and he was very evasive. That explains the behavior.
Dr. Myers: That’s exactly why. They do not want to speak ill of their colleagues. There’s a code of honor among them.
Dr. Weber: So my follow-up question, or my next question I have for you Bill, is about the fact that we have a sense, in this country, that access to healthcare is something that we want to maximize. Maybe we don’t think, some people, don’t believe in universal health care coverage, but you know inmates in prison get healthcare, people who are poor get help with Medicaid, people who are elderly get Medicare, so there’s this sense in which there is some obligation the public has to support medical care. Yet, there is an interesting way in which we differentiate health insurance from dental insurance. Some things are thought of as essential and medically necessary, and then some things, dental issues, are treated as though they are not exactly your healthcare. Somehow, they’re luxury. Or, they’re treated as such as, “well that’s not covered under health insurance because it’s in your mouth,” kind of thing. I wondered if you can talk about the extent, in your eyes, what you think is necessary for healthcare, but more specifically about the ways in which it is odd how we differentiate obligations to provide medical health from your dental needs. Why do you suppose there is this difference, and what can you tell us about it to make sense of this distinction? Should we make such a distinction?
Dr. Myers: Dentists have played a part in this as picturing more on the mechanical, more on the commercial model, just being profit takers. You come in. I fix your teeth. Research has shown more and more over recent years that oral health is intricately tied to your overall physical wellbeing. There are patients who will come in, many expressing some physical symptoms. When their oral health gets better, that improves their overall health. So, our current state of dental health has some real problems. The dental school, UAB, they have a clinic where students go to learn dentistry. You can go there and be treated by a student dentist. You may the be the first person to ever do that, but you know a lot of the people who do that come there because it’s cheap. They come on an emergency basis. There are people who come in, the only time their teeth get cleaned in any way is when they go to that dentist-they don’t own a toothbrush. Part of that is because, in rural areas, there is no access to dentists. They certainly don’t have dental insurance. To me, this is an area of serious neglect. We should be focusing on our oral health as much as we focus on our medical health. Those two should be integrated.
Dr. Cashio: I live in a rural area here in Wise Country, Virginia. We have remote area medical that comes in, RAM. At the wise county fairy ground, they set up, and a line starts two days before it even opens at the fair ground of people just to get dental work. For many of these people, it is the only time they get any dental work done whatsoever, so dentists and dental students come from all over to do this. It’s good because it’s the only dental care they get, but it upsets me because it ought not to be.
Dr. Myers: The only time their teeth ever even get cleaned. It’s just foreign to us.
Dr. Weber: Right. Well, I tell you one way I’ve thought about obligations about healthcare. You know, I’m presently in Kentucky, but I lived for nearly a decade in Mississippi. There’s a lot of folks who want to debate about smaller government and more liberty and don’t think we all have such an obligation and so-forth, but at the same time think about it this way: if you have a terrible toothache and you have nothing but life in this world-
Dr. Myers: Your autonomy is severely compromised.
Dr. Weber: There’s that, and that all you have to do to have your teeth taken car of is to stab somebody. You get put in prison, and all of a sudden the state has to take care of you because you’re in their custody. All of a sudden, if you need dental care all you need to do is steal someone’s purse and you might get health care. That shouldn’t be the way we divvy out healthcare. I’m not saying we shouldn’t treat patients- w have to. At the same time we create an absurd incentive if someone is in some sort of pain that is the only way they can get care.
Dr. Myers: Yep.
Dr. Cashio: My wife is a nurse in the emergency room and patients will come in all the time with severe dental issues. Like, emergency dental issues. She’ll tell them, “You have to go to the dentist, you have to have this tooth pulled, it’s causing you a lot of pain and problems and it’s making you sick.” And they will wait. They’ll say, “RAM is in a few weeks, we’ll wait for that.” So ,they suffer and they get sick. They have abscesses in their mouths and they’ll wait.
Dr. Weber: This has been a big revelation for me Bill, to hear about the needs and neglect that there can be with respect to dental healthcare. I’m so glad to hear from you about this. We are going to talk with bill in one more segment after a short break. You’re listening to philosophy bakes bred- food for thought about life and leadership, a production of the society of philosophers in America. After a short break we are going to come back with our concluding segment with Dr. Myers. This is Dr. Weber with my cohost Dr. Cashio.
Announcer: Who listens to the radio anymore? We do. WRFL Lexington.
Dr. Weber: This is Dr. Eric Weber back in the studio. I realized in the last prerecorded segment we concluded, I concluded, by saying how glad I to learn from Bill how glad I was the neglect that he was explaining. I should clarify that I am glad to learn from Dr. Myers I am sad about the neglect. What am I glad about? Well one, I don’t revel in other peoples’ pain, but it’s important to learn and I appreciate that but we were hearing about some unfortunate types of neglect. I have some very good news for our listeners, especially for Matthew Akra. Matthew guessed correctly, or did research, probably, because he mentioned the internet. I said earlier that the Birmingham Letter is online so you could just search and find the answer. My question was, how many times did MLK mention Socrates by name in a Letter from a Birmingham Jail? And the answer, with Matthew got right before anyone else: was three. He mentioned Jesus eight times. Three is a big deal. Obviously he was a preacher, a minister, and his dependence and arguments based on Christianity were very influential and important, but at the same time, when you read a Letter from a Birmingham Jail you see how centrally important kings understanding of philosophy is for leadership. This is something I’ve written about but we don’t need to get into that. In any event, I wanted you to hear the correct answer, which is three. Letter from a Birmingham Jail is a remarkable letter that a man wrote in a prison cell and it is incredible. At the same time, it is worth nothing that, on MLK day, that MLK mentioned Socrates three times in a Letter from Birmingham Jail.
We’re going to come back in with a concluding segment from Dr. Myers. Thanks everybody for listening.
Dr. Eric Weber: Welcome back to Philosophy Bakes Bread. This is a production of the Society of Philosophers of America on WFRL Lexington 88.1, subsequently put out as a podcast. We have been talking with Dr. Bill Myers of Birmingham southern college on the subject of ethics and dentistry. And we now have in this last segment some final big picture questions to ask you, bill, as well as some lighthearted thoughts to show the softer side of philosophy, or the funnier side of philosophy. So we will end with also a pressing philosophical question that we want to ask our listeners. Then, of course, some information about how you all can get ahold of us with your comments, questions, criticisms, and bountiful praise…one hopes.
Dr. Cashio: One of our final questions comes from the inspiration for our show. Bill!
Dr. Myers: Yes.
Dr. Cashio: Would you say that philosophy bakes no bread, as the saying goes? Or would you say that it does bake bread? Is there any real life practicality at all?
Dr. Myers: Anthony, we have been baking bread for the last two segments.
Dr. Myers: …showing the importance of ethical integrity and everyday life. That is one place where philosophy bakes bread. That is only one place where philosophy bakes bread. I’ve been convinced by smart friends of mine that philosophy is the most useful major that any student can possibly choose for an undergraduate career. This is my 21st yr at Birmingham. We have had well over 50 graduates, and our graduates are fabulously successful at whatever they do. Only two of them are philosophers, by the way, Anthony Cashio being one of them. The others are doing all kinds of things- working in finance, teaching, running non-profits. They will tell you that their philosophy degree is the most useful thing that they could possibly have done. It teaches you to be adaptable, to think through problem clearly, to write, to communicate. Philosophy is the most useful thing that any student could possibly study. There.
Dr. Weber: There you go. Let me ask you a follow-up on that, Bill. For those people who aren’t in school or who aren’t yet, or who are on a path committed to another major, or they’re long past school- in a number of different scenarios- they have to work and can’t go to college- what are some ways that they can get into reading some philosophy, being exposed to it? Listening to this show as regularly as they possibly can?
Dr. Myers: This show is a good start.
Dr. Weber: What are some things people can do to learn a bit more about it if they’re not going to study it?
Dr. Myers: The resources out there are massive. There are online open courses- they’re everywhere out there. You can take a course in philosophy. I have a friend online who regularly takes these courses. Or, you know, go to the library and read a book; always the books.
Dr. Weber: What’s an example of a fun book someone who hasn’t read philosophy for might enjoy and get something from it?
Dr. Myers: Where would you start? I haven’t thought about that I a long time. There’s this little book that’s funny and educational? What’s it called, “Plato and a Platypus Walk into a Bar”? It’s an entertaining book, but it also teaches you some philosophy
Dr. Cashio: I have that book in my office.
Dr. Weber: It’s a long book, but it’s long and it’s accessible. It’s called Sophie’s World. Well, great! I just wanted to give some people a place to look. Plato and a Platypus Walk Into a Bar is what it’s called. If we find more we will share them on a podcast. The next segment we are going to move on to is called philosofunnies. As you know, Bill, we want people to see not only the serious side of philosophy but also the lighter side. In this segment, I want to invite you to tell us about dental ethics or just generally about philosophy- what’s a funny philosophy story or what’s a funny philosophy joke that you’d like to share with our listeners?
Dr. Myers: I have a very brief joke. What do you get when you gross the godfather with a philosopher?
Dr. Cashio: I don’t know. What do you get?
Dr. Myers: An offer you can’t understand.
Dr. Weber: Anthony, do you have a dentistry joke to close off this segment?
Dr. Cashio: I don’t know, Eric. I hear a good dentist is a little picky.
Dr. Weber: The other line is, you don’t have to brush all of your teeth just the ones you want to keep.
Dr. Cashio: Oh Eric, a good dentist never gets on your nerves.
Dr. Cashio: And last, but not least, we want to take advantage of the fact that today that we have powerful social media that allows two-way communications, even for programs like radio shows. We want to invite our listeners to send us their thoughts about big questions that we raise on the show.
Dr. Weber: Given that, we’d love to hear your thoughts bill on what question we should ask everyone after this segment. We will often put it at the beginning of every show in a segment called, ‘You Tell Me.’
Dr. Myers: Following up on my concern with dental ethics: When Reagan was president, he signed the emergency medical treatment act, which mandated that no one who goes to the emergency room be turned away, that they be treated accordingly to remediate their emergency. That effectively gives us a right to healthcare. Should there be a similar right to dental care?
Dr. Weber: This is not something just that president Obama or democrats pushed; this was something Reagan signed into law. It is a bipartisan push, at least there has been anyway, in the past for people to have access to healthcare. Will you ask again?
Dr. Myers: Sure. Emergency rooms are required to render medical treatment and they cannot turn away care from anyone who needs it. Should we have a similar right for dental care?
Dr. Weber: What are you all thinking? You may not remember how to get in touch with us but we’ll have information on that in a second.
Dr. Cashio: Thanks for listening to Philosophy Bakes Bread, questions about life and leadership. Your cohost Dr. Cashio and Dr. Weber are so grateful to have been joined by Dr. Myers. We hope you will consider joining us again. Consider sending us your thoughts about anything you’ve heard today, what you’d like to hear in the future, or about specific questions we’ve raised for you.
Dr. Weber: Again, you can reach us in a number of ways. You can contact us on twitter @philosophybb which stands for philosophy bakes bread. We’re also on Facebook at Philosophy Bakes Bread. Check out SOPHIA’s Facebook page. Our SOPHIA Facebook page is @philosphersinamerica.
Dr. Cashio: You can of course email us at philosophy bakes bread at gmail.com. You can also call us and leave a short, recorded message with a question, comment, or compliment that we may be able to play on the show at 859-257-1849. Join us again next time on philosophy bakes bread- food for thought about life and leadership
Dr. Weber: Hey folks, this is Eric Weber live in the studio. I’ve been playing you pre-recorded interviews and segments. One more time I want to say congratulations to Matthew Akra who has one a free Sophia t-shirt for answering first and correctly the fact that MLK mentioned Socrates three times in his famous Letter from a Birmingham Jail. Listen to us next week on Monday at 2 pm again on WRFL Lexington, which you can stream live at WRFL.fm/stream. Soon, I promise, we will have these episodes released as a podcast. Thanks for listening folks.