Beware the Jackalopes.

Abstract

Philosophers of science deploy mathematical models to describe epistemic communities, or groups of people creating and sharing knowledge for individual and collective purposes. These models capture in simplified terms experiences that are familiar to us all. For example, that there are times when one holds a belief but cannot determine how to convince someone else to hold it too, despite the conviction that the belief is justified from good evidence and analysis. One key finding from this research is how it describes states of polarity and conformity that emerge when people put forward claims that are candidates for belief (O’Conner and Weatherall 2019). As a social activity, the pursuit of knowledge can result in the formation of polarized groups, as it has in reproductive health care. People share information as they socialize, seeking to accrue knowledge, to display membership in social groups, or both. Camps form in the process, such as the “pro-choice” and “antiabortion” camps, also known as “pro-abortion” and “pro-life,” to use differently loaded terms. Network models of epistemic communities suggest that this polarization can be described in terms of “clumpy” communication networks (O’Conner and Weatherall 2019, 56ff). That is, there are factions, cliques, or “clumps” of believers and few connections between the cliques. When this happens, false beliefs take root in one or more camp because there are so few connections between them for the transmission of justified beliefs from one group to another. A telling example comes from the infamous story of Ignaz Semmelweis, the Hungarian physician who believed that handwashing reduced the incidence of puerperal fever during childbirth. His colleagues rejected these beliefs and childbearing women and children died from infections due to poor hand hygiene. We now know Semmelweis was right. His colleagues were not. But they formed a clique of believers that would not be swayed for decades, until eventually enough evidence was gained to persuade future physicians that handwashing improves mortality (O’Conner and Weatherall 2019, 73–79). As an occasional expert witness for plaintiffs responding to state legislation involving restrictions on reproductive healthcare, I have experience trying to connect clumpy communication networks. My role is to provide an analysis for the court, and to explain to judges the ethical implications of proposed restrictions on individual liberties in reproductive health care. My approach is to use methods of reasoning that are canonical in academic and clinical bioethics, where we provide an ethical analysis that refers to a common morality, in a proceduralist sense, and then justifies mid-level or low-level ethical conclusions by reasoning about how the principles rightly apply to the circumstances. Consequently, I have always testified that specific legislation restricting reproductive health care I have analyzed is unethical because, based on these principles, the restrictions undermine women’s autonomy to make medical decisions, fail to offer them benefits, harm them, and are unjust and inequitable. Typically, when I provide expert witness testimony, another expert witness provides an alternative analysis for the state, arguing that restrictive legislation is ethically permissible or even preferable. Bioethics is rightly a deeply pluralistic field, and so different ethical analyses of state restrictions of reproductive health care decision making are to be expected and are valuable. However, I have recently encountered something