Tag Archives: science/technology

How Do Physicians and Non-Physicians Want to Die?

We’re celebrating the end of the year with our most popular posts from 2013, plus a few of our favorites tossed in.  Enjoy!

A recent RadioLab podcast, titled The Bitter End, identified an interesting paradox. When you ask people how they’d like to die, most will say that they want to die quickly, painlessly, and peacefully… preferably in their sleep.

But, if you ask them whether they would want various types of interventions, were they on the cusp of death and already living a low-quality of life, they typically say “yes,” “yes,” and “can I have some more please.”  Blood transfusions, feeding tubes, invasive testing, chemotherapy, dialysis, ventilation, and chest pumping CPR. Most people say “yes.”

But not physicians.  Doctors, it turns out, overwhelmingly say “no.”  The graph below shows the answers that physicians give when asked if they would want various interventions at the bitter end.  The only intervention that doctors overwhelmingly want is pain medication.  In no other case do even 20% of the physicians say “yes.”

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What explains the difference between physician and non-physician responses to these types of questions.  USC professor and family medicine doctor Ken Murray gives us a couple clues.

First, few non-physicians actually understand how terrible undergoing these interventions can be.  He discusses ventilation.  When a patient is put on a breathing machine, he explains, their own breathing rhythm will clash with the forced rhythm of the machine, creating the feeling that they can’t breath.  So they will uncontrollably fight the machine.  The only way to keep someone on a ventilator is to paralyze them. Literally.  They are fully conscious, but cannot move or communicate.  This is the kind of torture, Murray suggests, that we wouldn’t impose on a terrorist.  But that’s what it means to be put on a ventilator.

A second reason why physicians and non-physicians may offer such different answers has to do with the perceived effectiveness of these interventions.  Murray cites a study of medical dramas from the 1990s (E.R., Chicago Hope, etc.) that showed that 75% of the time, when CPR was initiated, it worked.  It’d be reasonable for the TV watching public to think that CPR brought people back from death to healthy lives a majority of the time.

In fact, CPR doesn’t work 75% of the time.  It works 8% of the time.  That’s the percentage of people who are subjected to CPR and are revived and live at least one month.  And those 8% don’t necessarily go back to healthy lives: 3% have good outcomes, 3% return but are in a near-vegetative state, and the other 2% are somewhere in between.  With those kinds of odds, you can see why physicians, who don’t have to rely on medical dramas for their information, might say “no.”

The paradox, then — the fact that people want to be actively saved if they are near or at the moment of death, but also want to die peacefully — seems to be rooted in a pretty profound medical illiteracy.  Ignorance is bliss, it seems, at least until the moment of truth. Physicians, not at all ignorant to the fraught nature of intervention, know that a peaceful death is often a willing one.

Cross-posted at Pacific StandardThe Huffington Post, and BlogHer.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Millennials and “Modern Sexuality”

Screenshot_2I had the pleasure of being a guest on Take Part Live last week with Sex Nerd Sandra and comedian Will Weldon.  We talked about millennials and “modern sexuality.”  Will talked technology, Sandra defends the “premeditated hook up,” and I asked host Cara Santa Maria to be my boyfriend.  Good times.  Here’s a clip!

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

The Curious Evolution of the Sign Spinner

In the midst of the recession a new occupation emerged: the sign spinner.  These individuals stood on sidewalks outside of businesses, dancing with signs or arrows that they threw and twisted in the air and around their bodies.  Some of them were pretty cool, actually.

Yesterday NPR discussed the replacement of some of these spinners with mannequins. Robots that are programmed to spin the sign.  Of course, they aren’t nearly as good as a halfway decent human sign spinner.  But, it was argued, they’re getting the job done.

From human to machine, then.  But no one commented on the bizarre race- and sex-change that accompanied this shift.  In my part of the country, most human sign spinners are black or Latino men.  I suspect that’s true wherever there’s a substantial non-white, non-Asian population.  But the mannequins appear to be overwhelming white women.

The Google image search for each somewhat supports this narrative.  The mannequins are overly white women and the humans are almost all men and, arguably, disproportionately men of color.

Google search for “sign spinners” (click to enlarge):

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Google search for “‘mannequin sign spinners”  (click to enlarge):

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Isn’t. This. Interesting.

When the business owner or manager can make choices about what race and gender they prefer, they choose white females.  Presumably because “sex sells,” the female body (in a bikini) is the universal symbol for sex, and white women are the most valuable commodity in that market.

When we’re hiring low wage human workers, however, business owners and managers have less control over the race and gender composition of their workforce.  It appears most would prefer to hire white women in bikinis for everything but, because of institutionalized racism and the sex segregation of occupations, they get men and, perhaps, men of color.

How amazing that something so simple — the evolution of the sign spinner — can tell us so much about who we value and why.

Here’s a commercial for the new robotic sign spinners, to drive the point home:

Cross-posted at Racialicious and Pacific Standard.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Beauty = White: Photo Editing Software Edition

Here is something quite simple, sent along by Judy B.  It’s a screenshot of Gimp, an open source image editing application.  An optional plug-in, created by a user, offers a series of filters for images, including ones that “beautify.”  One of the options is “skin whitening.”

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This is one more reminder that we live in a racist society that conflates whiteness with beauty.  Remember, too, though, that someone — very possibly a set of people — had to make a conscious decision to include skin whitening as an option and position it as a sub-category of beautification.  Then they had to, literally, type the words into the program and make it so.

This shit doesn’t just happen.  It’s not random.  Racism isn’t just an ephemeral cultural thing.  It involves actual decisions made by real people who, if not motivated by racism, are complicit with it.

Cross-posted at Racialicious.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Does Europe Have a Sex Selection Problem?

Excess under age-60 female mortality in less developed countries is estimated to add up to 3.9 million missing women worldwide (World Bank, 2011).  A large proportion of this is due to sex-selective abortion practices.  The practice occurs most commonly among poorer families in societies where boy children are given greater economic and social status than girl children. In such a context, the transition to smaller families can lead parents to choose boys over girls. Notably, female fetuses are most likely to be aborted when the first child born is a girl.

The table below shows the countries with the most skewed ratios at birth in the world. While there is naturally a slightly higher sex ratio of boys to girls — between 1.04-1.06 — ratios above that are considered to be altered by technology due to gender preferences for boy children.

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The reason we find this newest 2013 data of particular interest is that, despite the popular Western focus on Asia, the practice occurs in more European countries. Perhaps most striking is the central European country that ranks at the top of the list—Liechtenstein. This strikes us as odd, given that Liechtenstein has never made this list in the past. Perhaps this is a data collection error (in very small populations, as also in Curacao, the results can be skewed). But we are surprised that no journalists have picked up on the fact that the worst offending son-preference country in the world is now, allegedly, a European country.  We contacted the CIA to ask them about this possible data anomaly but have not yet heard back.*

On the other hand, if the Liechtenstein data is accurate, this would be a very interesting story indeed, especially since Liechtenstein has the most restrictive laws against abortion in Europe.  A quick scan of gender equity policies in Liechtenstein shows that women there were not legalized to vote until 1984, indicating that it is not the most gender egalitarian of European countries.

In any case, whether Liechtenstein’s inclusion in this disreputable list is a data error or not, the other European countries on the list are legitimate.  They have been high for many years, and a recent report on Armenia, for example, documents longstanding norms in gender preference.  The disproportionate focus on birth sex ratios in China and India no doubt reflects their status as the #1 and #2 most populous countries, which means a much greater overall impact in sheer numbers.  Nevertheless, our point stands.  Why has the disproportionate inclusion of non-Asian countries on the above-list gone virtually unmentioned by journalists?

Do Developed Western Countries Prefer Boys?

Americans often think of parental sex preference as a thing of the past, or a problem in developing countries. After all, the U.S. sex ratio at birth falls in the normal range, at 1.05. This is in spite of the curious American cottage industry in sex-identification home use kits, such as the Intelligender, the GenderMaker and the Gender Mentor.

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In surveys, American parents report an ideal of two children and equal preference for boys and girls. However, American gender preferences manifest themselves in more sneaky ways. A 2011 Gallup poll showed that, if they were only able to have one child, the highest preference was for a boy.  These results are little changed from the same Gallup question asked of Americans in 1941.

To return to a point made in an earlier post on skewed sex ratios, Americans may not be so different, after all, in their gender preferences from the countries in the above table.  The crucial difference, she noted, is that some Asian countries are more enabled to act on their boy preference than others. It appears we should now be including some European countries in that “enabled” group as well.

* Neither the United Nations, Population Reference Bureau, nor the World Bank have published 2013 statistics yet for comparison to the CIA data.

Jennifer Lundquist is an associate professor of sociology at the University of Massachusetts, Amherst who specializes in stratification and social demography.
Eiko Strader is a PhD student in sociology at the University of Massachusetts, Amherst who studies inequality in labor markets and the welfare state.

Apple’s Seductive Brand Promise: Cultural Capital & Social Mobility

Screenshot_1This is the fourth post in a four part series.  Start at the beginning with: Whimsical Branding Obscures Apple’s Troubled Supply Chain.

Despite the recent scandals regarding Apple’s business practices, it has succeeded at cultivating a brand to which we feel positive emotional attachment. In three previous posts, I showed that the company accomplishes this with commercials that associate its products with playfulness, sentimentality, and cool youthfulness.  The most prominent theme, however, and I suspect the most powerful aspect of the company’s emotional branding strategy, is the hope it cultivates in each of us of who we could be by virtue of using the company’s products.

Taken together, the whole of Apple’s advertising campaigns suggest that, if we use their products, we will be our hippest, coolest, most creative, intelligent, adventurous, socially engaged, and admired selves. The idea of Apple users as standouts from the masses was introduced in the company’s first commercial that aired only once, during the 1984 Super Bowl broadcast:

In this commercial Apple attacks the “boring” IBM and its “mindless” users controlled by a televised ruler in an Orwellian dystopia.  It also suggests that there is something special about the company and its products that will allow it, with the help of its customers, to change the course of history. A commodification of the counter-cultural ethos of the 1960s and ‘70s, this theme was prominent in the first few years of the company’s advertising, but went dormant during Steve Jobs’ 12-year hiatus. It was resurrected in 1997 when Jobs returned to the helm of the company. The now iconic and much revered commercial titled “The Crazy Ones” launched the company’s slogan “Think Different” into our vocabulary, and helped reposition the company, then floundering, onto its path to meteoric financial growth:

With ads like these, Apple doesn’t suggest that one will become Mahatma Ghandi, Amelia Earhart, or Pablo Picasso per se, but that daring to be different (by purchasing an Apple product) opens up the possibility for one to do great things.

This trend continues today in commercials that appeal to our desire to be valued and admired as artistically creative, culturally relevant, and intellectually engaging. Apple’s commercial for the iPhone 4S and Siri, titled “Rock God”, aired in 2012 and exemplifies this trend:

Others, like the “iPad is Amazing” commercial that introduced the device in 2010, speak to how iPad users will be intellectually, culturally, and professionally engaged and valuable people for using the device:

Commercials like these emphasize that Apple products are tools for self-development. By providing the opportunity to learn, create, and share, Apple products facilitate the expression of one’s unique, individual, and socially valued identity. In today’s digitally mediated world where social networking is the norm, the promise of such narcissistic pursuits and outcomes is a key part of Apple’s brand strategy. “Be your best 21st century you!”, recent ads seem to shout.

In this sense, Apple products offer consumers the opportunity to increase their cultural capital. Social theorist Pierre Bourdieu defined cultural capital broadly as one’s accumulated knowledge and skills. Commercials like those above for the iPhone and iPad suggest that Apple helps its customers bolster their cultural capital and raise their social standing. In a time when we are all tasked with marketing and selling ourselves to make it in the world, commercials like these amount to a message about personal and financial success. This is a powerfully seductive promise.

Is it any wonder that news of worker abuse, poisoning, and workplace suicide fails to compromise the company’s financial standing? In fact, in the immediate aftermath of negative reports about its Chinese supply chain in early 2012, Apple went on to post record sales of iPhones and iPads. Most recently, a report by China Labor Watch that documents unlawful, unsafe, and abusive work conditions at Pegatron facilities throughout China has been popularly interpreted by the tech community and mainstream journalists as exciting news that a “cheap iPhone” is on its way. As I pointed out in my first post  in this series, Apple’s ability to obscure with its brand promise the environmental degredation and human rights abuses within its supply chain is commodity fetishism at both its best and its worst. Behind that beautiful fetish of aluminum and glass lies the reality of globalization.

Nicki Lisa Cole, Ph.D. is a lecturer in sociology at Pomona College. She studies the connections between consumer culture, labor, and environmental issues in global supply chains. You can follwer her at 21 Century Nomad, visit her website, and learn more about her research into Apple here.

Be Young, Be Cool, Be Happy…as an Apple Consumer

Screenshot_1This is the third post in a four part series.  Start at the beginning with: Whimsical Branding Obscures Apple’s Troubled Supply Chain.

I cannot watch this 2003 Apple iPod commercial without shaking my hips, even in the midst of delivering a lecture or conference presentation. In fact, I struggle deeply to refrain from jumping around in an ecstatic dance of joy.

This commercial moves me. But, why? Yes, it has rocking music and popping colors. But, I suspect, more importantly, it has hip young things gyrating to the music, lost in the euphoria provided by an iPod and earbuds, with seemingly no cares in the world. For four years Apple aired a string of these, which became known as the “Silhouette” commercials, each featuring a different soundtrack and style of dance. In my previous posts, I’ve focused on two important elements of Apple’s brand promise: whimsicality and  sentimentality. In this post I spotlight another key finding from our research: the association of Apple products with coolness, hipness, youth, and a carefree attitude.

This trend was introduced into the brand by the iPod commercial above, and it continues to be an important part of Apple’s brand promise today. Similar qualities are present in this ad from early 2012, titled “Road Trip,” which showcases the utility of the voice-activated assistant, Siri, on the iPhone 4S:

And, early this summer, Apple released this commercial that emphasizes the musical enjoyment that an iPhone can provide:

This ad, which seems a re-imagining of the “Silhouette” campaign, depicts these young, fit, and beautiful iPhone owners as indulgent in their passions, carefree, too cool to care about dancing in public, and thus hip, energetic, and fun to be around.

These three ads and the many like them in Apple’s oeuvre suggest that the product makes users spontaneous, proud to embrace their unique individuality, and happy to “let their freak flag fly,” so to speak. In this case, the brand promises uninhibited enjoyment. With their bouncing, lithe bodies and shiny, happy faces, these Apple users are the epitome of cool in today’s American culture.

Like the promise of playfulness, and sentimental connection to others, this aspect of Apple’s brand promise acts as a powerful fetish, in the Marxist sense, that obscures the troubling labor conditions and environmental pollution in the company’s Chinese supply chain. Who has the presence of mind to think about global social, economic, and environmental problems when they are busy rocking out, road-tripping, and dancing in the shower?

Next: Apple’s Seductive Brand Promise of Cultural Capital & Social Mobility.

Nicki Lisa Cole, Ph.D. is a lecturer in sociology at Pomona College. She studies the connections between consumer culture, labor, and environmental issues in global supply chains. You can follwer her at 21 Century Nomad, visit her website, and learn more about her research into Apple here.

Sentimental Consumerism, the Apple Way

Screenshot_4This is the second post in a four part series. Start at the beginning with: Whimsical Branding Obscures Apple’s Troubled Supply Chain.

In a recent post on the Apple brand and its cultural significance, I drew on my study with Gabriela Hybel of over 200 Apple television commercials aired between 1984 and the present to argue that Apple excels at what branding experts refer to as “emotional branding.” I pointed out that Apple commercials cultivate happiness through whimsical depictions of products and their users. In this post I focus on another key finding from this research, which is the prominence of sentimentality in Apple commercials. Both of these things — whimsicality and sentimentality — are key parts of the promise that Apple makes to its customers.

To this end, an important part of the promise that Apple makes to its customers is that using their products will strengthen the customer’s relationships with loved ones, and that the customer will experience positive emotions because of this. This trend, like playfulness, can be traced back to a commercial for the iMac and iMovie that aired in 2000:

Sentimentality features heavily in commercials for iPads and iPhones that have aired over the last few years. In the “I’ll be home for Christmas” ad for the iPad and iPad Mini, which aired in 2012, Apple technology provides the platform for the development of a seemingly long-distance relationship between a young girl and her grandfather:

A commercial that debuted just a month ago drips of sentimentality as it illustrates how Apple products strengthen our relationships with loved ones, near and far. But, also, and importantly, the commercial emphasizes the experiential aspect of the brand in a way that appeals to our desire to feel positive emotions:

With its subtly slowed motion, time and experience are stretched out in this commercial.  Regarding the company signature that appears on products, the narrator states, “You may rarely look at it, but you’ll always feel it. This is our signature. And it means everything” (emphasis added).

Apple product users are living in the moment, soaking up all the sentimental experiences of pleasure, love, satisfaction, and jubilation that the brand promises, and that the products appear to deliver upon. This promise is what sells Apple products. It shows us what we can have if we make the purchase, and in doing so, convinces us to turn a blind eye to the labor and environmental abuses in the company’s Chinese supply chain.

Next:  Be Young, Be Cool, Be Happy…as an Apple Consumer.

Nicki Lisa Cole, Ph.D. is a lecturer in sociology at Pomona College. She studies the connections between consumer culture, labor, and environmental issues in global supply chains. You can follwer her at 21 Century Nomad, visit her website, and learn more about her research into Apple here.