What to give them? Dr. Ewing Cook would know. Mulderick had worked with Cook for two decades, going back to her time as head nurse in the ICU. She knew he believed that certain drugs exist to relieve suffering. Unlike many doctors, he didn’t shy away from ordering them. For years as a pulmonologist he had helped patients who were taken off life support die without pain and anxiety. Cook believed in making dying patients comfortable. Also, we can focus on causes at different spots along a very long timeline. Some causes are more immediate or proximal in nature; that is, closer in time to the event itself. Most causes offered up by biologists, psychologists, and sociologists are of this nature. Some causes are distal in nature—that is, further away in time from the event itself. Causes from a historical or evolutionary perspective can be distal in nature. Historical causes can be considered distal because they occurred in the distant past, perhaps many centuries ago. Evolutionary explanations are distal because they concentrate on why a phenomenon, such as asexuality within humans, may have evolved during a time in the natural history of the species, and/or why this phenomenon may have conferred an adaptive advantage (or at least not a disadvantage) across time. Some causes are so distal as to be construable as “ultimate.” Thus, one might argue that the Big Bang or God is the ultimate or first cause of everything, including human asexuality. Such ultimate causes may be correct in a broad sense, but they are often not particularly useful in the science of understanding current events or in understanding differences between people in the here and now.{Like micro and macro causes, distal and proximate causes are not necessarily incompatible, as they can also coexist at different points along a (potentially very long) causal stream or pathway for a given phenomenon. For example, an evolutionary cause of gender differences in sexuality is that during human evolution, men and women developed different mating strategies. Women developed a more cautious mating strategy to maximize their large parental/reproductive investment (relatively few eggs, nine months of gestation). Men developed a more risky and indiscriminate mating strategy to maximize their small parental/reproductive investment (cheap, replaceable sperm). A compatible proximate explanation is that these different mating strategies are caused by hormone levels affecting sex drive, with women exhibiting lower levels of testosterone and a lower sex drive than men. Sometimes evolutionary causes are construed as thewhys, and proximate causes as thehows, of events and phenomena.} The third critical caveat of Rose’s logic is that it makes it effectively impossible to challenge the underlying science once it is invoked to defend a particular hypothesis, one that is said to benefit the public health. Policy and the public belief are often set early in a scientific controversy, when the subject is most newsworthy. But that’s when the evidence is by definition premature and the demand for clarification most urgent. As the evidence accumulates, it may cease to support the hypothesis, but altering the conventional wisdom by then can be exceedingly difficult. (The artificial sweetener saccharine is stillwidely considered unhealthy, despite being absolved of any carcinogenic activity in humans over twenty years ago.) Rose’s logic demonstrates why good science and public policy are often incompatible. The ability to imagine smells, in normal circumstances, is not that common—most people cannot imagine smells with any

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