4.4: Problems as Product

So far we’ve been thinking about problems as central to the process of developing a complex argument. The good news is problems can do double duty for us: articulating complex problems and posing fruitful questions is not only part of the process, but it is also part of the product. That is to say that most nonfiction opens with a problem that leads to a question. Below are a few examples of introductions that present problems, raise fruitful questions, and identify what is at stake. Notice that in some cases, it takes more than one paragraph to accomplish these three steps.

What follows is an excerpt from the dust jacket for Michael Pollan’s The Omnivore’s Dilemma, which was named by The New York Times as one of the ten best books in 2006:

What should we have for dinner? For omnivores like ourselves,
this simple question has always posed a dilemma: When you
can eat just about anything nature (or the supermarket) has to

offer deciding what you should eat will inevitably stir anxiety,
especially when some of the foods on offer might shorten your
life. Today, buffeted by one food fad after another, America is
suffering from what can only be described as a national eating
disorder. The omnivore’s dilemma has returned with a
vengeance, as the cornucopias of the modern American supermarket
and fast-food outlet confronts us with a bewildering
and treacherous food landscape. What’s at stake in our eating
choices is not only your own and our children’s health, but the
health of the environment that sustains life on earth.

This common and seemingly simple question—what should we have for dinner?—turns out to be not so simple at all. According to Pollan, behind this question is a national problem. This jacket blurb promises to present the complexity of the problem and pursue the question about what we should eat, and it also explicitly articulates the stakes of this question. The stakes in this case—the health of our children and the environment—are no small potatoes. Nonetheless, it is worth noting that Pollan is not asking the food question with the highest stakes: millions of people across the world do not have the luxury of deciding what to have for dinner because they do not know where their next meal will come from; how do we prevent the starvation of millions? There’s a strong allure to ask the question with the highest stakes, and it is obviously important that people out there are asking these questions and working to solve these problems. It is also important to realize that smaller problems and questions are worth pursuing, and pursuit of these smaller questions in our everyday life can help us chip away at larger problems. Pollan’s question ultimately suggests that individual actions can have large-scale implications.

The next excerpt comes from an article published in the New England Journal of Medicine entitled, “Should Physicians Prescribe Religious Activities?”:

There is increasing interest among the general public and the
medical community in the role of religion in medicine. Polls
indicate that the U.S. population is highly religious; most
people believe in heaven and hell, the healing power of prayer,
and the capacity of faith to aid in the recovery from disease.
The popular press has published many articles in which religious
faith and practice have been said to promote comfort,

healing, or both. A report that 77 percent of hospitalized patients
wanted physicians to consider their spiritual needs is
consistent with this trend.

Interest in the connection between religion and health
has also emerged in the medical community. The National
Institute for Healthcare Research, a privately funded, nonprofit
advocacy organization, has published extensive literature
reviews suggesting that religious faith and practice are
positively associated with health status. The organization’s
World Wide Web site encourages physicians to pay more attention
to religious matters and recommends that they take a
spiritual history at the time of each complete physical examination,
with any concerns raised by patients addressed during
follow-up visits. In addition, the National Institute on Aging
and Harvard Medical School sponsor meetings on the integration
of spirituality and medical practice. A survey of family
physicians found that they strongly support the notion that
religious beliefs can promote healing. Some physicians believe
that going to church promotes health, argue for spiritual and
religious interventions in medical practice, hope that the wall
between medicine and religion will be torn down, and assert
that “the medicine of the future is going to be prayer and
Prozac.”

Nearly 30 U.S. medical schools now offer courses on religion,
spirituality, and health. The American Association of
Medical Colleges has cosponsored a conference entitled “Spirituality
and Medicine: Curricular Development” for the past
three years, and each year it has attracted more than 100 physicians,
faculty members, and chaplains from hospitals and
medical schools throughout the United States.

As chaplains in health care settings, representing a wide
range of religious traditions, and as biomedical researchers,
we are troubled by the uncritical embrace of this trend by the
general public, individual physicians, and American medical
schools. We are concerned that broad generalizations are being
made on the basis of limited, narrowly focused, and methodologically
flawed studies of the place of religion in medical
practice. These generalizations fail to recognize the diversity
among physicians, patients, and practice settings and fail to

distinguish between superficial indexes of religiousness, such
as self reports of church attendance, and personal religious
motivation. Such generalizations will lead to considerable
confusion until more and better research is done. (1913–14)

In “Should Physicians Prescribe Religious Activities?,” Richard P. Sloan and Emilia Bagiella, et al. identify a significant problem in how medicine is practiced in America: the medical community has embraced the notion that religion plays a beneficial role in practicing medicine despite a lack of concrete evidence. The first three paragraphs pile up evidence of the medical community’s uncritical acceptance of religion’s curative powers. The question that emerges directly out of this problem is: “why should or shouldn’t physicians prescribe religious activities?” You may have noticed that the title of the article simplifies this question into a snappy title by posing it as a yes/no question, but the essay pursues a fruitful “why” question. The article goes on to articulate several reasons why physicians should not prescribe religious activities. It urges physicians to stop recommending religious activity until more and better empirical studies are conducted. The stakes of their question are articulated in the final sentence of the introduction: confusion among the medical establishment and patients will spread if the question is not answered.

Here’s one final example written by Johan, a student in my composition class at Columbia University. Johan happened upon this problem after reading an article by Steven Pinker published in the New York Times Magazine entitled “The Moral Instinct”:

You have two options: 1) wait in an endless queue for a kidney
donation or 2) ask a friend or relative to donate a kidney.
This was the dilemma Sally Satel, a 49 year old psychiatrist in
Washington, was facing. She had been given a death sentence
and the only possible appeal was to get a kidney transplant.
This does not seem to be an insurmountable problem since
“theoretically, kidneys should be in booming supply. Virtually
everyone has two, and healthy individuals can give one
away and still lead perfectly normal lives” (Satel 1). The National
Organ Transplant Act of 1984, however, prohibits the
sale of organs, leaving those in need of an organ to rely on
altruistic donation. Sally found this very upsetting: “it was
about the very fact that an organ had to be a gift” (Satel 4).

Sally’s emotional reaction may be understood in light of the
fact that her friends decided against donating a kidney to her
and that “since 1999 more than 30,000 U.S. patients with
kidney failure have died waiting for an organ that never arrived”
(Hippen 2)—in short, altruism alone, as it now stands,
is not enough to satisfy the demand of the many patients, like
Sally, who urgently need an organ.

The majority of academic articles that discuss organ trading
argue for legalizing a market in organs. Steven Pinker, a
prominent experimental psychologist, asserts, however, that
the general public considers organ trading taboo (38). This
discrepancy in opinion between medical researchers and the
public could be explained from the perspective that these researchers,
unlike the public, have centered their arguments
upon cost-effectiveness and number of lives saved rather than
on morality per se. For example, Arthur J. Matas University
of Minnesota, Minnesota, MN and Mark Schnitzler at the
Washington and Minnesota Schools of Medicine respectively,
found that organ trading could save “$94,579 (US dollars,
2002) [per kidney vended], and 3.5 quality-adjusted life
years” (1). Benjamin E. Hippen, a transplant nephrologist in
North Carolina, also argues for the cost and medical benefits
of organ trading (1). However, scientific data by itself is not
normative and cannot tell us what we should do—which is
what Hippen is trying to do: “The National Organ Transplantation
Act of 1984 which prohibits the sale of organs
should be repealed” (1).

If these proponents wish to repeal the organ act, they will
have to discuss the moral element of organ trading. They will
have to discuss how this moral obstacle against organ trading
can be overcome or appeased. After all “millions of people are
suffering, not because the organs are not available, but because
morality does not allow them to have access to the organs”
(Kishore 362). What argument should the proponents construct
to make organ trading compatible with morality? What
argument will encourage the public, who consider organ trading
taboo—that it is even too sinful to think about—accept
it as morally defensible? An answer to this question will either
bring an end to a “terrible policy failure” and of “human lives

unnecessarily lost” (Hippen 1) or give us a more nuanced and
rational rejection of the concept of organ trading—something
that the many people dying from a lack of donor deserve.

The problem Johan has uncovered in his essay entitled “Organ Trading: Supply and Demand Meets Morality” is multi-layered. First, people in need of organ transplants are dying because there are not enough organs available. Second, despite the fact that donating an organ is a safe procedure, people are reluctant to donate even to close friends. Third, while the academic community is overwhelmingly in favor of organ sales, the general public on the whole rejects the practice. The third problem is the one that leads to his paper’s fruitful questions: “What argument should the proponents construct to make organ trading compatible with morality? What argument will encourage the public, who consider organ trading taboo—that it is even too sinful to think about—accept it as morally defensible?” Johan articulates what is at stake explicitly at the end of his introduction by identifying what will be gained if this question is answered.

Each of these texts offers a useful model for how to present rich problems, pose fruitful questions, and articulate what is at stake in an inquiry. Reading texts this way not only provides you with approaches you can imitate, but it will also help you read more effectively. Studies suggest that reading texts on unfamiliar topics in unfamiliar fields can have a disorienting affect on a reader, making comprehension more difficult. Much of what you read as a college student is unfamiliar in content and form and requires a more attentive, deeper read. One way to get your bearings is to approach an unfamiliar text by identifying its purpose. Once you’ve identified an author’s problem and question, you’ll have a better handle on the rest of the text.