2026-01-12 20:30:00
There’s a familiar mood in American life right now, a frustration that feels both personal and ambient. The bridge doesn’t get fixed. The train line doesn’t get finished. The housing never gets built. The permits drag on. The timelines slip. The price tags balloon. And even when everyone agrees in principle that we really, really need to get things done, the system still can’t move.
Marc Dunkelman thinks that sense of paralysis isn’t a mystery, and it isn’t just a product of polarization or bad politicians. In his 2025 book Why Nothing Works, he argues that the deeper problem is structural.
Over the last half-century, we’ve built a governing regime designed to stop government from doing harm. And it largely succeeded. But it also made government far less able to do good, especially at scale. Progressives, Dunkelman argues, can’t explain away this crisis by pointing only at conservatives and lingering Reagan-era anti-government ideology. If the left wants to use government to solve big problems, it has to be willing to rebuild government’s ability to execute.
I invited Dunkelman onto The Gray Area to talk about that tradeoff between democracy’s need for participation and accountability, and its equal need for empowered institutions that can actually deliver. We talk about the founding tension between Jeffersonian suspicion of centralized power and Hamiltonian faith in state capacity, why the mid-20th century was the high point of American “building,” and how well-intended reforms created a procedural thicket where “everyone has a voice” slowly became “everyone has a veto.”
As always, there’s much more in the full podcast, which drops every Monday, so listen and follow us on Apple Podcasts, Spotify, Pandora, or wherever you find podcasts.
This interview has been edited for length and clarity.
Your book’s called Why Nothing Works. Are you arguing that America’s broken?
I’m trying to connect with people who feel frustrated that a country that used to do big things now seems incapable of doing even the mundane. That frustration feels like a clue that something deeper’s gone wrong in American governance.
You frame this as a tension any democracy has to manage: Citizens need a real say, but government also needs enough authority to make big decisions and execute them. You trace that tension back to the founding, and you map it onto Hamilton and Jefferson. What’s the basic story?
From the beginning, America’s caught between two impulses; one is fear of centralized power. Jefferson writes the Declaration of Independence out of the sense that a distant bureaucracy is coercing colonists and that freedom means getting out from under that.
After independence, the founders built a system under the Articles of Confederation. It’s essentially the anti-empire model: Power is dispersed, there’s no real executive, and any state can effectively veto national action. It’s like a government run entirely by filibuster, except any state can do it.
Within a decade, people realized that the system produces chaos. Power’s so dispersed that government can’t function. So they tried again in 1787 with the Constitution, which is an attempt to strike a balance. Hamilton’s side is basically if you want a pluralistic society to make decisions, you need a stronger center. You need institutions that can act.
But that tension between liberty and authority isn’t uniquely American. Is there something distinct about the American aversion to state power?
I don’t think disagreement and distrust are unique to America. Any group of people has to figure out how to make decisions when everyone wants something different.
My wife and I have two daughters. Imagine it’s Friday night, nobody wants to cook, and everyone wants something different for dinner. One kid wants fried chicken sandwiches, the other wants doughnuts, and my wife wants something healthy. You’ve got to pick a restaurant or you’re going to starve. That’s democracy in miniature. What’s the system for resolving disagreement? Do you vote? Does anyone get a veto? Do you rotate? The stakes are smaller, but the problem’s the same.
Where America is distinctive is that our system’s built in a way that lets us swing between extremes. Sometimes we empower authority too much, like in the mid-20th century. Sometimes we disperse power so much that nothing happens, like now. We’ve got a tendency to oscillate.
A lot of distrust in government didn’t come out of nowhere, though. Vietnam, Iraq, Watergate, institutional racism, corporate capture, pollution, corruption. Isn’t the current predicament less about irrational distrust and more about a public that’s seen enough?
You’re right that these swings are responses to real conditions. There are moments when people feel government can’t do anything and they want more capacity. There are other moments when centralized institutions look oppressive and people want checks.
At the turn of the 20th century, politics is dominated by machines. You can get favors if you know the right local person, but you can’t build strong systems at scale. That pushes reformers toward more centralized professional administration.
Then you get the mid-century era of powerful institutions doing things people start to hate. You’ve got industry putting out unsafe products, agriculture using chemicals with devastating consequences, technocrats sending kids to Vietnam, big city bosses entrenching segregation, figures like Robert Moses bulldozing neighborhoods. People look at that and say, This Hamiltonian model isn’t just efficient, it’s also abusive. And that helps produce the progressive turn, starting in the 1960s and 1970s, toward constraining state power.
So when did we get the balance right? When was the “high-functioning” window?
It’s hard not to look at the Tennessee Valley Authority and see a high point of state capacity.
The TVA was created in the early New Deal. The upper South had been left behind. Private power companies didn’t want to build poles and wires for poor farmers because they didn’t think it’d pay off. So people stayed in poverty.
Roosevelt decides to use public power to electrify the region, and he empowers the TVA to act at enormous scale: dam rivers, reforest mountains, build power plants, lay transmission lines, sell subsidized appliances. In an incredibly short period of time, a region roughly the size of England is transformed.
It wasn’t perfect. There were real costs, including environmental consequences and segregation in the workforce. But it’s an example of government doing enormous good fast, at scale, in a place where the market wasn’t going to deliver.
What’s an analogous project today, something on that scale that we can’t do because the system’s too jammed up?
Clean energy is the obvious one. We’ve got the technology to replace fossil fuel generation. We’ve got wind, solar, batteries, transmission tech. But the obstacle isn’t the science. It’s that you can’t build the transmission lines. Everyone has an objection — not through this forest, not near that school, not across this town, not if it shuts down that plant, not if it doesn’t directly benefit me.
High-speed rail is another obvious example. You see what other countries do and you think: Can we really not build a line between Los Angeles and San Francisco?
I’ll give you a more specific case that feels very much like the TVA in miniature. The Biden administration put $7.5 billion into the bipartisan infrastructure law for electric vehicle chargers. It’s a smart idea because there’s a catch-22: Companies don’t want to build chargers where they won’t be used, and people don’t buy EVs because they’re worried they’ll get stranded.
But there’s no public workforce now like the TVA had. So the money gets distributed through state highway departments. Those agencies know how to pave roads and build bridges, but they don’t know how to site EV chargers, negotiate leases, coordinate utility hookups, run the bidding process, and manage all the veto points.
So after years, you end up with something like 58 chargers opened. It’s a political disaster, and it’s not because people are lazy or stupid. It’s because the system’s been built to make implementation incredibly hard.
Help me connect the dots. Conservatives have always distrusted state power. But progressives are supposed to be the builders, the people who believe in government. How did the pendulum flip?
A big part of the story is Robert Caro’s The Power Broker, which won the Pulitzer in 1975. It’s about Robert Moses, the most powerful man in New York from the 1930s through the 1960s. Moses builds highways, housing, Lincoln Center, massive infrastructure. He really shaped the city.
The most famous chapter is about the Cross Bronx Expressway. Moses drives a trench through a working-class neighborhood in the South Bronx, displacing thousands of people. Communities beg him to move the route a few blocks. The mayor’s against it. Moses doesn’t care. He has the power and he uses it.
People look at this and say we need to stop Moses. We need environmental reviews, historic preservation rules, community input requirements, civil rights protections, rights of action so people can sue. The goal is to prevent top-down abuse. And it worked, in the sense that it made it harder for someone like Moses to bulldoze a neighborhood. But it also helped create a system where it’s hard for anyone to do good things, too. By design, we made change incredibly difficult.
“By design, we made change incredibly difficult.”
So it’s a rational response that eventually becomes self-defeating. You stop Moses, but you also stop Penn Station from getting fixed.
Exactly. The question I ask is: Why could nobody stop Moses in the 1950s, and then 50 years later we can’t fix Penn Station, one of the busiest transit hubs in the hemisphere. It’s the same underlying dynamic. We created a governance structure with too many veto points.
Some people will hear this and say that you’re blaming progressive reforms for dysfunction, while downplaying the conservative project to deliberately make government fail.
Conservatives absolutely play a role. But that story has become so dominant in progressive thinking that it gives us a pass. It lets us avoid self-criticism.
It also becomes a kind of political fatalism. If the story is always “Reagan broke everything,” then the only strategy is to win elections and hope. But if your pitch is that government should solve big problems, you’ve got to make government work in the places where it already has a mandate. Otherwise people won’t trust you with bigger ambitions.
What are the main policies and legal structures that jam things up now? NEPA comes up a lot. Is that ground zero?
NEPA is high on the list. It’s the National Environmental Policy Act, passed in 1970. It was originally meant to require project planners to consider environmental impacts and alternatives. In practice, it became a procedural litigation engine.
The key shift is that the legal question often isn’t whether a project’s impacts are worth it. It’s whether the study addressed every conceivable impact and alternative thoroughly enough. So agencies produce thousands and thousands of pages to anticipate lawsuits. It becomes a game: not “is this project good,” but “is the paperwork lawsuit-proof.”
And NEPA’s just one piece. There’s a whole regime of rules, mandates, and jurisprudence layered over decades. The cumulative effect is paralysis.
But who decides? Who has legitimate authority to make trade-offs that will anger people?
It’s got to be people inside government with discretion and accountability. In Moses’s era, you had “Moses men,” career public servants who stayed in jobs for a long time, took pride in building things, and had real authority. Today, a young public servant might enter government wanting to solve problems and end up spending their career managing risk, following rules, anticipating lawsuits, and trying not to get punished. They can spend 20 years and not feel like they made progress on the thing they entered government to do.
We need public institutions that aren’t oblivious to community concerns the way Moses was, but that also have enough discretion to make decisions in the public interest. The details are hard, but that’s the task.
We’ve got plenty of vivid examples: Obama’s Recovery Act triggering 192,000 NEPA reviews, the San Francisco public toilet saga, California high-speed rail. It’s lawsuits all the way down. What’s the model, if it’s not China?
The model is simple in principle: Nobody’s concern goes unheard, but nobody gets an automatic veto. We’re going to have to make hard choices, not just absurd ones like orchids versus carbon reduction, but genuinely hard trade-offs between environmental preservation and housing, between local disruption and regional benefit.
That means empowering executive-branch institutions to make decisions people won’t like. And it means changing the legal regime so disagreement doesn’t automatically translate into endless delay.
The trust problem is enormous. In the early 1960s, four out of five Americans trusted Washington to do what’s right. By 2022 it’s around one in five. Even if we rebuilt capacity, would people’s perceptions change?
This is the miraculous part of American democracy to me. If you lived in 1905 and saw how corrupt and incompetent government was, you couldn’t imagine we’d ever trust it with huge responsibilities. And yet by the mid-20th century we did.
Then in the 1950s and 1960s you had an establishment that looked totally impervious: Moses, Daley, Vietnam technocrats. You couldn’t imagine we’d ever end up in a world where the problem is that government can’t do anything, including rebuilding bridges.
We do swing. We do change. If government starts doing small things well, people will notice. There’s a virtuous cycle available. I can’t promise it’ll happen, but history suggests today’s dysfunction isn’t destiny.
Is it possible the mindset shift isn’t enough and we need constitutional reform? Courts, Congress, and states all contribute to anti-majoritarian gridlock. Can we rebuild state capacity within the existing order?
It’s possible we’ll need bigger reforms. I don’t want to rule it out. But we’ve gone through rough patches before, including periods of judicial obstruction and intense institutional conflict, and we’ve found ways to adapt. It can get worse, but it can also improve through changes in law, jurisprudence, and political will.
You suggest the left is the most plausible “builder coalition,” but is it possible the energy for a pro-building, pro-capacity agenda comes from the right first?
The left should stick to its core argument: There are people the market won’t serve, and government should help solve that. If the right starts borrowing those ideas, that’s a sign the argument’s winning. Ordinary voters aren’t committed to our ideological labels. They’re listening for what seems to work. If we can make government effective again, we’ll be in a much stronger position to persuade them.
Listen to the rest of the conversation and be sure to follow The Gray Area on Apple Podcasts, Spotify, Pandora, or wherever you listen to podcasts.
This series was supported by a grant from Arnold Ventures. Vox had full discretion over the content of this reporting.
2026-01-12 20:00:00
2026年1月7日，一名边境巡逻战术单位（BTU）特工在明尼苏达州明尼阿波利斯市对一名抗议者使用胡椒喷雾。| Alex Kormann/The Minnesota Star Tribune 通过盖蒂图片社提供
在对上周明尼阿波利斯市一名移民（Renee Nicole Good）被移民与海关执法局（ICE）特工致命射杀事件的调查中，由于网络视频的多种叙述和解读，使得调查变得复杂。但有一件事是无法否认的：美国国土安全部（DHS）在城市中的行动方式，与第二任特朗普政府之前任何时期都截然不同。特别是ICE，其在国内的运作方式与以往大不相同，包括在社区中大规模展示武力、似乎随意地逮捕移民（甚至公民），以及对旁观者和抗议者的粗暴对待。
这种转变是如何发生的？ICE在国内的执法方式具体发生了哪些变化？我向加州大学伯克利分校的法学教授大卫·豪斯曼（David Hausman）提出了这些问题。他是“遣返数据项目”（Deportation Data Project）的负责人，该项目是一个记录个人层面移民执法案例的数据库。他向我保证，目前在明尼阿波利斯所见到的情况并不正常，而且这些行动不仅仅是针对移民的。
我们的对话经过了删减和整理。在特朗普政府之前，国内移民执法的规模较小，大多数逮捕是由州或地方政府转交给联邦政府的。因此，ICE在社区中进行的逮捕非常罕见。现在，由于政府施加了巨大压力，要求增加逮捕数量，而ICE本身缺乏足够的逮捕能力，所以不得不采取更加随意的方式。
在特朗普政府的第一个任期中，ICE的逮捕行动主要集中在边境地区，而到了第二个任期，逮捕行动则扩展到了美国国内。此外，国会最近为建设更多的拘留中心拨款，这使得ICE在逮捕后能够更有效地拘留人员。同时，边境逮捕数量减少，而国内逮捕数量增加，这也反映了ICE在国内的活动更加频繁。
很明显，这种缺乏约束的执法行为是当前ICE行动的一个显著特征。我们经常看到ICE和边境巡逻局（CBP）的特工在公开场合或几乎公开的情况下，基于种族随意逮捕人员。这种现象的规模是前所未有的。
这种大规模逮捕是为了实现特朗普政府的“大规模遣返”承诺。ICE受到政府的巨大压力，必须提高逮捕数量。然而，由于在美国监狱和拘留中心中，非公民的数量有限，因此很难达到这些目标。这也解释了为什么在当前的行动中，被逮捕的人中只有很小一部分有犯罪记录。
这种执法方式对社区和人们如何看待ICE及其所在社区产生了怎样的影响？如果ICE突然开始监控公共空间，这将如何影响我们对公共空间的理解？
从轶事来看，人们开始害怕外出，甚至害怕进行正常活动。奥巴马时期的研究表明，当时移民执法的强度对社区产生了各种负面影响，包括失业率上升和健康状况恶化。因此，可以合理推测，这些影响现在会更加严重。
值得注意的是，很多当前的行动并非真正与移民有关。这可以从最近几次突袭中大量逮捕公民或拥有合法移民身份的人这一点上直接看出。然而，这些戴着面罩的特工在街头随意逮捕人们的行为，显然对社会产生了更广泛的影响。最近几个月我们看到的一些网络视频不仅展示了抗议者，还展示了旁观者或观察者被更严厉对待的情况。在许多案例中，这些被粗暴对待的人实际上是美国公民，这表明ICE特工已经超越了移民执法的范畴，开始对公民使用暴力。
我认为，在特朗普政府之前，国内的ICE执法其实并不主要针对移民。因为几乎所有的逮捕都发生在监狱或拘留中心，所以国内移民执法更多是针对非公民的犯罪记录施加额外惩罚，而不是控制移民流动。而如今这些随意的逮捕行动则深入到更广泛的社区中。
我认为，由于边境跨境人数减少，导致边境逮捕数量下降，这是当前国内执法行动得以展开的一个因素。边境逮捕减少和国内逮捕增加都表明执法力度加大，因为边境逮捕减少意味着边境活动减少，而国内逮捕增加则意味着ICE在国内的活动更加频繁。
As competing narratives and interpretations of viral videos muddy the investigations of the fatal shooting of Renee Nicole Good by an Immigration and Customs Enforcement officer in Minneapolis last week, there’s at least one thing that can’t be denied: the Department of Homeland Security’s operations in American cities are a sharp departure from how its agencies operated anytime before the second Trump administration.
ICE, specifically, is operating in a completely different way to how it has historically worked — with big shows of force in neighborhoods, seemingly indiscriminate arrests of immigrants (and citizens), and its careless treatment of bystanders and protesters.
But how did this shift develop? And what specifically changed in the way ICE operates domestically? I put these questions to David Hausman, a UC Berkeley law professor and the faculty director of the Deportation Data Project, a database of individual-level immigration enforcement cases. He assured me that none of what we’re seeing in Minneapolis is normal — and that these kinds of operations are about more than just immigration.
Our conversation has been edited for length and clarity.
How does domestic immigration enforcement now compare to how it used to work before Trump?
Before this current administration and going back to at least the first Obama administration, ICE was really an agency that didn’t conduct many arrests. The vast majority of arrests that ICE used to conduct were really transfers of custody from a state or local authority to the federal government. And as a result, ICE arrests out in the community were very, very rare. I think it’s fair to say that ICE didn’t have that much arrest capacity, and that’s part of the reason that, now that it’s under so much pressure to create arrests, it’s going about it so indiscriminately.
How did it evolve in the Trump administration?
I think the difference between the first and second Trump administrations in ICE arrests is the sense that this administration is just not acting subject to constraints. An additional difference is that Congress recently allocated a huge amount of money for building additional detention centers, which gives ICE more capacity to imprison people after arrests now. And then one last difference is that arrests at the border are very low now, whereas they were relatively high, especially towards the end of the first Trump administration. And that also means there’s more detention capacity for people who’ve been arrested inside the United States.
I think the easiest way to see the lack of constraint is the obvious one: We just see ICE and CBP randomly arresting people, often openly, or almost openly, on the basis of race. The scale of that phenomenon is new with this administration.
It’s to fulfill the Trump administration’s mass deportation promises, right?
That’s right. ICE is under tremendous pressure from the administration to increase arrest numbers. And there just aren’t enough people who are non-citizens in jails and prisons for them to meet those numbers, which is related to the more general point that there just aren’t that many non-citizens who’ve been convicted of crimes. And that’s why, under the new administration, such a small proportion of people they’re arresting have any criminal convictions.
What effect does that have on neighborhoods, on people’s perceptions of ICE and their communities? What is this doing to our understanding of public spaces if ICE is suddenly monitoring those spaces?
Anecdotally, we’re hearing about people being afraid to go out, afraid to do normal things. There’s research from the Obama era actually showing that the intensity of immigration enforcement back then had all sorts of bad effects in communities, including unemployment and health outcomes. So there’s every reason to think that those effects would be even larger now.
It’s important to recognize that a lot of what’s happening is not about immigration. We can see that most directly in the many arrests of citizens or people with lawful immigration status in these raids. But having masked men roving the street, seemingly randomly arresting people, obviously has implications well beyond immigration.
Some of these viral videos that we’ve been seeing over the last few months depict not just protesters, but bystanders or observers being treated much more harshly. In many cases, these are citizens who are being manhandled and pepper-sprayed — all of these ways that ICE agents have moved beyond immigration enforcement to use of violence against citizens.
What I’d say is that there’s a way in which interior or domestic ICE enforcement hasn’t been that much about immigration before Trump either.
And what I mean by that is that because almost all arrests were in jails or prisons, interior immigration enforcement was really much more about assigning an additional penalty for criminal convictions for non-citizens than about controlling immigration. And these new arrests in their randomness just reach much farther into communities.
I think that the decrease in enforcement at the border as a result of fewer border crossings, which is a trend that started under the previous administration, is part of what has made this domestic campaign possible.
Border arrests going down and interior arrests going up are both evidence of more enforcement because fewer border arrests are evidence of fewer border crossings, and more ICE arrests in the United States are evidence of more ICE activity.
2026-01-12 19:30:00
今年的流感季非常严峻，接种疫苗是预防严重疾病的最佳方式之一。如果你觉得这个流感季特别容易打喷嚏、咳嗽和发烧，那并非你的错觉。目前，流感正在美国45个州迅速蔓延，流感样症状的门诊就诊数量也创下了历史新高。流感每年都会上演，但即便到了2026年，我们依然面临着这些呼吸道病毒的困扰。那么，今年为何特别困难？我们邀请了流行病学家兼科学传播者凯蒂琳·杰特琳（Katelyn Jetelina）在本周的《Explain It to Me》播客中回答了这些问题。
杰特琳表示：“每年冬季我们都会看到呼吸道病毒数量上升，无论是普通感冒、流感、新冠还是RSV。冷天气确实会加速病毒传播，而这些病毒也在不断变异。”以下是我们的对话内容（已删减以提高可读性）。你可以通过Apple Podcasts、Spotify或其它播客平台收听完整节目。如果你想提问，可以发送电子邮件至[email protected]或拨打1-800-618-8545。
目前有哪些流感病毒在传播？流感正处于一个特殊的年份。流行病学家担心今年的流感情况会比往年更严重，原因在于一种名为甲型H3N2流感的病毒在夏季传播至澳大利亚和南半球时发生了变异。具体来说，它从J亚型变为了K亚型。这种变化是病毒传播过程中发生的微小变异，虽然并不罕见，但今年的变异幅度较大。这使得当前的疫苗可能无法完全识别这种变异后的病毒，从而导致病毒更容易逃避疫苗和既往免疫力，进而引发更多病例和更严重的疾病，尤其是在高风险人群中。
这并不意味着疫苗无效。我接种了流感疫苗，但最近还是感染了流感。我本以为自己已经做好了准备。但我要强调的是，接种疫苗仍然非常重要。我们并非无能为力。流感疫苗并不是为了防止感染，而是为了防止严重的疾病，比如住院或死亡。而我们正在交谈，说明你并没有因此死亡。虽然流感可能让人感到非常难受，但它可以帮助避免最糟糕的后果。
对于那些还没接种流感疫苗的人，现在是否还来得及？答案是：不晚。首先，流感尚未达到高峰，仍有大量病例可能出现。其次，流感疫苗需要大约两周时间才能让免疫系统产生反应，因此现在接种仍能提供保护。此外，流感有多种毒株在传播，不像新冠那样只有一种毒株（如Delta或Omicron）。因此，即使你已经感染了一种流感毒株，你仍可能在本季再次感染另一种毒株。接种疫苗可以帮助你避免感染其他毒株。
除了流感，还有哪些病毒在传播？很多！病毒特别喜欢这个季节。新冠也开始回升。RSV（呼吸道合胞病毒）也在传播，尤其对婴儿造成严重影响。还有普通感冒，以及一种名为诺如病毒（有时被称为“肠胃流感”）的病毒，它会导致腹泻和恶心，传播方式并非通过呼吸道，而是通过接触污染的门把手或食用受污染的食物。
那么，如何增强免疫力？关于增强免疫力的方法有很多传言。对于一般人群来说，膳食补充剂并不能有效预防或减轻疾病。维生素C或D对呼吸道病毒的预防和缓解作用尚未得到充分证实。冷水中浸泡（冷浴）等方法虽然流行，但相关证据并不明确，研究结果也存在矛盾。鼻呼吸、桑拿等方法在小规模研究中被提及，但效果尚不明确。最好的方法是给免疫系统足够的时间来发挥作用。这包括保持均衡、营养丰富的饮食，保证充足的睡眠，因为这是免疫系统进行大部分修复工作的时段。长期睡眠不足的人实际上更容易感冒。因此，确保充足睡眠和水分摄入对增强免疫力至关重要。适当的水分平衡有助于身体运输营养和免疫细胞，并清除许多病原体和废物。
If this cold and flu season seem especially sneezy-coughy-fevery to you, it is not your imagination. Flu is surging in 45 states and outpatient doctor visits for flu-like symptoms are the highest they’ve been since we started keeping track of the data.
It’s not like the flu is new: Literally every year we have to navigate cold and flu season. And yet here we are in 2026, plagued with these respiratory viruses again. What’s making this year especially difficult?
We pose those questions to epidemiologist and science communicator Katelyn Jetelina on this week’s episode of Explain It to Me, Vox’s weekly call-in podcast. “What we typically see every winter is just this rise in respiratory viruses, whether it’s the common cold or the flu or Covid or RSV,” she told Vox. “Cold weather really causes viruses to spread very quickly and these viruses just keep mutating.”
Below is an excerpt of our conversation, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get podcasts. If you’d like to submit a question, send an email to [email protected] or call 1-800-618-8545.
Which flu viruses are circulating right now?
Flu specifically is in a very interesting year. Epidemiologists are concerned that this year is going to be worse than previous years, and that’s because one strain of the flu called influenza A H3N2 mutated over the summer as it spread through Australia and the Southern Hemisphere. Specifically, it shifted from a J subclade to a K subclade. This is an incremental change that happened when this virus spread.
Mutations are normal for the flu. In fact, the flu is infamous for unpredictable curveballs. Flu can change in two ways: one is called a shift, which is a major overhaul that happens when two different flu viruses infect the same cell, swap genetic material, and create a new virus. This type of shift can spark a pandemic because our immune systems have never seen that version of the virus before.
That is not what we have. What we have this winter is called a drift, and this means there’s a smaller incremental change that happens as the virus spreads. It shouldn’t trigger panic. But what it does mean is that our current vaccines will likely recognize some, but not all, of this updated virus. It’s just simply bad luck that H3N2 evolved so much in the months before this flu season really took off. Together these factors mean that the virus will be better at slipping past vaccines as well as our prior immunity. That translates into more cases and more severe disease among those at highest risk.
This makes sense. I got the flu shot and still got the flu recently. I thought I prepared myself.
You did. I want to be very clear that vaccination still matters. We’re far from powerless. The flu shot is not designed to protect against infection. It’s designed to prevent hospitalization and you dying. And given that we’re doing this interview, you didn’t die.
Yeah!
Having the flu may still be miserable and it’s not fun, but it can help avoid the worst outcomes.
For people who didn’t get a flu shot, is it too late now? Do they just have to wait this season out with their fingers crossed?
No, it is not too late for several reasons. One is we haven’t even reached the peak of flu yet. There’s still going to be a lot of sickness out there. Flu vaccines take about two weeks for your immune system to really kick into gear, so there’s plenty of time to still be protected.
The other thing with flu is that there are many strains that circulate. With Covid, we were all used to one strain circulating like Delta or Omicron, but with flu, there’s two to three strains that circulate. So unfortunately what this means is that if you get infected by flu once, you could get infected by flu twice later on in this season. Getting a vaccine can help protect from those other strains as well.
What else is going around?
A lot! Viruses love this time of year, so Covid is also starting to increase. Another thing that’s circulating is RSV, which wreaks havoc among infants. We have other viruses like the common cold, and then something that is not fun at all either called norovirus, sometimes called stomach flu, which causes diarrhea and nausea. That spreads not necessarily through the respiratory tract, but through [things like] touching a dirty doorknob or eating contaminated food. So there’s plumes of viruses everywhere you’re going right now.
So if we want to boost our immune systems, what works and what doesn’t?
The rumor mill is really hot on ways to boost the immune system. For the general population, dietary supplements actually do not work in preventing or reducing severity of illness. Vitamin C or vitamin D just haven’t [been] shown to help with respiratory viruses. Or something like cold plunges: these have become increasingly popular for boosting immunity, but there’s really inconclusive evidence and a lot of conflicting studies showing whether they’re effective. Nasal breathing, saunas — a lot of these just have been tested in really small studies.
The best thing you can do is give your immune system time to do its job. How we do that is a balanced, nutrient-dense diet. Sleep is critical. This is when the immune system executes most of its repair process. Those who are chronically sleep-deprived actually tend to get more colds than those [who] aren’t. So make sure you get a lot of sleep as well as hydration. Proper fluid balance really ensures your body can transport nutrients and immune cells and remove a lot of these pathogens and waste products.
2026-01-12 19:00:00
美国最坚定的民主党人和共和党人很少在问题上达成一致。如果询问Bluesky和Truth Social的用户，他们对胎儿是否是人、无证移民是否是社会问题、跨性别女性是否属于女性、气候变化是否是危机、新冠疫苗是否是有毒的、税收是否过高、福利支出是否过低、是否应禁止AR-15步枪、是否应削减联邦官僚机构、警察是否歧视黑人、大学是否歧视白人男性，以及特朗普是否是法西斯、拜登是否是2020年去世的死人复活等议题，每个群体都可能给出截然不同的答案。然而，他们唯一一致的观点是，这些政策分歧源于更深层次的哲学冲突——即进步主义与保守主义在政治正义、真理和人性观念上的长期对立。
但一些政治学家、社会心理学家和哲学家认为，这种观点是“胡说八道”。他们认为，左翼和右翼的立场之间并没有共同的道德原则。例如，保守派既反堕胎又支持减税，而进步派既反枪支又支持环保，这些立场并非源于永恒的道德哲学，而是历史上的偶然联盟。例如，20世纪中叶，基督教传统主义者与自由派商人结盟，形成了共和党的保守派，他们认为反堕胎和减税都是维护美国建国价值观的必要手段。同样，1960年代，城市社区的枪支暴力问题和环保组织的污染担忧与民主党结盟，使进步派认为枪支管制和去碳化是社会正义斗争的一部分。
Hyrum和Verlan Lewis两位政治学者（同时也是兄弟）指出：“意识形态并不定义群体，群体定义了意识形态。”在他们看来，“进步主义”和“保守主义”并非持久的政府哲学，而是不断变化的联盟利益的合理化解释。
然而，Lewis兄弟的理论并非没有问题。他们承认，美国的左翼和右翼联盟确实存在一些任意的联盟，但这些联盟并非完全随意。例如，左翼通常更关注收入再分配、少数群体权利、集体谈判和女权主义，而右翼则更强调自由、稳定和对个人成就的尊重。这种道德上的统一可能解释了为什么某些政策组合在不同时期和国家中反复出现。
此外，左翼和右翼在某些看似无关的问题上也可能共享相同的道德直觉。例如，移民政策、对外援助和福利支出的分歧可能都源于对陌生人的信任和同情程度。研究显示，道德普遍主义者更倾向于支持左翼的移民、收入再分配和对外援助政策，而道德特殊主义者则更倾向于支持右翼的立场。
尽管Lewis兄弟认为意识形态本质主义是导致政治分歧的根源，但他们的观点也存在过度简化的问题。他们忽略了左翼和右翼在某些政策上的哲学统一性，而这种统一性可能有助于解释政策组合的重复出现。因此，即使没有意识形态本质主义，左翼和右翼之间的分歧仍然存在。
最后，Lewis兄弟认为，如果左翼和右翼能够认识到自己的意识形态并非永恒真理，而是历史联盟的产物，那么他们就能更开放地审视自己的政策立场，避免盲目坚持。只有鼓励思想多样性，才能确保政策真正符合其宣称的目标。
America’s most impassioned Democrats and Republicans don’t agree on much. Ask the inhabitants of Bluesky and Truth Social whether a fetus is a person, or undocumented immigrants are a scourge, or trans women are women, or climate change is a crisis, or Covid vaccines are toxic, or taxes are too high, or welfare spending is too low, or AR-15s should be banned, or the federal bureaucracy should be gutted, or the police discriminate against Black people, or universities discriminate against white men, or Donald Trump is a fascist, or Joe Biden is the reanimated corpse of a man who died in 2020, and each group is liable to provide warring answers.
If staunch Democrats and Republicans agree on anything, however, it’s that their myriad policy disputes all follow from a deeper philosophical conflict — the centuries-long clash between progressive and conservative conceptions of political justice, truth, and human nature.
But some political scientists, social psychologists, and philosophers say this is, to use a technical term, “bullshit.”
According to such thinkers, there are no coherent principles that bind the left and right’s various positions. No timeless precept compels conservatives to be both anti-abortion and pro-tax cuts — or progressives to be both anti-gun and pro-environment.
Rather, in this view, it is contingent historical alliances, not age-old moral philosophies, that explain each side’s motley assortment of issue stances: In the mid-20th century, Christian traditionalists happened to form a coalition with libertarian businessmen inside the GOP. Conservatives consequently discovered that banning abortion and cutting taxes were both indispensable for preserving America’s founding values.
Likewise, urban communities wracked by gun violence — and nonprofit organizations alarmed by pollution — happened to align with the Democratic Party in the 1960s. As a result, progressives realized that gun control and decarbonization were both part of the same eternal struggle for social justice.
In other words, as the political scholars (and brothers) Hyrum and Verlan Lewis write, “ideologies do not define tribes, tribes define ideologies.” To the Lewises and likeminded social scientists, “progressivism” and “conservatism” don’t name enduring philosophies of government, so much as ever-shifting rationalizations for the interests of rival alliances.
Few Americans were familiar with the left-to-right ideological spectrum until the early 20th century.
This theory of what divides our parties — and ails our politics — has its insights. But it also takes its case too far. The left and right’s policy disputes are not all manifestations of one ageless moral conflict. But it does not follow that progressives and conservatives are divided by nothing more than arbitrary alliances and tribal psychology.
This might sound like an invitation to nihilism. But in the Lewises’ view, the belief that all of the left and right’s disputes reflect one essential moral conflict — an idea they dub “ideological essentialism” — is even more pernicious. By convincing conservatives and progressives that all of their movement’s positions flow from their most cherished ideals, essentialism discourages ideologues from thinking through discrete issues on the merits. And by telling America’s rival factions that “there are two (and only two) ways to approach politics,” essentialism fuels Manichaean thinking and partisan strife.
The ideological spectrum was born in France about 237 years ago.
At the revolutionary National Assembly in 1789, radicals sat on the left side of the chamber and monarchists on the right, thereby lending Western politics its defining metaphor: a one-dimensional continuum between egalitarian revolution and hierarchical conservation. The more a faction (or policy) promoted change in service of equality, the farther left its place on this imaginary line; the more it defended existing hierarchies in the name of order, the farther right its spot.
European politics began organizing itself around this metaphor in the 19th century. But for its first 150 years or so, the American republic mostly made do without it.
As Hyrum and Verlan Lewis note in their book, The Myth of Left and Right, early American political parties did not define themselves in spatial terms. Nor did they fit neatly into our contemporary ideological binary. The Jeffersonian Republicans were more supportive of the French Revolution than their Hamiltonian counterparts, but also more fanatically committed to free-market economics. Jacksonian Democrats agitated against the Whigs to enfranchise poor white men — but also, to expand slavery, ethnically cleanse Native Americans, and restrict the federal government’s power.
It wasn’t until the early 20th century that mainstream American intellectuals and politicians began speaking of politics as a struggle between the “progressive” left and “conservative” right — with the former largely defined by its commitment to government intervention in the economy, and the latter by its fondness for laissez-faire.
This ideological conflict initially divided the parties internally. But gradually, beginning with the New Deal, the words “progressive,” “left-wing,” and “Democrat” became synonymous, as did the words “conservative,” “right-wing,” and “Republican.”
In the Lewises’ view, the left-to-right metaphor had some utility in the New Deal era. In that period, partisan conflict was concentrated overwhelmingly on a single fundamental issue: the size and scope of government. And on individual questions, one can coherently plot opinion on a spectrum. If you draw a line with “full communism” at its left pole — and “anarcho-capitalism” at its right one — you can logically place the New Deal’s proponents and adversaries at different points along your continuum. Partly for this reason, the spatial metaphor became entrenched in American political thought by the 1950s.
Over the second half of the 20th century, however, the number of salient political issues in the United States steadily multiplied. America’s “progressive” and “conservative” coalitions developed disparate stances on civil rights, abortion, military intervention, environmental protection, immigration, same-sex marriage, affirmative action, gun control, policing, and countless other topics. And as these disagreements mounted, the one-dimensional ideological spectrum — and with it, the very concept of a “left” and “right” — became increasingly incoherent, according to the Lewises.
After all, whether the US government should mandate a minimum wage and whether it should forbid abortions, or deport the undocumented, or tax carbon emissions, or provide public health insurance are all completely different questions. Believing a fetus is a person does not logically commit one to thinking that Medicaid should be cut.
Progressives and conservatives may believe that some fundamental, moral principle motivates all their movement’s stances. But the Lewises offer at least three reasons for doubting that premise.
First, the ideological valence of a given policy often varies across time and space.
For much of the 19th and 20th centuries, progressives supported free trade, believing that increasing economic interdependence would forestall war and raise living standards. Then, as foreign competition began undermining American industrial unions, the left started gravitating toward protectionism. Now that President Donald Trump has turned tariffs into a conservative cause (and political liability), liberals are inching back toward their erstwhile economic internationalism.
Similarly, support for free speech, immigration restriction, and American military intervention were all coded as “progressive” at some points in US history and “conservative” at others, in the Lewises’ account.
Second, they maintain that every attempt to define the essential disagreement between progressivism and conservatism is tendentious and unsustainable. In the context of revolutionary France, the left indisputably stood for egalitarian change, and the right, for the maintenance of traditional hierarchies. But one can’t easily shoehorn all of America’s contemporary policy debates into this binary.
To see their point, consider gun control. Does restricting firearm sales abet equality, since gun violence disproportionately afflicts disadvantaged racial and socioeconomic groups? Or will doing so reinforce hierarchy, since such rules increase the power imbalance between state and citizen, while boosting the incarceration rates of disadvantaged groups? There is no objective answer. And subjectively, gun rights advocates rarely understand themselves to be fighting for greater inequality.
Of course,“equality versus hierarchy” is just one popular framing of the left and right’s fundamental divide. But the Lewises suggest that all others, such as “big government versus small government or “equality versus liberty,” also collapse under scrutiny.
Finally, the authors note that most Americans tend to be ideologically heterodox, embracing “conservative” positions on some issues and “progressive” ones on others. It is only highly engaged partisans who discern some clear link between, say, cutting taxes on the rich and banning youth gender medicine (or between the opposite of those positions).
This could theoretically reflect impassioned partisans’ greater political knowledge — perhaps, the highly engaged have simply paid close enough attention to discern the essential unity of progressive and conservative policy stances. But the more plausible explanation, according to the Lewises, is that there is no connection between these stances — and so people will only arrive at uniformly “left-wing” or “right-wing” answers if they’re exposed to partisan cues instructing them which is which.
There is a good deal of truth in the Lewises’ narrative — but also, quite a bit of overstatement.
America’s progressive and conservative coalitions surely aren’t bound by first principles, alone. Each camp features some arbitrary alliances, which it reinforces and sanctifies through dubious storytelling: The left and right equate the pursuit of their allies’ disparate (and often petty) interests with the advancement of a timeless ideal, such as social justice, human liberty, or national strength.
But the Lewises are not satisfied with these observations. Their argument isn’t that the contents of “progressive” and “conservative” ideology are partly arbitrary and historically contingent, but that they are entirely so. In their view, coherent moral principles might justify the left and right’s respective positions on any single issue. But no philosophical assumption, or even psychological disposition, ties together any meaningful number of progressive and conservative policies.
Polarization over particularism plausibly imbues today’s partisan rift with some deeper moral substance.
Yet this theory sits uneasily with a basic fact: While some right-wing and left-wing positions vary between eras and countries, most do not.
For the past six decades, throughout the Western world, certain policy stances have clustered together with striking regularity. In the United States, the UK, France, Germany, Scandinavia and elsewhere, parties of the left have consistently been more supportive of income redistribution, minority rights, collective bargaining, and feminism than those of the right.
If progressivism and conservatism have no essential substance — but merely reflect the propagandistic myths of two contingent coalitions — then one would expect wild variation in each ideology’s contents across national contexts. Instead, certain alliances and policy bundles recur again and again.
In an interview, Hyrum Lewis attributed this merely to the modern media environment: In the digital age, foreign ideologues can import America’s culture wars. “As the globe has become more unified with globalization,” Lewis told me, “we’ve seen the correlations between these different issue positions become tighter.”
But there are reasons to doubt that this fully explains the phenomenon.
For one thing, the philosophical webbing between many of the left and right’s most common positions is thicker than the Lewises suggest. Progressives may not hold a monopoly on concern for equality in every sense of that term. But relative to conservatives, the left is plainly more committed to reducing the disadvantages of historically subordinated groups. And this moral commitment plausibly explains why progressives — across borders and time periods — have tended to be more supportive of income redistribution (which mitigates class inequality), equal pay legislation (which mitigates gender inequality), and anti-discrimination laws (which mitigate racial inequality) than the right has been.
Conservatives, for their part, readily agree that they are less concerned with class, race, and gender inequality than their left-wing counterparts. The mainstream right does not justify this position by celebrating “hierarchy” per se. But it does insist that progressive proposals for combating inequality put too little weight on liberty, stability, respect for earned distinctions, or other important goods.
Each side therefore can coherently argue that its stances on multiple issues flow from one overarching principle (its sense of equality’s importance relative to other ideals). And this philosophical unity may help explain the recurrence of certain policy bundles across eras and nations.
Moreover, even some logically unrelated left-wing and right-wing policies may nonetheless reflect a common ethical intuition. For example, there is some evidence that the left and right’s disagreements on the seemingly distinct issues of immigration, foreign aid, and social welfare spending are all rooted in each side’s degree of moral universalism — which is to say, the extent to which its members are more trusting and altruistic toward their inner circles than toward strangers.
There is no reason in principle why a person who supports increasing immigration must also back higher spending on foreign aid and social welfare. Yet a voter’s views on all three could theoretically be influenced by how much trust and concern they have for socially distant people: If you have little faith or interest in strangers, then you may be less inclined to fund food stamps with your tax dollars or allow foreigners into your country.
And more morally universalistic voters are indeed more likely to hold left-wing views on immigration, income redistribution, and foreign aid, according to a 2022 study from researchers at Harvard and the University of Bonn. Critically, the paper emphasizes that moral universalists aren’t necessarily more empathetic than moral particularists are; it is just that the former’s social concern is spread more evenly than the latter’s between their family, friends, countrymen, and humans in general. In other words, universalists might be less generous to their neighbors than particularists, but more compassionate to people they don’t know.
Put in these terms, many conservatives self-identify as moral particularists, arguing that progressives do not adequately prioritize their families over strangers, nor their fellow Americans over foreigners.
This split over universalism might not define the left-right divide in all eras and places; progressivism has at times been nationalistic and conservatism, cosmopolitan. But polarization over particularism plausibly imbues today’s partisan rift with some deeper moral substance.
All this casts doubt on the Lewises’ most hopeful idea: that if progressives and conservatives only recognized the true nature of their ideologies, then America’s partisan conflicts would no longer be explosive and destabilizing.
Ideologues surely overestimate the philosophical unity of their commitments. Rid the Earth of such confusion, however, and much of the enmity between America’s left and right would remain. The devotees of Donald Trump and Alexandria Ocasio-Cortez have genuinely different worldviews. Progressives aren’t wrong to perceive this White House as a threat to their conceptions of both democracy and social justice. And conservatives aren’t mistaken in thinking that the Democratic Party is hostile to their convictions about the nature of gender, economic liberty, and the metaphysical status of the unborn.
In an alternate dimension — where the terms “left” and “right” never entered America’s vocabulary — these conflicts would be sufficient to inspire bitter partisan divisions. Indeed, the Lewises’ own historical observations tell us that ideological essentialism is no precondition for political strife; Americans were largely unacquainted with “progressivism” and “conservatism” in the 19th century, yet still developed a partisan conflict incendiary enough to provoke a civil war.
This said, ideological essentialism is nonetheless a pernicious force in American politics. But this is less because it causes animosity between the parties than because it undermines sound policymaking within them.
The left and right hold some distinct principles. But neither can derive answers to all of today’s governance challenges from their broad moral precepts. You cannot discern whether zoning restrictions reduce housing affordability — or whether gifted programs harm disadvantaged students — merely by deciding that you care a lot about inequality. Nor can you determine whether tariffs or mass deportation will raise American living standards, simply by deciding that the government must put “America first.”
Yet ideological essentialism invites the opposite impression by casting all policy debates, even the most technical, as referenda on bedrock moral principles. This framework is attractive to partisans, as it reduces the cognitive burdens of political advocacy: It is much easier to decide how you feel about one philosophical premise than to carefully adjudicate dozens of technocratic claims. Further, when a policy argument is understood as a gauge of moral character — rather than a test of empirical propositions — it becomes a better vehicle for partisans’ self-expression and communal bonding.
Meanwhile, ideological essentialism also aids party-aligned interest groups, as it effectively equates their agendas with justice itself, thereby deterring intra-party dissent. If slashing taxes on business owners is tantamount to defending liberty, then one needn’t worry about whether working-class conservatives will end up paying the price. Likewise, if banning self-driving vehicles is synonymous with standing against class inequality, then one can more comfortably ignore human drivers’ greater propensity to get people killed.
In this respect, the Lewises’ book is edifying. If some of the left and right’s positions reflect contingent alliances — rather than timeless truths — then neither side has a basis for presuming the uniform righteousness of its current stances.
Given this reality, any political community that wishes for its policy positions to be genuinely principled — which is to say, conducive to its avowed objectives in both theory and practice — will need to encourage heterodoxy within its ranks. If progressives and conservatives feel that they can contest their faction’s orthodoxies without risking excommunication, then each camp will be more likely to detect its own errors and hypocrisies. If intellectual conformity is the price of factional belonging, then the left and right are bound to unwittingly undermine their own values.
In other words, for progressives or conservatives to develop anything resembling a perfectly principled platform, they must first recognize that none exists.
2026-01-12 19:00:00
《你的里程可能不同》是一档建议栏目，它提供了一种独特的思考道德困境的框架。该栏目基于“价值多元主义”这一理念，即每个人都有多种价值观，这些价值观虽然同样有效，但常常彼此冲突。如果你有相关问题，可以通过这个匿名表格提交。以下是本周读者的一个问题，已进行简化和编辑以提高清晰度：
我是一名30多岁的女性，我认为自己想要孩子，但我的健康状况使得怀孕比大多数女性更困难（但并非不可能）。怀孕对我来说也会更加不舒服和对身体造成更大的伤害。这不会导致永久性残疾，但身体上的影响足以让我不想怀孕。我很幸运，可能有足够的经济能力通过一家信誉良好的机构雇佣代孕母亲。但代孕在社会上常常受到批评，被认为不道德。很久以前，我认识一个人说她喜欢怀孕并为他人提供代孕服务，所以理论上，有人可能自愿成为代孕母亲，而不受经济需求的胁迫。但即使代孕可以被道德地进行，它也伴随着很大的社会偏见，我担心会被朋友和家人评判。似乎有一种观念认为，想要拥有生物孩子但不想用自己的身体来承载，是错误、不自然、自私或不符合女性身份的。而且，我并不是唯一一个觉得怀孕很痛苦的人。我认为我的体验可能比平均水平更糟糕，但总体而言，怀孕本身就是一件令人不快的事情，因此我不认为它对我的影响足够独特，足以让我有理由支付费用使用他人的身体。我希望能得到你的帮助。
亲爱的“真的不想怀孕”，有些关于代孕的伦理问题确实值得探讨，而有些问题则不值得你花时间去思考——我们先从后者开始。正如你所说，社会上对不想用身体承载孩子存在文化偏见，认为这是“错误”或“不女人”的行为。但这种想法完全是无稽之谈。认为女性应该以某种“正确”的方式成为母亲，是父权制的建构；任何告诉你“你不女人”因为不想怀孕的人，都是在反映对女性身体应用于生育劳动的性别偏见。因此，如果你的担忧来自于这种偏见，请不要在意。
当然，代孕确实会带来一些真实的道德问题。我想告诉你的是，我认为在某些情况下，代孕是可以被道德上证明的。首先，代孕并不是一个单一的概念。商业代孕（你支付他人怀孕）和非商业代孕（无偿的，将怀孕视为一种爱的劳动）之间存在显著区别。找到非商业代孕并不容易——毕竟怀孕本身就有风险——但我同意你的直觉，如果你幸运地找到愿意自愿承担这一角色的人，选择这种方式可以避免大多数关于商品化或剥削的担忧。
最终，也许我们都不可能完美地理解自己。但你有权成为自己的主要解释者——这意味着你拥有相应的权力和责任。
Your Mileage May Vary is an advice column offering you a unique framework for thinking through your moral dilemmas. It’s based on value pluralism — the idea that each of us has multiple values that are equally valid but that often conflict with each other. To submit a question, fill out this anonymous form. Here’s this week’s question from a reader, condensed and edited for clarity:
I’m a woman in my 30s and I think I want to have a child, but I have a health condition that makes it harder (not impossible) to get pregnant than for most women. It would also make pregnancy more uncomfortable and physically disfiguring than it is for many pregnant people. It wouldn’t be permanently disabling, but the physical effects would be bad enough that I really don’t want to be pregnant.
I’m fortunate enough that I can probably afford to get a surrogate through a reputable agency. But surrogacy is frowned upon and often considered unethical. Long ago, I knew someone who said she loved the idea of being pregnant and providing gestation as a service to other people, so maybe in theory, it is possible for someone to freely choose to be a surrogate without being coerced by financial need? But even if it could be done ethically, there’s such a stigma around it and I fear being judged by friends and family. There seems to be a sense that there’s something wrong, unnatural, selfish, or unwomanly in wanting to have a biological child but not wanting your own body to be the vessel for it.
Plus, it’s not like I’m the only person in the world for whom pregnancy would suck. I think my experience probably would be worse than average, but pregnancy is just an unpleasant thing overall so I don’t think I can claim it would be so uniquely bad for me that I’m justified in wanting to pay to use someone else’s body. I’d love your help with this.
Dear Really Don’t Want To Be Pregnant,
There are some ethical questions about surrogacy that it’s genuinely worth asking, and some that I don’t want you to devote another second to — so let’s start there.
As you said, there’s a cultural stigma around not wanting to turn your body into a vessel for childbearing — it’s deemed “wrong” or “unwomanly.” But that idea is pure garbage. The idea that there’s some “proper” way to be a woman is a patriarchal construct; anyone who tells you you’re “unwomanly” for not wanting to gestate is reflecting sexist expectations that women’s bodies should be available for reproductive labor.
So to the extent that your fear of being judged is about that, please don’t give it another thought. But of course, there are real moral questions that surrogacy brings up.
I’ll tell you right off the bat that I do think surrogacy can be ethically justifiable in some situations. First, it helps that surrogacy is not one monolithic thing. There’s a big distinction between commercial surrogacy (where you pay someone to carry a baby) and altruistic surrogacy (the unpaid version, where the surrogate carries the baby as a literal labor of love). It’s not easy to find an altruistic surrogate — after all, pregnancy is dangerous business — but I agree with your intuition that if you’re lucky enough to know someone willing to volunteer for the role, opting for that is a good way to avoid most concerns about commodification or exploitation.
Within commercial surrogacy, a second distinction has to do with where the surrogate lives. There’s a moral difference between hiring a surrogate in a developing country and hiring one in, say, the US. In countries like Georgia, for example, surrogacy agencies have been known to recruit at domestic violence shelters — some women see surrogacy as the only way to win financial freedom from an abusive spouse. Ukraine, Cyprus, and several others are also known to have ethically problematic surrogacy industries.
But American surrogates are typically not low-income; they’re usually middle-class white women with husbands and kids of their own, and they have other economic opportunities available to them. The better surrogacy agencies screen out poor women, who are at risk of coercion. That empirical context means there’s less (though not zero) potential for exploitation in the US, compared with international surrogacy.
Another reason I think surrogacy can be ethically justifiable is that for many, many people, the urge to have kids — including ones who are biologically related to them — feels like a need and not just a want.
Many opponents of surrogacy argue that nobody has a “right” to a biological child, so if you can’t or don’t want to be pregnant, too bad. And those opponents are right that nobody has an absolute right to have a baby — otherwise, the state would be obligated to ensure surrogates, egg donors, and sperm donors were made available regardless of their own willingness to participate! But people may still have a qualified right — the kind of right that we generally honor but that can be restricted to protect the interests of others.
When it comes to people who are physically unable to create a biological child — when they have what doctors call a “medical indication” — I think the qualified right to have a kid means that surrogacy can be ethical, provided it meets certain criteria like informed consent.
But your situation is trickier because it’s not impossible for you to get pregnant — it’s more that, for certain reasons, you don’t want to. Typically, your case would be referred to as “elective surrogacy.” Some professionals will refuse to arrange surrogacy if they deem it elective rather than medically indicated.
And yet, doctors are increasingly recognizing that the line between “medically indicated” and “elective” is not so tidy.
While elective surrogacy is often associated with vanity — it brings to mind a celebrity who doesn’t want to be pregnant because she doesn’t want to “mess up” her figure — it’s not like everyone in the elective camp is there for cosmetic reasons.
What about someone who could get pregnant but is deathly afraid of giving birth because she had a traumatic experience — like, say, her best friend dying in childbirth? Or what about someone who’s trans and who physically could carry a pregnancy, but who knows it would cause such gender dysphoria that there’s a risk of serious psychological harm? Shouldn’t a mental health need be considered a type of medical need?
These are not hypothetical experiences — real people have testified to them — but they often haven’t been taken seriously as medical needs. I suspect that these people have endured what the contemporary philosopher Miranda Fricker calls “epistemic injustice.”
Epistemic injustice refers to “a wrong done to someone specifically in their capacity as a knower.” When society denies someone the credibility to assess their own life experience, or discounts an important part of that experience because of a gap in our collective interpretive resources, that can be an example of epistemic injustice. I think people who fall in between medical categories are too often at risk of being wronged in this way, and I don’t want to see that happen to you.
So I want to acknowledge that I don’t know what health condition you’re referring to when you say you have a condition that would “make pregnancy more uncomfortable and physically disfiguring than it is for many pregnant people.” Since I don’t know the details, I’d encourage you to ask yourself: How much more uncomfortable? How much more disfiguring? And how heavy and lasting a toll would that discomfort or disfigurement take on your overall well-being?
Only you can really try to answer that last question, because the same effects can land differently for different people, depending on how well-resourced we are financially, socially, psychologically, and even spiritually.
Once you’ve thought about how big and enduring the risk of harm is to you, try asking yourself this: Is the risk to you so much greater than the risk to a woman of average health that you feel comfortable transferring the risk of pregnancy and childbirth onto her?
Some people will tell you that question is irrelevant. They will say that the only value that matters here is autonomy — yours and the potential surrogate’s — and if you and she both consent to a surrogacy contract, and she is not coerced into it by financial desperation, then that’s that!
But there may be another important value at stake here: justice.
Feel free to email me at [email protected] or fill out this anonymous form! Newsletter subscribers will get my column before anyone else does and their questions will be prioritized for future editions. Sign up here!
As far as I can tell, your case is in a gray area — surrogacy is neither obviously “medically indicated” nor obviously “elective” based on the information you shared. If you ask yourself, “Do I think there’s a significant risk that carrying a child would significantly harm me?” and you answer “Yes!” — then some doctors would say surrogacy is medically indicated. But if the answer you feel bubbling up is, “Well…no, not really,” then you may be closer to the “elective” side of the spectrum. And then I think it becomes reasonable to inquire whether it feels fair to ask another woman to take on the considerable risks of pregnancy and childbirth.
You wrote of pregnancy, “I don’t think I can claim it would be so uniquely bad for me that I’m justified in wanting to pay to use someone else’s body.” That suggests that you currently see yourself as more in the elective camp. I urge you to give yourself the space to really interrogate that with an equal measure of honesty and self-compassion. If honesty compels you to say you don’t feel justified in putting someone else’s body in harm’s way in a situation where she otherwise wouldn’t be, then maybe you’ve got your answer.
But if you’re discounting the risk of psychological harm to yourself because you don’t think that “counts” as real need, please know that mental health is just as medically legitimate as physical health. And if you talk to a medical professional about the option of surrogacy, please talk to more than one so you’re less at risk of getting boxed into a category that doesn’t capture you right.
At the end of the day, perhaps none of us can be a perfect interpreter even of ourselves. But you get to be the interpreter-in-chief — with both the power and responsibility that implies.
2026-01-11 20:00:00
一群训练师正在温哥华国际机场训练服务犬。| 李森/新华社 图片由盖蒂图片社提供
上个月，我像许多美国人一样，乘飞机回家过节。在从纽约飞往洛杉矶的航班上，一只佩戴着“服务犬”背心的狗在登机口对着我叫。这只狗（没有名字）看起来像一只胖乎乎的法国斗牛犬，来回踱步，还对着其他旅客吠叫。从洛杉矶机场返回时，我注意到更多佩戴服务犬背心的狗——有腊肠犬、另一只法国斗牛犬，还有一些混种犬——和他们的主人一起排队，等待与地勤人员接触。这让我意识到，如今越来越多的狗被指定为服务犬，多到不可能每一只都经过充分训练。其中一些狗可能是冒充的。
当然，由于假期期间很多人乘飞机，因此更容易发现这些情况；但我显然不是唯一注意到服务犬数量上升的人。这种现象引发了一些问题：为什么会有这么多服务犬？为什么这么多人拥有它们？获得认证是否很容易？真的有那么多人需要它们吗？为什么这只狗会对着我叫？这些人的目的是否只是想带狗出行？如果对某些人产生怀疑，我是不是很糟糕？假服务犬真的那么糟糕吗？
遗憾的是，我无法采访一只真正服务犬，以探讨这一争议话题。但我与专家、空乘人员和服务犬训练师交谈，他们表示，这些冒充的服务犬让他们的工作以及真正服务犬的工作变得更加困难。
越来越多的人希望带着宠物一起旅行，尽管航空公司声称安全，但主人仍对将宠物放在货舱中感到担忧。此外，带着狗登机的成本较高，而且也存在诸多不便。与此同时，在美国，将宠物狗带入机舱的规定非常严格，官方要求狗狗必须能适应指定的航空箱，能够转身，并且全程必须系好安全带。如果狗狗符合这些要求，大多数美国主要航空公司每段航程的费用大约为150美元。
然而，由于这些规定过于繁琐，许多主人选择通过服务犬的“漏洞”来带狗登机。服务犬可以免费进入机舱，而无需遵守这些规定。这使得服务犬成为一种“捷径”。
“我认为很多人开始利用我们希望狗狗能和我们在一起这一点，”Canine Companions（一家训练并安置服务犬的组织）的项目主管Jessica Reiss说道。在Canine Companions，拉布拉多犬、金毛犬以及拉布拉多和金毛的混种犬会接受为期六个月的训练，包括执行大约45项任务，如开门、响应警报、拉轮椅和物品识别等。服务犬的主人也会接受一个密集的培训课程。
尽管Canine Companions的培训非常严格，但像这样的项目并不是标准做法。部分原因在于，目前没有统一的标准。Reiss告诉我，尽管美国运输部试图阻止滥用宠物旅行规定（例如，禁止情绪支持动物），但人们仍然找到各种方法来规避这些限制。
“有一种漏洞，允许你私人训练你的狗成为服务犬，而根据定义，这意味着狗必须能够执行减轻残疾人障碍的任务，”Reiss说道。虽然私人训练可能更灵活和可及（例如，对无法负担训练师或没有附近训练师的人来说），但也意味着更多人会利用缺乏监管的漏洞。
“有很多主人训练的、行为良好的服务犬，他们训练狗执行实际的物理任务，他们应该享有通行权。但我也认为，很多人其实不想把狗留在家里，”Reiss说。
这种混乱和不一致的结果，就是为什么会出现像那只叫个不停的法国斗牛犬这样的情况，它和那些经过Canine Companions训练、社会化和服务犬享有同样的飞行权利。这也是为什么有很多关于“服务犬”在飞机上表现不佳的令人沮丧的故事。
我采访了几位美国空乘人员，他们证实，最近服务犬的数量确实增加了。但他们都表示，除了文件之外，他们不能询问主人任何问题，即使他们对一只吵闹的哈士奇幼犬有所怀疑。一位匿名的空乘人员说：“我确信这只老年的吉娃娃不会拯救任何人，但我的职责不是去验证这些事情。”
然而，问题变得更加复杂，因为没有人愿意被怀疑或质疑是否对待残疾人有偏见。那么，如何在不让人感到被攻击或被贬低的情况下，区分真正的服务犬和那些通过漏洞进入的狗？
作为一名拥有足够小的狗，可以作为随身携带物品的主人，我似乎没有理由遵守航空公司的规定。遵守航空舱内带狗的规定不仅花费更多（服务犬可以免费登机），而且会让飞行更加拥挤（被锁在航空箱中，而不是像服务犬那样可以躺在地板上或主人腿上）。
如果按照规定带狗登机如此随意且令人不快，而冒充服务犬的方式却相对容易且免费，那么遵守规则又有什么意义呢？
“说实话，这些规定根本不重要，”一位患有脑瘫并拥有服务犬Slate的女性Molly Carta告诉Vox。“我有时也这么想。我花了50美元去兽医那里做检查，只是为了填写一份表格，而旁边的人可以直接带着他们的狗上飞机。”
Carta表示，她每年旅行两到三次，过去十年中，她看到服务犬的数量迅速增长，尤其是在过去三到五年间。由于法律上没有官方的服务犬注册系统，这种增长更加明显。
她通过Canine Companions找到了她的服务犬Slate，这是她的第二只服务犬。最近，他们从康涅狄格州飞往威斯康星州，途中在芝加哥奥黑尔机场转机。
“在那个机场，有太多其他狗，以至于从我们的登机口走到下一个登机口都成了噩梦，”她告诉我，提到有多只狗试图与Slate互动、吠叫并靠近他。
尽管Slate被训练得在飞行中保持专注、静止和冷静，但干扰会让他的工作变得更加困难，甚至可能影响他在紧急情况下的帮助能力。
Carta使用轮椅和助行器，她表示，这种干扰也给Slate带来了不必要的压力。“如果我要和一群朋友一起出行，我通常不会带他，因为这可能不值得带来的压力。如果我知道周围有能帮助我的人，那我就会考虑带他。”她说。
Carta还经常担心自己在飞机上的座位安排。在她的经验中，残疾人和服务犬通常被安排在过道座位。如果有多位残疾人带着服务犬，谁会获得这些座位？这一排会不会有多个狗？
Carta对是否带服务犬出行的疑虑，似乎反映出旨在帮助她的规则存在缺陷。她还提到，她常常感到自己处于防御状态，因为人们会质疑Slate是否真的是服务犬，这可能源于他们之前与不守规矩的狗和滥用特权的人的经历。
但除非人们认识像Carta这样的人，否则很难理解她的经历会受到那些认为自己只是“轻微违规”的人影响。长期以来，Carta认为通过教育人们了解服务犬是医疗需求，是解决问题的办法。但随着时间的推移，她逐渐意识到，如果人们不愿意倾听，仅仅提高公众意识是不够的。
尽管Carta希望有相关立法，但如何在不损害真正需要服务犬的人的情况下，理清服务犬的混乱现状，仍然是一个难题，尤其是在如此多的人已经滥用这一漏洞的情况下。
“我不知道立法会是什么样子，但也许可以阻止那些不真正需要服务犬的人占用资源，”Carta说。“这关乎于认识到服务犬是一种医疗需求。”
也许最难克服的障碍就是个人的自私心理。在如此糟糕的旅行体验中，很难把别人放在自己之前，而带狗度假似乎也无害。在那一刻，没有人会想到社会契约或自己的狗可能对其他人造成影响。教导人们这种同理心，即使是服务犬也无法做到。
This past month I, like many Americans, flew back home for the holidays. On the first leg of that trip, from New York to Los Angeles, a dog in a “service dog” vest barked at me at the gate. The dog (not its given name), looked to be a stout French bulldog, paced back and forth, and yapped at a couple of other travelers.
On the way back from LAX, I noticed more dogs in service vests — a dachshund, another (different) Frenchie, a few mixed breeds — in line with their humans, waiting for desk agents. It all made me realize how many dogs traveling these days are designated service dogs, so many that there’s no way each one was a thoroughly-trained working canine. Some of these pooches had to be impostors.
Granted, because so many people fly during the holidays it was probably easier to spot them; but I’m obviously not the only person who’s noticed the rise of questionable, if not fake service dogs. Their proliferation raises a few questions.
Why are there so many? Why and how do so many people have them? Is certification that easy to get? Do this many people need them? Why is this one barking at me? Are these people who just want to take their dog on their trip? Does being suspicious of some of them make me awful? Is a fake service dog really that bad?
Sadly, I could not speak to an actual service dog for an interview regarding this contentious subject. But I did talk to experts, flight attendants, and people who train service dogs about how canine service impersonators make their job and the jobs of actual service dogs that much harder.
More and more people want to travel with their pets, and despite airline assurances about safety, owners still harbor some overall worry about traveling with their animals in cargo. They’re also managing the reality that boarding a dog can be expensive and comes with its own set of worries.
At the same time, traveling in the US with a pet dog in cabin — thanks to a multitude of rules — is actually difficult. Officially, pups must be able to fit in an approved carrier that fits underneath the seat in front of you. They must also be able to turn around in said carrier and must remain zipped up the entire time. If a dog fits all those requirements, it’ll cost roughly $150 per leg of the trip on most major US airlines.
Essentially, there’s a glut of people who want to travel with their dogs, and the only way they can is only available to small ones. Even then, not every small dog is happy to be in a secured carrier. And if there’s any certainty about people, it’s that some of them will find a way to get what they want.
“I think a lot of people started to take advantage of the fact that we really want our dogs to be with us,” says Jessica Reiss, the program director at Canine Companions, an organization that trains and places service dogs with people living with disabilities.
At Canine Companions, Labrador retrievers, golden retrievers, and Labrador-golden crosses (goldens and Labradors are two of the “fab four” breeds that experts say excel at becoming service dogs) undergo a six-month training program that includes responding to roughly 45 or so tasks that include opening and closing doors, responding to alarms and alerts, pulling wheelchairs, and item identification. Service dog recipients complete an intensive program as well.
“In order to place a dog with a person, that person comes in and stays with us for two weeks. They are literally living, breathing, everything with the dog 24 hours a day — [they’re taught] dog behavior, dog body language, how to deal with fear reactivity as the typical dog owner,” Reiss says, listing off just a few things that a person learns in those 14 days.
While training at Canine Companions is rigorous, programs like it are not the standard. Part of the problem is that there is no standard.
Reiss explained to me that even though the Department of Transportation has tried to stifle the travelers abusing pet travel (e.g., disallowing emotional support animals) and the US has made service animal designation seemingly stricter, people still find ways to circumvent those restrictions.
“There’s this loophole that says, you can privately train your dog to be a service dog, and by definition what that means is the dog has to be able to provide tasks that mitigate a person’s disability,” Reiss says. While private training can be more accommodating and accessible (i.e., for those unable to afford a trainer or who don’t have a trainer close by), it also means that more people take advantage of the lack of regulation.
“There are plenty of owner-trained, well-behaved service dogs, and they are training their dogs to do actual physical tasks, and they should be given access. But I think we’re also talking about a lot of people not wanting to leave their dogs at home,” Reiss says.
This result is a lot of confusion and lack of consistency. That’s how you get dogs like the barking Frenchy in a service vest that receives the same flying privileges as a dog that Canine Companions bred, socialized, and trained. It’s also why there are so many frustrating anecdotes of “service dogs” misbehaving on planes (and on land too).
I spoke to a handful of US flight attendants who confirm that they’ve seen an uptick in service dogs on flight. But they consistently noted that beyond paperwork, they’re instructed not to ask owners any questions, even though they might have suspicions about a rowdy, howling husky puppy. One who wished to remain anonymous put it to me this way: “Surely this geriatric Chihuahua is not saving anyone’s life…but it’s not in my job description to verify those things.”
That said, it’s even more complicated, because no one wants to be a person who treats someone with a disability with suspicion or doubt. How do you distinguish real service dogs from those sneaking in via the loophole without making someone feel attacked or dehumanized?
As an owner of a dog small enough to fit as a carry-on, there doesn’t really seem to be any benefit to following the airline rules. Following all the air cabin regulations for dogs costs more (service animals fly for free) and makes flying more claustrophobic (being zipped up in a carrier versus service animals who lay on the cabin floor or on a lap). If the “right” way to get a dog onboard is so arbitrary and unappealing, and the faux way is relatively easier and free, what’s the point in following the rules?
“That’s the thing, the rules don’t even matter,” Molly Carta, a woman living with cerebral palsy who has a service dog named Slate, tells Vox. “I feel that way half the time too. I’m like, why did I pay $50 for this vet visit to get this form filled out? This person over here is just going to walk on with their dog.”
Carta explained to me that she travels two to three times per year, and has seen the number of service dogs boom in the past decade, with the largest increase coming over the past three to five years. (By law, there is no official registry of service dogs.) Slate, whom she matched with through Canine Companions, is her second service dog, and recently they traveled from Connecticut to Wisconsin and made a connection in Chicago through O’Hare.
“There were so many other dogs in that airport that it was such a nightmare to even just get from our gate to the next gate,” she tells me, noting that multiple dogs tried to interact with, bark at, and approach Slate. While Slate is trained to maintain focus, stay put, and stay calm during flights, distractions make his job in assisting Carta harder — possibly inhibiting his ability to help her during an emergency. Carta, who uses a scooter and a walker, explains that this also puts an ample amount of unnecessary stress on Slate.
“If I’m going somewhere with a bunch of friends, a lot of times I won’t travel with him because it’s probably not worth the stress. If I know I have a bunch of people around that can help me in the same ways that he would,” Carta says.
Carta also often worries about where she’s placed on a plane. In her experience, people with disabilities and service dogs are seated in the bulkheads. Hypothetically, if there’s multiple people with service dogs, who gets that seat? And will there be multiple dogs in that row?
Carta having doubts about taking her service dog with her traveling sure seems like a failure of rules meant to help her and other people living with disabilities. She also mentioned that she tends to feel like she’s on the defensive because of people questioning whether Slate is an actual service dog — likely due to their prior experiences with unruly pups and people abusing the privilege. But unless people know someone like Carta in their lives, it’s hard to connect how her experience would be impacted by someone thinking they’re harmlessly fudging the rules.
For a long time, Carta believed that educating people about how service dogs are a medical need was the answer. But the more and more time that passes, the more she’s realized that more public awareness doesn’t work if people aren’t willing to listen. And while Carta hopes for legislation, untangling the knot of service animals without doing more damage to the people who need them is tricky too, now that so many people have abused the loophole.
“I don’t know what that legislation would look like, but maybe something that dissuades people from taking away from those of us that really need service dogs,” Carta says. “It’s about recognizing that they are a medical need.”
Perhaps the most difficult obstacle to overcome is plain individual selfishness. It’s hard to put other people ahead of yourself, especially in a situation as miserable as air travel, and taking your dog on vacation seems harmless enough. In that moment, no one is thinking about any kind of social contract or how their accompanying pooch could affect someone else down the line. Teaching someone that kind of empathy is something a dog, service or not, can’t even do.