Interested in getting an overview of bioethics? A Manhattan-based NGO, the Global Bioethics Initiative, has organiseda bioethics summer school in June and July. We asked Dr Ana Lita, the organiser, to explain what’s happening.
The Global Bioethics Initiative is a not-for-profit international organization founded in 2011. We keep the international community, policy decision-makers, the media, and the public informed of important bioethical issues through educational activities, like the summer school. Late last year, for instance, we organised a seminar on organ trafficking and human rights.
GBI is associated with the UN Department of Information and we are hoping for formal affiliation with the UN Economic and Social Council. We hope that our programs will eventually have a global reach through these links.
This is your first summer school. What prompted you to organize it?
Here in New York we have access to world-renowned experts and world-class institutions and hospitals. But we realized that there was no summer educational opportunity in bioethics from a global perspective in NYC, for students and professionals from allover the world. The globalized nature of bioethics lends itself to a more collaborative and international educational experience and in global capital like New York City, we have the benefit of having access to not only world-renowned faculty for the summer school, but also to world-class institutions and hospitals to facilitate learning in and out of the classroom.
The members of our faculty include bioethicists, lawyers, policy-makers, activists, transplant surgeons, researchers and practitioners. Many serve on influential international and national boards including, the WHO, UNESCO International Bioethics Committee, the United States Senate Committee on Aging, and the United Network for Organ Sharing.
Where will most of the students come from? Are many younger students taking an interest in bioethics?
We welcome students of all ages, including health care professionals, policy makers and journalists, but we are aiming especially at undergrads and post-grads planning to work in academia, biomedical and health-related industries.
Several interns work with your organization every year. Do many of them continue working in bioethics?
Yes, GBI has regular unpaid internships. We welcome intern students and volunteers interested in actively participating in our programs. Our interns and volunteers should expect to gain practical skills in organizing and advertising events, a greater understanding of the daily running of an international NGO as well as the opportunity to work alongside international organizations and UN agencies. As a former assistant professor of Applied Ethics myself, I work with students to accommodate university or departmental requirements to receive school credit for the internship. We welcome candidates interested in interning with GBI to contact us.
The summer school's lectures cover a wide range of topics. Which do you think will attract the most interest?
Controversial issues such as embryonic stem cell research, human cloning, cryonics, human genetic engineering, markets in organs, euthanasia and abortion, and human enhancement are topics of interest for most students.
There are other summer programs in bioethics but I am sure that none of the others offers a global perspective and a UN affiliation. The faculty is exceptional, with a complex multicultural educational and experience background. Many are full professors sitting on active international bioethics committees and boards.
Over five weeks, we hold lectures Monday through Thursday, and have field trips on Friday, plus social events. The early registration deadline is March 15. Contact Ana Lita for information.
Cows grazing at the U.S. Meat Animal Research Center in southern Nebraska
The Obama Administration has reacted swiftly to a scathing report on animal welfare at a Federal government laboratory in Nebraska in the New York Times. Agriculture Secretary Tom Vilsack has demanded an updated animal welfare strategy within 60 days. An animal welfare ombudsman has been appointed for the unit.
The Times expose claimed that treatment of animals at the US Meat Animal Research Center was far below basic animal welfare standards. Instead of trying to minimise animal pain, the center’s goal was to maximize meat production. It described some stomach-churning experiments in animal breeding and care: sows which produced so many offspring that they were crushed to death; cows which bore twins and triplets which were deformed and stillborn; lambs left to be torn apart by coyotes, among others.
Although the US Congress passed a landmark Animal Welfare Act in 1966, there was a gaping loophole: its provisions did not apply to research on farm animals used in agriculture.
“They pay tons of attention to increasing animal production, and just a pebble-sized concern to animal welfare,” James Keen, a veterinarian who worked at the center for 24 years told the Times. “And it probably looks fine to them because they’re not thinking about it, and they’re not being held accountable. But most Americans and even livestock producers would be hard pressed to support some of the things that the center has done.”
In a letter to the Times, Wayne Pacelle, the CEO of the US Humane Society, said that the “grotesque and inhumane” experiments at the center showed that government and business were colluding to treat animals as “throwaway objects”. “Is it any wonder that millions of Americans are now cutting their meat consumption and eating higher-welfare animal products when this is how government and agribusiness handle their animal-care responsibilities?”
While virginity tests for unmarried women have been universally regarded as unethical in Western countries, the practice is spreading in immigrant communities. Physicians in European countries have been asked to examine whether a girl’s hymen is intact, creating an ethical dilemma for them. If they comply, they may expose the girl to stigmatization, or even put her at risk of being the victim of an honour killing. If they certify her virginity regardless of the result, they will break the doctor’s compact of trust and honesty with patients.
Writing in the Journal of Medical Ethics, a South African physician argues that medical colleges should declare that virginity tests are unethical, thus giving doctors a right to refuse. The Quebec College of Physicians has already done this.
The author, Dr Kevin Gary Behrens, of the Steve Biko Centre for Bioethics, University of the Witwatersrand, is familiar with the issue, as it is a serious problem in South Africa. Girls who “fail” are called “rotten potatoes”. But girls who pass could be targeted by rapists or men who believe that intercourse with a virgin will “cure” AIDS.
He points out that research in The Lancet and the BMJ has shown that “virginity testing” is devoid of scientific value.
“This has the effect of rendering every virginity certificate ever issued by a physician scientifically fraudulent. Thus, for a physician to agree to perform a virginity test entails a flagrant disregard of the principle that medicine should be practised on the basis of scientific principles. The moral obligation of a physician who is approached to perform such a test is clear: the physician should inform the client that it is simply not possible to do what is being asked. Since there is no scientific basis upon which any physician can certify that a particular woman is or is not a virgin, it would be unethical for any physician to concede to such a request.”
The tests are also socially harmful, argues Dr Behrens, as they perpetuate stereotypes about women, misogyny and patriarchal attitudes.
Novel techniques of editing the genome have inspired some British scientists to call for a public debate on designer babies. Dr Tony Perry, of the University of Bath, recently announced that his team had successfully edited mouse DNA at the moment of conception. Using “Crispr” technology, it will be possible to delete and insert DNA in human embryos. "There's much speculation here, but it's not completely fanciful, this is not HG Wells, you can imagine people doing this soon [in animals],” he told the BBC. "At that time the HFEA [the UK's fertility regulator] will need to be prepared because they're going to have to deal with this issue."
Changing the DNA could remove genetic diseases from a bloodline, but it would also be genetic engineering. "Obviously in the UK, this is not allowed and there would have to be a change in regulations, which I suspect would have enormous problems,” Professor Robin Lovell-Badge, of the UK Medical Research Council, said. "But it is something that needs to start to be debated. There has been a blanket ban on germ-line therapy, so there needs to be a debate about that and some rational thought rather than knee-jerk reactions that, 'No you can't possibly do that.'"
A spokesman for the UK's Human Fertilisation and Embryology Authority commented: "We keep a watchful eye on scientific developments of this kind and welcome discussions about future possible developments."
At the intersection of marketing and bioethics is the issue of perpetuating racist stereotypes. In many countries, especially South Asia, a preference for lighter skin predates European colonialism. By some estimates the “fairness market” in India for both men and women is worth more than US$500 million. Matchmaking sites often mention “wheaten skin” as a desirable feature of a prospective soulmate.
Unilever’s Fair & Lovely is the market leader in India. Overseas brands are pushing similar products: L’Oreal’s White Perfect Deep Whitening Double Essence, Revlon’s Absolute Whitening Skin Care Range, Estee Lauder’s White Light, Yves St. Laurent’s Blanc Absolute Serum, Elizabeth Arden’s Visible Whitening Pure Intensive and so on. The Vaseline brand created a controversy with a Facebook widget which allowed users to lighten their complexion.
Marketing academics from the University of Hull Business School in the UK and James Cook University in Australia have questioned the ethics of these products in a recent paper. They claim that there are significant safety issues with these skin lightening products. While most tout the power of vitamins, many contain high levels of mercury. Another dangerous agent is hydroquinone, which can be carcinogenic.
The products are popular and their manufacturers claim that they are harmless. However their critics claim that there is social harm:
Advertisements in all the countries in which Fair & Lovely is sold show product users getting better jobs, getting married or having a brighter future (and being noticeably happier) as a result of their lighter skin. The primary target market is women aged 18 – 35, with the poor being a significant segment. There are reports of girls aged 12 – 14 using the product, which is marketed in ‘affordable’ small packages. Critics have claimed that the ads are socially objectionable, racist, demeaning or even ‘repellent’. Two ads have been taken off air in India as a result of protests, but others are still running.
However, demand is strong for the products. “The company is marketing a legal product, it is not breaking any laws, and it appears to have a loyal customer base, but can it claim to be doing good while it does well out of sales of the product?” The academics leave the question unanswered.
Arguments against physician assisted suicide and euthanasia often turn on a claim about the need prioritize the development of adequate palliative care. A new article in the Journal of Medical Ethics provides a sophisticated critique of this archetypal argument.
Joaquín Barutta (Ruhr University, Germany) and Jochen Vollmann (Italian Hospital University, Argentina) discuss a number of variants of the ‘argument from palliative care’ – the view that the existence (or, in some cases, the non-existence) of palliative care means that we should not allow physician assisted death (PAD). Barrutta and Vollmann claim that each variant of the position is flawed.
One formulation, sometimes put forward by more cautious pro-euthanasia advocates, is that a lack of available palliative care limits a patient’s autonomy. If a patient does not have all the options available to him, then how can he make a truly free decision? Barutta and Vollmann respond by arguing that ‘autonomy’, even in situations where palliative care is not available, is still present.
"Certainly, a lack of better options limits the choices a person has available. However, an autonomous decision is not the same as a decision after trying all other options… All we should require is that their choice is the result of correctly applying the skills needed to make a decision based on their own values and beliefs."
Barutta and Vollmann continue from this claim to discuss the second variant of the position, ‘the argument from existing alternatives’. Some would argue that patients should try all existing alternatives first before opting for euthanasia. The authors respond:
“we interfere with the autonomous decision of these patients to request PAD that we have discussed previously. Since doing so results in more suffering, it is hard to see how this could be justified using this argument.”
The authors also discuss the claim that PAD will be used primarily by those from low socio-economic backgrounds, precisely those social classes lacking adequate palliative care. They put forward the following rejoinder:
“PAD derive from lack of economic resources to get better care, forbidding PAD does nothing to help these patients. On the contrary, as already noticed when analysing the previous argument, it reduces their options even more, condemning many of them to a worse death.”
It strikes this writer that the oft-made argument from ‘lack of autonomy’, though not without promise, needs to be revisited if it is to address Barutta and Vollmann’s critique.
This may sound like a pretentious thought from a sci-fi movie, but one San Francisco geek believes we can make it a reality.
Austin Heinz, the founder of the start-up Cambrian Genomics, dreams of a future in whichcustomers tinker with the genetic codes of plants and animals and even design new creatures on a computer.
In a makeshift laboratory in San Francisco, his synthetic biology company uses lasers to create custom DNA for major pharmaceutical companies. The synthetic biology is nothing new – what’s novel is Heinz desire to make the technology cheap, fast and affordable, such that private users can take advantage of it.
“Anyone in the world that has a few dollars can make a creature, and that changes the game,” Heinz said. “And that creates a whole new world.”
The 31-year-old CEO has managed to attract over $10 million in support an investments from Silicon Valley venture capitalists. A significant amount has come from Peter Thiel’s venture firm Founders Fund.
Venture capitalist Timothy Draper, an investor in the company, expressed his enthusiasm for the project: “I love Cambrian,” he said. “The company is literally printing life. Can’t wait to see all the great things that come of it.”
Understandably, bioethicists have reservations. It is still unclear whether the company has adequate security measures to prevent customers from requesting dangerous DNA sequences. And the hubris of the Heinz’s rhetoric has some ethicists alarmed. Marcy Darnovsky, executive director of the Center for Genetics and Society, a bioethics watchdog group in Berkeley, described Heinz’s belief that “every problem can be solved by engineering” as a kind of “techno-libertarianism.”
The Supreme Court of the United States has agreed to hear a case about the constitutionality of a new execution method being used in Oklahoma's correctional facilities.
Due to a shortage of customary execution drugs, Oklahoma's authorities are using a new combination of barbiturates to execute prisoners. The combination involves the drugs midazolam, intended to cause unconsciousness, rocuronium bromide, which works as a paralytic, and then potassium chloride that serves as a heart-stopping agent.
In the case Glossip v. Gross, No. 14-7955, three Oklahoma inmates are claiming that the new procedure violates the eighth amendment. They argue that it poses a significant risk of 'terrible suffering'.
Medical experts testifying on behalf of the inmates at an evidentiary hearing said the effects of high doses of midazolam, which Oklahoma adopted, were too unpredictable to justify its use. They reminded the court that FDA has not approved the use of midozolam as a general anaesthetic in clinical practice.
The case is likely to appear before the Supreme Court this term.
“Petitioners are pleased that the Supreme Court will review their case,” said Dale Baich, one of the attorneys representing the death row inmates. In a statement, Baich said that the protocol is “not capable of producing a humane execution, even if administered properly.”
China has by far the greatest gender imbalance of any nation in the world, with conservative estimates from 2014 putting the ratio at 115.8 males to every 100 females.
The peak body responsible for family planning in the country, the National Health and Family Planning Commission, this week made its strongest statement yet on the crisis.
In a document published on the commission’s website, officials wrote, “China's sex imbalance problem among newborns is the most serious and prolonged in the world and the population it affects is the greatest”. They noted that there are over 33 million more men than women in the country.
Statistics published by the commission, suggest that the ratio has dropped from 121.18 in 2014 to 115.8 last year. Nevertheless, as the commission itself admits, “the gender ratio at birth is still dangerously high”.
There is an extant domestic ban on the use of blood testing to determine the sex of a fetus, but many Chinese couples are attempting to send their blood samples out of the country to be analysed by overseas agencies. In their statement last week, commission officials vowed to crack down on the practice, and reminded medical staff that carrying, mailing or transporting blood samples abroad is illegal.
A Dutch end-of-life clinic has been reprimanded for the third time in a year for moving the goal posts for euthanasia. The Levenseindekliniek in The Hague helped a woman to die because she complained of severe tinnitus, or ringing in the ears. An independent review commission conceded that tinnitus could satisfy the criteria for legal euthanasia, but said that the clinic should have referred 47-year-old Gaby Olthuis, a mother of two, to a psychiatrist. The other two complaints concerned an elderly woman who did not want to enter a nursing home and an elderly psychiatric patient.
The symptoms that Ms Olthuis claimed to have were severe: she constantly heard the sound of screeching metal and even the rustle of opening a plastic bag hurt.
Levenseindekliniek opened in 2012 for patients who could not find a doctor who agreed to euthanase them. Since then they have helped about 250 people to die. The director of the clinic, Steven Pleiter, said that he was exasperated by the reprimand. "We try to help people and do it in a very precise and careful manner. We find it annoying that we now have to deal with this for the third time."