Even writing a short column like this one is a tough job. Those who agree with you expect more gold when the lode is nearly exhausted; those who disagree with you demand minute documentation; those who are merely curious will not return if the punctuation is sloppy. There’s a deadline and it has to be posted quickly. It can make you quite dyspeptic.
Which perhaps explains a post written by the incoming associate editor of the Journal of Medical Ethics, Brian D. Earp. An Oxford theologian, Nigel Biggars, argues in the JME that there is a place for religion in bioethics and medicine. (See below.) Fiddlesticks, says Earp. “Some people will feel a shiver go down their spines—and not only the non-religious.”
I thought for a moment that he must have been referring to the intersection of religion and cardiology documented in The Discovery And Conquest Of Mexico, by Bernal Diaz. (A fabulous read, by the way.)
"The dismal drum of Huichilobos sounded again, accompanied by conches, horns, and trumpet-like instruments. It was a terrifying sound, and when we looked at the tall cue [temple-pyramid] from which it came we saw our comrades who had been captured in Cortés defeat being dragged up the steps to be sacrificed. …Then after they had danced the papas [Aztec priests] laid them down on their backs on some narrow stones of sacrifice and, cutting open their chests, drew out their palpitating hearts which they offered to the idols before them."
But no, Earp was referring to Christianity, whose distinctive contribution to medicine, apparently, is to deny women life-saving abortions. It’s odd that he ignored the Good Samaritan ethic which gave rise to the modern hospital system and the well-documented origin of bioethics in Catholic medical ethics. And, as Biggar points out, notions of human dignity and a preferential option for the poor are grounded in Christian ethics.
If we are looking for a philosophy to animate good medical care, we could do worse than Christianity, quite a bit worse. I think that the jury is still out on whether religion-less, secular medical ethics has really been a big improvement.
I just came across an opinion piece in New Scientist by one of its feature editors, Michael Le Page. It’s not the sort of opinion that surfaced in the media before Parliament passed the “three-parent baby” law earlier this month.
Mr Le Page says candidly that the law allows genetic engineering. “The decision to allow three-parent babies is right. But the fact is, opponents were also right to describe this as a step towards tinkering with the rest of our genome.”
He goes on to argue that most scientists concealed their true opinions on the matter out of “political expedience”. “I suspect many biologists harbour similar views, but not many say so openly. Instead, they back three-parent babies but say it isn't really genetic engineering.”
I wonder if Mr Le Page understands the seriousness of the allegation he makes here. He is saying that the scientists involved in selling the idea of “three parent babies” lied to the public -- even though this was clearly of the most ethically challenging bioethical issues ever debated in Parliament.
The last time I checked, lying was deeply immoral. Perhaps there are exceptions, though, if scientists need to lie to people who are troublesome and stupid. Then it’s probably OK.
The problem with lying, though, is that one quickly acquires the habit of deceit and manipulation. Then it becomes harder and harder to trust anything the liar says.
I do hope that Mr Le Page is wrong about this. What do you think?
If there is a theme for the stories in this week's newsletter, it is that poverty is bad for your health. After the Greek economy tanked, as Xavier Symons reports below, the standard of health care has become dismal. It's one more reason to fear a global economic meltdown.
But it also leads to some confused thinking. British Prime Minister David Cameron has announced that obese people who are collecting a sickness benefit may be kicked off the welfare rolls if they do not follow their doctor's treatment regime (see below). This tough medicine sounds sensible if you believe that obesity can be solved just by pushing yourself away from the table.
However, lots of research has shown that obesity is a complex problem. Poverty is one of its causes, or one of the factors associated with it. Will making people poorer make them slimmer? Is Mr Cameron's plan a daring new health policy, or is it just grandstanding? What do you think?
Assisted suicide in Canada has been described as “an idea whose time has come”. It’s a reality now after Friday’s unanimous Supreme Court decision.
What intrigues me is: why Canada? Something is going on there. Canada must be the only country in the world without an abortion law. Canada was the first sort-of Anglophone country to legalise same-sex marriage. And now Canada is the first sort-of Anglophone country to legalise assisted suicide.
Why is Canada so ethically progressive even though it struggles to keep from being stereotyped as “the world’s most boring country”? (Check Google.) Does it have something to do with the tension between Francophone Quebec and the rest of the country?
I suspect that Americans are really ignorant of the cultural currents in their northern neighbour. But to see where the US, the UK, Australia and New Zealand are heading, they need to study how the second largest country in the world already got there.
It was extremely distracting, but as we were toiling over BioEdge today, we also had to watch the final in the Asian Cup. The 2-1 win by the Socceroos over South Korea in extra time will be a great boost for soccer in a country where there are four competing codes: rugby, rugby league, AFL and soccer, all confusingly called “football”. There is even a small league playing what Americans call “football” and Australians call “gridiron”.
It was a great game, although the best goal of the tournament was scored by Tim Cahill in the quarter-final against China: a bicycle kick into the left corner of the net. It was quite stunning and the video went viral.
Um, bioethics…? OK, OK, OK. Sorry.
I came across a post on the blog of the American Journal of Bioethics about gridiron, sorry, football, which asks whether bioethicists can ethically watch a game with such poor health outcomes for its players. Many develop Parkinson’s, Alzheimer’s, uncontrollable aggression, cognitive impairment and other disorders. Not to mention another issue, the US$10 million that the NFL has spent studying concussed mice, to the disgust of animal rights activists. “It is important to question whether supporting the NFL detracts from our duties as bioethicists and the goals of our profession,” writes Keisha Ray.
Dr Ray seems to be dragging bioethics back to its roots in Catholic medical ethics, as this is a typical question debated by theologians in the field of “cooperation in evil”. The question she is really asking is whether bioethicists just have to be smart or whether they have to be saintly and smart.
Anyhow, after watching the Australia-South Korea match, I have a suggestion. What if the US banned gridiron and adopted soccer? Soccer lacks the moral complications of gridiron, has a lower level of injuries and is a world game. I doubt whether European soccer clubs are shelling out US$675 million to care for brain-damaged players and their families.
Just a thought which we can debate further after the New England Patriots meet the Seattle Seahawks tomorrow in Super Bowl XLIX.
There is an apocryphal story of an advertisement placed in the matrimonial pages of a North India newspaper: "Family seeks homely, attractive, convent-educated girl for son. Caste no bar. But must be able to drive tractor. Photo of tractor appreciated." That is a joke, of course, but the real advertisements are just as intriguing for Westerners. One feature of a desirable “boy” or “girl” is a fair complexion, often described as a “wheaten” complexion.
The industry which has sprung up to feed the demand for lighter skin in India is worth an estimated US$500 million. Advertisements in magazines and on television drum home the message that a lighter skin gets the boy/girl/job. This is obviously perpetuating stereotypes about beauty, class, and caste as well as exploiting anxieties about body image. Is it ethical? That is the question posed by one group of academics in a story below.
An even more serious issue in the same vein is whether doctors should comply with requests for virginity tests. Like female genital mutilation, this is a practice which has spread to Western countries with migration. A South African doctor argues below that national colleges of doctors should declare that this is completely beyond the pale.
Like most of you, I suspect, I have been mesmerised by the drama in France. Seventeen people dead at the hands of jihadists invoking the name of Allah. Millions of people marching through the streets of Paris. World leaders convoking meetings to discuss global security.
Global, that is, in the sense of both sides of the Atlantic. And Atlantic, in the sense of 30 degrees north of the equator.
In the meantime, the troops of Boko Haram, also invoking Allah, swept through the dusty town of Baga, in northeastern Nigeria and killed hundreds of people, men and women, old and young, and left their bodies to fester in the streets.
It’s not often that we are confronted with so stark a contrast. According to MIT’s Center for Civic Media, even Nigerian newspapers paid more attention to events in Paris than in Baga. The #JeSuisCharlie hashtag became so popular that entrepreneurs tried register it as a trademark. But no one is tweeting #JeSuisBaga.
My point is an obvious one, so obvious that it sounds like a tedious platitude. We may be living in a global village, but the other residents live like us, look like us and think like us. Outside the village live about 80% of the world population.
These two atrocities don’t have a lot to do with the kind of bioethical issues that we normally cover in BioEdge. But the contrast does suggest that we have a blind spot. Developing World Bioethics, an academic journal edited by Debora Diniz and Udo Schüklenk does a good job of examining some of the challenges in poor countries outside the neon lights of our hyper-connected Global Village. Touch wood, we’re making a New Year’s resolution to examine some of these problems in BioEdge as well.
Happy New Year! We’re back – and it has been a sombre week. Apart from the murders in Paris by Islamic terrorists there was the less publicised massacre of possibly 2,000 people in the Nigerian town of Baga by terrorists from Boko Haram, the local affiliate of al-Qaeda.
The violence really made me sick at heart. It was deeply disturbing to see the YouTube video of a young man killing a wounded policeman as he loped down the footpath. The casualness, the insouciance, the nonchalance was appalling. What sort of warped ideology shapes the brain of a young man to kill defenceless people without a second thought?
And to tell the truth, I also find it disturbing that the world’s leading activist for euthanasia is thinking of launching a new career as a stand-up comedian. Dr Philip Nitschke has been deregistered by an Australian medical tribunal over his involvement in a suicide of a man who was not terminally ill last year. But there are probably dozens of others who acted on his advice and are no longer with us. He will no doubt be using anecdotal material at the Edinburgh Fringe Festival in August this year. (This is not a joke.)
I think this shows how out-of-touch Dr Nitschke is with public morality. We expect doctors to be saving people’s lives, not joking about killing them. The problem is that he has become desensitized by years of helping people to kill themselves. “I’m hardened to them, he told the tribunal. “I behave to them perhaps on a way which some would see as insensitive.”
There is no comparison between the handiwork of Philip Nitschke and of the terrorists. Except in this: both are deeply nihilistic. Human beings have no intrinsic dignity and death is better than life. We don’t need either of them in a democratic policy.
Apologies for the brevity and late arrival of this week’s BioEdge. We plead pressure of Christmas and the holiday season… In any case, all of the bioethical oxygen this week was sucked up by the report from a US Senate committee on the “enhanced interrogation” techniques used by CIA operatives to convince al-Qaeda detainees to reveal their secrets. Although the broad outline of this drama was already known, the details are dismaying. It is shameful and unworthy of a great country, as Senator John McCain commented: “Our enemies act without conscience. We must not.”
On a different note, without prejudice to the truthfulness of the aforementioned excuses, I recently saw a stunning film by the brilliant Iranian director Asghar Farhadi, Le Passé (The Past). It begins as a conventional melodrama about an Iranian man who returns to Paris because his French wife wants a divorce. All the characters, both adults and children, are struggling to free themselves from a spider’s web of misunderstandings and secrets. The melodrama becomes an intensely engaging detective story.
The bioethical angle? At the heart of the conflicts is a brain-damaged woman, apparently in a permanent vegetative state. Is she still married? Does she have dignity? Is she still lovable? I can’t remember the last time I was so touched by the honesty, humanity and artistic skill of a film. Sorry, not true – the last time was Farhadi’s Oscar-winning film A Separation. But that lacked a bioethical angle.