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.
I just stumbled across a documentary which was recently released in Peru, Cicatrices del engaño (Scars of Deception), about the 300,000 women and 22,000 men forcibly or deceitfully sterilised by population control officials in the government of President Alberto Fujimori in the 1990s.
I hope that it will be released in English (at the moment, even the Spanish subtitles in YouTube are awful), so that we can all learn lessons from this ghastly abuse of human rights. Earlier this year the former president, who is currently serving a 25-year jail sentence for crimes against humanity, was exonerated of blame for the sterilization program. The prosecutor said that he could find no evidence that women had been systematically coerced.
The tears of the women in the documentary suggest otherwise. While Mr Fujimori and bigwigs in his administration ought to put in the dock for this atrocity, how about the doctors who did the tubal ligations? Shouldn’t they be investigated for their zeal in meeting sterilization quotas set by the government? “The worst of it all is that one of the doctors who damaged me for life is still working in the Izcuchaca health centre,” one woman told the IPS news service. “Every time I see him I feel furious, because nothing has happened to him.”
A closer examination of this dark chapter might reveal other enablers. The US government and the United Nations Population Fund gave development aid to the population program, for instance. Ironically, just before the 1995 Beijing Women’s Conference the government removed a ban on sterilization as a method of birth control. This was widely applauded at the time by feminist groups as a bold step forward and a poke in the eye to Catholic Church, which opposed sterilization. As they say: be careful what you wish for.
The other day I was speaking with a friend in Tasmania who has been researching the fate of a great-uncle who disappeared in the Battle of Fromelles. This was one of the worst defeats of World War I for Australia. In a single day, July 19-20, 1916, the 5th Australian Division was cut to pieces.
German intelligence later called the attack "operationally and tactically senseless". The Australians were not well prepared for conditions on the Western Front, were poorly led, did not have the element of surprise, and were exposed to flanking machine gun fire from higher ground. There were 5,533 dead and wounded.
After 98 years, you might think that this classic “over the top” tragedy would have been forgotten. Not so. Australian authorities are still trying to track down each and every one of their fallen.
In 2009 a mass grave of 250 Australian and British soldiers was discovered. Researchers set to work to identify the remains. With DNA testing and Google this has become much easier for them. They scour records for descendants and relatives of fallen soldiers and then ask for DNA samples. These are matched against the remains. It is a painstaking and expensive project, but one worthy of a civilised society where no one’s life is ever without value.
What struck me as I read comments on the Army website and on newspaper articles was that identification had brought peace to relatives three or four generations later. “This is my great great uncle,” wrote one woman. “We never knew what happened to him until now. We just assumed it was a death in the war, but it's now good to have some closure, even if we never had a chance to know him.
There is something deep, visceral, lasting, and even imperative about genetic ties. We are hard-wired to hunger for our roots. That’s partly why I am sceptical about contemporary moves to create genetic orphans through surrogacy, or possibly artificial gametes. Every child has a right to a biological mother and a biological father, not just to provide care and comfort, but to give them a sense of personal identity.
The Nuffield Council on Bioethics, the UK’s peak body for advising the government about bioethical issues, recently hosted a panel discussion on “Bioethics in 2025: what will be the challenges?” There were four panelists, all women and all “exciting new voices”, according to BioNews. Inevitably, each speaker interpreted the scope of the topic differently, but some interesting themes emerged.
Here are a few of the issues to watch for, the speakers said:
A more inclusive discourse must emerge in bioethics. Children, ethnic minorities, cultural minorities, patients and carers all deserve to be heard.
More inclusive access to reproductive technologies is needed.
There must be more global equity in access to healthcare.
We will understand better that the limits of our moral community should not stop at humans.
We will be considering the merits of a “morality pill” which will encourage socially acceptable behaviour.
Advances in human enhancement mean that our bodies will be repaired or augmented by animal or mechanical parts.
I regret that I was not able to attend, as it sounded like a very stimulating evening. But I wonder if bioethical challenges of the coming decade will really centre on inclusion and enhancement. These have a certain cachet in Hollywood and Harvard, but in the real world? I’d vote for euthanasia, markets in reproduction and organs, conscientious objection and a revival of eugenics.
What would you nominate as the leading bioethical challenges of 2015?
As I may have said before, I do not support assisted suicide. But I would like to understand it better. In this respect, I have found nothing better than a Swiss documentary about the work of Dr Jerome Sobel and his group Exit in the Francophone cantons of Switzerland.
Exit: le droit de mourir (Exit, the right to die) was made in 2005 and won a few prizes. I reviewed it some time ago and it always stuck with me. Earlier this year the director finally eleased it on YouTube (with subtitles). It is a stunning film with very subtle editing and brilliant photography. It is also quite disturbing as several people die before the unblinking gaze of the camera.
I was expecting ethical arguments in favour of assisted suicide such as terminal illness or unbearable pain. But to my surprise, his angle was that the accompagnateurs, the death escorts, are warm-hearted guardian angels who have a vocation to lead people into a better place. Sobel is depicted as a Christ-like figure; a board meeting is even framed as a Last Supper, featuring him surrounded by his 11 disciples.
Have a look for yourself, but my feeling is that a person with a vocation to help people die is a dangerous man or woman. Take Philip Nitschke, the recently suspended Australian doctor who informs people about how to kill themselves. He believes that he is crusading for human rights; he has been linked to a number of deaths. Sobel frames his work as a post-Christian work of charity. Perhaps that is why his organisation is pressing for access to Swiss nursing homes (see story here). They want to proselytise as many as possible.
This is one of the most dangerous aspects of legalised assisted suicide and euthanasia. It will be aggressively promoted by groups who feel that they have been called to kill.
One of Australia’s most renowned bioethicists died in Melbourne this week, nearly 40 years after he was diagnosed with a terminal illness. Nick Tonti-Filippini was 58. He suffered from chronic rheumatoid auto-immune disease which led to serious complications with his kidneys and heart, in addition to many other problems.
Nonetheless, he was a staunch and perceptive opponent of euthanasia. In an open letter to an Australian politician, he wrote:
“I cannot speak for all people who suffer from illness and disability, but think I can speak more credibly about suffering, illness and disability than those people who advocate for euthanasia presenting an ideological view of suffering and disability. Facing illness and disability takes courage and we do not need those euthanasia advocates to tell us that we are so lacking dignity and have such a poor quality of life that our lives are not worth living.”
But Nick was a highly competent professional bioethicist rather than a political campaigner. He was a member of the Australian Health Ethics Committee of the National Health and Medical Research Council and chair of sub-committees on the Unresponsive State and Commercialization of Human Tissue. He was much sought after as a consultant bioethicist by government bodies, including UNESCO, the US Congress and the German government.
Nick taught bioethics at the John Paul II Institute for Marriage and Family in Melbourne and was a devout Catholic. But the supervisor of his Master’s degree at Monash University was the world-famous utilitarian ethicist Peter Singer. It is hard to imagine men with two more different world views, but he used to speak warmly of Singer. “Peter has a great sense of humour. He’s quite unlike his public image, where he’s always looking for an argument,” he told The Age. He regarded some of Singer’s ideas as evil, but advised people not to confuse the ideas with the man. “Peter’s principles don’t touch Peter’s emotions. They are two separate things.”
Nick was a model of sober intellectual rigour and generosity of spirit. From time to time I used to seek his advice for background information. He always responded quickly and in great depth. He is a great loss for Australia and for bioethics.