Here’s an advertising idea which needs a report from a consultant bioethicist. Sky Deutschland (part of News Corp, but not related to the British Sky) is considering a novel channel for advertising – bone conduction through window glass.
The idea is that weary commuters often rest their heads against the windows of trains. At unspecified intervals, a spoken message is broadcast through the glass. No one else can hear the words. The video below shows startled commuters wondering where the message came from.
The BBDO advertising agency told the BBC: "If our customer Sky Deutschland agrees, we will start with the new medium as quickly as possible. Some people don't like advertising in general. But this is really a new technology. [It might] not only be used for advertising, but also for music, entertainment, mass transport information, weather reports and so on."
I don’t know much about psychiatry, but mightn’t a device like this spark latent paranoia in a few people? Isn’t there something creepy about invading people’s privacy in this way? Shouldn’t you ask for informed consent to plant an idea directly in people’s heads? Isn’t there something fundamentally different between this and ads on a TV screen?
As for me, I have already made up my mind. I won’t be waiting for the consultant’s report. The video shows that the message is transmitted through tiny black box which is linked to the window by a wire. I may never have the opportunity, but if I ever do and if anyone from Sky Deutschland out there is listening, I swear I am going to rip the wire out.
This week’s decisions from the US Supreme Court on same-sex marriage could quickly lead to more bioethical dilemmas. As we pointed out last year in BioEdge, surrogacy agencies in India and the US are looking forward to a clear legal status for same-sex marriage, as it would increase the demand for surrogate mothers.
Dr Samit Sekhar, of the Kiran Infertility Centre, in Hyderabad, told BioEdge: “Yes, we have a sizeable number of gay population that visit our clinic to have a baby using the services of an egg donor and we have seen an increase in the number of gay couples and single men approaching our clinic as soon as legitimacy to their public union is granted in their respective states or country.”
Indian authorities have recently made gay surrogacy more difficult, but demand will surely shift to other countries like Guatemala, Cyprus or the Ukraine. Even in the US, Dr Jeffrey Steinberg, a prominent IVF specialist in California, told us, legalization sparks a surge in demand for surrogates for gay couples.
This is an angle of the same-sex marriage debate which is seldom discussed. The stability of gay marriage means that some couples will adopt children. But no matter how pretty a picture the clinics paint, surrogacy on an industrial scale is exploitative and often dangerous. It’s an issue that deserves to be highlighted.
Sorry, it has been a busy weekend and I am afraid that this issue of the BioEdge newsletter is being sent out rather late.
Last week the media was full of news about the US government’s surveillance of the internet. As everyone knows by now, companies like Facebook, Google, Microsoft and Yahoo allow the National Security Agency to trawl through their records to prevent terrorist attacks. The US may be sharing some information with intelligence agencies of other governments as well.
Which leads one to ask whether privacy is possible any more. The bioethics angle on this is genetic privacy. It turns out that a skilled number-cruncher can identity participants in genetic research studies by cross-referencing their DNA with publicly available information.
When people become aware of this, will they be willing to disclose their genetic data to researchers? Is it ethical for researchers to store their records in the cloud? What safeguards must scientists and doctors take to ensure the privacy of participants and patients?
There are a lot of questions that need to be asked in the wake of Edward Snowden’s revelations.
Just as I was about to put BioEdge to bed, a couple of Wall Street Journal articles by Naftali Bendavid about euthanasia in Belgium popped up on Google News. They appeared just as the Belgian Parliament reached a consensus on allowing euthanasia for children who request it.
The articles present two very different images of euthanasia. The first is joyful and serene.
"It's something they are looking forward to," says one doctor who has euthanased more than 20 patients. "That sounds paradoxical, but it is the only way to step out in a dignified manner, having control over their life and death, and they see it as a kind of party. They are surrounded by loved ones, they sing songs sometimes. It's very, very strange."
The second is bureaucratic, lonely and stark. Tom Mortier, a chemistry lecturer, learned via email that his mother, who suffered from depression, had been euthanased. Then he received a bill for transport of the body to a science lab where it would be dissected. It was a sad way to die. "What the doctor does is like a god," Mr Mortier told the WSJ. "He decides if the life is worth living or not."
The Belgian media have enthusiastically embraced the first framework for euthanasia, with numerous features appearing about the beauty of choosing the time of one's departure. But I wonder if the experience of Mr Mortier’s mother is really the more common one.
Over the past ten years, more than 5,500 Belgians have been euthanased. Did they all step into the dark clinking champagne glasses and singing cabaret songs? Somehow I doubt it. But that is one of the many things which remains murky about legalised euthanasia. We need more information.
If you have an interest in how legalized euthanasia works, our lead story is quite compelling. (It is the first time that the news has appeared in English.) Dutch doctors are now allowed to take into consideration the suffering of parents when deciding whether or not to give a child a lethal injection. This is an interesting development. What will happen when the same principle is applied to the elderly? Will the tears of their middle-aged children decide whether they live or die?
Although bioethics deals with living beings and robot ethics deals with machines, their destinies are intertwined. As you can read in this week’s article about the development of Lethal Autonomous Robots (LARs), scientists, armies and politicians need to create ethical “codes” for killing machines. And quickly.
At the moment a human operator instructs a drone to release its missiles. But the time is not far off when the drones will “decide” for themselves. And since their decision-making power needs to be programmed by someone, who better than bioethicists?
The great science fiction writer Isaac Asimov created his famous Three Laws of Robotics as long ago as 1942. These are useful, but they really don’t apply to what currently worries the United Nations about these new weapons. The First Law is that no robot may harm a human being – but several countries are designing robots whose main function is to kill.
The task of creating a robot ethics will be harder than it seems. The fractured history of bioethics offers a cautionary tale: are they to be utilitarian robots, or deontological robots, or principalist robots, or feminist robots, or what? Anyhow, I suspect that there will be job opportunities for unemployed bioethicists with programming skills in the near future…
Thanks to everyone who commented on our plans for a new-look newsletter. We are hoping to list only the first few lines of the stories. When you click on the headline you will be taken to the complete article in the newsletter. I’m afraid that we move at a glacial pace, but it will happen. Stay tuned.
About half of the articles in this week’s newsletter involve assisted suicide. We aren’t campaigning on the issue; several stories cropped up together. But taking advantage of this, I might make an observation on a news theme from India.
Abdul Rahim is an impoverished shoemaker from the northeastern state of Shillong. His three sons, aged 9, 14 and 16, all suffer from thalassemia and he has spent all of his money on cures, with little to show for it. According to the Hindustan Times, he has appealed to the judiciary for permission to euthanase them as he cannot care for them properly.
This is a story which crops up again and again in the Indian media. It is always the same. A poor father with a very sick child asks for euthanasia, not because the child is terminally ill, but because he doesn’t have money to relieve their suffering. None of these requests have been granted because India does not allow euthanasia. The request is more a call of desperation rather than a studied proposal based on patient autonomy and the absolute to self-determination.
It seems a bit callous to draw a moral from Abdul Rahim’s anguish, but it is relevant to those of us who live in more developed countries. Mr Rahim wants his sons to live but he simply cannot afford to care for them any longer. The only solution he can think of is killing them.
Similarly, in our societies the demand for euthanasia seems strongest where the social fabric is weakest. Care is expensive, time-consuming and exhausting. But the real solution is not euthanasia, but more support, both financial and social. If we were to legalise euthanasia, the poor and the isolated would eventually be the ones who take most advantage of it.
Over the next couple of months we are hoping to make some improvements to the website and the newsletter. We’d like to ask your opinion.
The most significant change would be to shorten the text of the newsletter. Instead of the complete text of the stories plus illustrations, the newsletter would contain only the first one or two paragraphs so that you can decide whether you are interested in reading further. If so, you would click on a link which would bring you to the BioEdge website.
What is the reason for this? First of all, it will make the newsletter a bit easier to skim through. For quick readers, it is often too long. Also, more and more people are reading the newsletter on phones and tablets and for them it becomes a bit unwieldy.
But the main reason is to generate more traffic on the website. We would like to see BioEdge grow a lot more. Part of the solution is to increase the number of hits on the website so that it will be picked up by search engines more often.
I know that some people might prefer not to change the newsletter format. However, I think that the long-term effect will be to make BioEdge easier to read and more accessible.
Angelina Jolie’s decision to have a double preventative mastectomy is a teachable moment in bioethics. But as a columnist in the Financial Times points out, it’s hard to know what the lesson is. Jolie said that she made the news public to help other women realise that they have choices. But, given her celebrity status as an international sex symbol, she is in a league of her own. What exactly can women learn from her unique case?
Another lesson is political. Her op-ed in the New York Times was clearly aimed at influencing the deliberations of the US Supreme Court on Myriad Genetics’ claim that it can patent the BRCA 1 and 2 genes which indicate a susceptibility for cancer. Currently tests for the genes cost about US$3,000. Jolie says that women should be able to access “gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live”.
The most important lesson, perhaps, was glossed over in the wall-to-wall media coverage: how much fear influences women’s decisions about breast cancer. “We are confronting almost an epidemic of prophylactic mastectomy,” Dr Isabelle Bedrosian, a surgical oncologist at M. D. Anderson Cancer Center in Houston, told the New York Times. “I think the medical community has taken notice. We don’t have data that say oncologically this is a necessity, so why are women making this choice?”
Removing body parts is a pretty barbaric treatment for a disease which you don’t have. If campaigns to increase awareness of breast cancer leave women in a state of barely suppressed panic and make them take decisions which may be medically unwarranted, should we rethink the campaigns?
I just stumbled across an interesting debate in Canada over sex-selective abortion. A British Columbian MP is campaigning against it because it leads to gendercide. “Female gendercide is the systematic killing of women and girls, just because they’re girls,” says Mark Warawa. “The UN says that over two hundred million girls are missing in the world right now because of the female genocide.”
Apparently sex-selective abortion is increasing in Canada with immigration from India and China. Warawa’s is an entirely praiseworthy campaign which ought to attract bipartisan support.
Colby Cosh, a columnist for Maclean’s, is scathing in his criticism of Warawa. In an op-ed headed “Lord, send pesticide for the weed of ‘gendercide’”, he argues that if women are allowed to abort children for any reason whatsoever, why not a child’s sex? “Can we respect those choices (as we ought to) yet not respect the choice of a woman who doesn’t want to risk spending the next 20 years of her life raising” children of the “wrong” sex? “’Gendercide’ is incoherent religious militancy in cheap drag,” he sneers.
What Cosh – and the Canadian Prime Minister, Stephen Harper – don’t like about Warawa’s campaign is that its ultimate target is abortion. This is such an inflammatory subject that Harper does not want it even mentioned in Parliament. But despite Cosh’s ridicule, Warawa’s logic is irrefutable: you cannot say that you both oppose gendercide and support the procedure which makes it possible.
I suggest that the honest thing for Prime Minister Harper to do is to tell his Parliament: “look, one missing girl is a genuine tragedy; 200 million missing girls is just another bogus UN statistic; it’s no big deal. Look on the positive side: 200 million missing girls means 200 million women who made a courageous choice. Grow up. Get over it. Move on.”
This week we are highlighting a special issue of the Journal of Medical Ethics about what may be the biggest-ever controversy over an article in an academic journal. This is a paper by Alberto Giubilini and Francesca Minerva, “After-birth abortion: why should the baby live?” When it was published in February last year, it provoked much shrill criticism of bioethics as a discipline, not just of infant euthanasia. We were the first to report it, by the way.
I was pleased to note that we get a guernsey in the discussion. The editor of the journal Bioethics, Udo Schüklenk, said that BioEdge has “a larger real-world impact than most bioethics journals could dream of”.
Woo hoo!!! High fives all around!!
To be honest, I am quoting Dr Schüklenk – who is not a man to mince words -- out of context, as he regards BioEdge’s impact as baneful “agitprop”.
Oh well. Please make up your own mind on this. I’d appreciate any comments. BioEdge does have a background commitment of defending human dignity. This shapes the selection of the news and the angle of the articles. Event though absolute impartiality is impossible, our goal is to present the facts without embellishment and to let readers draw their own conclusions. We’ve tried to restrict opinions and rumination to this message from the editor (which is also available in blog form at Pointed Remarks).
Perhaps I should give a thumbs-up to the Journal of Medical Ethics and its editor Julian Savulescu. I don’t agree with his utilitarian bent, but, from a journalist’s point of view, he does a great job of presenting a wide range of newsworthy topics. They are normally quite readable, even by an agitprop Stakhanovite like myself.