A team of a team of undercover freelance investigative journalists called the Center for Medical Progress has been making life miserable for abortion provider Planned Parenthood over the past few weeks (while we were on holiday, sorry about the gap in coverage).
In a recent editorial the New York Times accused this unknown group of being, um, journalists. “The Center for Medical Progress video campaign is a dishonest attempt to make legal, voluntary and potentially lifesaving tissue donations appear nefarious and illegal.”
Well, actually, that’s not quite the case. It’s an attempt to see whether the donations are in fact legal and voluntary. Journalists tend to do that sort of thing. Being sceptical about bland reassurances from organisations with budgets of over $1 billion is kind of part of their job description.
This clothespeg-on-the-nose attitude is odd for a newspaper whose motto is “All the News That’s Fit to Print”. And even odder for a newspaper which defied the President of the United States by publishing revelations obtained illegally by whistleblower Edward Snowden. It editorialised at the time:
“Mr. Snowden was clearly justified in believing that the only way to blow the whistle on this kind of intelligence-gathering was to expose it to the public and let the resulting furor do the work his superiors would not.”
Large organisations like the National Security Agency, Phillip Morris or the Galleon Hedge Fund tend to deny that they ever have done, are doing or ever will do anything which is nefarious and illegal. That’s what their public relations staff are paid to say. What is extraordinary is that America’s paper of record has become an unpaid extension of Planned Parenthood’s PR office.
The Supreme Court has handed down a landmark ruling on same-sex marriage which effectively legalises it throughout the United States. President Obama welcomed the decision. “Today,” he declared, “we can say, in no uncertain terms, that we have made our union a little more perfect.” A rainbow light show was projected onto the White House as a sign of the Administration’s joy.
Although it’s a bit churlish of me to open the door of the party and let in the cold air, are there any bioethical challenges which follow in the wake of Obergefell v. Hodges? I can think of three.
First, most married couples want children. Where are the children of gay and lesbian couples going to come from? An adult outside of the relationship has to supply gametes to create the child. This has already led to a tangled web of relationships with multiple parents for a single child. This trend will accelerate. In due course, it may be possible to “manufacture” sperm and eggs from stem cells. This could provoke another stem cell debate.
Second, many gay couples will need surrogate mothers. Much of the demand for surrogate mothers in developing countries is generated by this consumer group. A couple of years ago BioEdge surveyed Indian IVF clinics. Most of them were expected a surge in demand if same-sex marriage was legalised. Surrogacy is dangerous work and only poor and desperate women take it on – which is why so few surrogate mothers live in New York’s Park Avenue. Surrogacy is a kind of exploitation which raises important ethical questions.
Third, conscience rights will be tested. In his dissent Justice Alito said, “the majority attempts, toward the end of its opinion, to reassure those who oppose same-sex marriage that their rights of conscience will be protected … We will soon see whether this proves to be true. I assume that those who cling to old beliefs will be able to whisper their thoughts in the recesses of their homes, but if they repeat those views in public, they will risk being labeled as bigots and treated as such by governments, employers, and schools.” Conscientious objection is already a big topic in bioethics journals. It will grow bigger.
One of the most famous obiter dicta from the US Supreme Court is Justice Anthony Kennedy’s “mystery” passage in the 1992 case Planned Parenthood v. Casey. “At the heart of liberty is the right to define one's own concept of existence, of meaning, of the universe, and of the mystery of human life.”
I’m sure that you will often hear it cited in the years ahead. It expresses perfectly the notion of freedom which underlies same-sex marriage and transgenderism, both of which will be on the boil for some time to come.
Kennedy’s eloquent words do sound appealing, but following them can lead us into an Alice in Wonderland world. For instance, Giuliana Mazzoni, a professor of psychology at the University of Hull in the UK, has suggested that artificial recreation of happy memories may become the next big weapon against depression. Depression blocks access to happy memories, but it might be possible for depressed people to artificially recreate good memories to allow for positive thinking.
If this technology becomes available – a big if – it could have very profitable commercial applications. Elderly people whose lives have been unhappy could get a loving spouse and a successful career for a few bucks. A drug addict could remember a steady job and an unbroken marriage. Bad memories could be erased.
According to Justice Kennedy’s understanding of liberty this would be completely ethical. If freedom is the opportunity to reshape reality, artificial memories would be a good thing. But somehow this defies common sense. A freedom that allows us to escape into a fantasy world rather than confronting reality is a peculiar freedom.
As a journalist, I tend to be impatient with fussy terminological precision, a character flaw which occasionally raises the hackles of readers with more exacting standards. However, I do believe that terminology shouldn't ever be fudged, especially in public debates over bioethical issues.
That’s why I was so disappointed to read this admission by Gerald Dworkin, an academic who has been lobbying with Compassion & Choices for assisted suicide in California. Professor Dworkin is the author of a 1998 book, Euthanasia and Assisted Suicide. Looking back, he admits that it was injudicious to use straightforward language in the book’s title:
“I should note that the use of the term ‘Physician-assisted suicide’ is now politically incorrect, for tactical reasons. I understand that the popular prejudice against suicide makes it more difficult to rally support for the bills I favor. And even some potential users of such measures object to their death-certificate reading ‘suicide’. But to list the cause of death, as many such bills do, as the underlying disease process seems to me simply a lie. What caused the person diagnosed with terminal cancer to die now, rather than somewhat later, is the secobarbital the patient took. But learning to keep silent about such terminological matters was only one of many lessons I had to learn.”
What a shame it is to win a debate by muddying the waters. As Samuel Johnson said, “It is more from carelessness about truth than from intentional lying, that there is so much falsehood in the world."
The big story in the tabloids this week was the transformation of Bruce Jenner, decathlon gold medalist and reality TV star, into Caitlyn Jenner. When the new Jenner, with flowing brunette locks, an ample bust and a corset, appeared on the cover of Vanity Fair, social media went mad. Within hours, the Twitter account of Caitlyn Jenner went from 0 to 1.1 million followers (BioEdge has about 5,000).
Beyond the titillation, there’s a lot to think about in the Jenner story. Is gender all in the mind? Is transitioning really possible? Is Jenner being cynically exploited by commercial interests? Where is a society based on self-defined identity going?
But the most thought-provoking comment, for my money, came from Nuriddeen Knight, an African-American woman writing inThe Public Discourse. She compared the trans experience with Toni Morrison’s first novel, The Bluest Eye, in which an African-American girl longs to become a blue-eyed white girl.
“We, as the readers, don’t applaud this … We know that it’s not really blue eyes she wants, she wants something much deeper—love, acceptance, respect, honor ... the intangible human desires we all crave but are not equally given,” she writes.
“But what if, instead of wanting to be white, I wanted to be a man?” she continues. “What if, instead of crying to my parents that I was really a white person, I told them that I was really a man and that I desperately wanted to change my body to match my mind? If, in this scenario, you think that my parents should applaud my courage, accept my new gender identity, and run to the nearest surgeon, please ask yourself: ‘Why?’”
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Same-sex marriage doesn’t really fall into the bioethics basket. However, the recent earthquakes in Nepal brought to light a link to the biggest social policy debate in the United States and Ireland at the moment.
Kathmandu, it turns out, became a surrogacy hub after India and Thailand imposed restrictions on this racket. According to one clinic operating there, it is a very attractive destination: “Surrogacy in Nepal is very affordable and recommended for same-sex couple like gays and lesbians, for singles and even married couple who are unable to take the chance of surrogacy in India.”
So poor women are renting out their wombs so that gay couples can take babies home. A number of babies commissioned by gay Israelis were airlifted out of the ruins of Kathmandu back to Tel Aviv on a defence force aircraft – but not the mothers.
It's an angle that the justices in far-off Washington will probably not consider, but it deserves to be mentioned: if same-sex marriage is legalised, how will gay couples get children? Will it be by exploiting women in places like Nepal?
The drama of bioethics is coming to light as more novelists and playwrights mine it for their stories. Last week we ran a feature about the world of the medical thriller and authors like Michael Crichton, Robin Cook and Tess Gerritsen. Now I've just discovered that the world premiere of a play about the development of IVF, "The Waiting Room", takes place next week in Melbourne.
The curious thing about this production is that the playwright is Kylie Trounson, the daughter of Alan Trounson. Trounson père is a controversial Australian scientist who was a pioneer of IVF in Australia. He developed a technique for freezing embryos and was an ardent promoter of the use of human embryonic stem cells. Bitter conflicts over the reproductive revolution emerge in the play, although the author -- who has a very good relationship with her dad -- seems to frame him as a new Galileo.
Are there any Melbournians out there who would like to review it for BioEdge?
Our apologies to readers who may have received an unwanted email from New Media Foundation, the publisher of BioEdge, the other day. We manage a few newsletters and one of them, MercatorNet, was inadvertently posted out to BioEdge subscribers. We are contacting the email company to ensure that it won't happen again.
In 2007 an infection swept through the pomegranate trees of Hyderabad-Karnataka in India. Pomegrates are a profitable export crop into countries like Germany, Switzerland, France, and Canada. Farmers had borrowed heavily to invest in pomegranates and the disease brought them to their knees. Then came floods. The banks threatened to foreclose. Politicians promised relief and did nothing.
Three hundred of these despairing farmers have a solution: they have petitioned the local governor for mercy killing, ie, euthanasia: "No yield, no money to repay the loans. The only option before us is to die," they say.
On the other side of the country, in Jharkhand, 130 prisoners have also petitioned the local governor for mercy killing. They claim that they have spent 20 years in jail and have done their time but the authorities have done nothing. They are suffering from extreme mental trauma and say that death is better than the lives they are living now.
Such requests for “mercy killing” are relatively common in the Indian media, believe it or not. Perhaps they are genuine. Perhaps they are calculated to capture the media spotlight. But in any case, no one is going to die. Euthanasia is illegal.
However, it’s easy to see how dangerous it could be for desperate people. Bureaucrats would rubberstamp their application for a lethal needle, for it would be easier to kill the petitioners than to give them jobs. If euthanasia were legal, people would die simply because they were luckless and poor.
Is there a lesson for us in more developed countries? I think so. As a committee of the Scottish Parliament wrote in a thorough report this week about an assisted suicide bill (see below), “there is no way to guarantee the absence of coercion in the context of assisted suicide.”