BioEdge on holidays


There is plenty of variety in this week’s BioEdge: a euthanasia pioneer surveys its progress in the Netherlands; a neuroethicist despairs over ‘fake news’; a legal expert assesses the chances of Noel Conway’s assisted dying request in the UK; an important new paper asks whether puberty suppression for transgender kids is ethical...

But the big news is that BioEdge (and its editor) are taking a solstitial holiday for a few weeks. The next issue will arrive on about July 21.

Cheers,

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Michelle Carter found guilty


A Massachusetts woman has been found guilty of involuntary manslaughter in a case which was reported across the United States and could affect the debate about assisted suicide.

In 2014 Michelle Carter, then 17, used phone calls and text messages to bully her boyfriend, Conrad Roy III, 18, into asphyxiating himself in his car.

Their relationship was a bizarre one. Although they lived only an hour away from each other, they met in Florida on family holidays. Thereafter they only met each other a handful of times. But they texted each other incessantly, especially about Roy’s desire to kill himself. Ms Carter encouraged him.

However, when he was sitting in his car and the fumes were building up, he got out, clearly wanting to live. She instructed him to get back in. He did and he died.

There are two schools of thought about Ms Carter’s bullying. Most people would agree with the judge that she had a duty to try to save Roy’s life and acted in a “wanton and reckless” manner.

But others, while acknowledging that her words were reprehensible, point out that Massachusetts has no law against assisted suicide and that words are not bullets. They argue that her incitement was protected free speech.  

The American Civil Liberties Union has yet another reason why Ms Carter should have been acquitted: “If allowed to stand, Ms. Carter’s conviction could chill important and worthwhile end-of-life discussions between loved ones.” In other words, this throws sand in the gears of legalising assisted suicide.

What do you think? 

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Not a happy camper


We may have over-egged today’s newsletter with stories about surrogacy, but they all appeared this week with a common theme: what about the mothers? The accepted wisdom is that most mothers are well compensated and give up the child happily.

Not always.

Take the case in England of a surrogate mother who has just been jailed for 22 weeks for stalking a judge and a court welfare officer. The terrified family court judge had awarded the child she bore to the commissioning gay couple even though Lian Harris had changed her mind and wanted to keep it.

Ms Harris snapped.

Over a year she harassed the judge, protested outside the house of politicians and lawyers, unfurled a banner on Westminister Cathedral saying “Family courts do evil”, attempted to fasten herself to the second-floor balcony of the social worker’s home, and tried to organised harassment on Facebook, amongst other stunts.

Not a happy camper.

Ms Harris is said to be an exceptional case. But how do we know? Where are the longitudinal studies to prove that surrogate mothers live happily ever after once they surrender the child they carried for nine months?

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Bioethicists: dust off your resumes


Now that President Donald Trump has backed out of the Paris Climate Change agreement, employment prospects for bioethicists may pick up. Let me explain.

The boundaries of bioethics are very elastic, and on some maps they include care for the natural environment. I would predict that in the measure that scientists lose faith in a political solution to global warming, some will back geoengineering projects to cool the planet.

These include tactics such as injecting aerosols into the upper atmosphere, dumping iron filings into the sea to promote algal blooms, and machines to capture carbon dioxide. These involve significant risk and place great power in the calculations of technocrats. They need to be studied very carefully. As University of Chicago climate scientist Raymond Pierrehumbert said a few years ago, “I see lots [of geoengineering ideas] that are feasible but they all terrify me.”

A 2010 conference on the ethics of climate intervention at Asilomar, in California, addressed some of these issues using principles drawn from the famous Belmont principles of autonomy, beneficence, non-malificence and justice. And who knows more about these than bioethicists? Dust off those resumés. 

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Sorry for the delay


I can't say that I agree with Nietzsche on everything, but he was onto something when he wrote, "what does not kill a database makes it stronger". 

We were hit by a bug over the weekend and this mini-Götterdämmerung  has delayed the newsletter. But soon, touch wood, it will be stronger than ever. Thanks, Friedrich. 

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If there is a market, let’s legalise and regulate it


The Economist is the world’s best news magazine. Its stylish, intelligent and well-informed coverage has made it the Bible of the global elite. “I used to think. Now I just read The Economist,” the former CEO of Oracle, Larry Ellison, once said.

Part of its appeal is its ideological consistency. Ever since 1843 The Economist has argued that aim of public policy should be to promote the market economy as the best way of achieving prosperity and democracy. A light touch of government regulation is needed only to ensure fairness and legal certainty. Thus it embodies the “classical 19th-century Liberal ideas” which made Britain, and later the United States, a bulwark of capitalism.

Whatever the merits of this ideology in framing public policy for economics and finance, it is ill-suited to questions of personal behaviour.

In principle The Economist supports all autonomous action which is either harmless (in its view) or profitable. Hence, in recent years it has thrown its considerable prestige behind campaigns for the legalisation and regulation of drugs, pornography, prostitution, euthanasia, and same-sex marriage.

And this month it has taken up cudgels in favour of an international market in surrogate mothers and babies. “Carrying a child for someone else should be celebrated—and paid”, is the defiant headline of its editorial. Given the magazine’s influence, this is a significant development. What do you think of it? 

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Ooops! Sorry about that


I'm afraid that we are having a few issues with the software behind BioEdge. We've upgraded it, largely to ensure security -- which seems like a Very Very Good Idea in the light of what happened this week to Britain's National Health Service.

Unfortunately upgrades always have a few bugs. We are slowly working through them, but as we prepared this issue of the newsletter, we discovered a few glitches that we hadn't anticipated. So we ask for your patience. Hopefully we'll have them fixed up by next week. 

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Euthanasia in Belgium interviews


Euthanasia is such a controversial topic that it is dividing healthcare professionals and organisations. In Canada, some doctors are vigorously protesting moves to make effective referral for euthanasia mandatory. And in Belgium, a Catholic religious order seems to have split over whether its psychiatric hospitals should offer euthanasia for non-terminally-ill patients. Below we feature interviews with the main players in this drama: Brother Rene Stockman, the Rome-based head of the order who is fighting a change of policy, and Raf De Rycke, who helped to shape the new policy. 

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Even more developments in Belgian euthanasia


The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.

Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 

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Fake news and BioEdge


We’re back from the Easter holidays, which in Australia are far longer than elsewhere, thank goodness. To get back into the rhythm of things, we have published two articles about “fake news” and bioethics. One reports that prospective IVF parents in Mississippi discovered to their horror that they were twins separated at birth. This went around the world before some spoilsport blew the whistle on it. The other is an announcement by British billionaire Richard Branson that he is setting up a sperm bank for dyslexics. Branson being Branson, it’s hard to tell whether this is fake news or not, but I suspect that it is.

The problem with BioEdge, some readers tell us, is that everything sounds like fake news. This, of course, is not true; we take great care to check our sources. However, all too often the articles seem to have been composed in some gigantic facility manned by bad news elves.

In fact, when you read today’s lead story, “Euthanised organ donors could dramatically shorten waitlists in Belgium, say doctors”, I must concede that it does sound so implausible as to be fake. But it’s not a report from The Onion, but from the Journal of the American Medical Association. Go figure. 

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