Happy Christmas! Happy New Year!


There will be no BioEdge newsletters over Christmas and New Year. However, we'll be working on ways to improve our coverage and presentation. Feel free to correspond and share your insights. 

All the best for the Christmas season to you and your loved ones. 

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Bioethics and ‘inappropriate behaviour’


There has been so much “inappropriate behaviour” in the press over the past two months, ever since movie mogul Harvey Weinstein was exposed as a serial molester of women, that it deserves its own acronym, IB. IB is a euphemism for a range of appalling actions, like sexual harassment, sexual assault, and rape.

And now, thanks to an Arizona Congressman we can add surrogacy to the IB list. Trent Franks resigned this week after revelations that he had pressured women on his staff to act as a surrogate mother. It’s not a pretty story, but it helps to expose the exploitative potential of surrogacy, which is so often depicted as generous and life-affirming.

Heads up: the next issue of BioEdge will be the last until January. Hey! Everyone deserves a holiday, even the staff of BioEdge. 

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‘Do not resuscitate’ tattoos. Rohingya and population control


Unlike issues such as euthanasia or stem cell research, the bioethics of tattoos is not highly developed. However, it presents its own challenges and complexities. What if a patient shows up in emergency with "do not resuscitate" tatooed across his chest? Is that a valid advance end-of-life directive? There are so many issues here. How do the doctors know if he (let's assume it's a "he") still wants a DNR? Did he get it when he was drunk? Was it voluntary? There are so many fascinating issues -- read our preliminary report below. 

On a completely different note, with Christmas drawing near, I’m making an incredibly self-interested suggestion. Why not put a copy of my recent book, The Great Human Dignity Heist: how bioethicists are trashing the foundations of Western Civilization, in someone’s stocking? It’s available through the Australian publisher, at Amazon and at Book Depository. I can’t think of a better gift! 

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Braggadocio


Good scientists have to be curious, tenacious, creative, intuitive and analytical. And it helps if they are humble, as well. At least that is my impression after reading about the Italian neurosurgeon Sergio Canavero (see below.)

Canavero is the latest figure in a long queue of talented scientists led astray just in the last couple of years by the glamour of celebrity. Dr Canavero would no doubt deny this, but the scientific community is very sceptical of his project to transplant living heads onto living bodies. And although he has not had a single success in this project, he is already dreaming of transplanting brains.

Celebrity and science can make a toxic mix. There is thoracic surgeon Paolo Macchiarini, another Italian, whose work on artificial tracheas was hyped as life-saving, but turned out to be fraudulent.

Dutch social psychologist Diederik Stapel was renowned for his controversial research. He had faked the results of his experiments and even his PhD. Michael LaCour made headlines for his surveys about changing minds about gay marriage. He never carried out the surveys.

Japanese stem cell scientist Haruko Obokata found an incredibly simple method for creating pluripotent stem cells. And in fact, it was incredible.

What makes extremely talented and creative researchers choose the path of a circus performer rather than a dedicated scholar? Everyone has a different story, but perhaps the ancient Anglo-French word vaynglorie (vainglory) expresses it best. Are there classes for post-graduate students in humility? Perhaps there ought to be. 

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Assyrian pre-nups


Several of our stories this week deal with end-of-life issues. For a bit of a change, how about an historical diversion?

“And when Rachel saw that she bare Jacob no children, Rachel envied her sister; and said unto Jacob, Give me children, or else I die.” You might recognise this quote from the Bible. It is often used to illustrate the pain of infertility, which hurts no less 4,000 years later.  

Jacob was a wandering pastoralist. But Turkish archaeologists announced this month that they had uncovered evidence of urban infertility in Kültepe, an Assyrian site in the centre of modern Turkey. It is a clay tablet with cuneiform script with a prenuptial agreement – also 4,000 years old. It may be the first pre-nup in recorded history.

If, after two years, the bride has still not borne a child, the tablet says, the wife will allow her husband to use a female slave as a surrogate mother to produce an heir. The slave would be freed after giving birth to a son.

Many ethical issues in the Reproductive Revolution have precedents, but it’s amazing to see that today’s surrogate mothers were anticipated by Assyrian slave girls four millennia ago. 

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The bioethics of social media


Autonomy being the central theme of contemporary bioethics, shouldn't bioethicists be concerned about the growing presence of social media, especially Facebook, in our lives? As we report below, what Facebook (and other social media) want is to "consume as much of your time and conscious attention as possible." This involves dulling consumers' willpower with tricks learned from the gambling industry and psychology, ie, making people less autonomous. 

The debate about Facebook at the moment revolves around nefarious schemes by Russia to hack American elections. Social media executives are being hauled before Congressional committees to explain why their products should not be considered threats to democracy. But isn't the addictive nature of Facebook an even greater threat?

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Are you lonely tonight?


Songs about loneliness are legion and range from the soppy and sentimental, like Roy Orbison’s “Only the Lonely” to the irony of the Beatles’ “Eleanor Rigby”. I’ve always been a sucker for Ralph McTell’s “The Streets of London”, with its piercing lyrics about homeless people in a big city. 

Perhaps the reason loneliness is such a potent theme is that we instinctively realise how dangerous it is. 

It turns out that loneliness is (a) a major social and health issue and (b) a widespread phenomenon. One US researcher has even estimated that it affects as many as 45% of retired Americans. This seems far too much, but the levels are certainly high. And since it increases the odds of an early death by 26%, I’d call it a challenge for bioethics. How can we heal the frayed and broken bonds of social cohesion?

A feature in this week’s JAMA examines the cost of loneliness – and the lack of solutions. We report on it below

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ShanidarCare


Stories like this have surfaced in BioEdge before, but I have always found them quite touching. We report below that researchers have found that a Neanderthal who lived in a large cave in Iraq about 50,000 years ago was terribly handicapped. Not only was he blind in one eye, missing a forearm, and crippled, but he was also profoundly deaf. With Pleistocene lions and tigers prowling in the neighbourhood, this was a big handicap for a forager.

How did he survive? His clan cared for him, tended to his needs, healed his wounds and protected him. He died at the ripe old age of 40 or 50 (equivalent to about 80 nowadays). Obviously Thomas Hobbes' infamous maxim -- that the life of man outside society is "solitary, poor, nasty, brutish, and short" -- needs to be revised. Primitive as they were, these Neanderthals had their own family-based version of Obamacare. 

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Blazing Australia


If you are not inclined to be disputatious, don’t visit Australia at the moment. Across the country is a heated debate about same-sex marriage. According to the bookies, the Yes vote is set to win, although the No vote is giving its opponents a good run for the money. Newspapers are full of op-eds for and against; the broadcast media seems to be only “for”; and Twitter is going wild.

But something equally important is being debated: assisted suicide. The lower house of the state of Victoria yesterday voted for a bill which will legalise it. If it passes, other states will almost certainly follow. It will mark a dramatic turn in Australia’s law and medicine. But – compared to same-sex marriage – almost no one is talking about it.

What accounts for the difference? Oxford bioethicist Professor Julian Savulescu, writing in The Conversation, says that people fear death and like talking about sex and that in evolutionary terms, death is less important than reproduction. 

It’s an interesting question. I don’t believe that I agree with his answer. I think that people intuitively understand that control of marriage is the hinge of social life and are reluctant to redefine it.

But what do you think? Why is the debate over same-sex marriage so much more engaging than the equally important debate over euthanasia?

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President Trump rewards pro-life supporters


During his campaign, President Trump promised pro-life voters that he would support their agenda. And he has delivered. He reinstated the Mexico City policy; he has cut funding to Planned Parenthood; he has rolledl back Obamacare's birth control mandate. And now a new strategic plan for the Department of Health and Human Services has definitely taken a pro-life turn, with references to protecting life from conception to natural death. "We are on track to seeing the most pro-life president this country has ever seen," says Tony Perkins, of the Family Research Council. 

Not everyone is happy about this. “This is a license to discriminate,” Susan Berke Fogel, director of reproductive health at the National Health Law Program, told Politico. “All of that language brings back all of these things that we’ve seen in the past that are just incongruous with really protecting health care and really improving people’s lives.”

What do you think? 

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