A Nobel Prize for bioethics?

There is a gap in the Nobel Prizes: there's no award for bioethics. There is the Nobel Peace Prize and the Nobel Prize for Medicine or Physiology. Both of them touch on bioethical issues in some fashion, but only tangentially.

True, some Nobel laureates have provoked bioethical controversies. The 1918 laureate in chemistry, Fritz Haber, was “the father of chemical warfare”. The 1956 laureate in Physics, William Shockley, was interested in eugenics and sterilizing people with IQs under 100. The 2010 laureate in Medicine, Robert Edwards, developed IVF. James Watson, the 1962 laureate in Medicine, was interested in designer babies. António Egas Moniz, the 1949 laureate in Medicine, developed the frontal lobotomy.

However, the time has come. As reported below, the 2018 Dan David Prize, worth US$1 million will be awarded “to an outstanding individual or organization in any field of the humanities or social sciences who have transformed our understanding of the moral and ethical significance of biological and medical innovations in our times.”

It appears that this will be the last time that the Dan David Prize will be awarded for bioethics. So it’s a great opportunity. Send us your nomination, with a brief explanation. If we get enough entries, we will publish them next week. 

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Belgian euthanasia under the microscope

For better or worse, this week’s newsletter seems largely dedicated to topics revolving around euthanasia. Belgium’s system is finally getting the close critical scrutiny it deserves in a new collection of essays from Cambridge University Press.

Coincidentally, the doyen of euthanasia there, Dr Wim Distelmans, has just released statistics about child euthanasia. “Nothing to see here; please move along,” seems to be his message. In three years, only two children have been euthanised. Perhaps that is an index of how normal euthanasia has become in his country.

Assisted dying is a hot topic, too, in Australia, in the states of Victoria and New South Wales. BioEdge has organised a free forum on NSW’s Voluntary Assisted Dying Bill on this coming Thursday in Sydney. It will be held at Parliament House, on Macquarie Street, from 9.30am to 12.30pm. A number of medical and legal experts will be discussing the possibility of legal euthanasia in New South Wales. For more details, please check our Facebook page.

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Is Planned Parenthood a Nobel Prize candidate?

Planned Parenthood is an organisation which inspires both love and loathing. One of its admirers is the Lasker Foundation, which has just presented it with the Lasker~Bloomberg Public Service Award for services to reproductive health.

Since many Laskers have gone on to win Nobels, PP is suddenly on the starting blocks for a Nobel Peace Prize. If it were only for its success in promoting contraception and abortion, it might be too controversial even for the Norwegian Nobel Committee. However, as a one-fingered salute to President Donald Trump, who has promised to defund PP, it could prove nearly irresistible. Read all about it below.  

On a completely different topic, if you happen to live in Melbourne and are free on Thursday evening, there will be a launch of my book, The Great Human Dignity Heist, in Carlton. The details are on our Facebook page. It would be great to meet lots of BioEdge readers there. 


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Revisiting “Father’s” Day

“Fatherhood” is what the guys in the business of policing the language call an “essentially contested concept” – no matter how much palaver you invest in it, you won’t make any progress. At least nowadays.

Below we feature a story from the Netherlands about two men who have each sired over a hundred children, one through sperm donation to IVF clinics, the other mostly through more conventional channels. Are they fathers?

Another story comes from Australia, which is girding its loins for a campaign on same-sex marriage. A group promoting closer links between fathers and their children, Dads4Kids, has been running a public service TV advertisement for 15 years. This year, a 30-second spot of a dad crooning to his wee sprog was rejected because it was “too political”.

A spokesman for the foundation complained:

“It is extraordinary that this is where we have come to as a country; we can no longer celebrate Father’s Day without being forced to look at it through the lens of the same-sex marriage debate. It’s a tragedy that a political motive is now implied in any mention of fatherhood. Not everything is about same-sex marriage.”

The history of this simple advertisement tracks the evolving concept. In a span of 15 years, fatherhood, or rather “fatherhood”, has shifted from a universally admired status to a politically suspect notion. Are we the better for it?

Happy Father’s Day to our Australian readers. 

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Thousand dying in Yemen of cholera

One unfortunate consequence of the omphalocentric state of American politics is that cries for help from the rest of the world are a mosquito’s buzz in a theatre full of bellowing politicians. President Trump’s antics suck all the air out of media interest in overseas tragedies.

One of these, as reported below, is a cholera epidemic in Yemen which has affected half a million people and killed about 2,000. The medical system in this country of 27 million has all but collapsed. About 10,000 civilians have died. Seven million are close to famine.

The United Nations has described Yemen as “the world’s largest humanitarian crisis” and The Lancet has compared Western indifference to its slowness in responding to the Rwandan genocide.

Notwithstanding his “America first” policy, Donald Trump promised that his country would “continue and continue forever to play the role of peacemaker”. Of course, the war in Yemen is a complex conflict in which the two sides are proxies for the Shia state of Iran and the Sunni kingdom of Saudi Arabia. But surely the US could help engineer a solution – if its president was not so busy arguing over Civil War statues and sacking his closest aides. 

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Psychiatrists versus Trump

President Donald Trump was elected because he promised to break moulds and drain swamps. “And now for something completely different” was basically the platform on which he campaigned. And something completely different is what Americans got.

Now is this difference due to mental illness or to a combination of personality and cunning political strategy? Yale University psychiatrist Dr Bandy Lee believes that it is the former. Trump is both bad and mad. In fact, not only Trump. In an interview with Salon, she said that the Administration and the Republican Party have lost touch with reality.

Is it a good idea for a psychiatrist to politicise her profession? The American Psychiatric Association asks its members to abide by the “Goldwater Rule” which forbids them from making public comment on the health of public figures whom they have not examined. It’s a good rule and Dr Lee is breaking it by publishing a book, The Dangerous Case of Donald Trump in October.

It’s a good rule because it protects the profession. Although half of Americans probably think Trump is mad without the benefit of Dr Lee’s input, the other half, including some psychiatrists, doesn’t. Inevitably many voters will think that Dr Lee is just a shill for the Democrats and that psychiatrists’ opinions can be bought.

What do you think? 

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Towards Belmont 2.0

In a recent article in the American Journal of Bioethics, bioethicist Art Caplan and three colleagues call for a complete overhaul of the venerable Belmont Report (see below). This is the 1979 US government report which set out three famous principles which have governed human research ever since: respect for persons, beneficence, and justice.

Most government reports are already gathering dust within a few months after their publication. But the Belmont Report’s influence has been enormous, as it shaped the bioethical framework for clinical and research decision-making in the US and many other countries as well.

Caplan & Co make a good case for revising the standards in the light of experience and changing times. But it comes at an awkward moment: the Trump Presidency.  What kind of commission would Mr Trump create to study this issue? Perhaps a noisy and truculent one, a bull in the bioethics china shop. Be careful what you wish for? 

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Shameless self promotion

We have a number of very important stories this week: a paper in Nature about gene-editing human embryos, a rise in euthanasia figures in the Netherlands, some appalling news about commercial surrogacy in India... plus a great interview with Yale bioethicist Lydia S. Dugdale about death and dying. 

But, for better or worse, this is a day for shameless self-promotion. Sorry. I have just published a book, The Great Human Dignity Heist, a collection of short essays on topics ranging from IVF to paleo-archaeology to polio epidemics to euthanasia and cannibalism. Its lurid sub-title is How bioethicists are trashing the foundations of Western civilization

If you live in Sydney, you are invited to a book launch at 1pm on this coming Thursday, August 10, at Parliament House, Macquarie Street, Sydney. Professor Margaret Somerville will be the main speaker. (RSVP to mcook@mercatornet.com.) 

And of course, if you cannot make it, feel free to order a book online

In Australia from the publisher, Connor Court

In the US and Canada from Amazon (feel free to leave a review of the book!)   


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The drama of little Charlie Gard

We're back! And although the northern hemisphere summer is normally a slow-news season, bioethics has been on the front page of world newspapers.

The drama of the dying British baby Charlie Gard, his loving parents, the doctors at Great Ormond Street hospital in central London, and the English law has captured the imagination of people everywhere.

To be honest, I am not sure whose "side" I should be on. Parents should normally make healthcare decisions for their children.

But there are cases in which their choices are plainly wrong -- as a Swedish doctor suggests below in his version of the mysterious resdignation syndrome among refugee children -- and the advice of doctors should be heeded.

Which was the case here? We'd love to hear from you. 

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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.


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