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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Khan Sheikhun


The civil war in Syria may have moved into a dangerous new stage. President Trump ordered a strike on a government air force base, blaming the regime for dropping sarin, a lethal chemical weapon, on a northern town. He announced his decision in an emotional speech:

"Assad choked out the lives of innocent men, women and children. It was a slow and brutal death for so many. Even beautiful babies were cruelly murdered in this very barbaric attack. No child of god should ever suffer such horror."

As everyone knows, there are no good guys in this appalling war. The attack on Khan Sheikhoun was just more spectacular than the daily slaughter of three here, a dozen there. If you consult the website of the Syrian Observatory for Human Rights or Syria Deeply, the headlines are enough to make anyone weep. One of the most distressing aspects of the conflict is the "weaponisation of healthcare" -- deliberately targeting medical personnel and facilities to terrorise the population. You can read about it below

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Do you remember the Zika virus?


Here’s something very odd. Back in 2015 terrifying news came from Brazil about an epidemic of microcephaly – babies born with very small heads and brain damage. It seemed to be associated with the mosquito-borne Zika virus. Neighbouring countries prepared for the spread of Zika with a sense of dread. Lobby groups urged relaxation of abortion restrictions.

But how often in the past six months have we heard about the Zika virus and microenphaly? A graph on Google trends shows that it has dropped off the media’s radar. With good reason – there has been no epidemic of microcephaly. The experts expected 1,000 cases, but there were only about 100.

Nobody knows why this is. There is an association between Zika and microcephaly, but it must be more complicated than scientists first thought. An article in the NEJM this week reports the good and canvases a number of explanations. It may be that for microencephaly to occur, a woman needs to contract both Zika and Dengue fever.

Perhaps there is a lesson here – however bad the news is, DON'T PANIC!! In particular, there is no need to push for changes in abortion legislation before we know all the facts...

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The transhumanist project and personal autonomy


A number of the eminences of Silicon Valley are besotted with immortality. Google, PayPal co-founder Peter Thiel, and Facebook’s Mark Zuckerberg are a just a few names amongst the many who want to do away with death, or at least add a few decades, or even a few hundred years, to their lifespans.

Even if this is achievable, is this desirable?

British sci-fi author and futurist Paul Graham Raven has written a blistering demolition of the transhumanist project. (Hat-tip to Wired.) It is basically a philosophy for selfish (and mostly white) rich guys, he suggests.

it turns out that technologies which extend, augment or otherwise improve human life are already here! You may have heard of some of them: clean water; urban sanitation; smokeless cooking facilities; free access to healthcare; a guaranteed minimum income; a good, free education. There are more – and you’d be surprised how many of them have been around in one form or another for decades, even centuries! But they’re unevenly distributed at the moment, so the first agenda item for all transhumanists should be looking for ways to get these technologies to everyone on the planet as soon as possible

But that is unlikely to happen. In their single-minded focus on maximising their own welfare, dedicated transhumanists are deaf to the needs of the society: “You look after yourself, I’ll look after me; what could be fairer than that?” Raven writes caustically. Come to think of it, this critique of personal autonomy could be applied to a number of other areas in bioethics. 

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Mortal remains


One of the star exhibits in the Royal College of Surgeons' Hunterian Museum of anatomy in London is the skeleton of Charles Byrne, an 18th Century Irishman who was about 8 feet tall. However, the museum is to close in May for renovations and there are calls to use the opportunity to remove or bury the remains. Does this make sense?

A celebrity in his day, Byrne died in 1783 of ill health and drink in London. He knew that John Hunter wanted to dissect him after his death, so he directed his friends to sink his body in a lead-lined casket in the English Channel. Alas, Hunter succeeded in stealing the body anyway and it eventually turned up in a display case.

Similar events darken the history of the Australian state of Tasmania. The last full-blood Aboriginal Tasmanian, William Lanne, died in 1869. Although the story is murky, it appears that before his funeral the Surgeon-General of the colony, William Crowther, stole his head for “scientific study” and someone else removed his hands and feet. There is no record of scientific studies. Crowther went on to become premier, and an impressive bronze statue of him was erected in the centre of the city.

The last full-blood Aboriginal woman in Tasmania, Truganini, was terrified that the same thing would happen to her and directed that her body be cremated. Her wishes were ignored and her skeleton ended up in a display in the Hobart Museum. It was finally cremated in 1976.

Nowadays body-snatching would not be tolerated (although the Hunterian Museum still refuses to remove Byrne’s body from display). But the notion that scientific curiosity is its own justification persists. University of Tasmania historian Stefan Petrow points out, that the fate of Lanne and Truganini demonstrate “the hegemony scientific knowledge sought to establish over fundamental human rights such as a decent burial”. Can’t the same thing be said about some aspects of stem cell research? 

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When is illness ‘terminal’?


A State Senator in Hawaii, Breene Harimoto gave an emotional address this week to persuade his colleagues to vote against a bill for legalising physician-assisted suicide for the terminally ill. He said that in 2015 he had been diagnosed with pancreatic cancer, which has a low survival rate and can be quite painful. But he was cured. “It is a miracle that I am still alive,” he said.

His point was that “terminal illness” is almost meaningless. Margaret Dore, a Seattle lawyer who lobbied against the bill, recalls an even more dramatic incident. “A few years ago, I was met at the airport by a man who at age 18 or 19 had been diagnosed with ALS (Lou Gehrig's disease) and given 3 to 5 years to live, at which time he would die by paralysis. His diagnosis had been confirmed by the Mayo Clinic. When he met me at the airport, he was 74 years old. The disease progression had stopped on its own."

If Senator Harimoto or Ms Dore’s friend had the option of assisted suicide, they might stopped fighting their disease and chosen a quick death. They would have chopped decades off their lives. “Terminal illness” is a pillar of assisted suicide legislation – and it just doesn’t make sense. 

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