Hawaii legalises assisted suicide


Hawaii legalised assisted suicide this week. It becomes the seventh American jurisdiction to do so. Since 1997, the legislatures of Hawaii, Oregon, Washington state, California, Colorado, Vermont and the District of Columbia have passed laws permitting assisted suicide. In Montana, a court decision found that it was legal, but there has been no legislation. 

The new law follows the controversial Oregon model. One of the drawbacks of this legislation is its definition of "terminal illness". It is usually understood to be a condition which will lead to death withinn six months or a year. But if a patient decides to spurn all treatment, treatment which could keep them alive for years, his or her illness will automatically become "terminal". This is a flimsy basis for such an important law. 

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Driverless ethics


The tragic death of a Florida woman struck by a driverless Uber has revived public interest in robot ethics. How do these cars make decisions in life and death situations? Are they transparent enough about the standards?

Such questions will be asked more and more as the age of autonomous vehicles approaches. Perhaps you could program it yourself. Highly Ethical Cars would take almost no risks and take two hours to get to work. Minimally Ethical Cars would run red lights and get there in five minutes. It’s going to be an interesting debate.

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A beautiful death


A recent US documentary recounts the story of an Oregon couple who committed suicide together in April 2017. The couple, Charlie and Francie Emerick, had both been diagnosed with terminal illnesses. They felt that, after having been married and together for some sixty odd years, it was only fitting that they exit this world as a couple.

Talk of “fittingness” in the context of death draws our attention to a broader topic, namely, the aesthetics of death. Just as we seek beauty in life, so also do we seek beauty in death.

There is a certain beauty to ending the narrative arc of our lives with a “fitting” poetic flourish. And in the context of euthanasia, it seems that many cases are underpinned by a desire not just for a peaceful death, but a beautiful death.

In 2016, a 41-year-old Californian multi-media and performance artist, Betsy Davis, ended her life with lethal medication. Davis wanted her suicide to be a “final act” in her artistic career, and she organised an elaborate weekend of celebrations and performances before consuming the lethal dose on a canopy bed by a hillside.

I wonder if, in seeking a beautiful death, we should look the wisdom the ages, rather than following our own artistic intuitions. The 15th century Latin tract Ars Moriendi provides persons in extremis with guidance for a good death. It encourages readers to face death bravely, to avoid temptations to despair, impatience or pride, and to surround oneself with those loved ones who, in life, have brought joy to one’s soul.

I’m not sure that the authors of the text had assisted suicide in mind when they outlined the elements of the ars moriendi

XAVIER SYMONS
Deputy Editor
 

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Remembering Proposition 71


In 2004, Californian voters overwhelmingly approved Proposition 71, a ballot initiative which created the US$3 billion California Institute for Regenerative Medicine. This was the apogee of stem cell fundamentalism around the world. Stem cells, especially human embryonic stem cells, were the key to unlock the secrets of human biology. They would lead to cures to dread diseases, perhaps not tomorrow, but the day after tomorrow.

Hollywood stars enthusiastically backed the ballot initiative. Quadriplegic Christopher Reeves told voters in an advertisement, "Stem cells have already cured paralysis in animals. Stem cells are the future of medicine." Parkinson’s victim Michael J. Fox said: "Vote yes on 71, and save the life of someone you love."

Fourteen years on, the CIRM (aka California taxpayers) has received its first royalties – a cheque for US$190,345.87 – a 0.00006% return on investment.  And that’s not for a cure, by the way. It’s for a drug which has only passed a Phase I clinical trial. Clearly, California voters were sold a pup. Is it time for the state to set up a stem cell truth and reconciliation commission? Read the story below. 

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Thailand needs bioethics


BioEdge is a bioethical gadfly, nipping and biting at what we perceive to be bad arguments and unhealthy developments. But the recent story about a Japanese man who fathered 13 children with the help of mothers hired in Thailand suggests that almost any bioethical approach is better than none – and “none” was the position of the Bangkok judge who awarded him custody.

"The petitioner is an heir and president of a well-known company listed in a stock exchange in Japan, owner and shareholder in many companies ... which shows the petitioner has professional stability and an ample income to raise all the children. Therefore, it is ruled that all the 13 children are legal children of the petitioner … and the petitioner is their sole guardian."

Any bioethicist would immediately comment that this decision ignores many important issues. Are children just property? What about the rights of the surrogate mothers? Is it right to raise 13 boys without mothers? Is it right to raise 13 boys together like cattle? Is wealth a substitute for parenting? Is fatherhood simply a matter of sperm donation?

It sounds as though the judge merely wanted to hand the boys over to Japan. In his words (as reported) I can detect no inkling of the fact that the issue is more complicated than a commercial property transaction. It sounds as though Thailand urgently needs bioethics education.

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At least one reason why Belgium is not boring


Last year the London Telegraph ran a travel article about Belgium, “10 reasons why Belgium is not as boring as you think”. A bit patronising, right?

Personally, I’d never call a country which has dared to legalise euthanasia boring. Anything but. This is a defiant poke in the eye to hundreds of years of Western civilisation. Whether you agree with Belgium’s regime of legalised euthanasia or not, it is a wildly exciting experiment in disrupting established social norms.

The latest news is that a whistleblower has accused the country’s euthanasia commission of breaking the law, muzzling dissent, and packing the commission with euthanasia practitioners. In other countries this would be called corruption. The whistleblower's letter to the Belgian Parliament is a searing indictment of a respected institution. You would think that the Belgian media would be baying for blood.

Nope. It was an American news agency, Associated Press, which broke the story. As far as I can see, it has been reported around the world, but not in Belgium. It’s a funny kind of journalism which ignores such a big story.  Perhaps the media there believes that Belgium really is as boring as you think. Or perhaps they are in the pocket of the euthanasia lobby. 

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Apologies


Sorry, readers -- this week's BioEdge is a bit abbreviated. 

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Conscientious objection twisting in the wind in Canada


For years bioethicists of a utilitarian cast have argued that conscientious objection has no place in medicine. Now Canadian courts are beginning to put their stamp of approval on the extinction of doctors’ right to refuse to kill their patients.

The Superior Court of Justice Division Court of Ontario ruled this week that if doctors are unwilling to perform legal actions, they should find another job (see report in BioEdge).

The case is sure to be appealed, but if the doctors championing conscientious objection fail, the consequences will be dire. Throughout Canada, doctors would be required to refer for euthanasia. If they refuse, they will be hounded out of their profession, or, at best, shunted into specialties where the question will not arise, like pathology or dermatology.   

This ruling shows how quickly tolerance vanishes after euthanasia has been legalised. In the Carter decision which legalised it, Canada’s Supreme Court explicitly stated that legalizing euthanasia did not entail a duty on the part of physicians to provide it. Now, however, 18 months and more than a thousand death after legalisation, conscientious objection is at risk.  

It also shows how vulnerable religious-based arguments can be. The plaintiffs contended that referring patients violated their right to religious freedom. While this is true, is this the main ground for conscientious objection? As several doctors pointed out in the Canadian Medical Association Journal last year, “Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.”

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First monkeys cloned in China


This week’s announcement by Chinese scientists that they had cloned macaque monkeys prompted a walk down memory lane for me. The scientists aver that they have no interest whatsoever in human cloning. One must take them at their word, I suppose, but the impulse to clone humans is a recurring lunacy.

Remember the Raelians? In 2002 Rael, the French-Canadian founder of the sect which believes that mankind was created by extraterrestrials and that cloning is a way to immortality, announced that his scientists had cloned a baby.

Remember Severino Antinori? The Italian gynaecologist announced that he had cloned babies in 2002. No proof was ever given. He is currently battling charges of kidnapping and forcibly removing eight eggs from a Spanish nurse.

Remember Hwang Woo-suk? The veterinary scientist claimed that he had cloned human embryos in 2004 and was featured on a South Korean stamp. Much of his work was fraudulent.

Remember Panayiotis Zavos? The Cypriot-American claimed in 2009 that he had implanted cloned 14 embryos and implanted them in four women. He has faded from the limelight in recent years.

I would wager that if the Chinese experiment is confirmed, there will be another wave of cloning attempts by rogue scientists. Watch this space.

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Singapore and gay parents. France debates bioethics. Dutch euthanasia dissent.


So much has been done; more, far more, will I achieve; treading in the steps already marked, I will pioneer a new way, explore unknown powers, and unfold to the world the deepest mysteries of creation.

Recognise these words? They are spoken by the pioneering scientist Victor Frankenstein in Mary Shelley’s rich and intriguing novel. This year marks the 200th anniversary of its publication in 1818 and it is being celebrated with a number of academic conferences.

In the era of CRISPR, artificial intelligence, and reproductive technology, it’s a good idea to revisit the novel. Despite its Gothic excesses, Frankenstein; or, The Modern Prometheus, is still an insightful critique of science and scientists. Make this your New Year’s resolution: “I will reread Frankenstein”.

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