The assassination of Osama bin Laden


May 7, 2011 

Hi there,

The news which has gripped everyone this week is the killing of Osama bin Laden. I have trawled through the internet to find a bioethical angle. I am afraid that I was not very successful or perhaps not very imaginative. However, I did discover that many neuroscientists believe that revenge is an evolved mechanism. If that is true, perhaps the killing is more properly a question for neuroscientists than ethicists.

The far more interesting question is a political one: is targeted assassination ethical? It is a tactic that Israel has been using at least since the lethal attack on its athletes at the Munich Olympics. The US seems to have adopted it, with drones, and now with Navy Seals.

Is this consistent with the human dignity which is at the heart of bioethics? If you think that capital punishment even for rapists and serial killers is wrong, what about assassinating seriously bad guys like bin Laden? Any ideas? If you want to respond, please comment on the lead article…

During the week you may have received my letter asking for financial support. Please consider giving. We have no big sugar daddies and depend mostly on support from our readers.

Cheers,

Michael Cook

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The bioethics of the royal wedding


Hi there,

Journalism is about news and editors are always desperate to spice up mundane stories with links to breaking news. So I cudgelled my brains on this morning’s flight from Hobart to Sydney for a bioethics connection to Will and Kate’s Big Day. Newspapers around the world are overflowing with the Royal Wedding and the Royal Smooch.

I’m afraid that I couldn’t find anything current. However, perhaps the fact that 3 billion people watched an English couple exchanging vows is a reminder of the intense seriousness of the passions and relationships which fuel the growth of assisted reproductive technology. The young couple’s life in a gilded cage is really a royal nursery to produce another heir to the throne. Would it be appropriate for them to resort to IVF or surrogate motherhood if there are difficulties?

Would the history of England and the world have been different if Henry and Catherine of Aragon had been able to use IVF? Would they have taken advantage of it?

My intuitive feeling is no. What do you think?

After the Easter break, our newsletter is longer than usual. I hope that you enjoy it.

Cheers,

Michael Cook

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Zsa Zsa Gabor to be a mother again? At 94?


Hi there,

Before I forget, there will be no BioEdge newsletter on the weekend of April 22-24, the Easter holiday, although we will post some articles.

In the course of trawling through the news, I sometimes come across situations so bizarre that they provide case studies for bioethical discussions. Take the news that Zsa Zsa Gabor’s husband (her ninth) has announced that she is going to become a mother again.

It’s an original idea. Zsa Zsa is 94, is bed-ridden, speaks very little, just had a leg amputated, and has had trouble with strokes and blood clots. However, hubbie Prince Frederic von Anhalt says that he has given sperm samples to the Southern California Reproductive Center in Beverly Hills. He plans to use a donated egg and a surrogate mother.

"We talked about it, saying 'Remember, we always wanted a baby, and now it's too late,'” he told AFP. “And I said to her, 'Well maybe it’s not too late.'"

He estimates that producing the child will cost about US$100,000. Even though Zsa Zsa now utters only about two sentences a day, he is confident that she likes the idea.

There are so many things wrong with this absurd proposal that it’s not worth cataloguing them. But the law provides no protection for the future child. If Prince what’s-his-name wants a kid and can pay for it, he can have it. Thankfully, this is probably nothing more than a publicity stunt. But it makes you think about the wisdom of allowing assisted reproduction to function with almost no regulation.

Cheers,
Michael Cook
Editor

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surrogate motherhood and the Daily Mail


Hi there,

Drizzle or no drizzle, there are times when I wish that I lived in London – when I get my hands on a London tabloid. Yes, I know they’re smutty and intellectually crude, but what glorious headlines they have! How could you resist a paper with a come-on like “Super Caley Go Ballistic Celtic Are Atrocious”. Or “I kicked burning terrorist so hard in the balls that I tore a tendon in my foot”. Or “Charles: Why I Stick Tooth Paste Up My Nose”. Or “Freddy Starr Ate My Hamster”.

Then there’s the bioethics angle. Nobody does the human drama of bioethics better than the Daily Mail, as far as I can see. Its reporters are expert at winkling the whole story out of the foot soldiers of the reproductive revolution. They slog through battlefield gore while plummy papers like the Guardian or the New York Times focus on the war games played in HQ. And the tabloids take a surprisingly old-fashioned finger-wagging view of these developments.

Take, for instance, surrogate motherhood. This is largely regarded as a progressive cause in Australia, the UK and the US, at least. But the Daily Mail’s Amanda Platell scolds a 29-year-old barmaid surrogate who has just given up a child to her aunt saying “it’s just a job to me”.

“How can she possibly say that? How can the act of carrying a baby for months — a child of your own genetic make-up — and giving birth to her be described as ‘just a job’? How can anyone treat the wonder of having children so casually?”

This is echoed another story (below) from the US about the agony suffered by an unplanned surrogate mother who had become pregnant with the wrong IVF embryo. She gave birth to the child anyway, but it was agonising for her to give up the child of her dreams. So she promptly hired her own surrogate and now she is soon to take delivery of twins.

Isn’t there a point at which the child’s identity matters more than a would-be parent’s dreams? Any ideas? It’s not an easy question.

Cheers,
Michael Cook
BioEdge

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India’s sex ratio


Hi there, 

There can be no bioethical issue which commands such universal support as the evil of gendercide. In many countries, girls are aborted or killed at birth because of a deep-seated preference for boys to carry on the family name. The issue is critical in South Korea, Vietnam, China, and most famously, India.

Across the ideological spectrum, the great and good staunchly oppose sex-selective abortion: the government, feminists, human rights groups, religious groups, the United Nations, UNICEF, economists, the media…. Yet couples and doctors still collude in the deaths of girls. The latest figures from India’s 2010 census show that the ratio of girls to boys between the ages of 0 and 6 continues to drop. (See figures below.)

Outrage is pointless. Obviously a deep cultural change is needed, despite India’s vibrant cultural life and economic dynamism. Any ideas?

On a similar front, we report on Rwanda’s drive to give 700,000 men vasectomies to curb population growth. Indira Gandhi tried this during the 1970s and it helped to scupper her government. I wonder if Rwanda’s president, Paul Kagame, is aware of that.

Cheers,
Michael Cook
Editor

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Does the future include three-month accelerated pregnancies?


Hi there,

The New York Times reviewed a thought-provoking book this weekend, “Future Babble: Why Expert Predictions Are Next to Worthless, and You Can Do Better”, by Canadian journalist Dan Gardner. One thing led to another and pretty quickly I discovered that the fallibility of experts is the theme of a a number of recent books with titles like “Wrong: Why experts keep failing us--and how to know when not to trust them”, “Being Wrong: adventures in the margin of error”, and “On Being Certain: Believing You Are Right Even When You're Not”.

It must have something to do with being blindsided by the Global Financial Crisis. But even if the track record of experts is no better than that of dart-throwing chimps, we don’t seem to have lost our appetite for predictions. The future is a bit like death: no one you know has ever done it before. So predictions are fascinating, even addictive.

That’s why I am intrigued by a series of short (10-minute) films by young directors about what US society will be like in 10 or 20 years. I have posted one of them on BioEdge, “Silver Sling”, which deals with surrogate motherhood. The premise is that this business could really take off if you could get three-month “accelerated pregnancies” for busy working couples.

Futurecasting is an undervalued part of the enterprise of bioethics. Many disputes over hot-button issues take the form of “if X happens, then we are on a slippery slope to Y”. When this is turned into a film, it becomes a powerfully persuasive.

Cheers,

Michael Cook
Editor

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New Hampshire eugenics


Hi there,

I’m not sure whether to laugh or cry over remarks made by a doddering member of New Hampshire’s lower house. Martin Harty told a constituent that "the world is too populated" and there are "too many defective people". This included "the mentally ill, the retarded, people with physical disabilities and drug addictions - the defective people society would be better off without." Nature has a way of "getting rid of stupid people," and "now we're saving everyone who gets born," he said.

This made national news. A local paper, the Concord Monitor, thundered that “Harty was elected to represent all his constituents, not just those he considers worthy of basic human rights. His views are an affront to common decency and a stain on the reputation of the New Hampshire House.”

So, after only two months as a state legislator, the 91-year-old Mr Harty resigned. Good riddance, I suppose, but isn’t there a double standard here? Getting rid of the disabled is an everyday occurrence in the US, Australia and the UK, and no doubt many other countries as well. In fact, in another article in this week’s newsletter, we report that scientists have developed yet another quick and easy pregnancy test for Down Syndrome. Well over 90% of these children are aborted, even though most of them could have lived happy and fulfilled lives. That, too, is “an affront to common decency. 

I hope that you enjoy the newsletter. Cheers. 

Michael Cook
Editor

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Does the Indian Surpreme Court need better bioethics advice?


Hi there,

Bioethical developments in India are not widely reported elsewhere. But the case of Aruna Shanbaug, which was decided by India’s Supreme Court this week, could have far-reaching consequences. Ms Shanbaug has been in a permanent vegetative state for nearly 40 years. In 1973 she was a nurse on duty at King Edward Memorial Hospital in Mumbai when she was savagely sexually assaulted by a wardsman. Ever since the hospital staff has taken care of her magnificently. The Court praised them as an example for all of India.

The justices declared that Ms Shanbaug should be allowed to live because she had such loyal friends, rejecting a request from an activist who felt that her life lacked human dignity. However, it set down principles which were poorly informed and badly phrased. It failed to distinguish between “passive euthanasia” and withdrawal of burdensome treatment and it appears to assume that ordinary nutrition and hydration is life support.

I wish that the learned jurists had sought advice from some competent bioethicists before laying down the law. See the story below or check out the video on the website

Cheers,
Michael Cook
Editor

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The tragedy of Rachel Nyirahabiyambere


Hi there,

It’s always best to wait for both sides of a story to emerge. But a New York Times report makes Georgetown University Medical Center and the US health system look quite heartless. After the children of a brain-damaged Rwandan migrant without health insurance could not pay for hospitalisation or nursing care, her feeding tubes were removed and she is slowly starving to death in a Maryland nursing home.

There will certainly be further developments in this breaking news. Not only is it a case study in medical ethics, but it will also give ammunition to opponents of President Obama’s healthcare program. They will surely use it as an example of what “death panels” could do. Stay tuned. 

Read the story below.

Cheers,

Michael Cook
Editor
BioEdge

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The puzzle of locked-in happiness


Hi there,

Heading up our list this weekend is a remarkable story about locked-in syndrome (LIS). Personally, I cannot think of anything worse. Even quadriplegic Christopher Reeves was able to give speeches, run a foundation and inspire supporters of his favourite causes. But someone with LIS can only communicate by blinking. A French journalist, Jean-Dominique Bauby, made it better known in his book (later turned into a film), The Diving Bell and the Butterfly.

But I might be wrong about this. Belgian neuroscientist Stephen Laureys has surveyed several dozen LIS patients in France and found that most of them believe that they are leading happy lives. This challenges preconceptions about unbearable suffering and about the usefulness of living wills. Only 7% were interested in euthanasia.

There are some caveats to this optimistic picture and the main one is that happiness comes only with time. The shock of suddenly becoming utterly immobile and dependent is devastatingly demoralising. It probably leads many patients initially to think that they would be better off dead. However, after a year or so, most of them feel that they are living happy and meaningful lives.

It is this caveat that Oxford’s utilitarian bioethicist Julian Savulescu seizes upon in his response to this research. He makes the radically pro-choice argument that LIS patients should be able to have euthanasia whenever they want. This is the case even if their subjective well-being will be substantially greater if they wait a while.

I am not a philosopher, but shouldn’t an informed choice lead you to choose something good? If the content of a choice makes no difference to a moral decision, what exactly is the point of ethics anyway? Whatever I choose is going to be the right choice, so why bother thinking about it? Perhaps some philosophers out there can enlighten me.

Cheers,
Michael Cook
Editor

 

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