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October
06
  5:26:00 PM

Canadians and Dutch fail to shift World Medical Association opposition to euthanasia

A view of Reykjavik

The pro-euthanasia Canadian Medical Association (CMA) and the Dutch Medical Association(KNMG) have failed in their bid to change the position of the World Medical Association. The CMA and the KNMG prepared a resolution at this year’s WMA meeting in Reykjavik, the capital of Iceland, but withdrew it for lack of support, according to a report from the Euthanasia Prevention Coalition.

The August issue of the WMA’s World Medical Journal contained reports from several regions where doctors had debated end-of-life care. In Brazil the local association declared that “if the doctor is prepared not only to cure but also to kill, the ethics of medical practice and the trust that the patient must have in his doctor will be very battered”. All of the medical associations in the Asia-Pacific and Israel (including Australia and New Zealand, Japan and China) were opposed to euthanasia. African medical associations were “unanimously opposed to euthanasia and physician assisted suicide in any form”.

The German Medical Association, the WMA and the Vatican also organised a symposium at which a majority of participants rejected euthanasia “as being diametrically opposed to the ethical principles of medicine and expressed concern that they could lead to misuse or abuse”.

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October
06
  5:15:00 PM

If you cannot remember a crime, should you be executed for it?

On April 18, 1985 Vernon Madison shot an Alabama police office in the back of the head at point blank range. He was tried three times for the crime and sentenced to death in 1994. He has been living on death row ever since. He is now 68 years old.

There is no doubt that he committed the crime. But his defence lawyers contend that after suffering two strokes in 2015 and 2016 he cannot remember it. Should he be executed?

His case has come before the US Supreme Court.

The Alabama Attorney General's office questions whether his amnesia is genuine and argues that Madison’s execution “will serve as an example to others that the intentional murder of a police officer will be punished”. It also contends that a prisoner with amnesia “is no less subject to deterrence than an inmate who remembers the crime that put him in prison.” 

“A failure to recall committing a crime is distinct from a failure to understand why one is being punished for a crime. An inmate’s personal recollection of the crime is irrelevant to whether the inmate shares the community’s understanding of the crime, has a moral responsibility for committing the crime, or understands why he is being punished for the crime.”

The Equal Justice Initiative, which is defending Madison, says that his health puts him “into the category of prisoners for whom an execution would serve no retributive or deterrent purpose.” They claim that the strokes have left Madison blind, with “vascular dementia, cognitive deficits, severe memory loss, and brain damage.” He has difficulty moving and speaking.

“He frequently urinates on himself and complains that no one will let him out to use the bathroom when there is a toilet inches away from his bed,” EJI wrote in a brief for the court. “His memory is so impaired that he can no longer recite the alphabet or do a simple math problem. He is unable to remember that his mother and brother are deceased and cannot identify the prison warden or officers who have been guarding him for years.”

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October
06
  5:10:00 PM

UK govt bodies clash over transgender fertility treatment

A government human rights agency in the UK plans to sue the government health service for not helping transgender patients to transition.

The Equality and Human Rights Commission claims that the National Health Service is obliged to provide fertility services for transgender patients with gender dysphoria, a treatment that normally results in a loss of fertility. If their sperm or eggs are frozen and stored, it is still possible for them to have children later in life.

But since many of these patients are teenagers, they cannot afford this. The EHRC claims that this constitutes discrimination against transgenders. The NHS responds that it is not responsible for providing fertility services to all patients.

Rebecca Hilsenrath, chief executive of the EHRC, says that “We are proceeding with our judicial review claim and will remain in discussions with NHS England about the need to ensure the transgender community can access health services free from discrimination, and that individuals do not have to choose between treatment for gender dysphoria and the chance to start a family.”

The NHS may be concerned about the potential for the cost of treating transgender patients to spiral out of control. The minister for women and equalities, Penny Mordaunt, has reportedly asked for an explanation of why the number of girls referred for transitioning has risen from 40 to 1,806 -- 4,400% -- over the past ten years.

If the NHS is forced to provide fertility treatment for them, it may be forced to reduce the level of service for conventional fertility patients – who are currently complaining bitterly about the low levels of service. A spokeswoman told the media: “NHS England has responded in detail to the EHRC explaining why we believe their request is both misjudged and potentially unfair to NHS patients.”

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October
06
  12:18:00 PM

Documentary makes powerful plea for open access publishing

Nothing warms the cockles of the heart like righteous outrage, so quite a few readers of BioEdge will be interested in Paywall, a documentary on academic publishing. Its argument is simple. Knowledge should be free. Academic journals aren’t free. Therefore the system is broken. Why does a US$25.2 billion industry coast along with profit margins of about 30% -- when an “evil corporation” like Walmart only has a profit margin of 3%? The world needs open access publishing!

The attack on the current model may be unfair, but you can’t say that it isn’t provocative and fascinating. Paywall: the business of scholarship is well worth watching – if you can organise a screening, because it costs individuals US$39.95 to download.

Here’s what The Lancet (whose publisher, Elsevier, is one of the main villains targeted by director Jason Schmitt) had to say about Paywall:

The film could ... have an impact on academics, many of whom still do not understand how profitable publishers are and how academic institutions could—if they worked together—make science available to all and retrieve the profits for more research.

More openness in science, the talking heads make clear, means better scholarship, more innovation, higher quality, more equality, and a better chance of solving fundamental problems like climate change, poverty, and the pushing back of disease. That publishers are making huge profits from restricting access to research is not a marginal problem, says István Rév, a professor of history and political science from Budapest, it's holding back the solution to fundamental problems. Indeed, he adds, the profits of publishers are one of the causes of rapidly rising tuition fees. Some colleges are having to close in part because of the continuing high cost of journals. “It's a catastrophe”, says Peter Suber, director of the Harvard Office for Scholarly Communication and director of the Harvard Open Access Project.

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October
05
  3:27:00 PM

Australian man convicted of counselling his wife to suicide

An Australian man has been found guilty of “counselling” his wife to commit suicide -- a conviction that appears to have no precedent in Australia or internationally.

Graham Morant, 69, was convicted by a Queensland Supreme Court jury on Tuesday of both counselling and aiding his 56-year-old wife Judy to take her own life. Mrs Morant suffered from chronic pain, but was not terminally ill.

The court hear that Mr Morant stood to gain A$1.4 million in life insurance from his wife’s death.

Judy Morant was found dead alongside a petrol generator in her car on November 30, 2014, and a note was found nearby saying “please don’t resuscitate me”. A week earlier Mrs Morant had told a close friend that she intended to commit suicide, and that her husband had a agreed to help her.

The court heard that Mr Morant, a devout Christian, had told his wife he wanted to use the life insurance payout to build a religious commune in the Gold Coast hinterland.

Initially Mr Morant denied any involvement in his wife’s suicide, though as police produced more evidence of his complicity his story began to change. “Slowly, very slowly, over the course of the next hour the accused explained he did assist his wife in her suicide,” Crown prosecutor Michael Lebanese told the court.

Prof Ben White, a law expert at Queensland University of Technology, told the BBC that assisted suicide-related convictions of any kind were “very rare” in Australia.

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October
05
  3:25:00 PM

Japan set to allow gene editing of human embryos

Japan is set to allow the gene editing of human embryos, with an expert panel representing the country’s health and science ministries releasing new guidelines late last month.

Although the country regulates the use of human embryos for research, there have been no specific guidelines on using tools such as CRISPR–Cas9 to make precise modifications in their DNA until now.

The new guidelines will allow for research to be carried out on early-stage embryos, with scientists hoping to gain insight into early human development and perhaps eventually fix genetic mutations that cause inherited diseases.

Yet ethicists are concerned that the technique could be used to alter the embryos for non-medical reasons. While the guidelines would restrict the manipulation of human embryos for reproduction, they are not legally binding.

Gene editing is still banned in most countries, though countries such as the UK have recently relaxed their restrictions.

Tetsuya Ishii, a bioethicist at Hokkaido University in Sapporo, says that before the draft guidelines were issued, Japan’s position on gene editing in human embryos was neutral. The proposal now encourages this kind of research, he told Nature.

The guidelines are open for public comment and will likely be implemented in the first half of next year.

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October
05
  3:23:00 PM

Canada: the latest surrogacy hotspot?

Canada may have become a hotspot for international surrogacy, with data suggesting that almost half of intended parents in some provinces live abroad.

Writing in The Globe and Mail, journalist Alison Motluck recounts how loopholes in Canada’s surrogacy law, and increasing restrictions on surrogacy in other countries, have contributed to an apparent spike in foreign intending parents having children via Canadian surrogates.

Precise figures are not publicly available and some provinces do not keep records of parents’ residency. Yet legal scholar Pamela White from the University of Kent recently obtained data from the government of British Columbia of births via surrogacy in the province in 2016 to 2017. According to White, almost half of the babies born to Canadian surrogates in the province were for intended parents who lived outside the country (45 of the 102 babies, or 44 per cent).

In a paper presented at the annual meeting of the Canadian Fertility & Andrology Society last month, University of Manitoba legal scholar Karen Bubsy noted that a loophole in Canadian legislation allows for surrogates to be paid provided that the money exchanges hands outside of the country. And unlike Russia and the Ukraine, Canada does not restrict surrogacy on the basis of marital status or sexual orientation.

Canada restricts payments for local sperm and eggs, yet prospective parents can purchase gametes for surrogacy in US states bordering Canada.

Even in light of the loopholes in legislation, there have been calls for the country’s official ban on commercial surrogacy to be abandoned. A bill is currently before the House of Commons that would amend the Assisted Human Reproduction Act to allow payment for surrogacy services.

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September
30
  10:41:00 PM

What are the ethical complications of a womb transplant?

In 2014, the first child to have been gestated in a donated uterus was born in Sweden. Although research into uterus transplantation is still in an early phase, many see the donations as a success. But are there ethical complications as well?

Thus far, trials around the world have resulted in the birth of ten children who were gestated in a transplanted uterus; eight of them in Sweden.

"If uterus transplantation is to take the step from trials to becoming a reality in the Swedish healthcare system, there must first be an ethical debate on the procedure," says Lisa Guntram, of Linköping University.

In 2016 a Swedish white paper on altruistic surrogacy argued that altruistic surrogacy should not be permitted. With this as a starting point, Guntram analysed the assumption that introducing uterus transplantation would be less problematic than altruistic surrogacy. Her research was conducted together with Nicola Jane Williams, of Lancaster University in the UK, and the results of the study have been produced in the journal Bioethics.

Some of the issues include:

1.That the transplant can threaten the autonomy of the donor, and subject her to pressure. In the Swedish trials, the donated uteruses come from a relative, in most cases the mother of the woman who is involuntarily childless. Consequently, some close relatives of involuntarily childless people can feel forced to donate, or be actively subject to external pressure.

2.That the intervention can lead to exploitation of women's bodies. There is a risk uteruses might become yet another organ, such as kidneys, on the black market.

3.That the research on the physical and psychological risks facing the child is inadequate. As in surrogacy contexts, little is known of the consequences of uterus transplantation for the child, because so few children have been born as a result of such a transplantation.

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September
30
  10:34:00 PM

Forget about those split infinitives: editors can have heavy moral responsibilities

Cast study 1: A recent Danish study found that antibiotics could be useful for treating the symptoms of a widespread chronic disease. But publishing the study was difficult. At least one reviewer noted that the study could lead to an increased use of antibiotics and thus ultimately adding to the problem of microbial multi-resistance.

Case study 2: The BMJ recently published an article suggesting that side-effects of statins may outweigh health benefits in patients at low and intermediate risk of cardiovascular disease. The article sparked intense debate, even in the mass media. As a result it is estimated that as many as 200, 000 people in the UK have stopped taking statins, potentially leading to 2000 cardiovascular events.

Should the results of the research have been published?

An article in the Journal of Medical Ethics argues that the consequences of making some medical research public are too negative to allow publication. Editors of medical journals have a moral responsibility for the harm that is caused, contends Thomas Ploug, of Aalborg University Copenhagen.

Editors can do some things to mitigate harm, Ploug points out:

They may require authors to explicitly describe and address the potential harmful effects and the need for regulation, and they may ask authors to revise unnecessarily strong, one-sided, unbalanced statements that are likely to be picked up and communicated uncritically by the mass media.

Editors may also influence the context of publications by inviting reviewer or open peer comments or by an editorial comment. They may choose to include such research in special thematic issues with a special emphasis on the wider effects of publishing this research. They may highlight the sensitive issues in their advertising on social media and in potential press releases to the mass media. They could even ask a panel of healthcare organisations and relevant decision-makers to comment in the journal on the potential harmful effects and the need for regulation.

But perhaps the best way of dealing with this issue is to develop a code of publication ethics which would “Acknowledge moral responsibility for the effects of publishing; Define benefits and harms of publishing, [and] Specify a range of actions an editor may take.”

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September
30
  10:29:00 PM

Editor bans religious arguments from bioethics journal

The editor of Developing World Bioethics, Udo Schüklenk, has decided to ban from his journal any articles whose assumptions are religious. “After much thought we have decided to more significantly limit exclusively religious contributions.”

Why? It’s not out of an anti-religious bias but because “Religion based arguments are, by definition, arguments that do not fall into the category of public‐reason based arguments.”

They rely on premises involving the existence of unobservable supernatural powers giving us direction in terms of how we must live our lives. Typically their guidance is provided in religious documents the content of which is credited to said unobservable supernatural powers...

Schuklenk makes an interesting summary of the argument for secularism:

Secular societies cannot possibly function as arbiters of the truth or otherwise of their diverse citizenries religious beliefs. The reasons for this are well‐known and reflected in myriad highest courts’ judgments delivered across liberal societies’ jurisdictions. As a consequence of this, while debates in such societies will countenance in varied ways religious arguments, ultimately only views that can be defended within the analytical frameworks of public‐reason based arguments can succeed in secular societies.

Developing World Bioethics is a companion journal to Bioethics, of which Schüklenk is a co-editor.

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Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
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Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.


 upcoming events

Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
July 28-31, 2010, Singapore
Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.


 upcoming events

Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
July 28-31, 2010, Singapore
Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.


 upcoming events

Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
July 28-31, 2010, Singapore
Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.


 upcoming events

Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
July 28-31, 2010, Singapore
Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.


 upcoming events

Passport to Parenthood: Evidence and Ethics behind Cross-Border Reproductive Care
November 24, 2010, London
Progress Educational Trust asks whether fertility tourism is a problem or a solution.

10th World Congress of Bioethics
July 28-31, 2010, Singapore
Bioethics in a Globalised World

Created in the Image of God: realities and challenges in caring for the human person
April 30 - May 2, 2010, Montreal
AGM of Canadian Federation of Catholic Physicians’ Societies; featured speakers include Edmund Pellegrino and Margaret Somerville.

Consequences of the Bio-Medical Revolution
May 1, 2010, Biola University, La Mirada, CA
Helping nurses understand technological advances in health care and their ethical consequences.

Fertility, Infertility and Gender
June 16-18, 2010, Maynooth, Ireland (near Dublin)
Sponsored by the Linacre Centre for Healthcare Ethics, Oxford.



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