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Questions to which the Answer is Yes

28 Nov, 14 | by Iain Brassington

Over at Practical Ethics, Charles Camosy asks a question: Can bioethics be done without theology?

Yep.  It can.

Well, that was quick and simple.

But – oh, all right: I probably ought to say a bit more.  Now, Camosy’s post is quite long, and that means that if I want to scrutinise it in any detail, I’d have to generate something at least as long.  I’m not sure if I – or any reader – has the patience for that, so what follows is probably not going to be without the odd gap.  All the same, this post has turned out to be something of a monster in its own right – so it might be worth going to make a cup of tea first if you intend to read it.

The tl;dr version is that I think that Camosy’s argument is fallacious in several places.  And though I’m arguing from a position of godlessness, I think that the problems ought to be apparent to those who do have faith as well.  With that caveat issued, here we go… more…

Oh, dear, Richard…

20 Aug, 14 | by Iain Brassington

Look, I know that Twitter really isn’t the place for nuanced debate.  But, by that token, everyone else should realise that as well – especially intellectual superstars. So how, then, to explain Richard Dawkins’ spectacular foot-in-mouth moment earlier today? It started off reasonably enough, with him tweeting about Catholicism’s stance on abortion and providing a link to this piece by Jerry Coyne in the New Republic; lots of people are going to agree with both Coyne and Dawkins, and lots to disagree, but we should expect that.  The tweet got a couple of replies.  I can’t be bothered transcribing them, but here’s a screenshot; you should be able to click to enbiggen it. Screen shot 2014-08-20 at 19.50.23

So far so good.  Dawkins’ reply is about as good a version of the sentience argument that you could cram into 140 characters; and InYourFaceNewYorker’s point articulates a problem faced by any number of women who are carrying a child with a disability of some kind.  (Well, by any number of parents, I suppose, except that it’s women who hold the moral trump here simply by dint of being the one carrying it.  Fathers could agonise about the best thing to do, too; it’s just that they don’t get to make the final decision.  Oh, you know what I mean.)  Where you stand on abortion doesn’t preclude recognising that it’s a genuine moral dilemma for many people, and a that there are respectable arguments and proponents of those arguments on both sides – by which I mean that people on either side should be able to recognise that their opponents are at the very least worth the effort of an argument. InYourFaceNewYorker goes on to articulate some of the aspects of the debate that make it so emotive and so intellectually rich:

Screen shot 2014-08-20 at 19.58.49

That doesn’t reflect Dawkins’ response to the dilemma, though.  Brace yourselves. more…

On Conflicts of Interest

28 Jul, 14 | by Iain Brassington

It’s only a few days since Richie’s paper on providing IVF in the context of global warming was published, but already there’s been a couple of lines of objection to it that have been fairly widespread; I thought it might be worth nodding to one, and perhaps offering an attempt of a defence against the other.

The first objection is that there’s no justification for the claim about same-sex couples in Richie’s paper – that she shouldn’t have treated homosexuality as a lifestyle choice and as “non-biological” infertility.  I think that there’s significant merit to this objection to the paper; and though neither Dominic nor I mentioned the objection explicitly, I think that it’s there between the lines of each of our commentaries.  (It’s certainly an aspect of the paper that’s picked up by the Telegraph‘s coverage of the paper, and it’s been mentioned a couple of times on Twitter and Facebook by people I know and follow.  (I note that the Telegraph also gave a highly bastardised version of my post here.  Ho hum.))  I think that Richie’s argument would have been at least as strong if she’d talked about providing IVF to anyone whatsoever – the qualifications about different “sorts” of infertility and lifestyle, I suspect, weakened the paper, inasmuch as that a paper with unnecessary and argumentatively weak aspects is more vulnerable to objections generally than one in which those aspects have been left out.  So, yeah: I think that that might count as having been – at best – a strategic error on Richie’s part.

Here’s the other claim that I’ve seen a few times about the paper: that it’s weakened by a conflict of interest because of the author’s affiliation.  This isn’t directly a claim about the quality of the argument in the same way that the previous objection is.  Rather, it’s a claim that there’s something unreliable about the very fact of the argument’s having been put.  (I’m not articulating the distinction very well, but I think you can see what I mean.)  In essence, the worry is this: Richie works for a Jesuit Institution; this isn’t clear from her affiliation in the paper; there’s something iffy about this; this iffiness is some form of conflict of interest and her argument is likely to be biased.

I’m not sure what to make of this. more…

How Not to Argue against a Proposed Law

5 Jun, 14 | by Iain Brassington

Yes, yes: it’s tedious and internecine, but it’s almost a year since I had a pop at Kevin Yuill’s book on assisted dying; how about an update?  Well, conveniently, there’s this, in which he tries “to convince my fellow liberal minded atheists to reconsider their support for legalized assisted dying”.  OK, then.  First up, this isn’t a pro-legalisation post: I’m much more interested in looking at the arguments presented in their own terms.  I think they’re bad; but that is to do with their form rather than their content.  Indeed, one of Yuill’s opening moves is something to which I’m sympathetic: in respect of Lord Falconer’s latest Bill to legalise assisted dying, he points out that

the chief sponsoring agency (Dignity in Dying) lamely differentiates between the dying (those with six months or less to live) and those with more time.
If the latter ingest poison in a room by themselves – well, that’s suicide.  But if those with less than six months take poison with the intent to end their lives, that is not suicide at all but <ahem> assisted dying. Nope, me neither.

I agree that the six-month time limit is arbitrary, and probably morally indefensible.  But…

*deep breath*

But note how Yuill botches even this point. more…

Their Poor Little Heads might Explode

1 Jun, 14 | by Iain Brassington

There’s a nice little piece by Martin Robbins in this week’s Guardian in which he talks about the fact that women seem to be less supportive of abortion than men.  That does seem counterintuitive, given that… well, given the obvious physiological facts and the relative burden of risks related to pregnancy.  So there’s an interesting little anthropological puzzle here; and he suggests a number of factors that might explain the phenomenon. For example, there’s some research that finds that women are more likely than men to agree that life begins at conception – though, as he points out, while that might help explain the different views of termination, we’d still need to know why more women think that to begin with. Another potential explanation is that men like the idea of not having to do the right thing by their pregnant partners by paying child-support or, if you’re reading this in the 1950s, marrying them: abortion gives a way out of that.  But – and Robbins doesn’t mention this – that again presupposes keeping the baby as the default position to which people are looking for an alternative.  We could also talk about social pressure, and the way that women are still expected to be mothers, and how that feeds into attitudes.  In fact, we could talk about a lot of things:

So which is it? Internalised sexism, men’s liberation, fundamentally different ideas about the point at which life begins, or something else entirely? I doubt only one factor is at work, but it seems that we lack a definitive answer. And that’s a shame, because in the ongoing battle of ideas it seems like a very important question to ask.

I suspect some will deride his “we need to do more research” conclusion, but it seems eminently sensible to say that, faced with a quirk of attitudes, a full explanation would be at least aesthetically satisfying, even if not especially urgent.  He also provides lots of useful links.

Over at the CMF blog, Philippa Taylor’s suggestion – which also has lots of useful links – is a little different. more…

This will hurt a bit

11 Apr, 14 | by David Hunter

In a piece titled in a fashion to simultaneously win the internet and cause every male reader to wince, Michelle Meyer asks “Whose Business Is It If You Want a Bee To Sting Your Penis? Should IRBs Be Policing Self-Experimentation?

In this piece she describes the case of a Cornell graduate student who carried out a piece of self-experimentation without IRB approval (based on the mistaken belief it wasn’t required) which aimed to assess which part of the body was worst to be stung by a bee on and involved:  “five stings a day, always between 9 and 10am, and always starting and ending with “test stings” on his forearm to calibrate the ratings. He kept this up for 38 days, stinging himself three times each on 25 different body parts.”

While IRB approval was required and not sought in this case, Meyer argues that this isn’t problematic effectively because in her view regulating researcher self experimentation constitutes an unacceptable level of paternalism:  “The question isn’t whether or not to try to deter unduly risky behavior by scientists who self-experiment; it’s whether this goal requires subjecting every instance of self-experimentation, no matter how risky, to mandatory, prospective review by a committee. It’s one thing to require a neutral third party to examine a protocol when there are information asymmetries between investigator and subject, and when the protocol’s risks are externalized onto subjects who may not share much or any of the expected benefits. Mandatory review of self-experimentation takes IRB paternalism to a whole other level.”

Perhaps this is just my inherent lack of a distaste for relatively benign paternalism but I don’t quite see this objection to regulating self experimentation working for three reasons.

Firstly the distinction Meyer draws between self and other experimentation assumes a high level of understanding of the risks and benefits on the behalf of the researcher in a way that negates the need for the normal consent process. This is probably right most of the time and so we can assume consent is present. Does this negate the need for external review? I am not sure it does since the researchers understanding is not perfect and they may be self deceiving in regards to the magnitude and level of risk. Meyer notes for example that this project originally involved stings to the eye, until the supervisor of this student pointed out that this risked blindness. So review by external experts regarding risks and benefits of research can and does reduce the levels of risks in research. In Research Exceptionalism James Wilson and I argue that this is a general justification for external research regulation – the ethics and risks and harms of research are complex and unpredictable and hence external regulation helps clarify these risks and ethical issues to enable researchers to fulfil their moral duties. This is of course paternalistic in the case of self-experimentation, but I presume that the student in this case is grateful to his supervisor for saving his vision, so I think it is the kind of paternalism we ought to endorse, since it is in regards to a risk that the person wouldn’t want to run.

Secondly valid consent, doesn’t just consist of having information, it also requires competency and particularly in these types of cases an absence of coercion. This is a graduate student who is to be frank in a vulnerable institutional position (like many of us in academia…) – if they want to improve their standing and move to the next level they need to keep their superiors happy. This makes them vulnerable to self exploitation and risk taking, which external regulation can reduce and remove.

Finally I suspect that what is going on here is a kind of reverse research exceptionalism where the regulation of research is seen as somehow more problematic than the regulation of other aspects of our lives. It is commonplace for health and safety to require us in the course of our employment to to act and not act in particular ways. This is both paternalistic insofar as it protects us, but it is also not paternalistic insofar as it protects both others and the instution we work at. In this case, this student is working in a lab in an institutional context and if something had gone wrong for the student or others in the course of this research then the institution could well have been held liable for damages arising from this. As such it seems perfectly within their rights to me to decide how to regulate these risks to them, and to decide to regulate these via prospective review.

Now as Meyer notes this is an external requirement rather than a choice that Cornell has made, but I don’t think this changes the justification for the regulation – given that we know in markets competition tends to drive towards failures to protect workers and others, there is nothing inappropriate with the state correcting the market failure here via legislation.

 

 

 

 

 

Medical Information for Sale?

21 Jan, 14 | by Iain Brassington

Reader Keith emailed me a week or so ago to tip me off about the government’s plans to allow private firms to access medical information.  It’s a story that has subsequently been picked up by  – inter alia – The Guardian.

As with the last post I made here, I’m going to have to cry off from saying much in my own right – I’ve got lectures that need to be written, and I need at least to go through the motions of being competent – but I would draw your attention the Christian Munthe’s take on the matter.

Touch wood, I’ll be able to get back to more frequent blogging soon.

Sex-Selection and Abortion: Is there a Problem?

17 Jan, 14 | by Iain Brassington

This is just a quick post, and it’s mainly to draw your attention to a couple of other posts worth reading elsewhere.

A little background: there’s been a minor fuss* in the media over the last few days concerning sex-specific abortion**, after The Independent reported that

[t]he practice of sex-selective abortion is now so commonplace that it has affected the natural 50:50 balance of boys to girls within some immigrant groups and has led to the “disappearance” of between 1,400 and 4,700 females from the national census records of England and Wales, we can reveal.

Now, there’s something a bit fishy about the article even on its own terms: alarm bells should be got ringing by this:

[O]ur deeper statistical analysis of data from the 2011 National Census has shown widespread discrepancies in the sex ratio of children in some immigrant families, which can only be easily explained by women choosing to abort female foetuses in the hope of becoming quickly pregnant again with a boy.

After all, it does seem to reduce to a claim along the lines that “I can’t think of a better explanation than e for phenomenon p, therefore e obtains” – but that tells us far more about the limits of the speaker’s imagination than about the state of the world.  Besides, while there are good reasons to favour the most simple explanation of p, one ought to keep a distinction between the simple and the simplistic.  Bluntly, an easy explanation isn’t any more likely to be true by dint of being easy.  E=mc2 is simple once you’ve derived it, but its derivation isn’t easy.

But how reliable is the Indy‘s analysis anyway?  I’ve not gone through the data myself, but Unity has, and has a couple of really good posts: the first is here, and the followup is here.

They’re very worth the read – but I recommend that you make yourself a good cup of tea before starting them.  They’re looooooong.  I’d be interested to know what others think, though.

 

UPDATE: There’s even more.  I think Unity’s enjoying himself with this.

 

* Minor in the sense that it’s been eclipsed by things like Oscar nominations.

** Here’s Christina Odone, for example, blaming it all on feminism.  Surprised?  You could knock me down with a bulldozer.

Identity and IVF

11 Jan, 14 | by Iain Brassington

It’s good to see that Stephen Latham is blogging again after a short hiatus; and he’s come back with a really thought-provoking post on IVF and problems of identity.

The background is this: apparently, there is evidence that children conceived by IVF are at an elevated risk of health problems compared to kids conceived naturally:

Compared to spontaneously-conceived singletons, singletons from assisted conception were almost twice as likely to be stillborn, more than twice as likely to be pre-term, almost three times as likely to have very low birth weight, and twice as likely to die within the first four weeks after birth. Outcomes varied by type of assisted conception. Very low and low birth weight, very preterm and preterm birth, and neonatal death were “markedly” more common in births from IVF and, to a lesser degree, in births from ICSI. Use of frozen embryos elminated the risks of ICSI, but not of IVF. But frozen embryos also had increased risk of macrosomia.

This is the paper that Stephen mentions; but it’s not the only one to report potential risks associated with IVF.  A rather kneejerk response to this is to go “Eeeep!  This means that IVF is dangerous, and we’re harming kids by conceiving them by this method”.  (I suspect that there’s an element of that in posts like this – though admittedly if that element is there, it’s being deployed merely as a part of a wider attack on IVF, motivated for different reasons.)  But, of course, kneejerk reactions are rarely all that morally insightful, and the conventional response to concerns about IVF is rather more sanguine.

Borrowing heavily from Parfit, the standard response is this: each of us is reliant on a particular egg and a particular sperm having fused in a particular way.  Had that been different, we would not have come into being.  A month later, and it’d’ve been a different egg; and it could easily have been a different sperm cell.  Any resultant child would be related to us only in the same way as a sibling – except that it wouldn’t be our sibling, because we wouldn’t be there.  This indicates that, if IVF represents a child’s only chance of coming into existence – and it probably is – it is hard to say that the child has been harmed or wronged thereby.  There may be a qualification to add, along the lines that should the child’s life be so bad that non-existence would be preferable, existence may be a harm; but that kind of outcome is probably hyperbolic in practice.  An elevated risk of any congenital characteristic is therefore unlikely to count as a harm.

So, as Stephen points out, we can ask a question: more…

An Attack of the What-Ifs

25 Oct, 13 | by Iain Brassington

Among the comments to the last post, there’s this from Parmenion59:

So…if a cure for lung cancer is found, and the study has been funded through money from a tobacco company…the BMJ won’t publish said study?
Way to go BMJ.

Hmmm.  At least on the face of it, this looks like an important point – one that deserves a bit of unpacking.  We can begin by distinguishing between responses to this particular point, and responses to the general idea behind it.  First things first.

I’m willing to bite the bullet and admit without worrying too much that the policy of not accepting papers funded by the tobacco industry may mean that some research is not publicised.  There’s a small handful of reasons why I’m willing to do that.  One of them – admittedly the weakest of the lot – is based on the idea that it’s not wholly clear that much tobacco money really is directed at finding a cure for lung cancer, rather than firefighting other research about the detrimental properties of tobacco.  But that, as I say, is weak, based on suspicion rather than anything enormously substantial; and even if the hunch is correct, it’s merely empirical rather than anything conceptual.  Still, even if the hunch is wrong, it shouldn’t matter, because there’re stronger reasons.

One is based around the idea that there’s a special providence in the fall of a pipette – or, put another way, you can’t keep a good truth down.  If something is there to be discovered and is worth the effort, then it’ll be discovered sooner or later; if not by Smith, then by Jones.  And, because scientific progress is invariably a matter of the accretion of the work of several teams, all working independently and making minor discoveries, rather than one heroic person who would be solely responsible for The Cure For Cancer ™, the loss of one paper here and there probably won’t make all that much of a difference in the grand scheme of things. If that’s correct, then the idea that we might lose the cure for cancer is not all that compelling – not one about which we should worry too much.

A final reason is that, as I’ve said before elsewhere, I’m not persuaded that research is obligatory: it’s admirable, but not required by duty.  There’s a range of second-order arguments one might present here, but most relevant has to do with the benefits that research might generate.   more…

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