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Curios

Kelly Hills, Data Miner

7 Nov, 12 | by Iain Brassington

Kelly Hills has been data-mining – collecting and collating information about the frequency with which certain terms appear in paper titles in three journals: the JME, Bioethics, and the AJoB.

I was going to say that the charts are not much use, but that they are pretty and quite cool; and I was going to add that their lack of utility doesn’t matter at all because prettiness and coolness is sufficient to make them worth looking at.  Not everything worthwhile is worthwhile because it’s useful, after all.  Being a philosopher, I have to believe that.

But then it occurred to me that there probably is some utility to them.  Taken with some care, they help us to see what is held to be important by people publishing work – and, I suppose, they might also help decide which journals are more receptive to certain topics (or, conversely, which journals are saturated with them).

Here’s what the JME‘s chart looks like:

The image isn’t perfect, of course: because size is a mark of brute numbers and the algorithm that generates the image isn’t sensitive to context, “ethics”, and “ethical” get separated, when the reality might not indicate that they merit separate consideration.  “Euthanasia” gets only a small amount of attention – which tells us something about the heat-to-light ratios in debates on the topic.  It also gives some support to John Coggon’s idea that it’s getting hard to find anything new worth saying in that particular field – though I’d’ve thought the same, and more, would apply in respect of consent, and that seems to generate a heck of a lot of attention.

But what if you Don’t Want to be Regulated?

2 Oct, 12 | by Iain Brassington

The Malaysian Parliament has just approved a law about traditional medicine.  The Traditional and Complementary Medicine Act is largely about the regulation of practitioners of TCM – notably, setting up a regulatory Council.  According to section II (5)

The Council shall have the following functions:

(a) to advise the Minister on matters of national policy relating to traditional and complementary medicine practice;

(b) to establish the eligibility requirements for each practice area;

(c) to recognize qualifications conferred by any institutions of higher learning established under any written law in Malaysia or any institutions of higher learning recognized and authorized by any countries outside Malaysia for the purpose of registration under this Act;

(d) to specify the appropriate academic qualifications or recognized skills certificate issued pursuant to the National Skills Development Act 2006 [Act 652] which are or is necessary before a person may apply to be a registered practitioner;

(e) to specify the necessary apprenticeship and training requirements including rules for undergoing apprenticeship, the scope of responsibilities and permitted conduct or activities of apprenticeship, duration of apprenticeship and post-qualification apprenticeship;

(f) to register individuals who will provide traditional and complementary medicine services to the public;

(g) to issue practising certificates to registered practitioners who have satisfied the prescribed conditions and paid the prescribed fees;

(h) to develop codes of professional conduct, rules relating to the professional conduct of registered practitioners, including penalties for breach of such codes or rules;

(i) to develop, undertake, prescribe and mandate any matter relating to or connected with the practice of traditional and complementary medicine or the professionalism of such practice;

(j) to specify, provide for and administer a complaints procedure and process;

(k) to develop rules upon which registered practitioners are to refer their patients to medical practitioners or dental practitioners, as the case may be;

(l) to obtain such relevant information from practitioners, and to provide the same to the Minister;

(m) to carry out such functions as may be specified by this Act; and

(n) to carry out all such other activities as may be directed by the Minister and such direction shall be consistent with the purposes of this Act.

Section IV (21) says that

(1) No person shall practise in any practice area which is not a recognized practice area.

(2) Any person who contravenes subsection (1) commits an offence and shall, on conviction, be liable—

(a) in respect of a first offence, to a fine not exceeding thirty thousand ringgit [approx £6000] or to imprisonment for a term not exceeding two years or to both; and

(b) in respect of a subsequent offence, to a fine not exceeding fifty thousand ringgit [£10 000, or thereabouts] or to imprisonment for a term not exceeding three years or to both.

Is this a good law?  Clearly, it is not a particularly exciting piece of legislation; and there might be problems with it – there’re problems with a lot of laws. more…

Is Bioethics Really a Bully? Really?

11 Sep, 12 | by Iain Brassington

On his blog in The Independent, John Rentoul has a long-running feature called “Questions to which the Answer is No“.  In it, he examines the kind of screaming rhetorical-question headline much beloved of certain middle-market tabloids: “Is this photographic evidence of Nessie?”, “Does coffee cure cancer?”, “Does coffee cause cancer?”, “Does MMR bring down house prices?“* and so on.

Here’s the first in an intermittent parallel series from me: “Questions to which the Answer is Eh?  What are you on about?  No, really: what?“.  For the inaugural post, step forward Dan Sokol, the BMJ”s “ethics man”, who asks in his latest column, “Is Bioethics a Bully?”.  The answer to this is Eh?  What are you on about?  No, really: what?.

(A warning before I start: I’m about to go off on one.  Even by my standards, this is big.  You might want to go and make tea.)

The general thesis of the article is this:

Bioethics, in its current form, has bullying tendencies. Ironically, it often adopts a paternalistic attitude towards clinicians, treating them as an ethically deficient species.  Although bioethics should not shy away from pointing out ethical concerns in medical practice, sometimes forcefully, it must not give way to negativism or, worse still, to a zeal to condemn.  Clinicians are easy targets and, without a command of the fancy theories and language of the accusers, possess few means to respond formally.

Is the thesis true? more…

Philosophy, Bioethics and Otherworldliness

31 Aug, 12 | by Iain Brassington

Hmmmm.

So Brian L picked up on Catarina’s post that picked up on Brian E’s post that picked up on the ever-simmering stuff about male circumcision – and the American Academy of Pediatrics’ latest policy position in particular – with the comment “Philosophers are a bit unworldly, but this is still quite something”.  I take the implication of that to be that, even by the standards of philosophers, this debate is abstract and abstruse and perhaps even a little omphalosceptic.

The comment reminds me of a conversation that Muireann Quigley and I had with someone – I can’t remember who – a couple of IAB’s ago: this unknown person – whom I think was a medic rather than a philosopher – was wondering aloud about the number of papers on things like enhancement, and IVF, and so on, and whether there weren’t more important things for bioethicists to think about – notably what to do about the various things that actually do directly threaten the life and welfare of real people right now. more…

Is Julian Savulescu Channelling Bryan Ferry?

24 May, 12 | by Iain Brassington

Specifically, I have in mind Roxy Music’s “Love is the Drug“.  (Annoyingly, I can’t get the video to embed.*)  And I don’t just mean Julian – I mean him, and Anders Sandberg, with Brian Earp somewhere in there too.

The thought crosses my mind because I’ve been reading this essay in New Scientist, which apparently prefigures a paper that’s soon to come out in Philosophy and Technology.  It deals with the possibility of using neurochemistry to maintain loving relationships.  The evolution of human emotions has not, they claim, kept up with the other changes that humans have undergone and caused over the past few hundred thousand years:

[I]n many ways we are stuck with the psychology and drives of our hunter-gatherer ancestors. We are not made for the world and institutions we have created for ourselves, including that of life-long marriage.

The suggestion is that, while there is no “love gland” that we could tweak, we do know enough about neurochemistry to be able to make a difference to the likelihood that a relationship will last.  With care, administering and manipulating things like oxytocin, dopamine and testosterone might allow us to alter our emotional landscape – allegedly for the better.

Convinced?

One of the worries that is articulated has to do with authenticity. more…

You’re Worth more Dead than Alive

18 May, 12 | by Iain Brassington

Via MedicalTranscription.net, here’s a rather fabulous little infographic about the value – well, the price – of transplant organs.
(Update: moved below the fold, because otherwise you have the time to grow a liver in a petri-dish before the page has loaded.) more…

Drugs and Sex – or Drugs and Less Sex

10 Apr, 12 | by Iain Brassington

Two slightly curious stories about drugs and sex.  Or, rather, two stories about drugs and sex curiously juxtaposed.

First, this story from Sunday’s Independent was inspired by this paper in The Journal of Sexual Medicine.  Quite how much weight we should put on the JSM‘s paper is a moot point – it’s a case study involving one person, rather than a full RTC – but I’m interested in the way that it was represented by the Indy:

Oxytocin, a hormone traditionally used to induce labour, is as sexually arousing to men as Viagra, according to new research.

Studies conducted in the US found that a married man who sniffed a nasal spray containing oxytocin twice daily became more affectionate to friends and colleagues and recorded a marked improvement in his sexual performance.  According to the actual breakdown of results, the man’s libido went from “weak to strong”, while arousal went from “difficult to easy”. Ego certainly wasn’t hurt either: sexual performance, according to feedback from his wife, was classed as “very satisfying”.

Let’s take it at face value, and ignore the leap from the experience of one man to all men, and the post hoc ergo propter hoc fallacy, and all the rest of it: a man who was apparently having some sex-related difficulties was helped by oxytocin.  Bravo for him. Hurrah.  Oxytocin for all!

Or maybe not. more…

Vaccination, and Policies for Enforcement

5 Apr, 12 | by Iain Brassington

Rob Crilly reported in the Telegraph a couple of days ago that Pakistan is to pursue a policy of fining people who do not have their children vaccinated against polio.  Now, at the time I write this, I can’t find this story or anything like it replicated elsewhere – Dawn, which is Pakistan’s biggest English-language newspaper and has carried 15 stories on polio so far this year (and which is supportive of mass vaccination), doesn’t mention it; nor does al-Jazeera – but let’s allow for the sake of the argument that the story is true, and that fines are to be imposed on parents who fail to get their children vaccinated (or that they’re being at least considered).  I’m in two minds about such a policy.

Obviously, the prevailing attitude in anglophone bioethics is to be suspicious of mandatory interventions into health decisions: it’s hard to get away from the Georgetown Mantra.

On the other hand, polio is very nasty indeed, and Pakistan is one of the three remaining countries in the world where it exists.  (The others are Afghanistan and Nigeria; in all three cases, there have been active campaigns against vaccination on the grounds that it’s “un-Islamic” – which I suppose is true, but only inasmuch as that it has nothing whatsoever to do with Islam – and suspicion of vaccination workers has grown in Pakistan over the last year because they’re seen as potential CIA operatives.)  Vaccination is much less nasty than polio, and Pakistan is already implementing a number of policies (such as offering it free at toll-booths) to increase vaccination.

There seem to be two questions that need to be addressed.  First, is a policy of mandatory vaccination permissible?  Second, is a fine the right way to enforce it? more…

A Small Solution for a Big Problem?

28 Mar, 12 | by Iain Brassington

BioNews asked me to write something about Matthew Liao, Anders Sandberg and Rebacca Roache’s paper on engineering humanity to minimise global warming.  I’d been meaning to for a while, so this was the prod I needed.  Anyway: my take on their paper is here; but I thought I’d also reproduce it on this blog.  What follows is the version I submitted; it’s substantially the same, save for a few tweaks that BioNews made to conform with their house style.  (They didn’t like the Latin…)  I am massively grateful to the student who made the point about small people taking more steps to get anywhere.  I’d also like to think that the idea of making people smaller led me to Lilliput, thence to Gulliver, thence to the voyage to Laputa.  It didn’t.  I’m not that clever.  Laputa made its appearance quite unbidden.  But – hey, it works.

 *     *     *     *     *

There’s a part of Gulliver’s Travels where Gulliver visits the grand Academy at Lagado, wherein one of the academicians is trying to derive sunbeams from cucumbers.  It’s tempting to wonder at first glance whether there’s something of the Academy to Liao, Sandberg and Roache’s proposed strategy for combating climate change: that we could engineer humanity to be less of a drain on the environment.  Their paper, “Human Engineering and Climate Change” (forthcoming in Ethics, Policy and the Environment, with a pre-publication version here), has already attracted a reasonable amount of media interest, and it’s not hard to see why.  The headline proposal is that we could engineer people to be smaller, on the grounds that smaller people require less food and fuel: a population that is smaller on the whole would have less environmental impact.  (A small part of this – and I’m genuinely fond of this idea – is that heavier people wear out shoes and carpets more quickly, so are more resource-hungry.  On the other hand, as one of my students has pointed out, short people take more steps to get across the room; the carpet might actually suffer more.  Moreover, a small person has a greater surface-to-volume ratio, and so would lose heat more quickly, possibly requiring more central heating and more food.) more…

Of Tusks and Tuskegee: A Problem in Research Ethics

1 Mar, 12 | by Iain Brassington

Xtaldave, by his own admission, has the horn.  Well, if you’re being accurate about it, he has the tusk.  But what’s important is that he has a whopping great piece of ivory to play with.

Dave works in the labs here in Manchester, doing clever things with chemicals and science and crystalography and that sort of thing.  The ivory has been confiscated by customs; it found its way into his lab because the dentine in a great big tooth is a useful medium on which to carry out research that may generate significant benefits.  In his words, the tusk is

an acceptable substitute for human bone in the sorts of assays that our lab does to test the effect of various substances on cells called Osteoclasts that are responsible for bone resorption (basically bone destruction).  During growth and development of the skeleton, bone is formed (by Osteoblasts) and broken down (by Osteoclasts) – it is thought that the bone disease Osteoporosis is caused by an imbalance of bone formation and destruction – i.e. too much Osteoclast activity.

If we can find a therapeutic agent that inhibits Osteoclast activity, we might be able to halt or slow the progression of Osteoporosis.  The upshot of all this is that our lab has obtained a section of Elephant horn that has been confiscated by the UKBA.  We will recycle this and use the dentine in our bone resorption assays.

Why’s this of interest here?  Well, the ivory trade is (a) illegal, and (b) deeply morally problematic.  The fact that it’s illegal means that the UK Border Agency confiscates ivory as it’s imported into the country in most cases.  (There are situations in which importation is legal, but they’re rare, and needn’t concern us here.)  And this confiscation means that the Agency ends up with a load of ivory on its hands.

One option might be to sell it; but that’s ruled out by the same considerations that make importation illegal to begin with.  Another is simply do destroy the lot.  A third is to allow labs like Dave’s to make use of it.  This is where the moral claims come in.  It would be, he says, immoral (as well as legally problematic) to sell the ivory, and

if someone has already killed the elephant and removed the Ivory, better that we use it to further medical research and perhaps save or improve some lives, than turn it into a bauble that sits on a shelf gathering dust.

Or, to put it another way: that the elephant has been killed is bad; but we can at least salvage something from the moral wreckage.

Is this correct?  Well, the structure of the argument seems to follow quite closely that which is sometimes presented in relation to the use of – for example – data derived from the morally repugnant experiments of the past.  If there is, in Stan Godlovich’s words, “demonstrably important and beneficial information gathered methodically through means completely unacceptable to us”, what should we do with it? more…

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