So there’s this letter published in the Journal of Bioethical Inquiry that moots the idea that the top biomedical ethics journals might be institutionally racist.  In it, Subrata Chattopadhyay, Catherine Myser and Raymond De Vries point out that the editorial boards of a good number of journals are dominated by members who are located in the global North – countries officially listed as being high or very high on the development index, with only 1.3% drawn from countries classed as least developed.

Developing World Bioethics has the highest proportion of its editorial board located in the least-developed nations; but even there, the figure is only just over 11%.  On the face of it, this doesn’t look too good, especially given the proportion of the world’s population in general that lives in the poorest countries.  The JME, by comparison, draws 100% of its editorial board members from people located in highly and very-highly developed nations.

Still: this isn’t likely to be the whole story.  Udo Schucklenk – a founding editor of DWB, of course – takes issue with the letter on a number of grounds.  For one thing, he he suggests that Chattopadhyay et al might be performing a sleight of hand with their metrics; by lumping together countries ranked as high and very high on the development index, they’re lumping together the UK, Germany, and the US with Iran, Malaysia, and Jamaica.  Neither Iran nor Jamaica is a classic basket-case economy; but, still, “high” and “very high” development covers a vast range of income levels.  Treating all these countries in the same way obscures that there’s a huge range of locations from which editorial staff may be drawn.

I’ll come back to this in a moment. more…

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.

Seriously!  Theoretical Medicine and Bioethics has published a paper with a hundred and ninety-eight listed authors!

I’ve always been slightly puzzled by multi-authored papers – by just how many people get to add their names to a piece of work.  A friend of mine who is a proper scientist once tried to explain how it works in the sciences to me – about how you need to give credit to the people who ran the experiment, but also to those who did the titration and general donkey-work.  That seems fair enough.  Having said that, I suspect that there’s often a bunch of people who get credits that shouldn’t be there.  (I remember once seeing a CV from a guy that had 45 pages’ worth of publications listed.  Granted, it was double-spaced… but, still: there must have been the thick end of a thousand papers listed; there’s no way on God’s good Earth that he could have played a significant role in all of them.  So why was he entitled to claim them?  Why did he take the credit?  Apparently, it was because, although not all of the papers referred to work he’d done, they did all refer to work done by other people in a lab he ran.)  Anyway… the Steinhauser et al ad infinitum paper, with its 198 authors, isn’t lab-based, so the credit-where-it’s-due argument wouldn’t work.

(Jozsef Kovacs, writing in a paper currently available as a pre-pub in the JME, is also concerned about authorial inflation, and who should get the credit for a given paper, and how to improve things.  It’s definitely worth a look.)

The author list for the Steinhauser paper seems to have been generated at least in part via the membership of a Facebook group (and one that no longer exists, or at least one that is so private that it doesn’t show up on a search).  That’s just silly, and there’s no way that anyone can successfully marshall so many contributors.  That turns a paper into an open letter.  Indeed: the “authors” seem to think that their paper could be treated as such without loss: more…

[IB: I'm taking the liberty of copying in its entirety Jon Cogburn's post on NewAPPS about submitting papers to journals, because it's worth reading.  He directs it to graduate students - but I think that the same point applies to anyone, especially if they're new to the field in which they're writing.  Since a lot of people writing for journals like the JME - especially on topics in clinical ethics - are medics before they're ethicists, or are coming at ethics from a non-standard direction, I think that the advice is particularly pertinent.]

A Plea to Graduate Students Submitting Papers

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…

… read this from Current Oncology - ”Pereira’s Attack on Legalizing Euthanasia or Assisted Suicide: Smoke and Mirrors” – if you haven’t already.

(via the Bioethics International FB group… and a million others.)

It was reported a couple of weeks ago that researchers had found a link between certain forms of assisted conception and an increased risk of birth defects.  The paper, published in the NEJM, suggested that ICSI (intra-cytoplasmic sperm injection) correlated with defets in just about 10% of births.  The base rate is about 5.8%, rising to around a 7.2% defect rate from IVF.

Does this tell us anything of any great moral import?

Several things spring to mind.  One is that, granted the claim that it’s better not to be born with a defect, it’s presumably also better for assisted reproduction not to elevate the risk of defects above the natural level.  There might even be an obligation to do more research into assisted reproduction, so that we can ensure the fewest possible birth defects (and maybe get better at generating healthy babies than nature: even a rate of 5.8% looks a bit slapdash).  Slightly more radically, some might claim that there ought to be a moratorium on certain assisted reproduction procedures – ISCI in particular – for the sake of minimising the number of birth defects.

Let’s deal with the radical claim first (what can be said about that will also speak to the less radical one). more…

Some very strange papers have just appeared in Bioethics regarding homeopathy.  Not so long ago, the journal published a paper by Kevin Smith that advanced the claim that homeopathy is not only ineffective, but ethically problematic.  The position taken was that homeopathy “ought to be actively rejected by healthcare professionals”, and that it is in fact ethically unacceptable, not least because of concerns about it reducing the likelihood that people would seek effective healthcare, and wasting resources.  The analysis is overtly utilitarian, but I don’t see any particular reason why a non-utilitarian theory wouldn’t come to essentially the same conclusions about using homeopathy, especially by public bodies.  (For example, there seems to be a reasonable justice-based claim that could be made on behalf of taxpayers, that it’s wrong to spend their money on stuff that lacks an evidence base: it should either be redirected to stuff that has evidence in its favour, or refunded.  This doesn’t have to be utilitarian in flavour.) 

But while I have no particular dispute with Smith’s paper, neither do I have any dispute with homeopaths getting a right to reply in the same journal.  They should have this right.  Papers could be wrong or need refining, and disinterested argument is a good way to correct errors.

Still: scientifically speaking, homeopaths have their work cut out.  And without the science, the ethics is going to be tricky. more…

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…

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…