A Court in British Columbia has ruled that the law against assisted suicide (AS) in Canada cannot be reconciled with the country’s Charter of Rights and Freedoms - notably item 7 -

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

- and item 15 -

Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.

The full ruling is available here (H/T to Ophelia Benson for the link): it’s long, and I’ve not had a chance to read it, so contributions in the comments below this post would be welcome.  From what I can tell, the decision is still liable to go to appeal, so it might yet turn out to be a false start; but it’s highly notable nonetheless.

Though I’ve made no bones here about my broad support for the legalisation of assisted dying, both as assisted suicide and euthanasia, I do wonder if in this case some of the judge’s reasoning may be a bit iffy.   more…

This is an interesting story picked up by the BBC: drugs are being used to “suppress sexual thoughts and urges” among sex offenders in an experiment at HMP Whatton.

It is early days, and the number taking part is small – so far fewer than 60 – but the graphs illustrating such measures as prisoners’ strength of sexual urges, or time spent thinking about sex, all show a downward trend.

The Ministry of Justice is pleased with the initial evaluation of the scheme. The treatment will continue to be available to high-risk sex offenders who are assessed as being suitable, it says.

There’s all manner of questions raised by the prospect of using drugs to alter, reduce, or otherwise manipulate sex drive.   more…

Just a quick post to note that Peter Singer has been made a Companion of the Order of Australia – which is, apparently, the Aussie equivalent of a KBE.  The right-wing press ain’t happy - but irrespective of whether or not you agree with his claims, or his methods, Singer’s contribution to bioethics (and ethics more widely) is undeniable.  And since it’s not the role of the academy to say things that’ll make people happy, the fact that he has a record of saying things that don’t make people happy says nothing about his deserving the award.

H/T Brian Leiter.

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…

The government in New Zealand is proposing to spend $1 million of funding for women on a benefit and their teenage daughters to get long-term reversible contraception – such as an implant. Advice on accessing this treatment and its implications will be provided by case workers in the Social Services.

The NZ government seems almost surprised that some people have been offended by the suggestion of this policy asserting that this is not interfering in the reproductive life of beneficiaries, and is just common sense – the Prime Minister John Key said

“Ultimately if people have unplanned pregnancies and are solely dependent on the state, you the taxpayer have to pay for a long period of time for that dependency and we know the outcomes aren’t terribly good.”

While I think they are quite right that this is not interfering in the reproductive life of beneficiaries this doesn’t exhaust the potential array of ethical issues involved in this sort of proposal.

It isn’t inherently coercive since offers are typically not coercive. However the close association between medical care and social services seems a little more sinister since it makes a connection (however unintended) between receiving social support and receiving this reproductive advice – and perhaps in the minds of some in taking it.

Could this connection be abused? Certainly. As one beneficiary notes

“she had already been told by a case officer to “shut your legs” I’ve even heard WINZ people say things worse than that to women. “I go in there for a fight, for an argument, every time. There are people in there who have huge power control issues and they just make it worse for us. They take their job description way too far.”

This doesn’t surprise me at all, any time policy is implemented it will sometimes be misapplied. And Work and Income New Zealand (WINZ) can be somewhat inflexible – when my first wife Kerry passed away I had to cancel her sickness benefit (she had cystic fibrosis) so her brother and I went into the nearest WINZ office to inform them. We were told we would need to fill in a change of circumstances form, and once we had completed this we were told that they couldn’t accept it because it would need to be signed by the recipient of the benefit… We eventually sorted it out, although we left with a copy of the paperwork to show to her…

Ronald Dworkin in his book Sovereign Virtue argues that the first and heaviest responsibility of a government is to treat its citizens equally. Does this constitute equal treatment? Targeting those on benefits in this way doesn’t seem to to me.

Providing long term contraception in general is a good thing (assuming cost-effectiveness & safety of course) since it provides for greater reproductive autonomy. But I’m not sure reproductive services ought to be targeted at the poor in this fashion. It seems to display the attitude of the government towards the reproduction of some of society’s poorest members – namely that it would be better if they didn’t breed – or as the government puts it “breaking the cycle of intergenerational welfare dependency”. And I am not sure that is an attitude that is defensible. While solving the cycle of intergenerational welfare dependency would be laudable, this strikes me more as a dissolution than a solution to the problem.

There is an interesting story here: in the Guardian about a research trial being carried out by the UK border agency using dental x-rays to try and identify the age of young asylum seekers.

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…

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…

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…

The proposal that there should be a minimum 40p/ unit price for alcohol, announced last week, has been broadly welcomed.  Not universally, but broadly.  There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal.

From a ethicist’s perspective, the objection that we might expect to hear articulated most has to do with paternalism: if the move is designed to coerce people into a certain kind of behaviour, and the motivation for this is a concern with people’s own good, then that might be presented as undue interference.  However, the response to this is simply to deny that paternalism of this sort is always a bad thing.  ”Respect for autonomy” has become something of a dogma among many people working in bioethicists, but it’s not beyond question – and it’s certainly not enough simply to stamp your foot and say, “Yes, but AUTONOMY” to defeat a proposal.  At the very least, the idea that governments should not intervene to prevent self-harming behaviour needs argumentative backing.  (I know that this is a particular bugbear of Angus Dawson and a number of other people working in public health ethics.  I don’t agree with the suggestion in some quarters that the “rules” of PHE are different from the “rules” of the rest of bioethics, such that autonomy is not as important in PHE as it is in those other areas – I think that ethics is ethics is ethics; but this simply means that unquestioning deference to autonomy and liberty is philosophically bogus right across the board.)

But, actually, the minimum-pricing policy doesn’t have to be defended on public health grounds.   more…