Doubtless many of you will have heard by now of Kerrie Wooltorton, who, apparently depressed by her fertility problems, drank anti-freeze, called an ambulance, and handed a living will to staff at A&E. Her story is reported by the Telegraph under the headline “Suicide woman allowed to die because doctors feared saving her would be assault” more…

I’m going a bit off-topic with this, I think, but John Coggon’s reply to today’s earlier post has got me thinking.  His reply pointed out that

[i]t might be worth noting that Article 9 of the European Convention on Human Rights (presumably the key right under issue) states:

“Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief, in worship, teaching, practice and observance.”

This has got me thinking about the nature of that supposed right. more…

Dan Sulmasy has a piece on Bioethics Forum at the moment in which he considers the next 40 years of bioethics.  It’s a curious piece, making six main claims or predictions about the future, to which I’ll return in a minute: but before that, I think it’s worth looking at his scene-setting:

I suggest that bioethics has evolved through three phases: a religious phase in the 1950s and ’60s, a philosophical phase in the ’70s and ’80s, and a political-empirical phase from the ’90s to the present. Much as been written and said about the first two phases, but little about more recent history.

By the late 1980s, just as I was starting serious study in the field, philosophical bioethics had created a standard canon and had begun to rest on its achievements. Physicians, who found the language of philosophers alien but had been taking courses in bioethics, began re-engaging the field (or, in some cases, reclaiming it as their own). 

The general public, policymakers, and many of the new young students entering the field of bioethics by this time also began to complain that philosophy did not supply enough concrete answers to their pressing questions. They wanted solutions to social policy problems such as the distribution of health care resources, cost-containment, and physician-assisted suicide.

I’m interested to know whether this natural history of bioethics is accurate.  On the face of it, I’m not sure.  It - perhaps - describes the genesis of bioethics in the US, but I’m not sure that the subject has followed the same route in Europe, where there simply has not been a religious or political phase.  Bioethics has grown out of a renewed interest in applied ethics, which has grown out of good, old-fashioned, seminar-room ethics.  To the extent that claims are made about what should be done, and what the law should say, bioethics is “political” - but it isn’t political in the strong sense that I think Sulmasy uses the term; it isn’t about activism on behalf of this or that group (and it shouldn’t be, either).  And I’ve already articulated my suspicions of the supposed “empirical turn” in the subject; empirical studies may feed ethical debate, but they oughtn’t to be treated as a substitute.

But back to the six points, which I’ve edited down here.

more…

The Child Poverty Action Group has published a report today in which the UK is accused of being among the worst places in Europe to be a child on a range of measures.  For example, the UK comes 24th out of 29 countries when it comes to the assessment of birth-weight; it’s 21st when it comes to children’s subjective assessment of their own wellbeing.  In other fields, things aren’t quite so bad - “the UK does quite well on health behaviours”, but, nevertheless, “it scores badly on immunisation rates for key childhood diseases.”

Now, of course, this has to be taken in context.  Just because the UK is towards the foot of a given table, it doesn’t follow that the situation is bad.  In any rank-ordering, someone has to come last.  The guy who finishes last in the final of the Olympic 100m sprint isn’t, by virtue of his place, a poor runner.  The same applies here: “worst” does not imply “bad” or even “getting worse”.  Children in the UK are, on the whole, probably better off in many if not all respects than were their parents and grandparents.

On the other hand, though, it is a bit worrying that, in terms of health, the UK is ranked only slightly better than Romania and Malta.  Nothing against Romania and Malta, of course - but the UK is significantly wealthier, and so one might reasonably expect health differentials to be greater.

The report’s only 11 pages long, and it’s well worth a read.  It’s also interesting to have a look at how its findings are reported in the media - just as a hint, and based on a fairly cursory survey, the more conservative the outlet, the more grudging and distorted the reportage.  After all, the report comes out in favour of higher public spending and refuses to condemn single mothers.  That doesn’t really fit in with the Broken Britain mantra, does it?

PZ Meyers recently blogged about his response to one of the perennial claims of pro-life advocates: that life begins at conception.  Predictably, he accuses pro-lifers of misunderstanding the question, and he does this by denying that life begins at conception because life began billions of years ago: everything else is just a part of a continuum heading from that.

Life does not begin at conception.

It’s an utterly nonsensical position to take. There is never a “dead” phase — life is continuous. Sperm are alive, eggs are alive; you could even make the argument that since two cells (gametes) enter, but only one cell (a zygote) leaves, fertilization ends a life. Not that I would make that particular claim myself, but it’s definitely true that life is more complicated than the simplistic ideologues of the anti-choice movement would make it.

Well, it’s hard to deny this - but I do wonder whether he’s actually got the point.  That is to say, I wonder whether he’s being a bit literal.

It might be necessary to break things down here a bit.   more…

Okay - since everyone else on teh t’interwebz seems to be blogging about Watchmen, I thought I might join in.  Especially because, if I don’t, David will: I think he’s more of a geek than I.  (Most people are.)  So, yeah.  Long, violent, extraordinarily faithful to the book except for the improved dénouement, I’d've shot the final scene differently, and so on.  But what struck me was the way in which the lead characters seem to embody certain moral archetypes almost perfectly.

***I don’t think that there are any spoilers ahead, but if you’ve not read the book or seen the film, you might want to take care…***

more…

I’ve been thinking recently about what’s going on when one’s engaged in a piece of ethical writing, and what counts as a proper parameter for it.  Particularly, I’ve been wondering whether there’s any obligation to be consistent between papers - is there any need for the papers that one publishes to be compatible at all?

Obviously, people sometimes change their minds over this or that issue, and perhaps they issue retractions or write papers saying, “In 2002 I thought that the sky was blue and the grass green.  However, I have been forced to reconsider this in the light of…” and so on.  That’s not really what I have in mind, though.  My thought has more to do with a broadly ethical question to do with the kind of role ethicists ought to take in print or the kind of thing a philosophical researcher ought to be.

Here’s the thought: Imagine that I can see an argument in favour of a given position, and an argument against it.  Each is formally valid - the difference is that they disagree on a premise.  (Let’s say that one is consequentialist, and the other non-consequentialist.)  Would it be OK for me to write and publish two papers - one advocating each position - if I could do so well?

Part of me thinks that there’d be no problem at all, and there’s a couple of reasons for this.  more…

This summer I realised with some horror that it was 20 years ago I first presented a paper at an international medical ethics conference while still being a medical student. That paper was on who should control the fate of aborted foetuses and the paper I gave the year after at the same conference was on whether “spare embryo” is a fixed category with moral importance. Both issues are still discussed in the literature and I just finished reading an excellent Danish PhD thesis discussing the current legal importance of these questions (1).

But would it not be better if we could finish with some issues one and for all and reach some kind of resolution?

In the current issue of the JME Carson Strong revisits an even older question in medical ethics – the question of the moral assessment of abortion. In his paper ‘A Critique of “The Best Secular Argument against Abortion”’ he analyses Don Marquis’ famous argument that what is wrong about killing adults is that it deprives them of a future like ours, and that since killing a foetus also deprives it of a future like ours abortion is a kind of wrongful killing.

The “future like ours” argument has already been extensively discussed in the literature and it would have been tempting to believe that everything that could be said about this argument had already been said, but Carson Strong has managed to find new and interesting problems in the argument.

Why should this be of any interest? Hasn’t the abortion issue been decisively settled? Well, the US Presidential election campaign shows that there is at least one major world power in which the issue has not been settled and current European debates concerning abortion tourism shows the problems that can arise if different jurisdictions regulate abortions in very different ways.

It is simply not the case that there is agreement about abortion or about the merit of the various arguments in the abortion debate.

Strong’s paper shows how an incisive critique can be combined with academic courtesy and is a model of how the abortion debate can be taken forward.

Go read! http://jme.bmj.com/cgi/content/full/34/10/727

1. Herrmann JR. Retsbeskyttelsen af fostre og befrugtede æg - Om håndteringen af retlige hybrider. København: Jurist- og Økonomforbundets Forlag, 2008

2. Marquis D. Why abortion is immoral. J Philos 1989;86:183-202.

It is rare to be able to review a book long before it is published. But my copy bears the publication year of 2009, even though I bought it in July 2008.

Be that as it may, seven is the number of perfection so it is relevant to ask whether the 6^th edition of Tom Beauchamp & James Childress  (B&C) “Principles of Biomedical Ethics” is moving towards or away from perfection. This question is even more pressing since we are here dealing with one of the classics in bioethics and undoubtedly the bioethics book that has sold most copies worldwide (with the possible exceptions of the Bible and the Quran, books that play a major role in theological bioethics).

Let me first put your mind at rest. B&C are still believers in the four principles and their account of these principles have not changed much.

What is new in the 6^th edition? As usual all chapters have been re-written and there is a new chapter on “Moral status” and a new major section on global justice issues. The authors have furthermore modified their account of the link between the famous four principles and common morality, probably to respond to criticism that the common morality used and the principles derived were too American.

The new moral status chapter illustrates the books strengths and weaknesses in equal measure. It gives a short and reasonably accurate account of a number of theories about what it is that gives an entity moral status, but claims in fairly typical B&C style that none of these give the correct answer and that we cannot sort out which of them is correct or reach a more consistent theoretical account. This is very similar to their treatment of theories of justice and in both cases the authors steadfastly refuse to nail their flag(s) to any mast(s). But this leaves the reader dissatisfied and the specific conclusions that B&C never the less reach dangling perilously in the air.

Over the years many of us have argued that what really needed improvement was the account of moral justification and the account of specification and balancing of principles. Very little has happened regarding specification and balancing and the account of justification which is presented in this edition is in my view even less plausible than the ones presented in previous editions.

So, perfection has not been reached in the 6^th edition, but then the number six does have quite different connotations than the number seven.

Let me finally try to answer the question “Who should buy the new edition?” I think there are three groups for whom it might be rational to buy the book:

1. Those who have never read any of the previous editions
2. Those who uses the book in teaching
3. Those who are engaged in critical work relating to principlism or common morality theories 

For most people who have the 3th,  4^th or 5^th edition there is probably not enough new material to warrant the purchase.

Søren Holm

Web-link to publisher

http://www.oup.com/us/catalog/general/subject/Philosophy/EthicsMoralPhilosophy/BiomedicalEthics/?view=usa&ci=9780195335705

It has been argued by some that bioethicists and in particular philosophers must be tolerant of the variety of different methods that might be employed in trying to answer the questions focused on by medical ethics/bioethics. Thus it is claimed we ought to accept as equally valid to classic philosophical analysis; empirical work, psychological work, social science, discourse analysis, hermeneutics, and so on. I think there is something right about this, but I am skeptical about uncritically couching this in terms of tolerance for two reasons.

Firstly tolerance has a disrespectful ring to it, I tolerate the drunk talking to me on the bus, but I hardly take him or his views seriously. If we tolerate colleagues in this fashion then we will be effectively just waiting quietly and politely for them to shut up so we can get back to the important stuff.

Secondly tolerance also sounds in someways too respectful, while I might whisper comments about him to the person speaking next to me about the drunk I don’t engage him in reasoned discussion about what he is doing. Likewise on many accounts of cultural tolerance it would be the height of rudeness to interfere with a cultural practice and to try and argue someone out of it. In other words we do positions and people a disservice when we don’t express critical comments but instead bite I our tongues out of “respect”.

Instead I think we ought to encourage members of our discipline to be respectful and open minded. We should explore different ways of doing things, different concepts of how to resolve problems or indeed to conceptualize the problems in the first place. But this respect entails not “tolerating” different methods but challenging them rigorously, testing their assumptions and usefulness. Just like cultures or indeed ethics or ways of life, methodologies are organic, they grow and change when fertilized with dispute, disagreement and debate. As such questioning the usefulness and appropriateness of a particular method is not the height of rudeness, but instead a helpful contribution.