When we decided to write this article about after-birth abortion we had no idea that our paper would raise such a heated debate.

“Why not? You should have known!” people keep on repeating everywhere on the web.  The answer is very simple: the article was supposed to be read by other fellow bioethicists who were already familiar with this topic and our arguments.  Indeed, as Professor Savulescu explains in his editorial, this debate has been going on for 40 years.

We started from the definition of person introduced by Michael Tooley in 1975 and we tried to draw the logical conclusions deriving from this premise.  It was meant to be a pure exercise of logic: if X, then Y.  We expected that other bioethicists would challenge either the premise or the logical pattern we followed, because this is what happens in academic debates.  And we believed we were going to read interesting responses to the argument, as we already read a few on this topic in religious websites.

However, we never meant to suggest that after-birth abortion should become legal.  This was not made clear enough in the paper.  Laws are not just about rational ethical arguments, because there are many practical, emotional, social aspects that are relevant in policy making (such as respecting the plurality of ethical views, people’s emotional reactions etc).  But we are not policy makers, we are philosophers, and we deal with concepts, not with legal policy.

Moreover, we did not suggest that after birth abortion should be permissible for months or years as the media erroneously reported.

If we wanted to suggest something about policy, we would have written, for example, a comment related the Groningen Protocol (in the Netherlands), which is a guideline that permits killing newborns under certain circumstances (e.g. when the newborn is affected by serious diseases).  But we do not discuss guidelines in the paper.  Rather we acknowledged the fact that such a protocol exists and this is a good reason to discuss the topic (and probably also for publishing papers on this topic).

However, the content of (the abstract of) the paper started to be picked up by newspapers, radio  and on the web.  What people understood was that we were in favour of killing people.  This, of course, is not what we suggested.  This is easier to see when our thesis is read in the context of the history of the debate.

We are really sorry that many people, who do not share the background of the intended audience for this article, felt offended, outraged, or even threatened.  We apologise to them, but we could not control how the message was promulgated across the internet and then conveyed by the media.  In fact, we personally do not agree with much of what the media suggest we think.  Because of these misleading messages pumped by certain groups on the internet and picked up for a controversy-hungry media, we started to receive many emails from very angry people (most of whom claimed to be Pro-Life and very religious) who threatened to kill us or which were extremely abusive.  Prof Savulescu said these responses were out of place, and he himself was attacked because, after all, “we deserve it.”

We do not think anyone should be abused for writing an academic paper on a controversial topic.

However, we also received many emails from people thanking us for raising this debate which is stimulating in an academic sense.  These people understood there was no legal implication in the paper.  We did not recommend or suggest anything in the paper about what people should do (or about what policies should allow).

We apologise for offence caused by our paper, and we hope this letter helps people to understand the essential distinction between academic language and the misleading media presentation, and between what could be discussed in an academic paper and what could be legally permissible.

Alberto Giubilini and Francesca Minerva

Guest Post by James Wilson

The controversy over the Giubilini and Minerva article has highlighted an important disconnect between the way that academic bioethicists think about their role, and what ordinary people think should be the role of bioethics.  The style of this dispute – its acrimony and apparent incomprehension on both sides – are a sure sign that we as bioethicists need to think harder about what we are doing, and who we are doing it for.

At the heart of tempest has been the authors’ claim that abortion and infanticide are morally equivalent. Nearly everyone will agree that the authors are wrong about this, and that infanticide is and should always remain beyond the pale.

The US Born-Alive Infants Protection Act 2002 stipulates that the category of person – and the full protection due to persons – must be extended to “every infant member of the species homo sapiens who is born alive at any stage of development“.  The deep question – from the perspective of academic ethics – is why every human being that is born alive should count as a person.

Often in bioethics the most difficult task is to articulate just what it is that lies behind the sorts of intuitive moral certainties that we all have: that is, to make clear to ourselves, and to those who are inclined to hold opposing views, just what our confidence in our own intuitive moral judgments is based on.  This is often extremely difficult to do.

Why Some Bioethicists Think that Birth does not Matter

At the heart of Giubilini and Minerva’s claim that infanticide is morally on a par with abortion is the premise birth by itself does nothing to change the moral status of a developing human.

According to them (and like minded philosophers such as John Harris, Peter Singer and Michael Tooley) what makes the difference between a person and something that isn’t a person must be something to do with the capacities and abilities that a person has.  On such views, if we want to say that all human beings should count as persons then we need to provide some account of what feature or features it is that all human beings have that renders it appropriate to treat them as persons.  The feature of being born alive to a human mother does not – according to them – fit the bill.

According to these philosophers, this definition of “person” is both too narrow, and too broad.  It’s too narrow, because it’s clear that there could be intelligent alien species who had the ability to engage in moral thinking; but yet who clearly would not be born to a human mother.  They need not be born at all: perhaps the aliens from the planet Zog assemble themselves out of flatpacks from an interplanetary Ikea.  But so long as they are able to live and to value things as we do, why should we deny them the status of persons?  To do so looks like a human-centred chauvinism, no more than speciesism.

But the feature of being born alive to a human also looks too broad: what if the brain of the infant has been irreparably damaged, so that it will remain in its intellectual functioning at a level far below that of a chimpanzee and will never be able to love, to form plans or even to recognize itself in the mirror?  Why (and in what sense) does an infant like this count as an equal of a fully functional adult?

John Harris has argued that we should strike down the thought that it is being born that makes the difference.  As he once put it, “the geographical location of the developing human, whether it is inside the womb or not, is not the sort of thing that can make a moral difference”.  (Even here, he was careful to clarify – as he has on this blog, that he was neither advocating infanticide, nor arguing for a change in the law.)

A Poor Reply: Banging the Table

The cheapest and easiest response to this challenge is to merely bang the table and assert the sheer obviousness of the difference that birth makes.  As an example of this approach, Richard Nicholson once accused John Harris of indulging in “a philosopher’s mind game”.  He continued, “He is wrong in saying there is no moral change that occurs in the process of birth.  That is a change that is recognised in the law.  Most parents would recognise their views about their newborn baby are considerably different than their views about the foetus in the mother a day earlier.”

All this, one feels, may be true; but it is hardly intellectually satisfying.  Just because most parents would feel differently, it doesn’t in itself follow that they are justified in changing their feelings this way.  It’s weak to counter an argument that puts forward reasons by merely appealing to force of numbers – pointing out that most people judge the same way you do.

Explaining the Significance of Birth

If we want to defend the moral significance of birth, then we need to provide some positive account of why birth matters.  I want to outline very briefly three possible positive accounts.

(1) The infant now counts as a person because he or she is now a separate living entity: he or she is viable and is not dependent on anyone else for existence.

Some worries: it seems that this explanation misfires, because ‘being a separate living entity’ is both too broad, and too narrow, to serve as the feature that makes the difference between a person and a non-person.  It’s too broad because dogs and cats are separate entities in their own right, but this does not make them persons.  But it’s too narrow, because there can be persons who are not viable separate living entities: both of a pair of conjoined twins can count as separate persons, but in a severe case it might be quite impossible for both to be able to survive separation.

(2) The infant was already a person, previously it was lodged in the mother’s body like a guest lodged in a house owned by someone else.

On this view, there were conditions under which it would have been legitimate to expel the foetus despite the fact that it was a person (in circumstances such as those that Judith Jarvis Thomson considers in her famous defence of abortion, for instance). The significance of birth is that all these reasons that the mother may have to abort the foetus are then defeated.

Some Worries: This approach seems initially promising, but it may only push the problem further back: (a) we now need to give some non-arbitrary account of why the foetus was already a person, and how it became a person. (b) On this view it turns out that it isn’t birth that is actually doing the work here in making an entity a person.

(3) Ethical vision beyond explicit arguments

Charles Taylor makes a useful distinction between two different modes of ethical argumentation, which he calls offering basic reasons and articulating a vision of the good.  As he says in Sources of the Self, “It is one thing to say that I ought to refrain from manipulating your emotions or threatening you because that is what respecting your rights as a human being requires.  It is quite another to set out just what makes human beings worthy of commanding our respect, and to describe the higher mode of life and feeling which is involved in recognising this.”

Ethicists often place a very high degree of value on explicitness and arguments from consistency, invoking basic reasons in Taylor’s sense.  A key part of Giubilini and Minerva’s argument has the following structure, for instance:

1. Persons are creatures with feature F.

2. The newborn does not have feature F.

3. Therefore the newborn is not a person.

A large part of the acrimony of the dispute seems to arise from the fact that many feel that to adopt this kind of schema fundamentally misunderstands the foundations of ethical consciousness.  For them, what is foundational is the fragility of the life of the infant, and that once that has been appropriately noticed or articulated, one should be called upon to respond.  So on this view, the answer may not be to describe those valuable features of human beings in terms that are applicable to any potential being at all, but rather to draw attention to just what it is about human being that we mean when we talk about the intrinsic dignity and value of human life.

This is something that is extremely difficult to do within the confines of analytic philosophy.  For such articulation of the phenomenology of our fundamental moral commitments, literature is far more powerful.  I’ll conclude this post with a bit from Tolstoy’s Anna Karenin, which perhaps provides some of this vision.  Levin is struck by wonder at the birth of his son:

Meanwhile, at the foot of the bed, in Lizaveta Petrovna’s skilful hands flickered the life of a human being, like the small uncertain flame of a night-light – a human being who had not existed a moment ago but who, with the same rights and importance to itself as the rest of humanity, would live and create others in its own image… Whence, wherefore had it come, and who was it? He could not understand at all, nor accustom himself to the idea. It seemed to him too much, a superabundance, to which he was unable to get used for a long time.

Richard Huxtable has asked me to publicise this:

The EACME (European Association of Centres of Medical Ethics) annual conference will be hosted by the Centre for Ethics in Medicine at the University of Bristol, between 20 and 22 September 2012:
http://www.eacme2012.org/welcome/

This conference will mark the 25th anniversary of the Association, which provides an ideal opportunity to reflect on the many contributions made in and to European bioethics to date.  The conference theme, “Other voices, other rooms: Bioethics, then and now” is borrowed from Truman Capote’s novel, which deals with issues of coming of age, including embracing one’s identity, understanding others, caring and being cared for, as well as searching for oneself and for those to whom one is relationally bound.

In keeping with these themes and the aims of the Association, we therefore invite speakers to reflect on the identity of European medical ethics, and the many places and people with whom it is intimately bound.  As such, we’re keen to hear from across the different disciplines which encounter bioethical issues, including (but not limited to) medical sciences, nursing, allied health, law, social sciences, philosophy, classics and drama. The deadline for abstracts is 1 March 2012.a

It’s a very tight turnaround to submit an abstract – but the conference as a whole could be very interesting, and touches on some of the worries I’ve articulated over the years here concerning what bioethics is.

Does oxytocin come as a liquid?  I can only assume that it does, and that it’s possible to drown in a vat of it.  I’ve come to this conclusion after reading this interview with Patricia Churchland in The Chronicle of Higher Education.  It ought to come as no surprise to those who’re familiar with Churchland’s reductionist approach to metaphysics that she thinks that the same kind of reductionism can be applied to ethics; but I’m going to have to get hold of a copy of her new book, Braintrust, just to make sure that she really is as reductionist as she appears here.  Because, based on the evidence of the interview, her position is… um… odd.

Things start off well enough: her picture seems to have something in common with Aristotle’s, inasmuch as

morality is not about rule-making but instead about the cultivation of moral sentiment through experience, training, and the following of role models.

There’re plenty of people who’d disagree with this, but it’s not a wildly outré position, and there’re plenty of people who’ll accept it, too.  But then… more…

Peter Singer had a piece in The Guardian last week comparing the way that we value lives around the world.  He points out that when NATO accidentally kills Afghan civilians, it pays out compensation.  This never goes above about £5000 per death.  In comparison, NICE’s threshold for funding a treatment on the NHS is £20-30k per QALY.  But, he reminds us,

that sum is per QALY, not per life saved. So if we take the bottom end of this range, Nice recommends that the NHS pay up to four times as much to extend the life of a British citizen by just one year, as the MoD is prepared to pay in compensation for killing a child or young person. That young person could – even allowing for Afghanistan’s dismal life expectancy – expect to live another 40 reasonably good-quality years. That suggests an answer to the question with which I started: it takes about 4 x 40, or 160 Afghan lives, to be worth the same as one British life.

But that would not be the right answer, because £5,000 will buy much more in Afghanistan than it would buy in Britain – according to international price comparisons, perhaps four or five times as much. Let’s say five times. Even with that adjustment, it is going to take 32 Afghan lives to be worth the same as one British life.

At the same time, the US government’s compensation has paid on average $1.8m to the family of each victim of the destruction of the World Trade Center.

Singer’s claim is that NATO doesn’t take seriously the idea that all human lives are valuable.  But while it’s easy to get swept along by his claims (and they are powerful) I’m not sure that they stack up – especially in relation to the NHS; this is a shame, because the basic point he’s making is important. more…

This workshop looks potentially interesting.

Public Dialogue Wednesday 9 March

Lindisfarne Centre, St Aidan’s College, Durham University

5pm Wednesday March 9th

Programme

5.15 pm Introduction to the Meeting – Dr Patrick Steel (Durham University)

5.20 – 6.45 pm A series of short talks from experts in the field providing a personalised view of synthetic biology and its future impact:

Dr Ray Elliott, Syngenta Ltd, “What Synthetic biology can do for agriculture”
Prof Mark Harvey, Centre for Research in Economic Sociology and Innovation, University of Essex, “Energy, food, materials and climate change: the 21st century challenge to biological science and technology”
Prof John Ward, Institute of Structural and Molecular Biology, University College London, “What synthetic biology can offer for bioengineering”
Prof Robert Song, Department of Theology Durham University, “Synthetic Biology: Some ethical issues”

6.45-7.00 Refreshments

7.00-8.30 pm Open Discussion Between Panels and Audience Chaired by:

Prof Robert Edwards, Chief Scientific Officer for the Food Environment Research Agency
Prof Phil Macnaghten, Institute of Hazard Risk and Resilience, Durham University

8.30 Buffet – free for all registered participants

SPPI-NET is a BBSRC funded network which has the objective of promoting interdisciplinary collaborative ventures, involving both academics and industrialists, to explore the potential for producing synthetic plant products for industrial applications.  The IAS (Institute of Advanced Study) is Durham University’s ideas-based Institute which brings together some of the world’s finest researchers from every discipline to examine themes of major intellectual, scientific, political and practical significance.

pace my earlier post about theological ethics, I’m assured by people whose opinion is sound that Song is a decent ethicist; I’ll suspend my grumbles in his case.

Ilora Finlay and Rob George* have a new paper in the JME that takes issue with Battin et al‘s 2007 paper, concerning who makes use of physician assisted suicide in Oregon and Holland.  Battin’s claim had been that there was

no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS.

These findings were, unsurprisingly, used by defenders of PAS to soothe worries among the antis that legalisation would put the vulnerable at risk.

Finlay and George, by contrast, claim that there’s a number of methodological oddities with Battin’s paper, such as to mean that those reassurances mayn’t be as convincing as all that. more…

“You’re a Kantian,” people in my department tell me.  At least, I think that’s what they say – I’m assuming that there’s no comma before the final syllable, and that I’ve got all the vowels right.  I don’t think I am, actually (a Kantian, that is – I couldn’t comment on the other option).  I’m fascinated by Kant, and think his moral system is magnificent, but I’m not sure it’s correct: I don’t buy the stuff about the nature of the will, I think he occludes the difference between reason and reasonability, and so on.  Rather, my hunch is that it’s like a magnificently-crafted carriage clock in which some of the more important cogs have the wrong number of teeth.  The mechanism may work smoothly and be a wonder of engineering, but the piece itself is deeply unreliable.

I’m not sure what my theoretical starting point is – I suspect it’s a kind of weirdly mutated Aristotelianism, laced with a bit of Kant (whom I think has more in common with Aristotle than he’d ever have admitted anyway).  Having said this, I’m reasonably sure that I’m a non-consequentialist, and quite possibly an anti-consequentialist to boot.

At least, that’s what I’d say if you asked me.  In practice, though? more…

Social Scientific Approaches to Bioethics: Methods and Methodologies

5-7 January 2011, Wellcome Conference Centre, Euston Road, London

Post the empirical turn scholars at work in bioethics have been making continually greater use of social scientific approaches. One the one hand this can be seen as a fulfilment of the promise of bioethics as a truly interdisciplinary area of research, on the other we risk becoming as a recent paper has it “Jack of all trades, master of none” (Clinical Ethics 3(4) 2008).  This conference seeks to go some way to engaging with this issue through offering four masterclasses on bioethics and an area of social scientific research.  These will be focussed on contemporary history; researching publics; sociology; and empirical ethics.  Each of these masterclasses will be prefaced by an established academic giving a presentation on the methodological contours of their approach. We seek postgraduate participants for the proposed masterclasses as well as paper presentations which address the conference theme.

There are also some limited audience member places. Preference may be given to those who address the conference theme and fall within the four areas identified.

There will also be a plenary lecture and some ‘added value’ sessions on academic life.  These will include talks by funders, a session by early career researchers and a dedicated networking event, will also form part of the programme.

Topics for papers may include but are not limited to:

• Contemporary history/ researching publics/ sociology/ empirical ethics/political economy.
• Quantitative methods and methodology.
• Cultural and Political Dimensions of Approaches to Bioethics.
• The methodological challenge of interdisciplinarity.
• Social Science in the Humanities.
• Anthropological Approaches to Bioethics.
• Bioethical Education and Educating Bioethics.
• Communicating new approaches to Bioethics.

Proposals for papers not more than 400 words are invited which should be submitted on the conference application form available from our website. The deadline for applications is the 31st of October 2010. Submission is by email to postgrad.bioethics@gmail.com.

We are exploring options for the publication of papers given at the conference.  In previous years papers have been published in Clinical Ethics, Bioethics, JME etc.

Plenary Lecture: Prof Søren Holm (Manchester)

Speakers & Masterclass Leaders:

Dr Duncan Wilson (CHSTM, Manchester) Contemporary History

Dr Alexandra Plows (Bangor) Researching Publics.

Prof Alan Cribb (CBAS, KCL) Methodology of Empirical Ethics.

Dr Leigh Turner (University of Minnesota) Sociology.

Follow us on Twitter for updates on the conference and for bioethics news:

http://twitter.com/BioethicsUK

Email: postgrad.bioethics@gmail.com

Conference Website: http://www.postgradbioethics.org.uk/

Over at Pea Soup, Ralph Wedgwood makes an interesting claim:

I suspect that on several issues that are the focus of fierce moral controversies today – such as homosexuality and the death penalty – there is significantly less disagreement among contemporary philosophers than in the population as a whole. Indeed, I tentatively suggest, the historical record indicates that philosophers have been pushed towards the liberal view on these issues by some fundamental features of philosophy itself.

To what extent is this true?  more…