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.

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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…

There’s a short paper in the latest JME about which I’ve been meaning to write something for a while – ever since I noticed it as a pre-pub: William Muirhead’s “When Four Principles are Too Many”.  (Raa Gillon provides a commentary here.)

Anyone who’s ever heard me talk professionally for longer than about 35 seconds at once will know that I have little time for “Principlism”.  This is not quite the same as a claim that I have little time for the principles themselves – but this itself is arguably because what those principles demand is vague, or trivial, or some combination of the two.  (It’s one thing to say that actions should be just, for example, but that just leaves open the question of what justice demands; and who in their right mind would demur from the idea that actions ought to be just, especially when no substantive account of justice is entailed?  Or what about respect for autonomy?  That’s often taken to mean that autonomy is king – but giving something its proper respect doesn’t tell us that a great deal of respect is warranted…)  But, anyway: a critique of Principlism is all groovy in my view.

Except… well, this one doesn’t quite seem to work for me; and it’s problematic for a few of reasons. more…

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…

There’s been a couple of things that’ve appeared on the net over the last few days that have revivified something that’s been niggling away at the back of my mind for quite a long time now: the status of bioethics as an academic discipline.

First there was Brian Leiter’s blog post.  Commenting on the oddness that has been overtaking the American Journal of Bioethics for the last couple of weeks (Not been keeping up?  Christian Munthe and Carl’s posts on the Fear and Loathing in Bioethics give a pretty good account), he points out that “[b]ioethics already has a fairly dim reputation in academic philosophy” – and he’s right: it does, even without the alleged strangeness at the AJoB.

And then there’s this interview with Hilde Lindemann in 3:AM Magazine, with this eye-catching passage:

A few years ago I was at a metaethics workshop, and over breakfast a male colleague and I made a game of ranking the different specialties in philosophy according to how prestigious they were – a ranking with a precise inverse correlation to gender. Here’s the list we came up with:

Philosophy of Mind, Philosophy of Language, and Metaphysics: The alpha-dominant philosophy, done by Real Men

Epistemology and Philosophy of Science: Done by manly enough men

Metaethics: Done by men who aren’t entirely secure in their masculinity

Ethics, Social and Political Philosophy: Done by girls

Bioethics: Done by stupid girls

Feminist philosophy, of course, is not philosophy at all.

The status of bioethics isn’t the primary concern of the interview, but it’s what jumped out at me; and – speaking as someone whose PhD was in metaethics in a very mind-and-language department, and who subsequently got work in bioethics - the ranking seems to be about right.  (I was warned at the start of my career that setting out down a bioethics path would make it hard to get a job in a “proper” philosophy department in future – a prediction that I think has something to it.  David Hunter’s recent move to a proper philosophy department is the exception that proves the rule, notwithstanding that his previous job was with a very good bioethics place.)

Bioethics employs philosophers, and makes use of philosophy; but it’s not enormously highly regarded as a discipline by philosophers.  Why should that be?  Does it matter?

more…

David Edmonds poses a question:

Imagine three cities.

1. A medieval city (something like Oxford).

2. A city heavily bombed in World War II and completely rebuilt, with original materials etc. (e.g. the centre of Warsaw).

3. A city constructed in 2012 to look just like the medieval city (e.g. Poundbury the ‘traditional’ village Prince Charles has created in Dorset).

Now imagine that these three cities look identical.  And let’s stipulate that the experience of living in them is pretty much the same (the houses are no more likely to suffer from dry rot in the first than the third).   Here’s the question: where would you rather live?

He reckons that most would prefer Oxford over Warsaw, and both – comfortably – over Poundbury.  I suspect that he’s right.  Why is this, and why does it matter for bioethics?

Edmonds’ hypothesis is that it’s because we care about origins and back-story.  We like to have some sense of where things came from – it’s a part of how we assess their worth.  The problem with a place like Poundbury is that its backstory is completely ersatz. (Whether an ersatz history is better than none at all is a further question, and we could extend the thought-experiment by adding a fourth option: what about living in an unashamedly modern town?  What if an architect was allowed to start from scratch, and didn’t look to the past at all?  Depressingly, my hunch is that many people would prefer to live in Poundbury than in Neopolis.  Without genuine history, they’d prefer fake history.  Prince Charles obviously would.  Mind you, if it wasn’t for a history, fake or imagined, he’d have nothing at all.  Except Cornwall.  And about a billion pounds.  But I digress…)

As for bricks and mortar, so for genetic origins. more…

Note: There’s a couple of errors of interpretation in this post.  I’m not going to re-write it, because I wrote what I wrote, and it’s in the public domain, and I don’t think it’s all that dignified to pretend that one never makes blunders; it’s better to acknowledge them, take the hit, and move on.  But please do have a look at Rebecca Skloot’s response in the comments, and at my answer to her. – IB, 8.ii.12

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Since I read it in the autumn, there’s been a few things nagging at the back of my mind about Rebecca Skloot’s The Immortal Life of Henrietta Lacks.  A few things that don’t seem quite right somehow; and prompted by Pär Segerdahl’s post on The Ethics Blog, I’m tempted to see if I can put them into words.

For those who haven’t read the book, it deals with the story of how it was that an apparently immortal cell culture line, HeLa, was obtained.  The cells were taken from a cervical tumour that went on to kill one Henrietta Lacks, a poor black woman who lived near Baltimore.  During the course of her treatment, a sample of cancerous cells was taken for testing, as was a sample of healthy cells.  (“HeLa” gets its name from the convention of naming culture lines by contracting the name of the person from whom they’re derived.)  These biopsies were apparently unconsented.  But what’s important about them is that, whereas most cell lines at the time died fairly quickly, the cancer sample kept on dividing and dividing.  The HeLa strain proved to be important in all kinds of areas of research.  Doubtless, some of this research has made some people very wealthy.  Yet Henrietta’s descendents have seen none of this profit.  Indeed, many of them are not much more enfranchised today than a black woman would have been 60 years ago; they weren’t even aware that there was such a thing as HeLa.

So what’s the problem?

One of them is definitely stylistic.  I have problems with something that Skloot thinks is a virtue, which is that “dialogue appears in native dialects” (xi).  I don’t share the notion that it’s in any way dishonest to polish out people’s linguistic infelicities, just as one would polish out all the ums and ahs and placeholders in everyday speech.  And I can’t shake the feeling that the professionals who get speaking parts in the book have had their speech tidied; though it’s probably true that the higher your social status, the less susceptible you are to malapropisms, I don’t believe that the educated people directly quoted in the book were always grammatically perfect and never used colloquialisms.  But this is a minor quibble.

What’s more nagging – and potentially more interesting from an ethicist’s point of view – is a question about why any of this is particularly important. more…

Across at NewAPPS, Eric Schliesser wonders aloud about how common nootropic drug use is in professional philosophy.  (Nootropics are are “drugs, supplements, nutraceuticals, and functional foods that improve mental functions such as cognition, memory, intelligence, motivation, attention, and concentration” - Wikipedia.)  And, quite rightly, some of the commentators have pointed out that it’s fairly common.

Actually, it’s more than that: it’s pretty much ubiquitous.  The definition of a nootropic drug just offered is pretty wide; we can allow it to cover any substance that improves intellectual capabilities.  Once we take that on board, it’s clear that we’re talking about things like modafinil, beta-blockers… but also about things like caffeine, alcohol and nicotine.  All these things have the capacity to improve our intellectual ability, at least temporarily.  And the last three are all over the place in academia – and probably professional most-other-things too.

(Granted, alcohol also has the ability to impair our intellectual ability after a fairly short while.  But (warning: anecdote posing as data ahead) it’s also the case that some of the best seminars have been those during which wine has flowed; and it’d be hard to imagine a conference that wasn’t at least paritially fuelled by booze.  And while philosophers do seem to have a reputation for drink, I don’t think that the picture is too different in other fields.  Plausibly, not the least of the reasons for this is that much intellectual labour is a shared enterprise – I’m not talking about co-authorship, as the knocking about of ideas – and something that makes you a bit more convivial makes that sharing more likely.)

So I’m going to take it as read that nootropics amplo sensu are common, and probably pervasive, throughout academia – and throughout all areas of life.  Whether nootropic drugs more narrowly defined are common is a slightly different matter: while there are comments to Eric’s post that tell of some use of things like modafinil and beta-blockers, these stories are – obviously – self-selecting.  (Incidentally: the question of nootropic use in academia was asked a few years ago in the THES.)  Nevertheless, I’d imagine that there is a non-negligible number of people working in academia that makes use of such supplements to enhance performance.

But I’m wondering if there might be a more radical question: might there be situations in which we have a responsibility to use them? more…

When John Sentamu stood up in the House of Lords a couple of weeks ago and spoke about the need for the NHS to concern itself with “spiritual” needs – and illustrated his claim with an anecdote about something resembling an exorcism – the response from a lot of the blogosphere was, at its friendliest, one of pointing and laughing.  It’s very easy to see why.  Not only is it slightly embarrassing that in the UK you can be made a Member of Parliament for being good at believing in the right kind of god in the right kind of way, but the NHS – and healthcare generally – is successful when and because its clinical procedures are based on science and reason, not spooky ghosty stuff.  (In fact, I struggle to see what Sentamu actually meant.  He was empatic that the spiritual is not the same as the psychological, but this just prompts a question: what, then, is it – if anything?  If you remove the psychological from the spiritual, does anything remain?  And if it does, how do we know?)

Anyway: I was prepared to go along with the pointing and laughing.  But then, on Saturday, I saw a DVD of The Exorcist for a couple of quid and impulse bought it; and, that evening, I turned off the lights and watched it.*  You’ll have to bear with me on this, but it made me wonder if there might be something interesting about the idea of “spiritual” care on the NHS.  Not that I believe for a moment that there’s such a thing as demonic possession, or such a thing as a soul or spirit.  Of course there isn’t.  But it doesn’t follow from that that such terms have no place in respect of some forms of care. more…