Cultural bias and the evaluation of medical evidence: An update on the AAP
Since my article on the American Academy of Pediatrics’ recent change in policy regarding infant male circumcision was posted back in August of 2012, some interesting developments have come about. Two major critiques of the AAP documents were published in leading international journals, one in the Journal of Medical Ethics, and a second in the AAP’s very own Pediatrics. In the second of these, 38 distinguished pediatricians, pediatric surgeons, urologists, medical ethicists, and heads of hospital boards and children’s health societies throughout Europe and Canada argued that there is: “Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision.”
The AAP took the time to respond to this possibility in a formal reply, also published in Pediatrics earlier this year. Rather than thoughtfully addressing the specific charge of cultural bias, however, the AAP elected to boomerang the criticism, implying that their critics were themselves biased, only against circumcision. To address this interesting allegation, I have updated my original blog post. Interested readers can click here to see my analysis.
Finally, please note that articles from the Journal of Medical Ethics special issue on circumcision are (at long last) beginning to appear online. The print issue will follow shortly. Also be sure to see this recent critique of the AAP in a thoughtful book by JME contributor and medical historian Dr. Robert Darby, entitled: “The Sorcerer’s Apprentice: Why Can’t the US Stop Circumcising Boys?”
This is a brief note to alert the readers of Practical Ethics that research by myself, Anders Sandberg, and Julian Savulescu on the potential therapeutic uses of “love drugs” and “anti-love drugs” has recently been featured in an interview for the national Canadian broadcast program, “Q” with Jian Ghomeshi (airing on National Public Radio in the United States).
Readers may also be interested in checking out a new website, “Love in the Age of Enhancement” which collects the various academic essays, magazine articles, and media coverage of these arguments concerning the neuroenhancement of human relationships.
Your password will probably be hacked soon, and how to (actually) solve the problem
The ancient art of password cracking has advanced further in the past five years than it did in the previous several decades combined. At the same time, the dangerous practice of password reuse has surged. The result: security provided by the average password in 2012 has never been weaker.
After the Twitter accounts for Burger King as well as Chrysler’s Jeep were recently broken into, Twitter apparently issued some advice to the effect that people should be smarter about their password security practices. So: use lots of letters and numbers, passwords should be 10-digits or longer, use a different password for every one of your online accounts and so on.
But this is nuts. Does Twitter know anything about how human beings actually work? Why do you think people reuse their passwords for multiple sites? Why do you think people select easy-to-remember (and easy-to-discover) factoids from their childhoods as answers to security questions?
“Treating” homosexuality in minors: Protected free speech or child abuse?
Should mental health providers be allowed to try to “cure” minors of their homosexuality?
UPDATE: AUDIO NOW AVAILABLE HERE.
Forthcoming talk: If I could just stop loving you: Anti-love biotechnology and the ethics of a chemical break-up
|Date & Time:||30th Nov 2012 4:00pm-5:30pm|
Abstract: “Love hurts” – as the saying goes – and a certain degree of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since, as it is often argued, some types (and amounts) of suffering can lead to personal growth, self-discovery, and a range of other essential components of a life well-lived. But other times, love is downright dangerous. Either it can trap a person in a cycle of violence, as in some domestic abuse cases, or it can prevent a person from moving on with her life or forming healthier relationships. There other cases of problematic love as well:
By Brian Earp
Gay genes and gay rights: On the science and politics of sexuality
If homosexuality has a genetic basis, and if gay sex produces no offspring, why hasn’t the culling force of natural selection bred it right out of the species? Neuroscientist Simon LeVay has recently taken to the electronic pages of the Huffington Post to tout his latest book and offer a few hypotheses.
In light of the article’s popularity, Professor LeVay was asked to join a panel of speakers to discuss not only the genetics of sexual preference, but also the social and political implications of such research. Since I had written on this topic on the Practical Ethics blog, I was invited to take part as well.
By Brian Earp
This is a rough draft of a lecture delivered on October 1st, 2012, at the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights (Helsinki, Finland). It will appear in a substantially revised form—as a completed paper—at a later date. If you quote or use any part of this post, please include the following citation and notice:
Earp, B. D. (forthcoming, pre-publication draft). Assessing a religious practice from secular-ethical grounds: Competing metaphysics in the circumcision debate, and a note about respect. To appear in G. C. Denniston, F. M. Hodges, & M. F. Milos (Eds.), Proceedings of the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights, published by Springer. * Note, this is not the finished version of this document, and changes may be made before final publication.
* * * * * *
My name is Brian Earp; I am a Research Associate in the philosophy department at the University of Oxford, and I conduct research in practical ethics and medical ethics, among some other topics. As you saw from the program, my topic today is the ethics of infant male circumcision—specifically as it is performed for religious reasons.
UPDATED as of 27 May, 2013. See the bottom of the post.
The AAP report on circumcision: Bad science + bad ethics = bad medicine
For the first time in over a decade, the American Academy of Pediatrics (AAP) has revised its policy position on infant male circumcision. They now say that the probabilistic health benefits conferred by the procedure just slightly outweigh the known risks and harms. Not enough to come right out and positively recommend circumcision (as some media outlets are erroneously reporting), but just enough to suggest that whenever it is performed—for cultural or religious reasons, or sheer parental preference, as the case may be—it should be covered by government health insurance.
That turns out to be a very fine line to dance on. But fear not: the AAP policy committee comes equipped with tap shoes tightly-laced, and its self-appointed members have shown themselves to be hoofers of the nimblest kind. Their position statement is full of equivocations, hedging, and uncertainty; and the longer report upon which it is based is replete with non-sequiturs, self-contradiction, and blatant cherry-picking of essential evidence.
“Legitimate rape,” moral consistency, and degrees of sexual harm
Should abortions be allowed in the case of rape? Republican Todd Akin—running for the U.S. Senate from the state of Missouri—thinks not. His reasoning is as follows:
From what I understand from doctors, [pregnancy resulting from rape is] really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down. But let’s assume that maybe that didn’t work or something. I think there should be some punishment. But the punishment ought to be of the rapist, and not attacking the child.
There appears to be no scientific basis for the claim that the trauma of forced intercourse can interrupt ovulation or in any other way prevent a pregnancy; indeed pregnancy is just as likely after rape as after consensual sex, according to the evidence I have seen. This news article sums up the relevant data - though please note that one of my readers [see comments] takes issue with the standard interpretation of the most frequently-cited studies.
Let’s start, for now, then, with a bit of data that is not in question: thousands of pregnancies per year, in the U.S. alone, ensue from cases of reported rape or incest–either through the caveat of Akin’s theory that “maybe [the body's defenses] didn’t work or something” or through the medically orthodox explanation that the body has no such defense. Assuming that falsely reporting rape is relatively rare, as seems to be the case; and acknowledging that many rapes are never reported in the first place, we should be able to agree that pregnancies resulting from rape are a life-changing reality for thousands of women on an annual basis. By “rape” I mean any penetrative act done without clear consent; and here I’m calling attention to the sub-set of such acts that result in conception. I won’t say much about the term “legitimate” — which I find troubling in a hundred ways — simply because other writers have gone to town on it, and I want to say something new.
Now, given everything I’ve just said, what could be going on with Todd Akin’s moral reasoning for him to casually downplay the relevance of rape and incest to the abortion debate while maintaining, as he does, that there should be no exceptions to anti-abortionism even in those cases? Psychologist Brittany Liu uses the notion of “moral coherence” to provide an explanation: