Uterine transplants: applaud, and then shut up
By Charles Foster
It was reported this week that 56 year old Eva Ottosson is planning to give her 25 year old daughter, Sara, the uterus in which Sara herself gestated. Sara suffers from Mayer Rokitanksy Kustner Hauser Syndrome: she was born without a uterus.
Predictably the newspapers loved it. And, equally predictably, clever people from the world’s great universities queued up to be eloquently wise about the ethics of the proposal.
But if ethics are concerned with what we should do, there was really nothing worthwhile to be said about Eva Ottosson’s altruism (bar the usual uninteresting caveats about dangerousness and resource allocation), except: ‘Fantastic’. Continue reading
Why Wills and Kate must breed
By Charles Foster
As some may have noticed, today there is a wedding. It has been immensely costly, and while I do not for a moment resent that expenditure, the cost has an important ethical corollary.
The money has been spent primarily to ensure dynastic continuity. By accepting our money for their Bollinger and bobbies, William and Kate are impliedly accepting our commission to use their best endeavours to breed. They have taken the People’s Shilling, and have become, first and foremost, breeding animals. Their gametes are held in trust for the nation, and they should guard them. Kate must marinate her eggs in the finest organic nutrients that Fortnums has to offer: William must never wear tight underpants, and always wear a box when he plays cricket. Continue reading
Autonomy: amorphous or just impossible?
By Charles Foster
I have just finished writing a book about dignity in bioethics. Much of it was a defence against the allegation that dignity is hopelessly amorphous; feel-good philosophical window-dressing; the name we give to whatever principle gives us the answer to a bioethical conundrum that we think is right.
This allegation usually comes from the thoroughgoing autonomists – people who think that autonomy is the only principle we need. There aren’t many of them in academic ethics, but there are lots of them in the ranks of the professional guideline drafters, (look, for instance, at the GMC’s guidelines on consenting patients) and so they have an unhealthy influence on the zeitgeist.
The allegation is ironic. The idea of autonomy is hardly less amorphous. To give it any sort of backbone you have to adopt an icy, unattractive, Millian, absolutist version of autonomy. I suspect that the widespread adoption of this account is a consequence not of a reasoned conviction that this version is correct, but of a need, rooted in cognitive dissonance, to maintain faith with the fundamentalist notions that there is a single principle in bioethics, and that that principle must keep us safe from the well-documented evils of paternalism. Autonomy-worship is primarily a reaction against paternalism. Reaction is not a good way to philosophise. Continue reading
You want to publish? Let’s hear all your dirty secrets
By Charles Foster
Most scientific journals require contributors to declare any conflict of interest.
But what about ethicists? We are much more ambitious and presumptuous in our aims than most scientists. We purport to tell our readers not which drug will reduce their blood cholesterol, or which type of plate is best for their radial fracture, but how best to live: how to make right decisions about things that matter far more than cholesterol; how to be the right sort of people. If we write good papers, amounting to more than newspaper opinion pieces, the papers support their conclusions with supposedly objective reasoning. We try to look scientific. And yet, try as we might, we can’t escape from our own histories and tendencies. If an ethicist has been sexually abused as a boy by a paedophilic priest, or forced to watch US evangelical TV, he’ll never be able to think that religion is anything but evil or ridiculous, and his articles will argue, with apparent but wholly fake objectivity, towards that conclusion. If the Jesuits got him before the age of 7, and etched the catechism into his subconscious rather than buggering him, the man they made out of the boy will be theirs for ever, in the Journal of Medical Ethics just as devoutly as in the confessional. And yet there’ll be not a whisper of a warning next to their papers. Those influences are likely to be far more determinative of the views expressed than any financial conflict of interest in a drug trial ever was. Everything about an ethicist’s life raises a potential conflict of interest. Continue reading
On rebuilding Noah’s Ark and drinking old Burgundy
By Charles Foster
In North Kentucky, forty miles from its Creation Museum (where you can see Eve riding on a triceratops and videos in which weeping girls blame their moral degeneracy on their failure to believe in the verbal inerrancy of Scripture), ‘Answers in Genesis’ is building a full-size replica of Noah’s Ark. It’s an expensive business. The total bill will be $24.5 million, of which $845,910 has been raised to date. ‘Partner with us in this amazing outreach by sponsoring a peg, plank or beam…’, pleads the website. A peg will cost you $100, a plank $1000, and a beam $5000. But if you buy a beam, you’ll also get a model of the Ark personally signed by Ken Ham, the President of ‘Answers in Genesis’. Continue reading
Education is child abuse
By Charles Foster
I took my son to school this morning. And I’m wondering if that was evil.
Proponents of human cognitive enhancement are fond of saying that there is nothing very novel about their suggestions. There is no difference in principle, they say, between improving someone’s neural processing power by (for example) manipulation of the genome, and improving that power by education. It is a potent argument. Brains are very plastic things. Education increases the number of neuronal connections. You can see the effect of education with an electron microscope. Education produces change every bit as physical as the bruises produced by a violently abusive parent.
Palmistry for the genome: genetic fundamentalism fights on
by Charles Foster
A recent paper in Social, Cognitive and Affective Neuroscience has the self-explanatory title Investigating the genetic basis of altruism: the role of the COMT Val158Met polymorphism. 1. The German authors aren’t as cautious in their claims as they should have been. They should have noted, nervously, the reception given to the infamous ‘God gene’ hypothesis,2 and entitled the paper something along the lines of ‘Some not very statistically significant correlations (from which we can’t begin to infer a causative relationship) between the COMT Val 158 Met polymorphism and some behaviour that might be markers of, amongst other things, being nice, whatever that means, ignoring other non-correlations with other more plausible markers of being nice.’
Virtue is back, and I’m worried about my mortgage
Professional ethicists have traditionally sniffed at virtue ethics, regarding them as folk philosophy; intrinsically subjective and therefore worthless. They are what you fall back on when you haven’t got a proper argument. You don’t need a PhD to hold a position justified by virtue ethics, and accordingly that position is suspect.
Is the UK’s HPV vaccination programme unethical and/or unlawful?
A colleague recently emailed me. Her daughter, just turned
12, had come back from school bearing an information leaflet about HPV vaccination
with the Glaxo Cervarix vaccine, and a consent form for the parent to sign.
The consent form nodded inelegantly to Gillick, asserting that ‘[t]he decision to consent or refuse is
legally [the girl’s], as long as she understands the issues in giving consent.’
There was no indication given, in the consent form or the accompanying
literature, as to whether and if so how that understanding would be tested. The
reality is that it won’t be tested at all.
Ethicists unite: you have nothing to lose but your non-citation
Yesterday Richard Ashcroft, Professor of Bioethics at Queen Mary College, London, wrote in a Facebook update: ‘I am fed up with being asked to come into science/medicine projects, add a bit of ethics fairy dust, usually without getting any share of the pie, just to shut reviewers up. I am not doing it any more. If they think we are important, treat us with respect. Otherwise, get lost.’
Lots of people liked this. So do I. Ethicists have for too long been the invisible but essential backroom boys and girls of biomedicine; patronised by the practitioners of ‘hard’ science; seen as unimaginative but powerful bureaucrats who have to be kept sweet; as despised social scientists who wield rubber stamps made essential by other zeitgeist-dictating social scientists who want to keep their woolly-headed chums in a job; as factotums who don’t deserve to have their names on the papers any more than the temp who does the photocopying. Why is this?
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