Nearly everyone would agree that a device or drug that relieves pain, or alleviates symptoms of depression confers a benefit – plausibly, a substantial benefit – on its user. No matter what your goals are, no matter what you enjoy, you are likely to agree that your life will go better if you are not in pain and not depressed: whether you’re a painter, a footballer, a Sudoku-enthusiast or a musician, you will be better able to pursue your projects and engage in the activities you love. It is unlikely that you will even question whether pain relief or alleviation of depression indeed constitute benefits.
This general consensus with respect to medical benefits makes it relatively straightforward for regulators to conduct risk-benefit assessments of medical products when they decide whether a particular product can be put on the market. A very small risk of a mild rash or gastrointestinal upset, for example, will be considered reasonable in the context of effective pain relief, as long as patients or consumers are informed. Even as the risks get more significant, substantial pain relief will be considered a large enough benefit to out-weigh a range of negative side effects in many cases.
So far, so straightforward. Continue reading
Professor Julian Savulescu further discusses this subject at The Conversation
Maria Sharapova has been caught taking the banned performance enhancing drug Mildonium (Mildronate). It was added to the ever growing list of banned substances by WADA in January 2016. She claims to have not read the information sent via email informing athletes of the change of rules and says that she had been taking the drug since 2006 for a magnesium deficiency, an irregular EKG, and her family’s history of diabetes. Mildronate is marketed by the company as a performance enhancer (alongside other uses) and is one of Latvia’s biggest medical exports, accounting for up to 0.7% of its total exports.
Should we feel sorry for her?
Every professional athlete nowadays knows:
- Strict liability obtains – that is, they are responsible for everything they put into their bodies. Ignorance is no excuse.
- If you are taking any potentially, even vaguely performance enhancing substance you have to watch the WADA banned list like a hawk. It is added to on a regular basis. Indeed, substances may not even be specifically named but fall under a generic category of effect, such as accelerating tissue healing.
- If you are taking a banned substance for medical reasons, you need to get a therapeutic use exemption. These are very common: there were at least 550 in cycling from 2008-2014. For example, a cyclist with a diagnosis of asthma can take the beta stimulant, salbutamol. In 2011, 8% of baseballers had a diagnosis attention deficit disorder (and so are allowed to take ritalin, related to amphetamine). Of course, the distinction between health and disease is fuzzy, but that is another story. It is very possible that Sharapova would have been granted a therapeutic use exemption, if she had applied.
Sharapova is a professional. Even if her medical need for what is widely advertised as a performance enhancer is justified, she should have known how to handle the administrative burden around it. Strict liability obtains. She broke the rules and will face the consequences.
The more interesting question is: why was Mildonium placed on the banned list?
Every day, for about thirty-five minutes, I sit cross-legged on a cushion with my eyes shut. I regulate my breath, titrating its speed against numbers in my head; I watch my breath surging and trickling in and out of my chest; I feel the air at the point of entry and exit; I export my mind to a point just beyond my nose and pour the breath into that point. When my mind wanders off, I tug it back.
The practice is systematic and arduous. In some ways it is complex: it involves 16 distinct stages. When I am tired, and the errant mind won’t come quietly back on track, I find it helpful to summarise the injunctions to myself as:
- I am here
- This is it
I alternate the emphases: ‘I am here’: ‘I am here’; ‘I am here’; ‘This is it’; ‘This is it’; ‘This is it.’
I note (although not usually, and not ideally, when I’m in the middle of the practice) that each of these connotations presumes something about the existence of an ‘I’. This is less obvious with the second proposition, but clearly there: ‘This’ is something that requires a subject. Continue reading
The following is a transcript of an interview conducted by Jim Brown from Canadian Broad Casting Corporation’s program, The 180, on 3 December between Margaret Somerville and Julian Savulescu
Margaret Somerville is the Founding Director of the Centre for Medicine, Ethics and Law, the Samuel Gale Chair in Law and Professor in the Faculty of Medicine at McGill University, Montreal. She’s also the author of the new book ‘Bird on an Ethics Wire: Battles about Values in the Culture Wars’.
Julian Savulescu is Uehiro Chair in Practical Ethics and Director of the Oxford Uehiro Centre for Practical Ethics at the University of Oxford.
JB: Julian Savulescu, if I could begin with you. You argue that there is a moral imperative for us to pursue gene editing research. Briefly, why do you think it’s so important for us to embrace this technology?
JS: Genetic engineering has been around for about 30 years, widely used in medical research, and also in agriculture, but gene editing is a new version of genetic engineering that is highly accurate, specific, and is able to modify genomes without causing side effects or damage. It’s already been used to create malaria-fighting mosquitoes, drought-resistant wheat, and in other areas of agriculture. But what’s currently being proposed is the genetic modification of human embryos, and this has caused widespread resistance. I think there’s a moral obligation to do this kind of research in the following way. This could be used to create human embryos with very precise genetic modifications, to understand how we develop, why development goes wrong, why genetic disorders occur. It could also be used to create embryonic stem cells with precise changes that might make subsequent stem cells, cancer-fighting stem cells, or even stem cells that fight aging. It could also be used to create tissue with say, changes to understand the origins of Parkinson’s disease or Alzheimer’s disease and develop drugs for the treatment of those diseases. This is what I’d call therapeutic gene editing, and because it stands to benefit millions of people who die every year of painful and debilitating conditions, we actually have a moral imperative to do it. What we ought to show more concern for and perhaps ban, is what might be called reproductive gene editing – editing embryos to create live-born babies that are free of genetic disease or perhaps more resistant to common, late-onset diseases or even enhanced in various ways. If we’re concerned about those sorts of changes in society, we can ban reproductive gene editing, yet also engage in the very beneficial research using genetically modified human embryos to study disease.
JB: And Margaret Somerville, what concerns you about this technology?
MS: Well, I’m interested in the division that Julian makes between the reproductive gene editing and what he calls the therapeutic gene editing. I’m a little surprised that he might not agree with the reproductive gene editing – that is, you would alter the embryo’s germline, so that it wouldn’t be only altered for that embryo, but all the descendants of that embryo would be changed in the same way. And up until – actually, up until this year, there was almost universal agreement, including in some important international documents, that that was wrong, that was ethically wrong, it was a line that we must never step across, that humans have a right to come into existence with their own unique genetic heritage and other humans have no right to alter them, to design them. Julian uses the term genetic engineering – to make them, to manufacture them. Where we would disagree completely is with the setting up of what can be called human embryo manufacturing plants, that is, you would create human embryos in order to use them to make products that would benefit other people, you would use them for experimentation, for research. And Julian’s right, we could do a great deal of good doing that – but there’s a huge danger in looking only at the good that we do. And what we’re doing there is we’re using human life as a product. We’re transmitting human life with the intention of killing it by using it as a product, and I believe that’s wrong. I think that human embryos have moral status that deserves respect, which means they shouldn’t be treated just as products.
Written by Toni Gibea
Research Center in Applied Ethics, University of Bucharest
My aim is to show that the decision made by ESL (Electronic Sports League) to ban Adderall in e-sport competitions is not the outcome of a well-reasoned ethical debate. There are some important ethical arguments that could be raised against the ESL decision to ban Adderall, arguments that should be of great interest if we are concerned about the moral features of this sport and its future development.
In the first part of this post I will explain why and when doping became a primary concern for e-sports and I will also sum up some of the officials’ reactions. After that I’ll present the main arguments that could be raised against the idea that the use of Adderall is an obviously impermissible moral practice. My conclusion is that we should treat this subject matter with more care so that in the future decisions in this area will have a stronger moral grounding. Continue reading
Many people are suspicious about being manipulated in their emotions, thoughts or behaviour by external influences, may those be drugs or advertising. However, it seems that – unbeknown to most of us – within our own bodies exist a considerable number of foreign entities. These entities can change our psychology to a surprisingly large degree. And they pursue their own interests – which do not necessarily coincide with ours.
One argument against human enhancement is that it is cheating. Cheating others and oneself. One may be cheating oneself for various reasons; because one took the easy path instead of actually acquiring a certain capacity, because once one enhances one is no longer oneself, because enhancements are superficial among others. I would like to try to develop further the intuition that “it is not the same person any more”. I will concentrate in forms of enhancement that involve less effort, are considered easier, or faster than conventional means because the cheating argument seems directed at them. In fact, most forms of non-conventional technological enhancements being proposed seem to be easier routes towards self-improvement. I will also explore how my considerations might mean trouble for any type of disruptive technology besides radical human enhancement, such as superintelligence or whole-brain emulation. Continue reading
That people in all cultures around the world use plant drugs to heal, intoxicate, or enhance themselves is well known. What is less well known – at least to me – is that many cultures give drugs to their dogs to improve hunting success. A new paper in Journal of Ethnopharmacology by B.D. Bennett and R. Alarcón reviews the plants used in lowland Ecuador, Peru and elsewhere.
They find a wide variety of drugs used. Some are clearly medicinal or just hide the dog’s scent. Others are intended as enhancers of night vision or smell. Some are psychoactive and intended to influence behaviour – make it walk straight, follow game tenaciously, be more alert, understand humans, or “not become a vagrant”. Several drugs are hallucinogenic, which may appear bizarre – how could that possibly help? The authors suggest that in the right dose they might create synaesthesia or other forms of altered perception that actually make the dogs better hunters by changing their sensory gating. Is drugging dogs OK? Continue reading
The internet and print media are happy to herald that movie director Lars Von Trier can’t work without alcohol. He reports that he tried to be sober and went to AA meetings for half a year, but has now started drinking again in order to be able to work. This is a victory for those who believe that artists are more creative on drugs. As Von Trier himself ranted late last year, before going in rehab, he thinks that going clean will probably mean the end of his career. He probably won’t be able to make movies at all, and what he will produce, will be ‘shitty’. ‘There is no creative expression of artistic value that has ever been produced by ex-drunkards and ex-drug-addicts. Who the hell would bother with a Rolling Stones without booze or with a Jimi Hendrix without heroin?’ He states that he wrote the screenplay for Dogville during a 12-day drug binge, but working on the screenplay for Nymphomaniac, while sober, took him 18 months. Continue reading