Enhancement

Video Series: John Harris Defends Gene-Editing in Human Embryos

Novel gene editing technologies, such as CRISPR/Cas9, allow scientists to make very precise changes in the genome of human embryos. This could prevent serious genetic diseases in future children. But the use of gene editing in human embryos also raises questions: Is it safe? Should prospective parents be free to choose the genetic characteristics of their children? What if they want to use gene editing to have a deaf child, or a child with fair skin and blue eyes? Should gene editing be regulated globally, or should each country have their own legislation? In this interview with Katrien Devolder, John Harris (Professor Emeritus, University of Manchester &  Visiting Professor in Bioethics, King’s College London) answers these and other questions, and defends the view that we have the strongest moral obligation to gene-edit human embryos, not only to prevent disease but also for the purpose of enhancement.

Guest Post: Track Authorities Are Wrong To Ban Women With Naturally High Testosterone levels

Michael S. Dauber, MA

 According to a story by Catherine Caruso published in STAT News this week, authorities at the International Association of Athletics Federations (IAAF) are getting set to debate whether or not women with hyperandrogenism, or higher-than-expected testosterone levels, should be restricted from competing against women with “normal” or “expected” levels. The debate over the IAAF rules began in 2011, when a rule was first created to prevent women with high testosterone levels competing because of the belief that their hormone levels gave them an unfair advantage. The rule was challenged in 2015, and the IAAF was given two years to provide further justification for its position.

As Caruso writes, the main focus of the current controversy is the legal case of Dutee Chand, an Indian athlete whose testosterone levels exceed “the 10 nanomoles per liter limit, the level deemed to be the lower end of the ‘male range,’” i.e., the amount of testosterone in the blood typically exhibited by male athletes. Testosterone is widely considered a hormone that assists in athletic performance, given that it increases the rate of muscle development and bone mass, among other traits. The idea behind the IAAF’s position is that “unnaturally” high levels of testosterone that exceed levels typical of one’s gender would give such athletes an unfair advantage over other competitiors. Insofar as the IAAF is concerned with creating the fairest competition possible, the presence of elevated testosterone levels in a select group of athletes, like Chand, presents a serious problem.

The problem with the IAAF’s position, however, is that it overlooks one of the central nuances of sporting ethics. It is true that sporting events are supposed to be fair in a wide sense: we would not consider the competition just if one athlete took some action that made it impossible for other athletes to win. This is why athletes are given certain rules to which they must conform. In basketball, for example, one is forbidden from reaching out and grabbing the opposing player’s arm to prevent them from dribbling; in hockey, players are forbidden from tripping each other; and soccer players cannot decide to randomly touch the ball with their hands (unless, of course, they are a goalie).

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Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

By Brian D. Earp (@briandavidearp)

Please note: this piece was originally published in Quillette Magazine.

 

Four members of the Dawoodi Bohra sect of Islam living in Detroit, Michigan have recently been indicted on charges of female genital mutilation (FGM). This is the first time the US government has prosecuted an “FGM” case since a federal law was passed in 1996. The world is watching to see how the case turns out.

A lot is at stake here. Multiculturalism, religious freedom, the limits of tolerance; the scope of children’s—and minority group—rights; the credibility of scientific research; even the very concept of “harm.”

To see how these pieces fit together, I need to describe the alleged crime.

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Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

Guest Post by Philipp Kellmeyer

Imagine you had epilepsy and, despite taking a daily cocktail of several anti-epileptic drugs, still suffered several seizures per week, some minor, some resulting in bruises and other injuries. The source of your epileptic seizures lies in a brain region that is important for language. Therefore, your neurologist told you, epilepsy surgery – removing brain tissue that has been identified as the source of seizures in continuous monitoring with intracranial electroencephalography (iEEG) – is not viable in your case because it would lead to permanent damage to your language ability.

There is however, says your neurologist, an innovative clinical trial under way that might reduce the frequency and severity of your seizures. In this trial, a new device is implanted in your head that contains an electrode array for recording your brain activity directly from the brain surface and for applying small electric shocks to interrupt an impending seizure.

The electrode array connects wirelessly to a small computer that analyses the information from the electrodes to assess your seizure risk at any given moment in order to decide when to administer an electric shock. The neurologist informs you that trials with similar devices have achieved a reduction in the frequency of severe seizures in 50% of patients so that there would be a good chance that you benefit from taking part in the trial.

Now, imagine you decided to participate in the trial and it turns out that the device comes with two options: In one setting, you get no feedback on your current seizure risk by the device and the decision when to administer an electric shock to prevent an impending seizure is taken solely by the device.

This keeps you completely out of the loop in terms of being able to modify your behaviour according to your seizure risk and – in a sense – relegates some autonomy of decision-making to the intelligent medical device inside your head.

In the other setting, the system comes with a “traffic light” that signals your current risk level for a seizure, with green indicating a low, yellow a medium, and red a high probability of a seizure. In case of an evolving seizure, the device may additionally warn you with an alarm tone. In this scenario, you are kept in the loop and you retain your capacity to modify your behavior accordingly, for example to step from a ladder or stop riding a bike when you are “in the red.”

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Should Russian athletes really be banned from competing in the Rio Olympics?

Julian Savulescu

Originally posted in The Conversation 

The audience vote is a resounding yes, all Russian track and field athletes should be banned from competing. But is the International Olympic Committee (IOC) justified in giving individual sports federations the right to decide whether athletes can participate in Rio 2016?

In the run-up to the IOC’s decision, anti-doping leaders from 14 countries signed an open letter demanding the Russians’ exclusion. A petition calling for the whole team to be banned was closing in on its aim of 10,000 signatures, while another arguing against a blanket ban had just managed eight.

The IOC decided to face the mob and take a more nuanced approach; it will allow each sporting federation to decide whether the evidence is sufficient to ban athletes in their discipline. Tennis players, who are regularly tested around the world, are in the clear, for instance, with cyclists set to follow.

But athletes in track and field are banned as a group, although individuals may compete as neutral athletes. Is this kind of “collective responsibility” – or “collective punishment” as Mikhail Gorbachev described it – fair?

Standards of evidence

There’s a genuine dilemma here and the situation is not nearly as clear everyone appears to think – and as the World Anti-Doping Agency (WADA) pretends.

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The Unfairness of Unattractiveness

In the job market being attractive is advantageous. According to economist Daniel Hamermesh, an attractive man can earn, over a life time, $230,000 more than an unattractive one[1]. Attractive solicitors raise more money for charities[2].  Very attractive individuals are less likely to engage in criminal activities, whereas unattractive ones have higher propensity for crime[3]. Attractive criminals are punished less severely than unattractive ones[4].

Both children and adults judge attractive people to be more helpful, more intelligent, and more friendly than their unattractive counterparts[5].

Cute infants elicit stronger motivation for care-taking than less cute ones[6]. Moreover, cute infants are rated as most adoptable[7].

Adults have higher expectations of attractive kids compared to non attractive ones[8] and mothers of attractive infants tend to be more affectionate, playful, and attentive when interacting with their children than mothers of less attractive infants[9]. Teachers expect better performances from attractive students[10]. Transgressions of unattractive children are judged more negatively than transgressions of attractive ones[11].

Being attractive is also an advantage in romantic relationships[12] as there is a positive correlation  between physical attractiveness and dating [13][14].

One response to unfairness is to get people to stop discriminating unfairly. This might work for some domains, such as employment where interviews could be conducted blind. But it won’t be possible to counteract all the potential downsides.

We can’t require people to like or fall in love with people they find unattractive. There are at least two possible responses:

  1. Assist people to find attractive what they currently find unattractive
  2. Assist people to be more attractive to those who currently find them unattractive

Both of these are reasonable solutions. The second is cosmetic enhancement.

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Why ‘smart drugs’ can make you less clever

Nadira Faber

Originally posted at The Conversation 

It is an open secret: while athletes dope their bodies, regular office workers dope their brains. They buy prescription drugs such as Ritalin or Provigil on the internet’s flourishing black market to boost their cognitive performance.

It is hard to get reliable data on how many people take such “smart drugs” or “pharmacological cognitive enhancement substances”, as scientists call them. Prevalence studies and surveys suggest, though, that people from different walks of life use them, such as researchers, surgeons, and students. In an informal poll among readers of the journal Nature, 20% reported that they had taken smart drugs. And it seems that their use is on the rise.

So, if you are in a demanding and competitive job, some of your colleagues probably take smart drugs. Does this thought worry you? If so, you are not alone. Studies consistently find that people see brain doping negatively.

A main concern is fairness. Imagine that while you are going for a run to boost your mental energy, your colleague is popping Ritalin instead. While you believe in your afternoon nap to regain concentration, your office mate relies on Provigil. Unfair? The general public thinks that taking smart drugs is cheating, because it can give users a competitive edge. In fact, even several academics have argued that brain doping is unfair towards people who don’t do it.

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Love by design: when science meets sex, lust, attraction and attachment

A version of this post was originally published in the Conversation 

You are on holiday with your partner of several years. Your relationship is going pretty well, but you wonder if it could be better. It’s Valentine’s Day and you find a bottle on the beach. You rub it. A love genie appears. He (or she) will grant you three special Valentine wishes. Here are some of your choices:

  • to have more or less sexual desire (lust);
  • to remain always as “in love” as you were when you first fell in love (romantic attraction);
  • to be more or less bonded to your partner emotionally (attachment);
  • to be (happily) monogamous or polygamous.

What would you choose? What should you choose? What would your partner choose? Would you choose together, if you could? What would you choose for your partner?

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Whose lifestyle benefits? Regulatory risk-benefit assessment of enhancement devices

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

Shame on Sharapova? Time to Rethink the Banned List

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:

  1. Strict liability obtains – that is, they are responsible for everything they put into their bodies. Ignorance is no excuse.
  2. 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.
  3. 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?

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