Ethics

Pandemic ethics: Never again – will we make Covid-19 a warning shot or a dud?

by Anders Sandberg

The Covid-19 pandemic is not the end of the world. But it certainly is a wake-up call. When we look back on the current situation in a year’s time, will we collectively learn the right lessons or instead quickly forget like we did with the 1918 flu? Or even think it was just hype, like Y2K?

There are certainly plenty of people saying this is the new normal, and that things will never be the same. But historically we have adapted to trauma rather well. Maybe too well – we have a moral reason to ensure that we do not forget the harsh lessons we are learning now.

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Coronavirus: Dark Clouds, But Some Silver Linings?

By Charles Foster

Cross posted from The Conversation

To be clear, and in the hope of heading off some trolls, two observations. First: of course I don’t welcome the epidemic. It will cause death, worry, inconvenience and great physical and economic suffering. Lives and livelihoods will be destroyed. The burden will fall disproportionately on the old, the weak and the poor.

And second: these suggestions are rather trite. They should be obvious to reasonably reflective people of average moral sensibility.

That said, here goes:

1. It will make us realise that national boundaries are artificial

The virus doesn’t carry a passport or recognise frontiers. The only way of stopping its spread would be to shut borders wholly, and not even the most rabid nationalists advocate that. It would mean declaring that nations were prisons, with no one coming in or out – or at least not coming back once they’d left. In a world where we too casually assume that frontiers are significant, it doesn’t do any harm to be reminded of the basic fact that humans occupy an indivisible world.

Cooperation between nations is essential to combating the epidemic. That cooperation is likely to undermine nationalist rhetoric.

2. It will make us realise that people are not islands

The atomistic billiard-ball model of the person – a model that dominates political and ethical thinking in the west – is biologically ludicrous and sociologically unsustainable. Our individual boundaries are porous. We bleed into one another and infect one another with both ills and joys. Infectious disease is a salutary reminder of our interconnectedness. It might help us to recover a sense of society.

3. It may encourage a proper sort of localism

Internationalism may be boosted. I hope so. But if we’re all locked up with one another in local quarantine, we might get to know the neighbours and the family members we’ve always ignored. We might distribute ourselves less widely, and so be more present to the people around us.

We might even find out that our local woods are more beautiful than foreign beaches, and that local farmers grow better and cheaper food than that which is shipped (with the associated harm to the climate) across the globe.

4. It may encourage altruism

Exigencies tend to bring out the best and the worst in us. An epidemic may engender and foster altruistic heroes.

5. It may remind us of some neglected constituencies

Mortality and serious illness are far higher among the old, the very young, and those suffering from other diseases. We tend to think about – and legislate for – the healthy and robust. The epidemic should remind us that they are not the only stakeholders.

6. It may make future epidemics less likely

The lessons learned from the coronavirus epidemic will pay dividends in the future. We will be more realistic about the dangers of viruses crossing the barriers between species. The whole notion of public health (a Cinderella speciality in medicine in most jurisdictions) has been rehabilitated. It is plain that private healthcare can’t be the whole answer. Much has been learned about the containment and mitigation of infectious disease. There are strenuous competitive and cooperative efforts afoot to develop a vaccine, and vaccines against future viral challenges are likely to be developed faster as a result.

7. It might make us more realistic about medicine

Medicine is not omnipotent. Recognising this might make us more aware of our vulnerabilities. The consequences of that are difficult to predict, but living in the world as it really is, rather than in an illusory world, is probably a good thing. And recognising our own vulnerability might make us more humble and less presumptuous.

8. Wildlife may benefit

China has announced a permanent ban on trade in and consumption of wildlife. That in itself is hugely significant from a conservation, an animal welfare, and a human health perspective. Hopefully other nations will follow suit.

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Pandemic Ethics: the Unilateralist Curse and Covid-19, or Why You Should Stay Home

by Anders Sandberg

In Scientific American Zeynep Tufekci writes:

Preparing for the almost inevitable global spread of this virus, … , is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.

We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone.

…you should prepare because your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time.

I think this is well put. As a healthy middle-aged academic my personal risk of dying from Covid-19 seems modest – maybe about 0.4% if I get it, which in turn might be below 10% depending on how widespread the virus becomes. But I could easily spread the disease to people who are far more vulnerable, either directly or indirectly. Even slowing the spread is valuable since it helps avoid overloading the medical system at the peak of the epidemic. Continue reading

Heritable Human Genome Editing Can Cure or Prevent Diseases

By César Palacios-González

@CPalaciosG 

More than a year after the fallout from He Jiankui’s announcement to the world that he had edited human embryos in order to made them resistant to HIV, the debate on whether we should move ahead with heritable human genome editing has given no signs of slowing down. For example, just a couple of days ago the UK House of Lords was debating this issue, and the WHO’s advisory committee on genome editing is running a consultation on the governance framework that should rule over human genome editing. While there are many ethical questions surrounding human genome editing, there is a question that recently has gained prominence: is heritable human genome editing therapeutic? Continue reading

The Right Not to Know and the Obligation to Know

By Ben Davies

Most people accept that patients have a strong claim (perhaps with some exceptions) to be told information that is relevant to their health and medical care. Patients have a Right to Know. More controversial is the claim that this control goes the other way, too. Some people claim, and others deny, that patients also have a Right Not to Know.

A number of considerations (harm to the patient; autonomy; privacy) have been marshalled on either side of this debate over the past few decades (e.g. Laurie 2004; Robertson and Savulescu 2001; Herring and Foster 2012; Takala 2019). In this post, I focus on a distinct argument and its apparently unassailable logic. This is the view that a comprehensive Right Not to Know cannot be justified because in many cases a patient’s ignorance will likely lead harm to third parties (Council of Europe 1997; Rhodes 1998; Harris and Keywood 2001).

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Responsibility, Healthcare, and Harshness

Written by Gabriel De Marco

Suppose that two patients are in need of a complicated, and expensive, heart surgery. Further suppose that they are identical in various relevant respects: e.g., state of the heart, age, likelihood of success of surgery, etc. However, they differ on one feature: for one of these patients, call her Blair, the need for the heart surgery is due to her lifestyle (suppose she was a smoker), whereas the other, Ingrid, has not had this lifestyle, nor any other that would lead to the need for the surgery.

Some people think that:

  1. We can be responsible and blameworthy for our actions and their consequences.

Some of those people also think that:

  1. We can, or should, take this into account when making decisions about how to distribute healthcare resources.

For the purposes of this blog post, let’s assume 1 and 2 are true. Commonly, it is thought that, in order to be blameworthy for something, one must be responsible for it. Further, it is commonly thought that, whatever the appropriate response is to blameworthiness for something or other (assuming that there is an appropriate response), it will be negative in some sense or other. Now further suppose that Blair is blameworthy for her illness. Given 1 and 2, this fact about Blair, combined with the fact that Ingrid is innocent with regard to her illness, suggests that, at least in some contexts, we should treat them differently (or at least it would be permissible to do so). Call a healthcare policy that adopts, and reflects, 1 and 2 a Responsibility-Sensitive Policy, or RSP for short.

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Mutilation or Enhancement? What is Morally at Stake in Body Alterations

By Brian D. Earp (@briandavidearp)

 

Those who follow my work will know that I have published a number of papers on the ethics of medically unnecessary genital cutting practices affecting children of all sexes and genders (a partial bibliography is at the end of this post). When my writing touches on the sub-set of these practices that affect persons with characteristically female sex-typed genitals, I have on occasion received some pushback for using the term ‘FGC’ for female genital cutting rather than ‘FGM’ for female genital mutilation (though I have also received words of appreciation, so, I cannot please everyone).

A recent instance of such pushback came from a respected colleague in response to a forthcoming paper of mine in Archives of Sexual Behavior, in which I explicitly argue against the use of ‘mutilation’ in certain contexts, as there is evidence that such stigmatizing language may have adverse effects on the very people who are meant to be helped. The paper, “Protecting Children from Medically Unnecessary Genital Cutting Without Stigmatizing Women’s Bodies: Implications for Sexual Pleasure and Pain” is available as a pre-print here.

Given that this terminological issue is likely to keep coming up, I thought I would share parts of the reply I wrote to my colleague (lightly edited). I certainly don’t expect that everyone will agree with what I say below, but I hope it can shed some light on at least one plausible way of thinking about such difficult matters.

One last thing. In order to understand my reply, you need to know that my colleague argued that my use of ‘FGC’ rather than ‘FGM’ is disrespectful because it goes against the recommendation of the 2005 Bamako Declaration adopted by the Inter-African Committee (IAC) on Traditional Practices Affecting the Health of Women and Children. My answer is immediately below.

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Lying About Santa: The Sequel

Written by Ben Davies

Another Christmas, and another blog about the ethics of Christmas-based lying.

Around this time last year, Alberto Giubilini wrote a post about whether we should allow children to believe in Santa. Alberto was pretty scathing about some of the arguments in favour of Santa-based honesty, but I want to offer some ethical considerations in favour of this unpopular view.

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The Good Place, the Bad Place, and the Ugly Consequences

written by Gabriel De Marco

I recently started to watch The Good Place again, a sitcom by NBC which takes place in the realm of the supernatural. The show has taken us to the good place (somewhat like heaven, where good people go after they have shuffled off their mortal coil), the bad place (the opposite of the good place), and a few others. Although the show is mainly a comedy, it manages to be funny while discussing many interesting ethical questions, and explicitly introducing a variety of ethical views and principles.

In this world there is a system, call it The System, that determines who goes to the good place and who goes to the bad place. The details of The System have never been fully clear, which turns out to be an important part of the show. Yet, there are some things we do know about how The System works. First, it assigns positive or negative points to actions. The points assigned to a given action seem to be a function of a variety of factors, including its use of resources, the intentions behind it, its effects on others. (It has also been suggested in a recent episode that if the only reason one performs an action is to make one’s points go up, one will not receive points). Whether a person ends up going to the good place is a matter of what their overall score is, and this overall score seems to be the sum of the points assigned to one’s actions.

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