International/ Global Health

Why advertising gay conversion therapy is like advertising make-up

by Rebecca Roache

Various news sources—including The Huffington Post, Gay Star News, and the London Evening Standard—are reporting a High Court case in which a campaigner for gay conversion therapy is fighting Transport for London (TfL) over a ban on its bus adverts that suggest that homosexuality can be ‘cured’.

Dr Mike Davidson is head of Core Issues Trust which, according to its website, is ‘a non-profit Christian ministry supporting men and women with homosexual issues who voluntarily seek change in sexual preference and expression’. Davidson, who is married with children, insists that his own gay feelings were removed by therapy. He told The Huffington Post that he had homosexual feelings ‘from the moment [he] opened [his] eyes’. Even so, he believes that ‘gay’ is a ‘late twentieth century political construction’ that people can reject. His adverts read, ‘Not gay! Ex-gay, post-gay and proud. Get over it!’—a response to similar posters by lesbian, gay and bisexual charity Stonewall which read, ‘Some people are gay. Get over it!’ Davidson’s adverts have been deemed ‘offensive to gays’ by London Mayor Boris Johnson, who is also head of TfL. Continue reading

The Ethics of Meatballs

In the light of the unfolding horsemeat scandal, it was only a matter of time before some equine entrails were uncovered in an Ikea meatball. This is a shame on many levels, not least for the poor pigs, cows, and horses whose flesh will now end up as landfill. I personally am quite partial to an Ikea meatball, would not object on the mere grounds that it contained horsemeat (I think I would have been hard pressed to identify the ingredients anyway prior to the scandal), and recently enjoyed an Ikea meatball dinner in Budapest with a colleague from the Uehiro Centre, not a million miles from where the offending meatball was uncloaked. But for those who consider eating Ikea meatballs intrinsically good, but eating horsemeat intrinsically bad, how could they be advised?

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FGM and the Golden Rule

When Binta Jobe [not her real name] was nine, she was taken into the Gambian bush where she suffered female genital mutilation at the hands of an amateur surgeon without anaesthetic. She is now a 23-year-old asylum seeker in the UK, trying to prevent her three-year-old daughter from a similar experience if she is forcibly returned to the Gambia. Continue reading

The Immorality of the News

People tend to worry a great deal about censorship of the press, and to talk about the obligation governments and others are under to allow the press the freedom it needs to report accurately. But maybe we should worry more about what the press itself chooses to leave out, and think about its reporting obligations. Continue reading

The AAP report on circumcision: Bad science + bad ethics = bad medicine

By Brian D. Earp

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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. Both documents shine as likely examples of a “lowest common denominator” mélange birthed by a divided committee, some of whose members must be well aware that the United States is embarrassingly out of tune with world opinion on this issue.

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Replying to a critic: My last circumcision post (for a while) – with video debate

By Brian D. Earp

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VIDEO DEBATE LINKED TO BELOW – ARI KOHEN AND I DISCUSS THE ETHICS OF RELIGIOUSLY-MOTIVATED CIRCUMCISION

Ari Kohen doesn’t like my recent post about circumcision—the one in which I argue that it is unethical to remove healthy tissue from another person’s body without first getting his permission. I then go on to say that religious justifications cannot override this basic principle. Here’s that post again.

Ari is a professor of political theory and human rights at the University of Nebraska at Lincoln. In this blog post, he takes me to task for failing to take seriously the religious commitments of Jews in framing my arguments. And while he gets some things wrong about, for example, the relevance of “sexually-sensitive tissue” to my overall reasoning; and while he misses the point of my bringing up female genital cutting entirely (I’ve since edited my post to clear up any lingering ambiguity) – he is probably right that my approach to debating this issue is unlikely to win me any converts from within the ranks of the religious.

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Peter Singer and Christian Ethics: Beyond Polarization

For those of us doing Catholic moral theology, we most often hear and read the name “Peter Singer” invoked by our colleagues in a dismissive way.  Indeed, if one can somehow show that another’s argument is heading in a Singer-like direction, then for many of us one essentially has reduced it to the absurd.  Furthermore, and very unfortunately, Singer remains consistently dismissed as a ‘popularizer’ who can’t be taken seriously as an academic given how widely his work is read.

But when I actually look carefully and systematically at his work I see not only how consistent and even rigorous it often is, but also how much it common it has with Christian Ethics.  Consider, for instance, the topic of abortion.  Though Peter Singer is pro-choice for abortion and infanticide, and the Catholic position condemns the intentional killing the fetus and early embryo as intrinsically evil, the actual disagreement between the two on this very complex topic turns out to be very narrow. Both believe that public policy cannot retreat into a privacy-centered moral neutrality with regard to (1) the moral status of the fetus and (2) whether one can kill or refuse to sustain a fetus.  Both also agree, assuming for the sake of argument that a fetus is a person, that no unintended negative effects of making abortion illegal would justify allowing for the legal killing of fetuses. Both reject the American Supreme Court abortion decision Roe v. Wade.  Both agree (again, assuming a fetus is a person) that not only would it be morally wrong to kill a fetus, but that one has a moral duty to support a fetus for nine months with one’s body.  Both reject the idea that viability is a morally significant dividing line.  Both also see a strong logical connection between one’s view of abortion and one’s view of infanticide.  In fact, it is my contention that the wide divergence in their ultimate conclusions comes from a very complex argument involving the distinction that Aristotle and Thomas made between “active” and “passive” potential.  On every issue but that one, Peter Singer looks a lot like John Paul II on abortion.

Singer also criticizes Christianity for being speciesist, but he (along with, to be fair, many Christians) is largely unaware of how complex the tradition is on this topic. For instance, the traditional definition of a person is “an individual substance of a rational nature”—with no mention of biological species as morally significant. Indeed, the Christian tradition makes explicit room for non-human persons (angels and aliens are good examples) and even (in the past) for the concept of human non-persons (human beings who are “slaves by nature”, for instance). Furthermore, the Catechism of the Catholic Church insists that it is seriously morally wrong to needlessly cause non-human animals pain and suffering, and even PETA has used the words of Pope Benedict (now known as “the Green Pope” for his heroic ecological work) criticizing factory farming in their advertisements. This should not be a surprise to anyone who reads Genesis and learns that not only are non-human animals created “good” without any reference to human beings, but that God intended other animals to be our companions, not our food.

The most overwhelming case of all for overlap involves how each understands our duties to the poor. Singer broke on the academic scene with his 1972 article on Famine, Affluence and Morality, and continues to hammer away at the problem of poverty through his continued work (especially his recent book: The Life You Can Save) and personal giving. Modern-day Roman Catholic movements to aid the impoverished (led by the American Bishops via their poverty arm called Catholic Relief Services) are not only absolutely massive in scale and trend-setting among their peer organizations, but their roots go back to the very beginnings of Christianity. Indeed, though Jesus himself rarely speaks of Hell, when he does so it is almost always connected to a failure of one’s duties to the poor, and the early Christian Church largely served as the social welfare system of the ancient world.  Singer himself built on precisely this point when, in the second edition of Practical Ethics, he suggested we give 10% of our resources to those in absolute poverty in part because this was the tithing percentage required by the social welfare mechanism of the age: the Catholic Church. In a shocking indictment of most of us, I suspect, both approaches insist that a selfish failure meet one’s duty to aid the global poor is seriously immoral behavior—akin to something like indirect homicide.

Those who are familiar with ethical theory are probably the most skeptical of conversation between Peter Singer and Christian Ethics—especially because Singer is utilitarian and the Church is a big fan of exceptionless moral norms. But even here the possibilities for overlap are striking and important. The Catholic Church has a teleological ethic which, yes, is ultimately directed toward union with God, but is proximately directed at the flourishing of the “universal common good.”  Even exceptionless moral norms are teleological in nature given that they are at the service of this kind of flourishing. Furthermore, Singer is exploring a new kind of objectivity in his moral theory—even to the point where it is no longer clear that he will remain a preference utilitarian. Indeed, in his latest edition of Practical Ethics he admits that preference utilitarianism is at variance with his moral intuitions about replacement theory (especially of persons), the good of distant future persons, and whether the existence of persons at all is a morally good thing. Especially as Singer moves to include more objectivity into his theory and go beyond preference utilitarianism, he becomes an even better conversation partner for Christian Ethics.

Much more needs to be said to back up these ideas and arguments, of course, and I try to do just that in my new book Peter Singer and Christian Ethics: Beyond Polarization—just released this weekend in the United States by Cambridge University Press. (Available in both paperback and Kindle versions.)  I’m certainly interested in any feedback about the book, so feel free to send me a note (either here or via e-mail: camosy@fordham.edu), or join the discussion on the book’s Facebook page.  The book will also serve as the basis of an exchange/debate between Julian Savulescu and myself next Autumn, so if you are in or around Oxford October 17th-19th, come by and see us.

Charlie Camosy

Fordham University (webpage is here)

www.catholicmoraltheology.com

When bad science kills, or how to spread AIDS

By Brian Earp

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A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa will increase transmission of HIV

Step 1. How not to design or conduct an experiment

A handful of circumcision advocates have recently begun haranguing the global health community to adopt widespread foreskin-removal as a way to fight AIDS. Their recommendations follow the publication of three [1] randomized controlled clinical trials (RCCTs) conducted in Africa between 2005 and 2007.

These studies have generated a lot of media attention. In part this is because they supposedly show that circumcision reduces HIV transmission by a whopping 60%, a figure that wins the prize for “most misleading possible statistic” as we’ll see in a minute. Yet as one editorial [2] concluded: “The proven efficacy of MC [male circumcision] and its high cost-effectiveness in the face of a persistent heterosexual HIV epidemic argues overwhelmingly for its immediate and rapid adoption.”

Well, hold your horses. The “randomized controlled clinical trials” upon which these recommendations are based (I use scare quotes deliberately) represent bad science at its most dangerous: we are talking about poorly conducted experiments with dubious results presented in an outrageously misleading fashion. These data are then harnessed to support public health recommendations on a massive scale whose implementation would almost certainly have the opposite of the claimed effect, with fatal consequences. As Gregory Boyle and George Hill explain in their exhaustive analysis of the RCCTs:

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Kony 2012, Malaria and Pizza

Last week this blog  mentioned the Kony 2012 video, and suggested that many of the criticisms of it were ‘dishonest’ in a particular sense, and biased. Criticisms of such a worthy cause, and other charities seeming to piggy-back on Kony 2012’s success, often meet with great anger. But such piggy-backing is entirely justifiable. Continue reading

Practical Ethics Given Moral Uncertainty

Practical ethics aims to offer advice to decision-makers embedded in the real world.  In order to make the advice practical, it typically takes empirical uncertainty into account.  For example, we don’t currently know exactly to what extent the earth’s temperature will rise, if we are to continue to emit CO2 at the rate we have been emitting so far.  The temperature rise might be small, in which case the consequences would not be dire.  Or the temperature rise might be very great, in which case the consequences could be catastrophic.  To what extent we ought to mitigate our CO2 emissions depends crucially on this factual question.  But it’s of course not true that we are unable to offer any practical advice in absence of knowledge concerning this factual question. It’s just that our advice will concern what one ought to do in light of uncertainty about the facts.

 

But if practical ethics should take empirical uncertainty into account, surely it should take moral uncertainty into account as well.  In many situations, we don’t know all the moral facts.  I think it is fair to say, for example, that we don’t currently know exactly how to weigh the interests of future generations against the interests of current generations.  But this issue is just as relevant to the question of how one ought to act in response to climate change as is the issue of expected temperature rise.  If the ethics of climate change offers advice about how best to act given empirical uncertainty concerning global temperature rise, it should also offer advice about how best to act, given uncertainty concerning the value of future generations.

 

Cases such as the above aren’t rare.  Given the existence of widespread disagreement within ethics, and given the difficulty of the subject-matter, we would be overconfident if we were to claim to be 100% certain in our favoured moral view, especially when it comes to the difficult issues that ethicists often discuss.

 

So we need to have an account of how one ought to act under moral uncertainty.  The standard account of making decisions under uncertainty is that you ought to maximise expected value: look at all hypotheses in which you have some degree of belief, work out the likelihood of each hypothesis, work out how much value would be at stake if that hypothesis were true, and then trade off the probability of a hypothesis’ being true against how much would be at stake, if it were true.  One implication of maximizing expected value is that sometimes one should refrain from a course of action, not on the basis that it will probably be a bad thing to do, but rather because there is a reasonable chance that it will be a bad thing to do, and that, if it’s bad thing to do, then it’s really bad.  So, for example, you ought not to speed round blind corners: the reason why isn’t because it’s likely that you will run someone over if you do so.  Rather, the reason is that there’s some chance that you will – and it would be seriously bad if you did.

 

With this on board, let’s think about the practical implications of maximising expected value under moral uncertainty.   It seems that the implications are pretty clear in a number of cases. Here are a few.

 

1.

One might think it more likely than not that it’s not wrong to kill animals for food.  But one shouldn’t be certain that it’s not wrong.  And, if it is wrong, then it’s seriously wrong – in the same ballpark as murder.  So, in killing an animal, one risks performing a major moral wrong, without any correspondingly great potential moral upside.  This would be morally reckless.  So one ought not to kill animals for food.

 

2.

One might think it more likely than not that it’s not wrong to have an abortion, for reasons of convenience.  But one shouldn’t be certain that it’s not wrong.  And, if it is wrong, then it’s seriously wrong – in the same ballpark as murder.  So, in having an abortion for convenience, one risks performing a major moral wrong, without any correspondingly great potential moral upside.  This would be morally reckless.  So one ought not to have an abortion for reasons of convenience.

 

3.

One might think it more likely than not that it’s not wrong to spend money on luxuries, rather than giving it to fight extreme poverty.  But one shouldn’t be certain that it’s not wrong.  And, if it is wrong, then it’s seriously wrong – in the same ballpark as walking past a child drowning in a shallow pond.  So, in spending money on luxuries, one risks performing a major moral wrong, without any correspondingly great potential moral upside.  This would be morally reckless.  So one ought not to spend money on luxuries rather than giving that money to fight poverty.

 

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