Julian Savulescu’s Posts

Victoria’s Voluntary Assisted Dying Law isn’t on a Slippery Slope

By David Copolov and Julian Savulescu 

This week the Australian Senate will debate a private members’ bill that will consider whether to overturn the 21-year-old Euthanasia Laws Act that nullified the ability of Australian self-governing territories to pass legislation in relation to euthanasia and assisted suicide.

The deliberation on whether to continue the arbitrary over-riding of the territories’ legislative autonomy in this domain will inevitably also turn a spotlight on the judiciousness of Victoria’s recent voluntary assisted dying legislation that empowers terminally ill people who are residents of our state and who are experiencing unrelievable suffering, to end their lives on their own terms.

Standing firmly and resolutely against such legislation is Professor Margaret Somerville, from the University of Notre Dame, who was interestingly described in an article in the Sydney Morning Herald two days ago as having “spent decades observing euthanasia in Canada”, even though medically assisted dying only became legal in that country in 2016.

One of the concerns she has raised is the “slippery slope” to unethical assistance in dying. Currently, this might well be on people’s minds because of the reports of the deaths of three minors during 2016-2017 as the result of euthanasia in Belgium, out of 4337 deaths during that period. The deaths of the under-18-year-olds occurred as a result of the removal of age limits on access to euthanasia in Belgium that took place as a result of legislation introduced in 2014, 12 years after the introduction of euthanasia for adults.

In contrast to Belgium (which is the only jurisdiction that places no age restrictions on euthanasia or assisted dying), the Victorian Parliament passed the Voluntary Assisted Dying Act in November last year, which limits voluntary assisted dying (VAD) to terminally ill people 18 years and older, who fulfil very strict criteria in relation to experiencing unrelievable suffering and possessing sufficient decision-making capabilities. They must be in the last six months of life, unless they’re suffering from a neurodegenerative disease, in which case they must be in the last 12 months of life.

There are many reasons that both the Victorian Legislative Council’s Inquiry into end of life choices and the Ministerial Advisory Panel on Voluntary Assisted Dying recommended limiting VAD to adults, including the fact that the extensive consultations with the Victorian public led to the firm conclusion that, as stated in the inquiry’s final report: “Victorian values do not support allowing assisted dying to be provided to those who are yet to reach adulthood.”

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Should Gene Editing Be Compulsory?

Written by Julian Savulescu

Hypothetical Case 1: Enzyme Replacement Therapy for Gaucher’s Disease

Consider a hypothetical version of a real life disease, Gaucher’s Disease. Gaucher’s disease is an inherited disorder caused by a genetic mutation. The mutation means an enzyme–  glucocerebrosidase — is not produced. A a result, glucerebrosides (fats) build up, damaging cells. This can cause bone fractures, liver enlargement, and bleeding but most importantly, brain damage. Once this has occurred it is irreversible.

Enzyme Replacement Therapy (ERT) is now available and for the purposes of this hypothetical case, the treatment offered, if given from the moment of birth, will prevent all damage (in real life current enzyme replacement treatments do prevent most symptoms, but do not affect nervous system involvement).

In our hypothetical case, a child is born to parents known to carry the mutation for Gaucher’s Disease, and prenatal testing has already confirmed that the baby is affected. ERT must be started at birth in order to prevent brain and other damage. However, the parents are Christian Scientists and refuse medical treatment. They believe prayer can cure their child’s condition.

Doctors are concerned the missing enzyme needs to be replaced before the child’s brain is damaged. They take the case to court where judges agree that therapy is in the child’s best interests.

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The Psychology of Uncertainty, Vaccinations, and Protecting the Most Vulnerable: Was Rawls Right After All?

written by Andreas Kappes (@AnKappes), Anne-Marie Nußberger (@amnussberger ), Molly Crockett (@mollycrockett ) & Julian Savulescu  (@juliansavulescu)

Measles is making a comeback in Britain and Europe with numbers rising to record levels this year. Last year in Europe, measles killed 35 people, including young children . The re-emergence of measles can be traced to falling rates of vaccination and might make you want to re-think your summer plans. Crowded environments with low levels of hygiene, also known as summer festivals, are something to avoid if unsure about whether you have been properly vaccinated. And maybe re-think going for holidays to Romania, Italy and Greece, the countries with the highest rates of measles outbreaks this year.

But of course, even if you are not vaccinated, your chances of getting measles are low. And if you are infected, dying from measles is rare. The people that die during measles outbreaks are vulnerable babies that are too young to be vaccinated and unvaccinated people with compromised immune systems. And what are the chances that you infect one of these vulnerable people? Extremely low. Your intuition then might be that even if you are unsure about your vaccination status, the low odds don’t seem to justify the effort to engage with the NHS or any other health care provider. Maximize your benefits, and others will surely be fine. Individually, this feels right, but for the communities and countries we live in, this is disastrous, slowly eroding herd immunity that protects the most vulnerable.

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Ethical AI Kills Too: An Assement of the Lords Report on AI in the UK

Hazem Zohny and Julian Savulescu
Cross-posted with the Oxford Martin School

Developing AI that does not eventually take over humanity or turn the world into a dystopian nightmare is a challenge. It also has an interesting effect on philosophy, and in particular ethics: suddenly, a great deal of the millennia-long debates on the good and the bad, the fair and unfair, need to be concluded and programmed into machines. Does the autonomous car in an unavoidable collision swerve to avoid killing five pedestrians at the cost of its passenger’s life? And what exactly counts as unfair discrimination or privacy violation when “Big Data” suggests an individual is, say, a likely criminal?

The recent House of Lords Artificial Intelligence Committee’s report acknowledges the centrality of ethics to AI front and centre. It engages thoughtfully with a wide range of issues: algorithmic bias, the monopolised control of data by large tech companies, the disruptive effects of AI on industries, and its implications for education, healthcare, and weaponry.

Many of these are economic and technical challenges. For instance, the report notes Google’s continued inability to fix its visual identification algorithms, which it emerged three years ago could not distinguish between gorillas and black people. For now, the company simply does not allow users of Google Photos to search for gorillas.

But many of the challenges are also ethical – in fact, central to the report is that while the UK is unlikely to lead globally in the technical development of AI, it can lead the way in putting ethics at the centre of AI’s development and use.

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The Disunity of Utilitarian Psychology: Runaway Trolleys vs. Distant Strangers

Guy Kahane**, Jim A.C. Everett**,

Brian D. Earp, Lucius Caviola, Nadira Faber, Molly Crockett,

and Julian Savulescu

Last week, we invited people to find out “How Utilitarian Are You?” by filling out our newly published Oxford Utilitarianism Scale. The scale was widely shared – even by Peter Singer (who scored predictably highly). The Oxford Utilitarianism Scale does a pretty good job of measuring how well people’s views match up with “classical” utilitarians (think Bentham and Singer), which is the form of utilitarianism we used to anchor the scale. But that’s not all it does. It also teases apart two different dimensions of utilitarian thinking, tracking two ways in which utilitarianism departs from common-sense morality. Our new research recently published in Psychological Review links these two factors to distinct components of human psychology.

The first peculiar aspect of utilitarianism is that it places no constraints whatsoever on the maximization of aggregate well-being. If torturing an innocent person would lead to more good overall, then utilitarianism, in contrast to commonsense morality, requires that the person be tortured. This is what we call instrumental harm: the idea that we are permitted (and even required) to instrumentally use, severely harm, or even kill innocent people to promote the greater good.

The second way that utilitarianism diverges from common-sense morality is by requiring us to impartially maximize the well-being of all sentient beings on the planet in such a way that “[e]ach is to count for one and none for more than one” (Bentham, 1789/1983), not privileging compatriots, family members, or ourselves over strangers – or even enemies. This can be called the positive dimension of utilitarianism, or impartial beneficence.

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How Utilitarian Are You? Measure on The Oxford Utilitarianism Scale

Blog Authors: Julian Savulescu, Brian D. Earp, Jim A.C. Everett, Nadira Faber, and Guy Kahane

This blog reports on the paper, Kahane G, Everett J, Earp BD, Caviola L,  Faber N, Crockett MJ, Savulescu J, Beyond Sacrificial Harm: A Two Dimensional Model of Utilitarian Decision-Making, Psychological Review [open access]

How Utilitarian are you? Answer these 9 questions to find out…

If you enjoyed taking our ‘How Utilitarian Are You?’ test,  read our new blog post discussing how we developed it, what it shows, and why it’s important

Utilitarianism is one of the oldest and most influential theories about what the right thing to do is. It says that the right act is the one which has the best consequences. In the first formulation by Jeremy Bentham, hedonistic utilitarianism, the right act is the one which maximises happiness and minimises suffering. Richard Hare and Peter Singer made preference utilitarianism famous: the right act is the one which maximises satisfaction of preferences.

Utilitarianism was a novel egalitarian theory when it was developed in the 1700s. It was a radical departure from authoritarian, aristocratic or otherwise hierarchical ways of thinking, positing that each person’s happiness and suffering was to count the same. In stark contrast to the social norms of the day, utilitarianism held that the happiness of the pauper is just as important as the happiness of the Prince or the Pope.

Utilitarianism has fallen into disrepute. It is now equated with Machiavellianism: the end justifies the means, whatever those ends may be. It is also seen as coldly calculating, or else simplistically pragmatic. The German philosopher Friedrich Nietzsche described it as a morality appropriate for shop keepers. Recently it has even been portrayed a doctrine for psychopaths. Pope Paul II put it succinctly in 1995:

“Utilitarianism is a civilization of production and of use, a civilization of ‘things’ and not of ‘persons,’ a civilization in which persons are used in the same way as things are used.”

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Womb Transplants and Child-Centred Surrogacy

 

Julian Savulescu

Womb transplants are again in the news as Richard Paulson, president of the American Society for Reproductive Medicine (ASRM), said there was no reason to believe that the treatment could not work for transgender women at recent conference in Texas.

The ethical issues of performing a womb transplant for a transgender women are substantially the same as the issues facing ciswomen.

The most important ethical consideration in the UK for a womb transplant is distributive justice. Limited health care resources should not be used for womb transplants because there are more cost effective methods of assisted reproduction available. However if an individual wishes to use their own funds for such a procedure, they should be made aware of the risks (which are very significant), and the alternatives, such as surrogacy.

The best interests of the future child is another critical consideration. The moral status of the fetus is a topic of much debate. However, even if we consider abortion to be acceptable, and deny that the fetus has a moral status that accords it its own interests, in cases where the mother plans to carry the pregnancy to term, the fetus represents the future child who does of course have interests (albeit that they are to be weighed against the mother’s own interests, and that the mother is responsible for making decisions on their behalf).

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Blade Runner 2049, Parfit and Identity

Julian Savulescu

 

Contains spoilers for both Blade Runner films. This is a longer version of a shorter piece without spoilers, Blade Runner 2049: Identity, Humanity, and Discrimination, in Pursuit 

Blade Runner 2049, like the original, is about identity, humanity and discrimination.

Identity and Humanity

In both films, bioengineered humans are known as replicants.  Blade Runners “retire” or kill these replicants when they are a threat to society. In the original, Blade Runner Rick Deckard (Harrison Ford) has all the memories and feelings of a human and believes himself to be a human, only at the end to discover he is a replicant. In the sequel, K (Ryan Gosling) is a replicant but comes to believe (falsely) that he is Deckard’s child. In Blade Runner 2049, we are left to watch K dying, realising his memories were implanted by Deckard’s daughter.

In both films we are left wondering what difference there is between a human and a replicant. In the original, rogue replicant Roy Batty (Rutger Hauer) saves Deckard’s life (as Deckard was trying to kill him) and delivers famous “Tears in the Rain” speech:

“I’ve seen things you people wouldn’t believe. Attack ships on fire off the shoulder of Orion. I watched C-beams glitter in the dark near the Tannhäuser Gate. All those moments will be lost in time, like tears in rain. Time to die.”

Roy comes across as more human than the humans in the film. Indeed, in a preceding scene, a thorn or spike appears through his hand reminiscent of Christ, whose own identity as fully human and fully divine has puzzled Theologians for two millenia.

Both films challenge what it is to be human. In 2049, K believes the child of Deckard might have a soul because it was born.

Who are we?

The films both raise fundamental questions about personal identity: who are we? What fundamentally defines the existence of a person from one moment to the next? In both films, there is the suggestion that the biological mass, the body, is not what matters but the mind. In the original, bioengineered Roy seems as human as Deckard, as human as someone could be. In 2049, the idea is extended further still: K’s girlfriend Joi is an AI but seems as real as the other characters and her death is equally tragic.

Derek Parfit died in January this year. He was the world’s most famous moral philosopher (and his favourite film was another Ridley Scott classic, The Duellists). One of his famous ideas is that “identity” is not what matters. He articulated this in his masterpiece, Reasons and Persons (Oxford: Clarendon Press, 1984). According to Parfit, what matters is psychological continuity and connectedness, that is, the unity of our mental states.

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Cross Post: Sex Versus Death: Why Marriage Equality Provokes More Heated Debate Than Assisted Dying

Written by Julian Savulescu

A version of this article has been published by The Conversation

Epicurus wrote: “Death does not concern us, because as long as we exist, death is not here. And when it does come, we no longer exist. ”

We are in the midst of two great ethical debates: marriage equality and assistance in dying. The great plebescite is ongoing and the Victorian parliament is debating a new law to allow assistance in dying in the last year of life.

A search of Victorian paper “The Age” reveals about 2400 results for “marriage equality” and only about 1700 for assisted dying related terms. But even more striking is the difference in the strength of the feelings they have embodied: despite the fact that one of these topics is literally a life and death matter, the same-sex marriage debate has been far more polarizing. Continue reading

Flu Vaccination for Kids: a Moral Obligation?

Written by Ben Bambery and Julian Savulescu

Rosie Anderson, aged 8, died from influenza infection last Friday the 15th of September. Her tragic death followed the recent death of young father, Ben Ihlow, aged 30, who died suddenly on Father’s Day this year, also from influenza infection.

Contrary to public perception, “the flu” is a deadly disease. In Victoria this year, at least 97 people have lost their lives to influenza. The majority of these deaths are amongst the elderly, who are particularly vulnerable to severe disease, but as made painfully clear by Rosie and Ben’s deaths, the flu kills young people too. Continue reading

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