Julian Savulescu’s Posts

Geoengineering: Lessons from Human Bioengineering

[W]e have no non-radical solutions left to deal with climate change… either we face a radical climate catastrophe or we must radically shift our economy and modes of social organisation away from the current fossil fuel economy

That was the message given by David Spratt, author of Climate Code Red, and Ian Dunlop, who formerly chaired the Australian Coal Association but has since become a climate activist, at the Breakthrough 2014, National Climate Restoration Forum, last month in Melbourne, reported by Green Left Weekly.

One source of radical solutions is the growing geoengineering industry. Recently proposed methods for the sequestering of carbon dioxide include  ants, iron sulfate  and artificial trees .

Debate continues about when and how geoengineering might ever be deployed. Amongst environmentalists, support for geoengineering methods is low. Green Left Weekly explains:

as Clive Hamilton describes in his book Earthmasters, geoengineering technologies are supported by leading climate denial organisations and by the fossil fuel industry. This is because they seem to offer a way that fossil fuel use can continue unabated. The side effects of these technologies could be brutal: for example, severe drought in Africa and Asia. Moreover, if spraying was stopped, temperatures would rise rapidly, leading to even more devastating impacts.

Will regulation help? Green Left Weekly argues that governments have been unable to regulate fossil fuel industries effectively, and that they will be unlikely to succeed more here.

It is fruitful to look at comparisons with human genetic or biological modification, or human bioengineering.

Both are complex systems affecting life processes. There has been considerable debate and reflection on human bioengineering, human bioenhancement or genetic selection. Could the results of this reflection be of use in considering the ethics of geoengineering?

Continue reading

Essendon, Doping and Bad Arguments

By Julian Savulescu. @juliansavulescu

The Australian newspaper ‘The Sunday Age’ reports today that “The Australian Sports Anti-Doping Authority has built a ”non-presence” drug case against 34 Essendon footballers, adopting a strategy similar to the one used to ban Lance Armstrong without a positive test.”

1. What should we think about this latest drugs “scandal” at Essendon, the so called “war on doping” in the Australian Football League (AFL), and in sport in general?

Continue reading

Is Home Birth Really As Safe As Hospital Birth? “Woman-centred Care” vs “Baby-centred Care”

Imagine that you and your partner are having a baby in hospital. Tragically something goes wrong unexpectedly during birth and the baby is born blue. He urgently needs resuscitation if there is to be a chance of preventing permanent severe brain damage. How long would it be reasonable for doctors to wait before starting resuscitation? 15 minutes? 5 minutes? 1 minute?

What would be a reasonable excuse for delaying the commencement of resuscitation? They wanted to get a cup of coffee? The mother wanted to hold the baby first? The mother had catastrophic bleeding and this needed urgent attention?

If it were my baby, I would not want any delay in starting resuscitation. And there would be no justification for delaying resuscitation except some more serious, more urgent problem for another patient, such as the mother.

Yet when people choose homebirth, delay is precisely what they choose. It is simply not possible to start advanced resuscitation in the home within minutes. And their reason is not typically some relevant competing health concern that necessitates delivery at home.

Choosing home birth is choosing delay if some serious problem arises which requires immediate resuscitation.

Continue reading

Moral Enhancement and Violence

In recent years, I’ve written a lot on moral enhancement, including moral bioenhancement (e.g., here, here and here), and argued that we should not reject its potential benefits out of hand. One common objection has been to say something along the lines of “sure, this would be good in theory, but the science behind it is so far off that you may as well be talking about the number of angels on a pinhead”.

But recent research suggests our moral behavior is already improving in some respects. In the UK, admissions to hospital due to violent crime fell by 12% . And in the US, a recent survey revealed a decline in violence experienced by children over the past decade, particularly assault and sexual violence.  This is also a major theme of Stephen Pinker’s “Better Angels of Our Nature.” Pinker documents the widespread reduction in violence over centuries.

Continue reading

Trouble Brewing? The Ethical Significance of Synthetic Yeast

Back in 2010, I blogged about Craig Venter’s creation of the first synthetic organism, Synthia, a bacteria.

Now, in 2014, the next step has been made by a team at John Hopkins University, the use of synthetic biology in yeast, which, whilst still a simple organism, has a similar cell structure to humans (and other more complex organisms): a nuclei, chromosomes and organelles. The engineered yeast has been reproduced to over 100 generations, passing on its new DNA.

The pace is breathtaking. Moore’s law describes a phenomenon in computing, where computer capacity (so far) doubles every two years. Kurzweil uses Moore’s law to predict the ‘singularity’: a state where humans no longer control, or even comprehend, the progress that technology continues to make.

It’s difficult to measure scientific progress in the same way as computer power, but it’s clear that leaps in progress are now measured in years, not decades. Yet still we wait until technology is upon us before we act.

Continue reading

The Tragedy of Moral Mistakes

A tragic case was recently reported of a man who died following botched care via the NHS’ telephone helpline. Suffering from blood poisoning, a series of errors, mis-recording and failure to listen meant that he was told simply to take the remedy ‘Gaviscon’. He died shortly afterwards.  This was rightly widely reported in the press as a major failing of the health system. Many such catastrophic errors in medicine are reported in the press, and wherever possible safeguards put in place to prevent their re-occurrence.

However, we seem to accept deaths that occur not through medical mistakes but through what I will call moral mistakes. For example, each day 3 people die on the waiting list to receive organ transplants. Many of those could be saved if all those eligible and consenting to give organs did so. But instead, organs are withheld even when those who have opted in to organ donation die, because their families decide against it. Others are withheld because we have failed to introduce an opt out system of consent, meaning that those who simply never got around to signing up are excluded from bringing life to another person.

This is just one example of how mistakes in medical ethics can kill people. There are many more.

Continue reading

Winchester Lectures: Kamm’s Trolleyology and Is There a Morally Relevant Difference Between Killing and Letting Die?

The Winchester Visiting Lecturerships were established in 1995 for the purpose of inviting visiting lecturers in the fields of International Relations, History, Philosophy, Religion, Theology or Law. We are grateful to the committee for this opportunity to bring Professor Frances Kamm to Oxford for this series of two lectures October 21 – 22, 2013.  

Over the series, Frances Kamm considered a kaleidoscope of cases in which one innocent person must be killed to prevent 5 innocent people being killed. She argued in some situations, killing one is permissible to prevent 5 other people being killed, yet in other cases it is impermissible to kill one to save 5. Or so go her intuitions. She points to what she finds are morally relevant considerations that distinguish permissible from impermissible killing.

The most straight forward case of impermissible killing, and the one in which she and many others have a clear intuitions, is Transplant.

In Transplant, a doctor contemplates killing one innocent person and harvesting his/her organs to save 5 people with organ failure. This is John Harris’ survival lottery.

But this is a dirty example. Transplant imports many intutions. For example, that doctors should not kill their patients, that those with organ failure are old while the healthy donor is young, that those with organ failure are somehow responsible for their illness, that this will lead to a slippery slope of more widespread killings, that this will induce widespread terror at the prospect of being chosen, etc, etc

A better version of Transplant is Epidemic.

Continue reading

Electroceuticals and Mind Control

“Electroceuticals”, or therapies utilising electricity, are nothing new and range from the widely accepted defibrillator/ pace makers to the more controversial electric shock therapies like ECT sometimes employed to treat severe depression.

But a recent article in Nature argues that these are just a small, crude sample of what electroceuticals may be able to offer in the future. Universities and pharmaceutical companies are researching a wide range of therapies based around electrical stimulation, promising benefits (in the long term) as diverse as mind-controlled prosthetic limbs to a treatment for anorexia. Transcranial Electric Stimulation (TES) is delivering some promising results in depression and treatment of learning disabilities.

Not only is the research potential there, but it appears that the funding is too. Nature report that GlaxoSmithKline are funding 40 researchers to pursue research in this area, amongst other initiatives to kick start electroceutical development. And earlier this year, the US invested $110 million from 2014’s budget for the “Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative”. At the same time, over in Europe, work has commenced on a 10 year, billion pound ‘Human Brain Project, bringing together 135 institutions to try to map parts of the human brain via computer simulations.

We may be starting out on the track for the “holy grail” of neuroscience: strategic control of single neuronal activity. This is, apparently, one of GSK’s goals.

With that level of control, we could finally reach the realms of science fiction: where the mind and therefore the person is under external control. Freedom might be annihilated.

We would face confronting questions over authenticity and identity. There would be alienation between the pre-existing person and their subsequent brain activity.

Burgess’ A Clockwork Orange is a graphic illustration of a common objection to enhancement, the erosion of freedom. TES at present does not appear to represent a major threat to freedom, but it is one of a family of technologies that could one day be used for effective mind control.

Continue reading

Ethical Enhancement

Scientists in America have found a way to reduce crime amongst some high risk groups by 30-40%. It involves a simulation of crime scenes where the victim is a hologram representing the potential criminal in question, followed by discussion with a trained therapist. The experience causes the subject to feel greater empathy and reduces violent crime. We should introduce this therapy now, as a matter of priority.

There is no such therapy, sadly. But there is something which promises the same effects in some groups. Ritalin. A Swedish study found that taking ADHD medication significantly reduced the criminality rate amongst those with ADHD: by 32% in men, and 41% in women. ADHD has itself been associated with an increase in criminality.

Some people will argue that this is a therapy for ADHD, not an enhancement. But ADHD is not a disease like cancer – it is likely a variant of normal functioning involving lower levels of impulse control and attention.

Ritalin, Adderall, Modafenil are all taken by thousands of professionals and students to enhance performance, in a similar way to caffeine. The film Limitless was loosely based on modafenil (in fact, Modafenil doesn’t appear to have such a dangerous side effect profile as is portrayed in the film, though there are as yet no long term studies of normal people). Ongoing research into Alzheimers disease and other impairments will lead to other drugs which enhance normal cognition.

Continue reading

Safety First? How the Current Drug Approval System Lets Some Patients Down

Andrew Culliford, whose story is featured in the Daily Mail, is one of the estimated 7 in 100,000 people living with Motor Neuron disease, a progressive degenerative disease which attacks muscles, leaving those affected eventually unable even to breathe unassisted. For Andrew, a young father who has a severe form of the disease, it means a two to five year life expectancy.

Like Les Halpin and Jenn McNary, the mother of twins afflicted with a similar rare disease, he has a simple request: earlier access to medicines that might help improve or extend his life.

The US introduced a mandatory pre-approval process for pharmaceutical drugs after over 100 people were killed by an untested drug formulation . Today, each drug must go through a series of strictly controlled trials, including Phase 1 tests on healthy volunteers, followed by Phases 2 and 3 which test the drug and dosages on smaller and then larger patient groups. The process is estimated to cost $500 million per drug and to take 8 – 12 years.

The process is designed to ensure the efficacy of drugs has been scientifically demonstrated to a very degree of confidence, and to ensure that patient safety is sufficiently protected. In many ways it has been a triumph of science and regulation.

But it has been a failure for one small group of patients: those with rare, imminently lethal diseases, for whom there are no existing good treatments. Those who will die in less than 8 years. It is these patients who are asking to have access to untested medicines, and to avoid placebo controlled trials, where half the participants are given no drug at all. Les has proposed innovative methods of patient recording data. I have discussed this proposal previously on this blog , and in a joint paper with Les Halpin and clinicians.

Continue reading

Authors

Affiliations