Cultural bias and the evaluation of medical evidence: An update on the AAP
Since my article on the American Academy of Pediatrics’ recent change in policy regarding infant male circumcision was posted back in August of 2012, some interesting developments have come about. Two major critiques of the AAP documents were published in leading international journals, one in the Journal of Medical Ethics, and a second in the AAP’s very own Pediatrics. In the second of these, 38 distinguished pediatricians, pediatric surgeons, urologists, medical ethicists, and heads of hospital boards and children’s health societies throughout Europe and Canada argued that there is: “Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision.”
The AAP took the time to respond to this possibility in a formal reply, also published in Pediatrics earlier this year. Rather than thoughtfully addressing the specific charge of cultural bias, however, the AAP elected to boomerang the criticism, implying that their critics were themselves biased, only against circumcision. To address this interesting allegation, I have updated my original blog post. Interested readers can click here to see my analysis.
Finally, please note that articles from the Journal of Medical Ethics special issue on circumcision are (at long last) beginning to appear online. The print issue will follow shortly. Also be sure to see this recent critique of the AAP in a thoughtful book by JME contributor and medical historian Dr. Robert Darby, entitled: “The Sorcerer’s Apprentice: Why Can’t the US Stop Circumcising Boys?”
We’ve come a long way, as a species. And we’re better at many things than we ever were before – not just slightly better, but unimaginably, ridiculously better. We’re better at transporting people and objects, we’re better a killing, we’re better at preventing infectious diseases, we’re better at industrial production, agricultural and economic output, we’re better at communications and sharing of information.
But in some areas, we haven’t made such dramatic improvements. And one of those areas is parenting. We’re certainly better parents than our own great-great-grandparents, if we measure by outcomes, but the difference is of degree, not kind. Why is that? Continue reading
This is a brief note to alert the readers of Practical Ethics that research by myself, Anders Sandberg, and Julian Savulescu on the potential therapeutic uses of “love drugs” and “anti-love drugs” has recently been featured in an interview for the national Canadian broadcast program, “Q” with Jian Ghomeshi (airing on National Public Radio in the United States).
Readers may also be interested in checking out a new website, “Love in the Age of Enhancement” which collects the various academic essays, magazine articles, and media coverage of these arguments concerning the neuroenhancement of human relationships.
The first two weeks of 2013 were marked by a flurry of news articles considering “the new science” of pedophilia. Alan Zarembo’s article for the Los Angeles Times focused on the increasing consensus among researchers that pedophilia is a biological predisposition similar to heterosexuality or homosexuality. Rachel Aviv’s piece for The New Yorker shed light upon the practice of ‘civil commitment’ in the US, a process by which inmates may be kept in jail past their release date if a panel decides that they are at risk of molesting a child (even if there is no evidence that they have in the past). The Guardian’s Jon Henley quoted sources suggesting that perhaps some pedophilic relationships aren’t all that harmful after all. And Rush Limbaugh chimed in comparing the ‘normalization’ of pedophilia to the historical increase in the acceptance of homosexuality, suggesting that recognizing pedophilia as a sexual orientation would be tantamount to condoning child molestation.
So what does it all mean? While most people I talked to in the wake of these stories (I include myself) were fascinated by the novel scientific evidence and the compelling profiles of self-described pedophiles presented in these articles, we all seemed to have a difficult time wrapping our minds around the ethical considerations at play. Why does it matter for our moral appraisal of pedophiles whether pedophilia is innate or acquired? Is it wrong to imprison someone for a terrible crime that they have not yet committed but are at a “high risk” of committing in the future? And if we say that we can’t “blame” pedophiles for their attraction to children because it is not their “fault” – they were “born this way” – is it problematic to condemn individuals for acting upon these (and other harmful) desires if it can be shown that poor impulse control is similarly genetically predisposed? While I don’t get around to fully answering most of these questions in the following post, my aim is to tease out the highly interrelated issues underlying these questions with the goal of working towards a framework by which the moral landscape of pedophilia can be understood. Continue reading
On the morning of December 14th, 20-year old Adam Lanza opened fire within the halls of Sandy Hook Elementary School in Newtown, Connecticut, killing 20 children and six adult staff members before turning his gun on himself. In the hours that followed, journalists from every major news station in the nation inundated the tiny town, and in the days that followed, the country as a whole started down a familiar path characterized best by the plethora of ‘if only-isms’.
It began in the immediate hours following the shooting: if only we had stricter gun control laws, this wouldn’t have happened. This is perhaps an unsurprising first response in a country that represents 4.5% of the world’s population and 40% of the world’s civilian firearms. Over the next few days, as a portrait of the shooter began to emerge and friends and family revealed that he was an avid gamer, a second theory surfaced in the headlines: if only our children weren’t exposed to such violent video games, this tragedy never would have occurred.  And just in the past few days, public discourse has converged on the gunman’s mental health, the general conclusion being that if only we had better mental health services in place, this wouldn’t have happened. (The National Rifle Association [NRA] even tried to jump on board, suggesting that “26 innocent lives might have been spared” if only we had an armed police guard in every school in America. They seem to be the only ones taking themselves seriously.) Continue reading
“Treating” homosexuality in minors: Protected free speech or child abuse?
Should mental health providers be allowed to try to “cure” minors of their homosexuality?
Regularly, media reports reveal that Western companies have children working in their manufactures in Third or Second World countries – may it be for clothing, furniture or, as recently, technical gadgets. Such reports are often followed by people calling for a boycott of the company’s products.
‘Work done by children’ is an extremely broad expression. There is nothing else than to vehemently fight against ‘work’ that goes along with gross abuse like forced labour, prostitution, involvement in drug trafficking, carrying heavy weights or any other activity putting a child’s physical or mental wellbeing in danger.
But also in cases where no such exploitation is taking place, we have good arguments against children doing work. We fear they might be ‘the cheapest to hire, the easiest to fire, and the least likely to protest.’ And we don’t want them to be deprived of the opportunity to get a proper education.
So what should we do if we read media reports about a company employing minors? Even if we don’t know the exact circumstances: joining a boycott of this company’s products can’t be wrong, can it?
By Brian Earp
This is a rough draft of a lecture delivered on October 1st, 2012, at the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights (Helsinki, Finland). It will appear in a substantially revised form—as a completed paper—at a later date. If you quote or use any part of this post, please include the following citation and notice:
Earp, B. D. (forthcoming, pre-publication draft). Assessing a religious practice from secular-ethical grounds: Competing metaphysics in the circumcision debate, and a note about respect. To appear in G. C. Denniston, F. M. Hodges, & M. F. Milos (Eds.), Proceedings of the 12th Annual International Symposium on Law, Genital Autonomy, and Children’s Rights, published by Springer. * Note, this is not the finished version of this document, and changes may be made before final publication.
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My name is Brian Earp; I am a Research Associate in the philosophy department at the University of Oxford, and I conduct research in practical ethics and medical ethics, among some other topics. As you saw from the program, my topic today is the ethics of infant male circumcision—specifically as it is performed for religious reasons.
By Charles Foster
Fast food permanently reduces children’s IQ, a recent and unsurprising study reports.
What should be done? The answer is ethically and legally simple. Parents who feed their children junk food, knowing of the attendant risks, are child-abusers, and should be prosecuted. If you hit a child, bruising it, you are guilty of a criminal offence. A bruise on a child’s leg is of far less lasting significance than the brain damage produced by requiring a child to ingest toxic junk. A child injured by a negligent or malicious parent can also bring civil proceedings against the parent.
The findings of the recent study mirror those in other jurisdictions. And now that they have been widely disseminated it will be hard for parents to plead ignorance. Continue reading
Some days ago, two 13-year-old boys have been charged with first degree murder in Wisconsin (USA), as reported by the Daily News (New York). Allegedly, they went to one of the boy’s great-grandmother’s home, killed her using a hatchet and hammer, then stole her jewellery and her car – and went for a pizza afterwards.
After giving horrid details of the killing, the Daily News concludes its report with stating that the boys’ defence attorney tries to have the case moved to juvenile court. The reason why these 13-year-olds are not automatically charged as juveniles but stand trial in an adult court is that the USA allows prosecutors to try minors as adults when they commit certain violent felonies. In several states, children as young as 7 can be – and are – tried as adults for some years now. They can be convicted to adult sanctions, including long prison terms, mandatory sentences, and placement in adult prisons. (Since 2005, however, under 18-year-olds can’t be convicted to death sentence any more.)