Twitter, paywalls, and access to scholarship — are license agreements too restrictive?
I think I may have done something unethical today. But I’m not quite sure, dear reader, so I’m enlisting your energy to help me think things through. Here’s the short story:
Someone posted a link to an interesting-looking article by Caroline Williams at New Scientist – on the “myth” that we should live and eat like cavemen in order to match our lifestyle to that of our evolutionary ancestors, and thereby maximize health. Now, I assume that when you click on the link I just gave you (unless you’re a New Scientist subscriber), you get a short little blurb from the beginning of the article and then–of course–it dissolves into an ellipsis as soon as things start to get interesting:
Our bodies didn’t evolve for lying on a sofa watching TV and eating chips and ice cream. They evolved for running around hunting game and gathering fruit and vegetables. So, the myth goes, we’d all be a lot healthier if we lived and ate more like our ancestors. This “evolutionary discordance hypothesis” was first put forward in 1985 by medic S. Boyd Eaton and anthropologist Melvin Konner …
Holy crap! The “evolutionary discordance hypothesis” is a myth? I hope not, because I’ve been using some similar ideas in a lot of my arguments about neuroenhancement recently. So I thought I should really plunge forward and read the rest of the article. Unfortunately, I don’t have a subscription to New Scientist, and when I logged into my Oxford VPN-thingy, I discovered that Oxford doesn’t have access either. Weird. What was I to do?
Since I typically have at least one eye glued to my Twitter account, it occurred to me that I could send a quick tweet around to check if anyone had the PDF and would be willing to send it to me in an email. The majority of my “followers” are fellow academics, and I’ve seen this strategy play out before — usually when someone’s institutional log-in isn’t working, or when a key article is behind a pay-wall at one of those big “bundling” publishers that everyone seems to hold in such low regard. Another tack would be to dash off an email to a couple of colleagues of mine, and I could “CC” the five or six others who seem likeliest to be New Scientist subscribers. In any case, I went for the tweet.
Sure enough, an hour or so later, a chemist friend of mine sent me a message to “check my email” and there was the PDF of the “caveman” article, just waiting to be devoured. I read it. It turns out that the “evolutionary discordance hypothesis” is basically safe and sound, although it may need some tweaking and updates. Phew. On to other things.
But then something interesting happened! Whoever it is that manages the New Scientist Twitter account suddenly shows up in my Twitter feed with a couple of carefully-worded replies to my earlier PDF-seeking hail-mary:
UPDATED as of 27 May, 2013. See the bottom of the post.
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.
By Brian Earp
A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa may increase transmission of HIV
1. Experimental doubts
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  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 claim to show that circumcision reduces HIV transmission by a whopping 60%, a figure that (interpreted out of context) is ripe for misunderstanding, as we’ll see. Nevertheless, as one editorial  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 are not without their flaws. Their data have been harnessed to support public health recommendations on a massive scale whose implementation, it has been argued, may have the opposite of the claimed effect, with fatal consequences. As Gregory Boyle and George Hill explain in their exhaustive analysis of the RCCTs:
It was probably hard for the US National Science Advisory Board for Biosecurity (NSABB) to avoid getting plenty of coal in its Christmas stockings this year, sent from various parties who felt NSABB were either stifling academic freedom or not doing enough to protect humanity. So much for good intentions.
The background is the potentially risky experiments on demonstrating the pandemic potential of bird flu: NSABB urged that the resulting papers not include “the methodological and other details that could enable replication of the experiments by those who would seek to do harm”. But it can merely advice, and is fairly rarely called upon to review potentially risky papers. Do we need something with more teeth, or will free and open research protect us better?
By Charles Foster
I have just finished writing a book about dignity in bioethics. Much of it was a defence against the allegation that dignity is hopelessly amorphous; feel-good philosophical window-dressing; the name we give to whatever principle gives us the answer to a bioethical conundrum that we think is right.
This allegation usually comes from the thoroughgoing autonomists – people who think that autonomy is the only principle we need. There aren’t many of them in academic ethics, but there are lots of them in the ranks of the professional guideline drafters, (look, for instance, at the GMC’s guidelines on consenting patients) and so they have an unhealthy influence on the zeitgeist.
The allegation is ironic. The idea of autonomy is hardly less amorphous. To give it any sort of backbone you have to adopt an icy, unattractive, Millian, absolutist version of autonomy. I suspect that the widespread adoption of this account is a consequence not of a reasoned conviction that this version is correct, but of a need, rooted in cognitive dissonance, to maintain faith with the fundamentalist notions that there is a single principle in bioethics, and that that principle must keep us safe from the well-documented evils of paternalism. Autonomy-worship is primarily a reaction against paternalism. Reaction is not a good way to philosophise. Continue reading