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Julian Savulescu

Refusing Cochlear Implants: Is It Child Neglect?

Australian Graeme Clark developed the cochlear implant, or bionic ear, in the 1970s. It does not amplify sound but directly stimulates any functioning auditory nerves in the inner ear. The Australian Government has promised a screening program of all babies for deafness from 2011. At present, only 70 percent children who might benefit are picked up early. The earlier deafness is detected, the more effective treatment can be.

Lobby group Deaf Australia says the implant "implies that deaf people are ill or incomplete individuals, are lonely and unhappy, cannot communicate effectively with others and are all desperately searching for a cure for their condition. [This] demeans deaf people, belittles their culture and language and makes no acknowledgment of the diversity of lives deaf people lead, or their many achievements."
Some deaf parents have denied their children cochlear implants. Is this right?

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Why We Need a War on Aging

Based on presentation given at 2009 World Economic Forum in the Live Long and Prosper session, January 28, 2009 by Professor Julian Savulescu.

  1. There is no normal human life span, or if there is, it was very short.

Life-expectancy for the ancient Romans was circa 23 years; today the average life-expectancy in the world is circa 64 years.

For the past 150 years, best-performance life-expectancy (i.e. life-expectancy in the country where it is highest) has increased at a very steady rate of 3 months per year.

  1. Aging is the biggest cause of death and misery in humanity.

100 000 people die per day from age-related causes.  150 000 people die per day in total. Cardiovascular disease (strongly age-related) is emerging as the biggest cause of death in the developing world.

  1. Progress is possible

The goal should be to extend the HEALTHY, PRODUCTIVE lifespan, not to just keep people alive longer on respirators or in old people's homes. This is embodied in the concept not of life span but “health span”.  The easiest way to do this is to prolong healthy life not attempt to compress morbidity

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Stem Cell Trials – Should They Go Ahead? Why Harm to Patients Is Not a Reason to Stop Them

Professor Savulescu comments:

Professor Julian Savulescu is Uehiro Chair in Practical Ethics and Director of the Uehiro Centre for Practical Ethics at Oxford, Director of the Oxford Centre for Neuroethics, and Director of the Program on the Ethics of the New Biosciences. He was also recently awarded a major Arts and Humanities Research Council grant on Cognitive Science and Religious Conflict.


THE FDA has approved for the first time a clinical trial of embryonic stem cells to treat spinal injury patients. The trial will be conducted by Geron. A similar trial by Reneuron has been approved recently in the UK (The Scotsman, and the BBC). The research in the UK to treat stroke patients has already attracted stern criticism from “ethical campaigners.” The first wave predictably objected on the ground that it involved abortion "It involves cannibalising an unborn child.” But no child was aborted for the purposes of providing stem cells. These would have involved abortions that would anyway have occurred for a variety of reasons. Such opponents predictably object to anything involving destruction of embryos and fetuses – abortion, IVF, prenatal testing, contraception – so it is hardly surprising that they would object to this form of medical treatment.

The second wave of ethical campaigners, not clearly distinct from the first, claim now that the treatment is too risky. But is it too risky?

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The Future of Making Organs for Self-Transplantation

Scientists have been able to create a new windpipe using stem cells. They took a windpipe from a dead patient, removed all the cells, and placed stem cells from a patient onto the remaining scaffolding to create what was in effect a new windpipe, with the patient’s own cells. The patient had an irreparably damaged her windpipe from TB.

The significance of this is that it opens the door to creating whole organs, like kidneys, livers and perhaps even hearts and lungs. This is a radical advance because up until now, stem cells have only really been useful to replace tissue, or bits of the body without a complex organized structure. But this means we could potentially replace any part of the body with a person’s own stem cells. New livers for people with liver failure, new kidneys from those with kidney failure – and because the cells would come from the patient, there would be no rejection. Indeed, this patient has shown no signs of rejection.

Does this raise any ethical issues?

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Preimplantation Genetic Screening: One Step Closer to the Perfect Baby?

Prospective parents will be able to screen embryos for almost any known genetic disease using a revolutionary “universal test” developed by British scientists, led by Prof Alan Handyside 
The £1,500 test, called karyomapping, which should be available as early as next year, will allow couples at risk of passing on gene defects to conceive healthy children using IVF treatment.  The “genetic MoT” will transform the range of inherited disorders that can be detected. Currently only 2% of the 15,000 known genetic conditions can be detected in this way. Not only can it test for muscular dystrophy, cystic fibrosis and Huntington’s disease, but it can be used for testing for the risk of developing heart disease, cancer, diabetes and Alzheimer’s in later life.

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Identifying Sperm Donors, Genetic Privacy and Public Benefit: How to Have Your Cake and Eat It Too

A story in today’s Daily Mail reveals some of the harms experienced by children born to sperm donors. Since 2005, children born to sperm donors have had access to the identity of the man who donated sperm that created them. But prior to that point, donors were not required to disclose their identity. These children are often susceptible to diseases which have a genetic component, like diabetes or bowel cancer, and are unaware that they have such susceptibility. They also sometimes describe a sense of not fitting in with their family, having a different personality and character. Many desperately and vainly seek out their biological fathers.

One problem is that historically, donors gave sperm on the condition of anonymity. Thus they consented believing they would remain anonymous. This was the case in Victoria, Australia, where similar problems have been reported.  The option to remain anonymous was thought to be necessary to ensure a supply of willing donors, and to protect donors from financial and other claims made by their offspring.  But now we place greater value on the genetics of the donor and many children wish to know their biological father and his genes.

So donors have a legitimate interest, based on the conditions of their consent and self interest, in protecting their anonymity. How is this interest to be weighed against the interests in their offspring accessing knowledge about them?

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Abortion is No Place for the Law

Victorian politicians are debating how to reform law on abortion. In Victoria, as in other states, abortion remains a crime. This is inconsistent with what happens. There are nearly 100 000 abortions every year in Australia.

The Victorian government will decide between 2 Models. According to Model B, abortion will be available on request until 24 weeks of pregnancy, but after that point 2 doctors must agree that it is indicated. Doctors who fail to comply with the law would receive professional and other sanctions. On Model C, abortion is available on request all through pregnancy. Premier Brumby and a majority of politicians support Model B.

Why is the imposition of sanctions on doctors who provide abortions so attractive? Firstly, abortion is an undesirable means of birth control. Most people would prefer to find other ways of not having unwanted children. Secondly, many people believe that as the fetus grows, and looks more like a baby, its moral status increases. After 24 weeks, some fetuses are even capable of living in intensive care units, outside the womb, as extremely premature newborns.

Despite its superficial attractiveness, Model B is deeply morally flawed. According to Model B, the moral status of the fetus, and whether it is kept alive or aborted, depends on the judgement of 2 doctors. Their decisions will usually be based on whether there is a disease or disability present. But this implies that fetuses with disabilities have less of a right to life than those which do not have disabilities. This is discrimination against the disabled and those with diseases. We would not allow 2 doctors to kill a child just because it had spina bifida. Why would we think the presence of spina bifida should change the moral standing of a fetus? Doctors can withdraw medical treatment leading to the deaths of their patients, but only when the patient’s life is no longer worth living. This is not the case in virtually all abortions.

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How to Improve on Bolt’s Performance

You might think after Usain Bolt’s almost superhuman performances in the 100 and 200 m that the war on doping has been won. However winning one battle is not winning the war. As the example of Lyudmila Blonska shows, doping is still occurring. It is almost certain that there are other medals and world records that were achieved by athletes who were doping but were not caught. The sophistication  of the technology means that just because we are picking up fewer positive tests, it does not mean that there are fewer athletes doping

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How to Win the War on Drugs in Sport

Drug scandals again tarnish the Tour de France. Last week three riders, Spaniards Manuel Beltrain and Moises Duenas and Italian climber Riccardo Ricco, winner of two mountain stages, failed tests for the banned performance enhancer EPO. This year has seen fewer spectacular expulsions, but of course the game is not over.

Does this mean the drug testers are winning the war on drugs? It might. But it might also mean that cyclists and their doctors are getting better at evading testing. A recent BBC investigation supports the latter conclusion. WADA labs have been proven to fail to pick up positive results. There are 80 copy-cat drugs, produced in China, India and Cuba, which are difficult to detect. And labs apparently collude with doctors to “exchange knowledge” on testing procedures. Expert Professor Bengt Saltin, a leading anti-doping expert and a former winner of the IOC Olympic Prize, the highest honour in sports science, said

"I would think that most of the medal winners and many in the finals of endurance events – there is a big risk for them having used EPO."

So despite the numbers of athletes being prosecuted for EPO declining by two-thirds between 2003 and 2006, Professor Saltin concluded this was due to evasion, not a reduction in use.

"The reason that I am still a little bit upset with the whole situation is that I have seen too many suspicious samples that are clearly abnormal. Athletes are getting away with it. Look how many have been caught for EPO misuse recently."

The response is predictable: widen testing critieria. Experts have suggested that urine samples should be tested for any evidence of naturally produced EPO. If there is none, it should be classed as suspicious because the use of artificial EPO for doping causes the body’s own production to shut down. These experts also call for testing of blood profiles as well as the urine. An analysis of the number of young red blood cells can also indicate doping.

Is this a solution? No. It will simply escalate the war to the next level. History has proven the ability of athletes and their doctors to ingeniously evade detection. We will never win the war on doping.

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