Julian Savulescu

Essendon, Doping and Bad Arguments

by Julian Savulescu
June 14, 2014June 14, 2014

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?

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

by Julian Savulescu
May 13, 2014May 13, 2014

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.

Moral Enhancement and Violence

by Julian Savulescu
May 1, 2014May 1, 2014

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.

Trouble Brewing? The Ethical Significance of Synthetic Yeast

by Julian Savulescu
April 3, 2014

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.

Ethics of Editing the Book of Life

by Julian Savulescu
November 9, 2013November 9, 2013

It’s got Nobel Prize written all over it. The scientific innovation, CRISPR, which enables accurate ‘editing’ of DNA (compared to current techniques where a viral vector introduces the DNA at random), has had one team member “jumping out of my skin with excitement”. Still at basic science level, it has already been hailed as a potential new treatment for Huntington’s Disease, HIV and other disorders. It is apparently so easy to use that Professor Mello, who was involved in the project, has said, “a total novice in my lab got it to work”.

One possible application that has been suggested is ‘correcting’ the germline: changing the genetics of sperm, eggs and embryos, to eliminate diseases not just in individuals, but in future generations. The designer baby is in production.

The Tragedy of Moral Mistakes

by Julian Savulescu
October 29, 2013

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.

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

by Julian Savulescu
October 23, 2013

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.

Should athletes be allowed to use performance enhancing drugs?

by Julian Savulescu
October 22, 2013October 18, 2013

Press Release: British Medical Journal Head to Head: Should athletes be allowed to use performance enhancing drugs? Stories about illegal doping in sport are a regular occurrence. On bmj.com today, experts debate whether athletes should be allowed to use performance enhancing drugs. Professor of ethics Julian Savulescu, from the University of Oxford, argues that rather than… Read More »Should athletes be allowed to use performance enhancing drugs?

Electroceuticals and Mind Control

by Julian Savulescu
October 14, 2013

“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.

Ethical Enhancement

by Julian Savulescu
September 20, 2013September 20, 2013

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.