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Bioethics

When you prick me do I not cry?

A fascinating study in the Lancet this week has suggested that a very commonly used and simple analgesic in newborn infants may not actually be preventing them from experiencing pain. The study’s authors suggest that this medicine should no longer be used routinely in newborn infants. A headline in the Guardian reads “Newborn babies should not be given sugar as pain relief”. But there are scientific, philosophical and ethical reasons why this conclusion, though possibly correct, is premature.

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Enhancement – Keep the Game, Change the Basis

Paradoxically, elite sports is largely about seeking for inequality, but simultaneously trying to level the playing field in order to equalize the opponents. So, how is it possible to cultivate inequality through equality? Anti-doping activists argue that enhancing substances falsify the individual and naturally given capability to perform in a competition. As a result, there might be a lack of equal opportunities. In contrast, enhancement advocates underline that doping might be able to level the playing field by removing the effects of genetic inequality, and therefore provides equality.[1] In fact, both arguments imply the noble aspiration of equality. So then, equality must be the ultimate aim.

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Should doctors come clean? Religion makes a difference to end-of-life decisions

In a paper released today in the Journal of Medical Ethics, a large survey of UK doctors found that doctors’ religion influenced their views and practice of end-of-life care. Why does this matter? A number of headlines highlighted that atheist or agnostic doctors were more likely to report having participated in “ethically contentious end-of life actions”: ie taking part in terminal sedation or in actions that they expected or partly intended would hasten the patient’s death. But other headlines emphasised the obvious flip-side: doctors who identified themselves as ‘very religious’ or ‘extremely religious’ were about 35% less likely than non-religious doctors to report having taken this sort of step.

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Cosmetic Surgery – What is the Matter with Dr Salesman?

Written by Roman Gaehwiler

Reconstructive plastic surgery to correct ravages of disease and injuries as well as gross physical abnormalities constitutes a core medical practice. Reconstructive procedures, however, lie along a continuum, without any clear boundary between therapeutic reconstructive surgery for diagnosable problem and purely cosmetic surgery.[1]

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Is it criminal not to breastfeed?

by Rebecca Roache

The Brazilian
model Gisele Bundchen recently—and controversially—claimed that mothers should
be required by law to breastfeed their babies for the first six months of their
lives. 
A few days later, she partially retracted the claim on her blog, insisting that her talk of a breastfeeding law should
not be taken literally.  It was simply a way of expressing her belief in the
importance of doing the best for her child. 
After all, legally enforcing breastfeeding would be madness, right?

Not
according to the Indonesian government. 
It recently passed a law giving babies the right to six months of
exclusive breastfeeding,
except in cases where medical problems prevent their mothers from breastfeeding.  Mothers who do not comply face a year in
prison or a fine of 100,000,000 Rupiahs (around £7,100), and those who prevent
mothers from fulfilling their breastfeeding obligations also face punishments.  Scientists and health professionals generally
agree that breastfeeding is healthier for babies than the alternatives (see,
for example, here),
that not enough mothers do it (see here),
and governments around the world invest huge sums trying to get mothers to
breastfeed.  But is criminalising non-breastfeeding mothers a good idea?

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Demedicalising and decriminalising drugs

Is drug addiction a disease? Substance Dependence appears as a diagnosis in the influential Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV). There are medical specialists in the field who use a range of different drug and non-drug treatments for patients who are addicted. There are hospitals and clinics where those who are addicted can seek help. But if it is a disease why is it treated as a crime? After all we do not lock people up because they have cancer, or hepatitis, or heart disease.

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The ethics of prescribing antibiotics

Antibiotics are overprescribed. That is, they are given out in many cases where they will achieve little or nothing for the patient. On its own, this would merely be wasteful, but usage of antibiotics increases the development of antibiotic resistant organisms and this is bad for everyone. Today's Guardian has an article suggesting that antibiotic resistance could become a *very* big problem, with all major antibiotics becoming ineffective within a couple of generations (see also the original research in the Lancet). This leads to some very interesting questions concerning the ethics of prescribing antibiotics.

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Competing against Mutants

Introduction

In a recently broadcasted documentation about gene-doping, multiple award winning Swiss science journalist and author, Beat Glogger, reflected the issue of gene-doping in a sensitive and objective manner. In this Swiss-German co-production Andy Miah, a bold British Bioethicist, argued that gene-doping is supposed to be a natural friendly method of performance enhancement, whereas many other practices in the past weren’t. Simultaneously, he considered athletes no more as natural creatures by arguing: “We have to get rid of the imagination, that athletes are natural human-beings” (freely re-translated from the German version). Despite the fact that this statement is rather an anti-thesis than a substantiation for his strident position, I have to admit that the current development in gene technology tends to construct a sort of athletic hybrid. No doubt, this is a serious future issue we have to face. Nevertheless, Andy Miah’s declaration implies that athletes might kind take on a pioneer role regarding the subject of genetic enhancement. Therefore, is that an issue worth considering or even to achieving?

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Ethicists unite: you have nothing to lose but your non-citation

Yesterday Richard Ashcroft, Professor of Bioethics at Queen Mary College, London, wrote in a Facebook update: ‘I am fed up with being asked to come into science/medicine projects, add a bit of ethics fairy dust, usually without getting any share of the pie, just to shut reviewers up. I am not doing it any more. If they think we are important, treat us with respect. Otherwise, get lost.’

Lots of people liked this. So do I. Ethicists have for too long been the invisible but essential backroom boys and girls of biomedicine; patronised by the practitioners of ‘hard’ science; seen as unimaginative but powerful bureaucrats who have to be kept sweet; as despised social scientists who wield rubber stamps made essential by other zeitgeist-dictating social scientists who want to keep their woolly-headed chums in a job; as factotums who don’t deserve to have their names on the papers any more than the temp who does the photocopying. Why is this? 

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