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Is the non-therapeutic circumcision of infant boys morally permissible?

On the ethics of non-therapeutic circumcision of minors, with a pre-script on the law

By Brian D. Earp (Follow Brian on Twitter by clicking here.)

PRE-SCRIPT AS OF 25 SEPTEMBER 2012: The following blog post includes material from an informal article I wrote many years ago, in high school, in fact, for a college essay competition. I would like to think that my views have gained some nuance since that time, and indeed with increasing speed, as I have researched the topic in more detail over the past several months–specifically during the period of a little over a year since the blog post first appeared online. Since quite a few (truthfully: many thousands of) people have come across my writings in this area, and since I am now being asked to speak about circumcision ethics in more formal academic company, I feel it is necessary to bring up some of the ways in which my thinking has evolved over those many months.

The most significant evolution is away from my original emphasis on banning circumcision. I do maintain that it is morally wrong to remove healthy tissue from another person’s genitals without first asking for, and then actually receiving, that person’s informed permission; but I also recognize that bringing in the heavy hand of the law to stamp out morally problematic practices is not always the best idea. It is a long road indeed from getting one’s ethical principles in order, to determining which social and legal changes might most sensibly and effectively bring about the outcome one hopes for, with minimal collateral damage incurred along the way. Until enough hearts and minds are shifted on this issue, any strong-armed ban would be a mistake.

In the long term, however, I think the goal remains: that each child should have the same moral, legal, and policy protections regardless of sex or gender, designed to preserve their sexual anatomy in their healthy, intact form until such time as they are mentally competent to make a decision about altering them, surgically or otherwise.

The project for the meantime is to work on hearts and minds.

I am grateful to the many hundreds of individuals who have left thoughtful comments on my sequence of posts on the ethics of circumcision, and I look forward to developing my arguments in ever more sophisticated ways in the coming months and years as this important debate continues. I am especially grateful to those of my interlocutors who have disagreed with me on various points, but who have done so in a thoughtful and productive manner. May we all aim at mutual understanding, so that the best arguments may emerge from both sides, and so that the underlying points of genuine disagreement may be most clearly identified. — B.D.E.

* * *

Routine neonatal circumcision in boys is unethical, unnecessary, and should be made illegal in the United States. Or so I argue in this post.

Yet lawmakers in California, it is now being reported, have introduced a bill with the opposite end in mind. They wish to ban legislation that could forbid circumcision-without-consent. What could be going on?

Read More »Is the non-therapeutic circumcision of infant boys morally permissible?

“Focus Pocus” and Beyond: consumer brain computer interfaces for health, self-improvement and fun

 In September 2011 ,the most advanced computer game to use a consumer brain computer interface (BCI) will go on sale. Its name is Focus Pocus (see video trailer here, its awesome) and it is aimed at children with ADHD so that they might use gamification to train their brains to improve focus and impulse control.

Use your brain to battle an evil necromancer!

The game is based on neurofeedback enabled by the use of the Neurosky dry-electrode EEG (Electro-EncephaloGram) headset, which anyone can purchase for under $100 (or 100 Euros if in Europe)  Earlier this week, BBC2 did a special on the headset. The basic Idea is that the single electrode on the Neurosky headset (placed on the forehead) is able to pick up a few simple and characteristic brainwaves (created by activity in populations of neurons), some that have been shown to be enriched when the subject is awake and attentive (ex. Beta-waves), and some when the subject is relaxed (ex. alpha waves). Neurosky has developed algorithms to funnel these and other brain waves into measures of “focus” and “meditation.” Look here for more details on how it works.

Read More »“Focus Pocus” and Beyond: consumer brain computer interfaces for health, self-improvement and fun

Considering the Instrumentalization and Exploitation of Elite Athletes

Why did Wladimir Klitschko and David Haye not wear helmets during their boxing fight a few weeks ago? Actually, they do tend to wear them during training, but obviously not when an official boxing match takes place. Why not? Presumably, it is because wearing helmets could foster tactical fights and finally turn them into unspectacular victories won on points. Instead of impressive knock outs, swaying hulks and eye-rolling fighting-machines, an audience would have to content itself with scampering human rocks and rare surprise effects. From another perspective, boosting knock outs (or not wearing helmets) could even be seen as a degrading or even a humiliating act against an athlete’s integrity.

What is the point of being a doctor when conscience overrules professional duties?

A new study recently published on the Journal of Medical Ethics and  reported by the newspapers explored the attitude towards conscientious objection of 733 medical students from four different UK medical schools (Cardiff University, King’s college London, Leeds University and St George’s University of London).The results of this survey are interesting and deserve to be introduced in details.When the students were asked if doctors should be entitled to object to any procedure for which they have a moral, cultural or religious disagreement, the 45.2% agreed doctors should be entitled to make conscientious objection, the 40.6% disagreed and the 14.2% was unsure.

Read More »What is the point of being a doctor when conscience overrules professional duties?

Government encourages traumatic brain injury on city streets?

What happened to governments sending this type of message?
Traumatic Brain Injury

I was just in LA. I was surprised and pleased when a good friend of mine mentioned this brilliant new transportation scheme the city had developed. Basically, with sponsorship from a few businesses the city had placed hundreds of electric cars at street-side parking-spots (where the car batteries recharged) throughout the most frequented neighborhoods. The idea was that anyone (tourist or city-dweller) could rent the electric car by the half-hour, paying by card at a nearby pay station. Then the renter could bring the electric car back to any of the city parking spots by the set time. What was even more convenient was that city-dwellers could get an “LA-Car Card” by paying a nominal fee that would allow them to take out electric cars for up to a half hour at a time for free! Environmental AND convenient! So of course I went straight to the nearest electric car parking-spot, paid the fee, and was soon zooming about the streets of LA. I had never driven an electric car before, so it felt a bit odd, but I was so excited by the new car scheme that I didn’t let it bother me. Everything was grand until a reckless driver ran a red light in front of me and nearly took me off the road. Thankfully it was only nearly. But with that close-call, I realized that the reason the car had felt a bit odd is that the car had NO SEATBELTS! That’s right: no seatbelts. What would have happened if I had been in a car accident?

These electric cars were environmentally friendly, yes. Super-convenient, yes. But wasn’t it irresponsible for the city to encourage needless risk-taking (and traumatic brain injury) by providing this transport without the most basic safety feature?? For worried as I was about my safety in not having a seat-belt (and I would never drive my own car without my seat-belt), I found myself renting and driving the cars for the rest of my stay just because they were so darn convenient. I oscillated between decrying the city’s irresponsible behavior and applauding their creation of such a convenient scheme. Which was the proper stance? And was there a rational reason why these cars did not have seat-belts??

Read More »Government encourages traumatic brain injury on city streets?

“The Madness of Normality” – On why the DMS-5 is fundamentally wrong

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the world widely recognized classificatory system of psychiatric disorders, published by the American Psychiatric Association (APA). It is currently under major revision; the release version DSM-5 is expected in May 2013. The “psychiatrist´s bible“ has overwhelming impact: Inclusion in the DSM carries weight far beyond the psychiatrist’s office. It has major influence on whether insurers will cover therapy for a condition, whether research will be pursued for a specific disease or whether the health technology assessment agencies will approve medications that can be marketed for it.

Many interesting issues in DSM-5 could be discussed: the prevailing categories “substance abuse” and “dependence” will be substituted by “addiction and related disorders”, gender and ethnicity specific distinctions will we introduced and instead of distinguishing different entities like “Autistic disorder” or “Asperger´s disorder”, the manual introduces the term “Autism spectrum disorder”.

In this blog post, I want to focus on one particular innovation: The introduction of so-called risk syndromes. This is a collective term for all those conditions, which do not “yet” meet the “full” clinical diagnostic criteria, e.g. for schizophrenia: In this case, you would suffer from the “attenuated psychotic syndrome”. The aim is obvious: “Young people at risk for later manifestation of a psychotic disorder can be identified“. (http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=412#). This is a clear paradigm shift towards early diagnosis and prediction in psychiatry. Is this shift ethically justified?

Read More »“The Madness of Normality” – On why the DMS-5 is fundamentally wrong

Shocking behavior: Government scare tactics, smoking, and public health

Coming to a mini-mart near you. The FDA has just approved nine very grisly looking warning labels—to be slapped on cigarette packs throughout the USA. But will they work to cut smoking … or will they backfire?

Here are some of the top reasons why these labels may not only fail to achieve the FDA’s desired outcome, but could actually do the opposite – leading to more smoking, not less.Read More »Shocking behavior: Government scare tactics, smoking, and public health

Uterine transplants: applaud, and then shut up

By Charles Foster

It was reported this week that 56 year old Eva Ottosson is planning to give her 25 year old daughter, Sara, the uterus in which Sara herself gestated. Sara suffers from Mayer Rokitanksy Kustner Hauser Syndrome: she was born without a uterus.

Predictably the newspapers loved it. And, equally predictably, clever people from the world’s great universities queued up to be eloquently wise about the ethics of the proposal.

But if ethics are concerned with what we should do, there was really nothing worthwhile to be said about Eva Ottosson’s altruism (bar the usual uninteresting caveats about dangerousness and resource allocation), except: ‘Fantastic’.Read More »Uterine transplants: applaud, and then shut up

Excitement vs Importance: Do we have any sense of proportion?

When I was choosing a topic to write about today, I almost passed over a story on the grounds of it being too boring. It was about a large corporate donation of vaccines for developing countries — much less exciting than some other stories, such as the outbreak of killer bacteria in Germany. But then I realised that as stories go, the vaccine donation was *very* important. It also raised some very interesting questions about ‘important news’ versus ‘exciting news’.Read More »Excitement vs Importance: Do we have any sense of proportion?

Should we be able to know how long we have to live?

A new test, soon to become available to the general public in the UK, can tell people how fast they are aging, thereby allowing them to estimate their life expectancy. The test, which should be available for €500 (£435), is based on an analysis of the telomeres, small protective caps at the extremities of a person’s chromosomes. Short telomeres are associated with a shorter lifespan and indicate a more advanced biological age (by contrast with the person’s chronological age). The test has been described as opening an “ethical Pandora’s box”. Concerns have been raised regarding people’s possible reaction to information about how long they still have to live. Some are also worried that the test might be used by organizations selling dubious “anti-aging” remedies to attract potential customers, and that insurance companies might demand to have access to such information before providing cover, requiring people with shorter telomeres to pay higher premiums. Should the prospect of the public availability of such a test concern us, and should we try and restrict it?

Read More »Should we be able to know how long we have to live?