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Julian Savulescu’s Posts

Should We Be Erasing Memories?

By S. Matthew Liao, Anders Sandberg, and Julian Savulescu

Scientists from the Medical College of Georgia in the US recently claimed to be able selectively to wipe out traumatic memories. These scientists experimented with mice and found that a particular protein plays a crucial role in the formation of memories. When they made the mice produce an excess of this protein, memories of painful events were completely eliminated.  Such research raises hope for treating conditions such as post-traumatic stress disorder (PTSD), in which painful memories become intrusive and damage an individual’s ability to live an ordinary life.  In theory, such memories could either have their emotional strength reduced or be blotted out altogether. In practice we are still some distance away from being able to achieve this, but it does not seem unreasonable to think that within the next decade we will be able to control the erasing of memory.

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Death Fiction and Taking Organs from the Living

By Julian Savulescu and Dominic Wilkinson

Imagine you could save 6 lives with a drop of your blood. Would you have a moral obligation to donate a drop of blood to save six people’s lives? It seems that if any sort of moral obligation exists, you have a moral obligation to save six lives with just a pinprick of your blood.

But every day people do far worse than failing to give a drop of blood to save 6 lives. They choose to bury or burn their organs after their death, rather than save 6 lives with these organs. And it would cost them nothing to give those organs after their death. Our failure to give our organs to those who need them is among the greatest moral failures of our lives. At zero cost to themselves, not even having to endure a pinprick, many people choose to destroy their lifesaving organs after their death.

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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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Sport, Sudden Cardiac Death and Liberty

Sport, like life, is dangerous. Several fit young footballers have died of sudden unexpected heart attacks. Doctors are now calling for mandatory testing using ECGs of all athletes. Italy has been pursuing mandatory testing for 25 years. This has revealed over 5% have some abnormality. Some people have congenital heart rhythm abnormalities which place them at high risk of sudden heart attack during or after sport. The call for mandatory testing is a sensible one. The interesting question is what is to be done with the results.

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“Reanimation” and Taking Organs from Living People

One of the greatest fears associated with organ transplantation is that the person from whom organs are taken is not really dead.

That nightmare was almost realised in France last week when a French patient “came back to life” after 30 minutes of unsuccessfully heart massage. In 2007, in order to address the shortage of organs for transplantation, French authorities allowed the trial of using people whose hearts have stopped beating, but who have not met brain death criteria for being dead, as organ donors. These are called Non-Heart Beating Donors. Organs can also be taken from such donors in the UK. Such patients’ hearts have stopped beating but they have not met brainstem criteria for death.

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Setting a Minimum Price for the Sale of Organs

Professor Maqsood Noorani, a leading surgeon made the headlines asking for legalisation of the sale of organs to prevent the exploitation that exists in the black market. Yet his comments show that he is uneasy with the concept of a market in organs. He believes that the sale of organs in richer nations would ‘tarnish the process’, and suggests that even in poorer countries accommodation or education should be offered in exchange instead of cash. 

When two people want to freely exchange some good or service, we need good reasons in a free market to prevent the exchange. Moreover, when it comes to a market in organs, the good in question is life saving. Why then should we prevent such exchanges when there are willing buyers and sellers?

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