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Medical ethics

Can the religious beliefs of parents justify the nonconsensual cutting of their child’s genitals?

By Brian D. Earp

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 See updated material below – reply to a critic. 

Of faith and circumcision: Can the religious beliefs of parents justify the nonconsensual cutting of their child’s genitals?

Circumcising minors on religious grounds amounts to grievous bodily harm according to a German court ruling issued on Tuesday. AFP News reports:

The regional court in Cologne, western Germany, ruled that the “fundamental right of the child to bodily integrity outweighed the fundamental rights of the parents. The religious freedom of the parents and their right to educate their child would not be unacceptably compromised, if they were obliged to wait until the child could himself decide to be circumcised.”

Some Jewish groups are up in arms. They insist that God has “non-negotiably” required that circumcision take place on precisely the eighth day after birth; hence waiting to perform the operation until the child could consent would amount to breaking this keystone covenant with their deity. Using the force of law to delay circumcision, then, is no different from banning it outright, since a delayed circumcision is religiously meaningless.

I don’t find this argument very compelling.

Read More »Can the religious beliefs of parents justify the nonconsensual cutting of their child’s genitals?

To kill or to violate?

By Charles Foster

A highly intelligent 32 year old woman has profound anorexia. She has had it for years. It is complicated by alcohol and opiate dependency, and by personality disorder. Her BMI is 11.3. A healthy BMI is around 20. Less than 17.7 is in the anorexic range. Less than 14 indicates dangerous weight loss. Over the last 4 years her BMI has been well below 14. She describes her life as ‘pure torment’. All the things she wanted to do have been frustrated by her illness. She feels unable to give anything to the world, or to take anything out. For years she has had intense treatment for her anorexia and related conditions. On about 10 occasions she has been sectioned under the Mental Health Act. One of those periods lasted almost 4 months. Twice she has executed advance decisions refusing life-saving or life-prolonging treatment.
There are only two options: death or the violation of her autonomy . If she is not admitted against her will to hospital, detained there for not less than a year, and forcibly fed under physical or chemical restraint, she will die. She understands this perfectly well. She doesn’t actively seek death, but doesn’t want to be force fed. As well as the anorexic’s usual horror of calories, the forcible medical administration of nutrition reminds her horribly of the sexual abuse she suffered as a child.Read More »To kill or to violate?

Should you take ecstasy to improve your marriage? Not so fast …

Love drugs and science reporting in the media: Setting the record straight 

By Brian D. Earp, Julian Savulescu, and Anders Sandberg

Love. It makes the world go round. It is the reason we have survived as a species. It is the subject of our art, literature, and music—and it is largely the product of chemical reactions within the brain.

No wonder science is starting to unravel the ways in which we can influence it, and perhaps even control it.

Just as Darwin’s finding that we are descended from apes shocked people in the nineteenth century, so people will be shocked to find that our most lofty social ideal is something we share with our mammalian cousins and which is the subject of scientific scrutiny and even chemistry-book manipulation.

In 2008, two of us (Julian Savulescu and Anders Sandberg) published an article in the journal Neuroethics on the topic of “love drugs” – a term we use to refer to pharmacological interventions based on existing and future bio-technologies that could work to strengthen the bond between romantic partners. All three of us have an article just published in the journal Philosophy & Technology in which we build upon that earlier work. Interested readers will take the time to study those papers in full, but we have a feeling that much of the population will stop at a handful of media reports that have recently summarized our ideas, including at least one article that we think has the potential to mislead. Let us set the record straight.

Read More »Should you take ecstasy to improve your marriage? Not so fast …

Bad seed is a robbery of the worst kind: prolific sperm donation and screening

New York Times writes about “In Choosing a Sperm Donor, a Roll of the Genetic Dice”: recipients of sperm donation have found out the hard way that there is a risk of genetic disease affecting their children. In at least one case a donor with a clean bill of health and who had, according to the laboratory, been tested for genetic conditions. Unfortunately he turned out to be a carrier for cystic fibrosis like the mother, and the child suffered. Other cases of transmission of genetic conditions to multiple children from a single donor have appeared, suggesting a need to do something. Is there an ethical need for ensuring genetic testing in the case of sperm donation – or is the problem that some donors father many children?

Read More »Bad seed is a robbery of the worst kind: prolific sperm donation and screening

Is Darwinian Medicine Good for Us?

 The New Scientist has recently interviewed Dr Paul Turke, paediatrician and advocate of ‘Darwinian Medicine’: http://www.newscientist.com/article/mg21428600.300-hold-the-painkillers-says-darwinian-paediatrician.html. Dr Turke is working on a book expounding his views, with the working title Bringing Up Baby: A Darwinian View of Pediatrics. It is unfair to form a settled judgment of Dr Turke’s views before he has had a chance to develop them fully in his book. Nevertheless, I think it is worth making a few comments now, as Dr Turke is not the only advocate of Darwinian medicine and his interview raises a cluster of interesting issues.

One good point that Turke makes is that there is benefit to be had by considering the possible evolutionary functions of our bodies’ responses to injuries and infections. Experiencing a fever is unpleasant, but it seems to be part of our bodies’ preparation to fight certain forms of infection. As such, the propensity to experience fever may well be an evolutionary adaptation that we have acquired because of its contribution to our survival. Similarly, the swelling and pain that we experience when we twist a joint looks like an evolutionary adaptation to prevent us from using that joint and so promote healing and ultimately, long term survival. It surely helps medical practice to understand how and why particular bodily responses evolved, as this helps us to better understand what their functions are.

 Read More »Is Darwinian Medicine Good for Us?

Psychiatric drugs to enhance conformity to religious norms, and conscientious objection

An article in the Israeli newspaper Haaretz reports on the (alleged) frequent use of psychiatric drugs within the Haredi community, at the request of the religious leaders, in order to help members conform with religious norms. Haredi Judaism is the most conservative form of Orthodox Judaism. It is sometimes referred to by outsiders as ultra-Orthodox. Haredim typically live in communities that have limited contact with the outside world. Their lives revolve around Torah study, prayer and family.

In December 2011, the Israel Psychiatric Association held a symposium entitled “The Haredi Community as a Consumer of Mental-Health Services”.  One of the speakers was Professor Omer Bonne, director of the psychiatry department at Hadassah University Hospital. Professor Bonne is claimed to have said that sometimes yeshiva students (yeshiva is a religious school) and married men should be given antidepressants even if they do not suffer from depression, because these drugs also suppress sex drive.

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Nudge Drugs: should the social side-effects of medications weigh into public health?

You are a public health official responsible for the purchasing of medications for the hospitals within your catchment area in the NHS. Your policies significantly affect which, out of the serpentine lists of heart disease medications, for example, are available to your patients. Today, you must choose between purchasing one of three heart disease medications: Drug A, Drug B, and Drug C. They are pretty similar in efficacy, and all three have been being used for many years. Drug B is slightly less expensive than Drug A and Drug C, but there is emerging evidence that it increases the likelihood that patients will take “bad bets,” i.e. make large gambles when the chance of winning is low (and thus might contribute to large social costs). Drug C costs a tiny bit more than Drug A, but there is some evidence that Drug C may help decrease implicit racial bias. You have been briefed on the research suggesting that implicit racial bias can lead to people making choices that consistently and unintentionally limit the opportunities of certain groups, even when all the involved parties show explicit commitments to social equality.  Finally, there is emerging evidence that drug A both helps people abstain from alcohol and dissociates negative emotional content from memories.

Which drug should you purchase?

 

Let us begin to think about this question through the lens of the idea of the “Nudge,” which has exploded onto the public sphere (and blogosphere) since Thaler and Sunstein’s published their book, “Nudge: improving decisions about health, wealth, and happiness.”   (see the blog here). I briefly and incompletely introduce nudges here, in hopes that we may soon move on to discuss the kind of “nudge drugs” our thought experiment considers.

Read More »Nudge Drugs: should the social side-effects of medications weigh into public health?

Should the government have policies to deal with fear of zombies?

Would you vote to be protected from him?

From the always sublime Dara O’Briain:

I give out when people talk about crime going up, but the numbers are definitely down. And if you go, “The numbers are down”, they go, “Ahh, but the fear of crime is rising.” Well, so fucking what? Zombies are at an all-time low level, but the fear of zombies could be incredibly high. It doesn’t mean you have to have government policies to deal with the fear of zombies.

But let’s look at this in more detail. If there was a large demand for it, should the government have policies to deal with the fear of zombies? By zombies, we do mean non-existent flesh-eating fictional undead monstrosities that don’t exist.

Read More »Should the government have policies to deal with fear of zombies?

Moormann

Arbitrary Execution: Why the Law Needs Help from Neuroscience, Psychology and Philosophy

On February 29th, 2012, Robert Henry Moormann was executed in Arizona for murder. Back in 1984, he was in prison for kidnapping and molesting an eight year old girl, when the state gave him three days of compassionate leave. His elderly adoptive mother took a long bus trip to go and meet him. After an argument in a motel room where she was staying, he beat, stabbed and suffocated her, then dismembered her body. He asked a number of local businesses if he could dispose of “spoiled meat and animal guts” in their refuse containers, before disposing of most of her remains in bins and sewers around town. He also asked a prisoner officer to dispose of a box of what he described as “dog bones”. This behaviour raised suspicion. Moormann claimed not to remember the details of the crime, and at the original trial, Moormann’s lawyers mounted a defence of insanity. The jury rejected it. Since 1985, he had been living on death row while his appeals process was gradually exhausted.

In light of the gruesomeness of his crime, it is easy to think that if anyone ever deserved the death penalty, Moormann did. But the contention of Moormann’s defence lawyers that he was intellectually disabled casts a new light on the case.

Read More »Arbitrary Execution: Why the Law Needs Help from Neuroscience, Psychology and Philosophy

Is it OK to have an affair if your partner is asexual?

I am desperate to start a sexual relationship with an old acquaintance but his wife, who has no interest in sex, would be appalled if she knew. Does that matter?

I read this in the Guardian’s ‘Life & Style’ section. Every week, a reader can present a dilemma she/he is faced with in her/his ‘private’ life and ask other readers for advice.

The full story goes like this:

I recently reconnected with an old classmate from my teens, and we fell in love almost immediately. We are in our early 50s and both in long marriages to good people whom we love. Leaving our spouses is not an option [….] Despite our desire for each other and the fact that his wife and my husband may be asexual, my friend and I have not slept with each other. My husband has given me permission to have a lover, but my friend’s wife would be appalled if he asked for the same set-up. Shouldn’t someone with no interest in sex and minimal romantic attachment to their spouse (they are like roommates) allow that spouse to fulfil her or his needs for stimulation and affection (discreetly) elsewhere without calling it “cheating”? My friend and I are moral people, but life is short.

Some of the readers’ replies are:

Whose word do we have for it that his wife is asexual?…Oh, only his… What a surprise.

Of course it is ok!  Go and fuck with everyone in sight and don’t bother! 🙂

Fortunately, other replies are more sophisticated. Most people seem to acknowledge the dilemma is real. None of the proposed options are ideal. For example, those who suggest asexual married couples should never have extramarital sexual relationships at the same time acknowledge that this solution is not ideal as sexual frustration may build up and may have devastating effects on the marriage. Those who suggest the individuals who are attracted to each other (henceforth ‘sexual’ individuals) should be honest about it to their partners, and that the ‘affair’ (consented to by all parties concerned) may be justified,  realise this will make their ‘asexual’ partners unhappy, with potentially devastating effects for both marriages. Perhaps some will find it obvious that one of these alternatives is better than the other, but surely we must except that whichever option one chooses, there is some harm, or risk of harm.

Could what Savulescu and Sandberg, in their 2008 paper, have called ‘love drugs’  help resolve the dilemma?

Read More »Is it OK to have an affair if your partner is asexual?