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Medical ethics

Rick Santorum, birth control, and “playing God”

By Brian Earp

See Brian’s most recent previous post by clicking here.

See all of Brian’s previous posts by clicking here.

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Rick Santorum, birth control, and “playing God”

Rick Santorum thinks that birth control is immoral. Santorum, a former Senator from Pennsylvania, is one of two human beings – if the polls have it right – likeliest to become the Republication nominee for President of the United States this election cycle.

Read More »Rick Santorum, birth control, and “playing God”

Obligatory Ventilation: why Elective Ventilation should not be elective

On the BBC’s Moral Maze this evening, the question of elective ventilation was discussed at some length. (For those who missed it, the program is still available here). There were several striking features of that discussion, but one argument that stood out was the argument against elective ventilation based on the importance of respecting the autonomy of patients, and the absence of consent, This has been the basis of previous ethical concerns about Elective Ventilation.

But actually, it seems to me that the consent/autonomy argument is completely upside down.* Patient autonomy provides one of the strongest arguments in favour of elective ventilation. So strong, in fact, that the proposed form of Elective Ventilation should arguably not be ‘elective’. It is morally obligatory that we embrace Elective Ventilation.Read More »Obligatory Ventilation: why Elective Ventilation should not be elective

10-year-old gets a tattoo, mother gets arrested

By Brian Earp

Follow Brian on Twitter by clicking here.

See Brian’s most recent prior post on this blog here.

See a list of all of Brian’s previous posts here.

 

Inking arms, piercing ears, and removing foreskins: The inconsistency of parental consent laws in the State of Georgia 

Gaquan Napier watched his older brother die in Acworth, Georgia after being hit by a speeding car. He was with him in those numbing final moments. And now Gaquan wants to keep his brother close to his own heart as he picks up the pieces and moves through life: in the form of a tattoo on his upper arm. Malik (that’s his brother’s name) plus the numbers from Malik’s old basketball jersey. Rest in peace. A memorial to his sibling and best friend, whose life was cut tragically short.

Gaquan is ten years old. So he asked his mother, Chuntera Napier, about the tattoo. She was moved by the request, by the sincerity and maturity of her son’s motivations. She assented. She took Gaquan to have the remembrance he wanted etched into his arm in ink.

Now stop the presses. Chuntera was arrested last week under child cruelty laws and for being party to a crime. Someone at Gaquan’s school had seen his tattoo and tattled to the authorities. But what was the offense?

Read More »10-year-old gets a tattoo, mother gets arrested

Taking drugs to help others

Primaquine is an anti-malarial drug. When taken as a single dose by someone infected with the falciparum malaria parasite, it reduces the risk of transmission to mosquitoes and so to other people. However it confers no direct benefit on the individual who takes the drug. Indeed it poses a net risk, since it has side-effects, including the potential for a severe haemolytic reaction (breakdown of red blood cells) in a certain class of individuals (those with genetic G6PD deficiency).  Nevertheless, primaquine is taken as a single dose by millions of people annually.

Cyproterone acetate (CPA) is a testosterone-blocking drug that has been used to ‘chemically castrate’ certain sexual offenders, including paedophiles. It can’t redirect misplaced sexual desires. But it can attenuate them, thereby reducing recidivism. Again, though, it can have serious side effects for the user, including liver damage and possibly depressive mood changes. Still, more than twenty countries allow the use of CPA in sex-offenders, and several US states have authorised the use of a related agent (MPA).

Primaquine and CPA might appear to have little in common. But ethically, there are some interesting parallels.Read More »Taking drugs to help others

The cost of living and the cost of dying

X, a patient with reliably diagnosed PVS, lies in a hospital bed for years, fed via a nasogastric tube. He has not, and by definition never will have, any capacity for pain, pleasure or any sort of sensation. Devoted family members come each day to sit by his bedside, but he has no idea that they are devoted, or that they exist.
It is expensive to keep him alive. He occupies a bed and consumes a good deal of nursing time.
The NHS Trust responsible for his care has a limited budget. It decides that the money spent on maintaining his merely biological life would be better spent on dialysis machines. It can, and does, justify its decision in purely utilitarian terms. It writes in the minutes of the relevant committee meeting: ‘For the money we spend keeping X alive, we can save the lives of 10 kidney patients, each of whom will have a good quality of life for many years. The QALY arithmetic makes X’s continued existence nonsensical.’Read More »The cost of living and the cost of dying

The moral case for elective caesarean section

Should a father dive into a flowing stream to aid his daughter, struggling to keep her head above water? Should a mother donate a kidney to her child with renal failure? Is it ethical for a parent to work two or three jobs so that they can pay private health insurance or school fees for their children? In all of these situations most of us would think that it is commendable for a parent to take these actions. We applaud and approve of a parent who decides to take on some personal risk, who sacrifices his or her own wellbeing and health in order to prevent a risk of serious harm to their child. It is one of the duties of a parent to do whatever they reasonably can to avoid risks  and secure benefits to their children. How morally important it is for parents to make these sacrifices depends on the balance between the risks to the child and those to the parent. But it is appropriate for a parent to give greater weight to the risks to their child than to themselves. Indeed we might well be critical of a parent who failed to do so.

What then, of a mother who decides to undergo abdominal surgery in order to reduce the risk of her child suffering brain injury, or being admitted to intensive care? Shouldn’t we also applaud this decision?Read More »The moral case for elective caesarean section

Are Dopers better Sports(wo-)men?

by Roman Gaehwiler The crusade against artificial performance enhancement in sports is varicoloured and almost exhaustively debated. Nevertheless, there are still several approaches from the athlete’s perspective which are worth to consider. On the one hand, there is the noble and doubtlessly essential pedagogic approach fostering the educative aspect implying that the misapplication of pharmaceuticals… Read More »Are Dopers better Sports(wo-)men?

Is a child a blessing?

By Charles Foster

Three years ago Ana Mejia bore a son, Bryan Santana. To her surprise he had no arms and only one leg. I should have been warned about this, she recently told a Florida court. It was negligent not to warn me. Had I been warned, I would have had an abortion. She asked the court for $9 million compensation. The jury gave her $4.5 million.

The disability rights lobby is predictably outraged. Why, they say, should it be presumed (as it clearly is), that a disabled person’s life isn’t worth living?

If that is Ana Mejia’s presumption, then (at least in relation to a child as relatively mildly disabled as Bryan) it is plainly reprehensible. I don’t know her motivation, but I doubt that she saw it that way. Many parents in her situation (and this is a very common issue in medico-legal practice) don’t make their decisions on the basis of their child’s quality of life at all. A much commoner thought is: ‘A disabled child will disrupt my own life. One of the purposes of pre-natal screening is to enable me to decline to bring into the world a child who does not fit with my ideas about how I should be living my life.’ I will call this thought the ‘pre-natal screening default thought’ (PNSD).Read More »Is a child a blessing?

Why Pro-Life Counsellors Ought to Lie

Those who are pro-choice often get frustrated by anti-abortion advocates, who are seen as using underhanded and immoral tactics to decrease numbers of abortions. These include presenting misleading information about abortions at their advice centres.
For example, it is claimed that some abortion counsellors show pictures of late-stage abortions when discussing early-stage abortions, exaggerate the trauma felt by people who have had abortions and assert that foetuses feel pain earlier than scientists believe they do. A large part of the opposition to the amendment proposed by Nadine Dorries , which would have prevented bodies which carry out abortions from counselling women, was that this might mean that more women would be counselled by anti-abortion groups who cannot be trusted to provide accurate information about abortion. I’m going to suggest that it is a mistake to think that anti-abortion advisors are failing morally by providing misleading information about abortions. Indeed, they might be failing morally if they did not do so.Read More »Why Pro-Life Counsellors Ought to Lie