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Suicide for sale in Oregon: a “valuable service”?

Suicide for sale in Oregon: a “valuable service”?

Oregon is currently the scene of a controversy about the sale of so-called “suicide kits” or “helium hoods” (see here and here). These kits are sold by mail by a two-person company called The Gladd Group; one of its owners is reported to be a 91-year-old San Diego County woman who has been selling the kits for four years. The device is now receiving increased media attention following the suicide, with the help of the helium hood kit, of 29-year old Nick Klonoski, who had health-related issues that had brought him into depression, but was not terminally ill. His tragic death has now sparked a movement to outlaw the sale of those kits in Oregon. However, the woman selling the kits protests that she is providing a valuable service, and is quoted as saying that “[i]t is not my intention to hurt anybody, but to offer people comfort when they die”. Is the sale of those suicide kits a legitimate form of business, or should it be banned?

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Should surgeons other than cardiac surgeons publicise performance information?

Mortality rates for common forms of cardiac surgery have been made public in the United Kingdom for several years now. This information is individualised. If you are considering having a particular surgeon perform a common form of cardiac operation on you, you can make a better-informed decision by getting on the internet and finding out how many times that cardiac surgeon has conducted that operation, how many of his or her previous patients have survived such operations and how often they have not survived. You can also find out how your prospective surgeon compares to other surgeons performing similar operations. Although the publicising of cardiac surgeons’ performance information was controversial when it was first introduced, it has attained a broad level of acceptance in areas in which it has been introduced, in large part because this form of transparency has been effective in reducing mortality (see Justin Oakley and Steve Clarke ‘Surgeon Report Cards’, in Patient Safety First: Responsive Regulation in Health Care, edited by Judith Healy and Paul Dugdale, Sydney, Allen and Unwin, 2009, pp. 221-236). For discussion of a range of ethical issues related to the disclosure of surgeons’ performance information see Informed Consent and Clinician Accountability: the Ethics of Report Cards on Surgeon Performance, edited by Steve Clarke and Justin Oakley, Cambridge, Cambridge University Press, July 2007.

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Catholic bishops condemn France’s first ‘bebe medicament’

Last month, doctors in France announced the arrival of the country’s first so-called ‘saviour sibling’. Born to parents of Turkish origin, Umut Talha (Turkish for ‘our hope’) was conceived through in vitro fertilisation (IVF) using preimplantation genetic diagnosis (PGD). This technique, in conjunction with Human Leukocyte Antigen (HLA) typing, commonly known as ‘tissue-typing’, has enabled families to have a child – a ‘saviour sibling’ – that is capable of donating life-saving tissue (usually umbilical cord material) to an existing sick sibling. Umut’s parents approached the hospital in Clamart a year ago requesting tissue-typing PGD. Their two existing children had beta thalassaemia, an inherited blood disorder that requires monthly blood transfusions.

An embryo was screened and genetically selected from an original group of twelve embryos to ensure that it was both free of the disorder and a tissue match for one of the existing siblings. The resulting saviour sibling, Umut, did not have thalassaemia, and cells from his discarded umbilical cord will be used to cure his older sister, now aged two, and her monthly blood transfusions will be discontinued. Umut’s parents plan to return to Clamart to undergo the same procedure to cure their other child, Umut’s four-year-old brother.  

Saviour sibling selection is nothing new. Read More »Catholic bishops condemn France’s first ‘bebe medicament’

The patient vanishes

by Dominic Wilkinson

If a patient’s family refuse to allow withdrawal of breathing machines should doctors provide long-term support in an intensive care unit for a patient who is clinically brain dead? Should doctors provide heart-lung bypass (ECMO) for a child with anencephaly? Should doctors perform a tracheostomy and provide a long-term breathing machine for a patient in a documented persistent vegetative state?Read More »The patient vanishes

Libya and Moral Responsibility

Much of the ongoing debate about Libya has rested on what I believe to the mistaken philosophical premise that the United States, or any other potential intervening party, becomes more morally responsible for the fate of Libya if it chooses to intervene than if it doesn’t.  Ross Douthat presents the most sophisticated defense in this post.  Most relevant line:

But America’s leaders are not directly responsible for governing any country besides their own, which means that almost by definition, they/we bear less responsibility for tragedies that result from our staying out of foreign conflicts than for tragedies that flow from our attempts at intervention.

Douthat here is equivocating two senses of “responsibility;” the first empirical, and the second philosophical.  It is true that the United States is only “directly responsible” for governing its own citizens in a contingent sense: the only people subject to U.S. law are, well, Americans.  But that brute fact says nothing “by definition” about who to whom the American government is morally responsible.  Douthat’s arguments rest on the foundation that empirical responsibility entails moral responsibility: that if we cause something, we are more morally responsible for it than we would have been otherwise.  But is this position defensible?

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Murder in an English Village

Midsomer Murders is an ITV drama based around English village life: it pulls in millions of viewers and has been running for over a decade.   The co-creator of the series has just been suspended for saying he deliberately kept ethnic minorities out of the series.  “It wouldn’t be an English village with them”.   Cue outrage… Read More »Murder in an English Village

Galliano, Westboro Baptists, and the question of free speech

Despite the protestations of Albert Sydner, the father of a young soldier killed in Iraq, the American Supreme Court has ruled in favour of the Westboro Baptist’s right to picket military funerals. The religious group has demonstrated at 200 funerals, sporting events, and concerts, claiming that the wars in Iraq and Afghanistan are god’s way of punishing America for tolerating homosexuality. Their protests are quiet. There is no personal abuse, no threats of force either, and they operate 1,000 feet from the church in which the funeral takes place, under police supervision. They merely hold signs with offensive messages such as “God Hates You” and “God Hates Fags”. No matter how morally outrageous these messages are, the Court has been clear that the picketing is protected by the First Amendment and, therefore, should be allowed. Samuel Alito was the only judge who dissented in the Supreme Court decision. He argued that a commitment to free speech does not license verbal assault. I found myself sharing Alito’s intuitions and that, considering his conservative and libertarian views, put me in an uncomfortable position. So, I asked myself, why do I oppose the Court’s decision? Another piece of news helped me to think through this issue. While the Westboro Baptists were celebrating the verdict, John Galliano was fired for declaring his admiration for Hitler and he will now be prosecuted. These two cases can be compared in several respects, but I will point to two.Read More »Galliano, Westboro Baptists, and the question of free speech

How to Stop the Medical Killing Spree

According to a recent study, around 350 patients die in Australian hospitals every two weeks. The figure would be expected to be much higher in the UK.

Prof Jeff Richardson, from Monash University, appropriately said, “The issue of adverse events in the Australian health system should dominate all others. However, it would be closer to the truth to describe it as Australia’s best kept secret.”

I have a personal interest in this issue. My father died as a result of a “preventable hospital error.” He was having a routine imaging procedure of his liver and bile ducts and a major artery was hit. The bleeding was not recognised til too late and he bled to death. (The autopsy report claimed he died of a heart attack! The heart eventuyally does stop when there is not enough blood.)

So what is the answer? Current debate is focussed on improving systems. Mandatory reporting of incidents, immunity from prosecution for those who report, etc.

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Does euthanizing animals lead to the devaluing of human life?

Not long ago a study on British veterinarian suicide rates [Bartram, D.J. and Baldwin, D.S., ‘Veterinary surgeons and suicide: influences, opportunities and research directions’, Veterinary Record 162(2): 36-40] received a bit of media attention when it reported that veterinarians in Britain have a suicide mortality rate that is four times that of the general population and more than twice that of other high-risk healthcare professionals such as pharmacists, doctors and dentistsRead More »Does euthanizing animals lead to the devaluing of human life?