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Top hats and top-ups: better health for the better off

Top hats and top-ups: better health for the better off

The health secretary announced today that patients in the UK who choose to buy medicines not funded by the national health service, will no longer be excluded from receiving public health care. This announcement follows controversy about expensive cancer drugs that are available in other countries, but may not be available under the NHS.

Given that private healthcare is available in the UK (and overseas) for those who are able to pay for it, it seems unreasonable to punish patients who choose to spend their money on cancer drugs by denying them access to the public health system for part of their care. (See here, and here for previous blogs on this topic).

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Re-creating mammoths and the family dog: two different cases

The idea of reproductive cloning can easily be perceived as offensive, as a practice that constitutes the dark side of cloning and should be prohibited under all circumstances, by contrast with therapeutic cloning, the benefits of which are increasingly acknowledged. However, such reactions typically assume that it is human cloning we are talking about. Regardless of how we should assess this latter practice, it seems difficult to make a plausible case for a complete ban on reproductive cloning of nonhuman animals. On the contrary, such a technique appears to open up exciting prospects. A group of Japanese scientists, as recently reported in the press (by the BBC and the Guardian, among other sources) have thus managed to produce clones from dead mice that had been frozen for 16 years. According to the aforesaid scientists, this achievement raises the possibility of re-creating extinct species such as mammoths from their frozen remains – a bit like what happens in Steven Spielberg’s movie Jurassic Park.

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Election ex machina: should voting machines be trusted?

When election of public officials through
public voting was instituted in the US,the framers of the constitution
had no inkling about how large the voting public would one day become. Beside logistical problems that
accidentally enfranchise goldfish and the many issues surrounding voter
registration a growing concern is the reliability of electronic voting
machines. As electronic voting machines are being installed, concerns about their reliability are being raised and legal battles ensue. In a Finnish election the system lost 2% of
all electronic votes. About 60% of American votes are cast on
paper ballots, but it might increase locally after problems with voting machines. The real fear is not that people might misvote due to misunderstandings or that votes might be miscounted, but that the machines themselves might be biased or easily tampered with. Can we trust the machines? Or are elections by their nature too messy for these problems to matter?

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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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From doomed lamb to potential phoenix – the story of a modern sacrifice

‘Is there a place for sacrifice in the modern world?’ a colleague asked during a conference in Oxford this weekend. To an extent the answer appears to depend on what we mean by sacrifice. The traditional religious version is arguably in demise in a secular and increasingly individualistic society, but could it be that another version is on the rise? It has become almost standard procedure that when a politician, business leader or other public person is caught doing something they really shouldn’t do, they go for the public apology. In this grovelling mea culpa parade they offer themselves up in tasty little morsels intended to satisfy the public appetite. Sometimes the outrage is such that, for all their efforts, they are still sent packing. Yet all is not lost, after a while out in the cold a surprising number resurface to take on new posts involving big responsibilities presumably requiring both a strong character and sound judgement. But do we really have good reason to think that time out of the lime light equals time spent on moral contemplation?

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The Morality of Suicide Bombing

Since the 1980s, the popularity of suicide attacks – primarily bombing – has grown rapidly. There are now hundreds every year. As I write, the BBC is reporting a suicide bombing which appears to have killed eight people in Pakistan: http://news.bbc.co.uk/1/hi/world/7701435.stm The motivation of suicide bombers has been widely discussed by sociologists, historians, psychologists, and others. My topic, however, is not their motivation, but their moral status.

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Euthanasia and Perverse Incentives

Debbie Purdy is a British woman suffering from multiple sclerosis. Worried about her degenerating condition, she has planned to end her life at the Swiss clinic, Dignitas, which practices euthanasia for people with crippling medical conditions. The story entered the media when she challenged the British High Court to specify whether or not they would prosecute her husband if he went with her to Switzerland. Yesterday the High Court ruled that they would not provide any special advice about the likelihood of prosecution.

A key feature of this case is that the current law is creating a perverse incentive. Debbie Purdy has said that she is not prepared to risk the prosecution of her husband and thus in the absence of an advisory indicating he would not be prosecuted, she would travel to Dignitas by herself. However, since her condition is debilitating, she would have to undergo the travel and euthanasia at an earlier stage of the illness if she was to do it all by herself. The law would thus make things worse for her, as she would die while her life was still bearable and furthermore, she would die away from her husband. It would also be worse from the British Government’s point of view as presumably if they see euthanasia as bad, then premature euthanasia would be worse.

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Travelling for Treatment

A BBC report today suggests that “many” UK couples are going overseas to choose the sex of their children. What seems most odd about this is that in some cases they go to places where sex selection is illegal.

What is interesting here is the fascination with what people do when they go overseas or why they go overseas. There are a whole range of stories about Britons going overseas to get things that they cannot get in the UK – or cannot get in the UK as cheaply. The obvious examples are sex selection, assisted suicide or treatments not available on the NHS.

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Compulsory chemical castration for sex offenders

A month ago, the Polish Prime Minister, Donald Tusk, called for the introduction of forced chemical castration for sex offenders. The call followed a particularly nasty case of incest and paedophilia in the country: a 45 year old man was found to have sexually abused his 21-year-old daughter over a period of six years, and to have fathered two children by her. A poll showed that 84% of the Polish population supported the Prime Minister’s proposal, however many commentators condemned it as an affront to human rights. In response, the Prime Minister, Donald Tusk, claimed that the sex offenders he has in mind cannot be described as human beings, and therefore have no human rights (see here). Nevertheless, high level opposition has forced the government to replace the proposal with a plan for voluntary chemical castration, which is already allowed in Great Britain, Denmark, Sweden, Germany, Switzerland, and some US states. 

It is interesting to compare the claims that have been made for and against Mr Tusk’s proposal with those that we might expect to surround alternative proposals for reducing rates of re-offending among sex offenders. Suppose the Prime Minister had instead suggested the introduction of a compulsory education programme for sex offenders in which they would be forced to confront the devastating effects that their actions can have on their victims. It is difficult to imagine such a proposal being greeted with the claim that it breaches human rights. And it is also hard to imagine the proponents of such a programme resorting to the claim that sex offenders aren’t human. Instead, the debate would probably focus on weighing the costs and benefits of the proposed programme.

Can these differing responses be justified? Is there any good reason to think that compulsory chemical castration is a matter of human rights, while compulsory re-education is not?

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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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