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ethics

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.

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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?

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Rick Santorum, birth control, and “playing God”

By Brian Earp

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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.

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The P-Factor

Electoral reform is an often-discussed topic.  But the issues often concern minor modifications to the status quo. Here I suggest an entirely new approach to electing leaders of a country.  It would have numerous benefits over the current system, including: –       Better voter turnout –       Better representation of the working classes among those who vote… Read More »The P-Factor

Love and other drugs, or why parents should chemically enhance their marriages

By Brian Earp

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Love and other drugs, or why parents should chemically enhance their marriages

Valentine’s day has passed, and along with it the usual rush of articles on “the neuroscience of love” – such as this one from Parade magazine. The penner of this particular piece, Judith Newman, sums up the relevant research like this:

It turns out that love truly is a chemical reaction. Researchers using MRIs to look at the brain activity of the smitten have found that an interplay of hormones and neurotransmitters create the state we call love.

My humble reckoning is that there’s more to “the state we call love” than hormones and neurotransmitters, but it’s true that brain chemistry is heavily involved in shaping our experience of amour. In fact, we’re beginning to understand quite a bit about the cerebral circuitry involved in love, lust, and human attachment—so much so that a couple of Oxford philosophers have been inspired to suggest something pretty radical.

They think that it’s time we shifted from merely describing this circuitry, and actually intervened in it directly—by altering our brains pharmacologically, through the use of what they call “love drugs.”

Read More »Love and other drugs, or why parents should chemically enhance their marriages

Practical Ethics Given Moral Uncertainty

Practical ethics aims to offer advice to decision-makers embedded in the real world.  In order to make the advice practical, it typically takes empirical uncertainty into account.  For example, we don’t currently know exactly to what extent the earth’s temperature will rise, if we are to continue to emit CO2 at the rate we have… Read More »Practical Ethics Given Moral Uncertainty

Choosing one’s own (sexual) identity: Shifting the terms of the ‘gay rights’ debate

Choosing one’s own (sexual) identity: Shifting the terms of the ‘gay rights’ debate

By Brian Earp (Follow Brian on Twitter by clicking here.)

UPDATE: See HuffPost Live debate on this topic here.

Can you be gay by choice? Consider the following, from the Huffington Post:

Former “Sex and the City” star Cynthia Nixon says she is gay by “choice” – a statement that has riled many gay rights activitists who insist that people don’t choose their sexual orientation.

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

By Brian Earp

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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?

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What is so bad about polygamy?

By Brian Earp (Follow Brian on Twitter by clicking here.)

What do gay marriage and polygamy have in common?

To find out, watch this exchange between US Republican presidential hopeful Rick Santorum, and a New Hampshire college student.  Here’s an edit to give the gist:

Student: How about the ideas that all men are created equal, and the rights to happiness and liberty? [Applause.]

Santorum: Ok, so — Are we saying that everyone should have the right to marry?

Audience: Yes! Yes!

Santorum: Everyone? Ok, so, anybody can marry anybody else.

Audience: Yes, yes!

Santorum: So anyone can marry several people? …

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Experimenting with oversight with more bite?

It was probably hard for the US National Science Advisory Board for Biosecurity (NSABB) to avoid getting plenty of coal in its Christmas stockings this year, sent from various parties who felt NSABB were either stifling academic freedom or not doing enough to protect humanity. So much for good intentions.

The background is the potentially risky experiments on demonstrating the pandemic potential of bird flu: NSABB urged that the resulting papers not include “the methodological and other details that could enable replication of the experiments by those who would seek to do harm”. But it can merely advice, and is fairly rarely called upon to review potentially risky papers. Do we need something with more teeth, or will free and open research protect us better?

Read More »Experimenting with oversight with more bite?