Practical Ethics

The point of death

The Guardian yesterday reported the death of the man who had been so tragically shot in Antigua, with his wife, three weeks after their wedding. It began like this:

"Ben Mullany, the newlywed who was shot on honeymoon in Antigua in an attack that killed his wife, Catherine, died in hospital in Wales yesterday after his life support machine was switched off.  The 31-year-old trainee physiotherapist, who had suffered a fractured skull and had a bullet lodged in the back of his head, was flown back to Britain while in a coma on Saturday. Tests carried out when his condition stabilised after the 24-hour journey established he was brain dead." 

This is a familiar way of describing such happenings, even among clinical professionals.   Brain death is pronounced, so the life support machine is switched off, and the patient dies.   The clear implication is that brain death is not death.  The machine is still keeping the patient alive, and it is switching off the machine that causes real death. 

Reproductive science: is there something we're missing?

Thirty years after the first test-tube baby, Nature asks various experts for their views on what the next thirty years of reproductive medicine will bring. Some of the more startling predictions are:

• No more infertility, with both children and 100-year-olds able to have children
• Embryos created from stem cells, increasing the ease of embryo research and genetic engineering of children
• … with the resulting greater availability of embryos making it easier to create cloned humans
• Artificial wombs, enabling babies to develop outside the mother’s body
• … which, some worry, could become compulsory as an alternative to abortion, or to avoid premature birth or fetal alcohol syndrome
• ‘Genetic cassettes’ implanted in embryos to counteract the effects of inherited diseases
• Increase in litigation following evidence that IVF babies may later suffer adverse effects from the environment in which they were grown as embryos

What’s wrong with the hermaphrodite world?

Making headlines last week, Melbourne bioethicist Rob Sparrow argued that in order to create the best future for their children, parents should select only girl children or hermaphrodites. He imagined a  “post-sex” world in which males are no longer conceived, and women use frozen sperm, or artificial gametes to reproduce.

My Genes, not a Doctor's

California has sent cease-and-desist letters to firms offering Web gene tests to consumers. The legal reason is that California law requires a licenced physician to order any lab tests. This follows from a similar crackdown in New York. Wired responds by top 10 reasons that regulators should not hinder genetic testing. Is there any good reason to limit public access to genetic testing besides protecting incumbents and gatekeepers?

Cloning and animal exploitation

The Daily Mail reports this morning that 8 clone-offspring cows have been born in the UK. Also today, the first survey of public opinion on ‘clone farming’ has been released indicating significant unease and opposition to the idea of meat products or milk from cloned sources.

There are strict prohibitions on reproductive cloning for humans in most countries (for example, the recently debated HFEA bill in the UK, and the Human reproductive Cloning Act 2001). However there are few, if any, constraints on the cloning of animals. Is this the start of a new era of animal exploitation?

Betting on bad health (with inside information)

Personal DNA testing is here. For $1,000 you can send off a DNA sample to an american company and find out your genetic predispositions to a wide variety of illnesses and problems, from male pattern baldness to cancer. The Telegraph is running a story by a woman who has just ordered such a test and has seen her predispositions. The story makes many of the issues quite vivid and shows how one can use the bad news in such tests, say a predisposition to a certain illness, to make special efforts to guard against that illness, or at the very least to be ready for the effect it might have on your life. There is, however, a problem with these cheap, voluntary tests. It is not a problem for the individual taking them, but a problem for society.

HFEA and Regulating Reproduction:Triumph for Rationality and Victory for Secular Ethics

MPs voted on Tuesday on two of the most controversial issues surrounding reproduction- the provision of IVF treatment, and the availability of legal abortion. Under the new laws, IVF clinics will no longer have a legal requirement to consider the need for a father, but will instead be asked to ensure provision of 'supportive parenting', removing any barrier to single women and lesbian couples conceiving through the treatment. In a separate amendment, MPs were asked to consider the legal time limit on abortion, which currently stands at 24 weeks. Given the option to reduce this limit to 22, 20 or even just 12 weeks, MPs voted by a comfortable majority to stick with the status quo. 

The UK is now at the forefront of rational reform to legislation governing reproduction and research. The Human Fertilisation and Embryology Bill has now approved the creation of human admixed embryos, with important implications for scientific advance.

Blog on Admixed Embryos
Savulescu, J., The Case for Creating Human -Non Human Cell Lines, Bioethics Forum
Human Enhancement papers, media and other resources for free download

It has also reformed the regulation of reproduction in a thoroughly sensible manner.

Saviour Siblings Saved!

Two attempts to amend the Human Fertilisation and Embryology Bill’s provision to allow ‘saviour siblings’ failed in the House of Commons yesterday. The first attempt was to block the practice and failed 342 to 163. The second attempt was to limit the provision to life-threatening cases. It was defeated 318 to 149. As it stands the Bill allows embryo testing and hence selection for ‘saviour siblings’ provided that “there is a significant risk that a person [the sibling ‘to be saved’] … will have or develop a serious physical or mental disability, serious illness or any other serious medical condition.”

Humane Evolution

Professor John Harris wonders Who’s afraid of a synthetic human? in the Times. He argues we should support the Human Fertilisation and Embryology Bill because it will help us develop effective therapies and enhance ourselves. Science is about bettering our lot, after all. In particular, he says, synthetic biology may help us avoid going extinct due to our vulnerabilities and instead enable us to choose (or become) our successors as a species.

Many people become confused by the possibility of a posthuman future. The traditional view of the future is a stark one: either humanity extinct, or humans roughly as they are today. The posthuman options would be that we either change ourselves so radically that the resulting species is so  fundamentally different from humanity that we would regard it as something entirely new, or that we create some kind of independent beings that continue our culture even as traditional humanity retires from the forefront (hopefully as proud parents of the new beings). The range of possible options within these scenarios is endless, inviting equally endless and loud speculation. That tends to distract from the key message of Harris’ essay: we are leaving the realm of natural evolution and entering what he calls a realm of enhancement evolution.

A Second Human Singularity?

New Scientist reports this week claims that the reason human cognitive powers are so superior to those of other animals has to do not with biology alone, but also with our ability to interact with others and with the world.