Practical Ethics

How to Improve on Bolt's Performance

You might think after Usain Bolt’s almost superhuman performances in the 100 and 200 m that the war on doping has been won. However winning one battle is not winning the war. As the example of Lyudmila Blonska shows, doping is still occurring. It is almost certain that there are other medals and world records that were achieved by athletes who were doping but were not caught. The sophistication  of the technology means that just because we are picking up fewer positive tests, it does not mean that there are fewer athletes doping

How to Win the War on Drugs in Sport

Drug scandals again tarnish the Tour de France. Last week three riders, Spaniards Manuel Beltrain and Moises Duenas and Italian climber Riccardo Ricco, winner of two mountain stages, failed tests for the banned performance enhancer EPO. This year has seen fewer spectacular expulsions, but of course the game is not over.

Does this mean the drug testers are winning the war on drugs? It might. But it might also mean that cyclists and their doctors are getting better at evading testing. A recent BBC investigation supports the latter conclusion. WADA labs have been proven to fail to pick up positive results. There are 80 copy-cat drugs, produced in China, India and Cuba, which are difficult to detect. And labs apparently collude with doctors to “exchange knowledge” on testing procedures. Expert Professor Bengt Saltin, a leading anti-doping expert and a former winner of the IOC Olympic Prize, the highest honour in sports science, said

"I would think that most of the medal winners and many in the finals of endurance events - there is a big risk for them having used EPO."

So despite the numbers of athletes being prosecuted for EPO declining by two-thirds between 2003 and 2006, Professor Saltin concluded this was due to evasion, not a reduction in use.

"The reason that I am still a little bit upset with the whole situation is that I have seen too many suspicious samples that are clearly abnormal. Athletes are getting away with it. Look how many have been caught for EPO misuse recently."

The response is predictable: widen testing critieria. Experts have suggested that urine samples should be tested for any evidence of naturally produced EPO. If there is none, it should be classed as suspicious because the use of artificial EPO for doping causes the body's own production to shut down. These experts also call for testing of blood profiles as well as the urine. An analysis of the number of young red blood cells can also indicate doping.

Is this a solution? No. It will simply escalate the war to the next level. History has proven the ability of athletes and their doctors to ingeniously evade detection. We will never win the war on doping.

Sport, Sudden Cardiac Death and Liberty

Sport, like life, is dangerous. Several fit young footballers have died of sudden unexpected heart attacks. Doctors are now calling for mandatory testing using ECGs of all athletes. Italy has been pursuing mandatory testing for 25 years. This has revealed over 5% have some abnormality. Some people have congenital heart rhythm abnormalities which place them at high risk of sudden heart attack during or after sport. The call for mandatory testing is a sensible one. The interesting question is what is to be done with the results.

“Reanimation” and Taking Organs from Living People

One of the greatest fears associated with organ transplantation is that the person from whom organs are taken is not really dead.

That nightmare was almost realised in France last week when a French patient “came back to life” after 30 minutes of unsuccessfully heart massage. In 2007, in order to address the shortage of organs for transplantation, French authorities allowed the trial of using people whose hearts have stopped beating, but who have not met brain death criteria for being dead, as organ donors. These are called Non-Heart Beating Donors. Organs can also be taken from such donors in the UK. Such patients’ hearts have stopped beating but they have not met brainstem criteria for death.

Setting a Minimum Price for the Sale of Organs

Professor Maqsood Noorani, a leading surgeon made the headlines asking for legalisation of the sale of organs to prevent the exploitation that exists in the black market. Yet his comments show that he is uneasy with the concept of a market in organs. He believes that the sale of organs in richer nations would 'tarnish the process', and suggests that even in poorer countries accommodation or education should be offered in exchange instead of cash. 

When two people want to freely exchange some good or service, we need good reasons in a free market to prevent the exchange. Moreover, when it comes to a market in organs, the good in question is life saving. Why then should we prevent such exchanges when there are willing buyers and sellers?

Brain Boosting and Cheating in Exams: Four Responses

A report by the Academy of Medical Sciences looking at different aspects of drug use and mental health has identified a growing trend for off-label use of drugs intended for the treatment of diseases including narcolepsy, ADHD and Alzheimer’s. The use of such drugs by a healthy individual can improve memory, alertness and concentration. While the report does not condemn the practice, it raises a number of potential concerns over safety, and fairness. Professor Les Iversen, report co-author, highlighted concerns that the use of enhancement in exams would unfairly advantage wealthier students, and suggested that the use of such drugs could be considered cheating. The report recommends that legislation is prepared to tackle the misuse of such drugs, including the potential for urine testing in schools and universities.

Below are responses from Julian Savulescu, Nick Bostrom, Anders Sandberg and Mark Sheehan on the effects of cognitive enhancing drugs, and the issue of cheating

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.

The New Law on Admixed Embryos and the Genetic Heritage of the Living Kingdom

Scientists in the US recently created a fluorescent human embryo. This was achieved by inserting a gene for green fluorescent protein. This shows that it is possible to successfully transfer a gene from a non-human animal to a human and for that gene to express its function. Other animal studies have shown that such gene transfer is both safe and effective, creating super animals, such as mice with colour-vision derived from human genes transferred.

The Ethics of 'Human Admixed Embryos': Concerns and Responses

By Loane Skene, Professor of Law, University of Melbourne and Julian Savulescu,  Uehiro Chair in Practical Ethics and Director Uehiro Centre for Practical Ethics, University of Oxford

The Human Fertilisation and Embryology Authority (HFEA) Bill, currently before the UK Parliament, will, if passed, permit HFEA to license the creation for research of embryos that combine human and animal genetic material (called, in the Bill, ‘human admixed embryos’). These embryos include cybrids which are formed by inserting the nucleus of a human body cell into an animal egg that has had its nucleus removed. Cybrids would produce embryonic stem cells that are 99.9% human. The Bill would also permit other types of embryos to be formed from human and animal genetic material that would be up to half animal. This post explains why scientists want to create human admixed embryos. It then outlines some ethical concerns about the creation of these embryos and responses that may be made to those concerns.

The Choice to Have Artificial Blood: Less than the Best?

Controversy has erupted around whether experiments to test artificial blood should stop. Experimental blood substitutes raised the risk of heart attack and death, yet U.S. regulators allowed human testing to continue despite warning signs, says a scathing new report.

Blood substitutes, or artificial blood, could be stored for years without refrigeration, and be used in battlefield situations. It would carry no risk risk of infection with hepatitis or HIV. It would be an acceptable alternative to Jehovah’s Witnesses who refuse life saving blood transfusions.
In a new report, researchers pooled data from 16 separate studies of five different blood substitutes, involving over 3,700 patients. Researchers found a 30 percent higher risk of death overall for patients who received transfusions using the blood substitutes. The risk of heart attack was nearly tripled in the groups receiving blood substitutes.

“Experts speculate that hemoglobin in the blood substitutes scavenges nitric oxide from the blood, causing blood vessels to constrict and sticky platelets to build up. That increases the risk of heart attacks.”