Practical Ethics

Killing is killing - or is it?

In the headlines this week is the tragic story of Frances Inglis, whom a jury at the Old Bailey found guilty of murdering her disabled son Tom and sentenced to nine years in jail. Tom Inglis had been left severely braindamaged after falling from a moving ambulance in 2007, throwing his mother in a state of deep distress. She refused to believe an (apparently isolated) encouraging prognosis from one of the doctors at the hospital, and concluded that it was her duty to release her son from the “living hell” in which he found himself. Horrified on learning that the only legal way of allowing her son to die was an application to the High Court for Tom’s food and water to be withdrawn, Frances Inglis decided to take action on her own. After a first unsuccessful attempt 14 months earlier, she took her son’s life by injecting him with a lethal dose of heroin in November 2008.

 

Why the minaret ban?

I would like to try and throw additional light on the motives that led a majority of Swiss voters to a surprise acceptance, on November 29, of an initiative forbidding the construction of future minarets – already commented on by Russell Powell in his entry on this very blog yesterday. Some supporters of the initiative, such as far-right politician Ulrich Schlüer, who co-launched it (and was already notorious for his questionable campaign in 2004 against simplified naturalisation procedures), might simply want to prevent any minority with a cultural and religious background different from their own from expanding and expressing itself. Others might have been misled into thinking that all Muslims are extremists, supporting terrorist attacks. Yet I also suspect that a significant proportion of those who endorsed the minaret ban, while not being fundamentally hostile to Islam, might have been motivated by the worry that the further expansion of the Muslim community in Switzerland (and Europe in general) poses a threat to certain core values of Western liberal democracies, such as gender equality, freedom of speech, and the separation between church and state.

 

Diluted evidence: is there anything special with homeopathy?

Last week I participated in the Royal Society MP-Scientist Pairing Scheme where I got a chance to see Westminster from the inside. I was lucky to end up listening to a hearing in the Parliamentary Science and Technology Select Committee about whether the government was really pursuing evidence based medicine when it funds homepathic medicine through NHS and makes MHRA decisions for homeopathy pills. Ben Goldacre was there and has of course written eloquently about the whole thing. While Booths at least admitted they selling the remedies because they made money from them, the proponents tried both to claim clear results in their favor, that statistical measurement methods did not work and that placebo had nothing to do with what they are doing. A particular howler was how one speaker argued that homeopathy should be respected for its 200-year long history, yet it was "still early days" for explaining how or if it worked.

A controversial use of taxpayer funds

The health care reform bill currently being debated in the United States has re-ignited controversy there over abortion, and in particular over the availability of federal government funding to pay for the procedure. Earlier this month, the House of Representatives version of the health care bill passed narrowly, and with a last minute amendment that will restrict provision of abortions. The so-called “Stupak amendment” says that no health care plans receiving any subsidy from the federal government may offer abortions, except in the case where abortion is the result of rape, incest, or to save the woman’s life, and it maintains this restriction even if the government subsidies are kept separate from the private payments made into the plans, and no government subsidy is ever used to pay for abortions. The Stupak amendment represents a tightening over existing policy, according to which the federal government is prohibited from directly funding the provision of abortions, but may provide funds for hospitals, for example, that also provide abortions – so long as the hospitals pay for the abortions themselves by some other means.

The argument for Stupak’s additional restrictions on abortion funding is supposed to be that since money is fungible, the old prohibition does not really work to prevent federal funds indirectly playing a role in providing for abortions. Whatever the merits of this argument, it’s worth noting that many of its proponents in congress make it hypocritically; they are more than willing to accept generous campaign contributions drawn from the profits of health insurance companies that provide insurance for abortions as a component of their plans. But I want to focus here on the question of having any restriction of this kind at all. Can the federal government legitimately be prohibited from funding abortion?

Is your fingerprint part of you?

In a report expressing concern about the increasing use of biometric information to protect security and privacy, the Irish Council for Bioethics (ICB) claimed earlier this month that “an individual’s biometric information is an intrinsic element of that person”. Such claims are quite commonly made in relation to genetic information, though the ICB’s extension of the concept to other forms of biological information, such as that acquired from fingerprinting, voice recognition software, and gait analysis, may be novel.

The claim that biometric information is an ‘intrinsic element of the person’ seems designed to invoke powerful intuitions about our ownership of our own body parts: we own our biological information just like we own our kidneys. Indeed, the ICB go on to say that “the right to bodily integrity.... should apply not only to an individual’s body, but also to any information derived from the body, including his/her biometric information”. But both the metaphysical claim that biometric information is an intrinsic element of the person,and the moral claim that it is covered by rights to bodily integrity are highly problematic.

Switzerland gets tough on suicide clinics

The Swiss government (the Federal Council) has recently announced its intention to crack down on “suicide tourism” and to severely restrict the activities of suicide clinics like Dignitas and Exit, which have regularly made the headlines outside Switzerland in the last few years (particularly Dignitas), as foreigners make up a large proportion of the hundreds of people they help to die every year. The government is proposing two draft Bills for public deliberation until March. The first option is an outright ban on suicide clinics; were it to become law, clinics like Dignitas and Exit would simply have to close down. Such an extreme measure, however, doesn’t have the favors of most members of the Federal Council, and probably won’t have those of the Parliament either. The second option is more likely to prove popular, and I will thus focus on it: it would involve much stricter regulations – rather than a ban – being imposed on the activities of these clinics. Violations of those regulations would involve sanctions of up to five years in prison.

Speaking truth to power

The sacking of Professor David Nutt from the Advisory Council on the Misuse of Drugs has led to a spirited row between politicians and scientists. Colleagues in ACMD are resigning, refusing to be used as mere rubber stamps for pre-determined agendas. The home secretary seems to want to reorganize it to his liking.

The origin of the conflict is Nutt's staunch harm-reduction and evidence based policy position: he thinks drugs should be legally classified by the harm they do, not so much by political expediency. Alcohol and tobacco are more harmful than cannabis, taking ecstasy appears to be less risky than horse riding (when counting injuries and death). Hence he has criticised policies ministers for upgrading medically less harmful drugs. While certainly controversial in the anti-drug community his arguments appear to be based on solid science. As a scientist he should also sound the alarm if the government is "devaluing and distorting" the scientific evidence.

Alan Johnson sees things differently: "He was asked to go because he cannot be both a government adviser and a campaigner against government policy." The role of an advisor is only to advice, while the government decides policy. But if the policy is against the evidence, should not the advisor advise to change the policy?

Reshaping the financial system after the storm

The question of the social utility of the financial services and of the appropriate modes of remuneration of its actors has occupied a central place at the G20 meeting held in Pittsburgh. Indeed, the G20 leaders expressed a shared willingness to back new global regulatory standards for the banking industry. Yet, their reasons for doing so need some unpacking.

The recent interview by Prospect magazine of the FSA Chairman Adair offers a case in point, as does his recent speech at Mansion House. Turner suggests that the financial services sector should slim down to a more ‘socially useful’ size and reduce bankers’ pay accordingly. He also estimates that market deregulation has led to an oversized financial sector. Finally, he proposes that regulators should step in to reconnect the size, profit and pay level of the sector to what is ‘socially optimal’.

Though it may sound intuitive, the idea of a ‘social optimum’ that could be used as a guideline for regulating finance is ambiguous and deserves a close look.

Why Drugs Should be Legalised

Former Brazilian President, Fernando Henrique Cardoso, has argued that the war on drugs has failed and cannabis should be decriminalised. He argued that the hardline approach has brought "disastrous" consequences for Latin America. Having just returned from Rio, one can only agree. I was staying with an eminent professor of philosophy. We were returning to her house with her 11 year old daughter, only to have our way blocked by police with machine guns. They were hunting a drug lord in the local favella – this road was the only escape route and they were preparing for possible altercation.

Cardoso highlights the practical failure of a zero-tolerance approach. A zero tolerance approach to a crime like taking drugs must always fail, in the same way as a zero-tolerance approach to alcohol, prostitution or drugs in sport will always fail. Paradoxically, the worst thing you could do to the drug lords in Rio is not to wage a war on them, but to decriminalise cocaine and marijuana. They would be out of business in one day. Supplies could be monitored, controlled and regulated – the harm to users and third parties significantly reduced.

The instrumental case for legalising drugs has been made often, most recently and significantly by Cardoso. Harm would be reduced. (We could approach a more civilised society like the Netherlands.) But one rarely hears a moral argument in favour of liberalisation of laws on drugs. I will give one.

What's special about selling gametes?

Dominic Wilkinson posted yesterday on the issue of whether payment for egg and sperm donation should be legalised. This question attracted significant media attention yesterday after Lisa Jardine, of the HFEA, called for debate on the existing UK ban on payment for donors. Today's Guardian contains a piece highlighting several ways in which people can already sell their bodily parts or products, ranging from livers to breast milk, and from blood to hair. Sale of many of these bodily parts/products is regarded is ethically problematic, and is, in many cases, illegal. But not in all cases. For example, few would have a problem with the sale of hair for use in wigs.