Torture is an issue on which the public might expect bioethicists to be moral absolutists. Never again! Never ever! It was somewhat surprising, then, to read in the New York Times that one of the world’s leading animal rights theorists, Oxford’s Jeff McMahan, support torture. . . . Full Text
Tag: Michael Cook
What are the issues in post-mortem sperm retrieval?
In 2010 21-year-old Niklas Evans was assaulted outside a bar in Texas. He ended up in a coma and died after 10 days. His heartbroken mother, Missy Evans, requested the hospital to retrieve her son’s sperm so that she could create a grandchild with a surrogate mother. The case was too controversial for American fertility clinics so she ended up travelling to South Africa.
Did Missy and her doctors act ethically in removing sperm from Niklas’s dead body without his consent? This is the question that Anna Smajdor, of the University of East Anglia, tackles in the Journal of Medical Ethics, based on a discussion of some cases which have occurred in England. Like many other bioethicists, she opposes it.
The dead still have interests. The logic of post-mortem sperm retrieval without explicit consent could be extended to many other issues, like organ extraction, exhibition of the body, probate law and so on. Legally speaking, much more than a child is at stake.
The validity of inferred consent is a dangerous principle. “In medicine generally, consent for procedure X cannot be inferred from someone’s previous beliefs about situation Y,” she writes. If men knew what was involved in electro-ejaculation, they might well refuse their consent, even if they did express a wish to have children.
Proxy consent for one’s own benefit is a dangerous principle. She writes:
Relatives can agree to donate a loved one’s tissue, but they cannot demand access to that tissue for themselves. The reasons for this are straightforward. Human tissues and organs are valuable commodities. This means that the bodies of dead and dying patients are vulnerable to exploitation. If the person testifying as to the patient’s wishes and providing proxy consent is alsothe one who stands to gain from the tissue that is made available, there is a clear conflict of interest.
The desire for offspring is not sufficient reason. From a woman’s ardent desire for a child one cannot infer consent. “Couples’ reproductive decisions are not necessarily based on symmetrical and equally held desires … It is risky and unjust to assume that one partner’s reproductive desires can be inferred from those of the other. And if this is the case in the living, it is still more so in the case of the dead or dying, who cannot articulate their dissent.”
Smajdor makes two specific recommendations. First, that the rules for posthumous gamete donation be tightened. Second, that the discretionary authority of the UK’s fertility watchdog, the Human Fertilisation and Embryology Authority, be rescinded so that it cannot permit the export of gametes obtained without consent.
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Stop fretting about 3-parent embryos and get ready for “multiplex parenting”
The controversy over three-parent embryos could soon be old hat. Writing in one of the world’s leading journals, one of Britain’s best-known bioethicists has outlined a strategy for creating children with four or more genetic parents. He calls it “multiplex parenting”.
John Harris, of the University of Manchester, and two colleagues, César Palacios-González and Giuseppe Testa contend in the Journal of Medical Ethics (free online) that this is one of many exciting consequences of using stem cells to create synthetic eggs and sperm. (Or as they prefer to call them, in vitro generated gametes (IVG).)
After the discovery of induced pluripotent stem cells in 2007, theoretically any cell in the body can be created from something as simple as a skin cell. Mice have already been born from sperm and eggs created from stem cells. Harris and his colleagues believe that the day is not far off when scientists will be able to do the same with humans. In their paper, they spin an ethical justification for this and outline some possible uses.
First, is it ethical? Of course it is, so long as experiments on mice show that it is safe. After all, they write, this is already a much higher ethical bar than the one used for the first IVF babies. “If impractically high precautionary thresholds were decisive we would not have vaccines, nor IVF, nor any other advance. Nothing is entirely safe.” Besides, any children brought into the world are better off than if they never existed. . . [Full Text]
Conscientious objection to “patriarchal norms”
Hymen restoration and ‘virginity certificates’ in Sweden
Informed consent and conscientious objection are easy to fulminate about, but tricky to discuss with consistency. Take, for instance, the delicate topic of requests for hymen restorations and virginity certificates. Worldwide, an estimated 5,000 women were victims of honour killings in 2000. If a young woman from a culture which sanctions honour killing approaches a doctor, what should he or she do?
Refusal is not a popular or even, in some jurisdictions, a legal option for doctors who are asked to refer for an abortion or to prescribe contraception. But a request which reinforces “patriarchal norms” is different.
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Complicity after the fact
Moral blindness becomes a virtue and necessity
US scientists were “accomplices after the fact” in Japanese doctors’ war crimes
All of contemporary bioethics springs from the Nuremberg Doctors Trial in 1947. Seven Nazi doctors and officials were hanged and nine received severe prison sentences for performing experiments on an estimated 25,000 prisoners in concentration camps without their consent. Only about 1,200 died but many were maimed and psychologically scarred.
So what did the US do to the hundreds of Japanese medical personnel who experimented on Chinese civilians and prisoners of war of many nationalities, including Chinese, Koreans, Russians, Australians, and Americans? They killed an estimated 3,000 people in the infamous Unit 731 in Harbin, in northeastern China before and during World War II – plus tens of thousands of civilians when they field-tested germ warfare. Many of the doctors were academics from Japan’s leading medical schools.
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