Mill, Liberty and Euthanasia

h/t to Bioethics

The voluntary euthanasia debate often remains at the level of emotion and rhetoric. In a recent article in Philosophy Now, Simon Clarke of the American University of Armenia attempted to provide a philosophical defence of euthanasia, drawing upon the classical-liberal philosophy of John Stuart Mill.
Clarke considers Mill’s conception of human flourishing. For Mill, human beings fulfil themselves when  allowed to freely develop their own individual identity.

“An objectively good life, on Mill’s (Aristotelian) view, is one where a person has reached her potential, realizing the powers and abilities she possesses…By this he meant the development of a person’s unique powers, abilities, and talents, to their fullest potential.”

It was on the basis of this anthropology that Mill posited his famous ‘liberty principle’, namely that “The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others” (John Stuart Mill, On Liberty, 1859, ch.1).
Clarke proceeds to consider how Mill’s conception of liberty might apply to the spirited debate over voluntary euthanasia. According to Clarke, euthanasia is, at least potentially, an opportunity for self-actualisation and an expression of individuality.

“…a person may have reached a point in her life when no higher self-realisation is possible. In fact rather than merely fail to add to her achievement of individuality, continuing to live an increasingly incapacitated life may even detract from it. Having already reached her fullest potential, a much-diminished continued existence may significantly undermine it. To prevent this happening, a person must have the freedom to choose the timing and manner of her death…”

In other words, euthanasia is the final hurrah of the individualist. And it is precisely the individual concerned who is in the best position to tell whether euthanasia is appropriate: “At the end of a life during which a person has developed his talents and capacities, it is that person who is in the best position of being able to judge whether further self-development is possible or if his individuality has reached its fullest potential.”
Clarke’s essay is an interesting presentation of the issue from a Millian perspective, But some might disagree with his interpretation of Mill. Mill famously stated that to sell oneself into slavery was impermissible, and warranted intervention.

“…by selling himself for a slave, he abdicates his liberty; he foregoes any future use of it beyond that single act. He therefore defeats, in his own case, the very purpose which is the justification of allowing him to dispose of himself…”

It does not seem at all a stretch to think this principle applicable in the case of suicide. Is there really such a time as one is fully actualised, and can no longer grow in their individuality?  

- See more at: http://www.bioedge.org/bioethics/mill-liberty-and-euthanasia/11634#sthash.CFdCbmWm.dpuf

Scientists seek permission to genetically modify embryos

h/t BBC news

UK scientists are seeking permission to genetically modify human embryos for the first time.

Researchers at The Francis Crick Institute in London want to use a controversial genetic technique to carry out research into infertility.
The embryos would be destroyed after the research and not implanted into the womb.
The government's fertility watchdog said it had received the application, which would be looked at in due course.
In the UK, it is illegal to use gene editing of embryos in IVF treatment, but it is permissible for research purposes, under a licence.

"We have recently received an application to use Crispr/Cas9 (gene editing) in one of our licensed research projects, and it will be considered in due course," said a spokesperson for the Human Fertilisation & Embryology Authority (HFEA).

Image copyright Thinkstock

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Analysis: By Helen Briggs, Health Editor, BBC News Online
When scientists in China announced they had genetically modified human embryos in a world first earlier this year, there was an outcry.
The embryos were never destined for use in IVF, but there were concerns the work could be a slippery slope towards designer babies.
The technique - known as gene editing - can make precise changes to DNA. But any alterations would be passed on to future generations if the embryos were ever to be used in human reproduction.
It would be illegal to do this under British law, although it is permissible to use the technique for research purposes, where the embryos are eventually destroyed. The Francis Crick Institute is the first to apply for a research license, making it something of a test case.
The researchers want to use the technique to look at the earliest stages of human development, in the hope of better understanding why some women have miscarriages.
The HFEA will now consider the application, but no decision is expected for some weeks or months. Most scientists agree that genome editing should not be used for reproductive purposes at present. But they say this is not a reason to block research.

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'Foolish'

Research leader, Dr Kathy Niakan, said the aim was to understand the genes that human embryos need to develop successfully.
"Importantly, in line with HFEA regulations, any donated embryos would be used for research purposes only," she said.

UK scientists are poised to make a world-leading contribution to this exciting field

Dr Sarah Chan, University of Edinburgh

"These embryos would be donated by informed consent and surplus to IVF treatment."
Group leader of the institute, Prof Robin Lovell-Badge, added that any use of the technique for altering the genes of embryos intended for reproduction would be "foolish" at this stage.
"We are fortunate to have good regulations in the UK that permit research with a licence, but not the implantation of any embryo that has had its genome modified," he said.

Moratorium

Scientists say the new technique, called Crispr/Cas9, means that genomes can be manipulated in a more precise way than before.
However, there have been calls for a moratorium on such research, amid moral and ethical concerns.
Earlier this year, Chinese scientists announced that they had genetically manipulated human IVF embryos for research purposes in a landmark study.
The US later imposed a moratorium on federally-funded research in this area.
In the UK, experts recently called for debate on whether editing human embryos would ever be justified in the clinic.
Weeks later a group of influential scientists belonging to the Hinxton Group said it did not approve of GM babies being born yet, but the idea might one day become morally acceptable.
Dr Sarah Chan of the University of Edinburgh said the news that UK scientists had applied to the HFEA for a licence to perform genome editing research using embryos should be cause for confidence, not concern.
"UK scientists are poised to make a world-leading contribution to this exciting field," she said.
"At the same time, we should be reassured to know that this work is being carried out under a robust regulatory scheme that ensures high scientific and ethical standards."

What is Conscience?

“I deeply regret IVF is now so commercial”

IVF pioneer Robert Winston recently spoke out against the commercialisation of the IVF industry, saying that desperate UK couples are being exploited and grossly overcharged for treatment. Speaking with The Mirror, Baron Winston castigated the NHS and UK government for failing to stop greedy IVF companies preying on infertile couples:

“Patients’ desperation and some practitioners’ avarice is steadily raising prices.
“More and more infertile couples are being exploited by an increasingly grasping industry that frequently ignores ethical standards…neither the NHS nor the Government does enough to help. It’s not just some doctors who are responsible.”

Baron Winston told of one woman who paid more than £10,000 for one cycle – which should cost as little as £1,000.

Two per cent of babies born in Britain are now conceived via IVF. But Baron Winston, 75, believes more than half of patients involved could benefit from “far cheaper alternatives”.

He cited the case of one woman, 35, who spent £33,600 on seven failed IVF cycles. A £300 X-ray of her womb found uterus scar tissue, which was then removed in a 15-minute op. Five months later she was pregnant without further treatment and also had two more children.

Baron Winston has been a particularly vocal critic of the modern IVF market. He has even written a book, The Essential Fertility Guide, discussing various alternatives to standard IVF treatments.

The atheist case against euthanasia

A number of intellectuals have recently chided ‘godly types’ for arguing against legalising euthanasia. Outspoken Australian philosopher and humanist Russell Blackford this week slammed Anglican Archbishop Justin Welby for what he saw as ‘disingenuous religious propaganda’ under the guise of secular argumentation. And last week we reported on the Lancet’s swipes at Baroness Ilora Finlay, former president of the British Medical Association, whom editor-in-chief Richard Horton accused of “fibbing for God”.
So is it only religious types who are fighting against assisted suicide?  Not quite.
In a recent edition of the Spectator magazine, atheist commentator Douglas Murray – lauded by the late Christopher Hitchens as “youthful, defiant and principled” – argues that the so-called slippery slope argument is reason enough for parliamentarians to stay their hand:

“Those who are not religious can still have many philosophical objections to euthanasia… The principal objection to euthanasia is a slippery-slope argument — and many people profess to disdain such arguments. Nevertheless, anyone doubting the slipperiness of this slope should consider the places where euthanasia is already legal.”

Murray quotes one of Oregon’s most senior doctors, Professor William Toffler, who recently declared the state’s euthanasia legislation a ‘disaster’ that has, among other things, led to ‘a profound shift in attitude toward medical care’ and transformed the relationship between doctors and patients.
Murray also refers to various examples from Holland, where “Dutch law now blurs any difference between physical and mental illness.”
Murray is not just an anomaly. Kevin Yuill, a liberal humanist historian who specializes in the history of the US civil rights movement, has written numerous articles defending a existing British law on euthanasia. Recently he described the openness of Western societies to assisted dying as symptomatic of ‘narcissistic survivalism’ – “the inability of an entire culture to see beyond the corners of itself, to understand the self’s place in history, or to believe in its ability rationally to control the future.”
Yuill discussed the case of Gill Pharaoh, a healthy, 75-year-old retired nurse, who took her life on July 21 at a Life-Circle suicide clinic in Switzerland.

“Pharaoh… was not ill, but wished to die. She noted in her final blog that she wanted ‘people to remember me as I now am – as a bit worn around the edges but still recognisably me!’…”

Yuill extends the argument further, saying that the push to make euthanasia legal in the UK is not just so that people can avail themselves of the procedure, but so that the government endorse the sentiment of those who are suffering.

“…The narcissist sees a world that does not feel their existential pain (after all, physical pain does not even feature in the top-five reasons why people in Oregon opt for assisted suicide) as the cause of that suffering…
"If this is not narcissism, then why are Pharaoh and other assisted-suicide advocates so vocal about their need, not just to slip away quietly, but to have their decision validated by the state? The drive behind the assisted-suicide lobby is the idea that the world must mould itself around the perceived needs of ‘afflicted’ individuals.”

Assisted dying sinks in UK Parliament by 3-1 margin

A private member’s bill to legalise assisted suicide has been defeated in the British House of Commons by a crushing 3 to 1 margin. It was the first time in 20 years that a bill has come to the lower house. Despite high-profile support from the former director of public prosecutions, Sir Keir Starmer, now a Labour MP, and a former Archbishop of Canterbury, Lord Carey, MPs defied opinion polls and voted against the measure by 330 votes to 118.

However, the issue is far from dead. Sarah Wootton, chief executive of the group Dignity in Dying, which lobbied hard for the bill, says that the battleground will shift to Britain’s courts, which have sympathised with the view that assisted suicide is a human right.

“Parliament has failed to act and if it fails to recognise its responsibility over the next five years then the courts have no choice but to act instead, to end this suffering and injustice.”

Friday’s debate on the Assisted Dying (No. 2) Bill (link to Hansard) was of extraordinarily high quality. A number of the MPs are (or were) medical practitioners, adding an additional level of experience and insight.

Unlike most debates, in which the participants enter with closed minds and exit with closed minds locked tighter than ever, the MPs actually listened to each other. How often does one hear words like this?

I admit that I came into the House thinking that I would support the Bill, [said Ben Howlett, a Conservative], but listening to the speeches made by other Members, particularly the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Totnes (Dr Wollaston), has completely changed my mind.

The single most significant intervention probably came from Sir Keith, who oversaw about 80 cases of assisted suicide during his term as DPP and decided not to prosecute in 79 of them. The first of these came only six weeks into his job – the case of Dan James, a paralysed regby player who was taken to Switzerland by his parents to die there. “I took it to be the compassionate act of a loved one, and … decided not to prosecute.”

According to The Telegraph, the one of the most decisive speeches came from a Scottish MP, Dr Philippa Whitford. She told the House: “as a breast cancer surgeon for 30 years, I have been involved in the journey to death of many patients, but as a doctor I have never considered that death was a good treatment for anything, no matter what was wrong with anyone.” She concluded:

All our horizons will narrow as we get older. Someone who was hill walking when they were 20 might not manage to do so when they are 80. I have seen patients who are grateful to be at home being wheeled out on to the patio in the sun and having a good blether with their son who has come home from London. They consider that a good day. We might consider it horrific, looking at it in advance, but when we get there we will have changed. We should support letting people live every day of their life until the end, and make sure that, as legislators, we provide the means for them to live and die with dignity and comfort. We should not say, “When you can’t thole it [stand it], take the black capsule.” We should vote for life and dignity, not for death.

A Labour MP, Robert Flello, argued that assisted suicide might not be as painless as it it reputed to be:

more than half the people polled think that assisted suicide involves no pain or discomfort. Well, assisted suicide can take two forms. The first, which this Bill says it advocates, is as follows. The person is given a powerful medication to stop them from being sick. That is because the barbiturates that are used to kill them are a powerful emetic. The urge to throw up is strong and can be distressing and uncomfortable. The barbiturates are then dissolved in a tumbler full of water and have to be drunk. It takes between one minute and 38 minutes until the person falls into a coma. In around 7% of cases, the person suffers from vomiting or spasms. In one in every 10 cases there can be problems with administering the barbiturates. In Oregon, it takes, on average, 25 minutes for the person to die. But the longest period before someone died was four days. In addition, in about 1% of cases, the person has woken up. … compassion is misguided if we think that by prematurely ending someone’s life, we are alleviating suffering.

Peter Singer debates the legalisation of Euthanasia with the Catholic Archbishop of Sydney

https://m.youtube.com/watch?v=YzTYsFoO_-o

BioEdge: British woman seeks to bear dead daughter’s child

BioEdge: British woman seeks to bear dead daughter’s child

Donor dad not the genius he said he was

Donor dad not the genius he said he was

Is the world really as we see it?

What would Wittgenstein say about that dress?



Sometimes our senses cannot be relied on to inform us how the world is, have a look at this and think about our work on Plato and his analogy of the Cave.

Does religion have a role in bioethics?

Does religion have a role in bioethics?

UK approves three parent babies

The UK has now become the first country to approve laws to allow the creation of babies from three people. 

The modified version of IVF has passed its final legislative obstacle after being approved by the House of Lords.

The fertility regulator will now decide how to license the procedure to prevent babies inheriting deadly genetic diseases.  

The first baby could be born as early as 2016.

A large majority of MPs in the House of Commons approved "three-person babies" earlier this month. 

The House of Lords tonight rejected an attempt to block the plan by a majority of 232.

Power packs

Mitochondria are the tiny compartments inside nearly every cell of the body that convert food into useable energy.  

But genetic defects in the mitochondria mean the body has insufficient energy to keep the heart beating or the brain functioning.

The structures are passed down only from the mother and have their own DNA, although it does not alter traits including appearance or personality. 

The technique, developed in Newcastle, uses a modified version of IVF to combine the healthy mitochondria of a donor woman with DNA of the two parents.

It results in babies with 0.1% of their DNA from the second woman and is a permanent change that would echo down through the generations. 

Timeline

■   March to August - The UK fertility regulator will develop and then publish their licensing rules for assessing applications to perform three-person IVF

■   Early Summer - The team in Newcastle publish the final safety experiments demanded by the regulator

■   29 October - Regulations come into force 

■   24 November - Clinics can apply to the regulator for a licence 

■   By the end of 2015 - the first attempt could take place

'Hope'

In the debate, health minister Lord Howe said there was an opportunity to offer "real hope" to families. 

He stated the UK was leading the world and that three safety reviews by experts suggested it would be safe.

Lord Howe told the House: "Families can see that the technology is there to help them and are keen to take it up, they have noted the conclusions of the expert panel.

"It would be cruel and perverse in my opinion, to deny them that opportunity for any longer than absolutely necessary."

Lord Deben, the former government minister John Gummer, countered that there were "real doubts about safety".

He also voiced concerns about whether the creation of such babies would be legal.

"It is quite clear that there is considerable disagreement, let me put it simply like that, about whether this action is legal under European law." 

Baroness Scotland of Asthal, a former Labour attorney general, also questioned the legality asking: "Why the haste? 

"Everyone agrees we have to get this right. If we're going to do something which everyone agrees is novel, different and important internationally we really have to be confident that we are on solid ground. If we are not we give a disservice."

Fertility doctor, Lord Winston, told the House there were comparison with the early days of IVF which was "also a set in the dark".

He added: "I don't believe my Lords, in spite of what we've heard this evening, that this technology threatens the fabric of society in the slightest bit." 

Sally Cheshire, the chairwoman of the Human Fertilisation and Embryology Authority, said: "Britain is the first country in the world to permit this treatment, and it is a testament to the scientific expertise and well-respected regulatory regime that exists across the UK that Parliament has felt able to approve it. 

"The HFEA now have to develop a robust licensing process, which takes into account on a case by case basis the technical and ethical complexities of such treatments to ensure that any children born have the best chance of a healthy life. 

"The HFEA has a long tradition of dealing with medical and scientific breakthroughs, ensuring that IVF techniques, pioneered in the UK and now practised across the world, can be used safely and effectively in fertility treatment."

Prof Alison Murdoch, who was instrumental in developing the technique at Newcastle University, said: "For 10 years we have publically discussed mitochondrial donation to explain how it could help patients whose families are blighted by the consequences of mitochondrial abnormalities. 

"Whilst acknowledging the views of those who have a fundamental objection to our work, Parliament has determined that we should continue. We hope that opponents will accept its democratic decision.

"The science will be reviewed and, if accepted, we hope to be able to submit a treatment application to the HFEA when regulatory policies have been determined."

Objections 'hopeless'

James Lawford Davies, a lawyer from Lawford Davies Denoon which specialises in the life sciences, told the BBC: "All of the legal arguments made in opposition to the regulations are hopeless. 

"The regulations do not breach the Clinical Trials Directive which applies only to medicinal products. 

"The regulations do not breach the EU Charter of Fundamental Rights and Freedoms which prohibit 'eugenic practices' as this is intended to prevent practices such as forced sterilisation and reproductive cloning, not treatments intended to prevent the transmission of disease."

The Catholic and Anglican Churches in England said the idea was not safe or ethical, not least because it involved the destruction of embryos. 

Other groups, including Human Genetics Alert, say the move would open the door to further genetic modification of children in the future - so-called designer babies, genetically modified for beauty, intelligence or to be free of disease.

Estimates suggest 150 couples would be suitable to have babies through the technique each year. 

If the measure goes ahead, the first "three-person" baby could be born next year.