Peter Singer interviewed about, well, everything

h/t Bioedge

The Journal of Practical Ethics recently posed 20 hardball questions to Peter Singer about his philosophy. It is a terrific insight into his thinking as his long career draws to a close.

About utilitarianism: Why do many intelligent and sophisticated people reject utilitarianism? Some people give more weight to their intuitions than I do—and less weight to arguments for debunking intuitions. Does that reduce my confidence in utilitarianism? Yes, to some extent, but I still remain reasonably confident that it is the most defensible view of ethics. I don’t know if everyone will accept utilitarianism in 100 years, but I don’t find the prospect frightening. It would only be frightening if people misapplied it, and I do not assume that they will.

On critics: There have been many critics of my views about euthanasia for severely disabled infants. I had some good discussions with the late Harriet McBryde Johnson, who was not a philosopher but a lawyer who had a rich and full life despite being born with a very disabling condition. As long as she was alive, when I wrote anything on that topic, I wrote with her potentially critical response in mind.

The objective truth of morality: You could just say “these are my normative views, and I’m going to treat them as if they were true, without thinking about whether moral judgements really can be objectively true.” If you do that, then in practice your decisions will be the same whether or not moral judgements can be objectively true. But given that I think morality is highly demanding, it becomes easier to say that, since morality is so highly demanding, and there is nothing irrational about not doing what morality demands, I’m not going to bother doing what I know to be right. If there are objective reasons for doing what morality demands, it’s more troubling to go against them.

On absolute moral standards: There are still absolutists. Some are proponents of the “new natural law” tradition, which has its roots in Catholic moral theology, even though it is presented as a secular position. Others are Kantians, many of them outside English-speaking philosophy. In Germany, for example, you would find wide support for the idea that we should not torture a child, even if (as in Dostoevsky’s example in The Brothers Karamazov) that would produce peace on earth forever. To me it seems obvious that if by torturing one child you could prevent a vast number of children (and adults) suffering as much or more than the child you have to torture, it would be wrong not to torture that child. 

On inconsistency: The view that I take in Practical Ethics and some other writings is not that not aiding is the same as harming in all respects... [So why not donate a spare kidney?]  don’t think I’m weak-willed, but I do give greater weight to my own interests, and to those of my family and others close to me, than I should. Most people do that, in fact they do it to a greater extent than I do (because they do not give as much money to good causes as I do). That fact makes me feel less bad about my failure to give a kidney than I otherwise would. But I know that I am not doing what I ought to do.

On adopting out a [hypothetical] Down syndrome child: For me, the knowledge that my [hypothetical] child would not be likely to develop into a person whom I could treat as an equal, in every sense of the word, who would never be able to have children of his or her own, who I could not expect to grow up to be a fully independent adult, and with whom I could expect to have conversations about only a limited range of topics would greatly reduce my joy in raising my child and watching him or her develop.

On dogs, pigs, and disabled babies: Most people think that the life of a dog or a pig is of less value than the life of a normal human being. On what basis, then, could they hold that the life of a profoundly intellectually disabled human being with intellectual capacities inferior to those of a dog or a pig is of equal value to the life of a normal human being? This sounds like speciesism to me, and as I said earlier, I have yet to see a plausible defence of speciesism. After looking for more than forty years, I doubt that there is one.

On bestiality and infanticide: I don’t put forward provocative views for the sake of doing so. I put them forward where I think they have a basis in sound argument, and where it serves a purpose to have them discussed. I hope that other philosophers will do the same.

On the future:  I worry that if people who think a lot about others and act altruistically decide not to have children, while those who do not care about others continue to have children, the future isn’t going to be good.

On moral bioenhancement: I have some practical concerns: will it work? Will there be unexpected negative side-effects? But suppose that we can put aside those worries and can be highly confident that the proposed bioenhancement will reduce suffering and increase happiness for all affected—then I have no problem with human bioenhancement. Indeed, it would be a very positive thing. As for moral bioenhancement specifically, I doubt that it will happen quickly enough, or spread widely enough, to solve the global moral problems like climate change that we face right now. But once again, if we could do it, that would be very good.

Catholics shouldn't totally reject human gene editing – but it still has ethical problems

h/t CNA

By Adelaide Mena

Washington D.C., Feb 23, 2017 / 02:50 am (CNA/EWTN News).- Recent American guidelines for human gene modification have raised important ethical questions, especially with regard to modifying the genes of unborn children and of reproductive cells.

The National Academy of Sciences last week released a 261-page report on guidelines for editing the human genome to treat diseases and other applications. The report covers a wide array of topics, from the editing of adult cells for therapies such as cancer treatment, to the editing of embryos and germ cells (reproductive cells, i.e. ova and sperm), to the question of human enhancement.

John DiCamillo, an ethicist at the National Catholic Bioethics Center, spoke to CNA about the perils and the promises of gene editing, as well as the oversights contained in the National Academy of Sciences' report.

“Gene editing generally can be morally legitimate if it has a directly therapeutic purpose for a particular patient in question, and if we’re sure we’re going to limit whatever changes to this person,” DiCamillo explained. In this regard, the report’s guidelines for laboratory treatment of somatic – or non-reproductive – cells and human trials of somatic cell treatments were reasonable, he noted.

DiCamillo pointed to upcoming clinical gene therapy trials for cancer and proposed gene therapy treatments for disorders such as sickle cell disease. However, it’s important to limit these trials to non-embryonic persons, to ensure that the modifications – intended as well as unintended – are not carried in the patient’s reproductive cells.

While this would mean that patients treated for inheritable diseases “could still transmit it to their children,” any children who then developed the disease could themselves be treated through the same process.

The question of transmission to descendants opens two more points discussed in the National Academy of Sciences report: the modification of ova and sperm, as well as edits to the genomes of embryos. Both changes would mean that people would maintain these edits in all of their cells for all of their lives – and could pass on these edited genes to new generations.  

“There could be limited situations that could exist where the germ line could be legitimately edited. In other words, making changes to sperm, to eggs, or to early embryos as a way of potentially addressing diseases – inheritable diseases and so forth,” DiCamillo stated.  

However, permitting edits to germ line cells could also be “very dangerous on multiple levels,” he warned.

There are considerable, and not yet fully controllable, risks to genetic manipulation. A person conceived with edited genes could experience a range of “unintended, perhaps harmful, side effects that can now be transmitted, inherited by other individuals down the line.” An embryo who experiences gene modification could also carry and pass on edited genes, particularly if edits were performed before his or her reproductive cells began to differentiate themselves.

The National Academy of Sciences' regulations surrounding germ cells and embryos are also problematic for what they overlook, DiCamillo commented.

Manipulating sperm and ova requires removing them from a person’s body; if conception is achieved with these cells, it is nearly always through in vitro methods. This practice of in vitro fertilization is held by the Church to be ethically unacceptable because it dissociates procreation from the integrally personal context of the conjugal act.

In addition, scientific researchers rarely differentiate between experimentation on sperm or ova – which are cells that come from a human subject – and embryos, which are distinct persons with their own distinct genomes, DiCamillo noted.

The National Academy of Sciences’ guidelines reflect this lack of distinction between cells and embryos. “That’s very misleading because embryos are not germ line cells; they are new human beings,” DiCamillo said.

For research on embryos to be ethical, he continued, therapies should be ordered to treating and benefitting that “that particular embryo, not just for garnering scientific knowledge or seeing what’s going to happen.” DiCamillo condemned policies that see destruction of embryonic persons as a back-up if research does not go as planned, as well as current policies that require destruction of embryos as standard procedure.

“We’d be in that area of very dangerous exploitation of human life and destruction of human life,” he warned.

While the guidelines stumble across ethical roadblocks in regards to gamete and embryo research, the new report’s rules regarding human enhancement are strong, DiCamillo said.

The ability to edit genomes could also be used for purposes other than medical treatment. A whole host of human traits could be enhanced or changed, such as vision, intelligence, or abilities. “There’s any number of things that we could do to change the qualities of human beings themselves and make them, in a sense, super-humans … this is something that would also be an ethical problem on the horizon,” he warned.

The existence of these gene altering therapies raises a question of how much modification and enhancement is permissible. DiCamillo praised the report for its recommendation “entirely against enhancement efforts and that these should not be allowed.”

Currently, gene editing of both germ cells and somatic cells is legal in the United States, including on embryos. However, various US government institutions have policies in place prohibiting federal funding of such research efforts on germ cells and on embryos.

Furthermore, Food and Drug Administration regulations prohibit gene modification on viable human embryos – meaning that human embryos who receive gene modification are always destroyed.

The new guidelines from the National Academy of Sciences are significant because they lay a groundwork for future policy on human gene modification. They cautiously welcome the use of gene therapy on human embryos who are not later targeted for destruction after experimentation concludes.

DiCamillo recalled, however, that “they are merely guidelines – they are advice from the National Academy of the Sciences to the government in regards to future policy. This is not itself a new regulation or policy that the government has established.”

The ethics of gene editing has been questioned for several years – the Congregation for the Doctrine of the Faith addressed the issue in Dignitas personae, its 2008 instruction on certain bioethical questions. It has become more pressing recently, however, because a new technique known as CRISPR is easier to use and less expensive than previous means of gene editing.

Although the ethical questions surrounding gene modification are many and there are a number of problematic applications of these technologies, DiCamillo cautioned Catholics not to renounce completely human gene modification: “We don’t want to be hyper-reactive to the dangers. We have to realize there’s a great deal of good that can be done here.”

He pointed again to the kinds of modifications that can treat deadly genetic diseases and treatments that can be done in an ethical manner, with full respect to the dignity of human persons.

“We do need to be attentive to where the dangers are,” he warned, “but we don’t want to … automatically consider any kind of gene editing to be automatically a problem.”

Is denying transgender rights a kind of torture?

h/t Bioedge

Street mural in Brussels    

A completely different way of viewing transgender issues comes from the Oxford Human Rights Hub. Geoffrey Yeung, a Hong Kong activist studying at Oxford, argued last year that restrictions on transgender people are banned by the United Nations Convention Against Torture (CAT). He pointed out that

Many countries ... impose heavy burdens (such as sterilisation, surgery, hormonal treatment and psychiatric diagnosis) on transgender people before they can legally be recognised in their preferred gender ... [The Committee Against Torture has] explicitly recommended the repeal of “abusive” preconditions to legal gender recognition and called for respect for transgender people’s “autonomy and physical and psychological integrity”. 

The UN’s Special Rapporteur on torture, Juan E. Méndez, has given this interpretation of the Convention his blessing. “We have a tendency to regard violations against these groups as ill-treatment even where they would more appropriately be defined as torture,” Mr. Méndez said in a report to the Human Rights Council about gender-based violence.

Even if transgenders are not getting the bastinado, Yeung points out that what they experience in many countries is a kind of psychological torture:

It is important to make clear that what constitutes systematic ill-treatment (and thus torture under the CAT) is the legal requirement that all transgender people must undergo certain forms of medical or surgical treatment — regardless of their personal desires or medical necessity — to be recognised in their preferred gender.

If sex reassignment surgery is the answer, what is the question?

Sex reassignment surgery requires the intervention of doctors. But what kind of treatment is it? Is it a therapy for a disease which should be offered only after psychiatric authorization? Or is it a biomedical enhancement which anyone can freely choose?

The answer to this theoretical question has practical consequences. If it is a therapy, then transgenderism is a disease. If it is an enhancement, then it hardly deserves to be funded by the government.

In a very interesting article in the Journal of Medicine and Philosophy, Tomislav Bracanović, of the University of Zagreb, in Croatia, analyses the competing conceptions.

Transgender scholars contend that sex reassignment surgery is not a therapy for gender identity disorder, because the feeling of being a man in a woman’s body or a woman in a man’s body is not a disorder. It is a “normal, albeit rare, human condition that is medicalized as a consequence of general discrimination of transsexual population. It should be removed, therefore, from all classifications of mental disorders, and sex reassignment surgery should be made available without medical “gatekeepers” deciding who qualifies for it and who does not.”

Their conclusion is that a sex change is no more a therapy than a “nose job”. They would prefer to describe sex reassignment surgery as an enhancement, like cosmetic surgery.

But is it plausible to describe it as non-therapeutic enhancement? Bracanović believes that it is not. “It does not improve, augment, or increase—above average—any trait or function typically mentioned in philosophical debates about enhancement. Intelligence, vision, hearing, physical strength, and immunity, for example, after sex reassignment surgery remain more or less the same as they were before.”

There is another way of framing enhancement, though: the welfarist model – does it enhance quality of life? At first blush this seems plausible because people who have had the operation report more satisfaction and a decrease in dissatisfaction. However, Bracanović  points out that the evidence for this is weak. There have been very few long-term studies of postoperative transsexuals’s quality of life.

... imagine the “sex change drug” that has the same risk–benefit ratio as sex reassignment surgery. Even if it improved the condition of many clinical trial subjects, it would probably not be approved by any regulatory agency (as either “therapy” or “enhancement”), if a large number of subjects mysteriously disappeared from the trial after taking the drug.

So Bracanović concludes that it would be wise to keep the gatekeepers for this type of surgery and to restrict access to it. Given the current state of knowledge, there is too great a risk of harm to the patients. Furthermore, if it is an enhancement which increases a person’s well-being, as transgender scholars contend, it is obviously more like enhancement for artistic ability rather than curing paraplegia. With limited resources, society would normally focus on paraplegia rather than gender dysphoria. The only way to prioritise it above paraplegia would be to medicalise it and describe it as a serious disorder – which theorists vehemently reject.

h/t Bioedge