What do we mean by 'killing' and 'letting die'?

Ivar R. Hannikainen, Anibal Monasterio-Astobiza, & David Rodríguez-Arias
www.bioxphi.org
Originally published 22 Feb 20

Bioethicists have long asked how to distinguish killing from letting die. Opponents of the legalization of euthanasia routinely invoke this distinction to explain why withholding life-sustaining treatment may be morally permissible, while euthanasia is not. The underlying assumption is that, when physicians refrain from applying life-sustaining treatment, they merely let the patient die. In contrast, a doctor who provided a lethal injection would thereby be 'killing' them. At a broader level, this view implies that 'killing' and 'letting die' are terms we use to distinguish actions from omissions that result in death.

Theorists such as Gert, Culver and Clouser (1998/2015) advanced a radically different understanding of this fundamental bioethical distinction. In a germinal paper, they argue that to 'kill' involves a contextual assessment of whether the doctor violated a prior duty. In turn, whether the doctor violated their duty—namely, to preserve the patient's life—depends on the patient's preferences. (They actually argued for a more sophisticated view according to which only some preferences, i.e., refusals, constrain a doctor's duty—while others, i.e., requests, do not.) This view is qualitatively different from the first (what we call commissive) view. On this alternative view, which we refer to as deontic, 'killing' and 'letting die' serve to differentiate patient deaths that result from breaches of medical duty from those that do not.

How well does each of these theoretical perspectives capture people's use of the killing versus letting die distinction? In a recent paper published in Bioethics, our goal was to develop an understanding of the considerations that carve this bioethical distinction in non-philosophers' minds.

We invited a group of laypeople, unfamiliar with this bioethical debate and lacking any formal training in the health sciences, to take part in a short study. Each participant was asked to consider a set of three hypothetical scenarios in which a terminally ill patient dies, while we manipulated two features of the scenario: (1) the physician's involvement, and (2) the patient's wishes.

The info is here.

Docs Decry ‘Moral Injury’ From Financial Pressures Of Health Care

Melissa Bailey
Kaiser Health News
Originally published 4 Feb 20

Here are two excerpts:

But “the real priority is speed and money and not our patients’ care,” Corl said. “That makes it tough for doctors who know they could be doing better for their patients.”

Dean said people often frame burnout as a personal failing. Doctors get the message: “If you did more yoga, if you ate more salmon salad, if you went for a longer run, it would help.” But, she argued, burnout is a symptom of deeper systemic problems beyond clinicians’ control.

(cut)

“The health system is not set up to help patients. It’s set up to make money,” he said.

The best way to approach this problem, he said, is to help future generations of doctors understand “how decisions made at the systems level impact how we care about patients” — so they can “stand up for what’s right.”

Whether these experiences amount to moral injury is open for discussion.

Cynda Rushton, a nurse and professor of clinical ethics at Johns Hopkins University, who has studied the related notion of “moral distress” for 25 years, said there isn’t a base of research, as there is for moral distress, to measure moral injury among clinicians.

But “what both of these terms signify,” Rushton said, “is a sense of suffering that clinicians are experiencing in their roles now, in ways that they haven’t in the past.”

Dean grew interested in moral injury from personal experience: After a decade of treating patients as a psychiatrist, she stopped because of financial pressures. She said she wanted to treat her patients in longer visits, offering both psychotherapy and medication management, but that became more difficult. Insurers would rather pay her for only a 15-minute session to manage medications and let a lower-paid therapist handle the therapy.

The info is here.

Does Morality Matter? Depends On Your Definition Of Right And Wrong

Hannes Leroy

forbes.com
Originally posted 30 Jan 20

Here is an excerpt:

For our research into morality we reviewed some 300 studies on moral leadership. We discovered that morality is – generally speaking – a good thing for leadership effectiveness but it is also a double-edged sword about which you need to be careful and smart. 

To do this, there are three basic approaches.

First, followers can be inspired by a leader who advocates the highest common good for all and is motivated to contribute to that common good from an expectation of reciprocity (servant leadership; consequentialism).

Second, followers can also be inspired by a leader who advocates the adherence to a set of standards or rules and is motivated to contribute to the clarity and safety this structure imposes for an orderly society (ethical leadership; deontology).

Third and finally, followers can also be inspired by a leader who advocates for moral freedom and corresponding responsibility and is motivated to contribute to this system in the knowledge that others will afford them their own moral autonomy (authentic leadership; virtue ethics).

The info is here.

Autonomy, mastery, respect, and fulfillment are key to avoiding moral injury in physicians

Simon G Talbot and Wendy Dean
BMJ blogs
Originally posted 16 Jan 20

Here is an excerpt:

We believe that distress is a clinician’s response to multiple competing allegiances—when they are forced to make a choice that transgresses a long standing, deeply held commitment to healing. Doctors today are caught in a double bind between making patients’ needs the top priority (thereby upholding our Hippocratic Oath) and giving precedence to the business and financial frameworks of the healthcare system (insurance, hospital, and health system mandates).

Since our initial publication, we have come to believe that burnout is the end stage of moral injury, when clinicians are physically and emotionally exhausted with battling a broken system in their efforts to provide good care; when they feel ineffective because too often they have met with immovable barriers to good care; and when they depersonalize patients because emotional investment is intolerable when patient suffering is inevitable as a result of system dysfunction. Reconfiguring the healthcare system to focus on healing patients, rebuilding a sense of community and respect among doctors, and demonstrating the alignment of doctors’ goals with those of our patients may be the best way to address the crisis of distress and, potentially, find a way to prevent burnout. But how do we focus the restructuring this involves?

“Moral injury” has been widely adopted by doctors as a description for their distress, as evidenced by its use on social media and in non-academic publications. But what is at the heart of it? We believe that moral injury occurs when the basic elements of the medical profession are eroded. These are autonomy, mastery, respect, and fulfillment, which are all focused around the central principle of purpose.

The info is here.

American Psychological Association Calls for Immediate Halt to Sharing Immigrant Youths' Confidential Psychotherapy Notes with ICE

American Psychological Association
Press Release
Released 17 Feb 20

The American Psychological Association expressed shock and outrage that the federal Office of Refugee Resettlement has been sharing confidential psychotherapy notes with U.S. Immigration and Customs Enforcement to deny asylum to some immigrant youths.

“ORR’s sharing of confidential therapy notes of traumatized children destroys the bond of trust between patient and therapist that is vital to helping the patient,” said APA President Sandra L. Shullman, PhD. “We call on ORR to stop this practice immediately and on the Department of Health and Human Services and Congress to investigate its prevalence. We also call on ICE to release any immigrants who have had their asylum requests denied as a result.”

APA was reacting to a report in The Washington Post focused largely on the case of then-17-year-old Kevin Euceda, an asylum-seeker from Honduras whose request for asylum was granted by a judge, only to have it overturned when lawyers from ICE revealed information he had given in confidence to a therapist at a U.S. government shelter. According to the article, other unaccompanied minors have been similarly detained as a result of ICE’s use of confidential psychotherapy notes. These situations have also been confirmed by congressional testimony since 2018.

Unaccompanied minors who are detained in U.S. shelters are required to undergo therapy, ostensibly to help them deal with trauma and other issues arising from leaving their home countries. According to the Post, ORR entered into a formal memorandum of agreement with ICE in April 2018 to share details about children in its care. The then-head of ORR testified before Congress that the agency would be asking its therapists to “develop additional information” about children during “weekly counseling sessions where they may self-disclose previous gang or criminal activity to their assigned clinician,” the newspaper reported. The agency added two requirements to its public handbook: that arriving children be informed that while it was essential to be honest with staff, self-disclosures could affect their release and that if a minor mentioned anything having to do with gangs or drug dealing, therapists would file a report within four hours to be passed to ICE within one day, the Post said.

"For this administration to weaponize these therapy sessions by ordering that the psychotherapy notes be passed to ICE is appalling,” Shullman added. “These children have already experienced some unimaginable traumas. Plus, these are scared minors who may not understand that speaking truthfully to therapists about gangs and drugs – possibly the reasons they left home – would be used against them.”

Escaping Skinner's Box: AI and the New Era of Techno-Superstition

John Danaher
Philosophical Disquisitions
Originally posted October 10, 2019

Here is an excerpt:

The findings were dispiriting. Green and Chen found that using algorithms did improve the overall accuracy of decision-making across all conditions, but this was not because adding information and explanations enabled the humans to play a more meaningful role in the process. On the contrary, adding more information often made the human interaction with the algorithm worse. When given the opportunity to learn from the real-world outcomes, the humans became overconfident in their own judgments, more biased, and less accurate overall. When given explanations, they could maintain accuracy but only to the extent that they deferred more to the algorithm. In short, the more transparent the system seemed to the worker, the more the workers made them worse or limited their own agency.

It is important not to extrapolate too much from one study, but the findings here are consistent what has been found in other cases of automation in the workplace: humans are often the weak link in the chain. They need to be kept in check. This suggests that if we want to reap the benefits of AI and automation, we may have to create an environment that is much like that of the Skinner box, one in which humans can flap their wings, convinced they are making a difference, but prevented from doing any real damage. This is the enchanted world of techno-superstition: a world in which we adopt odd rituals and habits (explainable AI; fair AI etc) to create an illusion of control.

(cut)

These two problems combine into a third problem: the erosion of the possibility of achievement. One reason why we work is so that we can achieve certain outcomes. But when we lack understanding and control it undermines our sense of achievement. We achieve things when we use our reason to overcome obstacles to problem-solving in the real world. Some people might argue that a human collaborating with an AI system to produce some change in the world is achieving something through the combination of their efforts. But this is only true if the human plays some significant role in the collaboration. If humans cannot meaningfully make a difference to the success of AI or accurately calibrate their behaviour to produce better outcomes in tandem with the AI, then the pathway to achievement is blocked. This seems to be what happens, even when we try to make the systems more transparent.

The info is here.

Moral Enhancement: A Realistic Approach

Greg Conan
British Medical Journal Blogs
Originally published August 29, 2019

Here is an excerpt:

If you could take a pill to make yourself a better person, would you do it? Could you justifiably make someone else do it, even if they do not want to?

When presented so simplistically, the idea might seem unrealistic or even impossible. The concepts of “taking a pill” and “becoming a better person” seem to belong to different categories. But many of the traits commonly considered to make one a “good person”—such as treating others fairly and kindly without violence—are psychological traits strongly influenced by neurobiology, and neurobiology c
an be changed using medicine. So when and how, if ever, should medicine be used to improve moral character?

Moral bioenhancement (MBE), the concept of improving moral character using biomedical technology, has fascinated me for years—especially once I learned that it has been hotly debated in the bioethics literature since 2008. I have greatly enjoyed diving into the literature to learn about how the concept has been analyzed and presented. Much of the debate has focused on its most abstract topics, like defining its terms and relating MBE to freedom. Although my fondness for analytic philosophy means that I cannot condemn anyone for working to examine ideas with maximum clarity and specificity, any MBE proponent who actually wants MBE to be implemented must focus on realistic methods.

The info is here.

The Sex Premium in Religiously Motivated Moral Judgment

Liana Hone, Thomas McCauley, Eric Pedersen,
Evan Carter, and Michael McCullough
PsyArXiv Preprints

Abstract

Religion encourages people to reason about moral issues deontologically rather than on the basis of the perceived consequences of specific actions. However, recent theorizing suggests that religious people’s moral convictions are actually quite strategic (albeit unconsciously so), designed to make their worlds more amenable to their favored approaches to solving life’s basic challenges. In six experiments, we find that religious cognition places a “sex premium” on moral judgments, causing people to judge violations of conventional sexual morality as particularly objectionable. The sex premium is especially strong among highly religious people, and applies to both legal and illegal acts. Religion’s influence on moral reasoning, even if deontological, emphasizes conventional sexual norms, and may reflect the strategic projects to which religion has been applied throughout history.

From the Discussion

How does the sex premium in religiously motivated moral judgment arise during development? We see three plausible pathways. First, society’s vectors for religious cultural learning may simply devote more attention to sex and reproduction than to prosociality when they seek to influence others’ moral stances. Conservative preachers, for instance, devote more time to issues of sexual purity than do liberal preachers, and religious parents discuss the morality of sex with their children more frequently than do less religious parents, even though they discuss sex with their children less frequently overall. Second, strong emotions facilitate cultural learning by improving attention, memory, and motivation, and few human experiences generate stronger emotions than do sex and reproduction. If the emotions that regulate sexual attraction, arousal, and avoidance (e.g., sexual disgust) are stronger than those that regulate prosocial behavior (e.g., empathy; moralistic anger), then the sex premium documented here may emerge from the fact that religiously motivated sexual moralists can create more powerful cultural learning experiences than prosocial moralists can.  Finally, given the extreme importance of sex and reproduction to fitness, the children of religiously adherent adults may observe that violations of local sexual standards to evoke greater moral outrage and condemnation from third parties than do violations of local standards for prosocial behavior.

The research is here.

What Clinical Ethics Can Learn From Decision Science

Michele C. Gornick and Brian J. Zikmund-Fisher
AMA J Ethics. 2019;21(10):E906-912.
doi: 10.1001/amajethics.2019.906.

Abstract

Many components of decision science are relevant to clinical ethics practice. Decision science encourages thoughtful definition of options, clarification of information needs, and acknowledgement of the heterogeneity of people’s experiences and underlying values. Attention to decision-making processes reminds participants in consultations that how decisions are made and how information is provided can change a choice. Decision science also helps reveal affective forecasting errors (errors in predictions about how one will feel in a future situation) that happen when people consider possible future health states and suggests strategies for correcting these and other kinds of biases. Implementation of decision science innovations is not always feasible or appropriate in ethics consultations, but their uses increase the likelihood that an ethics consultation process will generate choices congruent with patients’ and families’ values.

Here is an excerpt:

Decision Science in Ethics Practice

Clinical ethicists can support informed, value-congruent decision making in ethically complex clinical situations by working with stakeholders to identify and address biases and the kinds of barriers just discussed. Doing so requires constantly comparing actual decision-making processes with ideal decision-making processes, responding to information deficits, and integrating stakeholder values. One key step involves regularly urging clinicians to clarify both available options and possible outcomes and encouraging patients to consider both their values and the possible meanings of different outcomes.

Should we create artificial moral agents? A Critical Analysis

John Danaher
Philosophical Disquisitions
Originally published September 21, 2019

Here is an excerpt:

So what argument is being made? At first, it might look like Sharkey is arguing that moral agency depends on biology, but I think that is a bit of a red herring. What she is arguing is that moral agency depends on emotions (particularly second personal emotions such as empathy, sympathy, shame, regret, anger, resentment etc). She then adds to this the assumption that you cannot have emotions without having a biological substrate. This suggests that Sharkey is making something like the following argument:

(1) You cannot have explicit moral agency without having second personal emotions.

(2) You cannot have second personal emotions without being constituted by a living biological substrate.

(3) Robots cannot be constituted by a living biological substrate.

(4) Therefore, robots cannot have explicit moral agency.

Assuming this is a fair reconstruction of the reasoning, I have some questions about it. First, taking premises (2) and (3) as a pair, I would query whether having a biological substrate really is essential for having second personal emotions. What is the necessary connection between biology and emotionality? This smacks of biological mysterianism or dualism to me, almost a throwback to the time when biologists thought that living creatures possessed some élan vital that separated them from the inanimate world. Modern biology and biochemistry casts all that into doubt. Living creatures are — admittedly extremely complicated — evolved biochemical machines. There is no essential and unbridgeable chasm between the living and the inanimate.

The info is here.

Lolita understood that some sex is transactional. So did I

Tamara MacLeod
aeon.co
Originally published September 11, 2019

Here is an excerpt:

However, I think that it is the middle-class consciousness of liberal feminism that excluded sex work from its platform. After all, wealthier women didn’t need to do sex work as such; they operated within the state-sanctioned transactional boundaries of marriage. The dissatisfaction of the 20th-century housewife was codified as a struggle for liberty and independence as an addition to subsidised material existence, making a feminist discourse on work less about what one has to do, and more about what one wants to do. A distinction within women’s work emerged: if you don’t enjoy having sex with your husband, it’s just a problem with the marriage. If you don’t enjoy sex with a client, it’s because you can’t consent to your own exploitation. It is a binary view of sex and consent, work and not-work, when the reality is somewhat murkier. It is a stubborn blindness to the complexity of human relations, and maybe of human psychology itself, descending from the viscera-obsessed, radical absolutisms of Andrea Dworkin.

The housewife who married for money and then fakes orgasms, the single mother who has sex with a man she doesn’t really like because he’s offering her some respite: where are the delineations between consent and exploitation, sex and duty? The first time I traded sex for material gain, I had some choices, but they were limited. I chose to be exploited by the man with the resources I needed, choosing his house over homelessness. Lolita was a child, and she was exploited, but she was also conscious of the function of her body in a patriarchal economy. Philosophically speaking, most of us do indeed consent to our own exploitation.

The info is here.

Dying is a Moral Event. NJ Law Caught Up With Morality

T. Patrick Hill
Star-Ledge Guest Column
Originally posted September 9, 2019

New Jersey’s Medical-Aid-in-Dying legislation authorizes physicians to issue a prescription to end the lives of their patients who have been diagnosed with a terminal illness, are expected to die within six months, and have requested their physicians to help them do so. While the legislation does not require physicians to issue the prescription, it does require them to transfer a patient’s medical records to another physician who has agreed to prescribe the lethal medication.

(cut)

The Medical Aid in Dying Act goes even further, concluding that its passage serves the public’s interests, even as it endorses the “right of a qualified terminally ill patient …to obtain medication that the patient may choose to self-administer in order to bring about the patient’s humane and dignified death.”

The info is here.

Is there a right to die?

Eric Mathison
Baylor Medical College of Medicine Blog
Originally posted May 31, 2019

How people think about death is undergoing a major transformation in the United States. In the past decade, there has been a significant rise in assisted dying legalization, and more states are likely to legalize it soon.

People are adapting to a healthcare system that is adept at keeping people alive, but struggles when aggressive treatment is no longer best for the patient. Many people have concluded, after witnessing a loved one suffer through a prolonged dying process, that they don’t want that kind of death for themselves.

Public support for assisted dying is high. Gallup has tracked Americans’ support for it since 1951. The most recent survey, from 2017, found that 73% of Americans support legalization. Eighty-one percent of Democrats and 67% of Republicans support it, making this a popular policy regardless of political affiliation.

The effect has been a recent surge of states passing assisted dying legislation. New Jersey passed legislation in April, meaning seven states (plus the District of Columbia) now allow it. In addition to New Jersey, California, Colorado, Hawaii, and D.C. all passed legislation in the past three years, and seventeen states are considering legislation this year. Currently, around 20% of Americans live in states where assisted dying is legal.

The info is here.

Three things digital ethics can learn from medical ethics

Carissa Véliz
Nature Electronics 2:316-318 (2019)

Here is an excerpt:

Similarly, technological decisions are not only about facts (for example, about what is more efficient), but also about the kind of life we want and the kind of society we strive to build. The beginning of the digital age has been plagued by impositions, with technology companies often including a disclaimer in their terms and conditions that “they can unilaterally change their terms of service agreement without any notice of changes to the users”. Changes towards more respect for autonomy, however, can already be seen. With the implementation of the GDPR in Europe, for instance, tech
companies are being urged to accept that people may prefer services that are less efficient or possess less functionality if that means they get to keep their privacy.

One of the ways in which technology has failed to respect autonomy is through the use of persuasive technologies. Digital technologies that are designed to chronically distract us not only jeopardize our attention, but also our will, both individually and collectively. Technologies that constantly hijack our attention threaten the resources we need to exercise our autonomy.  If one were to ask people about their goals in life, most people would likely mention things such as “spending more time with family” — not many people would suggest “spending more time on Facebook”.  Yet most people do not accomplish their goals — we get distracted.

The info is here.

Unraveling the Ethics of New Neurotechnologies

Nicholas Weiler
www.ucsf.edu
Originally posted July 30, 2019

Here is an excerpt:

“In unearthing these ethical issues, we try as much as possible to get out of our armchairs and actually observe how people are interacting with these new technologies. We interview everyone from patients and family members to clinicians and researchers,” Chiong said. “We also work with philosophers, lawyers, and others with experience in biomedicine, as well as anthropologists, sociologists and others who can help us understand the clinical challenges people are actually facing as well as their concerns about new technologies.”

Some of the top issues on Chiong’s mind include ensuring patients understand how the data recorded from their brains are being used by researchers; protecting the privacy of this data; and determining what kind of control patients will ultimately have over their brain data.

“As with all technology, ethical questions about neurotechnology are embedded not just in the technology or science itself, but also the social structure in which the technology is used” Chiong added. “These questions are not just the domain of scientists, engineers, or even professional ethicists, but are part of larger societal conversation we’re beginning to have about the appropriate applications of technology, and personal data, and when it's important for people to be able to opt out or say no.”

The info is here.

Proprietary Algorithms for Polygenic Risk: Protecting Scientific Innovation or Hiding the Lack of It?

A. Cecile & J.W. Janssens

Genes 2019, 10(6), 448
https://doi.org/10.3390/genes10060448

Abstract

Direct-to-consumer genetic testing companies aim to predict the risks of complex diseases using proprietary algorithms. Companies keep algorithms as trade secrets for competitive advantage, but a market that thrives on the premise that customers can make their own decisions about genetic testing should respect customer autonomy and informed decision making and maximize opportunities for transparency. The algorithm itself is only one piece of the information that is deemed essential for understanding how prediction algorithms are developed and evaluated. Companies should be encouraged to disclose everything else, including the expected risk distribution of the algorithm when applied in the population, using a benchmark DNA dataset. A standardized presentation of information and risk distributions allows customers to compare test offers and scientists to verify whether the undisclosed algorithms could be valid. A new model of oversight in which stakeholders collaboratively keep a check on the commercial market is needed.

Here is the conclusion:

Oversight of the direct-to-consumer market for polygenic risk algorithms is complex and time-sensitive. Algorithms are frequently adapted to the latest scientific insights, which may make evaluations obsolete before they are completed. A standardized format for the provision of essential information could readily provide insight into the logic behind the algorithms, the rigor of their development, and their predictive ability. The development of this format gives responsible providers the opportunity to lead by example and show that much can be shared when there is nothing to hide.

New Jersey will allow terminally ill patients to end their lives

Taylor Romine
CNN.com
Originally posted July 1, 2019

Terminally ill adults in New Jersey will now be able to ask for medical help to end their lives.

In April, Gov. Phil Murphy signed the Medical Aid in Dying for the Terminally Ill Act. It goes into effect Thursday.

It allows adults with a prognosis of six months or less to live to get a prescription for life-ending medication.

Other jurisdictions that allow physician-assisted suicide are: California, Colorado, Oregon, Vermont, Washington, Hawaii, Montana and the District of Columbia.

The law requires either a psychiatrist or psychologist determine that the patient has the mental capacity to make the decision. The prescription is a series of self-administered pills that can be taken at home.

"Allowing residents with terminal illnesses to make end-of-life choices for themselves is the right thing to do," Murphy said in a statement.

The info is here.

Societal and ethical issues of digitization

Lambèr Royakkers, Jelte Timmer, Linda Kool, & Rinie van Est
Ethics and Information Technology (2018) 20:127–142

Abstract

In this paper we discuss the social and ethical issues that arise as a result of digitization based on six dominant technologies: Internet of Things, robotics, biometrics, persuasive technology, virtual & augmented reality, and digital platforms. We highlight the many developments in the digitizing society that appear to be at odds with six recurring themes revealing from our analysis of the scientific literature on the dominant technologies: privacy, autonomy, security, human dignity, justice, and balance of power. This study shows that the new wave of digitization is putting pressure on these public values. In order to effectively shape the digital society in a socially and ethically responsible way, stakeholders need to have a clear understand-ing of what such issues might be. Supervision has been developed the most in the areas of privacy and data protection. For other ethical issues concerning digitization such as discrimination, autonomy, human dignity and unequal balance of power, the supervision is not as well organized.

The paper is here.

The Ethics of Treating Loved Ones

Christopher Cheney
www.medpagetoday.com
Originally posted May 19, 2019

When treating family members, friends, colleague, or themselves, ER physicians face ethical, professional, patient welfare, and liability concerns, a recent research article found.

Similar to situations arising in the treatment of VIP patients, ER physicians treating loved ones or close associates may vary their customary medical care from the standard treatment and inadvertently produce harm rather than benefit.

"Despite being common, this practice raises ethical concerns and concern for the welfare of both the patient and the physician," the authors of the recent article wrote in the American Journal of Emergency Medicine.

There are several liability concerns for clinicians, the lead author explained.


"Doctors would be held to the same standard of care as for other patients, and if care is violated and leads to damages, they could be liable. Intuitively, family and friends might be less likely to sue but that is not true of subordinates. In addition, as we state in the paper, for most ED physicians, practice outside of the home institution is not a covered event by the malpractice insurer," said Joel Geiderman, MD, professor and co-chairman of emergency medicine, Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles.

The info is here.

German ethics council expresses openness to eventual embryo editing

Sharon Begley
www.statnews.com
Originally posted May 13, 2019

Here is an excerpt:

The council’s openness to human germline editing was notable, however. Because of the Nazis’ eugenics programs and horrific human medical experiments, Germany has historically been even warier than other Western countries of medical technologies that might violate human dignity or could be exploited for eugenic purposes. The country’s 1990 Embryo Protection Act prohibits germline modifications for the purpose of reproduction.

“Germany has been very reluctant to get involved with anything that could lead to a re-introduction of eugenic practices in their society,” Annas said.

Despite that history, a large majority of the council called further development and possible use of germline editing “a legitimate ethical goal when aimed at avoiding or reducing genetically determined disease risks,” it said in a statement. If the procedure can be shown not to harm embryos or the children they become, it added, then altering a gene that otherwise causes a devastating illness such as cystic fibrosis or sickle cell is acceptable.

While some ethicists and others argue against embryo editing on the ground that it violates the embryos’ dignity, the German council wrote, “the question also arises as to whether the renunciation of germline intervention, which could spare the people concerned severe suffering, would not violate their human dignity, too.” Similarly, failing to intervene in order to spare a future child pain and suffering “would at least have to be justified,” the council said, echoing arguments that some families with a history of inherited diseases have.

The info is here.