Human Engineering To Solve Climate Change?

We could select shorter children via PGD to create smaller children so that mankind will on the whole expend less energy.

New York University professor of bioethics S Matthew Liao argues that human engineering is a plausible way to tackle energy resource challenges. According to Liao, modifying humans to simply use less energy deserves consideration because it is less risky than other options (such as geoengineering) in the long run. Even assuming that this premise is true, are the implications and risks involved with this kind of human engineering morally justifiable?

Liao justifies his proposition by saying these policies should be optional: “a voluntary activity rather than a coerced, mandatory activity”. Sure, this is entirely plausible assuming such alteration of height entirely affects the mature human population – humans able to give consent. However, this does not address the moral problem of parents taking away the right to an open future from their children: a matter large enough to present a convincing argument against “climate bioengineering”.

Indeed, parents selecting a shorter stature for children in this way (via PGD) is obviously done without the child’s consent: the children have no choice in this matter, therefore this proposal can’t count as voluntary. Steve Clark of Oxford echoes this sentiment: “as a society, we don’t give parents an unlimited right to make decisions on behalf of their children”. Creating smaller children to combat global energy scarcity is far from ethically justifiable.

http://www.wired.co.uk/news/archive/2012-03/13/bioengineering-humans-climate-change

http://www.smatthewliao.com/wp-content/uploads/2012/02/HEandClimateChange.pdf

http://blog.practicalethics.ox.ac.uk/2012/03/planet-of-the-little-apes/

Marijuana: Recreational or Medicinal?

In 1972, Congress made marijuana into a Schedule I controlled substance claiming that it has, “no accepted medical use”.  However, since then marijuana has been found to be a, “safe and effective treatment for the symptoms of cancer, AIDS, multiple sclerosis, glaucoma, epilepsy, and other conditions” and numerous studies have been published on this matter.  Consequently, 16 states have already legalized marijuana, but it is still a controversial topic around the US.  Interestingly, if marijuana is examined from an objective standpoint, meaning that we consider it as just another prescription drug and not associate it with recreational use and drug abuse, then the medicinal use of marijuana becomes apparently justifiable.  So why then is the topic still so controversial?

It is because people are unable to change their paradigm of looking at marijuana from that of a recreational drug used by drug addicts.  This becomes evident from the arguments critics against medical marijuana use.  The arguments primarily lie on three fronts; first, the critics claim that the medicinal properties of marijuana have not been adequately proven due to the, “lack of consistent, repeatable scientific data”.  But this is surely not the case, for instance, Jocelyn Elders, a former Surgeon General asserts that, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms”.  This “evidence” takes the form of controlled studies published in reputable journals around the US – so the critics are clearly just ignoring the facts and hiding behind their inability to shift paradigms. 

Second, critics claim that marijuana poses health risks, which makes its use unethical.  First of all, this has to be put in perspective – virtually all drugs that treat serious illnesses like cancer or AIDS have dangerous and potentially lethal side effects, so just because marijuana could have certain side effects does not immediately preclude it from medicinal use.  In fact, again the critics are just making assumptions about the health risks of marijuana despite the fact that numerous studies demonstrate its general safety.  Some people claim that marijuana could cause lung cancer or emphysema, but to this date not even one case of either disease has been attributed to marijuana use.  Moreover, critics also say that marijuana use can suppress the immune system, but in one study conducted on patients with AIDS, it was found that patients using marijuana had higher immune function than those on a placebo.  Admittedly, there are definite cases in which marijuana does decrease immune function, but as researchers agree, marijuana is far less toxic than drugs used in the aggressive treatments of other diseases, such as chemotherapy for cancer.  Thus, marijuana does not pose any health risks that are incomparable to other FDA approved drugs, so the critics are again, just clinging to emotional arguments and are ignoring the facts in front of them.    

Third, other critics claim that marijuana is addictive and a gateway for the use harder drugs.  Although studies have found that there can be withdrawal symptoms associated with marijuana, they are largely incomparable to those with other drugs, like nicotine.  In fact, the medicinal use of marijuana does not require use every day so addiction is far less likely.  Despite this, critics do claim that up to 10% of people who use marijuana for medicinal purposes end up getting addicted.  But again, this needs to be put into perspective, take pain killers for example, more than 15 million people use them regularly, which is a jump from half a million a decade ago.  Furthermore, morphine addiction is the 3^rd most common drug related reason people end up in the emergency room – but we still use morphine and vicoden as medicinal drugs.  Secondly, the “gateway” theory has been largely repudiated by studies which have shown that people who are predisposed to using drugs will use both marijuana and other harder drugs regardless.  The only reason that marijuana use starts first is that it is more readily available.  Hence, again, the critics’ arguments fall apart in the face of studies which they conveniently ignore.  Although they do bring up certain reasonable points about the properties of marijuana, they are still treating it as a recreational drug and are not looking at it through the larger perspective of medicine.

 All in all, there are no perfect drugs in medicine, all have potentially adverse effects but they are the best options available.  Similarly, there are no other drugs that can exactly replicate the therapeutic properties of marijuana, so despite the fact that it could have certain detrimental consequences, for the most part marijuana will be beneficial.  As a result, marijuana should be allowed for use in medical settings, where patients can be adequately monitored, minimizing any potential risks – just as all other potentially harmful drugs are administered. 

http://medicalmarijuana.procon.org/view.resource.php?resourceID=000141

http://www.morphineaddictionhelp.com/morphine-addiction-statistics

Sugar for Your Sinuses: The Market Implications of Effective Placebos

I’ve always been told about the power of positive thinking. Normally a tame issue, positive thinking becomes much more controversial when you apply it to medical issues, in the form of placebos. The commonly cited downside of using placebos is that you could be putting the patient at risk by not providing the highest quality of treatment. But how do the ethical implications change when placebos are found to perform equally well? A recent study showed that the placebo pills performed equally well as amoxicillin, a commonly used antibiotic. If they are equally effective, then how do we market said placebo to the public. If we charge nothing for the placebo, then no one will pay for the antibiotic. However, If no one pays for the antibiotic, then everyone will know that they have a placebo, and it will most likely not work as well. Another strategy is to charge them for the antibiotic and then give them what may or may not be a placebo, but this is no different from just administering antibiotics. One option is to offer a reduced price for what will be a placebo only a certain percentage of the time. But how do we regulate this percentage? We need some form of standardization for the amount of antibiotics used so that people still hold faith in the placebos, but also can buy at the lowest possible price. There’s no easy solution, but we must institute some sort of control to lower marginal cost of treating patients.

http://www.nytimes.com/2012/02/21/health/research/in-sinusitis-antibiotics-are-as-effective-as-placebos-study-finds.html

Surgery to Solve Obesity: Lifesaving Procedure or Moral Scourge?

Bariatric surgeries, procedures that surgically alter the gastrointestinal tract to reduce eating capacity or calorie absorption, are gaining popularity as a way to combat America’s ever-widening obesity epidemic. Bariatric surgery has been shown to produce a weight loss of up to 33% within a few years of the treatment, making it more effective than either diet and exercise or dieting pills. But is it moral? The American Journal of Bioethics recently conducted a survey of the various objections to bariatric surgery from the standpoint of medical ethics.

There are several potential objections to bariatric surgery. Some argue that bariatric surgery incentivizes an unhealthy or immoral lifestyle. Because it removes the consequences of overeating, it allows people who would otherwise exercise more self-control and lead healthier (and more globally sustainable) lifestyles to indulge their appetites without repercussion.

On the other hand, there are also arguments against bariatric surgery that take the side of the obese. Considering society’s pronounced discrimination against the obese (including the phenomenon of “fatism” in the workplace), overweight people may feel coerced into having bariatric operations even if they would otherwise be comfortable with their bodies. This challenges the medical ideal of voluntary consent.

Neither of these arguments, however, is sufficient to render bariatric surgery immoral. While the first argument takes issue with obesity because of the perceived immorality of the choices that lead to it, this argument ignores involuntary forms of obesity such as genetic obesity. The second argument ignores the fact that bariatric surgery remains only one of many options for those seeking to lose weight (whether out of personal desire or due to societal pressure).

What’s more, the benefits of bariatric surgery, both to the individual and to society, are tremendous. Bariatric surgery has a significantly higher success rate than traditional weight-loss methods such as diet and exercise. Additionally, the cost of bariatric surgery to the health-care system must be weighed against the cost of the host of other operations that would be necessary to deal with the symptoms of obesity, including diabetes and cardiovascular dysfunctions.  A recent study in Finland reports a cost of $45,000 for a gain of 7 quality-adjusted life years for bariatric surgery, compared to a cost of $64,000 for a gain of 6.5 quality-adjusted life years for patients undergoing surgeries that would have been prevented by bariatric surgery. It appears that bariatric surgery is not only not immoral but in fact a superior option that should be made more widely available to those suffering from obesity.

Source: Bjorn Hoffman, "Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery" The American Journal of Bioethics, 14 December 2010

CIA Interrogation Experimentation

Physicians for Human Rights released a report in 2010 accusing the Bush administration of conducting experiments on prisoners.  The report titled "Experiments in Torture: Evidence of Human Subject Research and Experimentation in the 'Enhanced Interrogation' Program" claims that prisoners of the CIA were exposed to "unethical and unlawful" experiments in which data was taken regarding interrogation techniques primarily waterboarding.  The CIA according to the report used saline instead of water while preforming interrogations in which they collected data and evaluated the differences between applying these techniques individually and in combination.   The purpose, the CIA claimed, of these data collections was to make the interrogation process both safer and more effective. However Nathaniel Raymond, director of the Campaign Against Torture at Physicians for Human Rights and lead author of the report states that, "What the evidence shows is science being applied to law as part of a attempt to insulate the Bush administration from charges of torture".  To what degree is this case unethical because of torture and to what degree is it unethical because of the use of data collection?  There seems to be an implication in this report that the actual gathering of information is the problem with this case.  Though there is certainly some grounds for debate on the subject of what methods of interrogation are ethical, it seems that the government's decision to gather data on its interrogations is not unethical and is a good decision.  The actual interrogation may be questionable, but the data collection is not.  The more data we gather the more we can keep our country safe by finding what interrogation techniques work.

http://www.democracynow.org/2010/6/8/experiments_in_torture_medical_group_accuses

Human Experimentation: Montioring cell phone users for developing diseases

Human Experimentation and cell phones. These two concepts aren’t generally associated with each other. One potentially invokes the grotesque acts of mad scientists and cold government agents on unsuspecting victims. The other is a symbol of how connected the human race has become, if not a bringer of careless driving. However, the two ideas are not nearly as separate as they appear and their relationship is about to become bigger than ever before. Literally.

This year, in Finland, marks the start of the COSMOS initiative, which has been described as the largest human experiment ever. One-hundred thousand Finnish people are estimated to have received invites to participate in the study, which is also being conducted in Sweden, Denmark, The Netherlands, and Great Britain.  The point of this study is to monitor the effects of electromagnetic radiation produced by cell phones on the people who use them over a long-term period.

Perhaps counter-intuitively, this well meant investigation is rife with ethical controversy. The first question that likely rises to anyone’s mind should be about how a device that is suspected of causing cancer and other severe conditions such as Alzheimer’s disease was ever allowed to become as central to modern society as cell phones are. This can be addressed by assuring the questioner that research has been done, like in the HERMO study, and it seems to indicate that there is nothing to fear. This may raise the question as to why research is being done when it is already accepted that no correlation has been found. Wouldn’t that be a waste of resources and personnel and constitute an ethics violation in the process?

Probably, but here is where the sticky issues come in. The research that has been done, while thorough, has been accused of being too narrow in focus, too short in duration, or biased as it was paid for by the big telecommunications companies, like Nokia, that stand to lose the most if a negative connection was discovered.

Additionally, studies such as Interphone, performed by the World Health Organization's International Agency for Research on Cancer, found data suggesting the opposite conclusion – that there is a correlation between excessive mobile phone usage and certain types of brain cancer, such as glioma. However, these studies also have problems, as there is some doubt in the rigor with which the IARC collected their data on cancer patients.

The ethical issues that rise out of this mess of conflicting conclusions can be simplified down to: are we wasting resources by conducting research on a closed case? Are we biasing the results and putting lives in danger by letting telecommunications companies fund these studies? Is it right to let the majority of the population use cell phones while they may potentially be causing cancer or other severe afflictions?

In light of the current disagreement surrounding this issue, it seems that the best course is to continue on with the research, while limiting the contribution of the phone companies as much as possible. In my opinion, this the most ethical way to proceed.

Just One Zap: Neuroenhancement with TDCS

When we discuss cognitive enhancement, we almost always focus on drugs. What can we develop to make our thinking more efficient, to make us learn faster and do more? Drugs that we classify as cognitive enhancers—Ritalin, adderall, modafinil, and even caffeine—however, are only one method of enhancing our thinking. Recent research into non-invasive brain stimulation techniques have shown promise in enhancing cognition. TDCS, or Transcranial direct current stimulation, has shown particular promise because of its efficacy and relative simplicity.

In TDCS, weak electrical currents (on the scale of 1-2 mA) are applied to the head through electrodes on the scalp. The currents pass through the skull and alters neural activity. The treatment has been used successfully in treating various condition such as depression, but the main interest of research into its effects lies in how it effects learning. Research into the treatment in both humans and animals have shown effects of the treatment, many of which improve the performance of mechanisms associated with learning, can last up to 12 months. Other TDCS studies have shown lasting improvements in fundamental areas such as motor skills, vision, problem solving and decision making, mathematical abilities, language, memory, and attention. These improvements appear with no obvious side effects. It is this seemingly free efficacy that makes TDCS so promising. It is well along the path to satisfying criteria for the holy grail of human neuroenhancement: painless, safe, cheap, and effective.

Given these qualities, TDCS presents few ethical issues. The ease of manufacturing and reusing TDCS machines means that unlike enhancement drugs which ethical problems with access to treatment, TDCS machines could become widespread and cheaply available enhancement. In addition, the apparent safety of TDCS separates it from the addiction potential and numerous side effects of drugs such as Ritalin. Removing the concerns about safety and fairness leaves TDCS in the same vein as nutrition: another aid for learning that does not replace hard work and effort.

Even with this in mind, TDCS should not be used until more research to confirm its safety is carried out. This is a particular concern in the child brain. We understand many of the effects of the treatment in adults, but not much research has been carried out in children. We do not know how it affects the developing brain. Until we know more, ethical issues remain for scenarios such as parents using such treatments on their children without understanding the long term effects. Because of its efficacy, relative cheapness, and known safety in the developed brain, however, TDCS does not present any clear ethical issues when used in adults.

http://www.ox.ac.uk/media/science_blog/brainboosting.html

Fatty Foods Will Cost You More Than Just Your Health In Denmark

Denmark has begun taxing fatty food at a rate of 1.29$ per pound. The country already has a tax on surgery food. While I don’t think the taxes will do much to reign in skyrocketing obesity rates, I think the little Scandinavian country has the right idea.

           

            Some see an ethical issue in the government attempting to influence the diet of its citizens. Others see it as just another tax grab, but it’s fair. In countries with government run health care, the tax dollars of the people who eat healthily are being sucked up in a disproportionate amount by citizens who are sick because of their poor diet.

            Take the example of the Canadian province of Ontario. There, 90% of the government run health care costs come from caring for only 10% of the population. Many of the chronic diseases that this 10% face, such as diabetes, high-blood pressure, cardiovascular disease and so on, are preventable and stem from poor nutrition. So is not fair that the provincial government is hiking up general taxes for healthy to pay for the sick.

            On top of discouraging people from buying unhealthy food, governments should give its population incentives to eat healthily by subsidizing good foods. Too often, highly processed and nutritionally depleted food is simply cheaper and more readily available; this has to change. Many countries subsidize things like education and sports for children to encourage them to pursue a healthy life, so why not subsidize good food?

            As for the ethical issue of government meddling in the diets’ of its citizens? Processed and refined foods are not a human right. Morally speaking, they are closer to cigarettes: an unhealthy pleasure. Cigarettes are taxes to discourage people from smoking and to offset the medical costs of caring for them when the effects of their unhealthy choices catch up. Unhealthy food should be treated much in the same way. Good on you Denmark!

http://www.bioethics.net/2011/10/danish-food-police-add-saturated-fat-to-their-list/