Bioethikos: Bringing Life to Bioethics

Archive for August, 2012


A Duty to Design Your Baby?

Wednesday, August 29th, 2012 by Dr. Dennis Sullivan

A prominent ethicist, writing in the pages of Reader’s Digest, no less, Julian Savulescu is the Uehiro Chair in Practical Ethics at Oxford University, UK. In an upcoming edition of RD, he claims it is not only permissible, but a moral obligation, for parents to genetically design their children. After all, claims Savulescu, we wouldn’t want to trust in the “natural lottery” for our children’s characteristics. They might have cystic fibrosis or Down’s syndrome, or they may have adverse psychological profiles such as poor impulse control or a propensity towards violence.

You may say, “But that sounds an awful lot like eugenics.” Here is Dr. Savulescu’s response:

Much of the unease about designer babies comes from the work of the 20th-century eugenics movement. It tried to use selective breeding to weed out criminals, the insane and the poor, based on the false belief that such conditions were caused only by genetic disorders. It reached its inglorious climax when the Nazis moved beyond sterilization to exterminate the “genetically unfit.”

But what was especially objectionable about this movement was the coercive imposition of a state vision for a healthy population. Modern eugenics, from testing for diseases to deciding whether you want a girl or boy, is voluntary. So where genetic selection aims to bring out a trait that clearly benefits an individual and society, we should allow parents the choice. To do otherwise is to consign those who come after us to the ball and chain of our squeamishness and irrationality.

So, according to Savulescu, all of this is acceptable because it’s voluntary for parents. No one gets hurt. Of course, if we were to agree with him, we would still be exterminating the “genetically unfit:” unborn embryos tossed out with the refuse of our throwaway society. In this version of modern-day eugenics, we can now snuff out small human beings who can’t speak up for themselves.

Society is becoming increasingly comfortable with these ideas. We have forgotten the lessons of the Third Reich, and are once again concluding that some human beings are “life unworthy of life.” If Savulescu has his way, his thinking will not only be acceptable, but required.

Reader’s Digest Article

Bizarre Episode Raises Questions About Research Ethics

Monday, August 6th, 2012 by Dr. Dennis Sullivan

Two prominent neurosurgeons at UC Davis Medical Center reportedly performed a bizarre experiment on three terminally ill patients last fall. According to an ABC News article from July 27, 2012 (cited below), Dr. J. Paul Muizelaar and Dr. Rudolph J. Schrot injected live bacteria into the head wounds of three patients. Each was suffering from glioblastoma, a malignant tumor of the supportive tissues of the brain.

The surgeons believed that infections arising from the bacteria would somehow attack the patients’ tumors, allowing them to live longer. All three patients gave their consent, though the research was performed without university authorization. Two patients died of sepsis shortly after the treatment was administered. The university has ordered the surgeons to cease and desist, and has barred them from any further human research endeavors.

In an interview with the Sacramento Bee, one of the doctors said, “We certainly didn’t blatantly trample any rules.” The surgeons insisted that the procedure was simply an unusual treatment, not actual research. The university believes otherwise. A review is underway, which could lead to problems with future research funding by the Food and Drug Administration.

A few comments:

1) There is sometimes a fine line between unusual or innovative treatments and research. A truly innovative treatment for cancer should be approved by a hospital or university Institutional Review Board (IRB). This protects vulnerable research subjects, such as the patients in this case.

2) The lack of IRB review in this case means such research may forever be tainted. What if the surgeons’ idea had actually worked? The fact that it was done without oversight casts doubt on any results, successful or not.

3) It is difficult to obtain truly informed consent from terminal cancer patients. They may be so desperate for a “cure” that they may consent to inappropriate or dangerous treatments. Think, for example, of the ongoing popularity of travel to Mexico for the treatment of various cancers with laetrile, despite its toxicity and lack of benefit.

The primary mandate of medical ethics still holds true: first of all, do no harm.

ABC News Article