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Bioethics

Bioethics in Barcelona

Before I forget, I must mention something about the Barcelona meeting (Ethics and Philosophy of Emerging Medical Technologies, Institut Borja de Bioetica, Universitat Ramon Llull, Barcelona, Spain), since sport appeared in a good handful of papers including: Keynote paper on Therapy and Enhancement Professor Ruth Chadwick

Argued in favour of the term 'improvement' rather than enhancement, as a basis for characterising the ethical issues arising from emerging technologies.

Ethical norms for research on biomedical enhancement susing human subjects Professor Max Mehlman

Max has written considerably on genetic enhancement and regularly uses sport as a case study in his work. The military was also a theme and there are some great analogies between sport and the military.

Honorary session for Lennart Nordernfelt

Thomas Schramme developed a case to inquire into the concept of 'health' the focus of this session and a tribute to Nordenfelt who gave an introduction and reply. Schramme's case discussed Lily, an athlete who wanted to jump 2m. He argued that Nordernfelt's work would argue that her inability to jump this high would qualify as failing to meet a vital goal and that, therefore, we could characterise it as an illness that should be alleviated by medicine. In short, we would characterise her less than healthy.

Schramme rejected the idea that this inability should be characterised as an illness and rejected the idea that the realisation of all vital goals falls within the proper role of medcine. Nordenfelt agreed with Schramme's conclusion, but did not accept that Lily's interest to jump 2m could be described as a vital goal. Being the best is not a reasonable expectation, but being good is.

Athlete or Guinea Pig? Sports and Enhancement Research Nancy M.P. King and Richard Robeson

Argued that medicine for the athlete should be characterised as enhancement research, but currently it is not. This led to some interesting debates about whether sport technology should go through a more rigorous liability check and whether this should be connected to anti-doping policy. I argue for this in my 2005 piece in the European Journal of Sport Science, though their emphasis is on medical procedures. I wonder whether blood spinning might fall within this category.

Finally, there was my wee paper

Posthuman Medicine & Imagined Ethics Developed posthuman theory in relation to transhumanism and cyborgology and subsequently argued for the need to consider imagined ethical issues. Used the gene doping case as an example of an 'imagined ethical' debate.

The Future of Our Memories

Last friday, I participated in a symposium by this title. The co-presenters were Professor Wendy Hall and Professor Neil Burgess. It was hosted by the Royal Institution of Great Britain and was part of the EPSRC Futures series. The Chair of the debate and Director of the series was Dr Dan Glaser, who did a first class jobs. Chairs rarely get credit, but Dan was really superb. He has had a lot of experience with public engagement and his management of this session made it very enjoyable. A number of possible futures were discussed and questions were asked about the use of metaphors and analogies when imagining what constitutes our memories. Movies came up a lot as well, particularly a compendium of Jim Carrey films (Bruce Almighty, Truman Show, and Eternal Sunshine of the Spotless Mind). Memento was also mentioned. I think we could have spent the whole evening just talking about film.

Prof. Neil Burgess also described some work on recollection that uses virtual reality environments as a means of evaluating how much people remember. Yet another example of computer game technology infiltrating the sphere of science. Last November, I learned of similar uses within surgery.

My paper attempted a socio-ethical take on the future of memory, wondering about how we might alter memories and on what basis we justify memory enhancement. Paralells are made with debates related specifically to neuroethics (recent edition of the AJOB has a number of papers about this) and the use of cognitive enhancers. It seems that the future indicates the potential to develop a refined knowledge hierarchy where some forms of knowledge will become more important than others. So, perhaps through sophisticated digital support systems, the importance of remembering factual information will be less. This could have radical implications for how we evaluate capacity and intellect.

Again, the emphasis I wish to make is that becoming posthuman need not imply radical, futuristic technologies such as memory erasure. Rather, the integration of digitisation alone into our daily lives transforms what it means to be human. A good indication of this is the use of community photograph sites, such as flickr, where your images become part of a collective memory of an event or moment.

Blurb on the Symposium Continuing our innovative look at what the future holds for us, the second in our series of ‘Futures’ debates will ask how will we use our memory in the future and how much we will rely on technology to do it for us. This reliance has already begun – consider how many phone numbers you can remember now that you can store them on your mobile phone – and looks set to continue with projects such as ‘Memories for life’. This is one of the grand challenges in the computing world, and its aim is to develop a system to both store and protect our individual memories while being sophisticated enough to allow us to sort through them. But what effects will this have on individuals and society as our ability to access information, and our dependence on external devices, increases? How can mass-storage devices be designed to interface with people and their brains so that more and more can be retrieved with less and less reliance on biological memory? And could this help people with memory impairments? Join Neil Burgess (University College London), Wendy Hall (University of Southampton) and Andy Miah (University of Paisley) as they look at the potential of future computer systems and ask should we be embracing or resisting this move towards an age when digital and physical activities not only coexist but co-operate. (Link to Royal Institution of Great Britain website).

A link to my presentation

UN warns of dangers of drugs sold on internet

In March 2004, The British Medical Journal reported on the International Narcotics Control Board statement on the sale of drugs over the Internet. They highlight popular drugs such as sildenafil (viagra) and fluoxetine (Prozac) - who hasn't received email about these substances!? It is interesting that some of these drugs are associated with so-called 'lifestyle' enhancements. While the lack of regulation over online drugs is significant, I wonder how much of their concern is about how these drugs reflect a shift in the way people use and perceive medicine. One of the difficulties facing the medical profession is how to curb the tide on lifestyle medicine. There seem to be a number of legal and moral questions arising from the development of online pharmacies and, even if the current regulations offer a structure through which action could be taken against a dodgy company, we need to take into account how online pharmacies are different social spaces, compared with high-street retail outlets. For example, how does a physician take a history of their patient through the Internet? What relationship between the physician and patient is possible?

There also seem to be difficult boundary issues facing regulation. Even if the legal issues are similar to the importation of substances from one place to another, the manner in which people transcend these boundaries is radically different - it is much easier to click on a website of a company in a country far away, than it is to go there or connnect with a supplier in that country.

Ethics of cybermedicine

Gregory Pence is keen on digital technology applied to medical encounters. He describes cases where patients use the Internet to develop shared communities, where they can talk about the illnesses thy suffer in open spaces. He is also concerned that technology often gets a rough deal in the media, where genetics is characterised as Frakenstein science and IT separates people from each other. In Chapter 2 of his book 'Re-Creating Medicine' , he discusses the Doctor-Patient role specifically, suggesting that doctors can use WebMD to find out about conditions they know little about and encourages a dialogue between patients and doctors about these discoveries. As he states: "Moral informational exchanges, ones that help and empower patients, rather than keep them in the position of passive children, do occure in cybermedicine. Such exchanges humanize both parties involved"

Superhumans, mutants and monsters

Superhumans, Mutants and Monsters: Gene Doping, Bioethics and the Posthuman GameUniversity of Toronto, Canada.

I just got back from UoT, where i gave a presentation on this topic. I wanted to talk a bit about how posthumanism is evolving as a body of literature and how it relates to competing ideas on transhumanism and cyborgology.

It always suprises me (pleasantly) at how different people approach this subject. The cover of GMA has written the content for many of my talks on this subject. This week conversations got into the subject of 'feline' modifications and the possible colonial interpretations of enhancement. For example, could we think about the discourse of posthumanism as similar to how people of certain races might have been characterised as savage or other. Alternatively, does the morphed human with cheetah tell us anything about the gendered nature of enhancement? What kind of animal would we like to look more like and what does thi reveal about our values and assumptions about beauty?

Interesting lines i think. If you would like to view the presentation click here (microsoft powerpoint needed, best on Mac OSX and office 2004)

Genetic tests for Rugby team

Dennis, C. (2005). "Rugby team converts to give gene tests a try." Nature 34: 260. Carina Dennis writes in Nature about an Australian rugby league team which aims to use genetic tests to stream-line training methods. The article quotes someone from the Australian Law Reforms Commission, whose report 'Essentially Yours' deals with this subject at some length. Australia seems to be taking a leading role in thinking through these issues. Ron Trent's work at the University of Sydney is central to this research and he claims that we still do not know enough about genes for this purpose. Issues of privacy and discrimination are central to this topic. Will genetically risky athletes be prevented from participation? Will young children who dont fit the profile be excluded? Will sports authorities have the legal power to demand genetic info from athletes?

'Altitude Chambers' in the JME

This month, the JME includes 3 articles on the ethics of hypoxic training chambers for sport. The lead article by Spriggs disusses the Australian Football League's investigation into the ethical parameters of these 'altitude chambers'. A commentary is then offered by Torbjorn Tannsjo, Claudio Tamburrini and finally by Peter Fricker. Generally, the articles favour enhancement and changing the rules of sport to make enhancement more commonplace.

The Public Autopsy

Miah, A. (2004). "The Public Autopsy: Somewhere Between Art, Education and Entertainment." Journal of Medical Ethics 30: 576-579. Miah, A. (2003). "Dead Bodies for the Masses: The British Public Autopsy & the Aftermath" CTHEORY E119

In November 2002, Gunter von Hagens conducted a public autopsy in London, UK. Legally, it was all a bit suspect, but it was a fascinating event. This media moment took place soon after von Hagens had exhibited his plastinated bodies in the UK.

Since then, he has presented a series of programmes on UK TV called 'Anatomy for Beginners', which was considerably more professional and valuable, as an indication of what medicine does. However, the entire process relies on his technological method of plastination, so identifying the realness of the process is no easy task.

Why we should allow performance enhancing drugs in sport

Savulescu, Foddy and Clayton author this leader for the British Journal of Sports Medicine. The publication does not say much new to scholars of sport philosophy, though it does make a particular play about the importance of testing for 'health' rather than drugs. Acknowledging the value of the health argument, the authors are interested to see a more permissible culture of drug use in sport. It is important that such arguments are made in this kind of publication by these authors. In the last year or so, bioethical concerns about sport have developed a greater interest in broader bioethical spheres. This article is one contribution that is leading to a steady pace of literature in this subject beyond the sport ethics circles. As an extension of their argument, it is necessary to further question the justification of 'health' as an ethical concern in sport. There is more than one definition of health and the privileged biomedical approach, which continues to undermin anti-doping programmes is not wholly sufficient. Arguably, we have moved beyond using medicine just for therapy and this need not imply any less respect for how it also alleviates human suffering. it is but a further way in which we seek to explore the limits of being human and we have always done this, not even just with technology.

[2007.04.24: By extension, my article with Bengt Kayser and Alex Mauron has just been published by BMC Medical Ethics: 'Current Anti-Doping Policy: A Critical Appraisal (2007) ] 

Boxing and the Medical View

A series of articles in the Journal of Medical Ethics discusses the role of the medical profession in how boxing is administrated. The first is by Sokol who argues that the profession should be limited to providing advice and information about the risks of boxing, rather than to campaign for it to be banned. Perhaps the most interesting article is by Spriggs who discusses the prospect of compulsory genetic tests for boxers as a way of deciding whether they should be granted a license. This matter has been raised elsewhere in the British J of Sports Medicine and in the Australian Law Reforms Commission report, 'Essentially Yours'. Since the significance of such genetic information is widely disputed, its role in determining what kind of sports people can play is certainly controversial.