Julian Savulescu is the editor of the Journal of Medical Ethics, one of the world’s leading platforms for academic debate in bioethics. Australian-born, he is Uehiro Professor of Practical Ethics at the University of Oxford. Xavier Symons, deputy editor of BioEdge, asked him about the nuts and bolts of editing.
Xavier Symons: How did you get involved in the Journal of Medical Ethics? Editing a monthly journal must take a huge amount of time!
Julian Savulescu: I first edited the Journal of Medical Ethics in 2001. It was a fantastic career opportunity for me at that time. I began a second editorship in 2011. This time my motivation was not career -- I had more than enough to do. Rather it was because of dissatisfaction and frustration with publishing in the…
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Sex selection is on the agenda in Australia. The National Health and Medical Research Council (NHMRC) has called for public comment on new guidelines for IVF clinics. The most contentious change involves removing a ban on destroying embryos because they are not of the desired gender.
In an article in The Conversation the chair of the Australian Health Ethics Committee, Ian Olver, gives a number of reasons why this could be an appropriate change. He dismisses the notion of a slippery slope towards selcting for genes and creating designer babies:
“Aside from such choices not yet being medically possible, the slippery slope argument may falter because there’s no natural progression between approving non-medical sex selection and approving being able to select other characteristics. Sex selection is a discrete choice around which a definite boundary can be drawn.”
A healthy 89-year-old Australian man has committed suicide under the inspiration of Philip Nitschke and has left nearly his entire estate to Exit International, Nitschke’s assisted suicide group.
Bill O’Brien, who lived in Perth, went to a hotel room and took a lethal dose of Nembutal in July last year. He left his A$1.8 million estate to Exit International to be spent on hiring a full-time political lobbyist, but only $5,000 each to his son and daughter. He was a personal friend of Dr Nitschke and one of three directors of Exit.
Dr Nitschke said that Mr O’Brien was not close to his children and that in any case they are “wealthy adults”.
China’s National Health and Family Planning Commission says that all stem cell treatments are deemed to be experimental, except for bone marrow transplants. There must be informed consent by the patient, clinical-grade stem cells must be used, treatment may take place only at authorised hospitals which are not allowed to advertise or charge for the procedures. The treament must be tested first on animals.
The Commission also warned overseas patients about the dangers of stem-cell tourism.
"Anyone caught breaking the rules will be punished according to the new regulation," said Zhang Linming, a commission official. The only problem is that no punishments have been specified.
More bioethics in the US presidential campaign. Democratic front-runner Hillary Clinton has compared Republican candidates to terrorists for promising to ban all abortions with no exceptions for rape, incest or the life of the mother.
“Now extreme views on women, we expect that from some of the terrorist groups, we expect that from people who don’t want to live in the modern world, but it’s a little hard to take coming from Republicans who want to be the president of the United States.”
She also gave strong support to beleaguered Planned Parenthood, which is fighting allegations that it is profiting from the sale of foetal tissue.
But the most interesting controversy is simmering in Ohio, where one of Ms Clinton’s would-be rivals, Republican Governor John Kasich, is mulling over whether or not to sign a bill banning the abortion of Down syndrome children.
The treasurer of a peak international fertility body has warned women not to rely on egg freezing to have children. Dr Edgar Mocanu of the International Federation of Fertility Societies stated that current science does not support the supposition that egg freezing will allow women to circumvent infertility:
“As regards social freezing, the scientific community believes there are not yet sufficient data to recommend oocyte cryopreservation for the sole purpose of circumventing reproductive aging in healthy women”, he wrote in BioNews.
He urged women not to overestimate the utility of the novel procedure:
“There is no denial that egg freezing offers the hope of a pregnancy irrespective of the reason for the initial freeze. Yet, delaying conception while betting on the availability of self-preserved or donor frozen eggs is foolish. What every woman should understand is that while career or personal goals.”
Researchers found that most of the patients participating in the study had more than one diagnosed mental illness, with depression being the most common (59 patients) followed by split-personality disorder (50 patients).
Out of the 100 patients involved in the review, 48 had their euthanasia requests granted, and 35 carried it out. Among those remaining, 6 committed suicide, one died by palliative sedation, and one by anorexia.
Scientists from the Ohio State University claim they have managed to produce an embryonic human brain in their labs. Presenting at Florida’s recent Military Health Research System Symposium, lead researcher Rene Anand, a professor of pharmacology, said that his lab team had managed to grow what is the most complete human brain model ever engineered.
He even had photos, to boot. Above is the picture of a white cloudy mass of nerve cells, with a discernable cerebral hemisphere and optic stalk.
Full details of the brain-growing process are currently being kept under wraps by Anand, who has a pending patent on the technique. However, it's believed adult skin cells were converted into pluripotent stem cells through a process of gene alteration. The cells were then grown in a lab where they were engineered to develop into the full range of brain tissues.
The latest edition of the American Journal of Bioethics features a fascinating serious of articles on doctor-patient trust and Shared Decision Making (SDM). The target article of the edition – written by Drs Maureen Kelly (Oxford) and Sandra Soo-Jin Lee (Stanford) et al – considers how patients perceive consent to Research on Medical Practices (ROMP).
As the authors observe, “research on medical practices (ROMP)—including medical record reviews, comparative effectiveness research, quality improvement interventions, and point-of-care randomization—is critically important to improving medical care, reducing risks to patients, and decreasing costs.”
They argue against more general informed consent procedures and in favour of a personalised, collaborative approach: “We propose an approach that promotes engagement grounded in the principle of respect for persons, either as patients or as research participants.”
While contemporary bioethics took shape in the United States, parallel developments in Britain have been extremely important in shaping debate on issues like embryo research and assisted suicide. Dame Mary Warnock, for instance, the Oxford philosopher, produced a report on embryo research in 1984 which framed future discussion.
A new book, The making of British bioethics, by Duncan Wilson, a Research Associate at the University of Manchester’s Centre for the History of Science, Technology and Medicine, provides the first in-depth study of how philosophers, lawyers and other experts came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists.
In Britain, perhaps more than in the US, the moral authority of individual bioethicists plays a prominent role.