Category: Population-Level Bioethics

Peter Singer on BatKid

Holly Fernandez Lynch 6 Comments

This is worth a read, and, in my opinion, absolutely right.  The discussion is relevant to broader questions of identified v. statistical lives, as well as “choice architecture” questions about how charities ought to seek out donations.  Take a look:

Heartwarming causes are nice, but let’s give to charity with our heads

Full disclosure: Several years ago my family took advantage of a Make-A-Wish trip resulting from my younger brother’s leukemia.  He is now a thriving adult and doing great, and the experience was incredible, especially for those families with children facing terminal diagnoses.  But the fact remains that this really has to be seen as a “luxury” charity – and when faced with a stark side-by-side choice of where the dollars could be spent, Peter’s analysis nails it.

Art Caplan on Mandela’s AIDS legacy of silence and courage

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Art Caplan has a new piece over at NBC News online on Nelson Mandela’s AIDS legacy:

[…] It had been an enormous mistake to ignore the epidemic, made even worse by installing an AIDS denialist as his favored successor.

In 2003 Mandela began to speak out plainly and forcefully about AIDS. And he acted. He created a foundation to fight HIV/AIDS, the Nelson Mandela Foundation, and began a fundraising campaign to support HIV prevention and public health efforts called 46664, his identification number when he was imprisoned by the apartheid government on Robben Island. For the rest of his life he urged people to talk about HIV/AIDS “to make it appear like a normal illness.” And he used his reputation to make HIV prevention and AIDS treatment an international issue. In his retirement, he put AIDS at the top of his personal agenda.

[…]

Mandela vigorously took on critics, speaking courageously about AIDS and the importance of using the best science and public health knowledge to defeat it. Our greatest ethical leaders like Mandela are never more instructive than when we learn not just from their triumphs, but also from how they recognize and respond to a mistake.

Read the full article.

If NeuroGaming Enables the Enhancement of Visual Multitasking, Should We Revise Distracted-Driving Regulations?

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By Matthew L Baum

I recently saw someone walk into a signpost (amazingly, one that signalled ‘caution pedestrians’); by the angle and magnitude that his body rebounded, I estimated that this probably really hurt. What I had witnessed was a danger of walking under the influence of a smart phone. Because this man lacked the ability to tweet and simultaneously attend to and process the peripheral visual information that would enable him to avoid posts, the sidewalk was a dangerous place. If only there existed some way to enhance this cognitive ability, the sidewalks would be safer for multi-taskers (though less entertaining for bystanders).

In a public event on neurogaming held last Friday as part of the annual meeting of the International Society for Neuroethics, Adam Gazzaley from UCSF described a method that may lead to just the type of cognitive enhancement this man needed. In a recent paper published in nature, his team showed that sustained training at a game called NeuroRacer can effectively enhance the ability of elderly individuals to attend to and process peripheral visual information. While this game has a way to go before it can improve pedestrian safety, it does raise interesting questions about the future of our regulations surrounding distracted driving, e.g., driving while texting. In many jurisdictions, we prohibit texting while driving, and a California court recently ruled to extend these regulations to prohibit certain instances of driving under the influence of smart phones (i.e. smart driving).

But if individuals were to train on a descendant of NeuroRacer and improve their ability to visually multitask, should we give them a permit to text while driving?

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HHIP: Evaluating Effective Charities – GiveWell cofounder Elie Hassenfeld: Tuesday, 8 PM

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Harvard High Impact Philanthropy presents:

Evaluating Effective Charities with Elie Hassenfeld of GiveWell

How can you maximize the impact of your charitable giving?  What distinguishes the most effective causes and organizations? Elie Hassenfeld, co-founder and co-Executive Director of GiveWell, will describe how his organization is revolutionizing charity evaluation with completely transparent, rigorous analysis. Q&A to follow.

8 pm, Tuesday, Nov. 12; Sever 102

RSVP here

Elie Hassenfeld graduated from Columbia in 2004 and co-founded GiveWell in mid-2007 where he currently serves as co-Executive Director. GiveWell finds outstanding charity and publishes the full details of its analysis to help donors decide where to give. The Boston Globe has called GiveWell “The gold standard for giving” and its research has attracted attention from Peter Singer and other media. GiveWell has tracked over $10 million in donations to its recommendations as a direct result of its research.

Is Turkey’s Health Systems Reform as Successful as It Sounds?

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By Cansu Canca

In July, the Lancet covered Turkey’s development and implementation of universal health coverage extensively in an article and in supplementary comments. The main article, written by those who are directly involved in the development of the health systems reform (including the former Health Minister), presents a success story. Within Turkey, however, the success of the reform has been disputed. Two points in particular are being repeated by the Turkish Medical Association (TTB), doctors, and journalists: the negative effects of the reform on (1) the quality of health care personnel and (2) privacy.

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More on the Debate over Vaccines and Liability

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Bill of Health Contributor Art Caplan has a new opinion piece online at MedScape: “YOUR Fault if Your Unvaccinated Child Makes Someone Sick.” (Note: Registration to access MedScape is free.)

Are you doing enough to make sure that your patients and their kids are getting vaccinated? Sometimes we leave this for the pediatrician to worry about, but I think that every doctor who sees patients should make it a part of taking the history to ask if they are up to date on vaccinations. Have they gotten their boosters? What are they doing with their kids?

All over the United States, we are tragically seeing the recurrence of diseases that weren’t here 20 years ago. Whooping cough, mumps, and measles are all on the rebound because people don’t vaccinate their kids or they don’t get the booster shots that they need to grant immunity to themselves. 

And Dorit Reiss has a new article up on SSRN: “Compensating the Victims of Failure to Vaccinate: What are the Options?“

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Haiti in a Time of Cholera

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By: Efthimios Parasidis

In the midst of “the world’s worst and fastest-spreading cholera epidemic“, with more than 685,000 infected and approximately 8,400 dead, five Haitian families are suing the United Nations in federal court in the Southern District of New York. The families are seeking $2.2 billion for the Haitian government’s relief efforts and unspecified damages for Haitian families affected by the outbreak. Despite evidence which indicates that cholera was introduced by UN peacekeepers, the UN has yet to admit responsibility and has denied compensation to the victims, though it continues to provide assistance to Haiti. The UN argues that immunity precludes legal recourse, and undoubtedly will move to dismiss the complaint. Aside from the legal arguments regarding immunity, the question remains whether the UN has a moral responsibility to provide compensation and more robust remediation measures, particularly because there were “documented sanitation deficiencies” at a UN camp that has been identified as the source of the outbreak. As we await a decision from the court, and a response from the UN, cholera continues to kill nearly three Haitians each day.

 

The priorities in the benefit packages vs. the priorities of those who dole out the benefits

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In my last post I promised I would provide details about the new piece of statutory legislation that was recently enacted by the Colombian Congress on the right to health, but first I should talk a little more about the prior jurisprudence that set the stage for it–especially since there’s so much of it. Every year, hundreds of thousands of right-to-health cases go before judges in Colombia, and some estimate that up to one out of every five Colombians has used the judicial system to gain access to health services.

By far, most of these cases are won by the plaintiff. And they should be.

Nearly 90% of the cases that involve procedures, and over 30% of the cases for medications, involve benefits that are actually already covered by the public benefit package (plan obligatorio de salud, or POS). And most of these aren’t over particularly expensive, complicated, or scarce benefits in the POS. The most frequently litigated medications are omeprazole (Prilosec) and oxygen. The most frequently litigated procedures aren’t even the procedures themselves, but specific parts of the procedures that aren’t explicitly listed in the bundle of benefits covered by the POS. For example, the POS covers colostomies, but the insurance companies systematically deny the colostomy bags. “We’ll open the hole in your flank, but it’ll be on you to figure out what to do with the excrement that’ll start oozing out. . .”

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The Whitehall Studies and Human Rights

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By Nathaniel Counts

Professor M. G. Marmot et al. conducted two studies, Whitehall I and Whitehall II, in which they studied morbidity and mortality in the British civil service sector in the 1960s and the 1980s.  British civil servants are under the same plan with the National Health Service, so the studies controlled for access to healthcare.  But what these famous studies found was that morbidity and mortality still correlated with income.  Further research and analysis has concluded that it is job satisfaction and social status more so than income that determines health outcomes.  Does an individual feel like she has control over the work she does?  Is she stressed out a lot?  How does she feel about herself in relationship to those around her?  Does she feel healthy?  Does she like her life?  Those who feel in control of their lives, feel valued by society, and feel good about their health actually end up living longer and healthier lives on average compared to those who don’t share these beliefs.

Deep structural inequalities exist in every society, and social justice groups work toward greater social equality everywhere.  Does the notion that social inequalities are hurting people in a physiological way change the way we feel about the mission of equality?  Is health so fundamentally different that individuals who accept economic inequality might mobilize over health inequality?  It is certainly implicated in the right to a dignified life, a concept underpinning the human rights movement as whole.  It may be though that the social inequalities on their own terms are an equal evil, because the limitations on one’s abilities to pursue her interests are as inimical to human rights as worse health.

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Upcoming Event: Larry Temkin speaking on “Global Poverty: Why Should We Care?”

The Petrie-Flom Center Staff Leave a comment

Want to know more about the ethics of aid? Want to hear the inspiring talk that’s convinced students across the northeast to take global poverty seriously? Join Harvard High-Impact Philanthropy for our first talk of the semester with ethicist Larry Temkin! RSVP here for

Global Poverty: Why Should We Care?

a talk by Larry Temkin

 Thursday, September 12

8 PM

Science Center E 

Each year, millions of children die from readily preventable causes. This raises an obvious and poignant question. What, if anything, should our reaction be to the apparent fact that each one of us could easily prevent the deaths of many innocent people who are not responsible for their unfortunate plight?

Larry Temkin is a professor of philosophy at Rutgers. He holds a Ph.D. from Princeton and is the author of “Rethinking the Good: Moral Ideals and the Nature of Practical Reasoning” (OUP, 2012) and “Inequality” (OUP, 1993). He has received seven fellowships and eight major teaching awards.

The lecture will take place in Harvard’s Science Center, Hall E (in the basement), and will be followed by a Q&A period.

This lecture is also the kick-off event for our Philanthropy Fellowship, a new program this year. Fellows will attend talks and private dinners/receptions with many speakers on effective altruism, including Princeton ethicist Peter Singer, Skype co-founder Jaan Tallinn, and cosmologist Max Tegmark. At the end, we’ll pick a cause that we think is important and raise funds for it ourselves, to be matched by an anonymous donor. To apply, fill out this short application by Sunday, Sep. 15!