An Ethical-Legal Analysis of Medical Assistance in Dying for Those with Mental Illness | Tanner | Alberta Law Review

One of mine!

This article considers sources of opposition to allowing access to medical assistance in dying for individuals with mental illness. It originated with an observation by members of the University of Toronto Joint Centre for Bioethics that in mainstream Canadian culture — as well as in political, academic, and professional circles — such opposition remains widespread (and often reflexive). This opposition exists even in light of broad support for access to assisted dying for individuals with illness manifesting in physical suffering. Most Canadians treat the prospect of assisted dying for those with mental illness with suspicion, and it is worth exploring why this opposition persists, what arguments can be leveled to support it, and whether those arguments can be sustained. To that end, I identify five objections to assisted dying for the mentally ill that seem to characterize the public debate, and argue that none are sustainable. They either rely on false premises or otherwise fail to secure the conclusion that assisted dying should be off limits to people suffering from mental illness, even when such mental illness is their sole underlying condition.

https://www.albertalawreview.com/index.php/ALR/article/view/2500

“My-side bias” makes it difficult for us to see the logic in arguments we disagree with – Research Digest

In what feels like an increasingly polarised world, trying to convince the “other side” to see things differently often feels futile. Psychology has done a great job outlining some of the reasons why, including showing that, regardless of political leanings, most people are highly motivated to protect their existing views.

However a problem with some of this research is that it is very difficult to concoct opposing real-life arguments of equal validity, so as to make a fair comparison of people’s treatment of arguments they agree and disagree with.

To get around this problem, an elegant new paper in the Journal of Cognitive Psychology has tested people’s ability to assess the logic of formal arguments (syllogisms) structured in the exact same way, but that featured wording that either confirmed or contradicted their existing views on abortion. The results provide a striking demonstration of how our powers of reasoning are corrupted by our prior attitudes.

https://digest.bps.org.uk/2018/10/09/my-side-bias-makes-it-difficult-for-us-to-see-the-logic-in-arguments-we-disagree-with/

Hasty change to assisted dying bill a serious error

When complex and controversial draft legislation is processed rapidly, significant potential implications of the bill – and any amendments made to it – can be missed. Unfortunately, this is precisely what happened with the federal government’s Bill C-14 to establish the federal rules regarding medical assistance in dying (MAID) in Canada. The legislation was introduced on April 14, 2016 and came into force on June 17, 2016.

Many, many amendments were considered and, unsurprisingly, most of the attention was focused on the most obviously controversial amendments — particularly on the unsuccessful attempts to allow access to MAID beyond only those individuals whose “natural death has become reasonably foreseeable.”

By contrast, another amendment received very little attention before being passed — a mere 10 minutes out of many hours of debate. Yet this amendment created the potential for extended intolerable suffering.

http://policyoptions.irpp.org/magazines/january-2018/hasty-change-to-assisted-dying-bill-a-serious-error/

On free will: Daniel Dennett and Gregg Caruso go head to head | Aeon Essays

Caruso: [Dan,] you have famously argued that freedom evolves and that humans, alone among the animals, have evolved minds that give us free will and moral responsibility. I, on the other hand, have argued that what we do and the way we are is ultimately the result of factors beyond our control, and that because of this we are never morally responsible for our actions, in a particular but pervasive sense – the sense that would make us truly deserving of blame and praise, punishment and reward. While these two views appear to be at odds with each other, one of the things I would like to explore in this conversation is how far apart we actually are. I suspect that we may have more in common than some think – but I could be wrong. To begin, can you explain what you mean by ‘free will’ and why you think humans alone have it?  

Dennett: A key word in understanding our differences is ‘control’. [Gregg,] you say ‘the way we are is ultimately the result of factors beyond our control’ and that is true of only those unfortunates who have not been able to become autonomous agents during their childhood upbringing. There really are people, with mental disabilities, who are not able to control themselves, but normal people can manage under all but the most extreme circumstances, and this difference is both morally important and obvious, once you divorce the idea of control from the idea of causation. Your past does not control you; for it to control you, it would have to be able to monitor feedback about your behaviour and adjust its interventions – which is nonsense.

https://aeon.co/essays/on-free-will-daniel-dennett-and-gregg-caruso-go-head-to-head

Safeguarding trials from racial bias

There is much to learn from the trial of Saskatchewan farmer Gerald Stanley on the dangers of not directly confronting the potential impact of racial bias on the trial process. Stanley was acquitted in February 2018 by an all-White jury in the shooting death of 22-year-old Cree man Colten Boushie. The law gives us tools to safeguard trials from racial bias that we shouldn’t ignore. One of these tools is the law of evidence.

What is the law of evidence? It is a set of rules aimed at regulating the admissibility and use of evidence, in order to fairly promote the search for truth. It recognizes that judges and jurors bring to court every day assumptions about human experience and behaviour that are grounded in unreliable, stereotypical or discriminatory assumptions. That is precisely why it gives judges a discretion to exclude evidence where its prejudicial effect outweighs its relevance or probative value. And why we have rules, for example, that make prior sexual history evidence in sexual assault cases or evidence that paints an accused in a negative light (bad character evidence) presumptively inadmissible.

Unfortunately, despite the fact that Indigenous, Black and Brown lived experiences are disproportionately before courts consisting of largely White jurors or judges, we have failed to ensure that our rules of evidence protect against racial bias in the same way that they do against other types of unreliable and discriminatory generalizations. The Stanley trial is a stark reminder of this reality.

http://policyoptions.irpp.org/magazines/october-2018/safeguarding-trials-from-racial-bias/

Seeking Human Generosity’s Origins in an Ape’s Gift to Another Ape - The New York Times

How generous is an ape? It’s a hard question for scientists to tackle, but the answer could tell us a lot about ourselves.People in every culture can be generous, whether they’re lending a cellphone to an office mate or sharing an antelope haunch with a hungry family.

While it’s easy to dwell on our capacity for war and violence, scientists see our generosity as a remarkable feature of our species. “One of the things that stands out about humans is how helpful we are,” said Christopher Krupenye, a primate behavior researcher at the University of St. Andrews in Scotland.

This generosity may have been crucial to the survival of our early ancestors who lived in small bands of hunter-gatherers.

https://www.nytimes.com/2018/09/11/science/generosity-apes-bonobos.html

Should patients with anorexia be force-fed to save their lives? - The Globe and Mail

Madam Justice Lise Bergeron of the Quebec Superior Court recently ruled that a 20-year-old woman who is suffering from severe anorexia should be force-fed to keep her alive.

The hospital where the young woman is being treated, Centre hospitalier universitaire du Québec, sought a court order when she began to suffer life-threatening pericardial effusion (build-up of fluid around the heart).

The patient, who is not identified for privacy concerns, has been under almost constant treatment since 2012. At one point she weighed a mere 32 kilograms, and was refusing to eat.

These cases are among the most ethically and legally challenging.

https://www.theglobeandmail.com/opinion/article-should-patients-with-anorexia-be-force-fed-to-save-their-lives/

Computer Programmers Get New Tech Ethics Code - Scientific American

Computing professionals are on the front lines of almost every aspect of the modern world. They’re involved in the response when hackers steal the personal information of hundreds of thousands of people from a large corporation. Their work can protect—or jeopardize—critical infrastructure like electrical grids and transportation lines. And the algorithms they write may determine who gets a job, who is approved for a bank loan or who gets released on bail.

Technological professionals are the first, and last, lines of defense against the misuse of technology. Nobody else understands the systems as well, and nobody else is in a position to protect specific data elements or ensure the connections between one component and another are appropriate, safe and reliable. As the role of computing continues its decades-long expansion in society, computer scientists are central to what happens next.

That’s why the world’s largest organization of computer scientists and engineers, the Association for Computing Machinery, of which I am president, has issued a new code of ethics for computing professionals. And it’s why ACM is taking other steps to help technologists engage with ethical questions.

https://www.scientificamerican.com/article/computer-programmers-get-new-tech-ethics-code/

Artificial Intelligence Shows Why Atheism Is Unpopular - The Atlantic

Imagine you’re the president of a European country. You’re slated to take in 50,000 refugees from the Middle East this year. Most of them are very religious, while most of your population is very secular. You want to integrate the newcomers seamlessly, minimizing the risk of economic malaise or violence, but you have limited resources. One of your advisers tells you to invest in the refugees’ education; another says providing jobs is the key; yet another insists the most important thing is giving the youth opportunities to socialize with local kids. What do you do? 

Well, you make your best guess and hope the policy you chose works out. But it might not. Even a policy that yielded great results in another place or time may fail miserably in your particular country under its present circumstances. If that happens, you might find yourself wishing you could hit a giant reset button and run the whole experiment over again, this time choosing a different policy. But of course, you can’t experiment like that, not with real people.

You can, however, experiment like that with virtual people. And that’s exactly what the Modeling Religion Project does. An international team of computer scientists, philosophers, religion scholars, and others are collaborating to build computer models that they populate with thousands of virtual people, or “agents.” As the agents interact with each other and with shifting conditions in their artificial environment, their attributes and beliefs—levels of economic security, of education, of religiosity, and so on—can change. At the outset, the researchers program the agents to mimic the attributes and beliefs of a real country’s population using survey data from that country. They also “train” the model on a set of empirically validated social-science rules about how humans tend to interact under various pressures.

And then they experiment: Add in 50,000 newcomers, say, and invest heavily in education. How does the artificial society change? The model tells you. Don’t like it? Just hit that reset button and try a different policy.

https://www.theatlantic.com/international/archive/2018/07/artificial-intelligence-religion-atheism/565076/

Effort to Diversify Medical Research Raises Thorny Questions of Race - Scientific American

It’s a summer Saturday morning and more than 160 people are packed into a windowless classroom beneath a Lower Manhattan street. Organizers had distributed the ad for the three-hour event just three weeks earlier. The goal was to gather people who identify as “Asian” on the U.S. census—and nearly everyone in the overcapacity room fits that label.

Attendees, the flyer says, will learn about precision medicine—a health care trend in which treatment and medication are tailored to an individual’s genes, environment and lifestyle. “Why is it that we’re all getting the same blood pressure pill, when it might work really well with one person and not the other?” event leader Colleen Leners asks the audience. Leners is the policy director for the American Association of Colleges of Nursing. Since mid-May she has been traveling across the country to lead enrollment efforts for a new federal governmentresearch project that is grounded in genetics and aims to overhaul the way health care is delivered.

https://www.scientificamerican.com/article/effort-to-diversify-medical-research-raises-thorny-questions-of-race/

'The discourse is unhinged': how the media gets AI alarmingly wrong | The Guardian

[...] A month after this initial research was released, Fast Company published an article entitled AI Is Inventing Language Humans Can’t Understand. Should We Stop It?. The story focused almost entirely on how the bots occasionally diverged from standard English – which was not the main finding of the paper – and reported that after the researchers “realized their bots were chattering in a new language” they decided to pull the plug on the whole experiment, as if the bots were in some way out of control.

Fast Company’s story went viral and spread across the internet, prompting a slew of content-hungry publications to further promote this new Frankenstein-esque narrative: “Facebook engineers panic, pull plug on AI after bots develop their own language,” one website reported. Not to be outdone, the Sun proposed that the incident “closely resembled the plot of The Terminator in which a robot becomes self-aware and starts waging a war on humans”.

Zachary Lipton, an assistant professor at the machine learning department at Carnegie Mellon University, watched with frustration as this story transformed from “interesting-ish research” to “sensationalized crap”.

https://www.theguardian.com/technology/2018/jul/25/ai-artificial-intelligence-social-media-bots-wrong

It's Time to Stop Using the 'Fire in a Crowded Theater' Quote - The Atlantic

From 2012, but very relevant these days:

Ninety-three years ago, Justice Oliver Wendell Holmes wrote what is perhaps the most well-known -- yet misquoted and misused -- phrase in Supreme Court history: "The most stringent protection of free speech would not protect a man in falsely shouting fire in a theatre and causing a panic."

Without fail, whenever a free speech controversy hits, someone will cite this phrase as proof of limits on the First Amendment. And whatever that controversy may be, "the law"--as some have curiously called it--can be interpreted to suggest that we should err on the side of censorship. Holmes' quote has become a crutch for every censor in America, yet the quote is wildly misunderstood.

https://www.theatlantic.com/national/archive/2012/11/its-time-to-stop-using-the-fire-in-a-crowded-theater-quote/264449/

Editing human embryos 'morally permissible' - BBC News

Should we or shouldn't we be allowed to modify human DNA in future children?

An inquiry into the ethical issues surrounding genetically altering a human embryo has found there is "no absolute reason not to pursue it".

But appropriate measures must be put in place before it becomes UK law, said the report - which calls for further research both medically and socially.

Inquiry chair, Prof Karen Yeung, said: "The implications for society are extensive, profound and long-term."

https://www.bbc.co.uk/news/health-44849034

Report located here: http://nuffieldbioethics.org/project/genome-editing-human-reproduction

That’s not Dad, that’s the Alzheimer’s that speaks, by Evelien van Veen (de Volkskrant 18 May 2018) – TrudoLemmens

It is March 9, 2018, and Luc Beemsterboer (52) enters the nursing home where his father has been living for three days. He walks through the long hallway and types in the access code for the glass sliding doors, behind which dad just happens to arrive. A little man, a little crooked by old age, neat jacket suit. When he sees his son, he momentarily pretends to run past him, a teasing twinkle in his eyes.

“How are you doing, Dad?”, asks Luc, when the tall and the short man stand head to head.

“Shitty”, is the answer – with a tone of: what did you expect?

Jacques Beemsterboer (80) is not in a nursing home because he really wanted it badly. He would by far have preferred to stay with his Toos, with whom he has been married for 55 years, in their new flat in the center of Papendrecht. But it did not work anymore. Jacques has Alzheimer’s, is confused, at home he ran around at night as a ghost, keeping Toos busy with him at the most impossible times. Sometimes, he realizes that he has dementia. “It enters your life insidiously,” he says when you ask him about it. “I can still participate quite well in conversations about nearly anything, but will I still know about it in fourteen days, that’s another question.

https://trudolemmens.wordpress.com/2018/07/14/thats-not-dad-thats-the-alzheimers-that-sounds-by-evelien-van-veen/

Voluntarily Stopping Eating and Drinking Is Legal and Ethical - The ASCO Post

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive care. Consequently, these patients sometimes persist in their requests for help with a hastened death. Because many clinicians are unsure how to respond to such requests, here we clarify the status of medical aid in dying laws and one important, yet still obscure, option for terminally ill patients looking to end their lives: voluntarily stopping eating and drinking

http://www.ascopost.com/issues/june-25-2018/voluntarily-stopping-eating-and-drinking-is-legal-and-ethical/

 

'It's nothing like a broken leg': why I'm done with the mental health conversation | The Guardian

Iam bleeding from the wrists in a toilet cubicle of the building I have therapy in, with my junior doctor psychiatrist peering over the top of the door, her lanyards clanking against the lock. Her shift finished half an hour earlier.

An hour later she calls the police, because I have refused to go to A&E or to let her look at me. Four policemen arrive. They are all ridiculously handsome. One of them is called Austin. Austin doesn’t have a Taser like all the others and when I question this, Austin says he hasn’t done his Taser training and all the others laugh. I feel bad for Austin.

I want to go home but I am not allowed. I am crying. The police ask me to tip out the contents of my jacket. Tampons fall out, with four sad coffee loyalty cards, each with a single stamp. Then I make a break for it because, seriously now, I just want to go home. The four officers surround me at the building entrance. One officer who has done his Taser training threatens to section me if I do not stop struggling.

As if you can just section me, I say. You can’t just say someone is sectioned and then they are sectioned. That is not how it works.

It turns out this is exactly how it works.

https://www.theguardian.com/society/2018/jun/30/nothing-like-broken-leg-mental-health-conversation

Why we need a clear definition of when death occurs - The Globe and Mail

Ontario Superior Court Justice Lucille Shaw released her long overdue decision this week in the case of a young Brampton woman pronounced dead in September, 2017, six months after closing arguments ended. Shaw concluded that Taquisha McKitty, 27, is in fact dead, rejecting arguments presented by her family that she was alive and had the right to continuing mechanical life support.

Justice Shaw determined that this woman died last September when doctors determined her brain had irreversibly ceased to function. While the wait was painful for everyone, Justice Shaw’s decision was clear: People need and deserve to know with simplicity, clarity and consistency when their family member is dead. At the heart of this ruling is the principle that identifying death has to be carried out in the same manner for all people in society, even if people choose to understand life in different ways.

https://www.theglobeandmail.com/opinion/article-why-we-need-a-clear-definition-of-when-death-occurs

Postmodernism vs. The Pomoid Cluster - Areo

Since I’ve been active on Twitter, I’ve had front row seats to the best intellectual slapfights no money can buy. It’s been uniquely interesting and yet frustrating. What’s hot right now in my bubble and its warzone-laden borderlands is “postmodernism.” The arguments usually start with tweets complaining about the latest social justice-related spat and using the word “postmodernism” or the phrases “postmodernist neo-Marxism” or even “cultural Marxism.” (These all mean the same thing, with slight differences in emphasis: “postmodernism” often focuses on a hostility to objectivity; “cultural Marxism” describes collectivist, conflict-based politics; “postmodern neo-Marxism” is the whole package.) Then other people criticize or mock the tweeters for not understanding what postmodernism is. Unproductive discussion results.

This bothers me for two reasons. One is erisological—this is a typical case of dysfunctional disagreement, i.e. a disagreement is fuelled by at least one party’s intentional or unintentional misunderstanding of either the other party’s position or the nature of their differences. The other is that I hate seeing arguments I’m fundamentally sympathetic to presented in a weak form.

I truly am sympathetic to those who complain about “postmodernism.” But I’ve spent too much time and effort learning to recognize disagreement patterns not to notice when “my side” is engaging in dodgy argumentation. Part of this is integrity (I hope), but another part is recognition of a tactical mistake: the sloppy use of terms like “postmodernism” or academically strange hybrids like “postmodern neo-Marxism” gives people an excuse to reject what you say. It’s good argumentation tactics to avoid making points which leave you vulnerable to criticism for trivial reasons, e.g. using a term in a way that suggests you don’t know what you’re talking about. Using technical terms in non-technical senses makes those in the know think exactly that and reject otherwise reasonable points

https://areomagazine.com/2018/06/30/postmodernism-vs-the-pomo-oid-cluster/