Can Physicians Work in US Immigration Detention Facilities While Upholding Their Hippocratic Oath? | JAMA

The modern successor to the Hippocratic oath, called the Declaration of Geneva, was updated and approved by the World Medical Association in 2017. The pledge states that “The health and well-being of my patient will be my first consideration” and “I will not use my medical knowledge to violate human rights and civil liberties, even under threat.”1 Can a physician work in US immigration detention facilities while upholding this pledge?

https://jamanetwork.com/journals/jama/fullarticle/2749507


‘They are together, they are equal’: the agonising choice facing father of conjoined twins | The Guardian

Marieme and Ndeye each have a sticker on their faces: a butterfly for Ndeye, and a green smiley face for her twin sister. They giggle as they take them off and stick them back on; then Ndeye decides it’s their dad’s turn, placing the smiley face over his right eye.

“Ndeye is the lively one, she likes attention, and Marieme is a quieter personality – calm and thoughtful,” said Ibrahima Ndiaye, the twins’ father. “Ndeye is fire and Marieme is ice.”

Their behaviour – and their differences – are typical for three-year-old twins, but Marieme and Ndeye are not typical at all. The sisters are conjoined: they have separate brains, hearts and lungs, but share a liver, bladder and digestive system, and have three kidneys between them.

Ndiaye brought his daughters from Senegal to Great Ormond Street hospital (GOSH) in London at the age of eight months after a desperate search for medical help. Over the past two and a half years, he and the hospital have wrestled with an agonising decision about whether to go ahead with a surgical separation that Marieme would not survive, but that could give Ndeye a chance of a reasonable life. Without a separation, both will almost certainly die.

https://www.theguardian.com/society/2019/aug/04/separation-conjoined-twins-dilemma


Should Chimpanzees Be Considered ‘Persons’? | New York Times

You might be aware that chimpanzees can recognize themselves in a mirror, communicate through sign language, pursue goals creatively and form long-lasting friendships. You might also think that these are the kinds of things that a person can do. However, you might not think of chimpanzees as persons.

The Nonhuman Rights Project does. Since 2013, the group has been working on behalf of two chimpanzees, Kiko and Tommy, currently being held in cages by their “owners” without the company of other chimpanzees. It is asking the courts to rule that Kiko and Tommy have the right to bodily liberty and to order their immediate release into a sanctuary where they can live out the rest of their lives with other chimpanzees.

The problem is that under current United States law, one is either a “person” or a “thing.” There is no third option. If you are a person, you have the capacity for rights, including the right to habeas corpus relief, which protects you from unlawful confinement. If you are a thing, you do not have the capacity for rights. And unfortunately, even though they are sensitive, intelligent, social beings, Kiko and Tommy are considered things under the law.

https://www.nytimes.com/2018/04/07/opinion/sunday/chimps-legal-personhood.html

Japan approves first human-animal embryo experiments | Nature

A Japanese stem-cell scientist is the first to receive government support to create animal embryos that contain human cells and transplant them into surrogate animals since a ban on the practice was overturned earlier this year.

Hiromitsu Nakauchi, who leads teams at the University of Tokyo and Stanford University in California, plans to grow human cells in mouse and rat embryos and then transplant those embryos into surrogate animals. Nakauchi's ultimate goal is to produce animals with organs made of human cells that can, eventually, be transplanted into people.

Until March, Japan explicitly forbid the growth of animal embryos containing human cells beyond 14 days or the transplant of such embryos into a surrogate uterus. That month Japan’s education and science ministry issued new guidelines allowing the creation of human-animal embryos that can be transplanted into surrogate animals and brought to term.

https://www.nature.com/articles/d41586-019-02275-3

Soon, intelligent machines could help decide whether to keep people in jail. It’s time to prepare | The Star

Fahad Diwan logs in and fills out the details of a person facing a bail hearing. Date of birth. Current charges. Pending charges. Past convictions.

Once his SmartBail program is done, he says, an algorithm trained on a mountain of data will be able to assess whether that suspect is a good candidate for pretrial release. Unlikely to be a flight risk. Unlikely to commit offences. Likely to comply with the conditions of release.

Suspects in custody are “legally innocent people,” said Diwan, 30, who hopes to one day put his software to use in Ontario’s bail courts. “We just want to find a way to make the system better, faster, economical.”

Proponents of this kind of program say machine learning would save time and money by quickly identifying people who should be released, speeding up bail hearings, reducing the number of people in jails and freeing up courts to focus on defendants who should have a full, contested hearing. All that with less bias and without affecting the crime rate.

https://www.thestar.com/news/gta/2019/07/19/soon-intelligent-machines-could-help-decide-whether-to-keep-people-in-jail-its-time-to-prepare.html

Prepare Yourself For The Shock Of Mass Implantable Brain Technology | Forbes

Patient Undergoing Implantable Brain Technology Procedure

Patient Undergoing Implantable Brain Technology Procedure


[…] The first wave of evolution is expected to offer healing-of-sorts for various individuals such as those profiled in the film with Parkinson’s Disease, paralysis, blindness and more. The next wave is more about general usage.

Of course, who would deny any person suffering from neurological disorders the ability to possess a better quality of life through brain implants? But when such technology is beginning to be touted via interviews in this documentary as that which will be able to help you jump higher, run faster, rid oneself of this habit or that, or that annoying personality trait or another via programming, we could be teetering on some very shaky moral and spiritual ground.

https://www.forbes.com/sites/laurencoleman/2019/05/12/prepare-yourself-for-the-shock-of-mass-implantable-brain-technology/


Should fentanyl dealers be charged with manslaughter if their customers die? | CBC News

The Sarnia, Ont., case of a drug dealer charged with manslaughter after a customer died from taking cocaine laced with fentanyl is raising questions about the legal and moral implications of such charges. 

As the opioid crisis in Canada deepens, the defence lawyer who represented the Sarnia drug dealer thinks there will be more such charges. 

In 2017, a drug dealer sold cocaine laced with fentanyl to someone who died of an overdose. The dealer was charged with trafficking and manslaughter, and this week, she pleaded guilty to the lesser charge of criminal negligence causing death. 

https://www.cbc.ca/news/canada/london/london-ontairo-fentanyl-should-dealers-be-charged-with-manslaughter-1.5120166

SCOTUS LGBT Discrimination Case Will Test Conservative Commitment to Textualism | Verdict

Last week, the Supreme Court agreed to review three lower court decisions posing the important question whether Title VII of the Civil Rights Act of 1964—which makes it unlawful for an employer or prospective employer “to discriminate against any individual . . . because of such individual’s . . . sex”—thereby forbids discrimination on the basis of sexual orientation and gender identity. There is little doubt that few if any of the members of the Congress that originally enacted the statutory language would have thought it had that effect.

However, as the late Justice Antonin Scalia wrote for the Court in a 1998 Title VII case that applied the statute’s sex discrimination prohibition to other circumstances that its drafters likely did not envision, “it is ultimately the provisions of our laws rather than the principal concerns of our legislators by which we are governed.” And there are straightforward reasons to think that discrimination based on sexual orientation or gender identity is sex discrimination.

The pending Title VII cases thus pose a test for the Court’s conservative majority. At one point or another and to varying degrees, all of the Court’s conservatives have embraced some version of the so-called textualist approach to statutory interpretation epitomized by Justice Scalia’s observation in the 1998 case, Oncale v. Sundowner Offshore Services, Inc. If they keep faith with their textualist commitment, they will rule in favor of the plaintiffs.

https://verdict.justia.com/2019/05/01/scotus-lgbt-discrimination-case-will-test-conservative-commitment-to-textualism

In Spain, prisoners’ brains are being electrically stimulated in the name of science | Vox

A team of scientists in Spain is getting ready to experiment on prisoners. If the scientists get the necessary approvals, they plan to start a study this month that involves placing electrodes on inmates’ foreheads and sending a current into their brains. The electricity will target the prefrontal cortex, a brain region that plays a role in decision-making and social behavior. The idea is that stimulating more activity in that region may make the prisoners less aggressive.

This technique — transcranial direct current stimulation, or tDCS — is a form of neurointervention, meaning it acts directly on the brain. Using neurointerventions in the criminal justice system is highly controversial. In recent years, scientists and philosophers have been debating under what conditions (if any) it might be ethical.

The Spanish team is the first to use tDCS on prisoners. They’ve already done it in a pilot study, publishing their findings in Neuroscience in January, and they were all set to implement a follow-up study involving at least 12 convicted murderers and other inmates this month. On Wednesday, New Scientist broke news of the upcoming experiment, noting that it had approval from the Spanish government, prison officials, and a university ethics committee. The next day, the Interior Ministry changed course and put the study on hold.

https://www.vox.com/future-perfect/2019/3/9/18256821/prisoner-brain-study-spain-aggression-neurointervention-ethics

Is Ethical A.I. Even Possible? | NYT

HALF MOON BAY, Calif. — When a news article revealed that Clarifai was working with the Pentagon and some employees questioned the ethics of building artificial intelligence that analyzed video captured by drones, the company said the project would save the lives of civilians and soldiers.

“Clarifai’s mission is to accelerate the progress of humanity with continually improving A.I.,” read a blog post from Matt Zeiler, the company’s founder and chief executive, and a prominent A.I. researcher. Later, in a news media interview, Mr. Zeiler announced a new management position that would ensure all company projects were ethically sound.

As activists, researchers, and journalists voice concerns over the rise of artificial intelligence, warning against biased, deceptive and malicious applications, the companies building this technology are responding. From tech giants like Google and Microsoft to scrappy A.I. start-ups, many are creating corporate principles meant to ensure their systems are designed and deployed in an ethical way. Some set up ethics officers or review boards to oversee these principles.

But tensions continue to rise as some question whether these promises will ultimately be kept. Companies can change course. Idealism can bow to financial pressure. Some activists — and even some companies — are beginning to argue that the only way to ensure ethical practices is through government regulation.

https://www.nytimes.com/2019/03/01/business/ethics-artificial-intelligence.html

China’s CRISPR twins might have had their brains inadvertently enhanced | MIT Technology Review

The brains of two genetically edited girls born in China last year may have been changed in ways that enhance cognition and memory, scientists say.

The twins, called Lulu and Nana, reportedly had their genes modified before birth by a Chinese scientific team using the new editing tool CRISPR. The goal was to make the girls immune to infection by HIV, the virus that causes AIDS.

Now, new research shows that the same alteration introduced into the girls’ DNA, deletion of a gene called CCR5, not only makes mice smarter but also improves human brain recovery after stroke, and could be linked to greater success in school.

“The answer is likely yes, it did affect their brains,” says Alcino J. Silva, a neurobiologist at the University of California, Los Angeles, whose lab uncovered a major new role for the CCR5 gene in memory and the brain’s ability to form new connections. 

“The simplest interpretation is that those mutations will probably have an impact on cognitive function in the twins,” says Silva. He says the exact effect on the girls’ cognition is impossible to predict, and “that is why it should not be done.” 

https://www.technologyreview.com/s/612997/the-crispr-twins-had-their-brains-altered/


Ketamine Could Be the Key to Reversing America’s Rising Suicide Rate | Bloomberg Businessweek

[…] Wright decided to try again in 2016, this time using a cocktail of drugs he’d ground into a powder. As he tells the story now, he was preparing to mix the powder into water and drink it when his dog jumped onto his lap. Suddenly he had a moment of clarity that shocked him into action. He started doing research and came upon a Columbia University study of a pharmaceutical treatment for severe depression and suicidality. It involved an infusion of ketamine, a decades-old anesthetic that’s also an infamous party drug. He immediately volunteered.

His first—and only—ketamine infusion made him feel dreamlike, goofy, and euphoric. He almost immediately started feeling more hopeful about life. He was more receptive to therapy. Less than a year later, he married. Today he says his dark moods are remote and manageable. Suicidal thoughts are largely gone. “If they had told me how much it would affect me, I wouldn’t have believed it,” Wright says. “It is unconscionable that it is not already approved for suicidal patients.”

https://www.bloomberg.com/news/features/2019-02-05/ketamine-could-soon-be-used-to-treat-suicidal-ideation

Wanting to die at 'five to midnight' - before dementia takes over | Andrew Bomford

It's not unusual for Dutch patients with dementia to request euthanasia, but in the later stages of the disease they may be incapable of reconfirming their consent - one doctor is currently facing prosecution in such a case. But fear of being refused is pushing some to ask to die earlier than they would have liked.

Annie Zwijnenberg was never in any doubt.

"The neurologist said: 'I'm sorry, but there's no way we can mistake this - its Alzheimer's," says Anneke Soute-Zwijnenberg, describing the moment her mother was first diagnosed.

"And she said: 'OK, then I know what I want.'"

Anneke's brother Frank chips in: "Maybe she hesitated for five seconds, and said: 'Now I know what to do.'"

They both knew she was referring to euthanasia.

You could say Annie's story is a textbook case of how euthanasia is supposed to happen in the Netherlands - with very consistent and clear consent. But there are other cases where the patient's consent is less consistent, and at the final moment, less clear.

https://www.bbc.com/news/stories-47047579

Certainty is not a defensible standard for policy making in the context of assisted dying | Udo Schuklenk

[…] The chairperson of the group drafting the report on mental illness and assisted dying, Kwame McKenzie, made a statement to Canadian news media in support of current government policy that excludes competent people who suffer from refractory mental illness from access to assisted dying. He reportedly cautioned that ‘no one can be completely certain that a mentally ill patient is never going to get better’.[3] Which takes me to the actual topic of this blogpost: certainty as a standard for health policy making. Complete certainty, if that were ever possible in the context of health and disease, where most decision making is based on probability as opposed to certainty, might be a defensible threshold if nobody were harmed by the implementation of such a high standard. If the setting of a high standard were cost neutral, there would be no good reason not to have such a standard.

https://ethxblog.blogspot.com/2019/01/certainty-is-not-defensible-standard.html

Europe's top rights court to hear Belgian euthanasia case | AP

LONDON (AP) — Europe’s top human rights court has agreed to hear a case being brought against Belgium by a man whose mother was euthanized in 2012 for depression, the second case that implicates one of Belgium’s leading euthanasia doctors.

In a statement Tuesday, lawyers for Tom Mortier said they brought their case to the European Court of Human Rights in Strasbourg after Belgian authorities declined to pursue it.

Robert Clarke, one of Mortier’s lawyers, said there were some “deeply worrying” details about the case.

“This was a woman who was under the care of a psychiatrist and according to medical definition was a vulnerable person,” Clarke said. “The state had a duty of care to protect her and it failed.

https://apnews.com/8217108af4f841b3a2d551ca73eecb9c

An Elephant’s Personhood on Trial | The Atlantic

Forty-seven years ago, the Asian elephant now known as Happy was one of seven calves captured—probably in Thailand, but details are hazy—and sent to the United States. She spent five years at a safari park in Florida, time that in the wild would have been spent by her mother’s side. Then she was moved to the Bronx Zoo in New York City. There Happy remains today, and since the death of an elephant companion in 2006, she has lived alone, her days alternating between a 1.15-acre yard and an indoor stall.

For a member of a species renowned for both intelligence and sociality, the setting is far from natural. In the wild, Happy would share a many-square-mile home range with a lifelong extended family, their bonds so close-knit that witnessing death produces symptoms akin to post-traumatic stress disorder in humans. It would seem that Happy, despite the devotions of the people who care for her, is not living her best life.

In considering Happy’s circumstances and what might be done to improve them, should something more than animal-welfare laws and zoo regulations—which the Bronx Zoo has not violated, but arguably are inadequate—be invoked? Should Happy be considered, in legal terms, a person? Which is to say, an entity capable of possessing at least some rights historically reserved for humans alone—beginning with a right to be free?

https://www.theatlantic.com/science/archive/2018/12/happy-elephant-personhood/578818/

Bioethicists under threat | Developing World Bioethics

The title of this editorial is not exaggerated: I am a developing world bioethicist and most of my work has been focused on reproductive rights. To be clear, most of my theoretical writings and empirical research are about abortion. Abortion is a crime in several developing countries, and, globally, the Latin American and Caribbean region has the most repressive laws against abortion, along with high rates of clandestine abortion. Women can go to the jail for having a miscarriage when they are not being properly protected against criminal prosecutions, as has happened in El Salvador. In my case, being an academic who is engaged in women's reproductive rights has led me to an unprecedented situation as an academic in Brazil: I have received threats against my life and can no longer go back to my university to teach, to meet students, or to participate in academic celebrations such as commencement, where I was the main speaker this year.

https://onlinelibrary.wiley.com/doi/10.1111/dewb.12212


Ethics in genetic counselling | Journal of Community Genetics

Difficult ethical issues arise for patients and professionals in medical genetics, and often relate to the patient’s family or their social context. Tackling these issues requires sensitivity to nuances of communication and a commitment to clarity and consistency. It also benefits from an awareness of different approaches to ethical theory. Many of the ethical problems encountered in genetics relate to tensions between the wishes or interests of different people, sometimes even people who do not (yet) exist or exist as embryos, either in an established pregnancy or in vitro. Concern for the long-term welfare of a child or young person, or possible future children, or for other members of the family, may lead to tensions felt by the patient (client) in genetic counselling. Differences in perspective may also arise between the patient and professional when the latter recommends disclosure of information to relatives and the patient finds that too difficult, or when the professional considers the genetic testing of a child, sought by parents, to be inappropriate. The expectations of a patient’s community may also lead to the differences in perspective between patient and counsellor. Recent developments of genetic technology permit genome-wide investigations. These have generated additional and more complex data that amplify and exacerbate some pre-existing ethical problems, including those presented by incidental (additional sought and secondary) findings and the recognition of variants currently of uncertain significance, so that reports of genomic investigations may often be provisional rather than definitive. Experience is being gained with these problems but substantial challenges are likely to persist in the long term.

https://link.springer.com/article/10.1007/s12687-018-0371-7


Medical Assistance in Dying | The Expert Panel on Medical Assistance in Dying

In December 2016, the CCA was asked by then Minister of Health Jane Philpott and Minister of Justice and Attorney General of Canada Jody Wilson-Raybould to undertake independent reviews related to medical assistance in dying (MAID). Specifically, the CCA was tasked with examining three particularly complex types of requests for MAID that were identified for further review and study in the legislation passed by Parliament in 2016: requests by mature minors, advance requests, and requests where a mental disorder is the sole underlying medical condition.

On December 12, 2018 the CCA released the three final reports of the Expert Panel, one on each type of request: The State of Knowledge on Medical Assistance in Dying for Mature MinorsThe State of Knowledge on Advance Requests for Medical Assistance in Dying; and The State of Knowledge on Medical Assistance in Dying Where a Mental Disorder is the Sole Underlying Medical Condition.

https://www.scienceadvice.ca/reports/medical-assistance-in-dying/

When Nonviolence Isn't Enough | Reason.com

Interesting read by Jason Brennan.

In August 2017, Richard Hubbard III stopped at a red light in Euclid, Ohio, but his front bumper went a few feet past the white line. The cops pulled him over. That's no surprise: Police in Euclid, Cleveland Heights, and the surrounding cash-strapped towns strictly enforce traffic rules. But officers didn't just give the driver a ticket.

The police demanded Hubbard—a black man—step out of his vehicle. Dashcam footage shows that he calmly complied. Yet one officer immediately spun Hubbard around, bent his arm, and slammed him against his Hyundai. He flipped Hubbard again, punched him in the face, and kicked his groin. Hubbard screamed and put his arms up to protect himself. The other officer joined in.

They threw Hubbard to the ground but continued to punch, hammer, and kick him. When he tried to protect his face, they chanted the informal motto of American police, "Stop resisting!" Even when Hubbard was subdued, prostrate with his hands behind his back and two large officers pinning him down, one officer continued to pummel his skull.

Imagine you witness the whole thing. A thought occurs to you: You're armed. You could shoot the officers, perhaps saving Hubbard's life or preventing him from being maimed and disabled. May you do so?

Below, I defend a controversial answer: Yes, you may. Shooting the cops in this case is dangerous—they may send a SWAT team to kill you—and in many places it's illegal. But it is nevertheless morally permissible, indeed heroic and admirable. You have the right to defend yourself and others from state injustice, even when government agents act ex officio and follow the law.

https://reason.com/archives/2018/12/07/when-nonviolence-isnt-enough

Another by Brennan on this topic: When the state is unjust, citizens may use justifiable violence

https://aeon.co/ideas/when-the-state-is-unjust-citizens-may-use-justifiable-violence