HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, November 25, 2004

On a bioethics listserv today, a colleague posted the following message:

>I would welcome the List's comments on the following scenario:
>A psychiatric patient is treated and released from a psych unit of a
>hospital. Nothing comes up during this stay that would lead treating
>staff to suspect that the patient has committed a crime or poses a
>danger to others. However, following the patient's discharge, several
>members of the health care staff read in the local paper a police
>profile of a person suspected in an armed robbery. These staff members
>believe the profile (which includes a police sketch) is of the psych
>patient released from the hospital. Aside from the legal issues raised
>by this case (which are governed by state law and HIPAA), the staff
>members want to know whether it is ethically permissible to notify the
>authorities of the identity of the suspect. For example, would it be
>permissible for the staff member to notify the authorities anonymously?
>The staff member is not certain that the psych patient is the suspect,
>though the patient fits the fairly detailed profile to a tee.
>Anyone faced this sort of situation before? Thanks in advance for your

The first three responses, from bioethicists on the listserve with real name-recognition in the field, were that notifying the officials would be (1) permissible, (2) impermissible, and (3) mandatory. 

Now, I don't offer this mini-colloquy as proof of anything, certainly not as proof that the field of bioethics lacks coherence.  But these responses made me take a bit more seriously than I might have an editorial from Michael Cook in The Age (Melbourne), in which he takes on "Julian Savulescu, the Uehiro professor of applied ethics at Oxford, who recently returned home to tell Australian parents that they have a moral obligation to genetically modify their children. An obligation, mind you, not just a nice idea":

Savulescu insists that this isn't Nazi eugenics, because Nazi eugenics was "a state-imposed vision".

He's wrong, of course. Eugenics is eugenics is eugenics. Eugenics means that people are bred like cattle to get the best genetic traits. And this is what Savulescu is advocating. He simply wants to achieve it through free-market, libertarian eugenics rather than through old-fashioned command economy eugenics. And as everyone in a globalised world realises, the libertarian approach has been far more effective at changing public preferences than Nazism or communism.

Savulescu is becoming a celebrity, but more for his brazen cheek in mentioning the unmentionable and trampling ancient taboos underfoot than for the depth of his arguments. His reasoning can accommodate any behaviour you want, as long as you make a freely chosen rational decision and accept the consequences. Stay tuned for further instalments.

Eugenics means that people are bred like cattle to get the best genetic traits. And this is what Savulescu is advocating.But rather than bat the shuttlecock of human genetic engineering back and forth across an ethical net, I'd simply like to ask what credentials Savulescu possesses to give him such prominence in the Melbourne media. Isn't it a bit unfair to the rest of Australia's fruitcakes to invite him to give public lectures? They have loopy ideas too. Why isn't anyone interviewing them?

The answer, of course, is that Julian Savulescu works at Oxford and is a bioethicist. But do these two qualifications really guarantee his credibility as a minor guru when he pays us a visit?

Only if you still suffer from cultural cringe. Oxford, ancient Oxford, the Oxford of postcards and poetry, radiates 800 years of scholarship. Savulescu, however, works in a new Oxford, a competitive, funding-hungry Oxford. A Japanese benefactor offered the new Oxford a generous endowment to create the Uehiro chair in "applied ethics" - a code word for the philosophy of Peter Singer. Oxford took the Japanese shilling and hired one of Singer's most distinguished disciples, despite the fact that even among bioethicists Singer is regarded as weird and narrow.

So wipe the Oxford glaze off Savulescu's outrageous proposals. Pretend that he teaches at the University of Lincolnshire and Humberside. How sensible do they sound now?

Nor does working as a bioethicist make you a font of wisdom. In fact, it is becoming increasingly clear that calling yourself a bioethicist is not necessarily an advance on qualifications in astrology.

The word "bioethics" was invented by American academics as recently as 1970. The new field metastasised quickly, invading medicine, ecology and sociology as well as traditional philosophy. But unlike sharp-edged disciplines such as physics or mathematics, the goals, methods and boundaries of bioethics are as murky as the bottom of the Yarra.

A couple of weeks ago, for instance, an article in the world's leading medical journal, The Lancet, called bioethics a "bankrupt" discipline. Professor Roger Cooter, of University College London, wrote that "hardly wet behind the ears, bioethics seems destined for a short lifespan". He argues that some US bioethics centres have been funded by pharmaceutical companies; that it has a narrow and old-fashioned notion of ethics; and that bioethicists themselves can't even agree how it started or what it means. And Cooter is by no means alone in his assessment.

Not meaning to offer a comment on Savelscu's work, which I haven't read, I am struck by the responses on the bioethics listserve today.  Evidence of bioethics' incoherence? Evidence of its rich and diverse underpinnings? Or . . . . ?

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