Archive for the ‘Ethics’ Category

Coronavirus ethics: When healthy and young has priority over sick and old

March 29, 2020

In the last few days, the prospect of limited intensive care places and too many patients has become more real. Professors of philosophy have been sought after for their views. In Sweden, the National Board of Health and Welfare (Socialstyrelsen) has produced new guidelines so that doctors and nurses forced to make life and death choices have support for their decisions. The guiding principle is stated to be the “expected remaining lifetime” without consideration of “social standing, disabilities or actual age”. Of course this is inherently contradictory since expected remaining lifetime and actual age cannot be divorced. In their new guidelines the Board skates over this contradiction by claiming that it is “biological age” that is being considered and not “actual age”.

The guidelines define priorities for intensive care (my translation):

Priority 1: Patients who have a serious illness but are expected to survive longer than 12 months. If it becomes necessary to prioritize within this group, it must not be done based on the patient’s social situation / position,  any disabilities or the person’s actual age. It may, however, be based on what is called biological age. The latter means that the expected life expectancy is calculated using a number of factors. Those who are younger are then given priority over the older if the health status of both is otherwise equal. But conversely, a patient who is older but otherwise in good health should be given priority over a younger person who, due to illness or otherwise, is expected to live shorter.

Priority 2: Patients with one or more severe systemic disorders with significant functional limitation. These include, for example, insufficiently controlled diabetes, COPD, morbid obesity (BMI ≥40), active hepatitis, alcohol abuse, pacemaker addiction and a heart attack or stroke older than three months. This group also includes those who have an expected survival of 6-12 months.

Priority 3: Patients with an expected low probability of survival. These may be cases where the intensive care unit is normally only used to enable a renewed assessment and consultation with related persons.

Swedish television reports:

SvT:

If the corona crisis worsens, healthcare will be forced to prioritize – and patients who have had good prospects of coping may be rejected. “It can be so in an extreme situation”, says Lars Sandman, Professor of health ethics.

Health care always needs to be prioritized. But in a situation where the number of corona-infected who need intensive care is increasing dramatically, this can result in many difficult decisions. Therefore, new guidelines for priorities in health care have been developed on behalf of the National Board of Health and Welfare. “Suppose we get completely full departments with many very seriously ill people who have marginal conditions to come back to life after intensive care and then other more basically healthy people knock at the door. Then it can be a very difficult decision”, says Andreas Hvarfner, chief physician in anesthesia and intensive care at Karolinska University Hospital in Solna.

Will this mean that infected elderly patients who have severe diabetes, lung disease, pacemakers and are overweight are at risk of not receiving intensive care? “Of course, that may eventually be so” says Andreas Hvarfner.

Lars Sandman, professor of health ethics at Linköping University, has been involved in developing the new guidelines. “When faced with these difficult decisions, it is important that there is clear support and that one can lean back on ethical principles that in this case are legal and instituted by Parliament in 1997. We have tried to clarify how they should be interpreted” , he said.

If there is now a storm that many believe, will people prioritize between people who may have roughly the same conditions? “It can be so in an extreme situation. Then we have stated in the guidelines that you can choose the one that has the longest remaining life expectancy . We want to avoid getting into that situation and therefore we are working hard to get more intensive care places”. This means that young people do come ahead of the elderly if they have similar conditions to survive. According to Lars Sandman, the problem is that there are no alternatives. “You can of course imagine a queuing situation, but then you run the risk that a patient who may have less chance of survival gets the place and that two patients instead of one die in the end”.

Consider the case of two sick patients and only one intensive care place. Younger and healthier will always have a higher expected remaining life and have a higher priority. If both have the same chance of survival, the younger will always get priority. For an older person to get priority by the remaining lifetime criterion, the chance of survival will have to be much higher than for the younger person. The stipulation that social standing have no impact means that a younger, healthier, anti-social, scrounger will get a higher priority than a worthy, productive, sicker, older person.

Of course, this is oversimplified. In reality the chances of survival with intensive care have to be first judged against chances of survival without. It is unlikely that chances of survival without intensive care could both be zero in two cases which had widely different chances with intensive care.

Take:  expected remaining life = (life expectancy – actual age) x chance of survival

Let us assume a life expectancy of 90 years and a base case of a very sick 20 year old with only a 10% chance of survival. Expected remaining life would then be 10% of life remaining giving 7 years. An older person would have priority if their chance of survival was sufficient to give an expected life remaining of greater than 7 years. To get priority a 50 year old would need a chance of survival of 17.5%, a 70 year old would need 35% and and an 80 year old would need a 70% chance of survival. Anybody over 83 would never get priority – even if they had a 99% chance of survival.

Of course, it is age discrimination disguised with words (biological age) to ostensibly comply with the laws on discrimination. But the Board really has no choice.

The issue I have is not really with the Board but with the delusion that the value of humans is not connected to their social behaviour and the myth that humans are equal.


 

Are rights real in this age of entitlement?

March 11, 2020
  1. A right is an entitlement to a privilege.
  2. A privilege is an actual advantage available (whether granted by anybody or not) to a particular person or group. (By analogy, your right is your ownership of another’s debt, an entitlement is that the credit is in your account and a privilege results when it is encashed).
  3. Having an entitlement is no guarantee that the privilege will result.
  4. A grant of an impossible entitlement or an entitlement granted by an incompetent authority cannot be realized as a privilege.
  5. The universe is not in debt to any living creature.
  6. There are no entitlements which flow from the laws of nature as rights of any kind except the obligation to comply with the natural laws.
  7. No living thing is born with any entitlements.
  8. There is no entitlement even to life. Survival is a result, not an entitlement.
  9. The primal drivers for all living things are survival and self-interest.
  10. Humans are not born equal. Each human is born with a unique set of genes and has the potential and the constraints given by that set of genes (nature). All humans are born naked, with no resources, no debts, no liabilities and with only those privileges as may be granted, or liabilities that may be imposed, by the local, surrounding human society.
  11. Humans are not brought up equally. Every individual receives varying amounts and quality of support from the surrounding community (nurture).
  12. Human lives are not equal in value. The value of a human life to its surrounding society is neither static nor a constant. It varies across individuals, across societies and across the lifetime of the individual.
  13. An individual’s capability for behaviour lies within the envelope of what is allowed by an individual’s genes (nature), as enabled or constrained by upbringing (nurture).
  14. An individual’s actual actions are limited first by capability (nature and nurture) and then as motivated or constrained by individual cognition.
  15. Every individual is free to act within his capabilities and his desires but within the physical constraints that the surroundings (environment or society) may have applied.
  16. Human brains give us the ability to reason which, in turn, gives our assessments of self-interest. All human behaviour is governed first by perceived self-interest.
  17. Even apparently altruistic actions are only as a subset of perceived self-interest.
  18. An individual’s immediate, perceived self-interest can override any consideration of causing harm to others.
  19. Coercion, physically or by the application of threats (including by legislation), can change the perception of self-interest.
  20. All societies – from family groups and up to nations – grant their members various privileges conditional always upon their behaviour.
  21. “Acceptable behaviour” is a dynamic, local, value-judgement. It varies across individuals, families, societies and over time.
  22. All societies create legislation to try and coerce “acceptable” behaviour from their members by rewarding “good” behaviour and penalizing “bad” behaviour.
  23. In practice, protecting or rewarding the perpetrators of “bad” behaviour shields and perpetuates that behaviour.
  24. “Improvement” of individual behaviour means eliciting a greater compliance with a society’s standards of behaviour.
  25. Global declarations of entitlements can only be effected (encashed) locally.
  26. There is no global, timeless definition of what constitutes “acceptable” or “barbarous” behaviour which is shared by all 7 billion humans.
  27. No society attempts to, or has the competence to, guarantee that any of its members will not be victims of “unacceptable behaviour” received from others.
  28. Human rights are an imaginary social construct.
  29. All declared human rights are of universally applicable, irrevocable, unconditional entitlements to some privilege of received behaviour.
  30. Declared human rights are free of cost and require no reciprocal duties.
  31. A declaration of human rights in itself creates no social contract.
  32. All claims of human rights are claims against the behaviour received or not received from others.
  33. Human rights entitlements are theorized to apply only after birth and cease with death. (A living murderer retains rights but not so the victim).

 

The red thread of the “progressives”

February 26, 2019

It can be sugar-coated but the reality is that abortion is already established as an acceptable method of contraception. It now seems to be that infanticide, immediately after the birth of a baby that could have been eligible for abortion, is also an acceptable method of contraception for US Democrats.

The “progressives” in the US are now finding that infanticide of the newly born can be ethical. Why not babies upto 12 months old?

I am not sure where the “progressives” (typified by the extreme wings of the Democrats in the US, Social Democrats and Liberals in Europe and Labour and Liberals the in the UK) are headed, but their path seems sanctimoniously suicidal.

It seems to me to be more a question of narcissistic self-indulgence than of ethics.


 

Where murderers can’t be executed but new born babies can ….

February 1, 2019

In New York, capital punishment is not allowed and murderers cannot be executed. But new born babies can be killed after-birth whenever an abortion could have been justified. And to have an abortion is apparently always justified.

It would seem that the moral justification of abortion on demand and for convenience, is now being extended to include infanticide by rebranding it as “after-birth abortions”.

In New York hospitals, you can find premature newborn babies surrounded by dedicated doctors and nurses fighting to save their lives. Next door, you now might find physicians and non-physicians alike giving lethal injections to babies the same age, thanks to the state’s new so-called Reproductive Health Act.

Over a decade ago, New York abolished the death penalty for convicted criminals, but as of last week, babies in the seventh, eighth and ninth month of their mother’s pregnancy — old enough to live outside their mother’s wombs — can now be given lethal injections.

Abortions at that stage are committed by piercing the baby’s brain or heart with a large needle and injecting her with enough digoxin to cause cardiac arrest. Labor is then induced, and the mother delivers her dead child into the hands of an abortionist.

Abortion-rights advocates say that late-term abortions are only performed in cases where a mother’s life or health is at risk or the child suffers from a life-threatening condition.

But this is false. According to research published by the Guttmacher Institute, which supports abortion rights, abortions for fetal abnormalities “make up a small minority” of late-term abortions; those for saving the mother’s life are an even smaller number. The majority of late-term abortions aren’t done for so-called “medical reasons” at all.

The academic community started the use of the euphemistic “after birth abortion”. The moral justification for infanticide that is now being developed by the “progressive” community is remarkably similar to the moral justification for race based eugenics developed in the 1930s. And – irony of ironies – such arguments are actually developed and disseminated in a journal calling itself The Journal of Medical Ethics. (a main stream, peer reviewed Springer publication)

“After birth abortion”


 

Killing humans is usually immoral

January 18, 2019

Morality is relative.

It varies over time and space.

There have always been situations where killing of some humans has been considered, not just not immoral, but actually a moral duty. To kill people of opposing faiths was justifiable for a long time. To put enemies or sufficiently “bad” people to death was once a moral duty. Even something to be proud of.

It is no different today.

For ISIS and other “terrorist” organisations killing the enemy in particularly brutal ways is something which is not only something to be proud of but also something which opens the gates to Paradise. Armies are trained to, and assessed, by their ability to kill the enemy – in bulk. Collateral damage is regrettable but allowed. It is never immoral. Many states allow individuals to kill when their own survival is threatened. Many other states do not. Many states exercise capital punishment for really “bad” people. Many other states do not and many of these mollycoddle the cancerous humans among them. In more “liberal” quarters the number of euthanasia deaths and abortions carried out have become something to be proud of. Paradoxically, the states which are most opposed to capital punishment are also the states which are most in favour of abortion and the “mercy” killings of the aged or the terminally ill.

There is no such thing as a “human right” to life. Any individual’s life is “cabined, cribbed, confined” by his genes, the privileges accorded by the surrounding society and the quirks of random events.

As with all so-called “human rights”  living is just another privilege.


 

Rape, the Swedish Academy and the Literature Nobel

October 1, 2018

The task of selecting the Literature Nobel has to be taken away from the Swedish Academy if the prize is not to be forever tainted by the spectre of rape.

Unless all the members of the current Swedish Academy resign and the Academy is reconstituted, the Nobel Foundation will have to take the task of selecting the Literature Prize away from the Academy and give it to some other institution. If not, every future Literature laureate will be forever coupled to an institution which, at best,  turned a blind eye to rape and sexual predation or, at worst, enabled rape and sexual predation. Even changing out all the members may not be enough to take the stain away.

Today Jean-Claude Arnold – referred to in the Swedish media as the “kulturprofilen” (the culture profile) – was sentenced to 2 years in prison for rape. Eighteen women accused him of sexual predation but only one of the cases came to a prosecution. He was married to a member of the Academy. The pair together ran a “club” which received large grants from the Academy.

Jean-Claude Arnault

BBC

A French photographer at the heart of a rape scandal that saw this year’s Nobel Prize for Literature postponed has been handed a two-year prison sentence. On Monday a Swedish court found Jean-Claude Arnault, 72, guilty of raping a woman in an apartment in Stockholm in 2011.

Arnault, who is well known in Sweden, is married to a former member of the centuries-old Swedish Academy.

The crisis forced the academy to cancel this year’s literature award in May. 

In late 2017, some 18 women came forward in a Swedish newspaper to accuse Arnault of sexual harassment and assault in the wake of the #MeToo movement, prompting an investigation by state prosecutors. He later denied all the alleged incidents, many of which were said to have happened at properties owned by the Academy or at his literary club. All but one of the cases ended up being dropped.

In April this year, the Swedish cultural organisation handed over an internal report it had conducted through lawyers to judicial authorities. The same month, it voted against removing Arnault’s wife, the poet and writer Katarina Frostenson, from its 18-person committee. This, along with accusations of conflict of interest and the leaking of Nobel winners’ names, is said to have divided the Academy and sparked a wave of resignations – including by Ms Frostenson and the Academy’s head, Prof Sara Danius. Technically, members of the Swedish Academy cannot resign from their positions, which are assumed for life. But they can stop taking part in its activities.

The members of the Academy have been fighting (like a bunch of horny cats comes to mind) in the media for the last year and a more unedifying spectacle is hard to describe. The unadulterated arrogance and narcissism of the members has been breathtaking.


 

Will recognition of “fake news” be followed by “fake science”

November 3, 2017

Collins Dictionary has chosen “fake news” as its word for 2017.

When a partisan publication exaggerates – even wildly – in favour of its own cause, it causes no great surprise.  It is not even too astonishing when it fabricates news or omits news to further its own agenda. The insidious nature of “fake news” is worst when it is a supposedly objective publication which indulges in fake news to further a hidden agenda. So when Breitbart or the Daily Mail or Huffington Post produce much of their nonsense it causes no great surprise and hardly merits the sobriquet of “fake news”, even if much of the “news” is slanted or exaggerated or skewed or just plain lies. It is when a publication, having a reputation for objectivity, misuses that reputation to push its own agenda, that “fake news” takes on a life of its own.

It is not that this is anything new but certainly the US Presidential Election has brought “fake news” to a head. “Fake News” applies though to much more than just US politics. Of course CNN heads the list of purveyors of “fake news”. CNN has never been objective but they once generally checked their facts and used to separate straight reporting from opinion. I used to find them, at least, fairly reliable for factual reporting. But they have abandoned that approach and I find that they not just unreliable but also intentionally misleading. Their “journalists” have all become lobbyists and “CNN” has become synonymous with “Fake News”.

I once was a regular reader of the Washington Post. They were biased but were not unreliable as to the facts. It was quite easy to just discount for bias and get what I thought was a “true” picture. But they, too, have degenerated swiftly in the last 2 years. Stories are not just distorted, they are even fabricated. But the real disappointments for me in the last 24 months has been the New York Times. Not just in the space of US politics. The NYT has its own definitions of what is politically correct in politics, in science and even in the arts. Somewhere along the way they have made a conscious decision that they are “lobbyists” rather than reporters. They have decided that, for what they have defined as being “politically correct”, pushing that view justifies omission, exaggeration, “spinning” and even fabrication. Straight reporting has become extinct.

Lobby groups such as Huff Post and Daily Kos and Red State are full of blatant falsifications but have no news reputation of any significance at stake. They are not, therefore, included in my take on the top purveyors of fake new.

If 2017 has seen the recognition of the widespread use of fake news, I am looking to 2018 to recognise the proliferation of fake science. There is fake science being disseminated every day in big physics (CERN funding), pharmaceuticals, “climate science”, behavioural studies, sociology, psychology and economics. Much of fake science follows funding. Perhaps there will be greater recognition that “good science” is neither decided by nor subject to a poll.


 

 

Does life start when the egg is laid?

April 9, 2017

Birds and reptiles (and the duck billed platypus which is a mammal), lay eggs for their offspring. Their only interaction of the parents with the egg after it is laid is to keep predators away and to incubate it – which is often done by the male. The development of the embryo in the egg requires no nourishment or any biological intervention from the parents.

In the case of a chicken’s development, the egg when laid consists of a minuscule embryo (0.0002 grams) and nutrients. The chick hatches when the nutrients have been consumed and its weight has increased to about 30-31 grams.

Image result for development of a chicken egg

from EnchantedLearning.com

Is the chick alive when the egg is laid?

One could argue that the embryo at that point is not yet deserving of the label “chick”. But I think there is no rational way in which to question that “life” has definitely started by the time the fertilised egg is laid. In the case of humans a fertilised egg is called a “zygote” until it has implanted itself (about 6 -10 days after conception) in the wall of the womb. It is then called an “embryo”. It is called a “fetus” only from 8 weeks after conception and remains a “fetus” till the birth of a “child”. Just as a “chick” only emerges after egg hatching, a human “child” only emerges after birth. But in both cases life, life has begun much earlier. By the time a hen lays an egg, the genetic identity of the embryo in the egg has already been fixed. The unique genetic identity whether for chicken or for human is actually fixed when conception occurs. The implantation of a human zygote in the wall of the womb is the corresponding point when an embryo is defined. The genetic identity of the embryo has then been well established and the life of a unique identity has clearly begun.

An individual human time line is then not so complicated as the Great Abortion Debate would make it to be:

0: Conception: Genetic identity is established. Life begins as a zygote.

+2: Implantation in the womb: Life continues as an embryo.

+8: Life continues as a fetus

+40: Life continues as a child.

+1340: Child becomes adult when brain development is complete

+4720 (approximately): Life of that unique identity ends


The time when a unique identity is established and life begins is quite simply defined and the Great Abortion Debate is actually about the ethics of terminating that life at different times during its existence. It is trying to make an ethical distinction between breaking an egg for a breakfast omelette or killing a chicken for a roast dinner. (But note also that many vegetarians eat eggs but a chicken eater is never considered a vegetarian). Abortion, infanticide, murder or euthanasia are just labels for different times at which life is to be terminated. Abortion always kills a fetus (not a child) and infanticide always kills a child (not a fetus). But whether it is a zygote which fails to implant itself, or a fetus which is aborted, or a child killed for being the wrong gender, or an aged person being assisted to die, it is the same life, the same identity, which is terminated.

And, I note, ethics are always personal and cannot be imposed by a society on someone. But a society can always exclude someone from the club for not complying with its ethical code.

This Slate article unnecessarily complicates the matter only to try and justify a particular ethical view.

When Does Life Begin? It’s Not So Simple

It actually is just that simple. A unique genetic identity and life are established with conception.


 

Did Jeb Bush commission the Trump fake report? and was it “laundered” by John McCain?

January 12, 2017

Fake news needs “laundering” for it to gain legs.

The Obama birther story was first started by Hillary Clinton’s supporters when she was standing against him in the Democratic primaries in 2008. It then took on a life of its own.

Now it seems the fake and scurrilous report about Donald Trump may have been commissioned from a former British intelligence officer as part of Jeb Bush’s efforts during the Republican primaries. To make it even more intriguing it may be that the fake report was passed through John McCain to the FBI – a sort of “laundering” of fake news to give it a semblance of authority. Whether McCain did it knowingly or was duped into the laundering exercise is unknown.

Of course CNN then played their part in “laundering” the fake news though that involvement is very likely intentional.

Reuters:

Christopher Steele, who wrote reports on compromising material Russian operatives allegedly had collected on U.S. President-elect Donald Trump, is a former officer in Britain’s Secret Intelligence Service, according to people familiar with his career.

Former British intelligence officials said Steele spent years under diplomatic cover working for the agency, also known as MI-6, in Russia and Paris and at the Foreign and Commonwealth Office in London. After he left the spy service, Steele supplied the U.S. Federal Bureau of Investigation (FBI) with information on corruption at FIFA, international soccer’s governing body. It was his work on corruption in international soccer that lent credence to his reporting on Trump’s entanglements in Russia, U.S. officials said on Wednesday. ……

……. Steele was initially hired by FusionGPS, a Washington, DC-based political research firm, to investigate Trump on behalf of unidentified Republicans who wanted to stop Trump’s bid for the GOP nomination. The British Broadcasting Corporation (BBC) reported that Steele was initially hired by Jeb Bush, one of Trump’s 16 opponents in the 2016 Republican primary. It was not immediately possible to verify the BBC’s report. ……

He was kept on assignment by FusionGPS after Trump won the nomination and his information was circulated to Democratic Party figures and members of the media. 

Steele’s dealings with the FBI on Trump, initially with the senior agent who had started the FIFA probe and then moved to a post in Europe, began in July. However, Steele cut off contact with the FBI about a month before the Nov. 8 election because he was frustrated by the bureau’s slow progress.  

And then we have McCain’s involvement.

Breitbart: 

Wednesday on CNN addressing media reports that he had turned over a dossier containing unverified claims about Russia and President-elect Donald Trump, Sen. John McCain (R-AZ) said, “I don’t know if it’s credible or not but I thought the information deserved to be delivered to the FBI, the appropriate agency of government.”

Partial transcript as follows:

MCCAIN: After looking at that information I took it to the FBI and have had no further involvement with it at issue. By the way, according to some media reports they already had that information, but I didn’t know that at the time. I did what any citizen would do, received sensitive information and then handed it over to the proper government agency and had nothing else to do with it.

Very commendable on the face of it but unlikely to be as innocent as all that.


 

CNN and Buzzfeed (fake news and garbage) have just shot themselves

January 12, 2017

“CNN and Buzzfeed” go together like “fake news and garbage”.

Buzzfeed provides the raw, unsorted garbage and CNN gives it the fake “news” label. But in their eagerness to attack Trump (CNN well deserves the label of being the “Clinton News Network”) they may have just provided Trump with all the justification he needs to sanction them. As lobby groups they really can no longer be considered “News Media”. They have dissipated and no longer deserve the protection that is due to journalistic activity since they have are engaged, now, primarily in advocacy rather than journalism. There are many other advocacy groups masquerading as purveyors of objective news. But most others provide a mix of advocacy and journalism. CNN sticks out as being particularly far removed from genuine journalism. CNN, from my own observations, has been consistently guilty of “politically correct” propaganda at least since the first Gulf War with the elder Bush. To my mind Blitzer (especially) and Amanpour and Tapper and their like are fatally tainted as journalists. At least Zakaria is openly a leftist advocate and does not pretend to be a journalist. CNN lost its objectivity and the skepticism necessary for quality journalism a long time ago.

This time they may have shot themselves in a much more vital area than the foot.

“CNN is fake news”

has a ring of truth about it.

This from Politico which is not particularly friendly to Trump though it has not been quite as rabid and shameless in its “politically correct” propaganda as CNN and WaPo and HuffPo

Politico: 

The best thing that happened to Donald Trump all week is that BuzzFeed published the raw Russia dossier about him.

It can’t be pleasant for anyone to see his name associated with prostitutes and a bizarre sex act in print, not even Donald Trump, who presumably has a higher tolerance for this kind of thing than the average human being, since he has lived and thrived knee-deep in tabloid muck for decades. But in the media’s ongoing fight with Donald Trump, BuzzFeed’s incredible act of journalistic irresponsibility represented the press leading with its chin. ……… 

……. BuzzFeed played right into his hands. There are legitimate questions raised about how determined Trump has been to ignore evidence of Russia’s hacking operations prior to the election. But BuzzFeed did more to obscure and discredit these questions than Trump Tower could ever hope to. By publishing the uncorroborated dossier, BuzzFeed has associated the Russia issue with fantastical rumors and hearsay.

Its decision to post the document has to be considered another chapter in the ongoing saga of the media and Democrats losing their collective minds. If the election had gone the other way, it is hard to see BuzzFeed publishing a 35-page document containing unverified, lurid allegations about President-elect Hillary Clinton that it didn’t consider credible. This was an anti-Trump decision, pure and simple.

It created a media firestorm, but everyone should realize by now that media firestorms are Trump’s thing. They have been literally since the day he got into the presidential race. They suck the oxygen away from everything except the transfixing melodrama surrounding Donald Trump. The question is always, “How can he possibly escape this?” And at the center of attention, vindicating his own honor and that of his supporters by proxy, he always does.

cnn-fake


 


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