Category Archives: Bioethics

Comment Of The Day: “Comment Of The Day: ‘No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not Discrimination.’”

The health care/ACA/AHCA commentary from readers continues to be uniformly excellent. (It was originally spurred by the post, No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not “Discrimination.”Spartan’s Comment of the Day on the topic has itself sparked its own Comment Of The Day, this one authored by Charles Green.

By fortune’s smiles, I was able to finally meet Charlie last week face to face, as he kindly alerted me that he would be passing through my neighborhood. Finally having personal contact with an Ethics Alarms reader is always a revealing and enjoyable experience, and this time especially so. I think you would all enjoy Charlie; I certainly did. Maybe I need to hold an Ethics Alarms convention.

Here is his Comment of the Day on the post, Comment Of The Day: “No, Insurance Companies Treating People With Pre-Existing Conditions Differently From Other Customers Is Not ‘Discrimination’.”

…The claim that “a free market system” and “freedom of choice” is the solution to all that ails us is a mindless mantra that is only occasionally true, but not always.

It’s important to be clear about when free market solutions are good, and when they are not. It’s not all that hard to sort out. Basically:

Free market solutions ought to be the presumptive default. Unless there is good reason to the contrary, they ought to be the rule.

1. Exception Number 1: Natural monopolies. It makes no sense to have competition for municipal water supplies; airports; multiple-gauge railroads; fishing grounds; groundwater; or police departments. The basic reason is the putative economic benefit is either simply not there, or is absurdly overwhelmed by the social confusion engendered by multiple suppliers.
In these cases, a form of regulated monopoly is desirable. (By the way, the airline industry at a national level is precisely this kind of market; we do not have too little competition there, but too little regulation).

2. Exception Number 2a: Wallet-driven market power monopolies. It’s strategy 101 in business schools that the way to be successful is to be #1 or #2, and the best way to do that is to get more market share than your competition, so you can drive them out of business. The one guaranteed way to do that is to cut prices so low that no one else can compete. Think Walmart. Think Amazon. Think Japanese in the 60s and 70s in any industry.
The reason we have anti-monopoly laws is to reset the playing field when a competitor dominates the market too strongly.

3. Exception Number 2b: Product-driven market power monopolies. Where the product is so obscure, expensive, infinitely variable, and difficult to understand that the producers are de facto in control, because it is too confusing and too dangerous to challenge them.
Drug prescriptions are an interesting example. The ‘free market solution’ to high drug prices was (partly) to let drug companies advertise, and to loosen up the definition of what constituted a ‘new’ drug. What did we get? New diseases like RLS, new definitions of ‘new’ (moving ‘off label’ to ‘on label’) and even higher drug company profits. Because who’s still going to argue with your doc? Especially when he or she gets side benefits from giving in to the latest DTC ads on network news programs?

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Filed under Around the World, Bioethics, Business & Commercial, Comment of the Day, Ethics Alarms Award Nominee, Finance, Government & Politics, Health and Medicine, Research and Scholarship

Ethics Quiz On A Story I’m Betting Is A Hoax: The “Identical Twins” Married Couple

I have now read three accounts in borderline news sources about a Mississippi married couple who went to a fertility clinic and discovered to their horror that they were “identical twins.” I’m assuming it is a fake news story, perhaps planted through collusion with the Trump campaign by Russian government operatives, and not just because identical twins cannot be different sexes. (Hey! Maybe one of them had  gender reassignment surgery! Now that would be a story!)

I suppose it’s possible; Robert Ripley found odder coincidences for decades, but never mind: let’s assume for the sake of ethics problem-solving practice that the story is true. (I’ll be stunned if it is.)

Your Ethics Alarms Ethics Quiz of the Day is…

What is the couple’s most ethical course now that they know they are siblings, or is there one?

Key question: Is this ick rather than ethics?

Trap: I’m not asking what’s moral.

It’s all yours…

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Filed under Bioethics, Ethics Alarms Award Nominee, Family, Gender and Sex, Health and Medicine, Law & Law Enforcement, Quizzes

Remember That Old 1963 Song By The Angels, “My Boyfriend’s Dead And I Want To Have His Baby (Hey-la, Hey-la, My Boyfriend’s Dead)”?

Neither do I.

This goes in the “How in the world does someone get the idea that this is ethical?” file.

Coloradan Kate Criswell’s boyfriend Tom Alexander died over the weekend after having heart problems while the two of them were hiking. Then she had a great idea: why not have the hospital harvest his sperm, so she could be artificially inseminated and have his baby! Unfortunately, sperm viability only lasts 24-48 hours after death, the hospital didn’t have the equipment necessary to extract and preserve Alexander’s sperm, nor was there any legal documentation of his consent for such a procedure.

Criswell doesn’t understand why taking his sperm should be such a big deal. After all, she says, he’s an organ donor. Isn’t that the same thing as being a “give my sperm to any woman who asks for it” donor?

“Tom was amazing,” says his ex-girl friend. “He was always so generous and loved me so much and always made sure that I knew that. He took such good care of me.”

Yes, I would imagine that she needs a lot of taking care of, since she is an idiot. Criswell said she will take up the fight with state lawmakers, so this doesn’t happen to anyone else, “this” meaning ” a couple doesn’t get married, he dies, and the law stops her from unilaterally using his sperm to have his baby without his consent, thus gaining claim to his estate, and maybe even part of his family’s estate.” And what if he had more girl friends? What empowers her to be the only one to with a claim to his genetic material? How many of his babies can she have? Does she want the legislature to declare any dead man’s sperm to be a public resource? What constitutes being a “girl friend”? If he had wanted to have a baby with Kate, why didn’t Tom get her pregnant before he died? Since he didn’t, isn’t there a rebuttable presumption that he didn’t want to start a family with her? If you wanted a baby so much, Kate, why didn’t you two love birds get married? Or are you thinking of Tom’s baby as more of a souvenir?

Based on the fact that this woman thinks “organ donor” applies to sperm, there may also be a public policy argument against this pregnancy based on eugenics.

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Pointer: Tim Levier

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Filed under Bioethics, Childhood and children, Ethics Alarms Award Nominee, Ethics Dunces, Family, Gender and Sex, Health and Medicine, Law & Law Enforcement, Romance and Relationships

In A Photo Finish Race For Incompetent Elected Official Of The Month, Ohio State Wes Retherford (R) Edges Texas State Rep. Jessica Farrar (D)

Both are embarrassments to their parties, their states, and the voters who elected them, however.

First the winner: Ohio State Representative Wes Retherford, R-Hamilton, who was discovered over the weekend passed out drunk in his car with a loaded firearm at a McDonald’s drive-thru . Wes was arrested by Butler County sheriff’s deputies, and faces charges of operating a vehicle under the influence and improper handling of a firearm in a motor vehicle, because there is no current criminal law covering unbelievably stupid conduct by an elected official.

Retherford was easily re-elected in November in the heavily Republican district, even though voters had to know he was a drunk. He had to defeat a challenger in the GOP primary after another candidate gained the party’s endorsement because Retherford had been criticized for “partying.” “Partying” is a euphemism, in this case, for “has a serious drinking problem and is likely to end up  passed out drunk in his car at a McDonald’s drive-thru with a loaded firearm. The Ohio House Speaker even had to order a drinks cart removed from Retherford’s office because it violated House rules. People voted for him anyway. They must be so proud.

Our runner-up is a different brand of fool, but a fool nonetheless: Texas State Rep. Jessica Farrar, a Democrat, offered what she termed a “satirical bill”  that would fine men for masturbating, allow doctors to refuse to prescribe Viagra and require men to undergo a medically unnecessary rectal exam before any elective vasectomy. Farrar says that she knows her bill will never pass, but says she hopes it will start a conversation about abortion restrictions. Continue reading

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Filed under Bioethics, Childhood and children, Ethics Alarms Award Nominee, Ethics Dunces, Government & Politics, Humor and Satire, Incompetent Elected Officials, Law & Law Enforcement, Rights

Comment of the Day: “Ethics Hero Emeritus: Edna Gladney (1888-1961)”

edna-gladney

I love when a well-considered comment is entered on an older post. It draws my attention back to topics I may have forgotten about, and as in the case of this Comment of the Day, it reminds me of people and things I really shouldn’t forget.

Rebecca, in her first visit to the comments wars, entered this reaction to the post about Edna Gladney (that’s her on the right above, with Greer Garson, her screen avatar, on the left), an amazing woman who should be better known than she is for her  pioneering work on behalf of orphans and unwed mothers. I suggest that you read the post about Edna first, and then read Rebecca’s Comment of the Day. Here it is:

I just recently saw the TCM movie and was instantly taken by her courage and perseverance, especially since I, too, consider myself a child and family advocate. However, once I read about the historical Gladney, I am saddened that Hollywood thought it necessary to change the storyline to “soften” the blow of Edna’s own illegitimacy. Just goes to show how much was (and still is) wrong with the media. Also goes to show how media perpetuates certain attitudes about our societal issues. For example, even though the movie was retrospect, and even though Gladney may have been successful in removing illegitimate designations on birth certificates, society itself was still hell bent on being judgmental….couldn’t even tell the story like it was for fear it wouldn’t be accepted.

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Filed under Arts & Entertainment, Bioethics, Childhood and children, Comment of the Day, Ethics Heroes, Family, Gender and Sex, Government & Politics, History

Health And Survival Rationing Ethics

cointoss

Beginning in 2012, Dr. Lee Daugherty Biddison, a critical care physician at Johns Hopkins and some colleagues have held public forums around Maryland to solicit the public’s opinions about how life-saving medical assistance should be distributed when there are too many desperately ill patients and not enough resources. The exercise was part of the preparation  for Biddenson’s participation in preparing official recommendations for state agencies that  might end up  as national guidelines regarding when doctors should remove one patient from a ventilator to save another who might have a better chance of surviving, or whether the young should have priority over the old.

Ethically, this is pure ends justifying the means stuff. The Golden Rule is useless—How would you like to be treated? I’d want to be left on the ventilator, of course!–and Kantian ethics break down, since Immanuel forbade using human life to achieve even the best objectives…like saving a human life. Such trade-offs of life for life (or lives) is the realm of utilitarianism, and an especially brutal variety….so brutal that I doubt that it is ethics at all.

When Dr. Biddenson justifies his public forums by saying that he wants to include current societal values in his life-for-a-life calculations, she is really seeking current biases, because that’s all they are. On the Titanic, it was women and children first, not because it made societal sense to allow some of the most productive and vibrant minds alive to drown simply because they had a Y chromosome, but because that’s just the way it was. Old women and sick children got on lifeboats;  young men, like emerging mystery writer Jacque Futrelle (and brilliant young artist Leonardo DiCaprio), went down with the ship. That’s not utilitarianism. That’s sentimentalism.

The New York Times article mostly demonstrates that human beings are incapable of making ethical guidelines, because Kant was right: when you start trading one life for another, it’s inherently unethical, even if you have no choice but to do it. Does it make societal sense to take away Stephen Hawking’s ventilator to help a drug-addicted, habitual criminal survive? Well, should violating drug laws sentence a kid to death? TILT! There are no ethical answers, just biased decisions. Continue reading

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Filed under Bioethics, Gender and Sex, Government & Politics, Health and Medicine, History, Professions, Rights, U.S. Society

A Deft And Appropriate Rebuke To Climate Change Hysteria

FLASHBACK: Jonestown combats climate change

FLASHBACK: Jonestown combats climate change

On her blog, Ann Althouse delivered a devastating and ethically profound defenestration to Jennifer Ludden, a  correspondent for NPR’s “All Things Considered” who delivered a mad feature she called “Should We Be Having Kids In The Age Of Climate Change?”  Now, the very question is incompetent and irresponsible, as it treats a speculative future event—she even admits that it is speculative!–of unknown cause, arrival, duration and seriousness as the equivalent of certain nuclear war or a zombie apocalypse. The essay and her attitude represent hysteria, cowardice, scare-mongering and an insufficient appreciation for the importance of continuing the species, or at least having people smart enough to spell “climate change” contributing to the gene pool so “Planet of the Apes” doesn’t become reality. No, the pre-emptive extinction of the human race is not a rational response to the problems posed by climate change, Jennifer, and why the hell are my tax dollars being wasted to hire people who want people to think it is?

That would be my crude response to this cretinous piece. Ann Althouse, however, is far cleverer, constructive, less confrontational and effective in her response, which in its own way is more damning than mine. She launches from this quote from the NPR piece:

“I said to [my children], ‘I hope you never have children,’ which is an awful thing to say. It can bring me to tears easily,” said 67-year-old Nancy Nolan, who had children before she learned found out about climate change.”

Prof. Althouse, contrary to my inclination, doesn’t counter with, “Oh? And what did you ‘find out,’ Nancy? Here are computer printouts of climate trends and projections from five different models. Which is correct? Explain it to me, please. Show me you understand what the hell you’re talking about that is so devastating that you wish your children had never been born, you silly, silly twit!”

Instead, she writes,

If anybody really cares about carbon emissions, stop your crying and be hard-headed about what emits carbon. It’s not the person per se, but what the person does. Back in 2010, I made a list of changes you could make to your behavior. No air conditioning isn’t on the list, because that is already a given. If you haven’t done that yet, Nancy and the Weepers, you are crying crocodile tears. So get up and switch that off. Forever. And now, read my list:

It includes such “common sense’ advice as this…

“Do not go anywhere you don’t have to go. When there is no food in the house to make dinner, instead of hopping in the car to go to the grocery store or a restaurant, take it as a cue to fast. As noted above, your weight should be at the low end of normal, and opportunities to reach or stay there should be greeted with a happy spirit.”

I won’t include any more here. The professor’s clear message: why don’t you make some sacrifices yourself rather than condemn the species to extinction?

Read the whole thing on her blog. Ann earned the click.

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Filed under Around the World, Bioethics, Childhood and children, Ethics Alarms Award Nominee, Journalism & Media, Research and Scholarship, Science & Technology, U.S. Society