AP drops 'homophobia'

I have been arguing for some time that it is inappropriate to label most forms of anti-gay (speech) acts as homophobic. The reason being essentially that phobias are anxiety disorders. Most of the actions described today as homophobic are simply anti-gay, those undertaking them are fully competent and the actions they engage in are not in any way expressions of anxiety disorders. Labelling them as homophobic suggests limited personal responsibility for their actions, because of the anxiety disorder link. 

I am delighted therefore that the Associated Press, in its revised style guide, asks journalists to refrain from using the term 'homophobic' or 'homophobia' precisely because these terms mislabel anti-gay actions, and because they suggest limited responsibility on the part of those who engage in anti-gay manners. AP Deputy Standards Editor Dave Minthorn explains, 'Homophobia especially -- it's just off the mark. It's ascribing a mental disability to someone, and suggests a knowledge that we don't have. It seems inaccurate. Instead, we would use something more neutral: anti-gay, or some such, if we had reason to believe that was the case.'

Why Not Sell Your Kidney for Personal Gain?

The Canadian Society of Transplantation tells on its website a story that is a mirror image of what is happening all over the world. More than two times as many Canadians are on waiting lists for transplant organs than there are suitable donor organs. Reportedly about 200 Canadians died last year while waiting for suitable organs. Most people on the waiting list are desperate for transplant kidneys. South of our border about 80,000 Americans are on waiting lists for kidney transplants. The current situation is not only unacceptable because people die preventable deaths when they could be looking forward to a productive and happy life, it is also immensely wasteful as kidney dialysis is a hugely expensive undertaking. How can we close the gap between the number of patients in need of transplant organs and the availability of suitable organs?

Dead donors

A number of different policies aimed at increasing the number of transplant organs in an ethical manner have been discussed and implemented in various countries around the world. I am personally in favor of an idea currently debated in PEI. The proposal is on the table that we should switch from an opt-in to an opt-out system of consent. The idea here is that for everyone who does not expressly refuse to donate their organs after their demise the reasonable assumption is made that they would be happy to see their organs utilized to preserve a fellow-Canadian’s life. However, some don’t like this proposition. As far as they are concerned, this is not just a question of solidarity but one of ownership. After all, nobody is entitled to take my car after my demise either, just because I have forgotten to stipulate that it should go to my loved-ones.

Living donors

Here is where an alternative idea comes into play: perhaps we should consider incentivizing potential sources of transplant organs, ie people like you and me. I am focusing here primarily on living donor kidneys. We have reasonably persuasive data today suggesting that it is perfectly safe for most healthy people to donate kidneys. As the autonomous owners of our bodies we are entitled to make decisions with regard to how we wish to use our bodies. There are lots of things we are morally and legally entitled to do with our bodies, including engaging in risky activities like playing rugby, scuba diving in shark infested waters and many others. Strangely, when it comes to the use of our bodies for medical research or transplantation purposes, the response we get frequently from religious leaders, medical ethicists and others is that we should contribute from the goodness of our hearts, rather than from a less altruistic motive. Any sensible medical system would focus here on outcomes instead, namely a maximization of the number of available suitable transplant organs, rather then a second-guessing of vendors’ motives. Given that we already accept altruistically motivated living donor kidney donations, it does not strike me as particularly plausible that people should continue to lose their precious lives because of an unreasonable societal squeamishness when it comes to paying people for their spare kidneys for transplantation purposes. 

It is important to recognize that our current system is not working in many ways. Precious lives are unnecessarily lost year after year. Desperate patients travel overseas and obtain kidneys frequently under questionable circumstances, often exploiting vulnerable impoverished people in developing countries. The list goes on. Suffice it to say: leaving things as they are is not a cost neutral choice!

Let’s try it

What I am proposing is to run a pilot program aimed at investigating whether strictly government regulated incentives for living donor transplant kidneys would result in additional available transplant organs with a resultant decrease or elimination of the current waiting lists.  The objective of this pilot program would be two-fold: 1) develop a system that would create successful incentives for organ vendors to offer their spare kidneys while at the same time 2) ensure that sufficient safeguards are put in place to guarantee that whatever incentives are offered do not generate additional harms. Benjamin Hippen, a US based transplant specialist sums up what features a government regulated market for transplant organs should have: It prioritizes the safety of both vendors and recipients; it must be transparent with regard to risks to vendors and recipients; it must safeguard institutional integrity regarding guidelines for cooperating with kidney vendors, and last but not least it must operate under a robust legal framework.

Ottawa Atheist/Humanist/Secular Event

The Ottawa Centre for Inquiry is hosting Eschaton 2012: Celebrating Reason at the End of the World, a 'weekend gathering of scientists, philosophers, authors, academics, skeptics, rationalists, humanists, atheists, and freethinkers, where you can see presentations and join discussions on science, skepticism, gender issues, theocracy vs secularism, godless ethics, parenting beyond belief. Featured speakers include blogger PZ Myers, author Ophelia Benson, philosopher Chris DiCarlo, science education activist Eugenie Scott, and many others.'

Check out the full  programme here. The line-up of confirmed speakers (including yours truly) is here. I must say, I am looking forward to hopefully meeting in person Ophelia Benson, one of the contributors to our 50 Voices of Disbelief.

I am part of the panel on 'Godless Ethics and Godless Communities'. My offering on the day will be this:

Myths about Atheist Values

In our forthcoming book ’50 Great Myths About Atheism’ (Wiley-Blackwell 2013) Russell Blackford and I analyze a variety of commonplace myths about atheism. I will discuss four such myths that are relevant to the panel topic, namely: ‘Without God there is no morality’, ‘Atheists are moral relativists’, ‘Atheism robs life of meaning and purpose,’ and ‘Atheists deny the sanctity of human life.’ These myths are a good selection for the panel, because they look at the question of whether we need a higher authority to ground ethics, whether – in the absence of such an authority – we are bound to create secular societies bereft of any stable values, and whether that would lead to our lives becoming meaningless and vacuous. In light of recent Canadian debates about the pro’s and con’s of introducing abortion legislation it seems apt to ask finally whether atheists really callously deny the sanctity of human life. 

Hope to see you there!

Canadian Supreme Court reaches sensible decision on HIV transmission

Today the Canadian Supreme Court reached a sensible verdict on the tricky issue of the criminalisation of HIV transmission. It found - essentially - that folks who are HIV infected, on HIV medicine, and who have a low viral load (note, it is not a requirement that there is an undetectable viral load) and who use condoms, are under no obligation to disclose their HIV status to their sexual partners.

The main logic of the Court's decision is that if there is no significant risk of bodily harm (as is the case if the above mentioned conditions are met) the legal requirement to inform one's sexual partners of one's infection falls by the wayside.

Of course, many AIDS activists will be annoyed by this decision as it maintains the criminalisation of non-disclosure in cases where someone's viral load is not low, or where someone is not using a condom at the same time that his or her viral load is low, etc.

However, this decision makes a powerful, and sensible case to people at significant risk of HIV infection to get tested, and to get on HIV medication (both to protect their health and that of people they choose to have sexual intercourse with), as well as to use condoms each time they have sex with people they have not disclosed their HIV status to. In fact, this line of reasoning was developed in a paper I published in 2011. You can find it here, the argument runs from p. 310ff.

It might be worth noting that this decision by the Court was unanimous, something quite remarkable, considering the Harper government's recent appointment of four judges to the Court.

Bad news for anti-euthanasia campaigners

One can understand why anti-euthanasia campaigners get ever more desperate in their campaign strategies. After all, they can't be entirely honest with us any longer about their true motives, namely their religious convictions that just are not shared by most of us. So they have resorted to go on and on and on about the dangers of sliding down a slippery slope from voluntary to non-voluntary euthanasia, endless warnings about abuses of all kinds, stuff like that. They even publish agitprop papers in scientific outlets. An example as good as any is an article by Ottawa palliative care specialist Jose Pereira in Current Oncology that consist to a large extent of empirically false claims 'supported' by references that do not sustain his claims. As far as stooping low is concerned, anti-euthanasia campaigners do not seem to know what shame is all about, they certainly seem to have none. Remarkably the online outlet that chose to publish Mr Pereira's agitprop piece has so far refused to publish what would be a very long list of corrections to Pereira's error ridden article. The interested public, coming across Pereira's piece in medical databases, is still downloading his stuff without being notified about the long list of errors the article contains, even though the editors of the online publication are very much aware of these mistakes. I do wonder why basic principles of editorial professionalism seem to be of no concern to them. For what it's worth, in my considered view as an experienced editor of a large international bioethics journal, Pereira's piece should have been retracted a long long time ago. I encourage you to read his article as well as the second piece I link to above (by Jocelyn Downie and colleagues - they're showing how error-ridden this article really is).

One of the biggest current claims by anti-choice campaigners is that vulnerable elderly are at grave risk of being abused, should voluntary euthanasia ever come about. The thing is, of course, there is exactly zero evidence that  the decriminalisation of assisted dying has resulted in abuse of anyone, including vulnerable elderly. Today the New York Times has a remarkable line on this particular matter. It writes about a medical doctor, 67 year old Dr Wesley, a patient suffering from ALS, a disease that in effect lays waste to our muscles while leaving our mind intact, as the New York Times so aptly describes. The article notes, 'Dr. Wesley is emblematic of those who have taken advantage of the law. They are overwhelmingly white, well educated and financially comfortable. And they are making the choice not because they are in pain but because they want to have the same control over their deaths that they have had over their lives.' None of this is any news to pro-choice campaigners, but this kind of information doesn't suits the anti-choice crowd's scare campaigns, so you will undoubtedly hear more about vulnerable elderly and abuse and horror etc etc. All this in the service of subjugating secular societies' citizens to religious dictates as to how our lives must end. 

Against male circumcision on religious or cultural grounds

There is something surreal about the current debates that are taking place in some European countries about male circumcision. Well, it is not so much male circumcision as such, but the circumcision of very young Jewish and Muslim boys in Germany and the Netherlands. In Germany a court has recently declared circumcision on non-medical grounds illegal – much like female genital mutilation is illegal in the country. The court’s rationale was, essentially, that male circumcision for religious or cultural purposes is akin to assault or battery. If there is no overriding clinical benefit to the child undergoing the surgery, it is not justifiable to proceed with it.

In the Netherlands the Royal Dutch Medical Association has recently come forward arguing that male circumcision should be discouraged. The association notes in a report that a large number of complications resulting from circumcision are known, including ‘infections, bleeding, sepsis, necrosis, fibrosis of the skin, urinary tract infections, meningitis, herpes infections, meatisis, meatal stenosis, necrosis and necrotising complications, all of which have led to the complete amputation of the penis.’ Even deaths have been reported. There is also some evidence that circumcision diminishes pleasure during sexual intercourse and generally has a negative impact on the enjoyment of sex. The results of a large cross-sectional study in Denmark, published in 2011, reveal that ‘circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfilment.’ It appears to be the case that that male circumcision is not a cost neutral, risk-free activity.

On the other side of the equation is what the World Health Organisation describes as ‘compelling evidence’ that circumcision reduces the HIV infection risk of adult males to a significant extent. This has led some to suggest population level circumcision of males in sub-Saharan African countries. A public health argument might plausibly be made for such a policy in areas with high HIV prevalence. However, neither Germany nor the Netherlands are located in sub-Saharan Africa. The prevalence of HIV/AIDS is thankfully quite low in those countries, and there is no reason to suggest that this is going to change any time soon.

Male as well as female genital mutilation are predominantly religiously or culturally motivated practices. Remarkably, the two world religions that tend to be so often at loggerheads, namely Islam and Judaism, both fervently support male mutilation while supporters of female genital mutilation will only be able to find support among Islamic scholars. I am not an expert in world religions and I have little doubt that theological arguments over what Judaism’s and Islam’s holy documents prescribe are likely possible, even among well-intentioned experts. Leaving theological arguments aside, however, there is a strong cultural consensus in Jewish and Muslim communities that male circumcision is something good.

Both in Germany and in the Netherlands representatives of the Islamic and Jewish faiths respectively charged those arguing against male circumcision with unfair discrimination. Indeed, one Rabbi reportedly went on the record claiming that the German court’s decision was ‘perhaps the most serious attack on Jewish life in Europe since the Holocaust.’ As has been noted by bioethics scholars quite a few times, we should be very suspicious if the holocaust argument is deployed in support or against something. Quite likely there is no reasonable argument to be had, hence the Nazi argument is wheeled in in order to discredit whatever it is that someone has a bone to pick with.

Of course, it is always possible that the motives of some of those arguing against circumcision are driven by ulterior intentions. You would have reason, for instance, to be suspicious if a Christian intelligent design organization hired an ex-Muslim atheist to campaign against Islam. However, it is surprising that it did not occur to these religious lobbyists that child welfare and fundamentally the child’s right to her bodily integrity are of paramount importance. In liberal Western democracies they rightly trump parental religious beliefs. The only issue that should matter in these debates is the affected children’s welfare. Religion or other cultural convictions, no matter how strongly felt, should not even enter into the equation. We do not permit Jehovah’s witnesses to prevent their off-spring from receiving blood transfusions when this is medically indicated. Why not? Simply put: we apply a child’s best interest standard. Best interest, when considered in a medical context, by necessity refers to health related concerns. It’s a legal standard applied, for instance in Canada. There is no good reason to deviate from this standard to accommodate the religious traditions of Muslims or Jews. It is also worth noting that we usually give parents significant room to make parental decisions on behalf of their children, precisely because we believe that they usually know what is in their children’s best interest. That might even explain why the paternalism-in-medicine doctrine has its roots in the idea of a good parent (well, father) doing what is in his child’s best interest, even if the child disagrees. In the case under consideration, however, it is clear that the motives driving the parents derive their strength from religious or cultural convictions rather than from empirical evidence in support of the need for a surgical intervention in every male child.  

Surprisingly, in Germany major political parties from the centre right Christian Democrats to the Liberals as well as the leftish German Labour Party fell over one another promising to introduce legislation aimed at safeguarding purported parental rights to mutilate their children’s genitals for religious reasons. The Greens were expressly more concerned about ‘religious freedom’ than about child welfare. The parliamentarians expressed worries that otherwise Muslim and Jews just could not live any longer in Germany. Strangely the same concern does not seem to apply to Jehovah’s Witnesses who are forced to adapt their religious practices to German law protecting children against parental abuse. The parliament passed a resolution asking the government to create legislation aimed at permitting male circumcision as long as it occurs without ‘unnecessary pain’. The German foreign minister reportedly thought the parliament’s vote demonstrated that Germany is a cosmopolitan and tolerant society, when arguably it demonstrated that the country’s politicians are readily prepared to subjugate child welfare concerns to concerns about alleged religious freedoms. Interestingly enough, the same parliamentarians had no problems protecting women against female genital mutilation with an argument suggesting that it is ‘sittenwidrig’, ie against German customs or morals. This, of course, is question begging. How is female genital mutilation any more sittenwidrig than male genital mutilation? In a historical sense it is arguably against German customs as there is no such tradition in Germany, but history cannot as such provide normative guidance. Female genital mutilation clearly causes more harmful consequences, but these cuts might possibly also be undertaken without causing unnecessary (sic!) pain, and that seems to be the odd yardstick against which male circumcision is held. One cannot help but wonder, what other bodily parts the German parliamentarians might in the future see fit to be removed lawfully as long as the removal does not cause unnecessary (sic!) pain and as long as some religious ritual or other is attached to it.

Germany as well as other countries would be well advised to reconsider permitting religiously or otherwise culturally motivated irreversible surgical body modifications of children that serve no uncontroversial medically beneficial purpose. If a competent adult or a mature minor wanted to go ahead with circumcision, a case could easily be made to respect such wishes. However, in the case of children the child’s –medically understood - welfare should take precedence over parents’ religious convictions. That is how most societies rightly address this problem with respect to Jehovah’s Witnesses’ prohibition of blood transfusions and that is how we should handle it with regard to genital mutilations of the various kinds that are popular among particular religions. Parenthood should not be confused with unrestricted ownership, neither by parents nor by parliamentarians trying to accommodate religious convictions. It is surprising that using children as mere means to satisfy parental religious or cultural needs should be considered acceptable in the 21^st century version of Immanuel Kant’s homeland.

Truvada and HIV Pre-exposure Prophylaxis

So the US FDA has finally approved Truvada as an HIV Pre-Exposure Prophylactic (or PrEp if you fancy acronyms). I am not sure what to make of this, to be honest. The proposition here is to prescribe a chemotherapeutic to perfectly healthy people so they can protect themselves against HIV, at a cost of 13900 US$ per annum. What other protections are available? Use condoms. If you've sex with someone who's HIV positive and you want to have unsafe sex, make sure they're on HAART. If they are, the additional protection daily chemotherapy would offer to perfectly health people is close to non-existent and certainly not worth the cost paid. If you live in a society with high HIV prevalence, the odds are that it's a developing country. Your healthcare system should likely not even consider paying for such a prevention strategy, it's simply not cost effective, considering competing health needs in your society.

The drug was tested mostly on folks in high-risk groups who engage in somewhat unusual high-risk behaviour such as having plenty of unprotected sex with folks they do not know or folks they know to be HIV infected (the press release says nothing about the question of whether the latter group included folks who were known by their risk-taking participants to be on HAART), sex workers, etc. So, if you happen to belong to a group of people who engage in high-risk sexual behavior, you likely are disciplined enough to take daily chemotherapeutic drugs to compensate for your risk-taking. Really? This explains probably a 42% efficacy when compared to the placebo control. Adherence might have been a bit of an issue there...  That might also explain why the FDA requires Gilead to keep track of everyone who's (supposedly ) taking Truvada and gets infected anyway. Drug resistance seems a serious concern. Little seems to be known about pregnancy and Truvada, so that's being tested while the drug is being marketed. - Who knows, there might be a market in this high-risk segment of the population, even though it seems unreasonable to me that someone who enjoys such thrills should go on chemotherapy while healthy. Might they might not better wait until they're infected? Equally, in societies where the prevalence of HIV is very high (say, Sub-Saharan Africa), is the proposition to hook large numbers of perfectly health people on these heavy hitting drugs, 'just in case'?

As I said, I'm not sure what to make of this, but I am surprised about the logic of prescribing chemotherapy to healthy individuals as a 'just in case' strategy. Good for the shareholders of Gilead, the maker of Truvada though. You're making money off 'treating' the healthy... To be fair, it is anything but unusual that healthy people are being subjected to treatment in prevention efforts. Just think of flu vaccines, Hep B vaccination and so on and so forth. However, in the case under consideration the proposition is lifelong chemotherapy. That has quite a different ring and quality to it. We should take our time to discuss the pro's and con's of such a prevention strategy carefully, instead of diving headlong into it.

Sick and tired of Calgary Stampede Animal Abuse

I am sick and tired of the animal abuse that continues to take place during the Calgary Stampede. The third year running horses, forced to participate in Stampede events, got killed in accidents. This time the accident was taped. Suffice it to say that it is truly gruesome, not at all surprising, and that one can only hope that whatever weak animal protection laws Canada has in place are sufficient to bankrupt those responsible for running this idiotic event.  One of the horse owners was displayed on TV, crying, describing the shock at the loss of his horses and calling them akin to being family members. He said, 'They're just like humans, they're our family. It's just devastating for our whole family. It's hard to take.' Quick question to you Sir: Would you also subject your other family members to participation in events where deadly accidents are an annual occurrence? If you do, perhaps you might want to seek professional help somewhere, because clearly you are terribly irresponsible with regard to your interactions with your family members.

A word, perhaps, to spectators in Calgary: Give that deadly accidents are an annual occurrence during the Stampede, it stands to reason that you're attracted to blood sports resulting in the gruesome deaths of sentient non-human animals.  If you're into that sort of thing, why not attend sporting events where humans volunteer in risk-taking, as opposed to events where animals are being forced into risking their lives for your entertainment needs?

There is no excuse whatsoever for continuing this 'tradition' with its ever increasing death toll!

Against TAZ censorship

Folks, apologies for the German language text. Just supporting a concerted effort to subvert a censorship act at the left-wing German daily 'die tageszeitung'. 

Here's a bit of background (also, unfortunately, in German).

Der homosexuelle Mann …
… in Aserbaidschan ist dem Westeuropäer ein Fremder. Möglicherweise ist — wie es in queerer Terminologie heißt — sein Konzept sowohl von Homosexualität als auch von Homosexuellenunterdrückung ein ganz anderes. Der gerade zu Ende gegangene Eurovision Song Contest sollte Aufschluß darüber geben. Denn kaum war im vergangenen Jahr in Düsseldorf das Duo aus Baku zum Sieger gekürt, fragten die ESC-Fans schon nach: Kann man als Schwuler überhaupt nach Baku reisen oder wird man gleich festgenommen beim ersten spitzen Schrei?
Viele von denen, die jetzt da waren, haben ihre Beobachtungen mitgeteilt, das Ergebnis ist ein »sowohl« als »auch«. Festgenommen wurde wohl keiner der schwulen Gäste, aber wirklich gerne gesehen war man auch nicht. Falls man überhaupt von »gesehen« sprechen kann. Denn das scheint die oberste Maxime der heimischen Schwulen zu sein: Aufpassen, dass man nicht gesehen wird. Ein schwules Leben ist möglich — als Doppelleben, im Versteck und in der Nacht.
Einzig Jan Feddersen, in Personalunion Baku-Blogger für taz und NDR, hat es anders wahrgenommen. Die Unterdrückung der Homosexuellen? »Westliche Gerüchte«, schreibt Feddersen, »Gräuelpropaganda von Menschenrechtisten«, stattdessen sei Baku ein einziger »schwuler Catwalk« mit Männern in »hautengen T-Shirts« und »Jeans mit eingebauten Gemächtebeulen«. Und die halten Händchen in aller Öffentlichkeit und sind »Buddies« ein Leben lang.
Feddersens höhnischer Ton immer dann, wenn es um Pressefreiheit und Menschenrechte in Aserbaidschan ging, erstaunte die übrigen Pressevertreter, seine verklärten Worte über das schwule Leben dort erzürnte die Beobachter schwuler Medien. »Das Mindeste, das du jetzt tun könntest, aus Solidarität zu denjenigen, die ein anderes Verhältnis zu den Realitäten haben«, schreibt queer.de-Redakteur Christian Scheuß in einem offenen Brief an Jan Feddersen, »halt in Sachen Menschenrechte doch einfach die Klappe.« Frank & Ulli schlagen auf ihrer Web-Seite »2mecs« vor, Feddersens Wortschöpfung »Menschenrechtist« zum Unwort des Jahres zu küren. Für die beiden Autoren macht es keinen Sinn einen neuen Begriff einzuführen, es gebe doch die »Menschenrechts-Aktivisten«: »Es sei denn«, unterstellen sie Feddersen, »man wolle ihrer Arbeit eine negative Konnotation anhängen, sie diffamieren, sie verächtlich machen.«
Auch Patsy l’Amour laLove lässt in ihrem Patsy-Blog kein gutes Haar an Feddersen und stellt — mit Blick auf seine idyllischen Mutmaßungen über muslimisch konnotierte Männerfreundschaften — fest: »Wenn Männersex in Badehäusern en vogue ist, dann träume ich nicht davon, wie befreit diese Gesellschaft sein muß, sondern denke darüber nach, warum schwuler Sex nur in der Begrenztheit dieser Räume stattfinden darf.« Die Polittunte setzt ihre Forderung gegen jeglichen falschen Zungenschlag: »Solidarität mit unseren Schwestern anstatt selbstgefälliger Romantisierung!« Denn »die Schwulenunterdrückung in Aserbaidschan ist kein Gerücht sondern Alltagsrealität!«
Elmar Kraushaar

Sabbatical Projects

I meant to write this awhile ago, but haven't had a chance to do so. These days I am pretty busy working on various book projects that involve fairly heavy writing as well as editing. I'm hoping, when my sabbatical is over in a year's time, I might have three books to show for the time spent away from university. So, here's the plan. I'm writing with Russell Blackford 50 Great Myths About Atheism. I guess it's fair to say that we are only a few weeks away from completing the manuscript. Then I'm producing with Helga Kuhse and Peter Singer the 3rd edition of the bioethics text book Bioethics: An Anthology. We hope to be done with this project by the end of this year. Last but not least, come August I will start writing in all earnest for a joint project with Christopher Lowry, a book called Global Health Ethics. All of these will be out with Wiley-Blackwell.

Well, other than these projects, I do continue editing both the journals Bioethics as well as Developing World Bioethics, with Ruth Chadwick and Debora Diniz, respectively. There's also a few other articles promised to editors of anthologies and bioethics journals that I am trying to complete. Yep, that's about it. It's gonna be a very busy time. It's interesting that fellow academics' first question, when they hear that you're going on a sabbatical, is 'where are you going?', when really they might as well ask, 'what will you be doing?'. Anyhow, I'm trying to travel as little as is feasible in order to get on with the task of completing these projects.

Follow-Up on 'Ex-Gay' Story

Some weeks ago I wrote here about Dr Spitzer, a noted US psychiatrist who penned many years ago a study ostensibly showing that it is possible to change the sexual orientation of homosexual people who wish to do so. His work has since been used by mostly religious fundamentalists for blaming gay people to be what and who they are, and for suggesting myriad bogus conversion schemes (all condemned by professional psychiatric and psychological associations the world all over etc.).

Dr Spitzer noted in an interview that he thinks he misinterpreted what 'ex-gay' homosexuals he interviewed for the purpose of the study told him. There was a big outcry over this. Spitzer claimed that he tried to retract his study but the Archives of Sexual Behavior where he published his work allegedly refused to do so. The Editor of said journal says that that ain't exactly how it happened, but be that as it may, in today's New York Times Spitzer declares in an interview that he has written a Letter to the Editor of the Archives of Sexual Behavior denouncing his own work and that this letter would be published in said journal. A draft of the letter has been leaked some time ago. It ends with an apology to the gay community for the harm done to the gay community by his study's baseless support of 'reparative therapy' for homosexuality.

It takes courage to admit that one is mistaken.

The German political system's bizarre state of affairs on offended Muslims

A remarkable article in the German news magazine DER SPIEGEL reports an incident in the German state of North Rhine Westfalia. A bunch of radical rightwingers and a bunch of fundamentalist Muslims ran into each other during a demonstration. The rightwingers clearly intended to provoke the Muslims by showing a Danish cartoon depicting the religious figurehead of Islam in a not particularly favorable pose. As you might recall, when a conservative Danish broadsheet published said cartoon there was a big outcry amongst Muslims (they don't like any depictions of their prophet, neither positive nor negative ones). A lot of people were duly killed by enraged Muslims (including, not unexpectedly, many Muslims). So, when in Germany the rightwing activist group Pro-NRW announced its demonstration and its intention to display the Danish cartoon it knew that its favoured enemy, enraged Muslims, would show up and make complete and militant fools of themselves. and so they did. - Between the two of us, without the help of radical Muslims and anti-Islamophobia leftist counter demonstrators, nobody would have taken notice of the 30 or so pro-NRW demonstrators. But hey, like bulls don't take lightly to red sheets of cloth neither do Muslims or leftists in Germany take kindly to a tiny rightwing group trying to look like they actually have the people on the ground to organise a serious demonstration. Fun was had by all involved: The end result, a whole bunch of seriously injured people, including police officers trying to keep the peace between the two sides.

None of this is terribly newsworthy, of course. Rightwingers (especially rightwing Christians) and fundamentalist Muslims love having goes at each other in Western societies, because the rightwing Christians mistakenly believe they own these places and need to defend them against Muslims wanting to establish Sharia law. It's of course a good idea to defend the secular state against any kind of religiously motivated legislation (lest you want to live in failing states like Iran or pseudo-outfits like the Vatican).

Here's the odd bit. The interior minister of the state where said demonstration took place wants to place restrictions on future demonstrations by the extreme rightwing group. A prohibition on showing the offending Danish cartoon during public demonstrations is in the making. Here is the tortured logic: The Islamic fundamentalists count about 1500 members according to the German security services. There is about 4 million Muslims in Germany that want to have little, if anything, to do with their violence. In order to protect German police officers from their violence it is necessary to prevent the extreme rightwingers from showing the cartoon during their demonstrations.

I have no sympathies for the rightwingers here, but it seems to me as if the German state is caving in to Muslim fundamentalists.  German citizens would - in future - be prohibited from doing things that could offend members of a Muslim fundamentalist sect in the country, lest the Muslims would otherwise go on a rampage injuring police officers and other demonstrators. Freedom of speech is subjugated to concerns about security of the security forces (whose job, among many other obligations, ironically, is to uphold German citizens rights to express even harsh criticism of religious ideologies). I can't wait to hear how the German courts will respond to this interior ministerial edict.

Interesting parallel:  in Jamaica, a Caribbean island state known for its large number of militantly anti-gay Christian citizens, we see the police routinely prohibiting demonstration by gay civil rights groups. Their logic also is that there are so many enraged Christians out there that they couldn't guarantee the safety of the demonstrators (at least - unlike in Germany - they're not concerned about the security of the security forces). Another example of a democratic society caving in to religiously motivated militancy.

The trouble with religious freedom is that it is all too frequently misunderstood as the unrestricted freedom of the religious to run roughshot over everyone else.

What is it about Christians and sex? Really...

Apologies to everyone for being a bit behind with blog postings these days. Russell Blackford and I are busily working away on our next book. It's going to be a follow-up to our popular 50 Voices of Disbelief - Why We Are Atheists. You can buy it now (other than in English) also in Polish, Korean and Spanish editions, if you feel so inclined. I understand that North Koreans won't be able to get their hands on the book because there is no picture of Kim Il Sung on the cover. My bad, should have thought of that :-). Anyhow, so we're close to completing the manuscript of a book tentatively called  50 Great Myths About Atheism. 

It is no secret that I am an atheist, and a gay one to boot, so there's no news in me having little time or patience for Christianity, Islam and whatever other religious this-n-that that has been invented by humans many centuries ago. I would not mind if god people went about their own business, praised their god in their houses of worship or at home and left it at that, but they don't seem to be able to stay out of OTHER people's lives. They just can't. It's not how they roll!

What truly drives me against the wall at the moment is aggressive campaigning by the Roman Catholic Church against marriage equality in the US and also the UK. In the UK, the Roman Catholic Church is now taking its campaign into its schools (taxpayer funded, that goes without saying, the Catholic Church wants maximum ideological influence in state affairs, but it hates paying for the privilege). Faith schools, of course, are a contradiction in terms. It's a bit like suggesting that there could be communist, capitalist, scientologist or any other ideological schools, as if there was more than one empirical reality to be taught. Now, IF that organisation was a beacon of morality and its senior management staff were known to abide by the Church's teachings all the time, I would still disagree with them, but there would be at least some begrudging respect from me for their consistency. The thing is, not a day goes by without further revelations of Cardinals (ie very senior Church management folks running around in usually wonderfully camp dresses - well, if you're into that sort of thing) protecting pedophiles amongst their staff (priests and upward) from state prosecution. They didn't even bother warning parents who mistakenly left their children in Church hands about the impending danger.  Really, I kid you not, they did not!

These same people think nothing of it to tell secular societies today how they should legislate in matters marriage. Old guys who never managed to hold a stable relationship with another human being in their lives - really? Old guys who count large numbers of pedophiles among their ranks lecture us - really? Do you, Roman Catholic Church, really have no shame at all?  On what grounds - really - do you claim competence in matters ethics or actual worldly life?

If you think, by the way, this was just a Catholic phenomenon... here's a Baptist preacher advising his congregation to beat up their kids, crack their wrists even, if they are suspicious the kids might be gay.

If you feel like reading up on Christianity's crimes throughout its history, you might want to take a closer look at learning German and reading Karlheinz Deschner's 10 (!) volume Criminal History of Christianity. It'll be well worth your time, and you likely will be even more reluctant to listen to Catholic clergy going on about morality.

Archives of Sexual Behavior Reportedly Refuses to Retract Ex-gay Study

A very significant story was published today in The American Prospect, unfortunately buried in the middle of an introspective story by the writer of the piece. 


It's about Robert Spitzer's 'ex-gay' study. Dr Robert Spitzer is - today - an 80 year old retired psychiatrist whose area of specialisation was sex research. He was, for most of his academic life, affiliated with Columbia University in New York. Spitzer's work has been very influential, he is credited - among others - with having significant influence in the USA on the declassification of homosexuality as a mental illness.  


Spitzer also published a study in the Archives of Sexual Behavior that well and truly made him notorious both among gay activist as well as among the homophobes of the world. The study in question interviewed a sample of gay folks who had undergone 'reparative' therapy aimed at changing their sexual orientation. Spitzer concluded, based on those interviews, that some highly motivated gay people could change their sexual orientation. 


The study has been vigorously criticized over the years, not least because its claims are based on self-reporting of 'ex-gay' folks who usually came from cultural (not to say fanatically religious) contexts where homosexuality was highly frowned upon (that's probably putting it too mildly still). Now, for a gay evangelical Christian to claim after 'reparative therapy; they he or she ain't gay any longer is understandable, given that the homophobic ideology they're hoping to fit into doesn't allow them to be who they are to begin with. It's another story to buy such self-reporting. 


Here's the relevant bit from the American Prospect article. Spitzer is quoted as saying: In retrospect, I have to admit I think the critiques are largely correct,” he said. “The findings can be considered evidence for what those who have undergone ex-gay therapy say about it, but nothing more.” He said he spoke with the editor of the Archives of Sexual Behavior about writing a retraction, but the editor declined.' 


The study in question has been used for many years by anti-gay activists as evidence that homosexual people can change their sexual orientation - and that they're blameworthy if they don't try to do so, given that homosexuality is an 'abomination' or an 'objective disorder' (as one of the churches operating on my university campus will have it). 


I think it's remarkable that the journal that published Spitzer's original findings refuses him the right to publish a retraction notice. We know now from countless examples that self-reported 'ex-gays' turned out to be - surprise, surprise - current gays. 


Addendum: 5:40pm EST - Usually well-informed sources tell me that the Archives of Sexual Behavior does not recall Spitzer's reported request - but it's all off-the-record. This leads to the following questions: 1) Did Spitzer tell the truth in the interview? 2) Did Spitzer actually say what he is reported saying? 3) Is the off-the-record information from the Archives a true reflection of what happened? I certainly don't know.
Addendum: 07:08am EST -The Archives have finally gone on record on this matter.Check out their entirely sensible views on the matter here. Over to Dr Spitzer. 

Humanist Bioethics - Is there such a thing?

I have been (and am) supportive of humanist endeavours pretty much since I decided for myself that atheism is the way to go. So, what about humanist bioethics? Well, it seems to me that any reason-based form of bioethical inquiry, ie one that is not based on religious magic wands of some kind or another actually qualifies as humanist bioethics. That means, of course, that humanist bioethics is more of an umbrella term covering all non-religious approaches to bioethics analysis. Some would argue that humanism is itself a form of speciesism, and that, in my view, is correct. So perhaps humanist bioethics needs a bit of fine tuning and reflection there. Humanist bioethics could be a(n) utilitarian, deontological, virtue ethical or any other secular ethical system of analysis. Indeed, it is perfectly possible for you to engage in humanist bioethics research and publishing, even if you are a committed Christian or Muslim, as long as your Christian convictions (ie the authority of the Bible) or your Islamic convictions (ie the authority of your Koran) don't muddy your critical analysis.

What does this mean for the bread-and-butter controversies in bioethics: Abortion? Euthanasia? Destructive embryonic stem cell research? Well, it's pretty clear from the above that certain types of arguments do not count: Reference to the infinite value of the human being based on claims about 'ensoulment' won't succeed as there ain't any empirical evidence that the human soul exists to begin with. Waving the Christian or Islamic magic wands (aka Bible or Koran) won't bring this soul into existence. Still, the important bit is perhaps, that humanist bioethics, so understood, leaves room for very significant disagreement on many subject matters that bioethicists are concerned about. However, humanist bioethics limits the types of arguments that can legitimately be deployed to those arguments that are not relying on higher God type entities and their authority.

Having attended and lectured during quite a few meetings of atheist and humanist groups, I have often encountered a clear misconception  of what humanist ethics or humanist bioethics could possibly be. All too often there was the assumption that humanist ethics or bioethics would somehow free us from the most reactionary provisions of Christian or Islamic ideologies while offering motherhood and apple pie type solutions to ethical conflict or controversy.  I suspect (!) that empirically that might well be true with regard to standard reactionary mainstream religions' provisions (prohibitions on homosexuality, voluntary euthanasia, etc). Peter Singer pointed out quite rightly in an early chapter of his book Practical Ethics that ethics does not give sexuality specific guidance. Sex as such does not give rise to special ethical issues. Ethics might admonish us not to hurt others while we engage in sexual intercourse, but the prohibition on harming others is not sex related, rather it is an ethical obligation not to harm others that also applies to sex. Secular approaches to ethics or bioethics would very likely free us from conservative religious infringements on personal freedom spaces. Humanists are more likely to ponder about the lives we live here and now as opposed to focusing on an afterlife that we don't think is awaiting us anyhow.

I am less sure about the motherhood and apple pie bits that I have frequently come across during the mentioned atheist meetings, eg human solidarity, tax the rich give to the poor, free tertiary education, public health care, sustainable development, *add any buzzword that engenders a warm feeling in you HERE*. I don't think anyone has as yet systematically investigated whether all varieties of humanist ethics or bioethics would necessarily lead us down that road. I sincerely doubt it.

Journal of medical ethics courts controversy

Good bioethics will invariably challenge boundaries. As my friend and colleague Julian Savulescu, Editor of the Journal of medical ethics has found out to his chagrin, publishing controversial ethical analyses will lead to very serious personal abuse.[1] His journal published on-line early a paper the authors of which take a stance on infanticide that is not terribly new or original in bioethics, as Savulescu rightly notes. The authors apply these arguments to maternal and family interests. Of course, an argument on infanticide, particularly one that does not reject infanticide out of hand, will likely upset some or even most readers. The same is true, to a smaller extent, for other issues. Bioethics runs occasionally invited guest editorials. A few issues back we published a guest editorial with a plea to ‘queer bioethics’.[2] Conservative commentators had a field day on the internet with what was arguably a tame editorial suggesting we should take into consideration patients belonging to sexual minority groups. As we have discovered in academic analyses of former US President Bush’s bioethics chief’s indefensible claim that if we find something repugnant it’s probably morally wrong, feelings of disgust and even horror are bad indicators of the moral soundness or otherwise of normative views, behaviors etc. Otherwise interracial marriages would likely have never come about, given how disgusted people were about this possibility just a few decades ago.

Good bioethical analyses will continue to challenge and test boundaries we take for granted. In that context it is legitimate to publish papers discussing infanticide as much as it is legitimate to publish papers discussing the participation of doctors in torture under certain circumstances. As Editors of bioethics journals we are interested in sound critical analysis, wherever those analyses take the substantive conclusions of papers in question. At Bioethics we have published religiously motivated analyses as much as we have published papers driven by secular modi of analysis. We will continue to do so. Savulescu certainly was right to publish the controversial paper in his journal, especially given that his peer reviewers indicated that the manuscript in question was worthy of publication in the Journal of medical ethics. No doubt there will be critical responses to the article, and that, too, is to be applauded. Arguments in our field cannot be tested by other means. It will be important for editors of bioethics journals not to yield to ideologically motivated outside pressures. We must not permit self-censorship to occur in anticipation of outcries by readers who find themselves in disagreement with content we publish. Instead, we encourage our readers to submit sound critical responses to analyses we publish. Express your rational disagreement in letters to the editor, critical notes, even article-length ripostes. I cannot think of a bioethics journal that would not welcome your response. Do not expect us, however, to respond to excited hand-waving in non peer reviewed outlets or on partisan internet sites. Time is too precious for this.

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[1] J Savulescu. 2012. “Liberals are disgusting.’ – In defence of the publication of ‘After-birth abortion’. http://blogs.bmj.com/medical-ethics/2012/02/28/liberals-are-disgusting-in-defence-of-the-publication-of-after-birth-abortion/ [Accessed February 29, 2012]

[2] L Wahlert, A Fiester. 2012. Queer bioethics: why its time has come. Bioethics 26(1): ii-iv.

Ethical considerations in the use of anti-retrovirals for HIV prevention

Call for Papers

Evidence-based approaches to reducing sexual transmission of HIV has remained a major challenge in responding to the HIV pandemic.  The past 18 months has witnessed a substantial shift in this landscape.  Controlled trials have demonstrated that the treatment of individuals with HIV infection reduces the risk of viral transmission to uninfected sexual partners (treatment as prevention).  Additional evidence suggests the possibility of providing anti-retroviral medications to uninfected individuals may reduce the risk of acquiring HIV infection from sexual partners (PrEP— Pre-Exposure Prophylaxis).

In view of scarce resources, there will inevitably be a need to prioritize who will get anti-retroviral drugs; those who are sick, those who can transmit HIV, those at risk for acquiring HIV. Research that focuses on the balance between efficiency and equity will be involved.  Ethical frameworks for guiding decision-making at the clinical level as well as the macro social policy level will be essential.

Among the questions that will need to be discussed are:  

i.                    What rights claims can uninfected persons make for access to ARVs for prophylactic purposes when millions across the globe are dying from AIDS because they cannot access ARV treatment? 

ii.                   What moral claims can justify the provision of ARV therapy to those who do not yet clinically require treatment as a way of reducing the risks of HIV transmission?

iii.                  What normative issues are raised in making the determination that there is sufficient evidence to demonstrate the effectiveness of either PrEP or Treatment for Prevention? 

iv.                 How should the social and biological vulnerability of women to HIV infection inform discussion about the allocations of resources for either PrEP or treatment as prevention? 

v.                  If there is a risk that PrEP will increase the risk of drug resistance and compromise treatment options for those already infected, what ethical questions must be confronted? 

vi.                 What conceptions of procedural fairness and inclusiveness should shape decision making processes about these allocation decisions?

vii.                How should current research findings inform the ethics of trial design?

viii.               Given current evidence what moral issues involving the protection of research subjects should be considered in determining the extent of ancillary services and care that should be provided in prevention trials? 

This issue of Developing World Bioethics will be guest edited by Ronald Bayer (email: rb8@mail.cumc.columbia.edu) and Quarraisha Abdool Karim (email: abdoolq2@ukzn.ac.za), Mailman School of Public Health, Columbia University, New York, NY  10032  USA.

Deadline for submissions: 31 July 2012

Odd CMAJ Editorial

There is a big of an outcry in Canada over an Editorial by the current Interim Editor-in-Chief of the Canadian Medical Association Journal, Dr Rajendra Kale. Kale argues that pregnant women in Canada should not be provided with information about the sex of the fetus to avoid female feticide among Indo-Canadians. Kale proposes that women should only be told 30 weeks after conception to make it more difficult for them to have an abortion based on an arbitrary marker such as the sex of the fetus. Indeed, The Toronto Star newspaper reports that there is some empirical evidence suggesting a not insignificant gender balance in parts of the country: 'Though Canada does not collect statistics based on ethnicity at birth, population statistics show the country, now home to more than a million Indo-Canadians, has a skewed gender ratio. According to the 2006 census figures, nationally there are 932 girls to 1,000 boys under age 15 in the South Asian community, compared to 953 girls to 1,000 boys in the general population. The numbers in the South Asian community in the Toronto area are further skewed with 917 girls to 1,000 boys in the Toronto Central Metropolitan Area. Broken down further, it shows 904 girls to 1,000 boys in Mississauga, and 864 girls to 1,000 boys in Brampton.'

The gender imbalance itself is not really a great deal of concern in the country as a whole, the differential between the South Asian community and the general populations is a mere 20. Not exactly a dramatic figure. That doesn't mean that this differential is not higher in certain parts of eg Toronto, but in the big swing of things this isn't a dramatic situation. Baldev Mutta, a staff member in a Punjabi Community Health Centre notes in the Star that there is a preference among recent immigrants in favour of male off-spring. Women are reportedly threatened with divorce if they don't agree to to abort female fetuses.

It goes without saying that putting women under such pressures is unacceptable. It also seems, for most circumstances, bizarre to me that - recent migrant or not - anyone would have strong preferences for the sex of his or her off-spring. However, there can be at least some ethically unproblematic reasons, too. For instance, a family might have a preference for a 50:50 ratio among their off-spring and so decide to abort a male or female fetus in favour of a future child of the desired sex. Having knowledge of their off-springs sex sooner rather than later arguably is better overall, because the aborted fetus would be less advanced in its development. There could also be good health reasons for wanting to know, for instance in the case of sex linked genetic diseases.

My point is that it is unacceptable to view certain reasons for wanting an abortion acceptable and other reasons sufficiently dodgy that one chooses ('doctor knows best', it goes without saying!) which women will be told of the sex of their off-spring and which women must not be told. It is clear from the statistics quoted by Kale in his Editorial that the overwhelming majority of Indo-Canadians do not actually choose abortions based on the sex of their off-spring. Preventing them -and anyone else -for that matter from knowing the sex of their off-spring is plain offensive. No wonder that a woman from such a cultural background is quoted along these lines in the Toronto Star, “It’s upsetting, to be honest with you,” says Hussain, who worries Kale’s editorial will further push this kind of discrimination. “It’s a stereotype that brown people will abort a child who is not a boy.”

I might be mistaken, but I suspect that Kale's real agenda is anti-choice to begin with. He confuses fetuses and 'girls' as well as fetuses and 'women' in his Editorial as this quote shows quite nicely, 'Postponing the transmission of such information is a small price to pay to save thousands of girls in Canada. Compared with the situation in India and China, the problem of female feticide in Canada is small, circumscribed and manageable. If Canada cannot control this repugnant practice, what hope do India and China have of saving millions of women?'

Of course, the lives of neither women nor girls are at stake here. The issue is whether or not pregnant women have a right to know the sex of their off-spring. In Canada they do. It's a good thing. Cultural biases need to be confronted where they occur, there mustn't be technical pseudo-solutions to them that infringe on hard-won individual liberties that women can rightly take for granted today in Canada. If the argument really is about the morality of abortion, Kale should have argued that case and should not have chosen to engage in skirmishing activities to do with Indo-Canadians.

Beware of Kuchenmeister

Happy New Year everyone!

I love Marzipan Xmas Stollen. NO excuses there, they're unhealthy, take you quickly closer to full-blown diabetes, but they're delightful.  Imagine how happy I was when I discovered Xmas Stollen from a German manufacturer (baker would be stretching it, considering the quantities they produce) in a local supermarket. Kuchenmeister, according to its own marketing is 'one of the largest cake exporters in the world'.

Well, I know now how they managed to become that largest cake exporter... fraudulent marketing. Simple as that. I would have expected the 'marzipan' Stollen I bought to have the marzipan centre you can see in the image below (carton). Compare that against the dreary reality of Kuchenmeister's actual product.

Let the buyer beware!

Margaret Somerville engages in anti-choice agitprop - again...

Margaret Somerville, a tireless campaigner for Catholic values the world all over, and a member of the law faculty at Canada's McGill university, has penned a truly embarrassing attack on the Royal Society of Canada's Expert Panel on End-of-Life Decision-Making Report in the Montreal Gazette. Without hesitation she repeats arguments that I have demonstrated in the blog entry below to be false and clearly deliberately misleading. My good colleague Daniel Weinstock, a Montreal based member of the expert panel, penned this in reply to Somerville's agitprop. Well worth reading and well worth disseminating. Ms Somerville, for far too long has got away with this kind of mischief making.