Tag: consent

Bioethics Blogs

How Different are Female, Male and Intersex Genital Cutting?

By Brian D. Earp  (@briandavidearp), with Rebecca Steinfeld, Goldsmiths, University of London 

Three members of the Dawoodi Bohra sect of Islam were recently indicted on charges of “female genital mutilation” (FGM) in the US state of Michigan. In Norway, meanwhile, one of the major political parties has backed a measure to ban childhood male circumcision.

Fearing that objections to female forms of genital cutting will be applied to male forms, some commentators have rushed to draw a “clear distinction” between them. Others, however, have highlighted the similarities.

In fact, childhood genital cutting is usually divided not just into two, but three separate categories: “FGM” for females; “circumcision” for males; and “genital normalisation” surgery for intersex children – those born with ambiguous genitals or mixed sex characteristics.

In Western countries, popular attitudes towards these procedures differ sharply depending on the child’s sex. In females, any medically unnecessary genital cutting, no matter how minor or sterilised, is seen as an intolerable violation of her bodily integrity and human rights. Most Westerners believe that such cutting must be legally prohibited.

In intersex children, while it is still common for doctors to surgically modify their genitals without a strict medical justification, there is growing opposition to non-essential “cosmetic” surgeries, designed to mould ambiguous genitalia into a “binary” male or female appearance.

Belgian model Hanne Gaby Odiele, for example, has spoken openly about the negative impact of the “irreversible, unconsented and unnecessary” intersex surgeries she was subjected to growing up.

In male children, by contrast, the dominant view is that boys are not significantly harmed by being circumcised, despite the loss of sensitive tissue.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Right to Die The Law of End-of-Life Decisionmaking – 2nd 2017 Supplement

For decades, Wolters Kluwer has been publishing an annual supplement for The Right to Die: The Law of End-of-Life Decisionmaking.  This year, we are moving to a semi-annual plan.  So, there will soon be a second 2017 update, the “2017-2 Supplement.”


Highlights of this extra supplement cover the most recent legal developments—judicial cases, legislation, and news accounts of important legal proceedings that are not officially reported—concerning end-of-life decisionmaking. Some (and there are many more) specific important matters covered in the supplement include:

  • The passage of statutes authorizing medical aid-in-dying in two more states, bringing the total number of jurisdictions in which the practice is legal to seven.
  • The passage of statutes explicitly criminalizing or otherwise prohibiting aid-in-dying in two more states.
  • The passage of statutes authorizing default surrogate priority lists in two more states.
  • An innovative Montana statute authorizing physician decisionmaking for incapacitated unrepresented patients with no surrogate, agent, or guardian.
  • The passage of a statute authorizing a POLST program, bringing the total number of jurisdictions formally authorizing or regulating POLST to thirty-three. 
  • A Kansas statute forbidding the institution of a DNR order for a minor without consent from the parent or guardian. 
  • The passage of statutes in four states both forming palliative care and quality of life task forces and directing health departments to promote both professional and consumer palliative care education.
  • A strong statement of support for autonomy through advance directives from the California Court of Appeals as it awarded attorneys’ fees to a governmental agency that challenged the end-of-life decisionmaking of a husband, with his wife as agent, supported by the health providers involved in his care. 

Source: bioethics.net, a blog maintained by the editorial staff of The American Journal of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Right to Die The Law of End-of-Life Decisionmaking – 2nd 2017 Supplement

For decades, Wolters Kluwer has been publishing an annual supplement for The Right to Die: The Law of End-of-Life Decisionmaking.  This year, we are moving to a semi-annual plan.  So, there will soon be a second 2017 update, the “2017-2 Supplement.”


Highlights of this extra supplement cover the most recent legal developments—judicial cases, legislation, and news accounts of important legal proceedings that are not officially reported—concerning end-of-life decisionmaking. Some (and there are many more) specific important matters covered in the supplement include:

  • The passage of statutes authorizing medical aid-in-dying in two more states, bringing the total number of jurisdictions in which the practice is legal to seven.
  • The passage of statutes explicitly criminalizing or otherwise prohibiting aid-in-dying in two more states.
  • The passage of statutes authorizing default surrogate priority lists in two more states.
  • An innovative Montana statute authorizing physician decisionmaking for incapacitated unrepresented patients with no surrogate, agent, or guardian.
  • The passage of a statute authorizing a POLST program, bringing the total number of jurisdictions formally authorizing or regulating POLST to thirty-three. 
  • A Kansas statute forbidding the institution of a DNR order for a minor without consent from the parent or guardian. 
  • The passage of statutes in four states both forming palliative care and quality of life task forces and directing health departments to promote both professional and consumer palliative care education.
  • A strong statement of support for autonomy through advance directives from the California Court of Appeals as it awarded attorneys’ fees to a governmental agency that challenged the end-of-life decisionmaking of a husband, with his wife as agent, supported by the health providers involved in his care. 

Source: bioethics.net, a blog maintained by the editorial staff of The American Journal of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Oxford Uehiro Prize in Practical Ethics: Prostitution: You Can’t Have Your Cake and Sell It*. Written by Simon-Pierre Chevarie-Cossette

This essay received an Honorable Mention in the Graduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Simon-Pierre Chevarie-Cossette

Abstract:        I offer a new** argument for the thesis that prostitution is not just a normal job. It has the advantage of being compatible with the claim that humans should have full authority over their sexual life. In fact, it is ultimately the emphasis on this authority that leads the thesis that prostitution is a normal job to collapse. Here is the argument: merchants cannot (both legally and morally) discriminate whom they transact with on the basis of factors like the ethnicity or the religion of their client; but if prostitutes are ‘sex merchants’, then they cannot (both legally and morally) discriminate whom they have sex with on the basis of these factors. Yet everyone should have the full discretionary power to refuse to have sex under any circumstances.

1. Introduction

You have made it thus far: the wedding preparation is almost over. You enter your local bakery, cheekily anticipating the moment when you’ll order a wedding cake for ‘John & John’. But to your dismay, the baker turns you down because your marriage goes against his ‘Christian beliefs’.

This is a true story and it is a recurrent one. In 2013, Administrative Law Judge Robert N. Spencer found the owner of Masterpiece Cakeshop guilty of discrimination on the basis of sexual orientation.[1] The decision was then maintained by the Colorado Civil Rights Commission[2] and again by the Court of Appeal[3].

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Male or Female – A cultural construct? Our medical and ethical assessment. VIDEO.

Expert professionals, in transsexuality and sexual identity, present this video for help to understand this difficult matter, but before proceeding any further, it is necessary to introduce the precise terminology, to define the meaning of sex, gender and transsexualtiy.

  • SEX is defined as the genetic, biological, anatomical and psychological characteristics of a person, while,
  • GENDER refers to the psychological identification that a person attributes to themselves — man or woman — and to their social assignment.
  • TRANSEXXUALITY. Based on the most recent psychiatric medical criteria, transsexuality should be defined as a disorder of sexual identity causing gender dysphoria, understanding as such the possible psychological imbalance that may arise when there is antagonism between a person’s desired and perceived body image. This psychological imbalance can be permanent or may be resolved at any time of life, especially after adolescence (see HERE).

Teaching gender ideology

These clear medical criteria do not prevent schools teach gender theory without parental consent all over the world.

On the transsexuality dilemma , what is being done?

In our opinion, the only thing that has been achieved so far is to try to adapt the body to the mind, instead of trying to alleviate the cerebral problem.

See our studies HERE

La entrada Male or Female – A cultural construct? Our medical and ethical assessment. VIDEO. aparece primero en Bioethics Observatory.

Source: Bioethics Observatory.

This article was originally published by the Bioethics Observatory of the Catholic University of Valencia. Up-to-date news and reports from the Bioethics Observatory at the Catholic University of Valencia (Spain), covering a wide range of bioethical issues including stem cell research, abortion, assisted suicide and much more.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Unbefriended and Unrepresented: Better Medical Decision Making for Incapacitated Patients Without Healthcare Surrogates

How should we make medical decisions for incapacitated patients who have no available legally-authorized surrogate decision maker? Because these patients lack decision making capacity, they cannot authorize treatment themselves. Because they lack a surrogate, nobody else can authorize treatment either. Clinicians and researchers have referred to these individuals as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients. Clinicians and researchers have also described them as “unimaginably helpless,” “highly vulnerable,” and as the “most vulnerable,” because “no one cares deeply if they live or die.”

The persistent challenges involved in obtaining consent for medical treatment on behalf of these individuals is an immense problem in ethics and patients’ rights. Some commentators describe caring for the unbefriended as “one of the most difficult problems in medical decision making.” Others call it the “single greatest category of problems” encountered in bioethics consultations.

Appropriately, this problem is getting more attention. Major policy reports from both legal and medical associations have focused on decision making for the unbefriended. Perhaps most notably, the elite mainstream media has repeatedly covered the problem of the unbefriended in the United States. Decision-making for the unbefriended has also been the primary topic of recent day-long or multi-day conferences, both themed, subject-specific conferences, and individual sessions at several national and regional professional association meetings.

Finally, the problem of the unbefriended has received increasing attention not only in the meeting halls of conferences, but also in the pages of academic literature. New articles have been printed in law journals, medical journals, nursing journals, long-term care journals, and bioethics journals.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Unbefriended and Unrepresented: Better Medical Decision Making for Incapacitated Patients Without Healthcare Surrogates

How should we make medical decisions for incapacitated patients who have no available legally-authorized surrogate decision maker? Because these patients lack decision making capacity, they cannot authorize treatment themselves. Because they lack a surrogate, nobody else can authorize treatment either. Clinicians and researchers have referred to these individuals as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients. Clinicians and researchers have also described them as “unimaginably helpless,” “highly vulnerable,” and as the “most vulnerable,” because “no one cares deeply if they live or die.”

The persistent challenges involved in obtaining consent for medical treatment on behalf of these individuals is an immense problem in ethics and patients’ rights. Some commentators describe caring for the unbefriended as “one of the most difficult problems in medical decision making.” Others call it the “single greatest category of problems” encountered in bioethics consultations.

Appropriately, this problem is getting more attention. Major policy reports from both legal and medical associations have focused on decision making for the unbefriended. Perhaps most notably, the elite mainstream media has repeatedly covered the problem of the unbefriended in the United States. Decision-making for the unbefriended has also been the primary topic of recent day-long or multi-day conferences, both themed, subject-specific conferences, and individual sessions at several national and regional professional association meetings.

Finally, the problem of the unbefriended has received increasing attention not only in the meeting halls of conferences, but also in the pages of academic literature. New articles have been printed in law journals, medical journals, nursing journals, long-term care journals, and bioethics journals.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Oxford Uehiro Prize in Practical Ethics: Is Sex With Robots Rape? Written by Romy Eskens

This essay was the winner in the Graduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Romy Eskens

On The Permissibility of Consentless Sex With Robots

Recent movies and TV-series, such as Ex Machina and Westworld, have sparked popular interest in sex robots, which are embodied AI systems designed to provide sex for humans. Although for many it may seem absurd to think that humans will ever replace their human bedpartners with artificial machines, the first sexbots have already entered the commercial market. In 2010, TrueCompanion introduced Roxxxy, a sexbot with synthetic skin and an AI system that allows her to interact with her user through speech and affective communication. Another example of sexbots currently for sale are the RealDolls, which are silicone sexbots available in different models and upgradable with insertable faces and body parts. The question I address in this essay is: do humans require consent from sexbots for sexual activity to be permissible?

There are convincing ethical reasons to create sexbots. To begin with, sexbots can replace human sex workers, thereby reducing harmful practices such as sex slavery and sexual abuse.[i] Moreover, they can provide satisfying alternatives for individuals with sexual desires that could harm human beings if brought into practice, such as the desire to have sex with children or to engage in extremely violent or degrading sex. Furthermore, sexbots can provide a solution for individuals who experience difficulty in finding sexual partners, and can provide intimate companionship for those who feel lonely or isolated.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Unusual Case of Ian Paterson and Criminally Harmful Surgery

Guest post by Alex Mullock, University of Manchester

On 28th April 2017 in the case of breast surgeon, Ian Paterson, the jury in Nottingham Crown Court agreed that in carrying out unnecessary and mutilating surgery the defendant had done what no reasonable surgeon would do.  Paterson was convicted of seventeen counts of wounding with intent to cause grievous bodily harm (GBH) and three counts of unlawful wounding (under, respectively, sections 18 and 20 of the Offences Against the Person Act 1861) against nine women and one man. These ten victims, however, have been reported to represent a tiny proportion of all Paterson’s alleged victims, a group that might amount to hundreds from his many years of practice in the NHS and private sector.

The “obscure motives” that compelled Paterson may forever remain a mystery but it is interesting that the charges against him relate only to patients he treated in his private practice.  This enabled the prosecution to create a narrative that suggested that financial gain could have been the motivating factor for Paterson’s crimes.  Without greed as a possible motive his actions are baffling, and the prosecution’s case, in alleging that surgery which Paterson argued was performed in the patient’s best interests actually constituted GBH or unlawful wounding, would be more challenging because of the medical context of the allegations.  Importantly, the medical exception to the criminal law – the principle that consensual surgery carried out by qualified professionals is legitimate (“proper medical treatment”) – means that there is an assumption that harm caused by surgery is not a matter for the criminal law because it is a risk that we accept in order to enjoy the benefits of surgical medicine.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

BioethicsTV: Violating consent, living with difficult patient choices, and helping family choose

by Craig Klugman, Ph.D.

On Grey’s Anatomy (Season 13, Episode 22), two storylines looked at when a physician’s desire to do good should outweigh a patient’s choice. [Shortcut answer: Rarely] In the first storyline, a young woman enters the ED after falling down a flight of stairs while leaving the apartment of a one-night stand. She has an inoperable heart tumor and has decided to spend her remaining time being as hedonistic as possible. At one point, she turns to the doctors and tells them that she knows what they are thinking: That they alone can give her a chance; that there is some technique that only they can do.…

Source: bioethics.net, a blog maintained by the editorial staff of The American Journal of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.