Singer and Fisher preach to their flocks in euthanasia debate

Benjamin T. Jones, University of Western Sydney

When the University of Sydney’s Catholic Society decided to organise a debate on legalising voluntary euthanasia, it was envisaged as a modest event to be held on campus. Interest in the topic and the high profile of the speakers soon saw the debate moved to Sydney’s Town Hall, which sold out over a week in advance.

The two protagonists symbolised forces far larger than themselves. His Grace, the Most Revered Anthony Fisher, Archbishop of Sydney, represented the power and prestige of the Roman Catholic Church. He had a strong support base in the crowd, which included nuns, priests and young Catholic students.

In contrast to his stern and authoritarian predecessor, George Pell, Fisher carried himself with a relaxed charm, happy to joke about his “strange clothes” and former life of sin – he was a lawyer before studying for the priesthood.

Peter Singer is Australia’s most prominent philosopher and the current Ira W. DeCamp Professor of Bioethics at Princeton University. A key figure in the animal liberation movement and a foundational member of the Australian Greens, his advocacy, under certain circumstances, of abortion, euthanasia, infanticide – and even bestiality – has certainly courted controversy. To his religious critics, he is very much the atheist bogeyman.

Euthanasia is a sensitive topic that elicits strong emotions. The moderator, the ABC’s online editor of Religion and Ethics, Scott Stevens, urged the speakers and audience to be more civil and respectful than the Q&A norm. It was a request mostly adhered to.

The full Singer-Fisher debate.

Singer spoke first and his argument was relatively straightforward. The audience was asked:

Why do we consider killing an innocent person to be wrong?

The answer is twofold. First, killing someone is a violation of their autonomy. But in the case of voluntary euthanasia, a person’s autonomy is not taken away but supported.

Second, killing an innocent person deprives them of the good things in life they would have otherwise experienced. At this juncture, Singer makes an important qualification. He is not an “absolutist” about autonomy. If a healthy young person is lovesick or depressed, they may temporarily feel that life is not worth living. However, there is much reason to suspect these feelings will pass.

Singer endorses the Canadian Supreme Court’s recent ruling that allows euthanasia only for people with:

… grievous and irremediable medical conditions.

Fisher drew on the movie The Water Diviner, where a young Australian soldier agrees to kill his mortally wounded brother rather than let him slowly and painfully bleed to death. The question put to the audience was:

Is it better to kill someone than let them suffer?

Fisher asserted that comforting people through their suffering requires more from us, but it also places more value on humanity and endorses the intrinsic value of life.

Fisher’s main argument was concerned with bracket creep. If we accept some people who suffer should be able to end their lives, what about others who suffer? Rather than respect for all life, euthanasia would lead to two classes of existence. The terminally sick could soon be joined by the mentally ill, clinically depressed, severely disabled, the elderly and unwanted babies in a growing group considered better off dead.

Singer strongly rejected this claim. He argued that there was no evidence of a slippery slope towards euthanasia becoming a widespread practice to remove undesirable people for financial or other motives. He pointed to the US state of Oregon, where only 105 people took advantage of the Death with Dignity Act in 2014.

Fisher insisted that the example of the Netherlands where, he said, euthanasia has rapidly increased proves that bracket creep is real. Once you accept some people are better off dead a moral line is crossed.

The questions from the audience hinted at its makeup. Of the 12 questions asked, ten were openly hostile to Singer or supportive of Fisher. Singer was asked if he supported the killing of babies with severe disabilities or elderly people with dementia. He became increasingly impatient and regularly reminded the audience he was only advocating voluntary euthanasia – which automatically excludes babies and those unable to consent.

One questioner was even ejected by the moderator for trying to start an infanticide debate stemming from Singer’s 1979 book, Practical Ethics.

So who won the debate? No-one really. Had there been a show of hands, Fisher would have been the likely victor but that would only have reflected the Catholic Society’s strong presence.

For much of the debate, the two did not address the other’s arguments. Singer kept a small target, advocating voluntary euthanasia only for competent adults with a terminal illness.

Fisher, and the questioners, wanted a broader discussion on the sanctity of life. As one questioner demanded to much applause:

Mr Singer, who are you to decide that some lives are worth more than others?

Singer responded, also to applause, that he could not see the connection between the question and what he had advocated. It summed up the night; arguments flew in both directions but rarely met.

With the debate finished, supporters of each man formed an excited line to buy a signed book and take the obligatory selfie. As with the debates about the existence of God made so popular by Richard Dawkins and Christopher Hitchens, the goal was never to change anyone’s mind but to speak to an existing base. Both camps left the majestic building satisfied that they had won.

Benjamin T. Jones is Adjunct Research Fellow, School of Humanities and Communication Arts at University of Western Sydney

This article was originally published on The Conversation. (Reblogged by permission). Read the original article.

What if Sydney University’s complementary medicine research shows it’s useless?

Simon Chapman, University of Sydney

The Faculty of Medicine at the University of Sydney has just announced A$1.3 of funding from Blackmores, the complementary medicine manufacturer, for a Chair in Integrative Medicine (a blending of evidence-based conventional and complementary medicine). It will be named after the company’s owner, Maurice Blackmore.

The Dean of the Faculty, Bruce Robinson, has given a coherent and persuasive account of why research in this area is of importance to modern medical practice. Nearly a quarter of Australians with chronic health problems use complementary and alternative medicine (CAM) and the bewildering range and often changing nature of these products are often of unknown efficacy, and may have important adverse or beneficial interactions with prescribed medicines. Still, more of the “worried well” regularly use unnecessary vitamins and other dietary supplements, often achieving little other than the generation of expensive urine in consumers and handsome profits in manufacturers.

Robinson is correct in arguing that medical practitioners and students know little about what a significant proportion of their patients are using and about whether these preparations help, harm, generate only placebo effects or simply waste patients’ money. And he is absolutely correct in making it clear from the beginning that the relationship will be at “arm’s length”, with Blackmores having no say in the research projects selected, in vetting the results produced, or in any post-publication researcher communications about those results. But there is already a great deal of evidence about a large number of complementary and alternative medicine preparations being useless, and about how faith in their magical properties can too often cause people with serious health problems to stay away from “conventional” evidence-based treatments of known effectiveness.

Complementary and alternative medicine manufacturers continue to produce and promote many of these substances, paying no heed to the evidence for their uselessness. Conventional medicines (so-called “ethical pharmaceuticals”) have to pass through onerous regulatory hurdles to prove both safety and efficacy. With the exception of the United States and New Zealand, prescribed medicines cannot be advertised directly to consumers. While the complementary and alternative medicine industry has to satisfy concerns about safety and toxicity, it does not have to satisfy standards of efficacy and can promote useless products in often quasi-mystical and vague language.

The University of Sydney needs to be extremely careful that its association with Blackmores does not turn into a “CAM-wash” exercise, where any adverse research findings on efficacy or interactions are ignored by the company, with the products not being withdrawn or the promotional language unchanged. There are social and financial costs in the mass consumption of unnecessary and ineffective “medicines”. The pages of medical journals routinely expose such drugs in the conventional medicines area. Many are highly sceptical that far too many players in the complementary and alternative medicine industry are the historical siblings of snake-oil medicine. For the Blackmores-University of Sydney association to repudiate that concern, it will be important to see evidence that the evidence-based and ethical principles at the heart of medical research are both shared and acted upon by the company.

In view of the sensitivities involved over potential reputational damage, the Faculty would do well to appoint an external audit committee to periodically review the relationship and to provide the Faculty with a report on the impact of the research program on the way Blackmores responds to the research it will have supported.

Editor’s note: please ensure your comments are courteous and on-topic.

Simon Chapman is Professor of Public Health at University of Sydney.

This article was originally published on The Conversation. (Reblogged by permission). Read the original article.