Examination V

Examination V

Friday, 7/5, we will take the fifth of our five examinations for the semester. You will have the full two hours of class-time in which to write the exam. Please be sure to arrive on time for class. Contra to the , the fifth examination is worth 200 points, as opposed to the 100 points I had originally planned. This, however, is only to your benefit, as the fifth exam is simply extra credit, to be added on to your four previous exam scores to calculate your semester total. This exam can only help you, in short; it cannot hurt you. You should try to outline answers to each of the questions and be sure you can write clear, complete, and comprehensive answers to them all. You may bring a single handwritten 4inx6in notecard to keep track of your outlines, for which you may use both sides of the notecard.

A. Medical Experimentation

Consider the following series of animal experiments described by Peter Singer in “Animal Experimentation”:

Very often, too, basic medical research has been going on for decades and much of it, in the long run, turns out to have been quite pointless. As an illustration, consider the following series of experiments stretching back nearly a century, on the effects of heat on animals:

In 1880 H. C. Wood placed a number of animals in boxes with glass lids and placed the boxes on a brick pavement on a hot day. He used rabbits, pigeons, and cats. His observations on a rabbit are typical. At a temperature of 109.5 degrees Fahrenheit the rabbit jumps and "kicks hind legs with great fury." The rabbit then has a convulsive attack. At 112 degrees Fahrenheit the animal lies on its side slobbering. At 120 degrees Fahrenheit it is gasping and squealing weakly. Soon after it dies.

In 1881 a report appeared in The Lancet on dogs and rabbits whose temperatures had been raised to 113 degrees Fahrenheit. It was found that death could be prevented by cool air currents, and the results were said to indicate "the importance of keeping down the temperature in those cases in which it exhibits a tendency to rise to [an] extreme height."

In 1927 W. W. Hall and E. G. Wakefield of the U.S. Naval Medical School placed ten dogs in a hot humid chamber to produce experimental heatstroke. The animals first showed restlessness, breathing difficulties, swelling and congestion of the eyes, and thirst. Some had convulsions. Some died early in the experiment. Those who did not had severe diarrhea and died after removal from the chamber.

In 1954 at Yale University School of Medicine, M. Lennox, W. Sibley, and H. Zimmerman placed thirty-two kittens in a "radiant-heating" chamber. The kittens were "subjected to a total of 49 heating periods.... Struggling was common, particularly as the temperature rose." Convulsions occurred on nine occasions: "Repeated convulsions were the rule." As many as thirty convulsions occurred in rapid sequence. Five kittens died during convulsions, and six without convulsions. The other kittens were killed by the experimenters for autopsies. The experimenters reported: "The findings in artificially induced fever in kittens conform to the clinical and EEG findings in human beings and previous clinical findings in kittens..."

In 1969 S. Michaelson, a veterinarian at the University of Rochester, exposed dogs and rabbits to heat-producing microwaves until their temperatures reached the critical level of 107 degrees Fahrenheit or greater. He observed that dogs start panting shortly after microwave exposure begins. Most "display increased activity varying from restlessness to extreme agitation." Near the point of death, weakness and prostration occur. In the case of rabbits "within 5 minutes, desperate attempts are made to escape the cage," and the rabbits die within forty minutes. Michaelson concluded that an increase in heat from microwaves produces damage "indistinguishable from fever in general...

In 1984 experimenters working for the Federal Aviation Administration, stating that "animals occasionally die from heat stress encountered during shipping in the nations transportation systems," subjected ten beagles to experimental heat. The dogs were isolated in chambers, fitted with muzzles, and exposed to 95 degrees Fahrenheit combined with high humidity. They were given no food or water, and were kept in these conditions for twenty-four hours. The behavior of the dogs was observed; it included "deliberate agitated activity such as pawing at the crate walls, continuous circling, tossing of the head to shed the muzzle, rubbing the muzzle back and forth on the floor of the crate, and aggressive acts on the sensor guards." Some of the dogs died in the chambers. When the survivors were removed, some vomited blood, and all were weak and exhausted. The experimenters refer to "subsequent experiments on more than 100 beagles...

Here we have cited a series of experiments going back into the nineteenth century-and I have had space sufficient to include only a fraction of the published literature. The experiments obviously caused great suffering; and the major finding seems to be the advice that heatstroke victims should be cooled.

In the space provided on this and the following page, use the above examples to i) explain Cohen’s argument (set out and justify the premises) that such experiments are morally permissible and ii) explain Singer’s argument (set out and justify the premises) that such experiments are morally impermissible. In considering and contrasting the two arguments, which do you find most clearly defensible? By what reasons specifically do you reject the argument you found, over all and all things considered, less defensible? Further, how did moral theory and/or moral principles inform the reasons you gave?

B. Medical Paternalism

Consider the following case from the 2005 National Ethics Bowl:

Dr. Thomas Daley was happy to see Kelly Patterson. He had been following her budding acting career through the local community newspaper. A 17-year-old high school senior, she would be graduating in a few months and heading off to the state university to major in theatre. He recalls the shy, reclusive girl she was before her rhinoplasty some years ago. Although Kelly’s mother was initially leery of a nose job for her then 11-year-old daughter, she and Kelly were desperate to put an end to the merciless teasing by other children about her nose. According to Mrs. Patterson, plastic surgery on Kelly’s nose dramatically improved her self-confidence. “She just became a different person, so much more outgoing,” her mother said, “it made such a big difference in her social life.”

Kelly and her mother entered Dr. Daley’s office and made small talk for a minute or so. Dr. Daley then asked Kelly about her reason for the appointment. Kelly looked at her mother and then said that she had been doing research on the internet about breast augmentation surgery and would like to undergo the procedure. Dr. Daley first assured Kelly that she was perfect the way she was. He then expressed some reservations about performing the procedure and sent the Pattersons away with some informational booklets that detail risks and side-effects of breast augmentation surgery.

Later that month, Dr. Daley found himself at the conference on plastic surgery, talking informally to another plastic surgeon, Dr. Sarah Carlson. He recounted to Dr. Carlson his discussion with Kelly and Mrs. Patterson, and then added that, although he does not doubt that she is sharp enough to understand the factual complexities about the breast augmentation procedure, he still, nonetheless, felt morally uncomfortable with Kelly’s request. Dr. Carlson confessed that in southern California, where she practiced, it was not uncommon for girls Kelly’s age to undergo breast augmentation surgery. “Besides Tom,” she said, “if you’re ethically uncomfortable with performing the surgery, you can just tell her that you won’t do it, that she’ll have to find someone else.” Dr. Patterson nodded and pointed out that where he practices, most plastics surgeons refuse to do breast augmentations on adolescents.

A few weeks later, Dr. Daley met with Kelly and her mom. They discussed the procedure in detail. Kelly’s remarks and questions reflected a thorough understanding of the risks and side-effects of the procedure.

In the space provided on this and the following two pages, explain and justify Dworkin’s extension of Mill’s Wager View to adults and the two requirements he concludes its extension imposes on professional paternalism. How does Dworkin’s analysis inform Dr. Daley’s troubling decision of whether or not to comply with the Patterson’s request? That is, in light of Dworkin’s two requirements, what course of action should Dr. Daley pursue given his role as physician to Kelly? Finally, in light of this case, explain why neither the Mechanic’s Model nor the Priest’s Model are morally justifiable in this case by giving at least two reasons against adopting each model of professional paternalism (thus, four reasons in total.)

C. Neuroethics

Consider Julian Savulescu and Anders Sandberg’s short article, “Engineering Love”:

It’s easy to forget that we humans are animals too. After all, our relatively large cortices have enabled us to create advanced technology, megacities, nuclear weapons, art, philosophy – in short, a radically different environment to the African savannah we inhabited for most of our history. To top that, we have developed an extraordinarily complex medical system capable of doubling the human lifespan.

Yet in many ways we are stuck with the psychology and drives of our hunter‐gatherer ancestors. We are not made for the world and institutions we have created for ourselves, including that of life‐long marriage.

Throughout most of our history, people survived for a maximum of 35 years. Staying alive was a full‐time job, and most pair‐bonds ended with one partner dying. Given this lifespan, at least 50 per cent of mating alliances would have ended within 15 years. This figure is surprisingly close to the current global median duration of marriage, 11 years. It seems unlikely that natural selection equipped us to keep relationships lasting much more than a decade.

The fact is that in the US divorce has surpassed death as the major cause of marital break‐up. This has significant consequences, especially for children. As law professor Katherine Spaht of Louisiana State University in Baton Rouge wrote in the Notre Dame Law Review: “In comparison with children of intact first marriages, children of divorce suffer in virtually every measure of well‐being.”

On the other side of the coin, stable, loving relationships are good for us, improving both parent and child welfare through the social support they provide. Most research confirms that successful marriages boost physical and emotional health, self‐reported happiness and even longevity. So how can we make up the gap between the health‐giving ideal of “till death do us part” and the heartbreaking reality and harms of widespread divorce? And do parents have a special responsibility to do so, given those harms?

One promising route is to consider the advances in neurobiology and see how we might use science. Some of the latest research suggests we could tweak the chemical systems involved to create a longer‐lasting love.

Helen Fisher, an evolutionary psychologist at Rutgers University in New Brunswick, New Jersey, argues that human love is constructed on top of a set of basic brain systems for lust, romantic attraction and attachment that evolved in all mammals. Lust promotes mating with any appropriate partner, attraction makes us choose and prefer a particular partner, while attachment allows pairs to cooperate and stay together until parental duties are complete.

Human love, of course, is complex. While there is no single “love centre” in the brain, neuroimaging studies of people experiencing romantic love have shown patterns of activation in areas linked to the hormones oxytocin and vasopressin, as well as the brain’s reward centres. These findings fit with research into the mating habits of monogamous prairie voles (Microtus ochrogaster) and their cousins the polygamous montane voles (Microtus montanus).

The receptors for these hormones are distributed differently in monogamous and polygamous voles. Infusing oxytocin into the brains of female prairie voles and vasopressin into the brains of males encouraged pair‐bonding activity such as spending time together exclusively and driving away sexual competitors, even in the absence of mating, while the hormones did not affect the non‐monogamous montane voles.

In one striking experiment, researchers introduced a vasopressin receptor gene from the faithful prairie vole into the brain of its promiscuous cousin. The modified voles became monogamous (Neuroscience, vol 125, p 35).

This gene controls a part of the brain’s reward centre. In humans, differences in this gene have been associated with changes in the stability of relationships and in partner satisfaction. If human and vole brains share similar wiring, as research suggests, we might be able to modify our mating behaviour biologically as well.

Tapping into the power of oxytocin could prove useful in other ways. Oxytocin is released during physical contact such as touching, massage or sex, and is involved in nursing behaviour, trust and “mind‐reading” – our attempts to work out what our partners think and feel – as well as in counteracting stress and fear. Taking oxytocin in the form of a nasal spray would promote unstressed, trusting behaviours that might reduce the negative feedback in some relationships and help strengthen the positive sides. It could also be used alongside marital therapy to open up communication and encourage bonding.

What of testosterone, the hormone that helps to control sexual desire in men and women? People who have been given the hormone report an increase in sexual thoughts, activity and satisfaction – though not in romantic passion or attachment. But since levels of sexual interest in men and women diverge as a relationship continues, and since this disparity strongly affects its stability, synchronising levels of desire by altering levels of testosterone might help.

It also looks likely that the strong dopamine and oxytocin signals elicited during the early romantic phase of a relationship and during sex help to imprint details of the partner and create positive emotional associations to the relationship. So it may be possible to trigger this imprinting by giving the right drugs while someone is close to their partner.

The stick rather than the carrot in the maintenance of a pair bond is that love is linked to fear and the sadness of separation. This may be due to corticotropin releasing hormone. Carefully boosting it or, rather, the processes behind the “stick” effect, might be useful as a deterrent from straying.

So what of the future? We already modify sexual behaviour, for example, by offering paedophiles chemical castration to squash their sex drive. And given the growing knowledge of the cognitive neuroscience of love and its chemical underpinning, we should expect far more precise interventions to become available soon.

Whether we should do any of this is another matter. Love and relationships are among the most potent contributors to our collective well‐being so there are strong moral reasons to make relationships better. But the use of neuroenhancements leads to many questions. Will they render relationships inauthentic, the product of pharmaceutical design? Could we become addicted to love? And could such drugs and chemicals be used to imprison people in bad relationships? So should we change our institutions or stick with modifying our behaviour using counselling and therapy instead?

On balance, no. We argue we need all the help we can get to liberate ourselves from evolution. It has not created us to be happy, but offers enough transient happiness to keep us alive and reproducing. Yet from our human perspective, happiness and flourishing are primary goals. In a conflict between human values and evolution we might well ignore what evolution promotes. “Love drugs” are not a silver bullet, but in a regulated, professional environment and with an informed public, they could help overcome some of biology’s obstacles. Why not use all the strategies we can to give us the best chance of the best life?

In the space provided on this and the following page, respond to their closing question, “why not use all the strategies we can to give us the best chance of the best life?” using both Classical Utilitarianism, on the one hand, and Kantian Ethical Theory, on the other. Do the theories both agree with their conclusion that we should develop neurotechnologies to enhance our romantic relationships and improve their stability over time, do both theories disagree, or have they different implications? Finally, do you agree or disagree with their conclusion? Justify your answer as clearly as you can using relevant moral principles.