Philosophy & Ethics

In America, the saying used to be 'my doctor should decide my medical treatment, not an insurance company'. 

In Netherlands, Dutch doctors do decide, including whether to withhold or withdraw treatment in a substantial proportion of elderly patients. End of life decisions are not made by patients or their families.

Why? It is not ageism, according to a survey in the Journal of Medical Ethics. It may be financial, since long-term care is paid for by the government, but survey respondents say they deny treatment out of respect for patients. Most commonly that means denying simple food and fluids.

Surveying news headlines in recent years, it seems that cheating is rampant.

In the athletic arena, Lance Armstrong was stripped of his seven Tour de France titles for using performance-enhancing drugs.

In business, some of the world’s largest banks have paid nearly $200 billion – the equivalent of the GDP of New Zealand – in fines over the past six years for cheating.

Since it was revealed that Andreas Lubitz – the co-pilot who purposefully crashed Germanwings Flight 9525, killing 150 people – had been treated for psychiatric illness, a debate has ensued over whether privacy laws regarding medical records should be less strict when it comes to professions that carry special responsibilities.

It has been widely argued that Germany’s privacy laws were to blame for the tragedy. The Times, for example, headlined an article: “German obsession with privacy let killer pilot fly.” Similarly, another article published in TIME said “German privacy laws let pilot ‘hide’ his illness from employers.”

There may be unconscious race and social class biases in trauma and acute-care clinicians, according to a survey, but they did not affects clinical decisions finds an analysis in JAMA Surgery.


The marketing, prescribing and selling of testosterone and growth hormone as panaceas for age-related problems is disease mongering, write the authors of a paper in Journal of the American Geriatrics Society .

Disease mongering is inventing new broader definitions of disease in conjunction with widespread marketing to increase sales of specific drugs and therapies.

The 2015 Alzheimer's Disease Facts and Figures report found that only 45 percent of people with Alzheimer's disease or their caregivers were told the diagnosis by their doctor.

That is significantly lower than the 90 percent of people told the diagnosis for the four most common cancers.

Why? The reason most commonly cited by health care providers for not disclosing an Alzheimer's diagnosis is fear of causing the patient emotional distress but, according to the report, "studies that have explored this issue have found that few patients become depressed or have other long-term emotional problems because of the [Alzheimer's] diagnosis." 

Overpopulation, greenhouse gases, climate disruption - it's a doomsday prophet's Nirvana.

You, dear reader, are basically a blight on the pristine goodness of nature, but even being told that you stink has not led most of you to demand policy action. Why not? And will a Nobel laureate telling you to get off your butt help?(1) 

Dr. Paul Cruzten, a 1995 Nobel Laureate in Chemistry, the fellow who popularized the term "anthropocene epoch", hopes his latest editorial, with Stanislaw Waclawek, on the subject creates a tipping point for change.

No doubt Lance Armstrong is still digesting the news that he has to repay $10 million (£6.4m) to previous sponsors following a ruling by an arbitration panel a few weeks ago.

This is on top of the lifetime ban from all sporting competitions that he was given several years back.

After they die, people are happy to donate their hearts, their eyes, even whole skeletons, without knowing anything at all about what will happen to them.

What about genetic information? 

Under current law, your genetic information is not inherited by default, so a child with a heritable form of cancer can't access their parent's genetic information after death if no consent was ever established. Clearly there needs to be a policy in the post-Human Genome Project age.