In defence of humanist morality

Geoff Keeling contemplates the biological origins of morality and ethics in humans.

Something about Hobbes

Thinkers like Thomas Hobbes believed that, short of the social contract, human nature only afforded humans a life that is ‘solitary, poor, nasty, brutish and short’. 

I recently watched a conversation between WikiLeaks editor Julian Assange, Slovenian philosopher Slavoj Žižek and the American conservative David Horowitz. In the heat of the argument Horowitz made the following claim:

‘War is the natural condition of mankind. There’s always been wars – right? From the beginning – and many of them. Peace occurs when there’s a concert of powers or a single power that could intimidate would-be aggressors.’

I couldn’t help biting my tongue here. As a humanist I believe in the inherent goodness of human beings. That we can be good – and that we are good – for the sake of goodness itself. Religious people sometimes ask sceptical questions about my ‘humanistic morality’. The idea is foreign to them because their thinking is grounded in the idea that ‘War is the natural condition of mankind’. In this article I want to defend the humanistic idea of natural morality. I hope it will be useful for other humanists facing the same questions.

Horowtiz’s thinking is based on the work of the English philosopher Thomas Hobbes. Hobbes’ basic idea can be summarised as follows:

‘There must be some coercive power to compel men equally to the performance of their covenants by the terror of some punishment greater than the benefit they expect by the breach of their covenant’[1].

Thinkers like Hobbes and Horowitz believe that humans existed in a state of nature before political society. It’s only through a social contract that we liberate ourselves from barbarism. In the Hobbesian state of nature life is solitary, poor, nasty, brutish and short. Modern human morality is a veneer: the Freudian superego that struggles to restrain our savagery. But as any social anthropologist will explain: there has been no period where humans lived outside of political society. This is also true of bonobos and chimps – our nearest evolutionary cousins – who have complex matriarchal and patriarchal societies respectively. The first step to refuting the idea of a ‘moral veneer’ is to show that humans never existed in the warlike state of nature.

The next step is to refute a common misunderstanding about evolution. The phrase survival of the fittest doesn’t lend itself to images of altruism and fairness. But in many cases organisms with genetic pre-dispositions towards co-operation have the upper hand when it comes to natural selection. A popular example is the ‘insurance policy’ that vampire bats have developed over food-allocation. It doesn’t take long for a bat to starve to death. But on any given night, it’s likely that a non-trivial percentage of the colony will come back on empty stomachs. In this instance the unsuccessful bats beg their peers to regurgitate some blood and feed them. And their peers usually do.

This may seem counter-intuitive. Surely, natural selection ought to preserve the best hunters? But think about it this way. Two randomly selected bats in the colony have a reasonable chance of sharing some DNA. Siblings share 1/2 of their genes and cousins 1/8. The bats need not know which of their fellow-bats is related to them. Do not let fellow bats die will increase the probability that their genes stored in other bats (including genes that code for co-operation) will be passed on to the next generation. This is because the set of related bats is a large subset of the colony, so there is no hard selection pressure for a more specific rule. There is also a second benefit. In the near future the regurgitator herself might be close to starvation. In sharing now she is more likely to receive blood when she needs it most[2].

Robert Trivers outlines the extent of natural co-operation in his paper The Evolution of Reciprocal Altruism[3]. Co-operation ranges from the symbiotic relationships of cleaner fish and their hosts, to birds warning their flocks when predators are near. But morality is more complex than simple co-operation. The distinction is that the co-operative instinct in higher primates is grounded in empathy: the ability to stand in another’s shoes. And our empathy is not just towards each other. Frans de Waal recalls a bonobo who nursed an injured bird back to health[4]. Humans often put themselves at substantial risk to save animals and other humans.

The brilliant thing about evolution is its use of general rules. Be nice to those you meet is much easier to code for than Be nice to close relatives – the latter of which is largely unnecessary as primates tend to grow up in the company of relatives. It’s these general rules that enable us to develop elaborate social constructs that underpin human morality. Evolution has programmed us to see empathy as a reward in itself. Evolution is indifferent to whether the biochemical reward comes via a religious framework or secular principles. What remains universal is the human propensity towards goodness. The Scottish philosopher David Hume observed:

‘How great soever the variety of municipal laws, it must be confessed, that their chief out-lines pretty regularly concur; because the purposes, to which they tend, are everywhere exactly similar.’ [5]

Though social anthropologists have observed huge variation in cultural traditions, the human moral passions exist to ensure co-operation and ultimately the perpetuation of our genes. But it’s so important to appreciate that this series of mutations – which has led to genuine compassion for others, is a real force that exists in each and every one of us. The fact that evolution has preserved this disposition doesn’t mean that kindness is just an evolutionary mechanism. With the constant barrage of ISIS atrocities and stories of lavish-bonuses in the finance sector, it’s easy to forget that although humans are capable of great wrongdoing, our natural stat is not one of war but of understanding. At the core of human nature – whether religious, secular or spiritual, is a profound evolutionary disposition towards compassion, fairness and kindness.


Geoff Keeling studies in the Department of Philosophy, Logic and Scientific Method at the London School of Economics. He is a humanist interested in philosophy of biology and cognitive science. He can be reached at g.keeling@lse.ac.uk.

 

Notes

[1] Thomas Hobbes (1651) Leviathan

[2] See O Curry (2005) Morality as Natural History or R Dawkins (1976) The Selfish Gene for a good explanation of this. For the original paper see GS Wilkinson (1988) Reciprocal Altruism in Bats and Other Mammals Ethology and Sociobiology pp85 – 100

[3] R Trivers (1972) The Evolution of Reciprocal Altruism Quarterly Review of Biology pp35-57

[4] F de Waal (2005) Our Inner Ape Granta Books p2

[5] David Hume (1989/ 1777) Enquiries Concerning Human Understanding and Concerning the Principles of Morals Oxford University Press p202

A victory for universality: UN Human Rights Council adopts resolution protecting LGBTI persons

Amelia Cooper reports again from the UN Human Rights Council in Geneva, where she speaks on behalf of the British Humanist Association

Amelia Cooper reports again from the UN Human Rights Council in Geneva, where she speaks on behalf of the British Humanist Association

‘There is no justification ever, for the degrading, the debasing or the exploitation of other human beings – on whatever basis: nationality, race, ethnicity, religion, gender, sexual orientation, disability, age or caste.’

This statement was made by the new High Commissioner for Human Rights, Prince Zeid Ra’ad al Hussein, in his introductory remarks to the UN Human Rights Council in Geneva: a powerful, timely reminder of the universality of human rights. Notable in this statement is the inclusion of ‘sexual orientation’, which has faced numerous attacks and denunciations as being outside the remit of the Council, despite the Universal Declaration of Human Rights’ emphasis that there will be no distinction ‘of any kind’ in the application of human rights. However, it is with great pleasure that I write to say that last night, following fierce debate, tense votes, and years of global advocacy, the Human Rights Council adopted a resolution based on sexual orientation and gender identity (SOGI), only the second of its kind.

The past year has been a tumultuous one for the rights of lesbian, gay, bisexual, transgender or intersex (LGBTI) people, with great successes regarding equal marriage taking place in the US and the UK, while elsewhere, such as in Russia, Nigeria, and Uganda, a spate of anti-homosexuality legislation has criminalized certain types of love, or made it impossible for LGBTI people to live openly. The global increase in homophobic aggression led one gay man to remark that ‘a hunting season is open, and we are the hunted’[1].

Without direct experience, however, it is easy to forget the rampant homophobia, both state-sanctioned and carried out by vigilantes, that permeates every aspect of daily life for LGBTI persons throughout the world – including in Europe.

Last week, I attended a side event hosted by ARC International, a leading advocacy group focused on achieving equality for LGBTI, and was shocked and heartbroken in equal measures to hear of the brutal violence that individuals suffer because of who they love.

Jabulani, from the South African Iranti Organisation, detailed innumerable cases of corrective rape and attacks carried out with impunity, ending by saying ‘The fact is that loving someone of your same sex is a direct threat to your bodily integrity’.

In Latin America, there are ‘curative clinics’ where LGBTI people are taken, abused and violated to ‘normalise’ their bodies. In the psyche of the perpetrator, this is not sexual abuse: it is a method by which people be ‘cured’ of their identity. The suicide rate among LGBTI youth in Latin America is 50% higher than their peers; in Central America, the life expectancy for transgender individuals is 24-28 years old. Transgender people do not have the benefit of ‘the closet’, due to their gender expression, and are therefore visible and oft targeted.

In Europe, Nori Spauwen of COC Netherlands said that the protection of LGBTI persons remains ‘a patchwork of national policy and Council of Europe recommendations’, and emphasized that having a legal, pro-equality framework is an indispensable precondition to elimination discrimination based on sexual orientation or gender identity. In the EU, more than half of all lesbian women have faced violence or verbal abuse in the past year, while crimes committed against LGBTI persons continue to be grossly underreported, due to the victims’ belief that nothing will change, or because they fear a homo/transphobic police reaction.

Any of these cases, on an individual basis, would suffice to show that discrimination based on sexual orientation and gender identity must stop; when together, they illustrate that this is a global scourge that must stop now.

Yesterday’s adoption of the resolution ‘combating violence and discrimination based on sexual orientation and gender identity’ is a critically important achievement in upholding the universality of human rights and creating a global framework to combat discrimination against LGBTI persons.

Introduced by Brazil, Chile, Colombia and Uruguay, and subsequently co-sponsored by an additional 42 states, the resolution expresses grave concern at acts of violence and discrimination suffered by LGBTI, calls for an updated study to be carried out by the Office of the High Commissioner for Human Rights, and ensures that the issue will remain on the Human Rights Council agenda.

The resolution faced a number of hostile amendments, including a proposal by Egypt (on behalf of ten states) to delete all references to sexual orientation and gender identity from the text. The Brazilian ambassador remarked that ‘Deleting all reference to sexual orientation and gender identity from this resolution would be the same as eliminating all references to women from the resolution on violence against women’. However, given that Egypt formed part of the core group who proposed the pernicious Protection of the Family resolution in June, their hostility to this resolution was hardly surprising.

A number of states spoke during the voting process, with impassioned statements from the resolution sponsors, including Chile’s statement that ‘this resolution does not seek to create new rights…there are some whose rights are more violated and need more protection’. Pakistan, speaking on behalf of the Organisation of Islamic Conference, framed LGBTI equality as a danger to the country, saying ‘The wider connotations of the term ‘sexual orientation’ can be extremely detrimental and inimical to our Muslim societies in particular, and to our youth as a whole’.

Thankfully, the resolution survived the persistent attempts to undermine it and was passed with by a vote of 25-14 (with seven abstentions, including from China and India) to huge smiles, happy tears and close embraces in a rare moment of emotional diplomacy.

While the resolution alone will not bring an end to discrimination based on sexual orientation and gender identity, it is a remarkable achievement in enshrining LGBTI equality as part of the international agenda, and provides a framework for further discussion of the issue. As the final regular session of the 2014 Human Rights Council has now closed, the resolution is an enormous step forward in terms of LGBTI equality, undermining the national legislation that criminalizes love and proving that human rights are truly universal.

 


 

For further information, see the joint NGO statement following the passage of the resolution.

[1] Dima, a Russian man who was left blind in one eye after an armed group stormed a gay community centre. Quoted by Channel 4, and featured in their documentary ‘Hunted’. http://www.channel4.com/news/gay-russian-sochi-hunting-season-we-are-the-hunted

 

Moral, religious, psychopathic, or just human?

Glen Carrigan looks at the science of morality

Science, increasingly, is answering questions which before only philosophers could attempt

Science, increasingly, is answering questions which before only philosophers could attempt

Why doesn’t Microsoft Word recognise the word ‘Neuropsychology?’ Maybe because it’s a rather new field, although people have been musing on the workings of the physical brain for a very long time indeed – don’t worry though, we’re not trepanning people anymore!

My interest is the moral brain, how humans – and other animals to some degree – draw the distinction between right and wrong to organise society. Some argue that moral standards are axiomatic and that moral compasses come from god. There actually seems to be some truth to this, in that some absolutist standards like Thou Shalt Not Kill or the Golden Rule seem to be very intuitive – as is the notion that you’re somehow a social pariah if you play World of Warcraft. A paper by Baumard and Boyer called “Explaining Moral Religions” shows just how universal this is.

Is the Golden Rule any good though? Maybe, but you’re making your own narrow individual experience the basis for how you treat others. Wouldn’t it be better to ask them how they’d like to be treated? This should indeed be the case for issues such as assisted dying, where holding to Thou Shalt Not Kill diminishes the dignity and autonomy of a feeling, reflecting being. To hold dogmatic moral views also only works if you believe in god and that at least in some religions, you’re good to escape punishment in the hereafter, rather than for the sake of the here and now.

Far from being divine in origin, there seems to be a wealth of evidence showing us that being an individual yet social animal, with a big (relative to body size) and healthy brain, necessitates certain behaviours for us to flourish in a group. This then, gives rise to our need to discuss and reflect upon what it means to be a moral agent. You can see similar intuitive behavioural patterns to our own in other animals that operate in social groups. A wonderful example is the reciprocal behaviour of vampire bats, who seem to understand that a good deed (donating a regurgitated blood meal – stomach churning I know) deserves repayment. There is much converging evidence in evolutionary psychology that points to animals being the origin of their own ‘moral’ codes. But there are driving forces behind being a good egg other than reciprocity.

Throughout history philosophers have struggled with what constitutes the virtuous act. We notice that certain behaviours are predictable and wrong such as rape and rightly condemn people for it. We also need to accept that we make choices – if we have free will – and should be responsible for them. The fact that certain prohibitions are intuitive might suggest an in-built moral acquisition and refinement device (MARD) which is nurtured by social experience, emotion and reflection, rather than an omnipotent law giver. Perhaps we are actually responsible for the holy books that seek to have us tow the moral line – although we were managing to beforehand – in any event we seem to be the only species we know of that spends a great deal of time writing books telling ourselves to be good, that we’re special, and that we should be humble about it!

Neuropsychology can perhaps tell us a bit about this MARD and how we think, rather than what we should think here: We establish the social norms after all and what acts constitute deviance. The archetypal Psychopath seems to be deviant to many of us and this is why I study them. The fact is that we all have psychopathic traits along a spectrum; it’s just that some people have more pronounced, what the majority consider to be, morally deviant tendencies. Neuropsychology shows us that Psychopaths seem to have diminished empathic concern, as well as, fail to notice the importance of intention in a harmful act. Since it’s us that establish that intention to cause harm is worse than an accident (the difference between murder and manslaughter) we view psychopaths as morally deviant in society – perhaps their MARD is broken?

People often panic here and think that if we can predict someone will think and perhaps behave murderously then the notion of choice in society falls apart. It might, if you want Neuroscience to strip us of our humanity. In my view, although we could see why such people might be like this, that doesn’t mean they walk away scot free. What matters is that we discuss our options reflectively and organise society around us as moral beings that makes choices, with a sense of responsibility, and who can be punished for transgressions, rather than allowing my brain made me do it as an alibi in all cases where mental instability is an issue. It’s also worth pointing out that most psychopaths actually don’t run around murdering people like Heath Ledger in Batman!


Glen Carrigan is a neuropsychology researcher at the University of Central Lancashire, as well as ex-military, a qualified fitness instructor, communications specialist, youth mentor, humanist, science presenter and model who advocates social and political activism in equality and education.

The sanctity of life

Emma C Williams casts an eye over the Irish sea, and discusses the rights of women in Europe

Emma C Williams casts an eye over the Irish sea, and discusses the rights of women in Europe. Photo: Steve Rhodes.

Behind every scandal lies hypocrisy and deceit. Behind the walls of a septic tank in County Galway lie hundreds of tiny skeletons, each one of them a shameful relic of man’s inhumanity to man.

St. Mary’s at Tuam was run by the Sisters of Bon Secours in the mid-20th century. Over the years they took thousands of pregnant young women, oversaw the delivery of their babies and were supposedly charged with their care. It is debatable whether the rate of infant mortality was higher at St. Mary’s than it was anywhere else across Ireland at the time; but the ghastly mass grave of 796 babies, a significant number of which were found in a sewer, shows contempt for the dignity of human life.

It is hard not to be emotive in the light of such discoveries, especially when apologists such as Caroline Farrow are prepared to waste their time and their energy on defending the indefensible. The nuns at Tuam were all part of an institution which claims to value the sanctity of life from the moment of conception. Yet conservative Catholic doctrine denied baptism to the babies of unmarried mothers, something which perhaps gave licence to their assumption that these unfortunate children were inherently worthless and undeserving of respect.

The sanctity of life is a cornerstone of Catholic doctrine; despite this, the case in Country Galway is by no means the only example of the heinous offences against women and children committed by members of the church.

Let us not forget the estimated 10,000 young women imprisoned in workhouse laundries in Ireland between the 1920s and the 1990s, a scandal which the Catholic journalist Tim Stanley thinks is greatly exaggerated. Unfortunately, it isn’t. Originally a place for “fallen women,” the workhouses imprisoned girls who fell pregnant, daughters born out of wedlock and girls who were supposedly “promiscuous” or simply considered a burden to their family. They worked for no pay, were given little or no freedom, and those who died in service were buried in unmarked graves.

Let us not forget the theft and trafficking of thousands of babies by nuns, priests and doctors in Spain, a practice which started under Franco and continued right up until the 1990s. Some of the babies were born to unmarried girls, some of them to married women with families. The mothers were told that their babies had died, and some were even shown a substitute corpse. In truth, their babies were sent to new families, some of them abroad, and many of them were sold for huge sums of money.

Let us not forget Savita Halappanavar, a 31-year-old married professional, who was admitted to hospital in Galway in the early stages of a miscarriage in October 2012. Despite her condition, her request for an abortion on medical grounds was denied and she died of septicaemia one week later.

Sadly, Catholicism is not the only religious institution which continues to interfere with the reproductive rights of women. While the landmark decision leading to the legalisation of abortion in the test case of Rose vs. Wade still stands, the evangelical pro-life movement in the US continues to grow at an alarming rate. Several states including Wisconsin, Texas and Alabama have made subtle but significant moves towards reducing access for women in recent years, and many Americans are now forced to travel hundreds of miles for a termination, assuming they can afford the journey.

To deny women autonomy over their own bodies is an aberration most commonly driven by religious dogma, and I suspect it will be some time before religion stops blaming women for all the world’s ills. Until we can break free from the tenets of these archaic and patriarchal institutions, we will continue to be controlled by them.

The cost of failing to address the place of religion in our schools

At last Ofsted and the Education Funding Agency have published their investigations into the ethos and curriculum of a number of Birmingham community schools. For the last few years many organisations, including the British Humanist Association (BHA), have been receiving reports from staff and parents at one or other of these schools outlining their concerns. These allegations have included gender discrimination, homophobia, creationism, discrimination in employment and disciplinary practices, bullying, and an unbalanced and closed curriculum, many of which have now been validated.

When we received them at the BHA and had permission, we passed them on to the Department for Education (DfE) and Ofsted, but it is questionable whether these legitimate concerns would ever have been taken seriously had it not been for the appearance of the ‘Operation Trojan Horse’ letter in March. This letter, now widely considered to be a hoax, gave rise both to investigations of a conspiracy to advance Islamic extremism and to a vicious public debate.

I think focusing on conspiracy and on violent or political extremism are distractions. What many of those who first blew the whistle in the various schools were reacting to was not these claims but to the teaching and ethos of community state schools being gradually changed to reflect a distinctive and narrow religious position, with a closing down of alternative ways of looking at the world, in a way that made the school an extension of the most religious home and denied the pupils alternative views. The most important issue within the situation in Birmingham remains that children in state schools were given an education that may have prepared them well for exams and formal academic achievement but did not open their horizons, develop their freedom of belief, and equip them as informed and critical citizens of modern society to the extent that we should expect.

The specific findings of unbalanced religious teaching and worship and narrow curricula in a number of disciplines in these cases are deeply shocking, but they are a symptom of underlying problems in a school system based on a general religious bias which is increasingly in tension with our more secular and plural society and where the antique provisions embedding religion in the nature even of our non-religious schools are giving rise to a range of perverse outcomes. The situation in Birmingham is symptomatic of our failure to face up to the consequences of these issues still being governed by a basic framework that is now seventy years old and this is a failure of successive governments, none of which have had an overarching strategy or a principled vision of how the state education system should deal with religion or belief.

The last serious attempt to look at all the issues holistically was in 2002 when the BHA published A Better Way Forward. It was the product of policy work and consultation with a range of religious groups as well as educationists and although its proposals may now look dated in a heavily reformed school system, the issues it engaged with are the same. The message was, and still is, simple: all state schools should be equally inclusive of all pupils and staff, with no one group being given special privileges. Schools should not proselytise or discriminate against anyone on the basis of their religion or belief, in admissions, employment, curriculum, ethos, or assemblies.

There are a number of ways in which our law and practice falls short of this: it allows religious discrimination in admissions and employment; it mandates daily acts of religious worship in all schools; it allows unbalanced confessional RE in many schools and makes minimal national prescription in relation to RE in most others, leaving decisions up to schools; beyond bare bones equality law, it fails to lay out any clear template for how schools can or should be made inclusive of children from different religious or belief backgrounds. When you look at them as a package, these facts are astonishing. Not only do they put our school system’s relation to religion way outside of clear international standards and the norms of other liberal democracies, they fail to respect the human rights of children to a horizon-widening education and they fail to recognise the necessity of inclusive civic institutions in a plural society. When combined with the increasingly consumerist approach to public services and our assumption that in schools it is the parent who is the consumer and not the developing child, the fact that the place of religion is so prominent in our school system can lead to people implementing outrageous policies while thinking them entirely acceptable and in keeping with our national provision.

If so many state schools continue to be allowed by law to select the children of Christians, of course Muslim parents and groups will make demands for theirs too. Few people are such policy nerds that they really understand different legal school types, so of course this desire will inevitably translate into influence over schools with no religious character but where most pupils are from Muslim backgrounds. Why shouldn’t a state school with a majority of Muslim parents have compulsory Muslim worship every day?  The law of the land encourages and allows it. And why should alternative activities be provided for children whose parents opt them out? They aren’t in the many schools where the worship is Christian and the potential opters-out are Muslim (or Hindu, or Jewish, or humanist…)

Why shouldn’t a school with children whose parents are mostly Muslim have imams coming in to talk regularly? Schools where most of the parents are Christians (and many where they aren’t) have vicars visiting frequently. Why shouldn’t RE lessons in schools with mostly Muslim parents be mostly about Islam and exclude non-religious beliefs? There’s nothing in the law to rule it out and in many other schools the lessons are mostly about Christianity, even confessionally so, and don’t include teaching about non-religious beliefs at all.

To me the answer is clear – it is because children have the right to a broad and open education tailored to their development as a whole person. No school should be prioritising religious identities over the need for inclusion in our civic institutions. If you agree with me, then surely you would extend the same principle to all state schools. And if so, surely the fact that these principles don’t currently extend in all these ways is the real issue underlying the present problems?

If this is the issue, that what is it that governments have been doing that has allowed this situation to continue? Haven’t they done anything to try to address it?

The Labour governments of 1997-2010 were culpable of engineering the biggest expansion of religious state schools in British history and in legislating to remove employment rights from many staff in these schools. But successive secretaries of state did work to address some of the issues of religion in the system in a more helpful direction – though always stopping short of complete reform. Charles Clarke introduced a national framework for a more balanced subject of RE in all schools – but he failed to make it compulsory. Alan Johnson introduced a duty to promote community cohesion on all schools, including in relation to religion – but failed to change the law allowing religious discrimination in admissions to many schools. Ed Balls introduced new guidance on RE and new resources for school assemblies that effectively replaced compulsory worship in many schools – but he didn’t change the underlying law on RE, he didn’t seek to remove the right of many schools to teach single religious instruction, and he left the law requiring worship on the statute books where it remained in force.

The current coalition government also has a mixed report card, and has similarly failed to treat issues of religion in our education system holistically. It has introduced a quota of pupils from different belief backgrounds in most new religious selective state schools – but it still allows such selection in other schools and has abolished the inspection of community cohesion. It has made provisions for no new school to be able to have pseudoscientific teaching, but has attenuated the regime of accountability to the extent that this is hard to enforce. It has given support to an inclusive new framework for RE but failed to make it compulsory. It has removed many inclusive provisions from subjects such as History, Citizenship, and others, and diluted the applicability of the national curriculum in any case. In its ‘freeing up’ of academies and free schools it has singularly failed to free them of the requirement to hold daily religious worship, which remains in force for all of them.

To seek to address the issue of religion and belief in our schools holistically is not to attempt to hijack the current debate – it is to debate what the real underlying issue is. In the Commons debate on Monday, Michael Gove did not see it this way. He preferred to focus on Britishness and inspection regime reforms – but the shadow education secretary did open up the issue. Perhaps like Labour secretaries of state before him, he might engage more seriously with it. Perhaps he might go further and address it in a genuinely holistic way. Surely he, or our current minister, or some future minister, must do so. We need a serious and inclusive national conversation at a policy level about this issue in the round, and the need is urgent.


Andrew Copson is the Chief Executive of the British Humanist Association. This article was first published on politics.co.uk.

The practical ethics of smart drugs

In this first post of a new feature on HumanistLife, one blogger tackles a contemporary ethical concern from a humanist, rationalist or evidence-based position. Below, Laurie Pycroft discusses the smart drug modafinil, and addresses concerns over its use.

Photograph: Anders Sandberg

What if you could make yourself smarter simply by taking a pill? The concept of drugs that improve cognitive functions has been prevalent in science fiction for many years, but only relatively recently has the proliferation of such pharmaceuticals been a serious possibility. “Nootropics” or “smart drugs” have been hitting the headlines lately, with the promise of increased focus, memory, and wakefulness being an appealing prospect for many. Most widely discussed have been stimulants, normally prescribed for medically recognised conditions, being used off-label by healthy individuals seeking to improve their performance at mentally demanding tasks. Modafinil (AKA Provigil) is probably the most prominent of these drugs in the UK. Originally developed as a treatment for narcolepsy, modafinil also improves wakefulness in healthy people and evidence suggests that it may improve other aspects of cognitive function in some individuals. As with any drug, however, modafinil has risks associated with it and may be harmful to those taking it. Furthermore, there is a danger of smart drugs having negative side-effects on a societal level. As such, it is important to carefully consider the ethical ramifications of widespread use of smart drugs such as modafinil. This is a substantial question, far too large for this short article to consider in depth, but hopefully this piece will provide a reasonable overview of the issue and pose a few interesting questions worthy of deeper consideration.

The first important point to consider is the fact that cognitive enhancement, whether using drugs or other methods, is nothing new. Perhaps the most obvious example is caffeine, a substance that many millions of people use on a daily basis with the intent of reducing tiredness and improving focus. Less obvious are technologies such as computers and organised education, along with healthy diet and exercise, all of which offer substantial improvements to our cognitive abilities. When considering the issue of smart drugs, one should always consider the comparison with established cognition enhancement techniques and remember that all of them have potential down-sides. The important question here is – what amount of benefit does the intervention offer, and is the level of risk associated with it acceptable?

Most established cognition enhancement techniques carry relatively little risk, from an individual standpoint. Caffeine is perhaps the best point of comparison for drugs such as modafinil. Caffeine is addictive and can produce unpleasant side-effects, but it is unlikely to seriously threaten health in most people, except at very high doses. Conversely, its benefits are quite minor – primarily improving perceived wakefulness for a short period of time. Modafinil’s benefits are likely somewhat greater, with research indicating that it can significantly improve working memory, concentration, alertness, and other cognitive abilities in sleep deprived individuals. Results are less clear-cut when it comes to those who have had sufficient sleep, but some studies have reported enhancements to aspects of memory and concentration, especially in individuals with a lower baseline performance in the experimental tasks. The negative effects of modafinil use in healthy people are still not fully understood – while it is not associated with the same level of addiction or cardiovascular damage seen with many stimulants, it is thought to carry a small risk of inducing some extremely rare but potentially life-threatening dermatological conditions. Relatively little research has been done into its long-term health effects and future smart drugs are likely to be similarly poorly understood. These risks are compounded by the fact that, currently, modafinil is illegal to sell (although not to buy) without a prescription in the UK, meaning that healthy users must purchase it from underground sources, raising the possibility of being sold impure or mislabelled products. Whether this level of risk is acceptable is, ultimately, a question that each potential user must ask themself.

The issues surrounding smart drugs are not, however, exclusive to the individual. Any new technology that has the potential to alter the cognitive processes of millions of people is bound to have effects on society as a whole. Two inter-related societal issues that smart drugs could impact are those of inequality and competition. The inequality issue comes down to the possibility of expensive new smart drugs exacerbating existing social divides – while modafinil is relatively inexpensive and the benefits it offers are modest, it is not inconceivable that new drugs could be developed offering greater improvements to cognition while being substantially more costly. Such a situation could lead to the rich having preferential access to cognition enhancement, making it even more difficult for the poor to compete. While this is a potential problem, it is far from insurmountable. A drug that offered such major benefits could be worth providing for free (or at reduced cost) to the population at large, whether through state health service or charity.

This already occurs with education, which requires a vast investment of time and money, but offers such great benefits that society is willing to foot the bill. The competition issue is often raised with regards to education – if one group is able and willing to take these drugs, do they have an unfair advantage over those who do not? A problem with this line of reasoning is its comparison of education to a zero-sum game such as competitive sports. In sport, if one person has an advantage, everyone else is negatively impacted as they are less likely to win. In education, however, the goal is not to “win”, but rather for everyone to learn as much as possible, with a better educated workforce tending to benefit society as a whole. There is still the issue of perceived competition and coercion – if society gets to the point where most people are benefiting from smart drugs, those who are not taking these drugs may feel pressured into doing so. Is this fair to those who, for issues of health, ethics, or religion do not want to ingest these drugs? If not, is the unfairness sufficient reason to restrict smart drug usage in the whole population, or to pass legislation preventing employers making hiring decisions on basis of smart drug use?

This coercion issue becomes more complex still when considering those whose job performance can seriously impact others’ lives. A recent study headed by Prof. Barbara Sahakian at Cambridge suggests that sleep deprived doctors may perform significantly more effectively at certain cognitive tasks after taking modafinil, and therefore could be more effective at their jobs when taking the drug. In an ideal world doctors would always get enough sleep, but in the real world modafinil may offer a way to reduce medical errors and improve the lives of patients. If this is the case, should doctors be encouraged or even required to take modafinil when tired? One can extend this reasoning to other professions that are relied upon to make important decisions when deprived of sleep, such as pilots and politicians. Is the risk of side effects outweighed by the risk to patients, passengers, and citizens posed by cognitively compromised decision-makers?

As with the public debate surrounding many drugs, both legal and illegal, the discussion of smart drugs is often typified by moral panic, political posturing, and a poor understanding of the science involved. News outlets are often content to discuss amazing miracle-pills or evil mind-destroying drugs, without seriously considering the risk/reward ratios of putative cognitive enhancers, and how they compare with existing methods. If modafinil and similar drugs continue to become more popular, the individual and societal ethical issues surrounding them will grow in importance. A sober and rational consideration of these issues is critical if policymakers are to make informed decisions on the topic, rather than simply following the knee-jerk reaction of the tabloid press. The questions posed above aren’t trivial, but finding acceptable solutions to them could be highly beneficial to society; if modafinil and future smart drugs can be harnessed appropriately, many people would be able to perform better at their jobs, be more productive, and have more fulfilling lives. Hopefully the novelty and potential risks of these drugs won’t completely overshadow the potential benefits.

 

Further reading:

 

Homeopathy, celebrities and marketing

By Lee Turnpenny

Photo by Philippa Willitts

Those who subscribe to the cult of homeopathy tend to be afflicted with a continually confused attitude to the concept of evidence. On Weds 25 November 2009, the House of Commons Science and Technology Sub-Committee convened for an Evidence Check on Homeopathy. Amongst the ‘witnesses’ was Dr Peter Fisher, Clinical Director and Director of Research at the Royal London Homeopathic Hospital (now the Royal London Hospital for Integrated Medicine). Dr Fisher unashamedly described the process of succussion (forward to 11:06). In case you’re not familiar, this is the action of vigorously shaking/striking a vial of liquid in order to activate the memory of a substance (ie, the ‘remedy’) that has been diluted out of it, whilst simultaneously detoxifying the effects of all the other stuff the water will inevitably have come into contact with (because water is promiscuous stuff).

The Government Response to the Committee’s report concluded overall that:

By providing homeopathy on the NHS and allowing Medicines and Healthcare products Regulatory Agency licensing of products which subsequently appear on pharmacy shelves, the Government runs the risk of endorsing homeopathy as an efficacious system of medicine. To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy. Homeopathy should not be funded on the NHS and the MHRA should stop licensing homeopathic products.’

However, despite this concurrence, the Government then weasel-y left it to Primary Care Trusts to decide whether to continue wasting NHS funds on homeopathy, under the sopping guise of patient ‘choice.’ (Homeopathy enjoys sympathy among MPs – including from the Secretary of State for Health.)

The majority of homeopathic products licensed by the MHRA are registered under a 1992 Simplified Scheme that prohibits ‘indications’ – ie the associated description of disease/conditions, and medical/therapeutic claims thereon. These MHRA regulations on the advertising of medicinal products thus inform the Advertising Standards Authority, which on 1 March 2011 widened its scope to encapsulate marketing/advertising on UK websites. And thereafter received copious complaints about the online claims made by an array of homeopaths/homeopathy organisations (to the extent that it requested abeyance). The ASA contacted the complained-of advertisers – and those UK bodies that represent homeopaths and homeopathy. Its letter explicitly states:

‘You must remove any content from your website that claims directly or indirectly that homeopathy and homeopathic products can diagnose/treat/help health conditions.’

This letter (well worth a read, by the way) also informed addressees that their sites were under surveillance, with three months in which to comply with guidance on the marketing of health-related products and services, as stipulated by the Committee of Advertising Practice (CAP).

During British Homeopathy Awareness Week back in June last year I took umbrage with various homeopathy organisations’ cheap, egregious, fallacious resort to endorsement by celebrity, including (to take just one) the British Homeopathic Association. The British Homeopathic Association’s ‘Celebrity Photography Project’ comprises quite fetching images of partaking celebs ‘… holding the source material of one of the homeopathic medicines that has helped them’ . If I’ve piqued your interest then, rather than take up word space here with quotes, I urge you to peruse for yourself this Goof’s Gallery.

I’m sure these celebrities are being ‘genuine’, in that they believe what they say. (After all, they subscribe to a belief system for people who like to feel all “Speh-shull.”) But I found this puzzling. Doesn’t that ASA letter apply to ‘… those bodies that represent homeopaths and homeopathy in the UK…’? Which must surely, I figured, encapsulate the British Homeopathic Association. Indeed, the Association’s website proudly boasts:

The British Homeopathic Association exists to promote homeopathy practised by doctors and other healthcare professionals.’ (My emphasis in bold.)

I therefore decided to flag this up to the ASA, because, to my eye, these celebrities are not only making/implying ‘… claims directly or indirectly that homeopathy and homeopathic products can diagnose/treat/help health conditions’; but they also imply ‘indications’ for these products, the majority of which are listed as registered under the MHRA Simplified Scheme (which prohibits indications). The ASA letter contains a paragraph I find particularly pertinent here:

Please note that testimonials from patients (which must be genuine) that imply efficacy for homeopathic treatment do not constitute substantiation but may give a misleading impression that efficacy is proven. Therefore it is essential that any testimonials also only make general references to an improved sense of well-being.’

Clearly, these celebrity statements constitute patient testimonials which imply efficacy for (unsubstantiated) homeopathic treatments. It appears to me that this project overall constitutes website content that (at the very least) ‘… claims directly or indirectly that homeopathy and homeopathic products can diagnose/treat/help health conditions.’ Which, to reiterate, are ‘Claims you cannot make’ under the CAP Code, as applies to advertisers, ‘… as well as those bodies that represent homeopaths and homeopathy…’.

The ASA declined to pursue this apparent anomaly. I had also written to the MHRA, whose guidelines also prohibit celebrity endorsement, but was informed (even though the remedies named by the celebrities marry with product names in its registration listing) that it only concerns itself with direct advertising of specific homeopathic medicinal product.’ As the BHA is not itself selling products, its celebrity endorsement falls outside the MHRA remit, as it constitutes promotional material, and on which it suggested I contact… the ASA. However, the ASA is likewise adamant that this complaint does not come under its remit (in apparent contradiction of its own letter) because the British Homeopathic Association is not itself directly supplying or transferring goods. So much for acting in the public interest.

Why does the British Homeopathic Association (and many other homeopathy-promoting bodies) seek testimonials, or mine for quotes, by celebrities? Just when does ‘raising awareness’ become ‘promotion’ become ‘advertising’? Although NHS support for homeopathy is on the wane (as of the end of last year, only 15% of PCTs were continuing to fund it), public money on this inefficacious ‘rubbish’ continues to be wasted, as chief medical officer Professor Dame Sally Davies recently reminded the CST committee. And in order to circumvent the ASA’s imposition on the advertising of their wares, homeopaths and homeopathy organisations such as the British Homeopathic Association have resorted to the patronising logical fallacy that is the appeal to celebrity (presumed) authority. Although the British Homeopathic Association does not itself (as far as I am aware) supply products and services, it represents – and promotes indirectly on behalf of – those homeopaths/homeopathic product providers who do. As the latter are covered by the ASA remit and can no longer legitimately advertise, the British Homeopathic Association is, it seems to me, exploiting a loophole – through the under-the-radar guise of ‘awareness-raising’ celebrity testimonials, which, in my opinion, are in contravention of the CAP Code.

As if a ‘senior homeopath’ spouting aqueous nonsense without compunction to a parliament committee is not ridiculous enough. What we have here, in effect, is a situation wherein, if you sell or provide certain dubious products and/or services, but are barred from making claims as to their efficacy, you can happily watch your representative umbrella organisation, which does not itself directly supply/sell/provide those products/services, make those claims indirectly on your behalf. Hence this permitted proxy-promotion of indication-prohibited, homeopathy products through a bunch of docile celebrities. A snake-oil-lubricated loophole.

www.leeturnpenny.com
First published in The Leicester Secularist,  (Jan 2013: see: http://www.leicestersecularsociety.org.uk/newsletter/index.php).