I am fairly new to this world of feminist analysis. I have always believed in equality between men and women and I have always been incredibly grateful to those who went before me so that I could go to university, earn a good salary, buy my own house, wear trousers, play sport, etc etc. But I am new to world of scrutiny, and figuring out where I stand on certain topics when it comes to women’s place in society*.
One such topic that has always baffled me is the world of strip clubs. On one side, it is blatant objectification, robbing women of any sense of personhood, with men seeing them merely as sparkly (or oily) objects twirling around a pole, with no interest in their personality, their history, their hopes… the things that make them human and differentiate them from the tables they pile their dollars on. Surely there has to be something wrong with that.
On the other side is the fact that for most female strippers (though I haven’t done any quantitative analysis on this), their job is their choice. No one is forcing them up there, in fact for some, it is something they enjoy. A friend of mine took up stripping once, albeit temporarily for one or two shifts, because she wanted the validation and to feel sexy. I can only assume since she quit so early, that is not what she received, though I’m sure others might. And certainly, they have the opportunity to make good money. Shouldn’t I be excited about this? Women, a career, earning money in a job they choose, perhaps even financial independence – it’s everything feminism fought for!
Except that it’s not. I have a theory, and this is very fluid so it might be different week to week, that the reason there are so many female strippers (in comparison to male strippers), is not because women are not ‘visual’. I, and many other women included, love the male body. Arms, backs, chest, butts, penises… it’s all great! I might not necessarily want to see a man sliding up and down a pole to the pussycat dolls, but the appreciation of the male form is just as strong as it is for men of females. The reason there is a market for female strippers and not for male strippers is because of the balance of power in society.
Regardless of the choices available to me as a young woman in Australia, there are still gross inequalities between men and women. Women still earn around 80 cents for every dollar that men earn over a lifetime. Male university graduates earn $5,000 more than women first year out. We hold 8 per cent of board directorships and 10 per cent of executive management positions. We still carry the burden of around two thirds of unpaid work and caring duties. Nearly one in five of us will experience sexual assault, one in three will experience some kind of family or domestic violence in our lifetimes. This is just in a forward thinking nation like Australia, let alone the third world where women are denied health care, education or careers. Men still hold the power.
And reducing a person to a mere object, whether they agree to it or not, seems to be a simple extension of that power. We are not comfortable seeing men as submissive to women – in work they ‘should’ earn more, in sport they ‘should’ perform better, in crises they ‘should’ be stronger. Perhaps the women that take jobs as strippers are those that accept the power distribution in society. “Women are seen as less valuable than men and I can use this to my advantage.” It makes being objectified an achievement – something that should concern both men and women alike.
I don’t mean to cast judgement on strippers, or those who watch them. Im simply perplexed by why there are so many more women than men in the profession.I don’t buy the idea that it is a result of market forces where women simply don’t enjoy seeing naked men. Ideas?
In a recent article on the Daily Life, Alecia Simmonds looks at the problems of screening foetuses for disabilities. She makes a strong argument, and brings together a lot of the criticisms of disability screening. Most importantly, she briefly looks at the idea that making an informed decision on whether or not to have disabled child is not actually a choice with equal options. If society does not support one option, if life will be more difficult financially, if it will strain the relationship with your partner, if people will see your choice as a ‘tax burden’, if the majority will consider your choice foolish, then really, what choice do you really have?
But she also throws in a bit of hyperbole to her essay. In referring to a German study which found that 90% of women whose foetuses were diagnosed with Down Syndrome terminated the pregnancy, Alecia says “as a society we are on a nightmarish quest for biological perfection and crushing normality.”
I would consider a nightmarish quest for biological perfection to be the kind seen in Gattaca, where we choose our child’s eye colour, their height, their intellect, their athletic ability (which many of us already do, in choosing a mate. We don’t choose who we are attracted to, but surprisingly, it’s not the disfigured midgets who cant pass an IQ test or catch a ball that are getting all the dates). Choosing not to give birth to a child that will lead a significantly impaired lifestyle is hardly in the same category. These children may well lead happy lives, but they are not ignorant to the things they will miss out on in life. Choosing to bring them into a world where most will be deprived of many simple pleasures like steady work, independent travel, relationships or a family of their own, when they had the option not to, could almost be considered cruel.
Of course, saying this in public is always a dangerous thing to do. Alecia sums it up here:
“I once told Toby that I was helping an academic with some research on the politics of aborting foetuses with disabilities. ‘But that’s ridiculous’ he scoffed. ‘That’s like saying I shouldn’t have been born’. He laughed, but beneath it you could see the hurt. The unspeakable agony and outrage of being told that the world would have been better off without you.”
Because people think that if you are pro-disability screening, you are making a statement that disabled people are better off never having been born. That the world would be better off without them.
If disability screening was allowed, Toby may not have been born, correct. But let’s not forget that at the time he may have been aborted, he wouldn’t have been ‘Toby’. He would have been an unnamed zygote. Or a foetus. Which to many, many people, is not that dissimilar from any of the other sperms or eggs that are expelled during masturbation or menstruation. Just like the woman who chooses an abortion because it will interfere with her career, or she is unable to support a child, or it will interfere with her general lifestyle, Toby could have been terminated because the life he will lead will automatically put the woman, and the child itself, at a disadvantage. ‘Toby’ could instead, be the next ‘healthy’ foetus. The next sperm and egg to combine that will not enter the world immediately set up for a life of challenges and hurdles that will affect everyone around him.
It may be a societal problem that disabled people are not well enough supported, and it is a pity that they are not, but it is a fact. Most parents do not have the time and resources to adequately care for a disabled child.
I do not believe the world is better off without disabled people – in fact, I think the diversity makes the world a more colourful, wonderful place. Disabilities people make society more tolerant, more accepting and kinder. They teach all of us about perseverance and overcoming challenges and contribute to a society of humility and humbleness. Many people with disabilities are also capable of incredible feats – the Paralympics certainly proved that and there are countless examples of artists and geniuses who battled with disability.
But there should be no obligation to bring a disabled child into the world, nor should there be resistance against disability screening. Is it taking the easy route? Yes. But why shouldn’t we? Raising a child is hard enough as it is. Why should we be expected to accept the random chance that it will be one hundred-times harder? We may love them unconditionally. They may even be one of the lucky ones who can live close to a normal life. But aborting a foetus that will be born disabled causes no more harm than aborting one who will get in the way of your career. Choice allows us to be selfish. Not all people will be. We accepted it in the 1960s with birth control. Why not accept it now?
And so go the slogans perched high on US billboards advertising a sterilisation program run by Project Prevention. The not-for-profit organisation offers addicts $300 cash to be sterilised, in an attempt to reduce the number of babies born addicted to drugs. In 2010, Project Prevention spread from the US into the UK, and as was reported, expects to be in Australia ‘real soon’[i].
To many it is simply a eugenics program, preventing the ‘undesirables’ of society from breeding. But those involved see it as a public service, improving the lives of drug addicts, who they say don’t usually want to be pregnant in the first place, and preventing harm to newborn babies.
But sterilisation is always a touchy subject because it was, for a period, the tool of eugenics movement[v]. Sterilisation of ‘undesirables’ was quite common in the 1920s in the US, UK and even Australia, but when the Nazi’s took it too far with the whole mass genocide thing, eugenics quickly fell out of favour. There are countless ethical issues that could be discussed, but for this post I will focus on what would happen legally (since laws are meant to be a reflection of a society’s morals) if Project Prevention expanded to Australia.
Today, sterilisations are freely available to competent adults, but the issue here is whether or not drug-dependent adults can be considered ‘competent’ and whether paying cash to addicts is financial coercion.
Since the addicts are being rewarded with cash, it is likely that they will use that money to purchase drugs. In Sydneyfor example, a payment of $300 would buy a whole gram of heroin, enough for 10 hits[vi]– an offer perhaps too good for an addict to refuse. The logic follows that if an addict would sacrifice anything to get their next hit, their ability to voluntarily consent is in question. It is based on the presumption that drug addicts have little regard for the fact that they are forfeiting their ability to have children, instead focusing only on their desperation to secure their next score.
However, one study found that 43% of ‘hard-core’ heroin users were employed with steady incomes[vii]. There is also the argument[viii] that we cannot consider financial coercion relevant since the heroin addict could get $300 in other ways. Even unemployed addicts are still capable of getting another hit through different means – they will have done so for months or even years before the offer from Project Prevention. Since the addicts face a choice – between sterilisation for money, or using their normal methods – it cannot be argued that the addicts were coerced. It is also unlikely that $300 is enough of an incentive to outweigh the large decision of never being able to have children, though whether this is rationalised in the decision process is uncertain and a matter of competency.
Competency refers to the ability to understand and assess consequences of decisions. The most widely accepted model for testing such competence is the Macarthur Model[ix] which requires all of the following:
1. The ability to understand a choice
2. The ability to appreciate a choice
3. The ability to rationally manipulate information
4. The ability to communicate a choice.
The question is, do addicts have these capacities while intoxicated or in withdrawal?
One argument is that addicts are always within two frames of mind: intoxicated, or in a constant state of craving, both which cloud their ability to consent[x].This idea of the overwhelming power of cravings and withdrawal is supported by the idea that heroin addiction by nature involves a loss of ability to resist the desire for heroin[xi]. As the famous Cynthia’s dilemma [xii] goes, “if you’re addicted to heroin, by definition you can’t say no to the stuff.”
The argument is that heroin addicts care too much about the benefits of the sterilisation (the cash). In a similar way, depressed people are often deemed incompetent for medical procedures because they care too little about the risks (who cares if I die?). The idea is that addicts cannot rationally weigh the risks and benefits of the trial, since “their sense of value is so warped and biased by addiction.[xiii]
It is a valid point, but in Australia, the courts have often stated that addiction does not make you incapable of decision making and thought-processing. For example, in R v Henry Barber Tran Silver Tsoukatos Kyroglou Jenkins, Chief Justice Wood stated that “the need to acquire funds to support a drug habit is not an excuse to commit an armed robbery, and of itself, not a matter of mitigation.” [xiv]
“Individuals do emerge from addiction. They do so with difficulty and generally need significant amounts of help. The decision to persist with an addiction, rather than to seek assistance, is also a choice.”
If the courts maintain that addicts have a choice in deciding whether or not to conduct robbery to fund their addiction, it follows that it they are capable of consent to other decisions, even if it results in money for their next hit.
Some may argue that addicts could be considered mentally ill- addiction does cause significant physical changes to the brain for example. However, section 16.1 (k) of the Mental Health Act (NSW) states that having taken alcohol or drugs does not make a person mentally ill. It’s almost a pity because if they were classified as mentally ill they would be covered by section 68 (a) which says that: the prescription of medicine to a person with a mental illness or mental disorder should meet the health needs of the person and should be given only for therapeutic or diagnostic needs and not as a punishment or for the convenience of others.
And isn’t that essentially what Project Prevention is going? Punishing addicts for their decisions in life, for the convenience of the rest of us who have to pay for the treatment, and care for, their potential children.
In summary, under current Australian case law and legislation, there is nothing that overtly criminalises the payment of drug addicts to undergo sterilisation. Addicts are not afforded the protections given to the mentally ill, their decisions regarding their actions are considered a choice by the courts and they are considered autonomous agents with rights and liberties.
This is not to say however that the courts would not assess the scenario differently in terms of its social consequences. The project makes the underlying statement that babies born to addict mothers are better to have not been born at all. It is for a similar reason that the courts disallow wrongful birth claims (after all, who wants to live in a society where parents can bring law suits to say that their child is better off dead? Oh right, Americans…)
*This looks solely at the legality of sterilisation in Austrlian law. It should be noted that Project Prevention also offers long term birth control to addicts, but with reduced payments.
[i] Carey, A. 2010. Charity `preys on weak, addicted`. The Age, Australia. Available: http://www.theage.com.au/national/charity-preys-on-weak-addicted-20101019-16sjp.html?from=age_sb
[ii] Black, K., Stephens, C., Haber, P., and Lintzeris, N. 2012. Unplanned pregnancy and contraceptive use in women attending drug treatment services. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 52(2): 146-150
[iii] National Institute of Drug Abuse.2011. Topics in Brief: Prenatal expose to drugs of abuse. National Institutes of Health, United States. Available: http://www.drugabuse.gov/publications/topics-in-brief/prenatal-exposure-to-drugs-abuse
[iv] Sawine, J. 2010. Drug addict sterilised for cash – but can Barbara Harris save our babies. The Telegraph,UK.
[v] O`Neill, N and Peisah, C. 2011. `Sterilisation` in, Capacity and Law. Sydney University Press, Australia. Available: http://www.austlii.edu.au/cgi-bin/sinodisp/au/journals/SydUPLawBk/2011/
[vii] Faupel, C.E. 1988. Heroin Use, Crime and Employment Status. Journal of Drug Issues, 18 (3): 467-479
[viii] Foddy, B. And Savulescu, J. 2006. Bioethics, 20 (1): 1-15. Available: http://www.neuroethics.ox.ac.uk/__data/assets/pdf_file/0013/16060/Foddy_and_Savulescu_-_Addicts_Consent.pdf
[ix] Hoge, S., Bonnie, R., Poythress, N., Monahan, J., Eissenberg, M. And Feucht-Haviar, T. 1997. The MacArthur Adjudicative Competence Study. Law and Human Behaviour, 21 (2): 141-179
[x] Charland, op cit
[xi] Charland, L. 2002. Cynthia`s Dilemma: consenting to heroin prescription. American Journal of Bioethics, 2 (2): 37-47
[xii] Ib id, p.37
[xiii] Ib id, p. 40
[xiv] R v Henry Barber Tran Silver Tsoukatos Kyroglou Jenkins  NSWCCA 111 (12 May 1999) Available: http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/nsw/NSWCCA/1999/111.html?stem=0&synonyms=0&query=mental%20illness%20addiction
I always imagined myself trudging up foreign mountains behind a smiley, toothless Sherpa named Lakhpa or Nawang. Disappointingly, here in Colorado my Sherpa has all his teeth and his name is Derek. And by Sherpa, I mean the hiking enthusiast I met at the hostel. Sometimes things don’t go exactly as planned.
Regardless, Derek is about 30 and speaks with the Canadian gait I’ve come to love, pronouncing every letter and relying on ‘eh’ for questions, comments, and straight up salutations. The affection might also stem from the fact that, as well as leading me up a gruelling 26km hike in theRocky Mountains, he’s also agreed to be my scientific guinea pig.
I suspect that only a Canadian would be so enthusiastically helpful as to pop on a heart rate monitor without asking why. Before us looms the demanding Long’s Peak summit and I’ll be monitoring him, and myself, for the effects of altitude on our bodies. The hike is a 26km roundtrip and the summit towering 4346 metres above sea level, just over half the size ofMount Everest.
As a fitness fanatic, the effect of altitude has intrigued me since I first read about the curious 1968 Mexico City Olympics. In short distance athletic events like sprinting and long jump, world records were decimated. But in endurance competitions, some international champions couldn’t even make the distance. Ron Clarke, an Australian who had set 17 world records collapsed and almost died from altitude sickness in the 10,000 metre final.
Why? The answer was up in the air – literally.Mexico Citysits 2,240 metres above sea level, the highest summer Olympic Games in history.
As Derek and I begin the trek we’re feeling good – my heart rate hovers around 150 beats per minute (bpm), his at 140. The walk is tough, even more so since we started in the darkness of 4am, and the breaks frequent. But as we get higher and my altimeter clocks 3000, my breath starts getting noticeably shorter and my heart starts beating faster. The altitude has begun to take its toll.
On Earth, whether you are perched atop Mount Kilimanjaro, or draped across the white sands of the Whitsundays, any given volume of air is comprised of 79% nitrogen, 20.9% oxygen and 0.1% other gases. But as you rise higher and higher above sea level, the pressure of the atmosphere decreases and although the proportions stay the same, the number of molecules in the air decreases.
This is due to the effects of gravity, which works to keeps molecules close to the ground. As you reach higher altitudes the gravity is weaker, enabling the molecules to drift further apart from one another. While the composition of the air stays the same, the expansion means that the air is ‘thinner’ – so at higher altitudes you inhale less oxygen and nitrogen molecules with each breath than you would at sea level.
Scientists have determined that at heights above 2,400 meters, we inhale approximately three quarters of the amount of oxygen molecules that we would at sea level. By the time we reach the summit of Long’s Peak, Derek and I will probably only be taking in half the amount of oxygen that we would at sea level. On the tip ofMount Everest(8,848m above sea level) hikers inhale only a third of the amount of oxygen they would at sea level, enough to kill them.
Although mentally I’m just feeling incredibly unfit as we reach the half-way mark, inside me the lack of oxygen is driving a cascade of physiological responses. To begin with, my body has increased its heart and breathing rate to up the amount of oxygen molecules taken in and circulated in my bloodstream. This explains my skyrocketing pulse, which my monitor tells me is up to 182 bpm.
My head is also starting to spin and nausea has set in. Im certain I didn’t drink last night, but the effect of altitude is the equivalent of a wine-fuelled, my-best-friends-wedding-was-the-night-before hangover. As I soldier on, I can’t tell if I’m hallucinating or if the number ‘191’ on my heart monitor is laughing at me.
The scientific verdict is still out, but some researchers believe altitude sickness is a result of the brain swelling from a lack of oxygen. A recent study atStanfordUniversityshowed that ibuprofen, a common anti-inflammatory drug, can significantly reduce the incidence of altitude sickness by reducing swelling in the brain. But in the name of science (or perhaps stupidity) we persist without.
By the time we reach the three-quarter mark, I’m starting to wish we had decided to make this an overnight trip – given enough time, my body would begin to acclimatise to the altitude. More than 200 genes are activated when we acclimatise, including one that increases the production of red blood cells, thereby increasing the amount of haemoglobin in the blood.
Haemoglobin is the protein that binds oxygen molecules to red blood cells. The more haemoglobin in the blood stream, the more efficient the cells will be at carrying oxygen around the body. This means that even though less oxygen molecules are making it into the lungs, it is more easily transported to the muscles.
Once acclimatised, the rapid breathing would also reduce the amount of carbon dioxide in the blood, lowering its acidity. To counter this, the kidneys release blood bicarbonate to try to balance the PH level. It sounds like something from a vampire’s cookbook but blood bicarbonate is the primary source of protection for muscles against lactic acid – the waste that builds up during exercise and leaves muscles feeling stiff and sore.
The down side for Derek and I is that many of these physiological responses can take days, even weeks, before they kick in. As I’m considering it, a quick, woozy look around at the barren mountainside with its jutting cliffs and gnarled tree branches reminds me it’s not really ideal.
It’s hard to believe since I’m almost doubled over trying to keep my head from swimming, but sport scientists around the world have found that athletes actually become more efficient after altitude exposure. Researchers have shown that being acclimatised to altitude means our bodies are able to use less oxygen to do the same amount of work. More than that, they’ve translated their findings into a training regime.
Many athletes from low altitude countries do short stints of ‘altitude training’ overseas in places likeArizona,KenyaorSwitzerland. Here at home at the Australian Institute of Sport, athletes do stints in a man-made ‘altitude house’ which simulates high elevation by changing the composition of the air within the house to approximately 85% nitrogen and 15% oxygen. The air is not thinner, but the presence of less oxygen is physiologically equivalent to being at altitude.
According to the Head of Physiology at the AIS, Professor Chris Gore, the house allows Australian athletes to simulate what other countries have already.
“This way we get similar benefits to what we would get from natural altitude by flying the athletes to train in sayEurope, but without having to sacrifice their access to their physios, doctors, nutritionists, friends and family,” Professor Gore said.
“By living in the house for 12 hours or so a day, the athlete’s red blood cell counts increase, their haemoglobin increases. As well, their muscle buffering capacity, ability to handle lactic acid and their efficiency also improves. They can then use these factors to their advantage in training and competitions,” he said.
“Overall, we’re talking about a 1-2% increase in performance, which mightn’t sound like much, but can be the difference between a medal and failing to qualify.”
But the effects don’t last forever. For example, Professor Gore quotes a study where Kenyan runners who lived and trained in high altitude all their lives were taken to a low-altitude region ofGermanyto train. After six weeks, the runners had lost 5% of their haemoglobin showing a relatively fast de-adaptation.
“The verdict is still out, but we’re looking at benefits lasting for between 2-4 weeks for sea level athletes who return to normal sea level training.”
For Derek and I, the benefits are far beyond even our oxygen-deprived imaginations. After eight hours, we’ve made it to the summit and our celebration is marked by food and a nap sprawled on flat, sunshine-soaked boulders. I’m certainly not feeling up to Olympic standards, but my head feels clear. Perhaps it’s the giddy euphoria of making it to the top, or a very concerning lack of oxygen, but I’m starting to think that perhaps my real calling in life is as that toothless Sherpa I’d always imagined.
Abortion is a crime against society.
This is not philosophical or religious rambling. This is the law in NSW. In 2012. In a secular country. Where women have rights.
Under the Crimes Act NSW, terminating a pregnancy can technically land the woman and her doctor in jail for up to 10 years. This is irrespective of how far along the pregnancy is, be it four weeks, or 32.
Division 12, section 83 states:
“Whosoever unlawfully administers to any woman, whether with child or not, any drug or noxious thing, or unlawfully uses any instrument or other means, with intent in any such case to procure her miscarriage, shall be liable to imprisonment for ten years.”
And yet, abortions are still accessible, with more than 130,000 performed in Australia each year.
In ACT, there are no laws governing abortion. In Victoria, abortions are only illegal after 24 weeks, following legislation to decriminalise the procedure in 2008. But in NSW they are illegal from day one. The result is that every single woman has to go in to a clinic with a readymade defence against the law. And that defence is called necessity.
As examples, in the criminal system you can use necessity to get out of speeding fines (if you need to get home to help a grandparent having a heart attack) or trespassing on a building site (because you heard screaming). In NSW, a woman must prove that she needs to have an abortion for the sake of her mental, physical or social wellbeing.
Simply not wanting a child is not enough. Women must be asked why they need an abortion and their responses must be recorded. If you cannot prove that you need an abortion, it is illegal for the doctor to go ahead.
Largely the system isn’t too impeding for women seeking abortions since most people have no problem citing career, financial hardship or immaturity as a need. Abortions may be freely available, this is not a huge social problem, but it is unnecessary and shows a lack of political courage for any party in NSW to step up and rectify an outdated law.
Feminists fought hard for women’s bodies to be recognised as their own – they choose how to dress it and who to sleep with. And yet we still don’t have the freedom to choose whether we want a child. Abortion is still not recognised as a choice, we still need to justify our decisions on the basis of need.
As an example, if someone plants an acorn in your backyard that will turn into a huge oak tree (that will cost you thousands in fertiliser to care for it properly, will affect your plumbing systems, and ruin your favourite social activity of backyard cricket) , you do not have to justify why you do not ‘need’ that massive oak tree once it has been planted. If you don’t want it, you can simply pick up the acorn and toss it aside. Why can’t we have the same freedom with our own bodies?
The NSW legislation needs to reflect that it is ok for a woman to simply not want a child. It is not a matter of need.
I cant imagine abortion ever being a simple decision. It is a fraught, complex, personal decision that should be made in consultation with a woman’s doctor and usually, her partner. But it should definitely not be a crime.
*In a future topic I will discuss the lack of men’s rights in reproductive law and as food for thought: in no jurisdiction is a woman required to tell her sexual partner of a pregnancy, or abortion.
In the wake of worldwide concerns about unsafe breast implants, an article yesterday reported one woman’s struggle with a ruptured implant seeping silicon into the rest of her body. And yet, far from sympathy, the initial response of many, including myself, was ‘well it serves you right for getting implants’. Is it tall poppy syndrome? Is it the feminist in me that finds it reprehensible to alter body parts that are uniquely feminine to conform to societal (and often male) preferences? Or is there something ethically wrong with cosmetic enhancement?
Enhancing ourselves is not something confined to physical appearances, and in many cases there are ‘natural’ methods of improvement and ‘non-natural’ methods – the difference between say eating healthily vs having liposuction.
In sport, athletes can improve their performance through rigorous training and diet regimes. Or they can see vast improvements through the use of drugs like steroids and blood doping techniques.
In education, students can spend days upon days studying and revising, sacrificing socialisation, leisure and anything else demanding your time. Or they can find an unethical doctor to provide ADHD medication to increase their focus, or take drugs to keep them awake all night the night before to achieve similar results without sacrifice.
We would be quick to say that using drugs to advantage in sport competitions is unfair*. But the lottery of genetics doles out unfair advantages all the time: Kenyan runners naturally have higher red blood cell counts, similar to effects of blood doping, from training at high altitudes; African runners are generally born with a bone structure that makes them naturally more gifted at sprinting**; and champion swimmer Ian Thorpe is born with huge size 17 feet that help propel him in the water.
So we can accept that people excel at sport thanks to their luck in the genetic lottery, but not if they win with the assistance of ‘unnatural’ manipulation. But why? As Savulescu argues, allowing performance enhancing drugs would actually level the playing field and make competition MORE equal. “The result will be that the winner is not the person who was born with the best genetic potential to be strongest… The winner will be the person with a combination of the genetic potential, training, psychology, and judgment [on which drugs to use, how much etc].” ***
To go back to breast implants and undergoing invasive surgery to increase your attractiveness, some people ‘win’ the genetic lottery and develop large, perky breasts, some people ‘lose’ and develop almost no breasts, or asymmetrical breasts… or simply breasts that don’t look like those on the women society emulates – models, porn stars, actresses.
So is getting breast implants just a way to level the playing field? If everyone got them, would mate selection actually be based on ‘the beauty within’ and the ‘personality that counts’? Is increasing your façade of sexual attractiveness ‘cheating’? I don’t want to generalize here so I will confine myself to my own opinions, but I can accept that some people are incredibly attractive as a result of genetic lottery, but I take issue with people who undergo invasive surgery to improve their lot. Not everyone thinks this way, but a lot do – if not about fake breasts, then about drugs in sport or academic testing.
So, why do we reward the genetic lottery and not enhancements?
My theory is that we revere people who are ‘freakishly good’. If it was possible for anyone to run 100metres in 9.5 seconds, if only they tried harder, we would all try, we would all work hard. Because who doesn’t want to be stunningly beautiful? Who doesn’t want to be the world’s fastest man? In our tall-poppy society, we would rather the elite be naturally talented, so that nothing we can do (drugs included) could enable us to compete. So it is better to bestow a mystical quality to them to explain why they get the glory and not us – it helps us ‘normal’ beings to cope with being somewhat inferior.
It also seems fair that some people are gifted because it was luck. Luck to be born beautiful, luck to be born athletic. As if all the humans on earth were lined up next to each other, and every 130th person was given a special talent or advantage. Everyone had an equal chance. And that means, that at the end of the day, it could have been you. Luck is the check to keep the whole herd in balance – a tool for acceptance that true equality in unsustainable – and that if you’re not the ‘chosen one’ it was just the luck of the draw – not that you are unworthy or inferior. Messing with the equilibrium by forcing advantage ruins that fallback for everyone.* “Anti-doping programs seek to preserve what is intrinsically valuable about sport. This intrinsic value is often referred to as “the spirit of sport”, it is the essence of Olympism; it is how we play true. Doping is fundamentally contrary to the spirit of the sport.” World Anti Doping Agency, 2009. http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-The-Code/WADA_Anti-Doping_CODE_2009_EN.pdf ** Savulescu, J., Foddy, B., and Clayton, M. 2004. Why we should allow performance enhancing drugs in sport. Journal of Sports Medicine, 38, (6). *** ibid
Recently, a young woman admitted to Melbourne’s Royal Women’s Hospital confronted a tragic dilemma and an even more tragic consequence. The woman, 32 weeks pregnant with twins, was informed that one of her twins suffered a congenital heart condition that would require years of operations – if he survived at all. On medical advice, she decided to terminate the unhealthy twin. During the abortion, the wrong twin was injected, and the healthy foetus was terminated. The mother was then required to have an emergency caesarean to abort the unhealthy foetus.
My maternal instincts may not yet have kicked in, but I can fully empathise with the horrible emotional tempest of loss, sadness and anger the family would be dealing with. But the thinker inside me questions how words like ‘dead’ and ‘killed’ are being thrown around, and what the legal ramifications for the hospital staff might be.
The media headlines so far include:
“Twins die in tragic hospital bungle”
“Hospital kills wrong twin in abortion, both babies now dead,”
“Medical bungle kills healthy foetus”
“Healthy twin dies in aborted bungle”
“Horror: 32-week unborn twins killed after hospital accidently aborts healthy baby”
(Keep in mind that the story would not have been news at all, if the procedure had gone successfully and only one foetus had been aborted. It is interesting to note, that one sick foetus’s abortion is a ‘termination’, while the other is a killing, a death, when in reality, both foetus’s were developmentally identical.)
If we accept the media’s account that the twin was ‘killed’ at the hands of another, then doesn’t it follow that the doctor then be charged with murder?
According to Sir Edward Coke’s 1797 definition of murder, a child in utero is not deemed a ‘reasonable creature in being’ until it is ‘born alive’.
The born alive rule maintains that a child can only be a victim of murder if the child has an independent existence from its mother. That is, death must occur after ‘the child is fully extruded from the mother’s body and is living by virtue of the functioning of its own organs’. This ‘born alive’ rule still prevails today in Australian law, despite being overturned inAmericaandCanada.
For example, in the 2003 case of R v King in New South Wales, a person deliberately caused the stillbirth of a pregnant woman by kicking and treading on her stomach. Under the born alive rule, the defendant was only charged with grievous bodily harm to the mother, not the murder of the foetus. 
So has a death occurred inMelbournetoday? If death is merely ceasing to exist, to function physiologically, then the foetus has died and someone should be responsible. But the foetus was fully-reliant on the mother’s womb, they certainly had no personality, arguably no intellectual capacity. Did they have a life per se to end? Although a future has been lost, has a life?
Under the born alive rule, there has been no death, at least of legal or ethical concern. The problem with the born alive rule is that there is almost no physiological or intellectual distinction between a near-term foetus and a newborn infant.
The story is heart wrenching, of that there is no doubt. But at least legally, the death is not of two people, but of two futures.
On a surgery table in an Indian warehouse just outside New Delhi, a local labourer lies face up on the table. Above him, a doctor wields a scalpel, hurriedly slicing through his abdomen to remove his left kidney. The operation means he will be at a higher risk of severe injury, high blood pressure and kidney abnormality for the rest of his life, but when the surgery is complete, he stuffs an envelope into his pocket, making him $1000 richer.
At the same time, a foreign tourist waits in the operating theatre of a nearby hospital for his transplant. Unable to find a suitable donor at home and running out of time, he has travelled to India on the assurance of a guaranteed match. For the organ alone, he paid $37,500. Hundreds of thousands of others like him bide their time on public waiting lists, until desperation pushes them to the same ends. And so continues the cycle of one of the most gruesome white-collar crimes to date.
Three years ago, Time magazine reported how Indian police shut down a black market organ transplant ring that had harvested kidneys from more than 500 Indian labourers, sometimes against their wishes, and sold them to cash-wielding foreigners desperate for transplants. In a situation where patients in the UK, USA and even Australia can die waiting for an organ, transplant tourism is a lucrative business. But the United Nation’s World Health Assembly forbids the sale of body parts. So why is it that paying for organs seems so intrinsically wrong – Is it simply because of the issue of exploitation? Would we still feel uneasy if there were a regulated market for organ sales? Is it ethical to pay people for body parts?
Professor Dame Marilyn Strathern asked that very question to a curious crowd at the Australian National University last night. As Chair of the Working Group on Human Bodies in Medicine and Research for the UK’s Nuffield Council on Bioethics, she is overseeing an inquiry into (amongst other things) remuneration options for organ donors – from free funerals to cold hard cash.
Illegal as it may be, black market organ trading is borne out of a global health issue – the worldwide scarcity of donated organs. Right now the fate of 80,000 people in the US alone rests on a waiting list for organ donations. Worldwide, the story is the same. As we deal with an ageing population and advances in medical treatments, more people would benefit from transplants now than ever before.
As a solution to the critical shortage, some scientists are investigating the use of animal organs to meet demand, while some countries and states (like Victoria and Western Australia) explore ‘opt-out’ systems for organ donations, where everyone is a donor upon their death by default unless they have legal documents stipulating otherwise. Another option, being considered by the Nuffield Council on Bioethics is the creation of a legitimate market for the sale of organs.
According to Professor Strathern there is a ‘meaningful absence of money’ in the donor-recipient relationship. When the gift is as large as a part of ourselves, the receiver has a need, an urge to reciprocate in some way. When there is no currency, and there is no way for recipients to ‘give back’, the debt can become a burden. Ethnographical studies have looked at participants’ attempts to relieve the debt, which include writing letters of thanks to donors, thinking of the donor daily, or feeling obliged to take care of themselves better. In some cases, recipients feel as if they cannot talk about their ‘ongoing medical misery’ since the others’ sacrifice is bigger.
Likewise, for families of people who require organs, there is a sense of obligation, guilt and duty to give up an organ, which can later lead to resentment. Even in cases when donors say they ‘didn’t even have to think about whether or not to donate’ one must consider the emotional coercion. Would any of us be willing to watch a loved one die because we didn’t sacrifice a non-vital organ?
What could prevent all of this however, is the availability of more organs, and the ability to pay for them, therefore eliminating the altruism from the act and warranting a sense of ‘justice’. The act of ‘give and receive’ is the basis of our economy and our relationships – when someone gives you a present, or invites you to a wedding, there is a sense of obligation to reciprocate. Organ donation is one of the few transactions where givers receive nothing in return. Whether or not true altruism exists is debatable, but the topic for another post. But as an example, in many donors there is a hope that their altruism will encourage the altruism of others, potentially to their benefit. (Professor Strathern used the example of a mother donating her kidney to a friend, with the expectation that if she needed one down the track, her two children would be able to donate).
In some countries, commercial systems and altruistic systems already exist side by side. In egg donation in the USA for example, women donate their eggs for research (often excess from IVF) for free, but can also sell eggs to infertile couples for high prices. Is money then, the currency needed to alleviate the expectations on family members, and the burden felt by recipients?
Joyce Robbins, co-director of the campaigning group Patients Concern argues that the act of paying is abhorrent.
“Paying the family of someone who has just died could tempt them to go against the wishes of a loved one at a time when they are most vulnerable.”
Remuneration by means other than cash are potentially the middle ground. Contributions to the donor’s funeral, or payments made to families after their death all avoid potential rash decisions by people needing quick cash. Unfortunately, they do not avoid Mrs Robbins concern of coercing people in vulnerable positions.
Unless the market is government regulated and subsidised by the health system, it also does little to alleviate the ethical concern that rich people will have quicker access to life-saving surgery, while poorer people depend on donations of friends and family.
In Iran, a commercial system overseen by Government is already underway whereby the donor of the kidney gets financial compensation from the Government and free health insurance for one year. In nine years, the waiting list for transplants has been obliterated. While no similar move is yet on the cards for Australia, the Nuffield Council report is due on October 11.