Thursday, October 13, 2016

Hunger in the USA


This paper provides research into the causes and supporting circumstances of hunger in the U.S. It will look at the number of people that fall into the category of food insecurity, the factors that may present a common link; socioeconomic status, environmental, race, regional, etc. The programs and corrective measures currently in place are analyzed for their effectiveness to rectify the situation. It seeks to point out the flaws in the current measures and explores a potential government lead initiative to end hunger in the U.S.

Keywords: strategies, food security, food insecurity, very low food security, low SES

Hunger in the USA

By Todd Claunch

Finding a way to bring about an end to the hunger and malnutrition that many Americans face on a daily basis should be a priority in this country. In a country of plenty we have overlooked the obvious that “world hunger” does include us. For decades, we as Americans, have been involved in providing financial aid and support to feed the starving and malnourished beyond our borders. The scale of suffering from hunger is not as dramatic in the United States as it is in many other countries. To come up with a workable solution to end hunger throughout the world, we must be able to come up with a viable solution here at home. There are many factors that are involved in creating an environment of hunger. Look at the programs or corrective measures that are currently in place to assist or rectify the situation of those that fall into this category.

In researching the statistics and data on this paper it was apparent that the numbers of those classified as experiencing hunger varied greatly from source to source. This identified another problem in tackling hunger in the U.S., being able to agree on the population to target for relief. So how is hunger defined in the U.S.? The USDA defines hunger as food security and food insecurity. Hunger is not measured by the USDA because it is a subjective experience that varies from an individual experience. The USDA established the definitions for food security in 2006 ( For the purpose of this research those who fall into the classification of “very low food security”, will be the population that is examined.

It is virtually impossible to separate poverty from hunger. In the U.S., approximately 43 million people live below the poverty line making up the majority of that number is approximately 25 million between the ages of 18-64. 6.3 million, households are classified as having very low food security, with 30% of this number represented by children living in single parent dwellings. There are 12 states that exhibit higher than average rates of very low food security; Mississippi is #1 at 21%, but represented in this list is states from the northeast, southeast, southwest, midwest, and south ( In looking at the statistics provided we can see that hunger is directly related to poverty, with the largest percentages represented by the households with the greater number of mouths to feed and the fewest bringing in an income. Also demonstrated by the statistics; is that hunger does not discriminate by age nor is it restricted to a particular part of the country.

A low socioeconomic status is a key predictor of recurrent food insecurity. Higher than average proportions of households and individuals earning a low income and having achieved lower educational levels experience very low food security on a more frequent basis than the rest of the population. Approximately 60% of low SES households do not report experiencing food insecurities (, p. 2-2, 2-3). Research has shown that the answer to this may lie in the economic and food assistance that these households receive something that will be discussed later in this paper. Similar to poverty and hunger, there is a common theme between SES and race. African American, Native American, and Hispanic households experience food insecurity at a higher rate than white households. Food insecurity is experienced by 25% of African American households with Hispanic households at approximately 23% (, p. 2-4, 2-5). The research has determined that poverty is the main factor in causing hunger. While low SES and race play a role in those who experience food insecurity at a higher rate than others it must be realized that hungers only preference is that of poverty. The point that must be taken from the research thus far is that hunger is more prevalent in the lower levels of poverty. Based on this it can be stated that poverty is the common link to hunger in the U.S.A.

Since congress sought to put in place a safety net in 1946, to feed the hungry in the U.S. assistance has been the major objective. There are 15 federally funded programs under the direction of the USDA to provide assistance to those who qualify as food insecure. Supplemental Nutrition Assistance Program (SNAP), a subset of this program Women, Infants, and Children (WIC), School Meals, and Child and Adult Care Program are a few of them (, p. 4-3, 4-4, 4-5). There are thousands of programs that serve are public funded that serve the hunger on a local level. On a micro-level there is assistance provided by neighbors who collectively gather food goods to deliver to another neighbor who may be experiencing hard times. These programs assist the food insecure in purchasing or by giving them food. The problem with the programs is that they do not enable the individual or the household to become independent in securing their own food. One of the main problems with assistance can be seen in the political partisan turmoil that SNAP is currently caught in. On Nov. 1 2013 an automatic financial cut to this program was set to take place. President Obama extended funding for this program through 2014 ( This program is still caught up in the legislative wrangling of a partisan congress. When individuals and households have to rely on financial support that they do not control their security is in doubt and those who fall into the very low food security classification are left teetering on the brink of starvation.

The strategies that have been discussed and in some cases implemented as permanent corrective measures for food security haven fallen short. Raising wages for low wage and minimum wage earners has been the go to fix for decades. There are many problems that exist with this plan to end hunger. Foremost, one has to be employed to reap the benefits of raised wages. For minimum wage earners getting a raise probably means exceeding their allowed asset privileges to maintain government assistance. In their case an increase in salary is takes them a step back in income. Many businesses that hire low-wage earners could not afford to stay in business if they had to pay higher salaries. Fostering job growth is another initiative that is often brought up in the discussion on poverty. It is true that more good paying jobs would decrease the amount of people in the U.S. that have food insecurities. Communities can offer reduced prices on land, tax incentives, and infrastructure improvements to attract industries and businesses to their location. These industries are going to place a high value on pre-skilled labor and/or educated workers. In many cases, the jobs brought to the community will go to people already employed who is willing to relocate for a better salary or job. The economic increase brought about in the community from the industry or business will drive up property value, food prices, and other related material costs. This will leave the majority of those who the jobs were intended for in an even more insecure position. If your community is isolated like a former coal mining town where there is a small labor force and transportation costs will be a factor it will be difficult to entice an industry or business to move in. Many urban settings face the same dilemma just under a different set of circumstances. Cities that are segregated due to SES will not be able to attract certain industries or businesses. If they do attract new business they face a loss of housing to make room for the economic venture and rise in the cost of the remaining housing. Many of the newly created jobs will not go to those they were intended for.

In conclusion, creating jobs and employment in the areas of a high prevalence of food insecurity and not fostering jobs is what is needed. The government needs to take the lead role in this solution. Instead of providing financial assistance it needs to assist in creating financial independence. Federal money can be provided to each state based on the statistics concerning poverty and food insecurity. Road, federal and state building, and other infrastructure projects can be developed by each state. Rather than bidding federal and state projects out, which in many cases go to companies that are not within the state where the work is being done, it will be completed on a local level. The state will employ the labor determined to need the job, in the community that the project is being done. If that labor force is not sufficient then it will employ those in the immediate surrounding communities. This will require changes in laws and additional legislation. Salaries can be determined based on the cost-of-living by state. Those who need jobs will not be the only ones who benefit economically. The precedent has already been set and the effect already measured. It will be reminiscent of the projects put in place to bring America out of the Great Depression by President Roosevelt’s administration. Instead of spending federal tax dollars on assisting people it can be spent in making people self-sufficient and make a great stride towards ending hunger in the U.S.A. There will still be those who require assistance but on much smaller and manageable level.


Feeding America. (2015). Hunger and Poverty Facts and Statistics. Retrieved from:

Jarrett, V., & Munoz, C. (2013). The Whitehouse President Barack Obama. Working to End Hunger in America. Retrieved from:

RTI International Center for Health and Environmental Monitoring. (2014). Current and Prospective Scope of Hunger and Food Security in America: A Review of Current Research. Retrieved from:

Abuse of Assisted Suicide in Oregon

Diane Coleman
President and CEO of Not Dead Yet

One of the most frequently repeated claims by proponents of assisted suicide laws is that there is “no evidence or data” to support any claim that these laws are subject to abuse, and that there has not been “a single documented case of abuse or misuse” in the 18 reported years. These claims are demonstrably false.

Regarding documented cases, please refer to a compilation of individual cases and source materials pulled together by the Disability Rights Education and Defense Fund entitled Oregon and Washington State Abuses and Complications.

(For an in-depth analysis of several cases by Dr. Herbert Hendin and Dr. Kathleen Foley, please read Physician-Assisted Suicide in Oregon: A Medical Perspective.)

The focus of the discussion below is the Oregon Health Division data. These reports are based on forms filed with the state by the physicians who prescribe lethal doses and the pharmacies that dispense the drugs. As the early state reports admitted:
“As best we could determine, all participating physicians complied with the provisions of the Act … Under reporting and noncompliance is thus difficult to assess because of possible repercussions for noncompliant physicians reporting to the division.”

Further emphasizing the serious limits on state oversight under the assisted suicide law, Oregon authorities also issued a release in 2005 clarifying that they have no authority to investigate Death with Dignity cases.

Nevertheless, contrary to popular belief and despite these extreme limitations, the Oregon state reports substantiate some of the problems and concerns raised by opponents of assisted suicide bills.

Non-terminal disabled individuals are receiving lethal prescriptions in Oregon

The Oregon Health Division assisted suicide reports show that non-terminal people receive lethal prescriptions every year.

The prescribing physicians’ reports to the state include the time between the request for assisted suicide and death for each person. However, the online state reports do not reveal how many people outlived the 180-day prediction. Instead, the reports give that year’s median and range of the number of days between the request for a lethal prescription and death. This is on page 7 of the 2015 annual report. In 2015, at least one person lived 517 days; across all years, the longest reported duration between the request for assisted suicide and death was 1009 days. In every year except the first year, the reported upper range is significantly longer than 180 days.

The definition of “terminal” in the statute only requires that the doctor predict that the person will die within six months. There is no requirement that the doctor consider the likely impact of medical treatment in terms of survival, since people have the right to refuse treatment. Unfortunately, while terminal predictions of some conditions, such as some cancers, are fairly well established, this is far less true six months out, as the bill provides, rather than one or two months before death, and is even less true for other diseases. Add the fact that many conditions will or may become terminal if certain medications or routine treatments are discontinued – e.g. insulin, blood thinners, pacemaker, CPAP – and “terminal” becomes a very murky concept.

The state report’s footnote about “other” conditions found eligible for assisted suicide has grown over the years, to include:
“… benign and uncertain neoplasms, other respiratory diseases, diseases of the nervous system (including multiple sclerosis, Parkinson’s disease and Huntington’s disease), musculoskeletal and connective tissue diseases, cerebrovascular disease, other vascular diseases, diabetes mellitus, gastrointestinal diseases, and liver disease.”

Overall in 2015, 7 percent, or 68 individuals, had conditions classified as “other”. In addition, it should be noted that the attending physician who determines terminal status and prescribes lethal drugs is not required to be an expert in the disease condition involved, nor is there any information about physician specialties in the state reports.

The only certifiers of non-coercion and capability need not know the person

Four people are required to certify that the person is not being coerced to sign the assisted suicide request form, and appears capable: the prescribing doctor, second-opinion doctor, and two witnesses.

In most cases, the prescribing doctor is a doctor referred by assisted suicide proponent organizations. (See, M. Golden, Why Assisted Suicide Must Not Be Legalized, section on “Doctor Shopping” and related citations). The Oregon state reports say that the median duration of the physician patient relationship is 12 weeks. Thus, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.)

The witnesses on the request form need not know the person either. One of them may be an heir (which would not be acceptable for witnessing a property will), but neither of them need actually know the person (the form says that if the person is not known to the witness, then the witness can confirm identity by checking the person’s ID).

So neither doctors nor witnesses need know the person well enough to certify that they are not being coerced.

No evidence of consent or self-administration at time of death

In about half the reported cases, the Oregon Health Division reports also state that no health care provider was present at the time of ingestion of the lethal drugs or at the time of death. Footnote 6 clarifies this point:
“A procedure revision was made mid‐year in 2010 to standardize reporting on the follow‐up questionnaire. The new procedure accepts information about time of death and circumstances surrounding death only when the physician or another health care provider is present at the time of death. This resulted in a larger number of unknowns beginning in 2010.”

While the only specific example mentioned is the “time of death,” other “circumstances surrounding death” include whether the lethal dose was self-administered and consensual at the time of death. Therefore, although “self administration” is touted as one of the key “safeguards”, in about half the cases, there is no evidence of consent or self-administration at the time of ingestion of the lethal drugs. If the drugs were, in some cases, administered by others without consent, no one would know. The request form constitutes a virtual blanket of legal immunity covering all participants in the process.

Pain is not the issue; unaddressed disability concerns are

The top five reasons doctors give for their patients’ assisted suicide requests are not pain or fear of future pain, but psychological issues that are all-too-familiar to the disability community: “loss of autonomy” (92 percent), “less able to engage in activities” (90 percent), “loss of dignity” (79 percent), “losing control of bodily functions” (48 percent), and “burden on others” (41 percent).

These reasons for requesting assisted suicide pertain to disability and indicate that over 90 percent of the reported individuals, possibly as many as 100 percent, are disabled.

Three of these reasons (loss of autonomy, loss of dignity, feelings of being a burden) could be addressed by consumer-directed in-home long-term care services, but no disclosures about or provision of such services is required. Some of the reported reasons are clearly psycho-social and could be addressed by disability-competent professional and peer counselors, but this is not required either. Moreover, only 5.3 percent of patients who request assisted suicide were referred for a psychiatric or psychological evaluation, despite studies showing the prevalence of depression in such patients.

Basically, the law operates as though the reasons don’t matter, and nothing need be done to address them.


The Oregon assisted suicide data demonstrates that people who were not actually terminal received lethal prescriptions in all 18 reported years except the first, and that there is little or no substantive protection against coercion and abuse. Moreover, reasons for requesting assisted suicide that sound like a “cry for help” with disability-related concerns are apparently ignored.

Thus, the data substantiates problems with the implementation of assisted suicide laws and validates the concern that the risks of mistake, coercion and abuse are too great. Well-informed legislators on both sides of the aisle should vote against assisted suicide bills.

Thursday, October 6, 2016

Baby Market in Belgium

Stephanie Raeymaekers attended a trade fair for would-be gay dads in Brussels where surrogate mothers were called “carriers” and egg donors “genetic material contributors”. A child's right to know his or her parents was almost completely overlooked. 

BRUSSELS -- For the second time around a surrogacy fair organised by the American company Men Having Babies landed on Belgian soil. This time it took place in a slightly more upscale venue. The ground floor at The Brussels Hilton became a stage where 220 potential customers from 12 European countries were welcomed.

Like last year, I was present. Me: the first in our generation to provide adults with a semi-biological child. It was the start of a lucrative business when fertility doctors discovered that the techniques used on a pig farm could also be useful for infertile heterosexual couples.

From the 1950s Belgian wombs were being filled with the sperm of unknown men. Fertility techniques improved and not much later they tapped into new target groups: single women and lesbian couples.

Branding unwanted childlessness as discrimination and injustice, several branches of the LGBT community are lobbying for gay men and transgender women to have biological children of their own.

Last Sunday almost everything was on offer: interpreters, gadgets, price lists, different formulas, the dos and the don’ts… But most of all, straight-to-your-heart-and-into-our-wallet sales pitches from companies which are able to connect anyone directly with eggs, surrogacy agencies and lawyers to make “a dream come true”. Lawyers handed out the metaphorical road map with instructions on how to by-pass laws to get your purchased child(ren) “legally” in your own country.

Towards an ethical framework

This year Men Having Babies also presented an “ethical framework” to convince opponents of their sincere and honest intentions. They claim to be a non-profit organization aiming to provide tools and means for gay men to pursue their right to have a biological family. The fact that their biggest sponsors happened to be the very fertility centers and law firms that pitched to the 220 attendees wasn’t viewed as a conflict of interest.

Surrogacy was described as “the act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give the child to the intended parents at birth”.

I have a very different perspective. I would describe it as the outsourcing of a personalized pregnancy that aims the trading/adoption of a donor-conceived child to those who ordered it whilst paying a fee for expenses.

New terms were launched to keep the transactions as business-like as possible: the surrogate mother was called “a carrier”, the egg donor “a genetic material contributor”. Some agencies also offered a money-back guarantees(no kidding) and “Multiple Cycle Package” deals.

Several times speakers advised against adoption. They said that nowadays there are not many young children to adopt and the probability that the mother may decide to keep “your” child is too great a risk. Surrogacy, once again, brought salvation.

Speakers strongly advised the participants to use eggs from a woman other than the surrogate, because the birth mother will then be more likely to give up the baby.

An enforceable 50-page contract also offers reassurance that you can take the child home with you after it is born. The contract even allows payments to stop if the surrogate does not comply with the terms of the contract. I must also mention that many contracts have a non-disclosure clause: they prohibit women from speaking publicly about any malpractice they endured.

A lot of time and attention was spent on the topic of conceiving as healthy a child as possible. Gender selection is included in this “service”. My consternation was huge when a fertility doctor asked the audience who would chose to abort a child with a defect. Most hands went in the air. Just for the record: abortion can also be enforced by contract.

Belgian hypocrisy

Apart from “I want my child to be as healthy and perfect as possible”, discussion of the welfare of the child was – as it is in Belgium – limited to the legal uncertainty that is created when there is a legal conflict between genetic lineage and legal parenthood. Only twice (and very briefly) were the right of the child to knowledge of his or her ancestry and identity mentioned. But these were immediately countered by economic and practical arguments.

Once again certain Belgian politicians have sought the media limelight to express their personal disgust regarding this event. Yet their dismay is hypocritical. They refuse to acknowledge that similar practices are taking place all the time in IVF clinics with the same ethical framework to justify them. Apparently a policy is ethical when the price is low, transparency is not needed and fancy brochures are not being handed out.

An ethicist once told me that something is not ethical when someone’s action harms another. Isn’t the intentional creation of a human being who has been deprived of vital information about themselves and a meaningful relationship with their biological family harmful? In my view the only ethical standard that needs be applied when considered whether or not to allow surrogacy and donor conception.

As disgusted as one might be by the American event, it is time to reflect, and to acknowledge that for decades we Belgians have been violating human rights on own soil when we enabled the commercialization of “Plan B parenthood” at the expense of children who are conceived to fulfil the dreams of an adult.

Stephanie Raeymaekers is the chair of Donorkinderen, a Belgian organisation that promotes cross-border registration of donors and the right of donor-conceived persons to know their parentage. The above article is reproduced from the Donorkinderen blog.

Related reading: Abducted Babies For Sell

Monday, October 3, 2016

Ethical Concerns Surrounding Animals

Animal rights demonstration in Malaysia
Alice C. Linsley

Concern about animal welfare and treatment is a old as Mankind. Early human populations depended on animals for food, hides and for implements that they made from antlers and hoofs. Humans developed a special relationship with some species, especially dogs.

An early animal rights advocate, Arthur Schopenhauer (1788-1860), wrote, “The assumption that animals are without rights and the illusion that our treatment of them has no moral significance is a positively outrageous example of Western crudity and barbarity. Universal compassion is the only guarantee of morality."

In our exploration of the topic we find a range of viewpoints on the value of animals, animals rights, animal protection, and the use of animals in biomedical experimentation. Here are some points upon which there is general agreement.
  • Animals have value.
  • Animals should be provided with basic necessities for survival: food, water, access to fresh air and protection from dangerous weather conditions.
  • Animals used in biomedical research should be treated as feeling beings and their suffering should be minimized.
Peter Singer takes a position that is sometimes described as anti-speciesism. In this article, Theron Bowers MD, takes issue with Singer's position:
Animal right activists often exhibit a stunning insensitivity to human tragedy. Animal liberation is routinely compared to slavery or the women’s rights even though no one would suggest a radical difference between blacks and whites or men and women. Over the last few years, the increasingly shrill People for the Ethical Treatment of Animals (PETA) have compared the victims of the Holocaust to animals kept in warehouses or killed. Whatever sympathy Holocaust on a Plate ad may bring for chickens, can such campaigns do anything but trivialized human suffering?

Such rhetoric may be mere attention-grabbing, hyperbole. However, the race card and Nazi bogeyman also reflect a popular rational basis for animal rights articulated by Princeton University bioethics professor, Peter Singer. Singer argues in Animal Liberation (1973), the Magna Carta of four-legged freedom, that the belief in the inherent dignity of human beings is speciesism and no more rational than racism. Of course the implication is that since racism is evil then the belief in human dignity is also evil.

Singer is not alone in the halls of our academies. Earlier this year, London School of Economics sociology professor Alasdair Cochrane published a paper contending that the concept of human dignity should be removed from bioethics. Cochrane at least avoids dragging in the KKK but attacks the claim that only and all humans have inherent moral worth as “unhelpful and arbitrary.”

If human dignity is only a crazy, cruel fiction, what happens when we dump the myth?

The English philosopher Thomas Hobbes (1588-1679) viewed humans as brutish beasts. To avoid mutual destruction, Hobbes proposed establishing security through cooperation. His solution was a social contract whereby individuals agree to a strong government (monarch) which keeps us from tearing each other apart. Hobbes’ account of humanity emphasizes our animal nature, yet his social contract assumes that humans can reason with one another, something animals cannot do.

Aristotle viewed the human as a political creature whose highest good is to seek his own holistic fulfillment. This too sets the Human apart from other animals.

Hobbes believed that the parent has authority over the child, not because the parent begat the child, but because the child consents to be cared for by the parent. By consenting to parental authority the child receives protection, material provision, training, guidance, nurture and perhaps sufficient bounty to make a marriage. We find in Hobbes’ view the beginnings of children’s rights. Later Jeremy Bentham (1748-1832) adapted this principle in his promotion of animal rights. Instead of regarding animals as inferior to humans because of their inability to reason, Bentham held that the capacity of animals to suffer that gives them the right to equal ethical consideration. Because animals suffer, their welfare is relevant to humans.

Saturday, October 1, 2016

The Failed Promise of GMOs

Pollan speaking at Yale in 2011

Alice C. Linsley

Last night I sat through a 2-hour presentation by California journalist, Michael Pollan. Most of the talk was a rehash of what he has written in his various books. However, one thing he said struck home. He spoke about the failed promise of GMOs to reduce hunger in America and globally.

The Food and Drug Administration has given approval to a limited number of genetically modified crops, including corn, soybeans, canola, alfalfa, and sugar beets. All of these are crops favored by the American industrial agricultural system which essentially is controlled by 6 big businesses. One suspects that a great deal of money has passed through various hands.

Pollan spoke about how GMOs serve that system by making it possible to increase the number of plants per acre. The increase does not come in the plant's yield.

Most Americans are wary of GMOs, but probably not for the right reasons. Our concerns should be directed toward the industrialization of American agriculture which has had the effect of reducing the variety of crops available to Americans. The smaller family-operated farms of the past were much more diversified. They had crops and animals and although they used a great deal of petroleum-based energy, they also used what was available on their land: natural fertilizers, decomposed organic material, etc.

In the conversation about GMOs we must face the reality that the promise to reduce hunger in American has failed. 

Tuesday, September 20, 2016

First Child Euthanized in Belgium

A terminally ill minor has become the first child to be euthanized in Belgium since age restrictions were lifted in the country two years ago, according to several sources.

A Belgian lawmaker told CNN affiliate VTM that the physician-assisted suicide happened within the past week.

The child, who was suffering from an incurable disease, had asked for euthanasia, Sen. Jean-Jacques De Gucht told VTM. The identity of the child and age are unknown.

"I think it's very important that we, as a society, have given the opportunity to those people to decide for themselves in what manner they cope with that situation," said Gucht, a supporter of euthanasia legislation.
Read it all here.

Saturday, September 17, 2016

Two Perspectives on Female Circumcision

The World Health Organization reports that more than 200 million girls and women currently have been subjected to female genital mutilation/cutting worldwide, and three million girls continue to be at risk each year. Vicenzo Puppo, an Italian sexologist, argues in the journal Clinical Anatomy that this “is a violation of human rights and must be abandoned”. In his article, he outlines various strategies to change what he describes as a cultural rather than religious ritual, especially the creation of alternative rites of passage for young women.

Coincidentally, Australian bioethicists argue in the leading journal Bioethics that Female Genital Cosmetic Surgery for adolescents should be permitted if they insist upon it. Merle Spriggs and Lynn Gillam discuss labioplasties for girls with body dysmorphic disorder. Patients with this condition can be so distressed by the appearance of their genitals that 21% to 44% are said to commit suicide.

So while the minor operation may not be physically necessary, “‘medical necessity’ should be interpreted broadly, and should include reduction of psychological distress just as much as restoring physical function”. From an ethical point of view, they say, this is not a controversial principle. A number of other common procedures do not restore health, but apparently reduce anxiety: C-sections, contraception, sterilization, laser surgery for short-sightedness, puberty- suppression treatment for an adolescent with Gender dysphoria. A similar argument is made for justifying abortion.

One strong objection to permitting adolescents with BDD to have genital cosmetic surgery is that they will subsequently move the focus of their distress to some other aspect of their appearance. But given that the surgery is minor, “The possibility that a condition may reappear after surgery, is not in itself a good reason not to do the surgery in the first place.”

Spriggs and Gillam note that this is a “counterintuitive” conclusion and one which made them feel uneasy initially. However, “this outcome shows the power of ethical reasoning. If pursued thoroughly, using the available evidence and working from first principles, it is similar to the scientific method, in that it leads to a logical conclusion, regardless of what one might have expected at the outset.”

Read more here.