the Electric Monk

Prison is a brutal place designed to punish people for crimes they willfully committed. And yet a large portion of US prisoners are  mentally ill, many so ill that they are not fully rational.

Due to the nationwide lack of available community psychiatric services, prisons have become the primary treatment provider for the mentally ill. After being charged with a crime, mentally ill offenders enter a vicious cycle of incarceration, abuse, exacerbation of symptoms, and recidivism—and the treatment they do receive is almost universally sub par. Some argue that prison is absolutely no place for the mentally ill. Others contend that prisons are the only source of guaranteed treatment and supervision for the mentally ill in this country.

On what grounds should we imprison the mentally ill? If there are none, what are we committed to do?

–William Kowalsky

From where we stand in America, Africa seems so far away – an ocean and plagues of malaria, tuberculosis and tropical diseases away. Yet merely a hundred years ago, the southern United States had similar rates of malaria running rampant through its warm climate.

So what happened? The US eradicated malaria through mosquito nets and draining the swamps that bred infected mosquitoes. But what of Africa?  Dr. Lachlan Forrow discussed the issue in his seminar “Moral Responsibility and Health Disparities in the U.S. and Africa: Lessons from Dr. Albert Schweitzer” this afternoon.

Economically, it’s relatively cheap to prevent malaria using the same techniques that we used in America, and these techniques are known to be effective. So we have the measures to eradicate it – Dr. Forrow even mentioned a malaria vaccine that will be tested in a randomized clinical trial on March 31 – but the progress in Africa has not been anything like that experienced in the southern US.

So what is limiting us from helping Africa eradicate malaria? Are we morally obligated at all to help them?
–Asra Shaik

A couple would like to have children but they have a problem. In spite of many rounds of in vitro fertilization, they have been unable to conceive. They have been working with a particular ART clinic for 10 years now, and both the couple and the clinic are in a sticky situation. The mother and father are now in their 50’s and 60’s, respectively, and are determined to bear a child through the use of a donor egg and gestational surrogacy:  another woman will give birth to their child. However, the clinic has a policy to not perform ART procedures in cases where the mother is of advanced maternal age, 50 years old being the cutoff. Is it right for the clinic to deny the couple on this basis?

The theme of the 2009 National Undergraduate Bioethics Conference is “New Technology, New Ideas, New Challenges.”  The dilemma faced by the clinic is one of those new challenges. Dr. Lisa Lehmann, Director of the Center for Bioethics at Brigham and Women’s Hospital, presented this story during her seminar on “Ethical Challenges of Technology in Clinical Practice.” She had planned to discuss two other issues, but the seminar participants became engrossed in the dilemma of the older couple.

What if it was your decision whether or not to allow the clinic to help the older couple conceive through gestational surrogacy? Would you deny them the child for which they’ve waited so long? (Be careful, for if you deem people unfit to have a baby due to advanced age, why stop there?)
–Richard Blissett

Welcome to Electric Monk, a many-headed bioethics blog launched for the occasion of the 2009 National Undergraduate Bioethics Conference at Harvard University.