Category Archives: Philosophy of Medicine

Raising the threshold for pain: Gene transfer, gene enhancement, or gene doping?

In this paper, co-authored with Professor House MD PillsMike McNamee from Swansea University,  we address the question whether it can be ethically justifiable to seek gene transfer to raise one’s own tolerance to pain in a therapeutic and in an elite sports context. As a case study we analyse a currently recruiting Phase 1 study that seeks to transfer Vascular Endothelial Growth Factor to treat pain in patients with peripheral artery disease, but that could plausibly be applied also in an elite sports context. We presented this paper at the International Association for Philosophy of Sport, Porto, Sept 12-15, 2012.

Camporesi S, McNamee MJ (2012) ‘Gene Transfer for Pain: A tool to cope with the intractable, or an unethical endurance-enhancing technology?’ Life Sciences, Society & Policy Journal 8: 20-31 doi:10.1186/1746-5354-8-1-20

You can read the full paper free of charge here.

Is fMRI the new ‘pain-ometer’?

In “Considering the lobster”, David Foster Wallace wrote: “Since pain is a totally subjective mental experience, we do not have access to pain except our own“. That was the year 2004. What has changed in our access to pain experiences (ours and of others) since then? Is it still true that we cannot have any kind of access to other people’s pain? fmri_scan

This paper is part of a special issue of the journal entirely devoted to ‘pain’ which includes many other contributions spanning from philosophy, biology, psychology, neurology, physiology, ethics, and the law. In this contribution we assess the implications of brain imaging techniques – in particular, functional MRI- to make pain visible, measurable and, to some degree, verifiable, and therefore to serve as a new kind of scientific evidence in the numerous legal claims of chronic pain where the jury has to assess the truthfulness of the claimants.

Read more on this: my post for the Centre for the Humanities & Health blog.

Camporesi SBottalico BZamboni G. (2011). Can we finally ‘see’ Pain?: Brain imaging techniques and implications for the lawJ Consciousness Studies, 18(9-10):257-276.

Choosing deafness with preimplantation genetic diagnosis: should it be permitted?

While screening and choosing for a ‘disability’ remained a theoretical possibility only a decade ago, it has now become reality. In 2006, Susannah Baruch and colleagues at John Hopkins University published a survey of 190 American preimplantation genetic diagnosis (PGD) clinics, and found that 3% reported having the intentional use of PGD “to select an embryo for the presence of a disability” (deafness or dwarfism).

Photo by William Duke for the NYTImes

Photo by William Duke for the NYTImes

In this paper I analyse the real case of genetically deaf parents seeking in vitro fertilization and PGD in the US to choose ‘children like themselves’, i.e. to choose to implant an embryo carrying the mutation for genetic based deafness.

The debate on using PGD to choose what kind of children to bring into the world has been monopolized by the discussion of the different notions of ‘disability’ and by the related topic of the treatment/enhancement distinction. Framed this way, different definitions of disability seem to imply different normative judgments about parental reproductive choices. I here adopt a different perspective, as I shift the debate from the level of ‘disability’ to that of ‘impairment’, and argue that choosing deafness withPGD is morally wrong, without claiming that deafness is a disability. I frame the issue in terms of justice toward the future children and limitation of a reasonably broad array of different life plans. I also support my view in terms of the balance between self-determination of parents within their sphere of reproductive freedom and their determination of future children.

Camporesi S. (2010): ‘Choosing deafness with pre-implantation genetic diagnosis: an ethical way to carry on a cultural bloodline?’ Cambridge Quarterly of Healthcare Ethics 19(1): 86-96.