blog.bioethics.net

MercatorNet Calls It Evidence-Based Ethics. I Call It Bogus Intuitionism.

Sometimes you just have to call it like you see it. I was intrigued to see that the third most popular post on the "bioethics" blog MercatorNet was entitled, "Who's the real expert?" and I was astonished to learn a multitude of answers ranging from, unsurprisingly the Pope, an epidemiologist hailing from Spain with a MPH and "doctorates in Medicine and Biostatistics and Epidemiology", and of course, the interlocutor from MercatorNet.

An expert in what you might ask? Ethics? Sure. Public health? You bet. The spread of HIV/AIDS and other STDs in Africa? Bingo! The interview with Dr. Jokin de Irala focused on prevention strategies for the spread of AIDS in Africa and to my astonishment the claim was so simple:

"any public health specialist who is aware of the epidemiological data knows that no major HIV epidemic in the world has been curtailed with programs centered on the the promotion and distribution of condoms."

I must have missed that day while I was earning my PhD in public health at Johns Hopkins.

How do we know that? The Pope told us so: "the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem."

It turns out that the ABCs of AIDS prevention--Abstinence, Be Faithful, and Use Condoms--actually doesn't need the "C" at all. Not at least, if you ask the Catholic Church. You just need AB's. Yet for all of Dr. Jokin de Irala's talk about "evidence-based ethics"--he cites no data whatsoever about the impact of doing away with condoms on the spread of HIV in nation's where condoms aren't part of the message.

Dr. Jokin de Irala relies upon a simple intuitionism about how abstinence means no risk of transmission and how being faithful embodies Christian values rather than citing any data at al. However, what we know about actual human behavior--real evidence about what people actually do--is that people will engage in sexual intercourse and absent condoms they will contract HIV in high prevalence countries. Absent education about how to use those condoms, they are likely to contract HIV and the epidemic will continue to spread. To believe anything else is only to contribute to the problem.

Such naivete about human behavior is a disservice to the African people and people around the world. Despite Dr. Jokin de Irala's claim that "many scientific experts have in fact said exactly the same as what the Pope is conveying...the Pope is being in fact more scientific than many of his critics," there is no evidence that the Church is directly responsible or that A and B alone without C makes people better off. And to see that MercatorNet is spreading this message to millions as though it is scientific fact is truly disheartening.

So before MercatorNet makes any further claims to "evidence-based ethics", I suggest that it actually puts some kind of data behind its claims.

Summer Johnson, PhD