It is in the interests of employers not to have to pay their employees. It is in the interests of employers not to offer vacation time. It is in the interests of employers not to spend money on ensuring health and safety measures are complied with.  It is in the interests of employers to do many things that violate the rights of their employees and as a society we prevent them from doing these things because the benefit to the business (and the economy as a whole) does not outweigh the harm caused by the violation of those rights. Most people who are being treated for HIV are no less productive than any other worker – 58% of people with HIV believe it has no impact on their working life. [1]  [1] Pebody, Roger, ‘HIV health problems cause few problems in employment, but discrimination still a reality in UK’, aidsmap, 27 August 2009,


disease health general sex sexuality house believes employees should be compelled

All these worthwhile aims can be achieved without employees having to tell their employers of their HIV status on an involuntary basis. The scale of the problem can be easily inferred from national and regional medical statistics. For example, mining companies in South Africa have put in place excellent programmes to combat prejudice and treat sick employees without compulsory disclosure.


It’s in the interests of co-workers  It’s in the interests of other workers. The possibility of transmission, while very unlikely, is real and one they have a right to know about so as to be able to guard against it. While most of the time it will not be problem as transmission requires a transfer of bodily fluids this may occasionally happen in a workplace. [1] This is particularly true of healthworkers (e.g. doctors, nurses, dentists, midwives, paramedics, etc) who should have both a moral and a legal obligation to disclose if they are HIV-positive. Even outside the medical field industrial accidents may expose employees to risk. Employers have a duty to protect their workforce.  [1] Centers for Disease Control and Prevention, ‘HIV Transmission’, Department of Health and Human Services,


Tackling HIV requires a responsible and active position by everyone  Businesses ought to take a responsible and active position on HIV. The issue isn’t going to go away. Successful programs designed to help HIV-positive employees remain in the workplace for as long as they want to do so should be developed. Procedures for treating personnel with fairness and dignity must be put in place. The potential fears and prejudices of other employees must be combated. The beginning of that process is ensuring they know about the problem and, crucially, the scale of it. Without knowledge of the numbers involved, employers may put in place inadequate medical and pensions arrangements that will ultimately prove inadequate.


Some very few people may do this and it’s the job of the government to attempt to educate people about the enormous dangers of doing so to minimise that. Nevertheless, most people will quite properly prioritise their lives and health over their job, which in any case legislation should safeguard by stopping unfair dismissal.


Employers have a right to know about issue which will affect their business. An employee with a serious incurable illness which requires a large amount of medication to control is inevitably going to affect the business in a way that the employer will have to know about in order to work around it.  Aside from the fact that HIV status need not be communicated to co-workers, managers and employers already have a duty to prevent harassment and prejudice in any circumstances and this would not change.


The risks of ignorance and prejudice are too high  This measure could be actively dangerous for HIV-positive workers. Ignorance causes so much bad behaviour towards AIDS sufferers and HIV-positive men and women. A fifth of men in the UK who disclose their HIV positive status at work then experience HIV discrimination. [1] The proposition seeks to institutionalise and widen the shunning and ill-treatment of HIV-positive workers that already happens when people find out about their condition. Even if not motivated by prejudice, co-workers will often take excessive precautions which are medically unnecessary and inflame unsubstantiated fears of casual transmission.  In addition, many people who are HIV-positive choose not to reveal their condition for fear of violent reactions to them from their families and the rest of society. If disclosure to an employer is compulsory, then the news will inevitably leak out to the wider community. In effect, they will lose any right of privacy completely.  [1] Pebody, 2009


It is a disincentive to get tested in the first place  The requirement to disclose their condition if known would be a disincentive to get tested in the first place. This is especially the case for many people in places like sub-Saharan Africa, but also applies widely elsewhere. Their job is so important to them (since there’s no safety net to speak of if they lose it) that they’d prefer to go in ignorance of their HIV status than find out and risk being fired for it. The medical repercussions of that are obvious.


Employers have no right to private medical information  Employers have no right to know. This is an arena into which the state has no right to intrude, or to compel intrusion by others. Employers will know if their employee’s work is satisfactory or unsatisfactory – what more do they need to know than that? If employers find out, they might dismiss workers – which is exactly why many employees don’t want to tell them.  If workers are forced to disclose the fact that they have HIV, the merit principle will go out the window. Even if not dismissed, their prospects for promotion will be shattered – because of prejudice, or the perception that their career has in any meaningful sense been ‘finished’ by their condition (which is often not the case as sufferers can work and lead fulfilling lives after diagnosis; life expectancy after diagnosis in the US was 22.5 years in 2005 [1] ).  Even if not fired and career advancement doesn’t suffer, prejudice from co-workers is likely. From harassment to reluctance to associate or interact with the employee, this is something the employee knows he might face. He has a right to decide for himself whether or not to make himself open to that. Managers may promise, or be bound, not to disclose such information to other workers – but how likely is enforcement of such an undertaking? For these reasons, even problems with huge HIV problems like South Africa haven’t adopted this policy.  [1] Harrison, Kathleen M. et al., ‘Life Expectancy After HIV Diagnosis Based on National HIV Surveillance Data From 25 States, United States’, Journal of Acquired Immune Deficiency Syndromes, Vol 53 Issue 1, January 2010,


Employers can be trusted to use this information responsibly. They are already used to keeping sensitive information (e.g. about salaries, annual reports, or employees' addresses and telephone numbers) confidential. Nor is it in their interest to open themselves up to lawsuits for bullying and discrimination in the workplace. There is no reason to assume that businesses will be more likely to leak information about someone's HIV status than doctors or hospitals, who already have such information.


disease healthcare international africa censorship ip house would produce high

The use of generic drugs can sometimes fail to bring about a reduced price. For the cost of drugs to decrease, there must be competition within the industry to drive prices down. The switch from patented to generic drugs in Ireland failed to bring about any significant saving for this reason [1] . African countries must therefore ensure competition in order for generic drugs to become truly affordable which could be problematic due to continued protectionism in some states.  [1] Hogan,L. ‘Switch to generic drugs fails to bring expected savings for HSE’


Savings can be used in other sections of medical care  The decreased cost of pharmaceuticals allows African states to focus on other aspects of medical schemes. Pharmaceuticals are not the only aspect in treatment, there needs to be sufficient staff, medical equipment and infrastructure [1] . These requirements cost money, which the savings made on pharmaceuticals provide. In Europe, 50% of dispensed medicines are generic yet they cost only 18% of pharmaceutical expenditure, with a similar model predicted for South Africa. This allows the state to focus on other aspects of medical schemes [2] .  [1] Ibid  [2] Health24, ‘South Africans embrace generic meds’


It is nearly impossible to remove black markets; medication is no exception. Attempts thus far to remove the African counterfeit pharmaceuticals have been unsuccessful. Corruption and a lack of manpower have ensured that counterfeits continue to reach Africa, especially from India [1] . As long as there is a profit to be made, fakes and bad drugs will be sold at a lower price than even generic drugs on the African continent which have the addition of importation and tax in their cost [2] .  [1] Sambira,J. ‘Counterfeit drugs raise Africa’s temperature’  [2] Ibid


Easily affordable drugs will mean greater access  Generic drugs are much cheaper to produce, which is ideal for Africa’s struggling population. While there has been significant gross domestic product (GDP) growth in Africa, the actual distribution of wealth is relatively unequal. According to Afrobarometer, 53% of Africans still feel that their economic condition is poor [1] . This restricts their ability to purchase high cost drugs. Generic medication would reduce the price of these drugs, making them affordable to the average citizen. The patented drug Glivec, used for cancer treatment, costs £48.62 for 400 mg in South Africa while its generic equivalent (produced in India) costs £4.82 [2] . Increased access will result in higher levels of treatment, which in turn will reduce death rates from preventable diseases in Africa.  [1] Hofmeyr, Jan, ‘Africa Rising? Popular Dissatisfaction with Economic Management Despite a Decade of Growth’  [2] Op Cit


Greater access of generic drugs can increase the chances of overexposure and misuse. This has a detrimental effect on fighting diseases. Greater access will lead to higher use rates which, in turn increases the chances of the disease developing an immunity to the drug [1] , as is already happening to antibiotics resulting in at least 23,000 deaths in the United States. [2] This immunity requires new pharmaceuticals to counteract the disease which can take years to produce. It is therefore, disadvantageous to produce high quality generic drugs for Africa.  [1] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’ pg.2  [2] National Center for Immunizations and Respiratory Diseases, ‘Antibiotics Aren’t Always the Answer’, Centers for Disease Control and Prevention, 16 December 2013,


Pharmaceutical companies investing in R&D deserve to make a return on their investments. Research and development can take a long time and will cost significant sums of money. The cost of creating many new drugs was estimated to be as high as $5 billion in 2013 [1] . There is also a risk that the drug may fail during the various phases of production, which makes the $5 billion price-tag even more daunting. It is therefore necessary for these companies to continue to make a profit, which they do through patenting. If they allow drugs to immediately become generic or subsidise them to some of the biggest markets for some diseases then they shall make a significant financial loss.  [1] Herper,M. ‘The Cost of Creating a New Drug Now $5 Billion, Pushing Big Pharma to Change’


Reduce the prominence of bad and fake drugs  The increased availability of high quality generic drugs will reduce the numbers of bad and fake pharmaceuticals on the markets. The cost of patented drugs has forced many to search for other options. This is exploited by the billion dollar global counterfeit drug trade [1] . Fake drugs are the cause of around 100,000 deaths in Africa every year. Bad drugs, which are substandard, have also found their way in to Africa; one in six tuberculosis pills have been found to be of a poor quality [2] . The widespread introduction of low cost, high quality drugs will hopefully ensure that consumers do not turn to sellers in market places.  [1] Sambira,J. ‘Counterfeit drugs raise Africa’s temperature’  [2] Ibid


Unfair to apply same patent laws universally  It is unrealistic to expect poorer countries, such as those in Africa, to pay the same price as the developed world’s markets. Current patent laws for many countries dictate that prices for buying patented drugs should be universally the same. This makes it extremely difficult for African countries to purchase pharmaceuticals set at the market price of developed countries. In the US there are nine patented drugs which cost in excess of $200,000 [1] . To expect developing African states to afford this price is unfair and reinforces the exploitative relationship between the developed and developing world. Generic drugs escape this problem due to their universally low prices.  [1] Herper,M. ‘The World’s Most Expensive Drugs’


These vital drugs will become outdated. Diseases often have the ability to build a resistance to treatment, making many of these currently generic drugs impotent. In Tanzania, 75% of health workers were providing lower than recommended levels of anti-malaria drugs which resulted in a drug resistant form of the disease becoming prominent [1] . Giving recently developed drugs to Africa will have a greater impact against diseases such as HIV than giving them twenty year old drugs to which a disease is already immune.  [1] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’


Some countries, such as India and Thailand, have specialised in producing generic drugs. These states provide the majority of generic drugs to Africa. This removes the burden of other countries to supply Africa with their own drugs whilst potentially damaging their own research companies. India has managed to create a very profitable industry based around cheap generic drugs which it mainly exports to the African continent [1] , decreasing the necessity of other states to contribute vast resources.  Providing generics to Africa will not damage development by the big pharmaceutical companies as at the moment these countries cannot afford the drugs so are not a market. The drugs are researched on the assumption that they will be sold in the developed world. What matters therefore is to ensure that generics for Africa don’t get sold back to the developed world undercutting patented drugs.  [1] Kumar,S. ‘India, Africa’s Pharma’


Cheaper drugs aren’t trusted by consumers  The differences in price between generic and patented drugs can be disconcerting to those wishing to buy pharmaceuticals. As with other product, logic generally follows the rule that the more expensive option is the most effective. There are reports from the USA of generic drugs causing suicidal tendencies [1] . These factors, combined with the lower levels of screening for drugs in Africa, mean that cheaper drugs are generally distrusted [2] .  [1] Childs,D. ‘Generic Drugs: Dangerous Differences?’  [2] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’


Most vital drugs are already generic  Many drugs which are used in the treatment of HIV, malaria and cancer are already generic drugs which are produced in their millions [1] . This removes the necessity to provide further high quality generic drugs as there is already an easily accessible source of pharmaceuticals. Effective treatments for Malaria, in conjunction with prevention methods, have resulted in a 33% decrease in African deaths from the disease since 2000 [2] . The drugs responsible for this have been readily available to Africa, demonstrating a lack of any further need to produce pharmaceuticals for the continent.  [1] Taylor,D. ‘Generic-drug “solution” for Africa not needed’  [2] World Health Organisation ’10 facts on malaria’, March 2013


Dominance of generic drugs will reduce reinvestment and innovation in donating countries  The production of high quality generic drugs endangers pharmaceutical progress. In order to export high quality generic drugs, some countries have suggested allowing generic drug manufacturers access to patented drugs. In Canada, amendments to Canada’s Access to Medicine Regime (CAMR) would have forced pharmaceutical research companies to give up their patents [1] . This is problematic however as research based companies invest a large proportion of their profits back in to the industry. The requirements proposed for some Western countries for obligatory quantities of generic drugs to be given to Africa have been accused to removing any incentive to invest in research to combat disease [2] .  [1] Taylor,D. ‘Generic-drug “solution” for Africa not needed’  [2] ibid


Medically there is no difference between generic and patented drugs. They are both identical, with the exception of aesthetic differences in some US drugs to avoid copyright infringement. Generic drugs cost less because they do not have to invest in R&D [1] . They focus on efficient methods of production and ensure that their product can be sold at a competitively low price. The lack of a need for R&D is therefore more prominent than quality in the pricing of generic drugs.  [1] Stoppler,M. ‘Generic Drugs, Are They as Good as Brand Names?’


addiction healthcare international africa house believes ghanas ban smoking public

What those statistics mean could be questionable – did the ban make people stop, or only provide an extra incentive or assistance for those who already want to stop to do so? It could be suggested that this would simply lead to increased smoking within the home.  Even so, other measures could be more effective, if the goal is a simple reduction in smoking numbers.


Reduce smoking  A ban on smoking in public places would help reduce the rates of people smoking, by making it appear socially unusual – people will have to leave enclosed public places to smoke, each time they want to smoke. This is particularly important in Africa which is at an early stage of the tobacco epidemic where it can be prevented from ever coming to be seen as being normal.  The ban both through the new obstacle and the change in norms could reduce smoking rates. In England, nine months after such a ban, the fall in smoking rates (such as with much of the Global North) accelerated 1 - it has been claimed by up to 400,000.  1 Daily Mail Reporter, “Smoking ban spurs 400,000 people to quit the habit”, Daily Mail, 4 July 2008,


It would require a large amount of resources for law enforcement to go in to such public places occasionally to see that the ban is being enforced.  It would be easier to enforce conditions relating to the packaging and production of tobacco, which occurs on fewer sites, than ban an activity in certain places which is not so enforceable.


Nip the problem in the bud  Smoking rates in Africa are relatively low; a range of 8%-27% with an average of only 18% of the population smoking 1 (or, the tobacco epidemic is at an early stage 2 ). That’s good, but the challenge is to keep it that way and reduce it.  A ban on smoking in public places at this stage would stop tobacco gaining the widespread social acceptability that caused it to thrice in the 20th century in the Global North. The solution is to get the solutions in now, not later.  1 Kaloko, Mustapha, 'The Impact of Tobacco Use on Health and Socio-Economic Development in Africa', African Union Commission, 2013,  , p.4  2 Bill and Melinda Gates Foundation, “What we do: Tobacco control strategy overview”, Bill & Melinda Gates Foundation, no date,


Lower healthcare costs  Smoking caused disease causes large expenses for healthcare systems, something which is particularly burdensome in countries without the rich well developed healthcare systems of the developed world. In the UK lung cancer, one of the diseases caused by smoking, costs £90 per person or £9071 per patient. 1 Even the cost per head of population is higher than Ghana’s entire healthcare budget of $83.4 (about £50) per person. 2  The reduction in smoking, which would be triggered by the ban, would lead to a drop in smoking related illness. A study in the US state of Arizona showed that hospital admissions for smoking related diseases dropped after a ban on smoking in public places 3 .  This would allow resources to be focused on the big killers other than tobacco – including HIV AIDS.  1 The National Cancer Research Institute, ‘Lung cancer UK price tag eclipses the cost of any other cancer’, Cancer Research UK, 7 November 2012,   2 Assuming Ghanaian health spending of 5.2% of GDP which is $40.71 billion split between a population of 25.37 million from World Bank Databank    3 Herman, Patricia M., and Walsh, Michele E. “Hospital Admissions for Acute Myocardial Infarction, Angina, Stroke, and Asthma After Implementation of Arizona’s Comprehensive Statewide Smoking Ban”, American Journal of Public Health, March 2011,


The argument that states will save money due to less people smoking based upon healthcare costs from treating smoking related diseases is over-simplistic. While smoking does cause medical costs, taxation can counterbalance this – in 2009, the South African government gained 9 billion Rand (€620 million) from excise duties on tobacco 1 . Paradoxically, less people smoking could lead to less money for other projects. Indeed, some countries in Europe raise the amount of health expenditure it causes from tobacco taxation 2 .  1 American Cancer Society, “Tobacco tax success story: South Africa”, tobaccofreekids.org, October 2012,   2 BBC News, “Smoking disease costs NHS £5Bn”, BBC News, 2009,


Is it really the job of African states to stop smoking? Africans have the same amount of personal responsibility to choose to smoke or not – policies should reflect that.


Yes, tobacco is harmful – but is it really a benefit to remove economic activity, which people choose to do? Labour abuses occur in other industries – but that’s an argument for increased labour protections and economic development, not economic self-inflicted wounds.


Easy to introduce  A ban on smoking in public places would be simple to enforce – it is an obvious activity, and does not require any form of complex equipment or other special techniques . It would largely be enforced by other users of public places and those working there. If it changes attitudes enough, it could be largely self-enforcing – by changing attitudes and creating peer pressure 1 .  1 See Hartocollis, Anemona, “Why Citizens (gasp) are the smoking police), New York Times, 16 September 2010,


Reduces growth of tobacco  Less people smoking means less tobacco being purchased – something that would contribute to the reduction in the tobacco industry. The industry is known for its exploitative labour practices, from child labour (80,000 children in Malawi work in tobacco farming, can result in nicotine poisoning – 90% of what is grown is sold to American Big Tobacco 1 ) to extortionate loans. 2 Reducing the size of such an industry can only be a good thing.  1 Palitza, Kristin, “Child labour: tobacco’s smoking gun”, The Guardian, 14 September 2011,   2 Action on Smoking and Health, p3


Even if such a link were true – the campaign against the ban on smoking in public places in the UK accept that it’s unlikely that it is the primary cause of closures in the UK 1 – the public health benefits would make it worth it. Reductions on spending in some areas of the economy is likely to be balanced by increases elsewhere; of course there will be losses in some industries – particularly tabacco itself but those who stop smoking will have the money to spend elsewhere.  Moreover the economic effects are likely to be different in Africa; smoking outside in the UK, bearing in mind the infamous British weather, is a far less attractive proposition than smoking outdoors in many African countries.  1 'Why we want government to amend the smoking ban', Save Our Pubs & Clubs,


Personal autonomy arguments sound reasonable, but often ignore the wider consequences. Public health is a key issue – the state has a role in stopping people harming themselves – they may be harming themselves but the cost often falls on government through public healthcare, and therefore on all taxpayers. Moreover smoking also harms others through passive smoking, this is particularly true in public places that are enclosed.


Unenforceable  Smoking bans are often unenforceable in higher income countries. This is because they require expensive manpower or CCTV in order to stop those flouting the ban, with scarce resources a police force will almost always have other more important crimes to deal with. If Berlin 1 and New York City 2 cannot enforce them, most African cities won’t be able to either.  Ghana's advertising ban has been flouted in the past. When asked in a survey about advertising 35% of Ghanaians recalled hearing a tobacco advert on radio or television despite such ads being banned. 3  1 AFP, 'Smoking Ban not Enforced in Parts of Germany', Spiegel Online, 2 July 2008,   2 Huff Post New York, 'NYC Smoking Ban In Parks Will Not Be Enforced By NYPD: Mayor', Huffington Post, 2 November 2011,   3 Kaloko, Mustapha, 2013,  , p.18


Pack labelling or taxation a better alternative  If it’s not enforceable, enforceable solutions ought to be used instead. It would be easier to enforce pack labelling and branding requirements, from larger and clearer health warnings to even brand-free packs. Of course, American-style lawsuits by governments against tobacco manufacturers could be tried, as suggested in Nigeria 1 .  1 IRIN, “NIGERIA: Govt hits tobacco companies with whopping law suit”, irinnews.org, 9 November 2007,


Ban would harm the wider economy  A ban could harm the wider economy – from bars to clubs, if smokers are unable to smoke inside, they may be more likely to stay away. According to some critics, this lead to the closures of bars in the UK when such a ban was brought in 1 . Research in the United States has shown drops in employment in bars of between 4 and 16 percent. 2  1 BBC News, “MPs campaign to relax smoking ban in pubs”, BBC News, 2011,   2 Pakko, Michael R., 'Clearing the Haze? New Evidence on the Economic Impact of Smoking Bans', The Regional Economist, January 2008,


Paternalistic  Personal autonomy has to be the key to this debate. If people want to smoke – and the owner of the public place has no issue with that – it is not the role of the state to step in. While smoking is dangerous, people should be free in a society to take their own risks, and live with their decisions. All that is required is ensuring that smokers are educated about the risks so that they can make an informed decision.


Each has its own disadvantages. A growing form of tobacco sales in Africa – Nigeria in particular – is the “single stick” 1 . If retailers break packets of cigarettes apart, customers won’t see the packets containing health warnings or similar.  Cost increases can lead to increased use of rollups 2 , or even counterfeit cigarettes, 3 both of which have happened in South Africa as a result of taxation. At any rate, it’s not a zero sum game – more than one policy can be introduced at the same time.  1 Kluger, 2009,   2 Olitola, Bukola, “The use of roll-your-own cigarettes in South Africa”, Public Health Association of South Africa, 26 February 2014,   3 Miti, Siya, “Tobacco tax hikes 'boost illegal traders'”, Dispatch Live, 28 February 2014,


It often doesn’t require enforcement – it changes attitudes itself, making people not do so. In Scotland, within three months 99% of locations abided by the ban, without the need for excess heavy handed enforcement 1 . This is because non-smokers will ask a smoker to stub it out if they are smoking where they are not allowed to. There seems little reason why this wont happen in Ghana or elsewhere in Africa just as in the west.  Even so, a lot of laws are not enforceable in all cases – that doesn’t mean that they will be complete failures.  1 The Scottish Government, 'Smoking ban gets seal of public approval', scotland.gov.uk, 26 June 2006,


health general weight house would ban junk food schools

Given all the responsibilities our society has transferred from parents onto schools and educators in the 21st century, is it really sensible to include caring for nutritional choices to this already bloated and unmanageable list?  We need to ask ourselves, is it actually right that kids turn to schools and peers about lifestyle advice, when this is so clearly a domain of parents and families and so obviously a burden on an already taxed public school system.


Schools are the best place to create lasting lifestyle changes.  Schools are playing an increasingly formative role, in the sense that they’re being tasked with not only knowledge transfer, but also the creation of behaviors and placing emphasis on teaching students how to apply their knowledge. [1]  Given this expanded mandate, the schools are not only obliged to therefore offer choices that would go hand in hand with healthier behavior, but also the perfect pressure point for lawmakers to go about introducing healthier lifestyles.  The simple reason is that our kids are increasingly looking not to their parents, but schools and the environments they provide, for advice on how to live their lives. They are also the traditional environments for youth to continuously invent and reinvent themselves and therefore hold immense potential for behavior modification.  [1] Fitzgerald, E., 'Some insights on new role of schools', New York Times, 21 January 2011,  , accessed 9/11/2011


Again, if this is in fact true, then the incentives are already in place for better choices both on the side of students as well as schools.  What the government should do is through subsidizing healthier meals and educational campaigns help both of them make those choices on their own, and not force an unnecessary ban on them.


Schools need to practice what they preach  Under the pressure of increasing media coverage and civil society initiatives, schools are being called upon to “take up arms” against childhood obesity, both by introducing more nutritional and physical education classes, as well as transforming the meals they are offering in their cafeterias. [1]  Never before has school been so central to a child’s personal and social education. According to a study conducted by the University of Michigan, American children and teenagers spend in school about 32.5 hours per week homework a week – 7.5 hours more, than 20 years ago [2] . School curricula now cover topics such as personal finance, sex and relationships and citizenship. A precedent for teaching pupils about living well and living responsibly has already been established. Some schools, under national health programs, have given out free milk and fruit to try and make sure that children get enough calcium and vitamins, in case they are not getting enough at home [3] .  While we are seeing various nutritional and health food curricula cropping up [4] , revamping the school lunch is proving to be a more challenging task. “Limited resources and budget cuts hamper schools from offering both healthful, good-tasting alternatives and physical education programs,“ says Sanchez-Vaznaugh, a San Francisco State University researcher. [5]  With expert groups such as the Obesity Society urging policy makers to take into account the complex nature of the obesity epidemic [6] , especially the interplay of biological and social factors that lead to individuals developing the disease, it has become time for governments to urge schools to put their education into practice and give students an environment that allows them to make the healthy choices they learn about in class.  [1] Stolberg, S. G., 'Michelle Obama Leads Campaign Against Obesity', New York Times, 9 February 2010,  , accessed 9/11/2011  [2] University of Michigan, 'U.S. children and teens spend more time on academics', 17 November 2004,  , accessed 09/08/2011  [3] Kent County Council, Nutritional Standards, published September 2007  , accessed 09/08/2011  [4] Veggiecation, 'The Veggiecation Program Announced as First Educational Partner of New York Coalition for Healthy School Food',18 May 2011,  , accessed 9/11/2011  [5] ScienceDaily, 'Eliminating Junk Foods at Schools May Help Prevent Childhood Obesity', 7 March 2010,  , accessed 9/11/2011  [6] Kushner, R. F., et al., 'SOLUTIONS: Eradicating America’s obesity epidemic', Washington Times, 16 August 2009,  , accessed 9/11/2011


Media sensationalism is a poor justification for any state intervention of any kind. What histrionic television documentaries usually provide nothing more than a warning that our kids are in danger, along with a list of all the diseases obesity might cause. But there is absolutely nothing that would explain how exactly something as drastic as a ban would do anything to begin solving this problem.  These observations highlight a distressing truth about contemporary western society – we are unable to accept that the state is unable to solve problems without the assistance and support of civil society. We have a hard time accepting the fact that responsibility will have to fall on the shoulders of parents to enforce (or, more likely, to adopt in the first place) a healthy and active lifestyle in their families.  Advice provided by the Mayo Clinic explains that just talking isn’t effective. Kids and parents should go together for a brisk walk, ride on the bike or any other activity. It is important for a healthy lifestyle that parents present exercise as an opportunity to take care for the body, rather than a punishment or chore [1] .  Finally, there is absolutely nothing stopping schools from offering healthier options alongside existing ones. In fact, many schools are choosing a healthier path already, without being forced by governments or regulatory bodies.  [1] MayoClinic.com, 'Fitness for kids: Getting children off the couch',  , accessed 09/10/2011


Better nutrition leads to better students.  There is a growing body of evidence linking a healthy lifestyle, comprising of both adequate nutrition and physical exercise, with improved memory, concentration and general academic performance. [1] A study has shown that when primary school students consume three or more junk food meals a week literacy and numeracy scores dropped by up to 16% compared to the average. [2]  This is a clear incentive for governments to push forward for healthier meals in schools for two reasons. The first obvious benefit is to the student, whose better grades award her improved upward mobility – especially important for ethnic groups stuck worst by the obesity epidemic and a lower average socioeconomic status.  The second benefit is to the schools, who benefit on standardized testing scores and reduced absenteeism, as well as reduced staff time and attention devoted to students with low academic performance or behavior problems and other hidden costs of low concentration and performance of students. [3]  [1] CDC, 'Student Health and Academic Achievement', 19 October 2010,  , accessed 9/11/2011  [2] Paton, Graeme, ‘Too much fast food ‘harms children’s test scores’’, The Telegraph, 22 May 2009,  accessed 20 September 2011  [3] Society for the Advancement of Education, 'Overweight students cost schools plenty', December 2004,  , 9/11/2011


There is absolutely nothing stopping the schools from finding ventures that are just as profitable with companies that offer healthy drinks and snacks. In fact, most of the existing contracts could simply remain in place, since most of the firms are conglomerates that could just as easily offer healthy alternatives to soda pops and cookies.  Where that would prove impossible, it is simply a question of priorities: how many children afflicted by diabetes type 2 are worth a field trip? How many a new sports program or new equipment?


We would be truly hard pressed to find a student, who isn’t very well aware of all the reasons we call certain food “junk food” and what the consumption of those does to the human body.  We already have fantastic mechanism of nutritional education in place and many very publicized campaigns stressing the importance of a healthy lifestyle. Yet what we don’t have are the results – obviously educating the public is not enough.  When we are faced with an epidemic that has such an immense destructive potential, we truly must face it head on and forget about well-intended yet extremely impractical principled arguments – such as the one proposed by the opposition.  What we need is results, and armed with the knowledge won from the war on tobacco, we now know that limiting access is a key mechanism of taking on childhood obesity.


Targeting schools will be an ineffective strategy.  Schools may seem like a perfect place to effect behavioral change in youth, since 95% of young people are enrolled in schools. [1]  But what researchers find is that changing the choices we have available does not necessarily lead to any behavioral change. Penny Gordon-Larsen, one of the researchers, wrote: "Our findings suggest that no single approach, such as just having access to fresh fruits and veggies, might be effective in changing the way people eat. We really need to look at numerous ways of changing diet behaviors. There are likely more effective ways to influence what people eat.” [2]  In the case of school children is this point seems particularly salient. Given that high school students in the US average only 6 hours in school [3] and the widespread availability of fast and other forms of “junk food”, we can hardly expect that impacting this single environment of the school will lead to any lasting behavioral changes. Realistically, what we can expect is for school children to go outside the school to find their favorite snacks and dishes.  Even if, by some miracle, the ban would change the behavior of children in schools, there is still the matter of 10 hours (the ATUS suggests kids sleep an average of 8 hours per day) they will spend outside schools, where their meal choices will not be as tailored and limited.  [1] Wechsler, H., et al., 'The Role of Schools in Preventing Childhood Obesity', National Association of State Boards of Education, December 2004,  , accessed 9/11/2011  [2] Nordqvist, C., 'No Single Approach Will Solve America's Obesity Epidemic', Medical News Today, 11 June 2011,  , accessed 9/11/2011  [3] Bureau of Labor Statistics, 'American Time Use Survey', 22 May 2011,  , accessed 9/11/2011


Pupils will bring unhealthy food with them to schools.  Frequently, a ban- whether or food, alcohol or forms of media- serves only to build interest in the things that has been prohibited. When a ban affects something that is a familiar part of everyday life that is generally regarded as benign, there is a risk that individuals may try to acquire the banned thing through other means.  Having had their perspective in junk food defined partly by attractive, highly persuasive advertising, children are likely to adopt an ambivalent perspective on any attempt to restrict their dietary choices. The extreme contrast between the former popularity of vending machines in schools and the austere approach required by new policies may hamper schools’ attempts to convince pupils of the necessity and rationality of their decision.  Even though schools may be able to coerce and compel their pupils to comply with disciplinary measures, they cannot stop children buying sweets outside of school hours.  When rules at an Orange county school changed, and the cafeteria got rid of its sweets, the demand was still up high, so that the school had to figure out a way to fix the situation. They created a “candy cart” – which now brings them income for sports equipment or other necessities. One of the pupils, Edgar Coker (18-year-old senior) explained that: “If I couldn’t buy it here, I’d bring it from home.” [1]  It is difficult to regulate junk food consumption through unsophisticated measures such as prohibition. A ban my undermine attempts to alter pupil’s mindsets and their perspective on food marketing and their own diets.  [1] Harris G., 'A Federal Effort to Push Junk Food Out of School', New York Times, 2 August 2010  , accessed 09/10/2011


“Junk food” sales are an important source of funding for schools.  An important issue to consider in this topic is the constellation of incentives that actually got us to the place where we are at today.  With the environment designed to incentivize improving schools’ performance on standardized tests, there is absolutely nothing that would motivate them to invest their very limited resources into non-core programs or subjects, such as PE and sports and other activities. [1]  Ironically, schools turned to soda and snack vending companies in order to increase their discretionary funds. An example cited in the paper is one high school in Beltsville, MD, which made $72,438.53 in the 1999-2000 school year through a contract with a soft drink company and another $26,227.49 through a contract with a snack vending company. The almost $100,000 obtained was used for a variety of activities, including instructional uses such as purchasing computers, as well as extracurricular uses such as the yearbook, clubs and field trips.  Thus it becomes clear that the proposed ban is not only ineffective, but also demonstrably detrimental to schools and by extension their pupils.  [1] Anderson, P. M., 'Reading, Writing and Raisinets: Are School Finances Contributing to Children’s Obesity?', National Bureau of Economic Research, March 2005,  , accessed 9/11/2011


Schools should educate about healthy choices, not make them on the students’ behalf.  Although it might be very tempting for the government to try and attack the problem of childhood obesity by attempting to change, in essence, the very choices our kids can make, this is the wrong way of going about doing it.  The purpose of schools is education – the genesis of active and useful members of society. A large extent of what schools do is imprinting the ideas the society values. In most western countries those would be the ideas of fairness, democracy, freedom of expression, etc. The other side of the coin is the transference of knowledge, knowledge of mathematics, history, but also of biology, health and nutrition.  We see thus that the proposed ban on specific choices one makes in school, whether be it choices regarding food or choices regarding the clothes one wears, the ideas one expresses, and so on, is truly meaningless in the existing concept of education.  What the schools should be doing is putting more emphasis on getting the message of the importance of a healthy lifestyle across. Our kids should be taught that this lifestyle consists of more than just whether or not we chose to eat a hamburger and fries for lunch. In short, this ban falls short of truly educating the children about how important physical activity, balanced meals and indulging in moderation are.  They should also focus on the importance of choice, since in the case of childhood obesity, making the right nutritional and lifestyle choices is of paramount importance. But they should also focus on the importance of choice for a society and how all should take responsibility for their choices in such a society.


First of all, such loop holes can be fixed and are just a problem of practicalities, if it helps to educate the pupils, we should do it. For example, there can be an agreement that parents should not buy candy for children to take to school or just restrict stores in the neighborhood to only selling junk food during school hours as they did in Tower Hamlets (UK).  In one school surveyed, all 1,700 pupils were obliged to follow strict rules stating 'no chips, fatty foods, sweets, fizzy drinks' can be sold at the school.  A nearby fast food shop was initially allowed to sell to pupils, but parents and teachers objected, fearing it would jeopardize the school's healthy-eating policy. One resident, Edward Copeland, was so angry that he brought the case to the High Court, where the court decided, that junk food stores are not be opened during school [1] hours to support the schools strict rules.  [1] Borland S., 'Judges declare fast food takeaway near school is »unlawful«', The Daily Mail, 6 December 2010  , accessed 09/10/2011


Even if students spend a small fraction of their time in schools – and 6 hours is by no means an insignificant amount of time – it is still an incredible opportunity for intervention for a very important reason.  The reason is the incredible potential for homogeneity of experience. at least in the aspect of food offered. We are able, to certain extent, control the school environment in such a way as to promote healthy choices and eliminate bad ones. When students return to their homes, we have lost that opportunity. In a nutshell, one healthy meal per day is much better than none.  It can also be contended that children often share experiences from school with their parents and siblings back home. Thus a healthy environment in school could, potentially, find its way into homes we couldn’t otherwise reach by any other means.


healthcare philosophy ethics house would allow donations vital organs even expense

Providing the choice to donate at expense of one’s life will simply increase the pressure on those who do not wish to donate as they now are presented with a much bigger burden when their loved one dies as they could lawfully have prevented it. Moreover the person who is receiving the donation would also have that sense of guilt of living with the knowledge that someone actively chose to sacrifice their life for them. This guilt may well be larger than having the possibility of saving someone but not acting. [1]  [1] Monforte-Royo, C., et al. “The wish to hasten death: a review of clinical studies.” Psycho-Oncology 20.8 (2011): 795-804.


The guilt may be too heavy a burden for the relative who could have saved a life  It is not fair to ask of a parent to live with the guilt of having been able to save their child and not doing so. Believing that they are guilty of their child’s death can cause Post-Traumatic Stress Syndrome, which in turn is a major cause of suicides. [1]  [1] Monforte-Royo, C., et al. “The wish to hasten death: a review of clinical studies.” Psycho-Oncology 20.8 (2011): 795-804.


Man is also a social being. While we have a right to our own body, we also have duties to those around us. If we choose to terminate our lives, we must consider the consequences for those who depend on us, physically or emotionally. Can we really judge whether our own life is less worth than that of the recipient? Human beings also often make decisions without all the relevant information. The choices we make may very well be ill-informed even if we believe otherwise. Part of the problem here is that all the consequences of our decisions can never be fully understood or anticipated.


Greater awareness will increase donations  There is a clear need around the world for more donors of organs. In the UK there are about 4000 transplants a year but there are always more waiting, in November 2012 there were 7593 people waiting so on average each will be waiting for almost two years. [1] In Germany there are over 12,000 waiting but only 2777 donations in 2012. [2] The sacrifice of individual relatives who willingly choose death to save their loved ones therefore brings the need for donations into focus. The media are likely to present heart-breaking stories about loving people who made the ultimate sacrifice. As a consequence, more people will be aware of the issue and wish to fill in donor cards so that they might be able to minimise the number of voluntary donations in the event of their death. Thus there will be more naturally donated organs available and more lives will be saved.  [1] NHS Choices, “Introduction”, 19 October 2012,   [2] Lütticke, Marcus, “Germany lags behind in organ donations”, Deutsche Welle, 4 January 2013,


It is a natural thing to do  We are biologically programmed to want to preserve our species. As such, our offspring will often be more important to ourselves than our own persons. Many doctors hear parents tell them how they wish that they could “take over” their child’s terminal illness rather than have the child suffer. [1] It is therefore natural and right for the older generation to sacrifice itself where possible to save the younger generation. As crass as this might seem, they are statistically more likely to die earlier than their offspring in any event and stand to lose less. They have had the chance to experience more of a life than their child. They are furthermore the cause of the child’s existence, and owe it to the child to protect it at any cost.  [1] Monforte-Royo, C. and M.V. Roqué. “The organ donation process: A humanist perspective based on the experience of nursing care.” Nursing Philosophy 13.4 (2012): 295-301.


Biology is a bad way of deciding moral behaviour. If we were to do what biology tells us to do, we would be no more than animals. Every person has a right to live their life and they do not lose it simply because they have family. In modern society we do not cease to live meaningful lives at the point when we have children, as Darwinians might have us believe, but many people have more than half of their valuable lives ahead of them at the point when their children are emancipated.


It is cynical to encourage people commit suicide to bring the media’s attention to an issue. If there is too little attention, the problem lies with the media and needs to be solved by changing the media. It is not the responsibility of vulnerable relatives to sacrifice their lives to redress that issue.  Moreover, if the proposal were to be put into practise, the government would be communicating that organ donations primarily is an issue for the family of the sick person. Thus, people will be less keen to donate their organs to someone that they do not know, as they believe that there will be a family member who will sort it for them. Sacrificial donations are always inferior and the motion would make them the norm rather than what is the case in the status quo.


This will only lead to family members pressuring terminally ill people to commit suicide prematurely. Even those who are terminally ill, value life, possible even more than others. These people are vulnerable and bereft of hope they are prone to be pressured into such action (Tremblay). [1] However, it is impossible to say whether six months of life for one person is more or less worth than six years for another. Furthermore, this assumes that we know that the recipient will indeed live that long, which we never can know about mortal beings.  As to the second part of the point, it is impossible to quantify human life. If the value of human life is indeed infinite, it is not as simple as to say that two lives are better than one. As long as we cannot say for sure, this is a slippery slope of quantifying human lives that we want to avoid at all costs.  [1] Tremblay, Joe. “Organ Donation Euthanasia: A Growing Epidemic.” Catholic News Agency, (2013).


The right to individual self determination is a fundamental human right, equal to that of life itself  It is a fundamental principle of the human being is that every human is born autonomous. Therefore, we believe that every person has a right to his or her own body and is thus competent to make decisions about it. This is because we recognise that whatever decisions we might make about our bodies, stem from the knowledge that we have about our own preferences. Nobody can tell us how to value different goods and therefore what matters to one person might matter less to another. If we were to undermine this right, nobody would be able to live their life to its fullest as they would be living their life to someone else’s fullest. The extension of this right is that if someone values another person’s life over their own it is their informed decision to sacrifice themselves for that person. It is not for others to decide, and in particular not for the State.


We should preserve the person with greater quality of life  We have to be able to measure quality of life relatively. There might be many cases where a relative is terminally ill, yet not dead yet. This person, with a survival prospect of maybe half a year of suffering and medication, might have a perfectly functional organ. [1] It is very rational, both for this person and for society as a whole to allow him or her to undergo euthanasia at an early stage to save the other person. [2]  Furthermore, a person might sacrifice his or her life to provide an organ for a specific individual, yet their other organs can still be used to save others, of whom the donor might not have been aware. It is sad that a person has to die, but as this is the only option [3] , it is a good thing that several people might live when one sacrifices their life.  [1] Monforte-Royo, C. and M.V. Roqué. “The organ donation process: A humanist perspective based on the experience of nursing care.” Nursing Philosophy 13.4 (2012): 295-301.  [2] Wilkinson, Dominc and Julian Savalescu. “SHOULD WE ALLOW ORGAN DONATION EUTHANASIA? ALTERNATIVES FOR MAXIMIZING THE NUMBER AND QUALITY OF ORGANS FOR TRANSPLANTATION.” Bioethics 26.1 (2012): 32-48.  [3] ibid


The risk of coercion might be true about voluntary donations of organs and blood where the donor survives. A donation is always a large decision and the authorities must take measures to ensure that the donor is acting freely. However, the harm of a person potentially being vulnerable is significantly lesser than that of a person dying because everyone who wanted to help this person had their hands tied.  Modern medicine has very powerful tools at their disposal to be able to know for a fact that a person is beyond saving if not given an organ. [1]  [1] Chkhotua, A. “Incentives for organ donation: pros and cons.” Transplantation proceedings [Transplant Proc] 44 (2012): 1793-4.


This argument is selfish and ignores how love might push a person to make great sacrifices. We might have imperfect information about our importance, but whatever information we have, gives us an idea of how to assess complicated situations. If we were to follow this logic, self-determination would be impossible


The recipient is forced to receive the sacrifice of another  In many cases, the recipient is not in position to consent to the donation. Thus, even if it saves his or her life, it is comes with an intrusion on his or her moral integrity that he or she might value higher than survival. If we are to receive such a drastic sacrifice from someone that we love – surely we must have a right to veto it? [1] This means that to enable the choice of the donor the choice of the receiver has been ignored, there seems to be little reason to simply switch those two positions around as is proposed.  [1] Monforte-Royo, C., et al. “The wish to hasten death: a review of clinical studies.” Psycho-Oncology 20.8 (2011): 795-804.


Doctors should not be asked to take the moral burden of people who want to commit suicide  It is not fair to ask doctors who have committed their lives to preserving health to act as an instrument of killing a person. The doctor will then have to live with the doubt as to whether the act of assisting in the donation was just or not. In other words, if the person who wanted to die for another did not do so voluntarily, the act of killing him or her is morally wrong and the doctor becomes complicit. In order to carry out this scheme, the individual moral autonomy of doctors will be violated. [1]  [1] Tremblay, Joe. “Organ Donation Euthanasia: A Growing Epidemic.” Catholic News Agency, (2013).


The role of society is to save lives not to assist in suicide  The purpose of society, the health sector and more specifically the doctors is to preserve health, not to be damaging health or even assisting in the ending of a life even if voluntarily. As part of this, death is sometimes something that must be affected. However, it is not in line with the purpose of medical professionals to kill a healthy person. The solution is to focus every possible effort on curing the sick person, but society cannot be complicit in killing a healthy person [1] .  [1] Tremblay, Joe. “Organ Donation Euthanasia: A Growing Epidemic.” Catholic News Agency, (2013).


This would encourage coercion for some to die to save others  By allowing sacrificial donations society becomes vulnerable to abuse of this system. It is possible that people are scared or coerced into sacrificing their lives for others. While society does all it can for those who are ill, it cannot start moving the boundaries for when it actively takes the lives of its citizens.  Even when there is no coercion, we cannot even know when a person is beyond all hope. Even in the direst situations, there are exceptional cases when people recover. However, if we take a person’s vital organs, the process is irreversible. Therefore, it is always wrong to prematurely kill another person, while the recipient is still alive and within the realm of luck and miracles. In the status quo the donor is already dead and the trade-off is not a problem, but this cannot be extended to the living


This is easily solved. Similarly to doctors who assist in cases of abortion or even executions doctors must have the option of opting out. However, once it is proven that this model is ethically good, it is likely that there are doctors who will realise the potential of this method and who will want to participate. After all, this is a motion that relates to the exceptional cases, so even if most doctors opt out there will still be doctors who will be willing to operate under this scheme.


Self-preservation is our primary moral duty  Many people, especially those who belong to religious groups believe that we have a duty to preserve our own lives. They would argue that suicide is never justified, even if the reasons might appear to be good. It is impossible to sacrifice your life for others, because you cannot know how important your life is to others in relation to how important other people’s lives are. Either life is invaluable and it is thus impossible to value one life higher than others, or it can be valued, but it is impossible for us to assess our life’s value in relation to others. Therefore, while we accept that some might die, it is not for the individual to take matters into his or her own hands and accelerate the process, as this decision might be made on the wrong grounds, but cannot be reversed.


If the purpose of society and the health sector is indeed to promote life and preserve health, surely it must be in that interest to find ways of saving people’s lives when possible. Whoever dies and leaves an organ behind saves a life, and often more than one life as shown by the UK having carried out 3960 transplants with 2143 donors in 2011-12, [1] and there is thus no loss of life. A person only gives up their own life if they have a good reason to do so. Thus, it is likely that this model will promote the preservation of younger and healthier lives over those who have less to lose by sacrificing theirs.  [1] NHS Choices, “Introduction”, 19 October 2012,


Firstly, this case is about emergencies. Consent is important, but it cannot be compared to the importance of saving a life. Secondly, the person whose consent matters is the donor who is making the sacrifice. The recipient can be expected to want to live, even if he or she cannot communicate this. [1]  [1] Monforte-Royo, C., et al. “The wish to hasten death: a review of clinical studies.” Psycho-Oncology 20.8 (2011): 795-804.


disease health general house would allow production generic drugs

Allowing the sale of generic drugs will not help the plight of the developing world. Many drug companies invest substantial amounts of money, gleaned from the sale of profitable dugs in the developed world, into researching treatments for the developing world. Without the revenues available from patent-protected drug sales, companies' profits will fall, precipitating a reduction in pro bono giving and research. Allowing the production of generic drugs will thus in the long run hurt the developing world.


Allowing production of generic drugs saves lives, particularly in the developing world  Many developing countries are fraught with terrible disease. Much of Africa and Asia are devastated by malaria, and in many parts of Africa AIDS is a horrendous scourge, infecting large percentages of many countries populations. For example, in Swaziland, 26% of the adult population is infected with the virus1. In light of these obscenely high infection rates, African governments have sought to find means of acquiring enough drugs to treat their ailing populations. The producers of the major AIDS medications do donate substantial amounts of drugs to stricken countries, yet at the same time they charge ruinously high prices for that which they do sell, leading to serious shortages in countries that cannot afford them. The denial of the right to produce or acquire generic drugs is effectively a death sentence to people in these countries. With generic drugs freely available on the market, the access to such drugs would be facilitated far more readily and cheaply; prices would be pushed down to market levels and African governments would be able to stand a chance of providing the requisite care to their people2. Under the current system attempts by governments to access generic drugs can be met by denials of free treatments, leading to even further suffering. There is no ethical justification to allow pharmaceutical companies to charge artificially high prices for drugs that save lives. Furthermore, many firms that develop and patent drugs do not share them, nor do they act upon them themselves due to their unprofitability. This has been the case with various treatments for malaria, which affects the developing world almost exclusively, thus limiting the market to customers with little money to pay for the drugs3. The result is patents and viable treatments sitting on shelves, effectively gathering dust within company records, when they could be used to save lives. But when there is no profit there is no production. Allowing the production of generic drugs is to allow justice to be done in the developing world, saving lives and ending human suffering.  1 United Nations. 2006. "Country Program Outline for Swaziland, 2006-2010". United Nations Development Program. Available: 2 Mercer, Illana. 2001. "Patent Wrongs". Mises Daily. Available: 3 Boseley, Sarah. 2006. "Rich Countries 'Blocking Cheap Drugs for Developing World'". The Guardian. Available:


Allowing the production of generic drugs will only increase production of drugs currently on the market. Without the profit incentive that patents provide, pharmaceutical companies will not invest in the expensive process of developing new drugs in the first place. It is a necessary trade-off, as patents are essential to incentivize innovation. Furthermore, many states have mandatory licensing laws in states requiring companies to license the rights to the production of drugs so as not to precipitate shortages.


You cannot own an idea, and thus cannot hold patents, especially to vital drugs  An individual's idea, so long as it rests solely in his mind or is kept safely hidden, belongs to him. When he disseminates it to everyone and makes it public, it becomes part of the public domain, and belongs to anyone who can use it. If individuals or firms want to keep something a secret, like a production method, then they should keep it to themselves and be careful with how they disseminate their product. One should not, however, expect some sort of ownership to inhere in an idea one has, since no such ownership right exists1. No one can own an idea. Thus recognizing something like a property right over something like a drug formula is contrary to reason, since doing so gives monopoly power to individuals who may not make efficient or equitable use of their asset. Physical property is a tangible asset, and thus can be protected by tangible safeguards. Ideas do not share this right to protection, because an idea, once spoken, enters the public domain and belongs to everyone. This should apply all the more with vital drugs that are fundamentally for the public good by improving health.  1Fitzgerald, Brian and Anne Fitzgerald. 2004. Intellectual Property: In Principle. Melbourne: Lawbook Company.


The current patent system is unjust and creates perverse incentives that benefit large pharmaceutical companies at the expense of ordinary citizens  The current drug patent regime is largely designed to benefit and shield the profits of large pharmaceutical companies. This is due to the fact that most of the laws on drug patents were written by lobbyists and voted upon by politicians in the pay of those firms. The pharmaceutical industry is simply massive and has one of the most powerful lobbies in most democratic states, particularly the United States. The laws are orchestrated to contain special loopholes, which these firms can exploit in order to maximize profits at the expense of the taxpayer and of justice. For example, through a process called "evergreening", drug firms essentially re-patent drugs when they near expiration by patenting certain compounds or variations of the drug1. This can extend the life of some patents indefinitely ensuring firms can milk customers at monopoly prices long after any possible costs of research or discovery are recouped. A harm that arises from this is the enervating effect that patents can generate in firms. When the incentive is to simply rest on one's patents, waiting for them to expire before doing anything else, societal progress is slowed. In the absence of such patents, firms are necessarily forced to keep innovating to stay ahead, to keep looking for profitable products and ideas. The free flow of ideas generated by the abolition of drug patents will invigorate economic dynamism.  1 Faunce, Thomas. 2004. "The Awful Truth About Evergreening". The Age. Available:


There is nothing unjust about the patent system. It protects everyone equally. The nature of democracy is such that people are allowed to express their opinions and to organize to further certain aims. Drug companies have a particular interest in protecting their patent rights so it is only natural that they should involve themselves in the process of how those patents should be treated legally. They are not miscreants, but rather are participants in a system that is designed to be as fair as possible for everyone.


Ideas can be owned, to a certain extent. The creative effort involved in the production of a drug formula is every bit as great as the building of a new chair or other tangible asset. Nothing special separates them and law must reflect that. It is a fundamental violation of property rights to steal from drug companies the rights they own to drugs by allowing the production of generic knock-offs.


The costs associated with the current patent regime are necessary to the maintenance of innovation. It may be costly, and technically inefficient to police property rights, but that does not make them less of a right. If firms feel they can benefit from fighting infringers of their patent rights, it is their right to do so. The state likewise, has an obligation to protect the rights, physical and intangible, of its citizens and cannot give up on them simply because they prove difficult and costly to enforce.


Production of generic drugs reduce medical costs by allowing increased production and the development of superior production methods, increasing market efficiency  The sale of generic drugs invariably reduces costs to consumers. This is due to two reasons. It may be the case that an individual or firm with a patent, essentially a monopoly right to the production of something, may not have the ability to efficiently go about meeting demand for it. Patents slow, or even stop the dissemination of the production methods, especially when a patent-holder is unwilling to license production to others1. Such an outcome is deleterious to society, as with no restrictions on drug production an efficient producer, or producers, will emerge to meet the needs of the public, producing an amount of drugs commensurate with demand, and thus equilibrating market price with that demand2. This market equilibration is impossible under conventional patent laws, as it is in the interest of firms to withhold production and to engage in monopolist rent-seeking from consumers3. This leads firms to deliberately under-produce, which they have been shown to do in many cases, as for example the case of Miacalcic, a drug used to treat Paget's Disease, in which its producer deliberately kept production down in order to keep prices high4. When a firm is given monopoly power over a drug it has the ability to abuse it, and history shows that is what they are wont to do. By allowing the production of generic drugs, this monopoly power is broken and people can get the drugs they need at costs that are not marked far above their free market value.  1 Kinsella, Stephan. 2010. "Patents Kill: Compulsory Licenses and Genzyme's Life-Saving Drug". Mises Institute. Available: 2Stim, Rishand. 2006. Profit from Your Idea: How to Make Smart Licensing Decisions. Berkeley: Nolo. 3 Lee, Timothy. 2007. "Patent Rent-Seeking". Cato at Liberty. Available: 4 Flanders Today. 2010. "Big Pharma Denies Strategic Shortages". Flanders Today.


When generic drugs are legalized firms and individuals no longer feel the incentive to misallocate resources to the race to patent new drugs and to monitor existing patents, or to spend resources stealing from one another  Patent regimes cause firms to inefficiently allocate resources. One such inefficiency arises from the duplication of effort by firms seeking to develop the same or very similar drugs, though only the first to do so may profit from it due to the winner-takes-all patent system. This leads to brutal races and excessive expenditure of resources to be first over the line and to monopolize the production, at least for a time. These races can thus lead to efforts by firms to steal research from one another, thus resulting in further wastes of resources in engaging and attempting to prevent corporate espionage. Another serious inefficiency arises in the production of similar products to existing ones, seeking to get around existing patents. Such has been the case for years in the pharmaceutical industry, which has succeeded, for example, in curing erectile dysfunction dozens of times. An overemphasis on such spinning off of similar products is the result of patent-generated inefficiency 1. The inefficiency does not end with production, however, as firms likewise devote great amounts of resources and effort to the development of non-duplicable products, in monitoring for infringement, and in prosecuting offenders, all of which generates huge costs and little or no return 2. Furthermore, the deterrent effect to patent piracy generated by all the efforts of the state and firms has proven generally minimal. Clearly, in the absence of patent protection for pharmaceuticals, markets and firms will behave more efficiently. This is shown by the introduction of generic antiretroviral drugs for treating AIDS where the introduction of generic drugs forced the price of the branded drugs down from $10439 to $931 in September/October 2000 3.  1 Gabb, Sean. 2005. "Market Failure and the Pharmaceutical Industry: A Proposal for Reform". National Health Federation. Available: 2 World Intellectual Property Organization. 2011. "Emerging Issues in Intellectual Property". Available: 3 Avert.org, "AIDS, Drug Prices and Generic Drugs",


No one can own an idea. Thus creating something like a property right over intangible assets is a meaningless endeavor. Doing so gives monopoly power to individuals who may not make efficient or equitable use of their inventions or products. Physical property is a tangible asset, and thus can be protected by tangible safeguards. Ideas do not share this right to protection, because an idea, once spoken, enters the public domain and belongs to anyone who can use it.


Dangerous generic drugs are rare, and when they are found they are quickly pulled from the market. Arguments against generics on the grounds of safety are no more than alarmist nonsense. When people go to the drug store they have a choice between expensive brand name drugs and cheaper generics. It is their right to economize and choose the less glossy alternative.


Patent rights allow firms to more readily release their products and methods into the public domain, particularly through licensing  Without patent protection, innovative and enterprising firms lacking the capacity to market successfully or efficiently produce new drugs might develop new drugs and never release them, since it would simply result in others profiting from their efforts. After all, no one likes to see others profit by their hard work, and leaving them nothing; such is tantamount to slavery. Patent protection encourages the release of new ideas and products to the public, which serves to benefit society generally1. The main mechanism for this is the system of licensing, by which firs can retain their right of ownership over a drug while essentially renting the ability to produce it to firms with productive capacities that would better capitalize on the new product. Furthermore, the disclosure of ideas to the public allows firms to try to make the product better by "inventing around" the initial design, or by exploiting it once the term of the patent expires2. If the drug formula never enters the public, it might never do so, leaving society bereft of a potentially valuable asset.  1 Rockwell, Llewellyn. 2011. "The Google Pharm Case". Mises Daily. Available: 2 Business Line. 2007. "Patents Grant Freedom to Invent Around". Hindu Business Line. Available:


Robust drug patent laws incentivize investment of time and money in developing new products  When a real chance of profit exists in the development of a new product or drug, people and firms put the effort into developing and creating them. The incentive to profit drives a great deal of people's intellectual endeavors. Research and development, for example, forms a major part of industries' investment, as they seek to create new products and inventions that will benefit consumers, and thus society as a whole. Research and development is extremely costly, however. The US pharmaceutical industry alone spends tens of billions of dollars every year on researching new drugs1. The fear of theft, or of lack of profit stemming from such research, will serve as a powerful disincentive to investment. Without the protection of patents, new drugs lose much of their value, since a second-comer on the field can simply take the formula and develop the same product without the heavy costs of research involved, leaving the innovative company worse off than its copycat competitor. This will lead to far less innovation, and will hamper companies currently geared toward innovative and progressive products. Patent protection is particularly important to companies with high fixed costs and low marginal costs, such as pharmaceutical firms. Without the guarantee of ownership over intellectual products, the incentive to invest in their development is diminished as they will not be guaranteed a payback for their research costs as a competitor could simply take the product off them. Within a robust patents system, firms compete to produce the best product for patenting and licensing that will give them a higher market share and allow them to reap high profits. These incentives lead firms to "invent around" one another's patents, leading to gradual improvements in drugs and treatments, benefiting all consumers2. Without patents the drugs companies are trapped in a kind of prisoners' dilemma where both are individually better off by refusing to innovate, yet both suffer if neither innovates. Patents are the solution to this: if a company innovates, it alone can reap the rewards of the new invention3. In the absence of patent protection there is no incentive to develop new drugs, meaning in the long run more people will suffer from diseases and ailments that might have been cured were it profitable to invest in developing them. Clearly, patent protection is essential for a dynamic, progressive pharmaceutical industry.  1 Congressional Budget Office. 2006. Research and Development in the Pharmaceutical Industry". The Congress of the United States. Available: 2 Nicol, Dianne and Jane Nielsen. 2003. "Patents and Medical Biotechnology: Empirical Analysis of Issues Facing the Australian Industry". Center for Law and Genetics Occasional Paper 6. Available: 3 Yale Law & Technology. 2011, "Patents: Essential, if flawed", Available:


The product of a firm's intellectual endeavor is the property of that firm, and it deserves to profit from it  When a firm directs individuals to mix their labor with its capital or other resources, part of that firm's identity inheres in the product that arises from the effort. This is the origin of, and fundamental philosophical justification for, property rights. Property rights are an unquestioned mainstay of life in all developed countries, and are an essential prerequisite for stable markets to develop and function1. The law protects patent rights in much the same way as more conventional physical property, as well it should. Individuals and firms generating ideas and using their effort to produce an intangible good, such as a new drug formula, have a property right on those ideas and the products that arise from them. It is the effort to produce a real good, albeit an intangible one, that marks the difference between an idea in someone's head that he does not act up, and intellectual property that can be protected by a patent. Developing a new drug is a very intensive endeavor, taking time, energy, and usually a considerable amount of financial investment2. The cost of developing a new drug varies widely, from a low of $800 million to nearly $2 billion per drug and is rising3. People and firms deserve as a matter of principle to benefit from the products of the effort of creation. For this reason, stealing intellectual property, which developing generic drugs is, is the same as stealing an actual physical product. Each is a real thing, even if one can be touched while the other is intangible in a physical sense. As a matter of principle, property rights can be assigned to intangible assets like drug formulae, and in practice they are a necessity to many firms' financial survival.  1Fitzgerald, Brian and Anne Fitzgerald. 2004. Intellectual Property: In Principle. Melbourne: Lawbook Company. 2 Congressional Budget Office. 2006. Research and Development in the Pharmaceutical Industry". The Congress of the United States. Available: 3 Masia, Neal, 2008, "The Cost of Developing a New Drug", Focus on Intellectual Property Rights, America.gov, Available:


Generic drugs often prove to be less effective than their brand name counterparts, and can even be dangerous  Generic drugs are meant to retain a substantial degree of bioequivalence with their brand name predecessors. Yet, even under strict testing laws in this regard, generic drugs have on several cases been shown to manifest side effects not present in their parent products. For example, a generic version of Wellbutrin XL, an anti-depressant, that was ostensibly chemically equivalent to the brand name drug, caused suicidal episodes in several users1. This demonstrates that no amount of chemical testing can guarantee true bioequivalence, and thus generic drugs cannot be considered as identical to brand name drugs in terms of safety. While improving testing of generics would go some way toward fixing this problem, it would not do so entirely, as the market for new drugs will be so greatly widened with the approval of generic production that the cost of screening will be very high and the likelihood of poor knock-offs reaching consumers, particularly in the developing world where screening is less robust, is increased substantially2. Brand name drugs may be more expensive, but their safety is more thoroughly guaranteed. Flooding the market with cheap, potentially dangerous alternative drugs helps no one but the undertaker.  1 Childs, Dan. 2007. "Generic Drugs: Dangerous Differences?". ABC News. Available: 2 Mercurio, Bryan. 2007. "Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines". Northwestern University Journal of International Human Rights. Available:


Research and development will continue, irrespective of intellectual property rights. The desire of firms to stay ahead of the competition will drive them to invest in research regardless. That their profits will be diminished by the removal of intellectual property rights is only natural and due to the fact that they will no longer have monopoly control over their intangible assets, and will thus not be able to engage in the rent-seeking behavior inherent in monopoly control of products. The costs of commercialization, which include building factories, developing markets, etc., are often much higher than the costs of the initial conception of an idea1 these are areas where competition will force down costs. Furthermore, there will always be demand for a brand name over a generic product. In this way the initial producer can still profit more than generic producers, if not at monopolistic levels.  1Markey, Justice Howard. 1975. Special Problems in Patent Cases, 66 F.R.D. 529.


If firms are afraid their formulae will be stolen, then they should keep them hidden. Otherwise, they should seek to make their new drug public, benefiting everyone so that the most people possible can have access to them. The release of ideas is most bountiful when there is active and constant competition to produce newer and better products and ideas. This is only possible in the absence of constricting patent protections. Furthermore, firms' attempts to "invent around" patents do not actually benefit anyone, as their aim is often not to improve upon existing models, but to design products that are as close to replicas as possible without violating law. This is a gross misallocation of resources created by the unjust patents regime.


disease health general healthcare house believes alternative medicine poses threat

Partly the problem here may well be that clinical research is simply looking for the wrong things. There is enough anecdotal evidence of success to at least suggest further research – it is worth noting that there’s no money in many of these treatments so they actually get relatively little academic discussion.  A meta-study of the available material on analyses of the effectiveness of complementary medicine by the Cochrane Library found positive or confirmatory outcomes in 34 percent of those papers it reviewed on the subject.  It is also worth reiterating that there is a massive financial interest in ignoring, sidelining or condemning therapies that pose a threat to the medical establishment.  It seems incredibly unlikely that people would come back for more than one dose of a treatment that was having no effect, and yet they do.


Although there are many accounts of the efficacy of alternative cancer treatments, not one has been demonstrated to work in a clinical trial  The National Centre for Conventional and Alternative Medicines has spent over $2.5bn on research since 1992. The Dutch government funded research between 1996 and 2003. Alternative therapies have been tested in mainstream medical journals and elsewhere. Not only have thousands of research exercises failed to prove the medical benefit ”alternative” treatments for severe and terminal diseases, serious peer-reviewed studies have routinely disproved them.  It’s all well and good to pick at mistakes in individual studies. Indeed, this tactic often forms the mainstay of pleas for legitimacy made by members of the alternative medical community. However, the odds against such consistently negative results would be extraordinary.  By contrast, conventional medicine only prescribes medicines and treatments that are proven, and vigorously proven, to work.


Statistics for alternatives are difficult to generate as patients will often move between practitioners and frequently self-medicate.  Clearly there are also conditions that any responsible practitioner would refer to a specialist in that particular field.  However, many people are mistrustful of so-called conventional medicine and the alternative medicine sector has proven both popular and has often brought about changes in lifestyle as well as direct health benefits, if anecdotal evidence is to be believed.  Responsible practitioners have welcomed the actions of those governments who have licensed and regulated the Complementary and Alternative sector.  Although science may struggle to explain the benefits of these therapeutic technics, as they do not lend themselves to the tools of commercial medicine.


Many alternative remedies, such as homeopathy, offer nothing but a false hope and can discourage patients from consulting a doctor with what may be serious symptoms  There are good reasons why new therapies are tested in scientific trials first, rather than just released on the public that it might work. The first is to weed out side-effects but the other is that if you give most people a medicine they will, not unreasonably, expect it to make them better.  An entire industry has grown out of alternative medicines. No doubt many alternative practitioners are well meaning, but this does not change the fact that people are making money out of something that, as far as anyone can determine, is basically snake oil.  Although many people take both alternative and established treatments, there are a growing number of patients who reject conventional medical wisdom ( there’s an account of one such case here [i] ) in cases that prove fatal the availability of alternative medicines raises serious ethical and legal concerns, and also undermines the stringent regimes of monitoring and supervision that qualified medical professionals are subjected to..  [i] David Gorski. “Death by ‘Alternative Medicine”: Who’s to blame?”. Science-Based Medicine 2008.


The overwhelming majority of practitioners of alternative therapies recommend that they be used in conjunction with conventional medicine. However, the rights and opinions of the patient are foremost and should be respected. In the case of cancer, since that is the study considered by proposition, there are many sufferers who decide that chemotherapy, a painful and protracted treatment, which rarely yields promising or conclusive results, may well be worse than the disease.  Of course there is a cost associated with alternative medicine, although it is as nothing compared with the cost of many medical procedures, notably in the US but also elsewhere. There are plenty of conventional practitioners willing to prescribe medications that may not be necessary or, at the very least, select medications on the basis of financial inducements from pharmaceutical companies.  Despite legal rulings [i] , such practices still take place; it would be disingenuous not to explore the extent to which commercial dealings influence the practice of conventional medicine.  Clearly advice should always be given on the basis of the needs of the patient. However, there are many circumstances in which conventional medicine fails to adhere to this principle. Venality and petty negligence are not behaviours that are exclusive to the world of alternative therapies.  [i] Tom Moberly. “Prescribing incentive schemes are illegal says European Court”. GP Magazine. 27 February 2010.


Overwhelmingly alternative therapies are used in conjunction with established remedies - oddly the latter tends not to get the credit for the miracle cure  Thankfully only 4.4% of the 60million or so Americans who say they use alternative therapies rely on them exclusively. It is odd that in the cases of anecdotal accounts of the success of alternative medicines this statistic is rarely mentioned [i] .  Equally, the impact of other treatment which may have been used by patients eager to credit complementary and alternative medicines with curing their conditions, tend not to get a look in, neither do the relative successes of conventional medicine.  This is probably why in every trial alternative medicine has a success rate of between 0% and 0%. By contrast there needs only be one instance of harm caused to demonstrate that this motion must stand. Interestingly, although conventional medicine publishes its mistakes in an effort to correct them, nothing similar exists for alternatives. Moreover, there are many accounts of fatalities caused by alternatives – both directly and indirectly through delaying accurate diagnosis as seen above (Oh, the same applies to animals too [ii] ).  The food supplements industry alone is worth $250 a year worldwide, with little examination of the medical impact of merrily shoving things into your system that were bought at WalMart or Tesco.  [i] JA Astin “Why patients use alternative medicine: results of a national survey” Journal of the American Medical Association 279 (19) 1548-53. May 1998.  [ii]


his is of course an excellent argument for more and better funded clinics, especially in parts of the world (including much of the West) where access to medicine is difficult.  It is also evidence that when people are genuinely worried about their health they tend to consult providers of conventional medicine who are, as a result, extremely busy.  It perhaps says more than anything else about many practitioners of alternative medicines that they have time to sit around bonding with their patients. Unsurprisingly, such a luxury is rare in an A and E ward or even in the average GP’s surgery.


This comes down to the ‘well it can’t hurt, can it’ approach to alternatives. There is simply no serious medic – or any other scientist for that matter who would suggest that it’s a good idea to ingest products that are of dubious origin and purport medical benefits without having been tested. In many cases these have been shown to be at least irrelevant and at worst actively harmful.  Of course it is painful to deny treatment to a patient on the basis that the medication has yet to complete its trial stage but there is a reason for doing that in that it allows doctors to be 100 percent sure of a product before they’re prescribed.


The pharmaceutical and medical industries are worth billions of dollars annually. They have an interest in ignoring the efficacy of remedies that are, for the most part, free or considerably cheaper  It’s understandable that the medical establishment has an interest in ignoring treatments that are freely available. Pharmaceutical companies make billions each year selling drugs that cost pennies to manufacture.  There is an enormous vested interest in insuring that the world in general- and the West in particular-remain tied to the idea that the only solution to disease is to swallow a pill provided by a man in a white coat. There are other solutions that have been used for thousands of years before anybody worked out how to make a buck out of it. For much of the world these therapies continue to be the ones people rely on and the rush of pharmaceutical companies to issue patents on genes of some of these traditional remedies suggests that there must be at least some truth in them.


Alternative medical practitioners tend to spend more time with their patients and get a better understanding of them as a whole, as a result they are more likely to treat the person than the symptom  Modern medicine tends to treat an individual symptom without putting it in the context of the whole person and so will often fail to see it as part of a wider pathology.  Alternative practitioners tend to spend more time with their patients and so are better placed to asses individual symptoms as a part of the person as a whole rather than just dealing with symptoms one as a time as the crop up.


A huge number of fully accepted medical practices started being seen as something a bit off the wall, it’s wrong to deny sick people access to a treatment that may be mainstream in 20 years  There is a fine line between what is considered alternative and what is thought of as mainstream. Techniques do move across that line and when they do so, they are seen as mainstream. However, this process of reform, refinement and acceptance takes time.  In the meantime it is simply unfair to deny treatment to patients who want it because the medical establishment is beholden to a conservative academic orthodoxy and drug and treatment providers with vested interests in ensuring that particular cures and techniques will continue to be purchased and utilised.


Absolutely nobody questions that many remedies can be drawn from nature- penicillin provides one example- but there is something of a jump that happens between chewing on a piece of bark and a regulated dose of a chemical.  Let’s deal quickly with the cost of medications – the second pill may well ‘cost pennies’; the first one, by contrast, costs hundreds of millions of dollars in research. On the basis that there is probably more than one medicine in the world that procedure will need to be repeated.  As for the idea that there are older or more traditional remedies and that these are still frequently used in much of the world, that is, indeed true. They are the same periods of history and parts of the planet were the bulk of humankind died – or continues to die – agonizing deaths from relatively commonplace diseases that modern medicine is able to cure with ‘a pill from a man in a white coat’. It is admittedly regrettable that more of the world isn’t covered by the protection science offers but that is scarcely the fault of science.


disease healthcare philosophy ethics life house believes assisted suicide should

Modern palliative care is immensely flexible and effective, and helps to preserve quality of life as far as is possible. There is no need for terminally ill patients ever to be in pain, even at the very end of the course of their illness. It is always wrong to give up on life. The future which lies ahead for the terminally ill is of course terrifying, but society’s role is to help them live their lives as well as they can. This can take place through counselling, helping patients to come to terms with their condition.


Those who are in the late stages of a terminal disease have a horrific future agead of them  The gradual decline of their body, the failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to ‘control’ their pain will often leave them in a delirious and incapable state. At least five percent of terminal pain cannot be controlled, even with the best care. Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and have the assistance of a doctor to die with dignity. One particular account was of Sue Rodriguez who died slowly of Lou Gehrig's disease. She lived for several years with the knowledge that her muscles would, one by one, waste away until the day came when, fully conscious, she would choke to death. She begged the courts to reassure her that a doctor would be allowed to assist her in choosing the moment of death. They refused. Rodriguez did not accept the verdict and with the help of an anonymous physician committed suicide in February 1994. [1]  [1] Chris Docker, Cases in history, euthanasia.cc, 2000  (accessed 6/6/2011)


Demanding that family take part in such a decision can be an unbearable burden: many may resent a loved one’s decision to die, and would be either emotionally scared or estranged by the prospect of being in any way involved with their death. Assisted suicide also introduces a new danger, that the terminally ill may be pressured into ending their lives by others who are not prepared to support them through their illness. Even the most well regulated system would have no real way to ensure that this did not happen.


Every human being has a right to life  Perhaps the most basic and fundamental of all our rights. However, with every right comes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the right to choose to die is implicit in the right to life. The degree to which physical pain and psychological distress can be tolerated is different in all humans. Quality of life judgements are private and personal, thus only the sufferer can make relevant decisions. [1] This was particularly evident in the case of Daniel James. [2] After suffering a spinal dislocation as the result of a rugby accident he decided that he would live a second-rate existence if he continued with life and that it was not something he wanted to prolong. People are given a large degree of autonomy within their lives and since deciding to end your life does not physically harm anyone else, it should be within your rights to decide when you wish to die. While the act of suicide does remove option to choose life, most cases in which physician assisted suicide is reasonable, death is the inevitable and often imminent outcome for the patient regardless if by suicide or pathological process. The choice for the patient, therefore, is not to die, but to cease suffering and tto chose the time and manner of their death.  [1] Derek Humphrey, 'Liberty and Death: A manifesto concerning an individual's right to choose to die', assistedsuicide.org 1 March 2005,  (accessed 4/6/2011)  [2] Elizabeth Stewart, 'Parents defend assisted suicide of paralysed rugby player', guardian.co.uk, 17 October 2008,  (accessed 6/6/2011)