I hope you are enjoying a good start to the summer. We're living in chaotic, uncertain times, and the need to focus on what really matters is becoming ever more apparent. OPIS is dedicated to getting our ethical priorities right: attending urgently to the most intense suffering and embedding this principle at all levels of governance. I'd like to share with you what OPIS has been working on since our last newsletter.
Access to morphine and palliative care
As you probably already read, we held a conference in Burkina Faso on 2-3 December 2019, in collaboration with the Ministry of Health and our partner Hospice Burkina, to launch a national plan to provide access to palliative care and morphine. The Minister of Health Prof. Léonie Claudine Lougue/Sorgho gave a speech and, meeting separately with a few of us (photo below), promised to implement the recommendations made. A few weeks after the conference, policy and legislative proposals that had been refined during conference working sessions were presented to the Ministry of Health.
While the arrival of the coronavirus temporarily shifted attention towards the pandemic, it has further underscored the necessity of implementing palliative care so that those whose lives cannot be saved can at least be spared as much suffering as possible. Since then, further progress was made last month towards changing the public code of health to include palliative care, and the Minister of Health has agreed to the production of liquid oral morphine. An article we wrote about this initiative, "How a Local Champion Can Bring the Government on Board", has just been published in the bulletin of Swiss health network Medicus Mundi. Prof. Felicia Knaul, Chair of the Lancet Commission on Global Access to Palliative Care and Pain Control, called this article an "important read on how to close the global pain divide at the national level."
Relieving the pain of cluster "suicide" headaches
We have been putting much of our focus on cluster headaches, one of the most excruciating conditions known to medicine, destroying people's lives with multiple daily attacks often rated at 10/10 on the pain scale, far above childbirth or migraines. Most cluster headache sufferers have suicidal ideations, and many commit suicide to escape the unbearable pain. Current medical options are helpful but unsatisfactory, and they rarely prevent episodes altogether. However, psilocybin and chemically related compounds have been found by many patients to be highly effective at both aborting and preventing attacks. According to one study by Yale medical professor Emmanuelle Schindler and colleagues, "psilocybin and LSD provided over 70% of those who tried them with at least moderate protection from attacks. Complete preventative efficacy was about 40% for each drug, which is greater than that reported for any other conventional medication." The problem is that these drugs are illegal to possess in almost all countries. This means that anyone seeking relief from the agony of cluster headaches risks being treated as a criminal if they seek to acquire these medications. The illegal status also limits their availability and makes it difficult to provide adequate information to patients. By creating an obstacle to the relief of extreme suffering, such laws are incompatible with compassionate ethics.
OPIS has a close collaboration with the Finnish Horton Association, a patient organisation that aims to provide cluster headache patients with the most effective treatments. We have been working on a policy paper to present to the Finnish government that outlines the problem and makes several suggestions on steps they can take. Together with OPIS researcher Zoë Gumm, we are still in the process of putting together a coalition of Finnish and international experts to support this initiative. We are also preparing to carry out similar initiatives in other countries with progressive governments, and hope in this way to set a precedent and model for other countries for adapting their drug policies to help relieve the suffering of cluster headache patients. We are also planning to create an online guidebook for patients that describes various treatment options, as many patients are not adequately advised by their doctors, who are often less knowledgable about the condition than patient communities. In addition, we have an ongoing Google ad campaign that has already provided information to a few thousand people looking for information about cluster headaches and treatment options.
The presentation "Relieving the Pain of Cluster Headaches", which was given at the EAGxVirtual Unconference on 20 June 2020, organised by the Effective Altruism community, describes the condition and our initiative.
Animal advocacy
The US has seen a series of ag-gag laws passed, attempts to silence whistleblowers who call attention to the horrific abuses of animals on factory farms. In several cases the laws have been found to violate First Amendment protections. However, Canadian provinces are now making similar attempts to prevent legitimate investigation into animal torture, and an ag-gag law was recently passed in Ontario, despite leading legal experts calling it unconstitutional. Just two days later, animal rights activist Regan Russell was tragically run over by a truck delivering animals to a slaughterhouse. (Read this tribute by OPIS team member Alyssa Berris on the website of Vegan Option Canada.) Québec is currently considering similar legislation. Transparency is essential to a democracy, and whistleblowers and investigators who reveal torture and other abuses must be protected, not targeted. OPIS - of which several team members are Canadian citizens based in or with strong links to Québec - is coordinating with Animal Justice and Droit Animalier Québec to prevent any such legislation from passing.
We continue to advocate in other ways against the torture and abuse of non-human animals, a moral catastrophe that too many people still choose to ignore. Our guide to vegan eating is also getting several thousand views a month thanks to a Google Ad campaign we set up.
Ethical governance
We are currently carrying out interviews and research for a new document that will serve as a white paper/manifesto on the elements of ethical governance. Although the world is complex, chaotic and driven in large part by self-interested entities in positions of power, there are some basic principles and ideas that if spread and implemented will increase the chances of transitioning to a kinder, more cooperative society with less suffering.
I recently led a panel discussion on designing ethical governance along with Matt Hawkins from the UK group Compassion in Politics; Louise Caldwell, who was a member of the Irish Citizens' Assembly; and Patrick Chalmers, a former Reuters journalist, writer and filmmaker. Part of a Campfire Convention event, the video recording of the session (1.5 hours) is available here and a transcript of my 10-minute talk here. A few key messages from my talk:
"We can’t create an ethical society that disregards the suffering of some because we decide, for superficial or self-interested reasons, that they don’t matter as much."
"By reforming the way we do democracy from one of confrontation to one of cooperation around finding solutions, that is based on listening and that takes into account the needs of all, we can not only reduce some harm in the short-term; we can also hope to build a larger consensus among the population for further transforming our society’s power structures."
Genital mutilation
OPIS Associate Jean-Christophe Lurenbaum is also closely involved with the association Droit au Corps and their efforts to bring an end to all forms of genital mutilation. On 30 May, during an online conference he organised for the Worldwide Day of Genital Autonomy, I gave a presentation on ethics that explained how genital mutilation is both a potential source of intense suffering and a direct harm often inflicted non-consensually, which is in conflict both with a basic moral intuition against causing harm unnecessarily and with the principle of non-violence. The broader perspective is to better align our actions with a set of basic ethical principles centred on the desire of all sentient beings not to suffer.
Digital sentience
The possibility of non-biological sentience and suffering is an area of uncertainty. While it's unclear whether classical computers are theoretically capable of having subjective experiences, it is entirely plausible that computers could be designed to be sentient, especially if modelled on the anatomy of biological beings. In fact, the Effective Altruism Foundation and its Center on Long-Term Risk consider this a plausible scenario for astronomical levels of future suffering. OPIS Associate Manu Herrán gave a presentation on 17 May at a symposium on Research, Innovation and Entrepreneurship organised by the D. Y. Patil College of Engineering (Formerly University of Pune), on "Digital sentience: recognising sentience in machines" where he shared his perspectives on how we might know if machines can feel and even suffer (slides here).
Coronavirus
As the scale of the danger posed by the new coronavirus became clear in late winter, we put together a page based on the best information we could find on the virus and how to protect oneself and others, starting with information compiled by OPIS Advisor Nell Watson and supplemented by further information put together by Manu Herrán and myself. We continued to update the page for a month until reliable information from other sources became widespread (although the crisis has shown that even large institutions can make mistakes with serious consequences, failing to follow the precautionary principle or to respond quickly to new data).
Please support us!
OPIS is a unique organisation that focuses on intense suffering as the most urgent phenomenon. We address specific causes of intense suffering and promote ethical governance that puts the prevention of suffering at the heart of decision-making. We have just launched a new crowdfunding campaign to support our activities and projects. You can also donate directly on our website. We have ambitions to make a real difference in the world and are dependent on private donations to carry out our work. We are very grateful for your support!
