Catholic Medical Quarterly Volume 73(4) November 2023

Practical Medical Ethics: Skin whitening, lethal paternalism, comprehensive bioethics and more

Peter Au-Yeung
Consultant Anaesthetist, Hong Kong

Hong KongThe usual hot button topics such as abortion, euthanasia, assistance in dying as well as reproduction will always have a place in Bioethics Corner. Gender ideology is a current hot topic and things have also moved in interesting directions here too. Looking at Michael Cook’s Bioedge ( in order to keep up with current developments, I found a piece about the use of skin whitening agents in Africa. Let’s face it, we Chinese are terribly discriminatory and whitening agents are no strangers to us. “Skin lightening agents in the form of pills and tablets being used by consumers (including pregnant women) with the erroneous impression that it would lighten the skin of their unborn babies.”

In another case, a teenager with mitochondrial disease is being denied life-sustaining therapy to go to Canada to try experimental therapy which may or may not help her. The UK Courts did not want her to go there and want to kill her there.

The Anscombe Bioethics Centre is the successor of the Linacre Centre which was established in a Catholic private hospital in St John’s Wood (London) before I came back to Hong Kong. There is a good analysis of this in Lethal Paternalism by the unit’s Director. (

Unlike earlier cases involving inarticulate children, the person at the centre of the case is a 19 year old (ST) preparing for her A-Levels and certainly articulate enough to make her views known. Stopping dialysis so that she cannot travel to Canada to try out experimental therapy is certainly barbaric of the UK Courts!! She has now died.

In Bioethics 28, we talked about bioethics for animals, now that we have evidence that plants think, we must also assume fungi can also think, what about bioethics for all plants, animals and fungi? Can we be sure minerals don’t behave the same way? Now, that would be rather interesting, wouldn’t it? It also makes vegetarianism and veganism obsolete.

In Assisted Reprodction Technology issues, apart from artificial gamete production and issues at the end of life, one article that will generate sympathy with female Catholic doctors is this article – Egg freezing and the mating gap ( life-issues/ivf/egg-freezing-and-the-mating-gap/).

Others would also find it an interesting read. In surrogacy, Georgia plans to end commercial surrogacy and Singapore bans sperm freezing.

Artificial Intelligence (AI) is causing concern in many areas worldwide. The existential threat to man is not from “blowing up the world”. Rather it will be from “undermining people’s capacity to make judgments, enjoy serendipitous encounters and hone critical thinking.” The Bioedge article ends with this quote from TS Eliot’s poem – the Hollow Men; “This is the way the world ends,”“not with a bang but a whimper.” For gender issues, Europe is providing the lead with Scandinavian countries starting to block drugs and England’s NHS considering doing so.

Finally we end with a story about Hemgenix, the most expensive drug in the world (GBP2.83 million) also temporary cures Haemophilia B (Christmas Disease*), by increasing the production of Factor IX by the liver.

End note.

Apart from the disease being named after Stephen Christmas, the article describing the discovery was published in the 1952 Christmas edition of the BMJ.