MSt in Practical Ethics

Closed to applications for entry in 2021-22

Applications for courses offered for admission in 2022-23 will open on 1 September 2021
Sign up to be notified when applications open for entry to the MSt in Practical Ethics, taught by the Oxford Uehiro Centre for Practical Ethics.

Applications for the modules as standalone courses are still available for some courses.

This flexible, part -time course consists of six modules and a dissertation. The MSt in Practical Ethics is a part-time course consisting of six taught modules and a dissertation. Modules may also be taken as standalone courses. Continue reading

Cross Post: COVID: Is it OK to manipulate people into getting vaccinated?

Written by Maximilian Kiener, University of Oxford

Bored Panda, a website that publishes “lightweight and inoffensive topics”, reports an allegedly true case from the US of a woman who refused to have her child vaccinated. The woman, who is described as a “conspiracy theory magnet”, provided 15 reasons why vaccines are more harmful than the disease they protect against.

When the doctor realised that he wouldn’t be able to dissuade her of her beliefs, he decided to present her with another one:

Have you considered the possibility that anti-vaccine propaganda could be an attempt by the Russians or the Chinese to weaken the health of the United States population?

The doctor deliberately deceived the woman and probably reinforced her belief in conspiracy theories by pretending to find them plausible himself. But the tactic worked. The mother consented to have her child vaccinated.

Right now, vaccination is key to overcoming the COVID-19 pandemic and regaining safe individual freedom. Yet a minority of people, like the woman in our example, still refuse vaccination on mistaken beliefs. But how far can we go to change their minds?

Would the doctor be justified in using similar tactics to make the woman consent to her own COVID-19 vaccination? Continue reading

General Anaesthesia in End of Life Care – GAEL.

by Dominic Wilkinson @Neonatalethics

Our paper General anaesthesia in end-of-life care: extending the indications for anaesthesia beyond surgery has been published today in Anaesthesia. It is part of a series of work led by researcher Antony Takla, together with Julian Savulescu and Dominic Wilkinson. The recent paper is a collaboration with Professor Jaideep Pandit, Professor of Anaesthesia at Oxford.

 

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Press Release: Medical and ethical experts say ‘make general anaesthesia more widely available for dying patients’

General anaesthesia is widely used for surgery and diagnostic interventions, to ensure the patient is completely unconscious during these procedures. However, in a paper published in Anaesthesia (a journal of the Association of Anaesthetists) ethics and anaesthesia experts from the University of Oxford say that general anaesthesia should be more widely available for patients at the end of their lives.

Painkilling medications (analgesia) are commonly given to dying patients. But they may not be enough, leading to the use of continuous deep sedation (also known as “palliative” or “terminal” sedation).

“However, for some patients these common interventions are not enough. Other patients may express a clear desire to be completely unconscious as they die,” explains co-author Professor Julian Savulescu, Uehiro Chair of Practical Ethics, University of Oxford, UK. “Some dying patients just want to sleep. Patients have a right to be unconscious if they are dying. We have the medical means to provide this and we should.”

The authors make clear that their proposal is not about assisted dying, currently illegal in the UK. Instead, their focus is on options available to ensure that patients are comfortable at the end of their lives.

Put simply, some patients will want to be certain they are unconscious and unaware as their final moments arrive.

“The desire to be unconscious as a means of eliminating the experience of physical or mental suffering is understandable,” says co-author Jaideep Pandit, Professor of Anaesthesia at Oxford University Hospitals NHS Foundation Trust, UK. “Unconsciousness through general anaesthesia offers the highest chance of making sure that the patient is unaware of going through an adverse process.”

He adds that “although general anaesthesia in end-of-life care has been used and described in the UK since 1995, modern multidisciplinary guidelines will be needed before this can be offered more widely. Raising this issue now is important, especially in view of international trends showing increased use of general anaesthesia for dying patients.”

Informed consent will, say the authors, be crucial in helping patients understand implications of general anaesthesia for end-of-life care, and the other options they have to manage their final days.

“It is vital that patients are informed of all the legal options available to them to relieve suffering at the end of life. That includes analgesia, sedation and, potentially now, anaesthesia,” says co-author Professor Dominic Wilkinson, Director of Medical Ethics, Uehiro Centre for Practical Ethics at the University of Oxford, UK. “The risks and benefits of each should be explained. Patients should be free to choose the option, or combination of options, that best meet their values.”

In a separate survey of the general public, published recently in the journal PLOS One, Professors Wilkinson and Savulescu found a high level of support for access to deep sedation in dying patients. Some 88% of those surveyed said they would like the option of a general anaesthetic if they were dying. About two thirds (64%) said they would personally choose to have an anaesthetic at the end of life.

Professor Wilkinson adds “members of the general public appear to value the option of deep sleep and complete relief from pain if they were dying. Our previous research indicates that the public believes that patients should be given this choice.”

The authors counter any concerns that the use of general anaesthesia for end-of-life care could hasten death. Studies show no statistically significant difference in mean survival time between patients at the end of life who receive continuous deep sedation and those who do not. In several countries, propofol infusion as used for general anaesthesia has been continued for up to 14 days. “This stresses the point that the purpose of administering anaesthesia is not to hasten death but simply to achieve unconsciousness.” explains co- author Antony Takla, Research Associate at the Uehiro Centre for Practical Ethics, University of Oxford.

The authors believe the UK medical community should prepare for increased requests for general anaesthesia for end-of-life care, based on current trends in Western Europe and Scandinavia.

They conclude: “we have described a potential role for general anaesthesia in end-of-life care. This has, in reality, been available to UK patients since the 1990s, but is not commonly discussed or provided. There is a strong ethical case for making this option more widely available. This does not imply that existing palliative care practice is deficient. Indeed, we might see that general anaesthesia in end-of-life care is requested by, or suitable for, very few patients.”

“However, the number of patients involved should not alone determine whether this issue is regarded as ethically important. Even if complete unconsciousness is desired by only a few patients, there is a moral imperative for national anaesthesia, palliative care and nursing organisations to prepare for the possibility that general anaesthesia in end-of-life care may be requested by some patients, and to work collaboratively to develop clear protocols to address all of the practical, ethical and medicolegal issues concerned.”

Cross-Post: The Moral Status of Human-Monkey Chimeras

Written by Julian Savulescu and Julian Koplin 

This article was first published on Pursuit. Read the original article.

The 1968 classic Planet of the Apes tells the story of the Earth after a nuclear war destroys human civilisation. When three astronauts return to our planet after a long space voyage, they discover that humans have lost the power of verbal communication and live much like apes currently do.

Meanwhile, non-human primates have evolved speech and other human-like abilities, and are now running the earth with little regard for human life.

The astronaut George Taylor, played by Charlton Heston, is rendered temporarily mute when he is shot in the throat and captured. In one scene he is brought before the Apes, as he appears more intelligent than other humans.

He regains the power of speech, and his first words are: Take your stinking paws off me, you damned dirty ape.”

Planet of the Apes may be fiction, but this month the world’s first human-monkey lifeforms were created by Juan Carlos Belmonte at the Salk Institute for Biological Studies in the US, using private funding. Professor Belmonte and his group injected stem cells from the skin of a human foetus into a monkey embryo.

This part-human lifeform is called a chimera.

If implanted into a monkey uterus, the chimera could theoretically develop into a live-born animal that has cells from both a monkey and a human.

While it has been possible to make chimeras for more than 20 years using a different technique that involves fusing the embryos of two animals together, this technique has not been used in humans. It has been used to create novel animals like the geep – a fusion of a sheep and goat embryo.

Professor Belmonte used a different technique– called “blastocyst complementation” – which is more refined. It enables greater control over the number of human cells in the chimera.

But why is this research being done?

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Crosspost: Learning to live with COVID – the tough choices ahead

By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu

This work was supported by the UKRI/ AHRC funded UK Ethics Accelerator project, grant number AH/V013947/1. The UK Ethics Accelerator project can be found at https://ukpandemicethics.org/

 

As mass vaccination continues to be rolled out, the UK is beginning to see encouraging signs that the number of COVID deaths is reducing, and that the vaccines may be reducing the transmission of coronavirus.

While this is very welcome news, a mass vaccination programme is unlikely to be enough to eliminate the virus, so we need to turn our thoughts towards the ethics of the long-term management of COVID-19.

One strategy would be to aim for the elimination of the virus within the UK. New Zealand successfully implemented an elimination strategy earlier in the pandemic and is now in a post-elimination stage.

An elimination strategy in the UK would require combining the mass vaccination programme with severe restrictions on international travel to stop new cases and variants of the virus being imported. However, the government has been reluctant to endorse an elimination strategy, given the importance of international trade to the UK economy.

One of the main alternatives to the elimination strategy is to treat coronavirus as endemic to the UK and to aim for long-term suppression of the virus to acceptable levels. But adopting a suppression strategy for the long term will require us to make a societal decision about the harms we are and are not willing to accept.

 

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Daunte Wright: Policing and Accountability

Written by Jake Wojtowicz and Ben Davies 

On April 11th, Daunte Wright was pulled over by police in Brooklyn Center, Minnesota. Shortly afterwards, he was shot and killed by police officer Kim Potter. Police Chief Tim Gannon described this as an ‘accidental discharge’. But framing events like this as accidents can be misleading and is just one way the police may insulate themselves from appropriate accountability.

The word ‘accident’ can bring to mind what we might call ‘sheer accidents’: bad fortune, acts of god, cars hitting the ice and veering off of the road. Even the language of an ‘accidental discharge’ can sound like Potter had the gun in her hand and it just somehow went off. But that isn’t what happened. Potter pointed the gun at Wright and pulled the trigger. She claims she meant to fire her taser.

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Nonconsensual Neurointerventions and Expressed Disrespect: a Dilemma

Written by Gabriel De Marco and Tom Douglas

This essay is based on a co-authored paper recently published in Criminal Law and Philosophy

Neurointerventions—interventions that modify brain states—are sometimes imposed on criminal offenders for the purposes of diminishing the risk that they will re-offend or, more generally, of facilitating their rehabilitation. A commonly discussed example is the use of hormonal agents to reduce the sex drive of certain sexual offenders. Some suggest that in the future, we will have a wider range of such interventions at our disposal, possibly including, for instance, treatments to reduce aggression or impulsivity, or treatment to enhance capacities for empathy or sympathy.

In a recent paper, we consider an objection to the imposition of such neurointerventions without the offender’s prior agreement. Some object to these ‘nonconsensual neurointerventions’ (or ‘NNs’) by claiming that they express disrespect for the offender. This, according to the objection, gives us reason not to implement them. On a strong version of the objection, NNs are invariably wrong because they always express disrespect. Continue reading

The Neuroscience of a Life Well-lived: New St Cross Ethics Seminar

Professor Morten Kringelbach (Aarhus and Oxford) recently gave a fascinating New St Cross Ethics Seminar on ‘The Neuroscience of a Life Well-Lived’ (YouTube; mp3). Continue reading

Mandating COVID-19 Vaccination for Children

Written by Lisa Forsberg and Anthony Skelton

In many countries vaccine rollouts are now well underway. Vaccine programmes in Israel, the United Kingdom, Chile, United Arab Emirates, Bahrain and the United States have been particularly successful. Mass vaccination is vital to ending the pandemic. However, at present, vaccines are typically not approved for children under the age of 16. Full protection from COVID-19 at a population level will not be achieved until most children and adolescents are inoculated against the deadly disease. A number of pharmaceutical companies have started or will soon start clinical trials to test the safety and efficacy of COVID-19 vaccinations in children and adolescents. Initial results of clinical trials seem promising (see also here and here).

There are strong reasons to inoculate children. COVID-19 may harm or kill them. It disproportionately affects already disadvantaged populations. For example, a CDC study published in August 2020 found the hospitalisation rate to be five times higher for Black children and eight times higher for Latino children than it is for white children. In addition, inoculating children is necessary for establishing herd immunity and (perhaps more importantly), as Jeremy Samuel Faust and Angela L. Rasmussen explained in the New York Times, preventing the virus from spreading and mutating ‘into more dangerous variants, including ones that could harm both children and adults’. Continue reading

It’s Only a Game

Written by Stephen Rainey

Footballers are increasingly prominent in speaking against social and political ills. They can draw attention to serious issues, given their public profile. If more of us followed their example, beyond supporting their causes, we could make a world less accommodating for moral complacency.

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