“Now we must wait, wait. These hours…. The gurgling starts again — but how slowly a man dies! …By noon I am groping on the outer limits of reason. …every gasp lays my heart bare.” Erich Maria Remarque, All Quiet on the Western Front
In Remarque’s novel, the agony of the German soldier, witnessing the slow death of an enemy combatant, is heightened by his own guilt (the narrator had stabbed another soldier in self defense). However, his powerful evocation of distress (and guilt) at witnessing a slow dying is very close to the expressed concerns of parents and clinicians who are watching the death of a child.
On Thursday 16th October, Professor Kenneth Kendler delivered his second (and final) Loebel Lecture, entitled ‘The dappled causal world for psychiatric disorders: implications for psychiatric nosology’. You can view it online here or listen here.
Whilst Kendler’s first lecture – summarised by Roger Crisp here - focused on empirical issues, the second lecture was more philosophical. Kendler’s key question in the second lecture could perhaps be formulated as: Given the complex aetiology of mental disorders, how can we best understand and explain how they arise? Continue reading
A GP in Guildford has recently revealed that the NHS is to pay GPs £55 each time they diagnose dementia in a patient. Writing on the medical website Pulse, Dr Martin Brunet, called the incentive scheme a “bribe,” put in place so that the government can “hit its target to raise diagnosis rates.”
The ‘Dementia Identification Scheme’ requires GPs to count how many patients with a dementia diagnosis there were on their register at the end of September, and to compare this with the number at the end of March 2015. They will then receive £55 for every extra patient. The full service specifications can be found here.
The Genetic Epidemiology of Psychiatric and Substance Abuse Disorders: Multiple Levels, Interactions and Causal Loops
What causes psychiatric disorders, such as depression or alcohol abuse disorders? It’s obvious that background and upbringing often play a significant role, as do life events, such as losing one’s spouse or one’s job. And we also know now that genetic propensities are important. But how do these different factors inter-relate with one another? For over three decades, these issues have been at the centre of the research of Oxford’s first Loebel Lecturer, Professor Kenneth Kendler.
Professor Kendler is one of the world’s leading, and most highly cited, psychiatric researchers. He uses a range of methods, including family studies, twin and adoption studies, and molecular genetics. He also has a serious interest in the philosophy of psychiatry. His first Loebel Lecture — The Genetic Epidemiology of Psychiatric and Substance Abuse Disorders: Multiple Levels, Interactions and Causal Loops – was presented at the Oxford Martin School on Wednesday 15 October 2014, and is now available on Youtube and as an MP3 audio file. Continue reading
The new DPP Alison Saunders has clarified the Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide issued by the previous DPP, Keir Starmer, in 2010. This has led to claims by right to life groups that assisted suicide will be available in the UK. This is, I argue, false. Assisted suicide remains a crime. I argue a better alternative under current law is Voluntary Palliated Starvation. This could render unconscious patients who embark on suicide by starvation and dehydration, such as the recent tragic case of Mrs Jean Davies. This could be lawful under current law and acceptable to doctors who do not wish to kill, but wish to relieve suffering.
A recent article by Marc Bekoff, written for the website The Dodo, asks whether it might be true that researchers who currently test on animals are less humane than their predecessors. Bekoff thinks it is. His reasons for that belief seem to be something like the following: We know considerably more about the cognitive and emotional faculties of animals now than we did in the past. That is, we know that even smaller mammals and birds can be quite cognitively sophisticated and emotionally developed. In the face of this knowledge, our continued use of those animals for the purpose of conducting research is less humane than it was at a time when we believed animals to not possess any such faculties. Bekoff uses this belief to cast doubt on the ethical status of continued research on animals. If we are being less humane in our research now than we used to be, then we are also being less ethical. It’s not clear to me that this inference is correct. Continue reading
We’re not good at large numbers. Our brains are adapted to living in groups of perhaps 150 individuals. City living is a very recent innovation, and our psychological mechanisms struggle to cope with it. One way in which we may go astray is through the misapplication of heuristics that worked well for our ancestors, but which misfire in very large groups. Suppose you learn that there is a person in your group prone to violence without provocation. If you live in a group of 150 individuals, you need to be on high alert: your paths will cross. But if you live in a city of 5 million people, you really shouldn’t worry (unless you have some reason to think the violent individual lives in your street). In fact, on learning that there is such an individual you will probably feel more anxiety than you should – not as much as you would if you knew your paths would cross, but more than you rationally ought to. Continue reading
You do not have a right not to be offended, insulted or verbally abused. You do not have that right because it might be right to offend, insult or verbally abuse you. You might believe stupid things, or even sensible things, and take offence at any and all critiques, rebuttals and refutations. You might be a pompous prig, a sanctimonious sop, an officious orifice. Even if you are not these things, there would be very little wrong in telling you you are. After all, you are not a six-year old child: you’re an adult. You can take it.
What of someone expressing their detestation of you, their hatred of you, wishing you ill, wishing you dead?
In a world where too many go to bed hungry, it comes as a shock to realise that more than half the world’s food production is left to rot, lost in transit, thrown out, or otherwise wasted. This loss is a humanitarian disaster. It’s a moral tragedy. It’s a blight on the conscience of the world.
It might ultimately be the salvation of the human species.
To understand why, consider that we live in a system that rewards efficiency. Just-in-time production, reduced inventories, providing the required service at just the right time with minimised wasted effort: those are the routes to profit (and hence survival) for today’s corporations. This type of lean manufacturing aims to squeeze costs as much as possible, pruning anything extraneous from the process. That’s the ideal, anyway; and many companies are furiously chasing after this ideal. Continue reading