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Announcement: Online Short Courses Open. Philosophy, Psychiatry and Mental Health, and Neuroethics

Applications are open to join our two June short courses on the ethics and philosophy of neuroscience, psychiatry, and mental health which will be run online this year.

For details and how to apply:

 

Guest Post: Pandemic Ethics. Social Justice Demands Mass Surveillance: Social Distancing, Contact Tracing and COVID-19

Written by: Bryce Goodman

The spread of COVID-19 presents a number of ethical dilemmas. Should ventilators only be used to treat those who are most likely to recover from infection? How should violators of quarantine be punished? What is the right balance between protecting individual privacy and reducing the virus’ spread?

Most of the mitigation strategies pursued today (including in the US and UK) rely primarily on lock-downs or “social distancing” and not enough on contact tracing — the use of location data to identify who an infected individual may have come into contact with and infected. This balance prioritizes individual privacy above public health. But contact tracing will not only protect our overall welfare. It can also help address the disproportionately negative impact social distancing is having on our least well off.
Contact tracing “can achieve epidemic control if used by enough people,” says a recent paper published in Science. “By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society.” Once someone has tested positive for a virus, we can use that person’s location history to deduce whom they may have “contacted” and infected. For example, we might find that 20 people were in close proximity and 15 have now tested positive for the virus. Contact tracing would allow us to identify and test the other 5 before they spread the virus further.
The success of contact tracing will largely depend on the accuracy and ubiquity of a widespread testing program. Evidence thus far suggests that countries with extensive testing and contact tracing are able to avoid or relax social distancing restrictions in favor of more targeted quarantines.

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National Ethics Framework For Use in Acute Paediatric Settings During COVID-19 Pandemic

This ethical framework is a modification of guidance developed for treatment decisions relating to adults. The principles relating to decisions for children in the setting of the pandemic are the same as those for adults. The framework emphasises that decisions should be ethically consistent and apply to patients both with COVID-related and non-COVID related illness.
The focus of the ethical framework provides guidance for a situation where there is extremely high demand and limited critical care capacity. However, it is important to note that at the time of writing (14 April 2020) there is enough paediatric critical care capacity across the UK. At the present time decisions about children in need of critical care should reflect the same fundamental ethical considerations as apply in normal times. Those decisions should be focused on the best interests of the child, and actively involve parents in decision-making.
The framework is available to read in full on the  Royal College of Paediatric and Child Health website.

Guest Post: Pandemic Ethics-Earthquakes, Infections, and Consent

David Killoren
Dianoia Institute of Philosophy
Australian Catholic University, Melbourne

People often seem to be stubbornly resistant to change. Consider humanity’s collective failure to respond adequately to the climate emergency. Consider the lifelong smoker who won’t quit even after an emphysema diagnosis. Consider the meat-eater who watches Dominion, resolves to go vegan, and then falls off the wagon the next day. Even when we feel that we have excellent reasons to change our lives, we often drag our feet.

Yet when the coronavirus appeared in late 2019, our antipathy to change suddenly seemed to evaporate. Medical experts and politicians called for sweeping changes and huge numbers of people simply heeded the call. To be sure, there are dissenters. America’s deeply strange president is among them. But the degree of compliance with new restrictions and requirements that we’ve seen in recent weeks is extraordinary. Work, education, dating, dining, art, sport, even casual conversations with strangers—all of these facets of life have been dramatically altered, canceled, or paused for an indefinite period that may last two years or more, and there’s been little complaining from the people. If nothing else, the coronavirus crisis demonstrates this: When conditions are ripe, we are willing to upend our lives.

I’m not here to criticize or to defend the way we’re responding to the virus. But I want to raise some questions that I think aren’t receiving due attention. Continue reading

Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Written by Dominic Wilkinson, University of Oxford

This article originally appeared in The Conversation

In a world where the adjective “unprecedented” has become commonplace, the news of British Prime Minister Boris Johnson being admitted to the intensive care unit of St Thomas’ Hospital with COVID-19 seemed to take it to a new level.

There is little information in the public domain about Johnson’s medical condition, but this is clearly a very serious step. He will only have been transferred to intensive care because it is perceived that his condition is potentially life threatening and there is a possibility that he would need urgent medical attention, including the possible use of mechanical ventilation.

What would happen if that became necessary? Would Johnson’s treatment be any different from anyone else with the same condition? Would he receive special treatment because of his political position, because of his importance for the country? Would he be prioritised for a ventilator? Continue reading

Oxford Uehiro Prize in Practical Ethics: An Account of Attitudinal Duties Towards Injustice

This essay received an honourable mention in the Graduate Category

Written by University of Oxford Student, Brian Wong

Injustices are ubiquitous around us. From authoritarian regimes’ crackdown on human rights, to exploitative trafficking of illegal migrants, to human-induced destruction of rainforests upon which indigenous groups depend – injustices are negative states of affairs violating moral commitments and duties caused by some level of human agency. Our ability to resist injustices are inevitably constrained, but I argue that even the least able amongst agents still possess attitudinal duties – duties to cultivate and possess particular attitudes towards injustice. Attitudes are mental states; here I focus specifically on explicit attitudes – attitudes that are accessible by introspection and non-automatically/reflexively generated.[1] I open with a pair of cases providing the intuitive preliminaries, prior to offering three interrelated arguments for attitudinal duties, namely from i) functional similarity, ii) relational justice, and iii) aptness. After outlining the plausible contents of such duties, I conclude by examining two objections – i) self-defeasibility, and ii) enforceability. Continue reading

Oxford Uehiro Prize in Practical Ethics: What, if Anything, is Wrong About Algorithmic Administration?

This essay received an honourable mention in the undergraduate category.

Written by University of Oxford student, Angelo Ryu.

 

Introduction

 The scope of modern administration is vast. We expect the state to perform an ever-increasing number of tasks, including the provision of services and the regulation of economic activity. This requires the state to make a large number of decisions in a wide array of areas. Inevitably, the scale and complexity of such decisions stretch the capacity of good governance.

In response, policymakers have begun to implement systems capable of automated decision making. For example, certain jurisdictions within the United States use an automated system to advise on criminal sentences. Australia uses an automated system for parts of its welfare program.

Such systems, it is said, will help address the costs of modern administration. It is plausibly argued that automation will lead to quicker, efficient, and more consistent decisions – that it will ward off a return to the days of Dickens’ Bleak House. Continue reading

Oxford Uehiro Prize in Practical Ethics: If Doctors Could Administer a Treatment That Would Move a Patient From a Vegetative State to a Minimally Conscious One, Should They Do So?

This essay was the runner up in the graduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Matthew Minehan.

INTRODUCTION
Sally is a healthy young woman who suffers catastrophic brain trauma. Over many months, her doctors subject her to functional Magnetic Resonance Imagining (fMRI) scans and other assessments that leave them in no doubt that she is in a vegetative state. While she shows sleeping and waking activity patterns, her body is operating on ‘automatic’ and she has no consciousness. She is “incognizant, incapacitated and insensate” (Fenwick 1998, p.86).

Sally’s doctors are aware of a new treatment that, if administered, would move her from the vegetative state to a minimally conscious one. This new state would involve fractured consciousness, a lack of awareness of her condition, an inability to direct her own life and an incapacity for complex thought. Because Sally has no known next of kin and issued no advance directive, the decision on her treatment is left to her medical team.

Should the doctors in this hypothetical scenario administer the treatment to Sally? Continue reading

Oxford Uehiro Prize in Practical Ethics: Can it be Wrong For Victims to Report Crimes?

This essay was the winning entry in the graduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student, Maya Krishnan.

 

Introduction

Late one night in Managua, Nicaragua, a man punched Leslie Jamison in the face and then ran away with her camera. Jamison called the police. Forty minutes later, a police truck pulled up with a man in the back. A sense of discomfort informs Jamison’s subsequent narration of the incident in her essay collection, The Empathy Exams (2014). Jamison found herself occupying a morally fraught role: that of a white American in Nicaragua who got the police to try to hunt down a likely significantly poorer man. Had she done something wrong by calling the police? Continue reading

Oxford Uehiro Prize in Practical Ethics: Can Science Ethically Make Use Of Data Which Was Gathered By Unethical Means?

This essay was the runner up in the undergraduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics

Written by University of Oxford student Toby Lowther

In this paper, I discuss the question of whether science can ethically make use of data which has been gathered by unethical means in seeking scientific and medical advances to alleviate future suffering. This is an ever-controversial issue of practical ethics, and although the American Medical Assosciation provides firm guidelines on the matter (AMA, 1995), the ethical question remains complex. I will begin by laying out the core issue: the conflict between the desire to censure unethical practices used in gathering such data and the desire to use all data available to bring about the greatest good for society. I will present arguments either side, leading to an ethical stalemate, before presenting how issues of practical consideration for scientific methodology resolve the conflict. I conclude that science cannot make use of data gathered by unethical means, because such data cannot ethically be replicated, and reproducibility is necessary for the validity of the scientific method. I leave open the question of whether it is ethical for the findings of such unethical experiments to guide future, ethical research. Continue reading

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