Ben Davies

Healthcare Ethics Has a Gap…

By Ben Davies

Last month, the UK’s Guardian newspaper reported on a healthcare crisis in the country. If you live in the UK, you may have already had an inkling of this crisis from personal experience. But if you don’t live here, and particularly if you are professionally involved in philosophical ethics, see if you can guess: what is the latest crisis to engulf the publicly funded National Health Service (NHS)?

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Rethinking ‘Higher’ and ‘Lower’ Pleasures

by Ben Davies

One of John Stuart Mill’s most well-known claims concerns the distinction between higher and lower pleasures. Higher pleasures—which are, roughly, ‘mental’ pleasures—are, says Mill, always preferable to lower pleasures—the pleasures of the body.

In Mill’s rendering, competent judges—those who have experience of both higher and lower pleasures—will choose a higher pleasure over a lower pleasure “even though knowing it to be attended with a greater amount of discontent” and “would not resign it for any quantity of the other [lower] pleasure which their nature is capable of”.

There are two ways we might interpret this claim:

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Should Vaccination Status Affect ICU Admission?

By Ben Davies and Joshua Parker

Intensive care units around the country are full, with a disproportionate number of patients who have not had a single COVID-19 vaccination. Doctors have been vocal in describing the emotional cost of caring for critically unwell patients suffering from the effects of a virus for which there is an effective vaccine. Indeed, one doctor has gone so far as to argue that the unvaccinated should contribute financially for their care. It is easy to understand doctors’ frustrations given the relentless pressures and difficult decisions they’ve had to face. In the face of very real dilemmas about how to allocate scarce ICU beds, some might wonder whether the NHS should adopt a policy of ‘no vaccine, no ICU bed’.

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Are Electoral Pacts Undemocratic?

By Ben Davies

In the early hours of Friday morning last week, the long-Conservative UK constituency of North Shropshire caused some political upset (and no little political joy) by electing a Liberal Democrat, Helen Morgan.

It is hard to exaggerate quite how significant a swing this was: the previous Conservative MP, Owen Paterson, whose resignation around accusations of corruption promoted the by-election, had a majority of nearly 23,000 when he was re-elected in 2019. Morgan beat the new Conservative candidate by nearly 6,000.

How was all this possible? One factor will likely have been Conservative voters staying at home, and a few switched to other right-wing parties. But at her acceptance speech, Morgan acknowledged that it was highly likely that voters who would have preferred a Labour MP (the party saw a collapse in its vote share) or a Green MP, lent her their support in order to have the best chance of avoiding a Conservative win. This will lead some to call again for a more formal electoral pact at the country’s next General Election, whereby Labour, the Liberal Democrats and the Greens agree to stand down candidates in seats currently occupied by a Conservative, and where there is a reasonable chance of one of these three parties winning if their anti-Tory rivals stand aside.

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Paying for the Flu Vaccine

By Ben Davies

As I do every winter, I recently booked an appointment for a flu vaccine. I get it for free in the UK. If I didn’t have asthma, I’d still get vaccinated, but it would cost me between £9 and £14.99. That is both an ethical error on the part of the government, and may be a pragmatic one too.

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In Praise of ‘Casual’ Friendship

By Ben Davies

Academics, especially early in our careers, move around quite a lot. Having done my PhD in London, I have also lived or worked in Leeds, Liverpool, Oxford, and rural Pennsylvania; I am far from the most well-travelled academic I know. In many cases, when we arrive at a new job, we know that it is likely to only last a short period, perhaps less than a year.

This blog post isn’t about how hard it is to be an academic (though there are plenty of real problems that arise from the precarity in which many early career researchers find themselves). Instead, I want to consider something which all this moving around necessitates: casual friendship.

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Compromising On the Right Not to Know?

Written by Ben Davies

Personal autonomy is the guiding light of contemporary clinical and research practice, at least in the UK. Whether someone is a potential participant in a research trial, or a patient being treated by a medical professional, the gold standard, violated only in extremis, is that they should decide for themselves whether to go ahead with a particular intervention, on the basis of as much relevant information as possible.

Roger Crisp recently discussed Professor Gopal Sreenivasan’s New Cross seminar, which argued against a requirement for informational disclosure in consenting to research participation. Sreenivasan’s argument was, at least in its first part, based on a straightforward appeal to autonomy: if autonomy is what matters most, I should have the right to autonomously refuse information.

I have previously outlined a related argument in a clinical context, in which I sought to undermine arguments against a putative ‘Right Not to Know’ that are themselves based in autonomy. In brief, my argument is, firstly, that a decision can itself be autonomous without promoting the agent’s future or overall autonomy and, second, that even if there is an autonomy-based moral duty to hear relevant information (as scholars such as Rosamond Rhodes argue), we can still have a right that people not force us to hear such information.

In a recent paper, Julian Savulescu and I go further into the details of the Right Not to Know, setting out the scope for a degree of compromise between the two central camps.

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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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Priority Vaccination for Prison and Homeless Populations

Written by Ben Davies

Last week brought the news that an additional 1.7m people in the UK had been asked to take additional ‘shielding’ measures against COVID-19, following new modelling which considered previously ignored factors such as ethnicity, weight and deprivation. Since many of this group have not yet been vaccinated, they were bumped up the priority list for vaccine access, moving into group 4 of the government’s vaccine plan.

Two other groups, however, have not yet been incorporated into this plan despite appeals from some quarters that they should be. First, new figures reinforced the sense that the virus is disproportionately affecting prisoners, with one in eight of the prison population having had COVID-19, compared with roughly one in twenty in the wider population (in the United States, the prison figure has been estimated to be one in five).

Second, some GP groups and local councils have offered priority vaccination to homeless residents, despite their not officially qualifying for prioritisation on the government’s plan. There have also been calls for the government to incorporate this into national plans, rather than being left to more local decision-making.

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Consent Without Alternatives

Written by Ben Davies and Joshua Parker

“COVID-19: Do not resuscitate orders might have been put in place without consent, watchdog says”. This recent headline followed an investigation by the Care Quality Commission into Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) decisions early in the pandemic. In a recent post, Dominic Wilkinson highlights two misconceptions in the coverage of this report, one of which is the ‘consent misconception’.

Dominic’s view is that “there is no ethical requirement…to seek the agreement of patients not to offer or provide a treatment” which a medical professional judges inappropriate. Of course, his position is not that consultation and discussion around CPR is inappropriate, only that consent is not necessary. This is the standard view on consent in this context and, due in part to the Tracey judgment, reflects doctors’ practice. Thus, an important distinction emerges between consenting to the withholding of some treatment, and discussion of that decision. Doctors may be ethically required to discuss a decision without also having an obligation to seek the patient’s consent. The absence of consent, then, does not signal that the DNACPR was unethical, whereas a failure to consult probably will.

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