By Hannah Maslen, Jonathan Pugh and Julian Savulescu
According to the NHS, the number of hospital admissions across the UK for teenagers with eating disorders has nearly doubled in the last three years. In a previous post, we discussed some ethical issues relating to the use of deep brain stimulation (DBS) to treat anorexia nervosa (AN). Although the trials of this potential treatment are still in very early, investigational stages (and may not necessarily become an approved treatment), the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this post, we show how different possible mechanisms of intervention raise different questions for philosophers to address. The prospect of intervening directly in the brain prompts exploration of the relationships between a patient’s various mental phenomena, autonomy and identity. Continue reading
Many important discussions in practical ethics necessarily involve a degree of speculation about technology: the identification and analysis of ethical, social and legal issues is most usefully done in advance, to make sure that ethically-informed policy decisions do not lag behind technological development. Correspondingly, a move towards so-called ‘anticipatory ethics’ is often lauded as commendably vigilant, and to a certain extent this is justified. But, obviously, there are limits to how much ethicists – and even scientists, engineers and other innovators – can know about the actual characteristics of a freshly emerging or potential technology – precisely what mechanisms it will employ, what benefits it will confer and what risks it will pose, amongst other things. Quite simply, the less known about the technology, the more speculation has to occur.
In practical ethics discussions, we often find phrases such as ‘In the future there could be a technology that…’ or ‘We can imagine an extension of this technology so that…’, and ethical analysis is then carried out in relation to such prognoses. Sometimes these discussions are conducted with a slight discomfort at the extent to which features of the technological examples are imagined or extrapolated beyond current development – discomfort relating to the ability of ethicists to predict correctly the precise way technology will develop, and corresponding reservation about the value of any conclusions that emerge from discussion of, as yet, merely hypothetical innovation. A degree of hesitation in relation to very far-reaching speculation indeed seems justified. Continue reading
Hannah Maslen and Julian Savulescu
In a pioneering new procedure, deep brain stimulation is being trialed as a treatment for the eating disorder anorexia nervosa. Neurosurgeons at the John Radcliffe Hospital in Oxford implanted electrodes into the nucleus accumbens of a woman suffering with anorexia to stimulate the part of the brain involved in finding food rewarding. Whilst reports emphasize that this treatment is ‘highly experimental’ and would ‘only be for those who have failed all other treatments for anorexia’, there appeared to be tentative optimism surrounding the potential efficacy of the procedure: the woman who had undergone the surgery was reportedly ‘doing well’ and had shown ‘a response to the treatment’.
It goes without saying that successful treatments for otherwise intractable conditions are a good thing and are to be welcomed. Indeed, a woman who had undergone similar treatment at a hospital in Canada is quoted as saying ‘it has turned my life around. I am now at a healthy weight.’ However, the invasive nature of the procedure and the complexity of the psychological, biological and social dimensions of anorexia should prompt us to carefully consider the ethical issues involved in offering, encouraging and performing such interventions. We here outline relevant considerations pertaining to obtaining valid consent from patients, and underscore the cautious approach that should be taken when directly modifying food-related desires in a complex disorder involving interrelated social, psychological and biological factors. Continue reading
If an offender is genuinely remorseful about the crime she committed, should she receive some small-but-non-trivial mitigation of her sentence? – i.e. should she be punished a little bit less than she would have been had she not been remorseful? In many jurisdictions, including England and Wales, this practice is written into the sentencing guidelines that judges have to follow. However, it is difficult to see how this practice can be justified, and intuitions about the relevance of remorse to criminal sentencing seem to vary wildly.
One first obvious concern is that it can be difficult to know whether an offender’s remorse is genuine: is she just pretending in the hope that her sentence will consequently be somewhat lighter than it would otherwise have been? Whilst the possibility of simulation indeed presents a practical challenge, the prior question is whether an offender’s genuine remorse should matter at all. Should judges try to determine whether an offender is remorseful and, if so, with what consequences? Continue reading
by Hannah Maslen, Julian Savulescu and Carin Hunt
A study examining pharmaceutical cognitive enhancement found that participants’ subjective enjoyment of various memory and problem-solving tasks was significantly greater when they had taken modafinil (a drug originally developed for narcolepsy) compared with placebo, but that mood ratings overall were not affected (Muller at al 2013). The authors of the paper therefore concluded that, in addition to the various performance effects, ‘an important finding of this study is that there was a striking increase in task motivation’. Whilst a lot of attention has been paid to the ethical implications of enhancing cognitive performance, much less has been paid to the striking task-motivation finding. We suggest, however, that motivation enhancement might be the more contentious effect, from an ethical point of view. Continue reading
At 7pm, as you’re eating your dinner, you get a call from an unknown number. You pick it up, half out of curiosity (perhaps your numbers have finally come up on the premium bonds), half out of worry (was a family member likely to have been driving at this time?), but wholly anticipating the interaction that in fact transpires:
‘Good evening, I was wondering whether I could talk to [Your Name]?’
‘Can I ask who’s calling?’ you deflect.
Enthusiastically: ‘My name’s Charlie and I’m calling from Well Known Phone Company Ltd. I wanted to check whether you had thought about updating your tariff? You’re due an upgrade.’
You have, in fact, been wondering about updating your tariff, but you’re not in the mood to do it now and dinner is getting cold. You think about explaining this to chirpy Charlie, but even the thought of engaging in an exchange about whether and when you might be free to discuss it feels like too much effort.
‘We’d be able to save you about…’
‘Sorry’, you interject with a shade of sincerity, ‘I’m not in the mood for being polite.’
‘Ok, well, I…’
You hang up, feeling a twinge of guilt and tremendous wonderment at how Charlie of Well Known Phone Company Ltd remains so chirpy in the face of such rejection.
Ordinarily, we tend to think there is a presumption towards being polite to other people. By ‘being polite’ I mean acting courteously – considering and acknowledging the needs and feelings of others with whom we interact, even when those interactions are very brief. If someone follows close behind you through a door, you should pause to keep it open rather than letting it shut in their face. If someone asks you the time, you should at least acknowledge their question. If someone lets you into the traffic, you should indicate your thanks. This presumption towards minimally respectful behavior arises partly from social convention and partly from our duty to acknowledge the moral reality of other people.
Given the presumption towards politeness, how polite must you be to Charlie the Salesman? Were you justified in hanging up mid-sentence or did your twinge of guilt inform you that you had behaved unfairly? Or, given a less tolerant day, would you in fact have been justified in expressing anger and contempt to Charlie? Continue reading
Last week, an article in the Pacific Standard discussed the evolutionary origins and present-day disutility of the Hostile Attribution Bias (HAB). The HAB is exhibited when an individual automatically attributes malicious intentions to another, often in cases where that person’s behavior is ambiguous. For example, when someone uses the colloquial phrase ‘he was looking at me funny’ as a justification for their own hostility, this is meant to imply that the utterer interpreted another person’s gaze as judgmental or even threatening; in fact, though, it may have been neither. Given that those with a propensity towards exhibiting this bias are also more likely to engage in aggressive behavior on its basis, the bias is widely seen not only to be irrational, but also detrimental. Indeed, the author of the aforementioned article says: ‘The trouble is, the more we sense hostility in others, the more aggressive we tend to be in return. And in many social contexts, hostile attribution bias is, as psychologists put it, highly “maladaptive.”’
In what way is the bias ‘highly maladaptive’? Is it wholly irrational? Continue reading
A recent study purports to demonstrate that mindfulness meditation techniques can reduce implicit biases. Affecting all manner of interpersonal interactions, implicit biases are unconscious attitudes or associations that influence our understanding, behavior and decisions. Implicit biases can be revealed using implicit association tests (IATs), which often measure the degree to which a participant associates particular stimuli (e.g. white or black faces) with negative and positive words by recording the speed and accuracy with which words are categorized when presented alongside ‘congruous’ or ‘incongruous’ stimuli. For example, white people are better at categorizing positive words when they presented alongside white, rather than black faces and better at categorizing negative words when they are presented alongside black, rather than white faces. Crucially, these implicit biases often do not correspond to participants’ explicit, reported attitudes to racial or other demographic minorities: even the most fervent (white, young) egalitarian can display implicit bias against black or elderly faces.
In their study, Lueke and Gibson sought to investigate whether mindfulness meditation could reduce implicit associations. Continue reading
The recent media coverage of the Parole Board’s decision to release Harry Roberts after serving his (minimum) murder sentence has reignited debate over how those convicted of killing a police officer should be punished. The fact that the people Roberts murdered were police officers seems to be of great significance in the outcry about his release: not only did he murder, he murdered police officers.
The current law in England and Wales states that the murder of a police (or prison) officer in the course of duty is a factor indicating a murder of ‘particularly high seriousness’, which must attract a minimum sentence of 30 years. Other factors indicating particularly high seriousness include: Continue reading