Mackenzie Graham

The Ethics of Consciousness Hunting

By Mackenzie Graham

Crosspost from Nautilus. Click here to read the full article

When Adrian Owen, a neuroscientist at the University of Western Ontario, asked Scott Routley to imagine playing a game of tennis, any acknowledgement would have been surprising. After all, Routely had been completely unresponsive for the 12 years since his severe traumatic brain injury. He was thought to be in a vegetative state: complete unawareness of self or environment. But, as Owen watched Routley’s brain inside a functional magnetic resonance imaging (fMRI) scanner, he saw a region of the motor cortex called the supplementary motor area—thought to play a role in movement—light up with activity. When he told Routely to relax, the activity ceased. And when he asked Routley to imagine walking around his house, he saw clear activity in the parahippocampal gyrus—a region of the brain that plays an important role in the encoding and recognition of spatial environment.

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One question that Owen didn’t ask Routley was if he wanted to die. It’s easy to imagine how Routley’s life might not be worth living. It might be painful, for example, or mean he could no longer do the things that he wanted to do in life, or involve the loss of his relationships. On the other hand, people who sustain debilitating injuries often report a level of well-being that approximates that of healthy people. Even patients in a locked-in state—total paralysis with the exception of eye-movement—have reported that they are happy with their lives.

Continue reading at: http://nautil.us/issue/64/the-unseen/the-ethics-of-consciousness-hunting

UK Supreme Court Decision Means Patients No Longer Forced to Live

By Mackenzie Graham

On July 30, The UK’s Supreme Court ruled that there is no requirement to obtain court approval before withdrawing clinically assisted nutrition and hydration (CANH), when there is agreement between physicians and the family that this is in the best interests of the patient.

In the judgement, Lady Black writes:

“If the provisions of the MCA [Mental Capacity Act] 2005 are followed and the relevant guidance observed, and if there is agreement upon what is in the best interests of the patient, the patient may be treated in accordance with that agreement without application to the court.”

Until now, requests to withdraw CANH needed to be heard by the Court of Protection to determine if withdrawing treatment was in the patient’s best interest. In addition to being emotionally difficult for families, this is a time-consuming and expensive process, and often results in the patient dying before a judgement is rendered.

I think this decision has much to be said in its favour. First, it means that when there is agreement that continued treatment is no longer in the best interests of a patient with a prolonged disorder of consciousness, these patients are no longer being ‘forced to live’ until the Court affirms that being allowed to die is in their best interests. In many cases, court decisions take months, meaning that a patient is forced to be kept alive, against their best interests and the wishes of their family. Making the decision to withdraw care from a loved one is highly distressing, and this is likely further compounded by the burden and distraction of court proceedings.

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Why It’s Important to Test Drugs on Pregnant Women

By Mackenzie Graham

Crosspost from The Conversation. Click here to read the full article.

The development of accessible treatment options for pregnant women is a significant public health issue. Yet, very few medications are approved for use during pregnancy. Most drug labels have little data to inform prescribing decisions. This means that most medicines taken during pregnancy are used without data to guide safe and effective dosing.

The United States Food and Drug Administration recently published draft ethical guidelines for how and when to include pregnant women in drug development clinical trials. These guidelines call for “the judicious inclusion of pregnant women in clinical trials and careful attention to potential foetal risk”. The guidelines also distinguish between risks that are related to the research and those that are not, and the appropriate level of risk to which a foetus might be exposed. Continue reading

Facebook, Big Data, and the Trust of the Public

By Mackenzie Graham

Facebook CEO Mark Zuckerburg recently appeared before members of the United States Congress to address his company’s involvement in the harvesting and improper distribution of approximately 87 million Facebook profiles —about 1 million of them British— to data collecting app Cambridge Analytica. In brief, Cambridge Analytica is a British political consulting firm, which uses online user data (like Facebook profiles), to construct profiles of subjects, which can then be used for what it calls ‘behavioural micro-targeting’; advertisements tailored to the recipient based on their internet activity. In 2016, Cambridge Analytica was contracted by Donald Trump’s presidential campaign, as well as the ‘Leave EU’ campaign prior to Britain’s referendum to leave the European Union.

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Faster, Higher, Stronger…Happier? Olympic Athletes and the Philosophy of Well-Being

Written by Mackenzie Graham

Last Sunday marked the end of the 2018 Winter Olympics in Pyeongchang, South Korea. Olympic athletes train intensely for years in preparation for a single opportunity at winning gold. Unfortunately, most of them will not be successful. Many will have missed out on a medal by fractions of a second or tenths of a point, an ill-timed crash or fall, or a split-second mental error. In some respects, it hardly seems worth all of the effort and sacrifice, required to be an Olympic athlete (at least in most cases). To focus and train so long and so hard on a single task, only to fall just short of one’s goal, seems an irrational way to organize one’s life.

On the other hand, we might think that this pessimistic view completely misses the point, and that Olympic athletes are actually living some of the best lives possible. The philosophy of well-being is concerned with what things have ‘prudential value’; what things make a life good for the person who is living it? Three conceptions of well-being have largely dominated the philosophical literature. Hedonist views of prudential value hold that, at a fundamental level, the only thing that is ‘good for me’ (or anyone else), is the experience of pleasure, and the only thing that is bad for me is the avoidance of pain. The best life for me is the one which maximizes my experience of pleasure, and minimizes my experience of pain.

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