Current Affairs

Mandatory submission of patient information about FGM: a pointless, damaging, discriminatory mess

Brenda Kelly and Charles Foster

Female Genital Mutilation (‘FGM’) is a term covering various procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons (WHO, 2012). It can be associated with immediate and long-term physical and psychological health problems. FGM is prevalent in Africa, Middle East and South East Asia as well as within diaspora communities from these countries

The Government, keenly aware of the political capital in FGM, has come down hard. The Serious Crime Act 2015 makes it mandatory to report to the police cases of FGM in girls under the age of 18. While we have some issues with that requirement, it is at least concordant with the general law of child protection.

What is of more concern is the requirement, introduced by the cowardly device of a Ministerial Direction and after the most cursory consultation (in which the GMC and the RCOG hardly covered themselves in glory), by which healthcare professionals, from October 2015, are legally obliged to submit patient-identifiable information to the Department of Health (‘DOH’) on every female patient with FGM who presents for whatever reason, through the Enhanced Dataset Collection (EDC). The majority of these women will have undergone FGM in their country of origin prior to coming to the UK. Continue reading

Rugby and the Love of the Underdog

The Rugby World Cup is now well underway in England and Wales, and rugby fans have possibly already seen one of its most surprising results and entertaining games. On the second day of the tournament, Japan defied the odds to earn a narrow 34-32 victory over South Africa. The result stunned the rugby world – prior to the result, South Africa had been hailed as possible tournament winners, having been already been crowned world cup champions in 1995 and 2007, whilst few outside the Japanese camp gave them a serious chance of success, with bookmakers classing them as 80-1 underdogs. It truly was a victory of Goliath-slaying proportions.

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Drinking at Schiphol with the fount of bioethics

A couple of weeks ago, in an airport bar, I met the foundation of modern bioethics.

I was crawling back to London: he was heading to JFK.

‘I usually fly First’, was his opening, as we sat on those vertiginous stools. ‘So I’m usually in the Lounge. But it’s good to be reminded how the other half live.’ I was glad, for about a minute, to be part of his democratic education.

He’d had quite a start on me, and was several G & Ts down when I arrived. That might have loosened his tongue. Or perhaps, and probably, he was as keen when sober to talk obsessively, self-referentially and self-reverentially about himself.  Continue reading

Behavioral Science, Public Policy, Ethics

The President of the United States has issued an executive order (see here) – government agencies are to use ‘insights’ from behavioral sciences to better serve the American people.

In my view this is a good thing. Science is our friend. Obama’s heart is in the right place. Nonetheless, the order raises a number of ethical and practical issues. Continue reading

Guest Post: Self defence and getting sacked

Written by Nick Shackel

Cardiff University


If you were attacked at a work party you would expect the person who attacked you to get sacked. In this case ( it seems to be the person attacked who got sacked, apparently because the boss doesn’t understand the right of self defence. Continue reading

The Ethics of Compulsory Chemical Castration: Is Non-Consensual Treatment Ever Permissible?

By Jonathan Pugh

Tory Grant, the justice minister for New South Wales (NSW) in Australia, has announced the establishment of a task force to investigate the potential for the increased use of anti-libidinal treatments (otherwise known as chemical castration) in the criminal justice system. Such treatments aim to reduce recidivism amongst sexual offenders by dramatically reducing the offender’s level of testosterone, essentially rendering them impotent. The treatment is reversible; its effects will stop when the treatment is ceased. Nonetheless, as I shall explain below, it has also been linked with a number of adverse side effects.

Currently, in New South Wales offenders can volunteer for this treatment, whilst courts in Victoria and Western Australia have the discretion to impose chemical castration as a condition of early release. However, Grant’s task force has been established to consider giving judges the power to impose compulsory chemical castration as a sentencing option. Notably though, New South Wales would not be the first jurisdiction to implement compulsory chemical castration in the criminal justice system. For instance, Florida and Poland also permit compulsory chemical castration of sex offenders.

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Why ethicists should read Middlemarch and despise Simon Cowell

There are a few ethicists who are interested in encouraging right behaviour, rather than simply discussing it.

Here is something for them from A.L. Kennedy:

As Vonnegut mentioned, Nazi Germany trained a population to be blind to the dignity and humanity of some others. A diet of soft porn, cheap sentimentality and hate proved effective. Radio Mille Collines pedaled fear, poisonous pop music and a sense of unhinged communal power – it helped to push Rwanda into the abyss.’ 1 Continue reading

Stripping Addicts of Benefits – Coercion, Consent, and the Right to Benefits

The UK government has announced plans to review the possibility of stripping drug addicts, alcoholics and obese individuals of benefits if they refuse treatment for their conditions. In support of the review, a consultation paper claims that the review is intended to “. . . consider how best to support those suffering from long-term yet treatable conditions back into work or to remain in work.”

One concern that has been raised against the plans is that stripping these individuals of their benefits is unlikely to be effective in getting them to seek treatment, with the Mirror reporting one campaigner as suggesting that “(this strategy) didn’t work in the Victorian times, (and) it’s not going to work now”.

In this post, I shall consider a challenge to the lawfulness of the proposals that is based on the claim that they would coerce individuals into accepting treatment. This is in fact a challenge that Sarah Woolaston, chair of the Health Select Committee has herself raised.

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#IminworkJeremy – the ethics of 24/7 consultant cover

By Dominic Wilkinson @Neonatalethics


At the bedside of a critically ill infant at 5am this morning I was tempted to tweet the latest meme, adding my voice to a chorus of NHS clinicians over the weekend. Last week, in a speech to the King’s fund, Health Minister Jeremy Hunt launched a drive towards 7 day NHS. In particular, he focused on consultant contracts, proposing that newly qualified hospital doctors will be required to work weekends as a condition of employment.

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Is the NHS surcharge just?

Not long ago the UK implemented an NHS surcharge – an extra fee that non-EEA nationals (Australia and New Zealand are also exempt) applying for leave to remain in the UK must pay. It costs £200 per year, and must be paid up front. So, for example, if you are applying for a work visa for 3 years, and you have a family of three, you must pay £1800 to cover the surcharge for you and your family (on top of other visa costs).

It is difficult to find much public discussion in the UK regarding this surcharge, outside of a few articles that recently noted that the surcharge is unlikely to do what we were told it would do – namely, benefit the NHS. (See here)

Is the surcharge a just policy? Continue reading