Current Affairs

The ethics of DocAdvisor: Is accountability always a good thing?

Dominic Wilkinson @NeonatalEthics

 

In the news this morning, the NHS has released data on individual surgeons’ performance, so called “surgeon report cards”. This represents the latest move towards increased transparency and accountability in the National Health Service. Elsewhere in the media today, there are numerous reports of the UK couple who were apparently charged £100 after posting a negative hotel review on an online website.

These parallel stories highlight one concern about certain types of health accountability: sensitivity to the negative impact of reviews (or poor performance figures) could lead to harmful changes in behaviour. For surgeon report cards, one frequently cited concern is that publishing report cards could lead surgeons to avoid high-risk cases. If surgeons choose patients with lower risk of dying, they will potentially end up with a better report card. However, then the results would be misleading (it would be the equivalent of someone getting a higher mark by choosing to sit an easier test). More worrying, it may mean that some high-risk patients are unable to access surgery.

Should we be worried about the negative effect of report cards on surgeons behaviour? Continue reading

Abortion on the grounds of sex

Apparently some UK doctors have been aborting babies because their parents don’t want a baby of that sex. In response the government is now planning to outlaw  abortion on the grounds of sex. It is already illegal, however, so we must wonder what the politicians are up to.  A question being ignored is whether it is right or  wrong to abort on the grounds of sex. I am going to consider various grounds on which abortion is considered permissible and examine whether that permissibility is consistent with abortion on the grounds of sex being forbidden.

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Twitter, Apps, and Depression

The Samaritans have launched a controversial new app that alerts Twitter users when someone they ‘follow’ on the site tweets something that may indicate suicidal thoughts.

To use the app, named ‘Samaritan Radar’, Twitter members must visit the Samaritans’ website, and choose to activate the app on their device. Having entered one’s twitter details on to the site to authorize the app, Samaritan Radar then scans the Twitter users that one ‘follows’, and uses an algorithm to identify phrases in tweets that suggest that the tweeter may be distressed. For example, the algorithm might identify tweets that involve phrases like “help me”, “I feel so alone” or “nobody cares about me”. If such a tweet is identified, an email will be sent to the user who signed up to Samaritan Radar asking whether the tweet should be a cause for concern; if so, the app will then offer advice on what to do next. Continue reading

Facebook and Apple – Increasing choice and control or creating biased solutions?

Reproductive technologies were in the headlines when Facebook and Apple announced they would offer female employees a $20,000 benefit to freeze their eggs. According to the report, this enables women to delay child bearing for different reasons and gives women more control. The announcement states that egg freezing is a pricey but increasingly popular option for women: The procedure typically costs up to $10,000, with an additional $500 for storage each year. After freezing eggs, in vitro fertilisation (IVF) can be used afterwards.

I wish to start with a disclaimer: I’m totally for increasing control and flexibility with reproductive technologies, I think the possibility as such is great, I cheer if some women genuinely wish to use this option, and I totally recognize that Facebook and Apple are just giving an option. However, there is room for questions. First, individual-level solutions are suggested where the actual issue is likely to be socially constructed, and secondly, IVF is seen merely as a handy option. These two are discussed in the following. Continue reading

Harsher sentences for murder of a police officer: what are the arguments?

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

Paying GPs for Dementia Diagnoses

A GP in Guildford has recently revealed that the NHS is to pay GPs £55 each time they diagnose dementia in a patient. Writing on the medical website Pulse, Dr Martin Brunet, called the incentive scheme a “bribe,” put in place so that the government can “hit its target to raise diagnosis rates.”

The ‘Dementia Identification Scheme’ requires GPs to count how many patients with a dementia diagnosis there were on their register at the end of September, and to compare this with the number at the end of March 2015. They will then receive £55 for every extra patient. The full service specifications can be found here.

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Cooperating with the future

This is a guest post by Oliver P. Hauser & David G. Rand.

“It often strikes me that the complex problems we face in the world – problems of corruption, environment, politics, and so on – almost always indicate a failure of moral ethics and inner values. … The failure of the 2009 Copenhagen Summit on the global environment was, sadly, an example of how, when parties fail to look beyond their own narrow self-interest, cooperation becomes impossible.”

— The Dalai Lama, Beyond Religion

Do we have a moral responsibility to sustain the planet for future generations? The Dalai Lama, in the quotation above, gives an almost unequivocal ‘yes’. But a cursory understanding of economics shows us that it’s not just about morality – or at least, that morality doesn’t always have the final word. We, today’s decision-makers, are simply better off economically if we harvest all resources today without thinking about the future. To state the economic, ‘rational’ argument in bald terms: why leave something for the future if we won’t benefit from it?

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Free the trolls

You do not have a right not to be offended,  insulted or verbally abused. You do not have that right because it might be right to offend, insult or verbally abuse you. You might believe stupid things, or even sensible things, and take offence at any and all critiques, rebuttals and refutations. You might be a pompous prig, a sanctimonious sop, an officious orifice. Even if you are not these things, there would be very little wrong in telling you you are. After all, you are not a six-year old child: you’re an adult. You can take it.

What of someone expressing their detestation of you, their hatred of you, wishing you ill, wishing you dead?

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To veil or not to veil?

As recent media coverage has documented, Muslim veils are a hot button issue at present.

Research suggests that “a major determinant of who is most vulnerable to anti-Islamic abuse may be the degree to which the individual is visibly identified as Muslim” (King & Ahmad, 2010, p. 886). For Muslim women, one such identifier is a veil. A veil can refer specifically to the hijab or head- scarf, covering just the head but leaving the face exposed, or the full-face veil, which covers the head and face. Hate crime and prejudice directed against Muslims seems to be strongly linked to such visible markers of “difference” (Dreher, 2006), and political discourse has used veils to represent “the problem of Islam” (Watson, 1994)

In recent work published in the Journal of Applied Social Psychology, I explored the way that such prejudice against Muslim women wearing veils may differ as a function of which particular veil is being worn. You can read the paper here for free (it’s open access), and so I won’t go into too much detail about how study and the psychological literature on prejudice and first impressions. Continue reading

Supermarkets, Spending, and Influences on Choice

Something of a twitter storm erupted last week over a poster placed in a supermarket window. The poster, placed in a branch of Sainsbury’s, issued a “50p Challenge”, urging employees to encourage every customer to “spend an additional 50p during each shopping trip between now and the years-end”. After a passer-by named Chris Dodd took a photo of the poster and posted it on twitter, a Sainsbury’s representative confirmed that the poster was intended only for employees and that it was not intended for public display. See a news report here. Continue reading

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