Guest Post

Guest Post: Introducing Charlie’s Law, Bambos Charalambous MP (Labour, Enfield Southgate)

Bambos Charalambous MP (Labour, Enfield Southgate)

The tragic case of Charlie Gard, who sadly died in 2017 following a serious and protracted illness, attracted significant global attention because of the harrowing dilemmas that it highlighted.
Charlie’s story, was fraught with high tensions and unfurled very much in the public eye as a result of the constant media coverage, highlighted the inadequacy of current processes to prevent prolonged and distressing legal conflicts between the parents of seriously ill children and those responsible for their medical care.

Since Charlie’s death Charlie’s parents Connie Yates and Chris Gard have campaigned with dignity and determination to improve the situation for everyone involved: parents, healthcare professionals, hospitals, and the NHS more broadly; recognising that everyone wants the same thing: to maximise the life chances and general welfare of children suffering from serious illnesses and to reduce any stress on their parents who may be coming to terms with the potential death of their child. Continue reading

How Should We Regulate Genetic Enhancement Technologies?

A Guest Post Written by Jonny Anomaly

 

It’s been 20 years since Allen Buchanan and his colleagues published From Chance to Choice: Genetics and Justice. The book was a landmark, and it repays careful reading.

But there is at least one kind of question that has been largely (if not entirely) ignored in discussions about whether we should regulate parental choice, once parents have access to technologies that allow them to sculpt the genetic endowment of their children. How should we think about reproductive choices that are good for each but not for all? What should we do when there is a conflict between parents selecting the best traits for their children, when a different distribution of traits might be better from a social standpoint? Another way of asking the question is this: how should we think about situations in which there is a potential conflict between the principle of procreative beneficence and the principle of procreative altruism? Continue reading

Guest Post: How Should We Evaluate Deaths?

Written by: Carl Tollef Solberg, Senior Research Fellow, Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen.
Espen Gamlund, Professor of Philosophy, Department of Philosophy, University of Bergen.

In 2015, there were 56.4 million deaths worldwide (WHO 2017).[i] Most people would say that the majority of these deaths were bad. If this is the case, why is it so, and are these deaths equally bad?

Death is something we mourn or fear as the worst thing that could happen—whether the deaths of close ones, the deaths of strangers in reported accidents or tragedies, or our own. And yet, being dead is not something we will ever live to experience. This simple truth raises a host of challenging philosophical questions about the negativity surrounding our sense of death, and how and for whom exactly it is harmful. The question of whether death is bad has occupied philosophers for centuries, and the debate emerging in the philosophical literature is referred to as the “badness of death.” Are deaths primarily negative for the survivors, or does death also affect the decedent? What are the differences between death in fetal life, just after birth, or in adolescence? When is the worst time to die? These philosophical questions, although of considerable theoretical interest, is particularly relevant for how we evaluate deaths in global health, and policy-makers spending money to finance different health programs need to know how to answer them.  Continue reading

Caster Semenya, What’s Next?

Guest Post: Torbjörn Tännsjö, Kristian Claëson Emeritus Professor of Practical Philosophy

Statistically speaking, women perform less well than men in most sports. Their top results are 10-12 % worse than those of men. If they are to have a chance to compete at the top level, they need a protected space. At least, this has been the received wisdom among sports authorities. The example of Caster Semenya means that this policy has reached the end of the road. What has surfaced is the fact that the idea of a special protected female sphere within sports doesn’t stand up to recent knowledge within medicine and psychology. Caster Semenya is the stone that tipped the scales. The very notion of being female has been put under pressure.

The theory of science teaches us that a fruitful classification must serve an important purpose. In addition to this, the classes used should be mutually exclusive and exhaustive. Every classified individual should belong to one class only and everyone should belong to some class. Historically, we have tended to think that this is true of the classification of human beings into the classes of being female and male. We were wrong. And today it is common knowledge that we were wrong. However, the sports authorities have turned a blind eye to this knowledge.

To break it down in simple terms, there are three main ways of distinguishing between female and male. We may look at sex chromosomes, at external sex organs, or at perceived identity. It is possible to be male in terms of sex chromosomes but female in terms of both external sex organs and psychological identity. Caster Semenya gives witness to this (See Robert Johnson, ‘What No One is Telling You About Caster Semenya: She Has XY Chromosomes’, LetsRun, 2 May 2019). We know also that some individuals with female sex chromosomes (XX) and external female sex organs don’t identify as female. They seek ‘correction’ of their external sex organs. And it is the other way around with some individuals with male sex chromosomes (XY) and male external sex organs. They don’t identify as male and they seek correction of their external sex organs. Even  classification based purely on sex chromosomes is not as simple as one may think. Some individuals lack an X chromosome (X, Turner syndrome) while some have an extra X chromosome (XXY, Klinefelter). And there are other variations as well.

How should sports authorities best handle this? Should they keep turning a blind eye to these facts or should they try to face up to them?

Continue reading

Response from David S. Oderberg to “Against Conscientious Objection In Health Care: A Counterdeclaration And Reply To Oderberg”

I am grateful to Prof. Savulescu and Dr Giubilini for taking the time and care to respond in detail to my Declaration in Support of Conscientious Objection in Health Care. I also thank Prof. Savulescu for giving me the opportunity to reply to their lengthy analysis. The authors make a series of important criticisms and observations, all of which I will face directly. The topic of freedom of conscience in medicine is both contentious and likely to become increasingly urgent in the future, so it is as well to dispel misunderstandings, clarify assertions and respond to objections as thoroughly as possible. That said, I hope I do not try the reader’s patience by discussing Giubilini and Savulescu’s objections point by point, in the order in which they raise them.

Continue reading

Fetal Reduction in a Multiple Pregnancy: the Case of Identical Twins

Written by Elizabeth Crisp and Roger Crisp

When a woman aborts a single fetus, that abortion can be a morally troubling experience for her. What about a situation in which a woman is pregnant with more than one fetus, perhaps identical twins, and wishes to abort just one of them – that is, engage in what is sometimes called ‘fetal reduction’ in a ‘multiple pregnancy’? Continue reading

Victoria’s Voluntary Assisted Dying Law isn’t on a Slippery Slope

By David Copolov and Julian Savulescu 

This week the Australian Senate will debate a private members’ bill that will consider whether to overturn the 21-year-old Euthanasia Laws Act that nullified the ability of Australian self-governing territories to pass legislation in relation to euthanasia and assisted suicide.

The deliberation on whether to continue the arbitrary over-riding of the territories’ legislative autonomy in this domain will inevitably also turn a spotlight on the judiciousness of Victoria’s recent voluntary assisted dying legislation that empowers terminally ill people who are residents of our state and who are experiencing unrelievable suffering, to end their lives on their own terms.

Standing firmly and resolutely against such legislation is Professor Margaret Somerville, from the University of Notre Dame, who was interestingly described in an article in the Sydney Morning Herald two days ago as having “spent decades observing euthanasia in Canada”, even though medically assisted dying only became legal in that country in 2016.

One of the concerns she has raised is the “slippery slope” to unethical assistance in dying. Currently, this might well be on people’s minds because of the reports of the deaths of three minors during 2016-2017 as the result of euthanasia in Belgium, out of 4337 deaths during that period. The deaths of the under-18-year-olds occurred as a result of the removal of age limits on access to euthanasia in Belgium that took place as a result of legislation introduced in 2014, 12 years after the introduction of euthanasia for adults.

In contrast to Belgium (which is the only jurisdiction that places no age restrictions on euthanasia or assisted dying), the Victorian Parliament passed the Voluntary Assisted Dying Act in November last year, which limits voluntary assisted dying (VAD) to terminally ill people 18 years and older, who fulfil very strict criteria in relation to experiencing unrelievable suffering and possessing sufficient decision-making capabilities. They must be in the last six months of life, unless they’re suffering from a neurodegenerative disease, in which case they must be in the last 12 months of life.

There are many reasons that both the Victorian Legislative Council’s Inquiry into end of life choices and the Ministerial Advisory Panel on Voluntary Assisted Dying recommended limiting VAD to adults, including the fact that the extensive consultations with the Victorian public led to the firm conclusion that, as stated in the inquiry’s final report: “Victorian values do not support allowing assisted dying to be provided to those who are yet to reach adulthood.”

Continue reading

Guest Post: Cambridge Analytica: You Can Have My Money but Not My Vote

Emily Feng-Gu, Medical Student, Monash University

When news broke that Facebook data from 50 million American users had been harvested and misused, and that Facebook had kept silent about it for two years, the 17th of March 2018 became a bad day for the mega-corporation. In the week following what became known as the Cambridge Analytica scandal, Facebook’s market value fell by around $80 billion. Facebook CEO Mark Zuckerberg came under intense scrutiny and criticism, the #DeleteFacebook movement was born, and the incident received wide media coverage. Elon Musk, the tech billionare and founder of Tesla, was one high profile deleter. Facebook, however, is only one morally questionable half of the story.

Cambridge Analytica was allegedly involved in influencing the outcomes of several high-profile elections, including the 2016 US election, the 2016 Brexit referendum, and the 2013 and 2017 Kenyan elections. Its methods involve data mining and analysis to more precisely tailor campaign materials to audiences and, as whistle blower Christopher Wylie put it, ‘target their inner demons.’1 The practice, known as ‘micro-targeting’, has become more common in the digital age of politics and aims to influence swing voter behaviour by using data and information to hone in on fears, anxieties, or attitudes which campaigns can use to their advantage. This was one of techniques used in Trump’s campaign, targeting the 50 million unsuspecting Americans whose Facebook data was misused. Further adding to the ethical unease, the company was founded by Republican key players Steve Bannon, later to become Trump’s chief strategist, and billionaire Republican donor Robert Mercer.

There are two broad issues raised by the incident.

Continue reading

Guest Post: Consequentialism and Ethics? Bridging the Normative Gap.

Written by Simon Beard

University of Cambridge

After years of deliberation, a US moratorium on so-called ‘gain of function’ experiments, involving the production of novel pathogens with a high degree of pandemic potential, has been lifted [https://www.nih.gov/about-nih/who-we-are/nih-director/statements/nih-lifts-funding-pause-gain-function-research]. At the same time, a ground-breaking new set of guidelines about how and when such experiments can be funded has been published [https://thebulletin.org/new-pathogen-research-rules-gain-function-loss-clarity11540] by the National Institutes of Health. This is to be welcomed, and I hope that these guidelines stimulate broader discussions about the ethics and funding of duel use scientific research, both inside and outside of the life sciences. At the very least, it is essential that people learn from this experience and do not engage in the kind of intellectual head banging that has undermined important research, and disrupted the careers of talented researchers.

Yet, there is something in these guidelines that many philosophers may find troubling.

These new guidelines insist, for the first time it seems, that NIH funding will depend not only on the benefits of scientific research outweighing the potential risks, but also on whether or not the research is “ethically justified”. In defining what is ethically justifiable, the NIH make specific reference to standards of beneficence, non-maleficence, justice, scientific freedom, respect for persons and responsible stewardship.

Much has been made of this additional dimension of evaluation and whether or not review committees will be up to assessing it. Whereas before, it is said, they merely had to assess whether research would have good or bad outcomes, they now have to determine whether it is right or wrong as well! Continue reading

Announcement: Medical Ethics Symposium on Health Care Rationing – Oxford June 20th. Registration Now Open

Practical medical ethics: Rationing responsibly in an age of austerity
Date: June 20th 2018, 2-5pm, includes refreshments
Location: Ship Street Centre, Jesus College, Oxford

Health professionals face ever expanding possibilities for medical treatment, increasing patient expectations and at the same time intense pressures to reduce healthcare costs. This leads frequently to conflicts between obligations to current patients, and others who might benefit from treatment.

Is it ethical for doctors and other health professionals to engage in bedside rationing? What ethical principles should guide decisions (for example about which patients to offer intensive care admission or surgery)? Is it discriminatory to take into account disability in allocating resources? If patients are responsible for their illness, should that lead to a lower priority for treatment?

In this seminar philosophers from the Oxford Uehiro Centre for Practical Ethics will explore and shed light on the profound ethical challenges around allocating limited health care resources.

Speakers include Prof Dominic Wilkinson, Professor Julian Savulescu, Dr Rebecca Brown. Guest lecture by Professor Thaddeus Pope (Professor of Law, Mitchell Hamline School of Law, Minnesota) – on the US approach to allocating organs

Topics  include:

  • Allocating intensive care beds and balancing ethical values
  • Moralising medicine – is it ethical to allocate treatment based on responsibility for illness?
  • Cost-equivalence – rethinking treatment allocation.

This seminar is aimed at health professionals/ethicists

There are strictly limited places. Early bird registration £15/10* if register by 29th April and £25/20* subsequently

*Discounted registration for students

Registration includes tea/coffee and Wine/soft drinks/cheese at the end

Online Registration 

*Philosophical case discussion and *prize*

The afternoon will conclude with a live “ethics committee” deliberation on a clinical case.
Attendees at the meeting are encouraged to submit a case for discussion based on their clinical experience.
If chosen for presentation, attendees will have the opportunity to present a short (5 minute) clinical summary.
They will also receive complementary registration at the seminar, and a £40 Blackwell’s voucher.

To submit a case, please send a short (less than 200 word) deidentified case description including the key ethical questions to dominic.wilkinson@philosophy.ox.ac.uk

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