Health

Brain size and socioeconomic status

A new drug, Numarol, is currently being trialled which increases the surface area of the brain in children. Numarol causes children to have bigger brains, do better in cognitive tests and generally improves their life prospects. One critic of Numarol recently pointed out it would be very expensive, and only the rich would be able to afford it. Its release would likely create a significant difference in brain size between the highest and lowest socioeconomic groups. Numarol would create a world in which biological inequalities are forged from economic ones.   The rich would not only have bigger houses, better cars, and better healthcare than the poor, their children would also have bigger brains. Such a world would be abhorrent.

But we already live in this world.  Numarol is fictional, but the rich do have children with bigger brains than the poor.   Social inequalities have already been written into our biology.  Continue reading

Science and Ethics: Deep brain stimulation for the treatment of anorexia

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

Is privacy to blame for the Germanwings tragedy?

Since it was revealed that Andreas Lubitz—the co-pilot thought to be responsible for voluntarily crashing Germanwings Flight 9525 and killing 149 people—suffered from depression, a debate has ensued over whether privacy laws regarding medical records in Germany should be less strict when it comes to professions that carry special responsibilities.

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Nancy Cartwright on the Limits of RCTs

Guest Post by Bill Gardner @Bill_Gardner

Many researchers and physicians assert that randomized clinical trials (RCTs) are the “gold standard” for evidence about what works in medicine. But many others have pointed to both strengths and limitations in RCTs (see, for example, Austin Frakt’s comments on Angus Deaton here). Nancy Cartwright is a major philosopher of science. In this Lancet paper she provides insights into why RCTs are so highly valued and also why they are by themselves insufficient to answer the most important questions in medicine.

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Smoking, Ice-Cream and Logical Progressions: Why We Shouldn’t Ban Smoking in Outdoor Public Places

It’s a beautiful warm sunny day, and you have decided to take your children to join a group of friends for a barbecue at the local public park. The wine is flowing (orange juice for the kids), you have managed not to burn the sausages (vegetarian or otherwise), and there is even an ice-cream van parked a conveniently short walk away.

An idyllic scenario for many of us, I’m sure you will agree; one might even go so far as to suggest that this is exactly the sort of thing that public parks are there for; they represent a carefree environment in which we can enjoy the sunshine and engage in recreational communal activities with others. Continue reading

Oxford Uehiro Prize in Practical Ethics: In light of the value of personal relationships, is immortality desirable? by Fionn O’Donovan

This essay, by Oxford undergraduate student Fionn O’Donovan, is one of the four shortlisted essays in the undergraduate category of the inaugural Oxford Uehiro Prize in Practical Ethics.

In light of the value of personal relationships, is immortality desirable?

In the future it is likely that advances in medicine will grant us the opportunity to prevent the process of ageing. The question of whether eternal life would be a good thing will then be of the utmost practical importance to humanity. In this essay, I claim that it would be, and that Williams’ concerns about immortality[1] can be assuaged with consideration of how life always gives us at least an opportunity to realise something commonly held to be incommensurably valuable, namely good relationships with others. I note here that, for the purposes of this essay, I assume there is no afterlife. I also want to note that the issues of immortality and euthanasia are linked: a similar question about whether death is ever desirable is central to debate on both. Therefore, many of the considerations I present below could also be used to support a more pro-life view on euthanasia. Continue reading

Oxford Uehiro Prize in Practical Ethics: May the state limit the free speech of individuals who advocate against vaccines intended to combat infectious disease? by Miles Unterreiner

This essay, by Oxford graduate student Miles Unterreiner, is one of the two finalists in the graduate category of the inaugural Oxford Uehiro Prize in Practical Ethics. Miles will be presenting this paper, along with three other finalists, at the 12th March final.

May the state limit the free speech of individuals who advocate against vaccines intended to combat infectious disease?

Freedom is the most contagious virus known to man.

-Hubert H. Humphrey

 

Philosophical arguments concerning freedom of speech have traditionally focused upon which types of expression the state apparatus may justly limit, and under which circumstances it may do so. The state has therefore been the locus of history’s most celebrated works on the subject, including John Milton’s Areopagitica (1644), chapter 20 of Spinoza’s Tractatus Theologico-Politicus (1670), and perhaps most famously J.S. Mill’s On Liberty (1859). Mill’s argument in favor of the free exchange of ideas remains today the most lasting and the most relevant, and his formulation of the “harm principle” – that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others” – continues to undergird significant components of law and policy in industrialized democracies today.[1] Continue reading

Does religion deserve a place in secular medicine?

By Brian D. Earp

The latest issue of the Journal of Medical Ethics is out, and in it, Professor Nigel Biggar—an Oxford theologian—argues that “religion” should have a place in secular medicine (click here for a link to the article).

Some people will feel a shiver go down their spines—and not only the non-religious. After all, different religions require different things, and sometimes they come to opposite conclusions. So whose religion, exactly, does Professor Biggar have in mind, and what kind of “place” is he trying to make a case for?

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On the supposed distinction between culture and religion: A brief comment on Sir James Munby’s decision in the matter of B and G (children)

On the supposed distinction between culture and religion: A brief comment on Sir James Munby’s decision in the matter of B and G (children)

By Brian D. Earp (@briandavidearp)

Introduction

What is the difference between ‘culture’ and ‘religion’ … ? From a legal standpoint, this question is important: practices which may be described as being ‘religious’ in nature are typically afforded much greater protection from interference by the state than those that are understood as being ‘merely’ cultural. One key area in which this distinction is commonly drawn is with respect to the non-therapeutic alterations of children’s genitals. When such alteration is done to female children, it is often said to be a ‘cultural’ practice that does not deserve legal protection; whereas, when it is done to male children, it is commonly said to be a ‘religious’ practice – at least for some groups – and must therefore not be restricted (much less forbidden) by law.

Is this a valid distinction?

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Conventional and non-conventional medicine and the Placebo Paradox

Alternative medicine is a trendy topic to discuss – both by despising and praising it in a contradictory manner. But there is something controversial in the categorical critique towards it. The controversies and fallacies in the categorical praise are much elaborated and I will mostly leave aside that part. Continue reading

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