Health

Guest Post: CARING ROBOTS

CARING ROBOTS

Written by Darlei Dall’Agnol[1]

Universidade Federal de Santa Catarina

As we humans find ways of enhancing our physical, intellectual, emotional and other capabilities and, as a result, our lifespan expands, caring for the elderly becomes more challenging and complex too. We may postpone aging, but perhaps not forever and serious care will be needed at some point. Now, recent figures show that the number of carers aged 85 and over has risen in England by 128% in the last decade and is around 87.000.[2] Half of these carers work for 50 hours or more each week. Most are compromising their own well-being showing that we must deal with the problem in a different way to avoid aggravating it. These individuals should be cared for and not be the ones caring. An aging population brings greater burdens for the health care system raising many issues about fairness and justice in distributing resources. In countries like Japan, with 25% of the population over 65,[3] caring is even becoming a social problem and some companies are turning to robots.

Pepper “a robot with a heart” will be sold to care for the elderly and children. Other examples include: Wakamaru a “companion robot” designed to co-inhabit with humans (see figure below); Paro a fur-covered robotic seal developed by AIST that responds to petting; Sony’s AIBO robotic dog and NeCORO robotic cat covered in synthetic fur used for therapeutic purposes; Secom My Spoon an automatic feeding robot; Sanyo robot for monitoring, delivering messages, and reminding about medicine and other devices to help on the problem of caring for the elderly. In continental Europe, there are a few robots in experimental tests as caregivers too. But are robots the best solution for caring for the elderly? Continue reading

Anorexia Nervosa and Deep Brain Stimulation: Philosophical Analysis of Potential Mechanisms

By Hannah Maslen, Jonathan Pugh and Julian Savulescu

 

According to the NHS, the number of hospital admissions across the UK for teenagers with eating disorders has nearly doubled in the last three years. In a previous post, we discussed some ethical issues relating to the use of deep brain stimulation (DBS) to treat anorexia nervosa (AN). Although the trials of this potential treatment are still in very early, investigational stages (and may not necessarily become an approved treatment), the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this post, we show how different possible mechanisms of intervention raise different questions for philosophers to address. The prospect of intervening directly in the brain prompts exploration of the relationships between a patient’s various mental phenomena, autonomy and identity. Continue reading

Guest Post: Why isn’t the world going vegan?

Written by Catia Faria

Universitat Pompeu Fabra

Last month, the Academy of Nutrition and Dietetics, one of the world’s most influential organizations in its field, published an updated version of a paper concluding that animal-free diets are absolutely healthy (Cullum-Dugan & Pawlak 2015). The article presents the official position of the Academy on this topic, according to which, when well designed, vegetarian and vegan diets provide adequate nutrition for all stages of the life cycle, including pregnancy, lactation, infancy, childhood and adolescence.

 It would be reasonable to expect that such conclusion had a significant impact on people’s dietary choices. If adopting a vegan diet imposed great costs on the health of human beings, then doing it might not be what we are required to do. Yet the health argument has been, again, debunked. So, why aren’t people going massively vegan? Continue reading

Do I have a right to access my father’s genetic account?

 Written By: Roy Gilbar, Netanya Academic College, Israel, and Charles Foster

In the recent case of ABC v St. George’s Healthcare NHS Trust and others,1 [http://www.bailii.org/ew/cases/EWHC/QB/2015/1394.html] a High Court judge decided that:

(a) where the defendants (referred to here jointly as ‘X’) knew that Y, a prisoner,  was suffering from Huntingdon’s Disease (‘HD’); and

(b) X knew that Y had refused permission to tell Y’s daughter, Z (the claimant), that he had HD (and accordingly that there was a 50% chance that Z had it (and that if Z had it there was, correspondingly, a 50% chance that the fetus she was then carrying would have HD),

X had no duty to tell Z that Y was suffering from HD. Z said that if she had known of Y’s condition, she would have had an abortion. Continue reading

What’s Wrong With Giving Treatments That Don’t Work: A Social Epistemological Argument.

Let us suppose we have a treatment and we want to find out if it works. Call this treatment drug X. While we have observational data that it works—that is, patients say it works or, that it appears to work given certain tests—observational data can be misleading. As Edzard Ernst writes:

Whenever a patient or a group of patients receive a medical treatment and subsequently experience improvements, we automatically assume that the improvement was caused by the intervention. This logical fallacy can be very misleading […] Of course, it could be the treatment—but there are many other possibilities as well. Continue reading

The moral imperative to research editing embryos: The need to modify Nature and Science

Chris Gyngell and Julian Savulescu

Human genetic modification has officially progressed from science fiction to science.  In a world first, scientists have used the gene editing technique CRISPR to modify human embryos. While the study itself marks an important milestone, the reason it is truly extraordinary is the scientific community’s reaction to it. In refusing to publish this study on ethical grounds, the world’s two leading science journals Nature and Science, appear to be demonstrating a lack of clear and consistent thinking on ethical issues. Continue reading

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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