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International/ Global Health

Fracking and the Precautionary Principle

By Charles Foster

Image> Leolynn11, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

The UK Government has lifted the prohibition on fracking.

The risks associated with fracking have been much discussed. There is widespread agreement that earthquakes cannot be excluded.

The precautionary principle springs immediately to mind. There are many iterations of this principle. The gist of the principle, and the gist of the objections to it, are helpfully summarised as follows:

In the regulation of environmental, health and safety risks, “precautionary principles” state, in their most stringent form, that new technologies and policies should be rejected unless and until they can be shown to be safe. Such principles come in many shapes and sizes, and with varying degrees of strength, but the common theme is to place the burden of uncertainty on proponents of potentially unsafe technologies and policies. Critics of precautionary principles urge that the status quo itself carries risks, either on the very same margins that concern the advocates of such principles or else on different margins; more generally, the costs of such principles may outweigh the benefits. 

Whichever version of the principle one adopts, it seems that the UK Government’s decision falls foul of it. Even if one accepts (controversially) that the increased flow of gas from fracking will not in itself cause harm (by way of climate disruption), it seems impossible to say that any identifiable benefit from the additional gas (which could only be by way of reduced fuel prices) clearly outweighs the potential non-excludable risk from earthquakes (even if that risk is very small).

If that’s right, can the law do anything about it?Read More »Fracking and the Precautionary Principle

Philosophical Fiddling While the World Burns

By Charles Foster

An unprecedented editorial has just appeared in many health journals across the world. It relates to climate change.

The authors say that they are ‘united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.’

Climate change, they agree, is the major threat to public health. Here is an excerpt: there will be nothing surprising here:

‘The risks to health of increases above 1.5°C are now well established. Indeed, no temperature rise is “safe.” In the past 20 years, heat related mortality among people aged over 65 has increased by more than 50%.Hi gher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality. Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities, and those with underlying health problems.’Read More »Philosophical Fiddling While the World Burns

Is a Publication Boycott of Chinese Science a Justifiable Response to Human Rights Violations Perpetrated by Chinese Doctors and Scientists?

By Doug McConnell

Recently the editor-in-chief of the Annals of Human Genetics, Prof David Curtis, resigned from his position, in part, because the journal’s publisher, Wiley, refused to publish a letter he co-authored with Thomas Schulze, Yves Moreau, and Thomas Wenzel. In that letter, they argue in favour of a boycott on Chinese medical and scientific publications as a response to the serious human rights violations happening in China. Several other leading journals, the Lancet, the BMJ and JAMA have also refused to publish the letter claiming that a boycott against China would be unfair and counterproductive.

This raises two separate ethical issues: 1. Should journals refuse to publish a letter arguing in favour of a boycott on Chinese medical and scientific publications? 2. Should journals actually establish a boycott on Chinese medical and scientific publications?Read More »Is a Publication Boycott of Chinese Science a Justifiable Response to Human Rights Violations Perpetrated by Chinese Doctors and Scientists?

Lockdown Erodes Agency

By Charles Foster

A couple of lockdown conversations:

  1. The other day I met a friend in the street. We hadn’t seen one another for over a year. We mimed the hugs that we would have given in a saner age, and started to talk. ‘There’s nothing to tell you’, she said. ‘Nothing’s happened since we last saw you. And that’s just as well, because, as you’ll find, I’ve forgotten how to talk, how to relate, and how to read ordinary cues. We’ve not been out. We’ve not changed anything. I wonder if we’ve been changed?’
  1. Another friend. ‘Zoom’s great, isn’t it? You switch off your camera and your microphone, and the meeting just goes on perfectly happily without you. Everyone thinks you’re there. Your name’s up on their screen. But you are just getting on with your own business.’

And a lockdown fact: Lockdown has been great for book sales. 2020 saw an estimated rise of 5.2% in volume sales of print books in the UK compared with 2019 sales. This was the biggest annual rise since 2007: Read More »Lockdown Erodes Agency

Vaccine Nationalism: Striking the balance

Written by Owen Schaefer and Julian Savulescu

This is an updated cross-post of an article published in MediCine

On 2 February 2021, the Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, issues a broadside against COVID-19 vaccine nationalism, calling it “morally indefensible” and “tantamount to medical malpractice at a global scale.” Rich countries representing 16% of the global population have snapped up 60% of the global supply of COVID-19 vaccines. [1] Meanwhile, India, which has only vaccinated 10% of its population, is facing a catastrophic COVID-19 surge.[2] And the COVAX facility – an international effort to get COVID-19 vaccines equitably distributed around the world – currently only projects capacity to offer vaccines amounting to about 3% of participating countries’ populations by mid-year.[3]

COVID-19 vaccine nationalism is not the exception to normal practice. In almost all matters, countries spend the vast majority of budgets on local needs, and only a small fraction of that foreign aid, even when the latter represents much greater need. But the fact that this is normal or expected does not amount to a moral defense.

Here, we explore a question of practical ethics: what is the appropriate extent to which a country can prioritize its own people over those in other countries in the securing of vaccines for COVID-19?

Read More »Vaccine Nationalism: Striking the balance

Cross-Post: Self-experimentation with vaccines

By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu.

This is a crosspost from the Journal of Medical Ethics Blog.

This is an output of the UKRI Pandemic Ethics Accelerator project.

 

A group of citizen scientists has launched a non-profit, non-commercial organisation named ‘RaDVaC’, which aims to rapidly develop, produce, and self-administer an intranasally delivered COVID-19 vaccine. As an open source project, a white paper detailing RaDVaC’s vaccine rationale, design, materials, protocols, and testing is freely available online. This information can be used by others to manufacture and self-administer their own vaccines, using commercially available materials and equipment.

Self-experimentation in science is not new; indeed, the initial development of some vaccines depended on self-experimentation. Historically, self-experimentation has led to valuable discoveries. Barry Marshall famously shared the Nobel Prize in 2005 for his work on the role of the bacterium Helicobacter pylori, and its role in gastritis –this research involved a self-experiment in 1984 that involved Marshall drinking a prepared mixture containing the bacteria, causing him to develop acute gastritis. This research, which shocked his colleagues at the time, eventually led to a fundamental change in the understanding of gastric ulcers, and they are now routinely treated with antibiotics. Today, self-experimentation is having something of a renaissance in the so-called bio-hacking community. But is self-experimentation to develop and test vaccinations ethical in the present pandemic? In this post we outline two arguments that might be invoked to defend such self-experimentation, and suggest that they are each subject to significant limitations.Read More »Cross-Post: Self-experimentation with vaccines

An Ethical Review of Hotel Quarantine Policies For International Arrivals

Written by:

Jonathan Pugh

Dominic Wilkinson

Julian Savulescu

 

This is an output of the UKRI Pandemic Ethics Accelerator project – it develops an earlier assessment of the English hotel quarantine policy, published by The Conversation)

 

The UK has announced that from 15th Feb, British and Irish nationals and others with residency rights travelling to England from ‘red list’ countries will have to quarantine in a government-sanctioned hotel for 10 days, at a personal cost of £1,750. Accommodation must be booked in advance, and individuals will be required to undergo two tests over the course of the quarantine period.

Failure to comply will carry strict penalties. Failing to quarantine in a designated hotel carries a fine of up to £10,000, and those who lie about visiting a red list country are liable to a 10-year prison sentence.

Read More »An Ethical Review of Hotel Quarantine Policies For International Arrivals

Video Series: How To Prevent Future Pandemics

First interview in the new  Thinking Out Loud series on ‘Animals and Pandemics’: Katrien Devolder in conversation with Jeff Sebo, Associate Professor of Environmental Studies at NYU, on how our treatment of animals increases the risk of future pandemics arising, and on what we should do to reduce that risk!

Crosspost: Is It Ethical To Quarantine People In Hotel Rooms?

Written by

Dominic Wilkinson and Jonathan Pugh,

 

The UK government announced that from February 15, British and Irish residents travelling to England from “red list” countries will have to quarantine in a government-sanctioned hotel for ten days, at a personal cost of £1,750. Accommodation must be booked in advance, and people will need to have two COVID tests during the quarantine period.

Failing to quarantine in a designated hotel carries a fine of up to £10,000, and those who lie about visiting a red list country could face a ten-year prison sentence.

Other countries have already implemented mandatory hotel quarantines for travellers, including Australia, New Zealand, China and India. When are such quarantines ethical? And who should pay for them if they are?

Read More »Crosspost: Is It Ethical To Quarantine People In Hotel Rooms?

Current Lockdown Is Ageist (Against The Young)

Written by Alberto Giubilini

Oxford Uehiro Centre for Practical Ethics and Wellcome Centre for Ethics and Humanities

University of Oxford

 

Former UK supreme court justice and historian Lord Jonathan Sumption recently made the following claim:

“I don’t accept that all lives are of equal value. My children’s and my grandchildren’s life is worth much more than mine because they’ve got a lot more of it ahead. The whole concept of quality life years ahead is absolutely fundamental if one’s going to look at the value of these things.”

This wasn’t very well received, to say the least. Experts were quickly recruited by the press to rebut his claims. Headlines were made to convey people’s outrage at the idea that we can put a value on human life, and what is worse, different values on different human lives (which, by the way, is precisely what the NHS regularly does whenever it decides whom to put on a ventilator when there are not enough ventilators for everyone, or when it decides not provide life-saving treatments that cost more than £ 30k per quality-adjusted-life-year).Read More »Current Lockdown Is Ageist (Against The Young)