Medical tourism for controversial treatment options

By Dominic Wilkinson

 

Baby C’s parents had done their research. They had read widely about different options for C and had clear views about what they felt would be best for their child. They had asked a number of doctors in this country, but none were willing to provide the treatment. After contacting some specialists overseas, they had found one expert who agreed. If the family were able to pay for treatment, he was willing to provide that treatment option.

However, when C’s local doctors discovered that the parents planned to leave the country for treatment the doctors embarked on court proceedings and contacted the police.

One of the questions highlighted in the Charlie Gard case has been whether his parents should be free to travel overseas for desired experimental treatment. It has been claimed that the NHS and Great Ormond St are “keeping him captive”. Why shouldn’t C’s parents be free to travel to access a medical treatment option? When, if ever, should a state intervene to prevent medical tourism? Continue reading

Cross Post: Re: Nudges in a Post-truth World 

Guest Post: Nathan Hodson

This article originally appeared on the Journal of Medical Ethics Blog 

In a recent article in the Journal of Medical EthicsNeil Levy has developed a concept of “nudges to reason,” offering a new tool for those trying to reconcile medical ethics with the application of behavioural psychological research – a practice known as nudging. Very roughly, nudging means adjusting the way choices are presented to the public in order to promote certain decisions.

As Levy notes, some people are concerned that nudges present a threat to autonomy. Attempts at reconciling nudges with ethics, then, are important because nudging in healthcare is here to stay but we need to ensure it is used in ways that respect autonomy (and other moral principles). Continue reading

The ethics of treatment for Charlie Gard: resources for students/media

by Dominic Wilkinson and Julian Savulescu

 

The case of Charlie Gard has reached its sad conclusion. However, it continues to attract intense public attention. It raises a number of challenging and important ethical questions.

The role of Practical Ethics in cases like this is to help clarify the key concepts, identify central ethical questions, separate them from questions of scientific fact and subject arguments to critical scrutiny. We have disagreed about the right course of action for Charlie Gard, but agree on the role of ethical analysis and the importance of robust and informed debate. Ethics is not about personal opinion – but about argument, reasons, and rational reflection.

We have collected together below some of the materials on the Charlie Gard case that we and others have written as well as some relevant resources from our earlier work. We will update this page as more material becomes available. (*Updated 4/8/17) Continue reading

Cross Post: Speaking with: Julian Savulescu on the ethics of genetic modification in humans

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Could genetic engineering one day allow parents to have designer babies?
Tatiana Vdb/flickr, CC BY

William Isdale, University of Melbourne

What if humans are genetically unfit to overcome challenges like climate change and the growing inequality that looks set to define our future?

Julian Savulescu, visiting professor at Monash University and Uehiro professor of Practical Ethics at Oxford University, argues that modifying the biological traits of humans should be part of the solution to secure a safe and desirable future.

The University of Melbourne’s William Isdale spoke to Julian Savulescu about what aspects of humanity could be altered by genetic modifications and why it might one day actually be considered unethical to withhold genetic enhancements that could have an overwhelmingly positive effect on a child’s life. Continue reading

Burke, Briggs and Wills: Why we should not fear the judgment in Charlie Gard

In a blog post today, Julian Savulescu argues that in a parallel adult version of the highly controversial Charlie Gard case, a UK court might thwart an unconscious patient’s previously expressed desire for self-funded experimental medical treatment. He finds the Gard decision deeply disturbing and suggests that we all have reason to fear the Charlie Gard judgment.

I respectfully beg to differ.

Julian’s thought experiment of the billionaire ‘Donald Wills’ is not analogous to the real Charlie Gard case, his analysis of the UK legal approach to best interests cases for adults is potentially mistaken, his fear is misplaced. Continue reading

Video Series: Charlie Gard should be allowed to die, says Dominic Wilkinson

Dominic Wilkinson, Consultant Neonatologist and Professor in Medical Ethics, argues that Charlie Gard should be allowed to die and that disagreement about this case is not necessarily ‘reasonable’ disagreement. He also explains what could possibly change his mind about the case.

 

Burke and Wills, Bowen and Gard: The English Courts, Best Interests and Justice

The Case of Donald Wills

Donald Wills is a self-made man. He is billionaire British banker who has taken an interest in technology. He believes the Singularity is near and wishes to live as long as possible. He completes an advance directive to use his money to keep him alive at all costs, should he become ill and unable to express his wishes. He tells his wife about these desires.

Donald develops a rare condition where the mitochondria in all his cells stop working. The mitochondria are power packs for every cell. Donald’s muscles stop working and he is admitted to a famous London hospital and has to be put on a breathing machine. His brain is affected- he suffers fits which need to be controlled by medication. There is no known cure and he is going downhill.

Doctors call in his wife and explain his dismal prognosis. “It is,” they say, “in his best interests to stop this burdensome treatment in intensive care. He will never regain normal brain function but he is conscious at times and feels pain. He should be allowed to die with dignity.” After all, Donald is 75.

Continue reading

Video Series: Peter Singer on the Pros and Cons of Defending Controversial Views

Peter Singer has probably done more good than many of us will ever do. Despite this, he has received threats, people have protested to stop him from lecturing, his views have been compared to those defended by Nazis, etc. How has this affected him? Should we ever refrain from defending controversial views? Is it okay if academics avoid working on controversial topics because they’re worried about their reputation or job prospects? Should academics be able to publish their controversial ideas anonymously? Should we engage in a calm and rational way with just any view? Where do we draw the line? These are some of the questions I asked Peter Singer.

Video Series: Professor Julian Savulescu argues in favour of an experimental treatment for Charlie Gard

How Social Media Distorts Our Perceptions of Groups.

We know that groups are internally diverse. For any group you care to pick out (Brexit supporters, feminists, tea drinkers), we know intellectually that they will disagree among themselves about a great deal. When people identify as a group member, they may feel pressure to conform to the group view, but there are countervailing pressures in the other direction which limit the effects of group conformity. Disputes internal to groups are often as – or more – heated than those between them. Continue reading

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