by Dominic Wilkinson @Neonatalethics
Consultant neonatologist, Director of Medical Ethics
Next week, junior doctors in England
and Wales will be taking part in industrial action for 15 hours over two successive days. This is the latest in a series of stoppages since late last year, and relates to a dispute over proposed changes to junior doctors’ contracts and pay. It is the first strike, (and the first in the UK since the establishment of the NHS), to include all medical care, including emergency treatment. Junior doctors will not be at work in accident and emergency departments, intensive care units, operating theatres and hospital wards between 8 and 5 on both of those days.
There are a series of questions raised by these strikes. There are disputed claims about the impact of contract changes on take home pay, on working conditions for doctors and on patient care. There are different views about the actual impact of next week’s strike on patients, on public opinion, or on negotiations about the new contract. But for the purposes of this article, I am going set those specific questions aside, and focus on a more general question. Should doctor strikes (particularly emergency care strikes) be legal, should they be allowed? Continue reading
Everyone I know thinks it’s obscene, and that the suffering of the dogs cannot possibly be outweighed by the sensual satisfaction of the diners, the desirability of not interfering, colonially, with practices acceptable in another culture, or by any other consideration. It’s just wrong.
‘It’s just wrong’ is the observation that moral philosophers exist to denounce. They draw their salaries for interrogating this observation, exploding its naivety, and showing that the unexamined observation is the observation not worth making.
But what can the moral philosophers bring to the discussion about the Chinese dogs? Alone, and unaided by science, not much. The philosophy turns out to be either (a) reheated science or (b) a description of our intuitions, together with more or less bare assertions that those intuitions are either good or bad. Continue reading
There is no telling what machines might be able to do in the not very distant future. It is humbling to realise how wrong we have been in the past at predicting the limits of machine capabilities.
We once thought that it would never be possible for a computer to beat a world champion in chess, a game that was thought to be the expression of the quintessence of human intelligence. We were proven wrong in 1997, when Deep Blue beat Garry Kasparov. Once we came to terms with the idea that computers might be able to beat us at any intellectual game (including Jeopardy!, and more recently, Go), we thought that surely they would be unable to engage in activities where we typically need to use common sense and coordination to physically respond to disordered conditions, as when we drive. Driverless cars are now a reality, with Google trying to commercialise them by 2020.
Machines assist doctors in exploring treatment options, they score tests, plant and pick crops, trade stocks, store and retrieve our documents, process information, and play a crucial role in the manufacturing of almost every product we buy.
As machines become more capable, there are more incentives to replace human workers with computers and robots. Computers do not ask for a decent wage, they do not need rest or sleep, they do not need health benefits, they do not complain about how their superiors treat them, and they do not steal or laze away.
Consider the following case. Imagine you inherit a fortune from your parents. With that money, you buy a luxurious house and you pay to get a good education, which later allows you to find a job where you earn a decent salary. Many years later, you find out that your parents made their fortune through a very bad act—say, defrauding someone. You also find out that the scammed person and his family lived an underprivileged life from that moment on.
What do you think you would need to do to fulfill your moral obligations?
The President of the United States has issued an executive order (see here) – government agencies are to use ‘insights’ from behavioral sciences to better serve the American people.
In my view this is a good thing. Science is our friend. Obama’s heart is in the right place. Nonetheless, the order raises a number of ethical and practical issues. Continue reading
Jim A.C. Everett
In case any readers have been living under a rock for the last few days, the ‘hard-left’ candidate Jeremy Corbyn has been elected Leader of the British Labour Party (see here for the BBC profile on him). Just by his fellow Labour ‘comrades’ (let alone his Conservative opponents), he has been proclaimed as the death of Labour, the savior of Labour, and everything in between. By all accounts Corbyn is a man who lives by his principles (whatever we think about these principles), and yet has sustained extensive criticism from across the political spectrum – particularly based on his close relationships with some very morally dubious individuals and organisations. Corbyn has been criticized with vigour, for example, for his support of Irish Republicanism and IRA terrorists, alongside the anti-Semitic and homophobic Hamas and Hezbolla (which he calls movements of “social justice”). Corbyn seeks closer ties with Russia and Putin (who has a sketchy human rights record to say the least), and has just appointed a Shadow Chancellor (John McDonnell), who credits the terrorism of the IRA with peace in Northern Ireland, who wanted to “assassinate Margaret Thatcher” and who apparently called for the “bitch” Tory MP Esther McVey to be “lynched”. Corbynistas (as the media has dubbed his supporters) have, as would be expected, come to his defense and argued that we cannot judge the man by his friends and that, anyway, some of these comments might have been taken out of context. Continue reading
There are a few ethicists who are interested in encouraging right behaviour, rather than simply discussing it.
Here is something for them from A.L. Kennedy:
‘As Vonnegut mentioned, Nazi Germany trained a population to be blind to the dignity and humanity of some others. A diet of soft porn, cheap sentimentality and hate proved effective. Radio Mille Collines pedaled fear, poisonous pop music and a sense of unhinged communal power – it helped to push Rwanda into the abyss.’ 1 Continue reading
In the strange, upside-down world of the Southern Hemisphere, cold and gloomy Winter is quietly slinking away, and raucous Spring in all his glory begins to stir. Ah, Spring! The season of buds and blooms and frolicking wildlife. One rare species of wildlife, however, finds itself subject to an open hunting season this Spring – the anti-vaxxer.
In April this year, the Australian Federal Government announced a so-called “no jab, no pay” policy. Families whose children are not fully vaccinated will now lose subsidies and rebates for childcare worth up to almost AUD$20,000 per child, except if there are valid medical reasons (e.g. allergies). Previously, exemptions had been made for conscientious and religious objectors, but these no longer apply forthwith.
Taking things a step further, the Victorian State Government earlier this week announced an additional “no jab, no play” policy. Children who are not fully vaccinated, except once again for valid medical reasons, will additionally now be barred from preschool facilities such as childcare and kindergartens.
I should, at this point, declare my allegiances – as a finishing medical student, I am utterly convinced by the body of scientific evidence supporting the benefits of childhood vaccination. I am confident that these vaccines, while posing a very, very small risk of severe side-effects like any other medicine, reliably prevent or markedly reduce the risk of contracting equally severe diseases. And finally, I believe that the goal of universal childhood vaccination is one worth pursuing, and is immensely beneficial to public health.
Despite my convictions, however, I still find myself wondering if the increasingly strict vaccination regime in Australia, and every-increasing punishments for anti-vaxxers, is necessarily the best means to go about achieving a worthy goal. It’s not clear, to me, that the recent escalation will have significant positive effects beyond a mere simple political stunt.
A recent article by Jeff Sparrow on the Australian writer Helen Dale/Darville/Demidenko has left me pondering the way that we form beliefs. Under the penname ‘Helen Demidenko’, Dale published a novel that told the story of a Ukrainian family, members of whom were perpetrators of crimes against Jews during the Holocaust. The novel was instantly successful, winning major awards, and equally controversial. It was described as anti-Semitic in its sympathetic depiction of ordinary Ukranians and its (alleged) caricatures of Jews. The book gained an aura of authenticity from the author’s claims that she based much of it on interviews with members of her own family, who had lived through the events depicted. Demidenko’s bubble burst when it was revealed she was born Helen Darville, and had no Ukrainian relatives to recount these tales. Continue reading
Not long ago the UK implemented an NHS surcharge – an extra fee that non-EEA nationals (Australia and New Zealand are also exempt) applying for leave to remain in the UK must pay. It costs £200 per year, and must be paid up front. So, for example, if you are applying for a work visa for 3 years, and you have a family of three, you must pay £1800 to cover the surcharge for you and your family (on top of other visa costs).
It is difficult to find much public discussion in the UK regarding this surcharge, outside of a few articles that recently noted that the surcharge is unlikely to do what we were told it would do – namely, benefit the NHS. (See here)
Is the surcharge a just policy? Continue reading