Press Statements

Press Release: Majority of UK public want choice at the end of life – survey

Most people in the UK would like the option of being heavily sedated, having a general anaesthestic or to having euthanasia, if they were dying, according to Oxford research published today in the medical journal PLOS One.

Professor Dominic Wilkinson, Professor Julian Savulescu and colleagues from the Oxford Uehiro Centre for Practical Ethics, surveyed more than 500 adults in August 2020 on their views about the care of a patient who had one week to live.

The study found a high level of support for access to deep sedation in dying patients.
Some 88% said they would like the option of a general anaesthetic if they were dying. Meanwhile, 79% of those surveyed said they would like to have the option of euthanasia.
But just 64% said they would personally choose anaesthetic at the end of life and nearly half said they would not choose euthanasia for themselves or a family member.

The report maintains, ‘This study indicates that a substantial proportion of the general community support a range of options at the end of life, including some that are not currently offered in the UK.’

According to Professor Wilkinson, ‘Previous surveys have shown that a large proportion of the UK public wish to have the option of euthanasia. This study shows an even larger number wish to have the choice of being heavily sedated or even receiving a general anaesthetic if they were dying.’

He continues, ‘Currently, in the UK it is legal for doctors to provide pain relief to dying patients, and to use sedatives if that is not enough to keep a patient comfortable. Heavy sedation is used as an option of last resort. General anaesthesia is not currently considered. But members of the general public value the option of deep sleep and complete relief from pain if they were dying. They believe that patients should be given this choice.’

Meanwhile, Professor Savulescu adds, ‘Patients have a right to be unconscious if they are dying. This survey shows that the general public want to have greater choice at the end of life.’
ENDS

Notes for Editors

For more information, please contact news.office@admin.ox.ac.uk

1. The survey is based on two anonymous online surveys of members of the UK public, sampled to be representative. They were given a scenario of a hypothetical terminally ill patient with one week to live and asked about the acceptability of providing titrated analgesia, gradual sedation, terminal anaesthesia, and euthanasia.
2. Across both surveys, a majority had undertaken higher education, with seven in 10 having A levels or higher qualifications. Meanwhile, just 2.4% overall had no qualifications.
3. Just over half of all respondents said they were religious with 13.8% describing themselves as very religious.

Press Release: UK Approves COVID-19 Challenge Studies

Responses to the UK COVID-19 Challenge Studies: 

“In a pandemic, time is lives.  So far, over a million people have died.

“There is a moral imperative to develop to a safe and effective vaccine – and to do so as quickly as possible.  Challenge studies are one way of accelerating vaccine research.  They are ethical if the risks are fully disclosed and they are reasonable.  The chance of someone aged 20-30 dying of COVID-19 is about the same as the annual risk of dying in a car accident.  That is a reasonable risk to take, especially to save hundreds of thousands of lives.  It is surprising challenge studies were not done sooner.  Given the stakes, it is unethical not to do challenge studies.”

Prof Julian Savulescu, Uehiro Chair in Practical Ethics, and Director of the Oxford Uehiro Centre for Practical Ethics, and Co-Director of the Wellcome Centre for Ethics and Humanities, University of Oxford

“Human challenge studies are an important and powerful research tool to help accelerate our understanding of infectious diseases and vaccine development.  They have been used for many years for a range of different infections.

“The announcement of the UK Human Challenge Program is a vital step forward for the UK and the world in our shared objective of bringing the COVID-19 pandemic to an end.  With cases climbing across Europe, and more than 1.2 million deaths worldwide, there is an urgent ethical imperative to explore and establish COVID-19 challenge trials.

“All research needs ethical safeguards.  Challenge trials need to be carefully designed to ensure that those who take part are fully informed of the risks, and that the risks to volunteers are minimised.  Not everyone could take part in a challenge trial (only young, healthy volunteers are likely to be able to take part).  Not everyone would choose to take part.  But there are hundreds of young people in the UK and elsewhere who have already signed up to take part in COVID challenge studies.  They deserve our admiration, our support and our thanks.”

Prof Dominic Wilkinson, Professor of Medical Ethics, Oxford Uehiro Centre for Practical Ethics, University of Oxford

Further Research

Read more about the ethics of challenge studies:

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Press Release: In Defence of Intersex Athletes

Julian Savulescu

The Court of Arbitration for Sport (CAS) has announced that multiple Olympic and World Champion runner Caster Semenya and other athletes with disorders of sex (DSD) conditions will have to take testosterone lowering agents in order to be able to compete in her events.

Reducing the testosterone levels of existing intersex female athletes is unfair and unjust.

The term intersex covers a range of conditions. While intersex athletes have raised levels of testosterone, its effect on individual performance is not clear.  Some disorders which cause intersex change the way the body responds to testosterone. For example, in Androgen Insensitivity syndrome, the testosterone receptor may be functionless or it may be partly functional. In the complete version of the disorder, although there are high levels of testosterone present, it has no effect.

As we don’t know what effect testosterone has for these athletes , setting a maximum level is sketchy because we are largely guessing from physical appearance to what extent it is affecting the body. It is not very scientific. We simply don’t know how much advantage some intersex athletes are getting even from apparently high levels of testosterone. Continue reading

Press Statement: He Jiankui

The response  to reckless human experimentation has to go way beyond Dr He’s dismissal. This is not merely a failure of compliance, Dr He failed to grasp the ethical principles and concepts he was vigorously espousing.  There will undoubtedly be more guidelines and laws on gene editing but we also need basic education of the next generation of scientists in what ethics is and why this kind of behaviour is wrong. This was not a failure of science, or even regulation, but ethics.

More important than He’s fate is the future for those victims affected. The couples and babies will need world class medical management and counselling. The second couple carrying a gene edited pregnancy should have already been fully informed of and understood the risks to their fetus and given the free choice to continue or terminate their pregnancy.

Prof Julian Savulescu
Uehiro Chair in Practical Ethics
Director Oxford Uehiro Centre for Practical Ethics
University of Oxford

Visiting Professorial Fellow
Murdoch Children’s Research Institute
And University of Melbourne

 

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