The first advert for the sale of a clinical trial place offers, for $2 million, the chance to participate as a patient in a trial investigating the Farmington virus (FARV) and its potential efficacy in treating certain forms of brain tumours. Meanwhile, Alexander Masters has written convincingly about his idea for a clinical trial dating agency: matching wealthy but sick donors with scientists who have an idea for a cure but no money for a trial (shorter version also available). In Masters’ idea as in the real life case, the proposal is that the wealthy donor will pay not just for himself or herself, but enough for the trial to go ahead with a full complement of those who could not otherwise afford it, recruited on the same basis as any trial.
Predictably, ethical concerns have been raised, perhaps the main one being equality: “In the UK, the principles in participating in clinical trials include open and equal access for those who chose to participate” (Kate Law, director of clinical and population research at Cancer Research UK, quoted in The Telegraph ).
In a world where too many go to bed hungry, it comes as a shock to realise that more than half the world’s food production is left to rot, lost in transit, thrown out, or otherwise wasted. This loss is a humanitarian disaster. It’s a moral tragedy. It’s a blight on the conscience of the world.
It might ultimately be the salvation of the human species.
To understand why, consider that we live in a system that rewards efficiency. Just-in-time production, reduced inventories, providing the required service at just the right time with minimised wasted effort: those are the routes to profit (and hence survival) for today’s corporations. This type of lean manufacturing aims to squeeze costs as much as possible, pruning anything extraneous from the process. That’s the ideal, anyway; and many companies are furiously chasing after this ideal. Continue reading
As recent media coverage has documented, Muslim veils are a hot button issue at present.
Research suggests that “a major determinant of who is most vulnerable to anti-Islamic abuse may be the degree to which the individual is visibly identified as Muslim” (King & Ahmad, 2010, p. 886). For Muslim women, one such identifier is a veil. A veil can refer specifically to the hijab or head- scarf, covering just the head but leaving the face exposed, or the full-face veil, which covers the head and face. Hate crime and prejudice directed against Muslims seems to be strongly linked to such visible markers of “difference” (Dreher, 2006), and political discourse has used veils to represent “the problem of Islam” (Watson, 1994)
In recent work published in the Journal of Applied Social Psychology, I explored the way that such prejudice against Muslim women wearing veils may differ as a function of which particular veil is being worn. You can read the paper here for free (it’s open access), and so I won’t go into too much detail about how study and the psychological literature on prejudice and first impressions. Continue reading
News outlets have been discussing a call to require health warnings on alcoholic drinks comparable to those placed on cigarette packets. Amongst other recommendations, the All Party Parliamentary Group (APPG) on Alcohol Misuse has called on political parties to include a health warning on all alcohol labels, and to deliver a government-funded national public awareness campaign on alcohol-related health issues.
If this proposal is to be implemented, it is important to note that there is an important disanalogy with placing health warnings on cigarette packaging. Whilst cigarettes always damage health to some degree, a large body of evidence suggests that moderate drinking is not only non-harmful to health but may in fact promote it. Continue reading
Epigenetics and Blaming Pregnant Women: Hasty Conclusions, Control, and Simplified Burden of Responsibility
In a recent (13.8.2014) article in Nature , Sarah S. Richardson and colleagues maintain that careless discussion of epigenetic research on how early life affects health across generations could harm women.
Authors discuss the extensive history of placing the burden of responsibility of a child’s health on the lifestyle of the pregnant mother – and the means for controlling women’s behavior. Authors describe how, for example, evidence of any fetal harm easily lead to zero-tolerance regulatory frameworks and severe informal and formal consequences (e.g. social condemnation for an occasional sip of alcohol despite the ambiguous evidence that very moderate and occasional drinking should harm the fetus), and how the “lack of emotional warmth” of the “refrigerator mothers ” was considered to be the reason to child autism as late as the 1970s. Going even more backwards in the history, various defects were attributed, for example, to the company the mother kept during pregnancy.
When Are Objections ‘Religious’ Objections?: Hobby Lobby, Wheaton College, and Contraceptive Coverage
On June 30th, the Supreme Court of the United States handed down its decision in Burwell vs. Hobby Lobby. The case required the court to consider whether closely held for-profit companies owned by individuals with sincere religious objections to abortion should receive a special exemption from providing healthcare coverage for contraceptives that may act after fertilisation but before implantation of an egg. Coverage of twenty types of contraceptives – including the four specific types that the owners consider to be abortifacients – is otherwise legally required as part of the employer-sponsored health insurance mandated by the Patient Protection and Affordable Care Act 2010 (ACA). For a more in depth overview of the facts of the Hobby Lobby case and the key questions before the court, see my previous post on this blog. Continue reading
Suppose that the government is proposing a new policy regarding buildings of historical significance. Rather than simply banning the destruction of ‘listed’ buildings, the new policy would allow their destruction, provided that whoever destroys the building agrees to construct, somewhere nearby, a new building of a similar size, in a similar style, exhibiting a similar range of architectural innovations, and of a similar level of beauty. Blenheim Palace could be flattened and built over with a shopping mall and carpark, provided that mall developers agreed to construct a replica of the palace somewhere nearby.
Most would be disturbed by such a policy. Part of the reason that they would be disturbed, I presume, is that it seems to manifest a failure to recognise the true value of historical buildings. Not all of the value of historical buildings consists in their possession of generic properties like ‘being beautiful’, ‘being in the baroque style’ or ‘using space to dramatic effect’. Some of their value is value that they have as particular objects, and that could thus not be realised in any other object. Part of the value of Blenheim Palace derives from it’s being the birthplace of Winston Churchill. This value could not be realised in a replica of the palace built 5 miles down the road.
Of course, no-one is proposing a policy of sort I’ve just outlined. I bring it up because I think reflecting on this kind of case may throw some light on recent discussion regarding biodiversity offsetting (see, for example, here, here and here). Continue reading
The National Institute for Health and Care Excellence (NICE) recently recommended that the NHS should learn from commercial weight loss programmes such as Weight Watchers, Rosemary Conley and Slimming World. The NICE guidelines suggested that doctors should take a “respectful” and “non-judgemental” tone when helping patients to lose weight. As well as this, GPs were encouraged to continue to identify overweight patients for referral to state-funded commercial weight loss schemes, run by companies such as Weight Watchers, with obese adults being given priority.
The plan is estimated to cost hundreds of millions of pounds, but is also likely to save the NHS vast amounts in the long run, if successful in reducing obesity. Approximately 1 in 4 adults in the UK are obese, a condition that is linked with other ailments such as diabetes, heart disease and some cancers. The costs to the NHS attributable to people being overweight and obese are projected to reach £9.7 billion by 2050. Figures show that Weight Watchers and similar schemes manage to reduce participant’s body weight by 3 per cent, and NICE believe that even this small amount will help in the long term. Is it right, therefore, that the NHS subsidise the cost of these commercially run weight loss schemes?
Last week, we held an expert workshop with key stakeholders to discuss our recent Oxford Martin School policy paper. Our policy paper put forward proposals for how we thought cognitive enhancement devices such as brain stimulators should be regulated. At present, if these sorts of devices do not make medical treatment claims (but instead claim to make you smarter, more creative or a better gamer, say) then they are only subject to basic product safety requirements. In our paper we suggested that cognitive enhancement devices should be regulated in the same way as medical devices and discussed how this could be implemented. Indeed, the devices that are being sold for enhancement of cognitive functions use the very same principles as devices approved by medical device regulators for research into the treatment of cognitive impairment or dysfunction associated with stroke, Parkinson’s disease and depression (amongst other conditions). Being the same sorts of devices, acting via similar mechanisms and posing the same sorts of risks, there seemed to be a strong argument for regulation of some form and an equally strong argument for adopting the same regulatory approach for both medical and enhancement devices.
Having published our paper, we were very keen to hear what people more closely involved in making policy and drafting legislation thought of our proposals. Individuals from the Medical and Healthcare Products Regulatory Agency, the EU New and Emerging Technologies Working Group, a medical devices company, the Nuffield Council on Bioethics, and experts on responsible innovation and on brain stimulation joined us. Overall, the response to our recommendations was positive: all participants agreed that some regulatory action should be taken. There was a general consensus that this regulation should protect consumers but not curtail their freedom to use devices, that manufacturers should not be over-burdened by unnecessary regulatory requirements, and that innovation should not be stifled. Continue reading
Scientists from the Drinking Water Inspectorate have recently discovered benzoylecgonine in water samples at four test sites, a finding that is thought to be a result of high levels of domestic cocaine consumption. Benzoylecgonine is the metabolised form of cocaine that appears once it has passed through the body, and is the same compound that is tested for in urine-based drug tests for cocaine. It is also an ingredient in a popular muscle-rub, however, so the origins of the compound in our water are somewhat uncertain. Steve Rolles from the drug policy think tank Transform has suggested that the findings are an indication of the scale of the use of cocaine in Britain today. According to a 2010 UN report, the United Kingdom is the single largest cocaine market within Europe, followed by Spain. In contrast to the shrinking cocaine market in North America, the number of cocaine users in European countries has doubled over the last decade, from 2 million in 1998 to 4.1 million in 2007/8. Although the annual cocaine prevalence rate in Europe (1.2%) is lower than North America (2.1%), the UK prevalence rate (3.7% in Scotland and 3.0% in England and Wales) is actually higher than the US (2.6% in 2008). According to the charity DrugScope, cocaine is the second most used illegal substance in the UK after cannabis: there are around 180,000 dependent users of crack cocaine in England, and nearly 700,000 people aged 16-59 are estimated to take cocaine every year. Further, according to the government statistics, in the years 2012-13, cocaine was the only drug to show an increase in use among adults between 16-59. All this does appear to suggest a possible link between the benzoylecgonine found in the water supply and high levels of cocaine use in the UK.