choice

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

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

Cross Post: Italy has introduced mandatory vaccinations – other countries should follow its lead

Written by Alberto Giubilini

This article was originally published on The Conversation 

In the first four months of this year, around 1,500 cases of measles were reported in Italy. As a response to the outbreak, the Italian government introduced a law making 12 vaccinations mandatory for preschool and school-age children.

Parents will have to provide proof of vaccination when they enroll their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of “conscientious objection”. Continue reading

Are Incentives Corrupting? The Case of Paying People to be Healthy.

Written by Dr Rebecca Brown

Financial incentives are commonplace in everyday life. As tools of states, corporations and individuals, they enable the ‘tweaking’ of motivations in ways more desirable to the incentiviser. A parent may pay her child £1 to practice the piano for an hour; a café offers a free coffee for every nine the customer buys; governments offer tax breaks for homeowners who make their houses more energy efficient. Most people, most of the time, would probably find the use of financial incentives unobjectionable.

More recently, incentives have been proposed as a means of promoting health. The thinking goes: many diseases people currently suffer from, and are likely to suffer from in the future, are largely the result of behavioural factors (i.e. ‘lifestyles’). Certain behaviours, such as eating energy dense diets, taking little exercise, smoking and drinking large amounts of alcohol, increase the risk that someone will suffer from diseases like cancer, heart disease, lung disease and type II diabetes. These diseases are very unpleasant – sometimes fatal – for those who suffer from them, their friends and family. They also create economic harms, requiring healthcare resources to be directed towards caring for those who are sick and result in reduced productivity through lost working hours. For instance,the annual cost to the economy of obesity-related disease is variously estimated as £2.47 billion£5.1 billion and a whopping $73 billion (around £56.5 billion), depending on what factors are taken into account and how these are calculated. Since incentives are generally seen as useful tools for influencing people’s behaviour, why not use them to change health-related behaviours? Why not simply pay people to be healthy? Continue reading

Cross Post: Why you might want to think twice about surrendering online privacy for the sake of convenience

Written by Carissa Veliz

DPhil Candidate in Philosophy, Uehiro Centre for Practical Ethics, University of Oxford

This article was originally published in The Conversation

Just a click away once you tick this too-long-to-read privacy agreement. Shutterstock

It is inconvenient to guard one’s privacy, and the better one protects it, the more inconvenience one must endure. Enjoying privacy, at a minimum, demands installing software to block tracking online, using long and different passwords for online services, remembering to turn off the WiFi and Bluetooth signals on your mobile phone when leaving the house, using cash, and so on. Continue reading

Cross Post: Liberal or conservative? Most of our beliefs shift around

Written by Prof Neil Levy,

Senior Research Fellow, Uehiro Centre for Practical Ethics, University of Oxford

This article was originally published on The Conversation

What? Okay, that sounds good. Justin Lane/EPA

One common reaction to the election of Donald Trump (and perhaps to a lesser extent, the Brexit vote) among liberals like me is an expression of dismay that some of our fellow citizens are more racist and more sexist than we had dreamed. It seems many were prepared, if not to support openly racist comments and sexist actions, then at least to overlook them. It looks as though battles we thought we had won, having to do with a recognition of a basic kind of equality, need to be fought all over again. Many have concluded that they were never won at all; people were just waiting for a favourable climate to express the racism and sexism they held hidden. Continue reading

Cross Post: Solomon’s frozen judgement

Written by Anders Sandberg

This post was originally published on Andert II

A girl dying of cancer wanted to use cryonic preservation to have a chance at being revived in the future. While supported by her mother the father disagreed; in a recent high court ruling, the judge found that she could be cryopreserved.

As the judge noted, the verdict was not a statement on the validity of cryonics itself, but about how to make decisions about prospective orders. In many ways the case would presumably have gone the same way if there had been a disagreement about whether the daughter could have catholic last rites. However, cryonics makes things fresh and exciting (I have been in the media all day thanks to this).

What is the ethics of parents disagreeing about the cryosuspension of their child? Continue reading

Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

Guest Post by Philipp Kellmeyer

Imagine you had epilepsy and, despite taking a daily cocktail of several anti-epileptic drugs, still suffered several seizures per week, some minor, some resulting in bruises and other injuries. The source of your epileptic seizures lies in a brain region that is important for language. Therefore, your neurologist told you, epilepsy surgery – removing brain tissue that has been identified as the source of seizures in continuous monitoring with intracranial electroencephalography (iEEG) – is not viable in your case because it would lead to permanent damage to your language ability.

There is however, says your neurologist, an innovative clinical trial under way that might reduce the frequency and severity of your seizures. In this trial, a new device is implanted in your head that contains an electrode array for recording your brain activity directly from the brain surface and for applying small electric shocks to interrupt an impending seizure.

The electrode array connects wirelessly to a small computer that analyses the information from the electrodes to assess your seizure risk at any given moment in order to decide when to administer an electric shock. The neurologist informs you that trials with similar devices have achieved a reduction in the frequency of severe seizures in 50% of patients so that there would be a good chance that you benefit from taking part in the trial.

Now, imagine you decided to participate in the trial and it turns out that the device comes with two options: In one setting, you get no feedback on your current seizure risk by the device and the decision when to administer an electric shock to prevent an impending seizure is taken solely by the device.

This keeps you completely out of the loop in terms of being able to modify your behaviour according to your seizure risk and – in a sense – relegates some autonomy of decision-making to the intelligent medical device inside your head.

In the other setting, the system comes with a “traffic light” that signals your current risk level for a seizure, with green indicating a low, yellow a medium, and red a high probability of a seizure. In case of an evolving seizure, the device may additionally warn you with an alarm tone. In this scenario, you are kept in the loop and you retain your capacity to modify your behavior accordingly, for example to step from a ladder or stop riding a bike when you are “in the red.”

Continue reading

Why is chemical castration being used on offenders in some countries?

Written by Dr Jonathan Pugh
This article was originally published on The Conversation
The answer for some. Shutterstock

Following a horrific act of sexual violence against a 14-year-old girl, the president of Indonesia, Joko Widodo, recently signed a decree into law, which, among other things, authorised the death penalty for convicted child sex offenders, and also the use of chemical castration of such offenders.

The main justification cited by Widodo was that castration would act as a deterrent. But how do such interventions fit in the criminal justice system? Are they likely to be successful? Continue reading

Guest Post: Abortion, punishment and moral consistency

Written by: Rajiv Shah, PhD Candidate, Faculty of Law, University of Cambridge

Donald Trump suggested that women who have abortions should face punishment. For that he was criticised by both the pro-choice side and the pro-life side. The latter claimed that their view is that women should not face punishment for having abortions but that only providers should. This raises the interesting question of whether the pro-life position is coherent. It would seem that it is not. If the foetus has the right to life then having an abortion is like murder and so those who abort should be treated as such. This post argues that the pro-lifer can coherently reject this implication whilst still holding that the foetus has the right to life. Since it considers the responses a pro-lifer could make this post will assume for the sake of argument that the foetus does have a right to life. Continue reading

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