ethics

Pandemic Ethics: Why Lock Down of the Elderly is Not Ageist and Why Levelling Down Equality is Wrong

By Julian Savulescu and James Cameron

Cross-posted with the Journal of Medical Ethics Blog

 

Countries all around the world struggle to develop policies on how to exit the COVID-19 lockdown to restore liberty and prevent economic collapse, while also protecting public health from a resurgence of the pandemic. Hopefully, an effective vaccine or treatment will emerge, but in the meantime the strategy involves continued containment and management of limited resources.

One strategy is a staged relaxation of lockdown. This post explores whether a selective continuation of lockdown on certain groups, in this case the aged, represents unjust discrimination. The arguments extend to any group (co-morbidities, immunosuppressed, etc.) who have significantly increased risk of death.

Continue reading

National Ethics Framework For Use in Acute Paediatric Settings During COVID-19 Pandemic

This ethical framework is a modification of guidance developed for treatment decisions relating to adults. The principles relating to decisions for children in the setting of the pandemic are the same as those for adults. The framework emphasises that decisions should be ethically consistent and apply to patients both with COVID-related and non-COVID related illness.
The focus of the ethical framework provides guidance for a situation where there is extremely high demand and limited critical care capacity. However, it is important to note that at the time of writing (14 April 2020) there is enough paediatric critical care capacity across the UK. At the present time decisions about children in need of critical care should reflect the same fundamental ethical considerations as apply in normal times. Those decisions should be focused on the best interests of the child, and actively involve parents in decision-making.
The framework is available to read in full on the  Royal College of Paediatric and Child Health website.

Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Written by Dominic Wilkinson, University of Oxford

This article originally appeared in The Conversation

In a world where the adjective “unprecedented” has become commonplace, the news of British Prime Minister Boris Johnson being admitted to the intensive care unit of St Thomas’ Hospital with COVID-19 seemed to take it to a new level.

There is little information in the public domain about Johnson’s medical condition, but this is clearly a very serious step. He will only have been transferred to intensive care because it is perceived that his condition is potentially life threatening and there is a possibility that he would need urgent medical attention, including the possible use of mechanical ventilation.

What would happen if that became necessary? Would Johnson’s treatment be any different from anyone else with the same condition? Would he receive special treatment because of his political position, because of his importance for the country? Would he be prioritised for a ventilator? Continue reading

Oxford Uehiro Prize in Practical Ethics: An Account of Attitudinal Duties Towards Injustice

This essay received an honourable mention in the Graduate Category

Written by University of Oxford Student, Brian Wong

Injustices are ubiquitous around us. From authoritarian regimes’ crackdown on human rights, to exploitative trafficking of illegal migrants, to human-induced destruction of rainforests upon which indigenous groups depend – injustices are negative states of affairs violating moral commitments and duties caused by some level of human agency. Our ability to resist injustices are inevitably constrained, but I argue that even the least able amongst agents still possess attitudinal duties – duties to cultivate and possess particular attitudes towards injustice. Attitudes are mental states; here I focus specifically on explicit attitudes – attitudes that are accessible by introspection and non-automatically/reflexively generated.[1] I open with a pair of cases providing the intuitive preliminaries, prior to offering three interrelated arguments for attitudinal duties, namely from i) functional similarity, ii) relational justice, and iii) aptness. After outlining the plausible contents of such duties, I conclude by examining two objections – i) self-defeasibility, and ii) enforceability. Continue reading

Oxford Uehiro Prize in Practical Ethics: What, if Anything, is Wrong About Algorithmic Administration?

This essay received an honourable mention in the undergraduate category.

Written by University of Oxford student, Angelo Ryu.

 

Introduction

 The scope of modern administration is vast. We expect the state to perform an ever-increasing number of tasks, including the provision of services and the regulation of economic activity. This requires the state to make a large number of decisions in a wide array of areas. Inevitably, the scale and complexity of such decisions stretch the capacity of good governance.

In response, policymakers have begun to implement systems capable of automated decision making. For example, certain jurisdictions within the United States use an automated system to advise on criminal sentences. Australia uses an automated system for parts of its welfare program.

Such systems, it is said, will help address the costs of modern administration. It is plausibly argued that automation will lead to quicker, efficient, and more consistent decisions – that it will ward off a return to the days of Dickens’ Bleak House. Continue reading

Oxford Uehiro Prize in Practical Ethics: If Doctors Could Administer a Treatment That Would Move a Patient From a Vegetative State to a Minimally Conscious One, Should They Do So?

This essay was the runner up in the graduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Matthew Minehan.

INTRODUCTION
Sally is a healthy young woman who suffers catastrophic brain trauma. Over many months, her doctors subject her to functional Magnetic Resonance Imagining (fMRI) scans and other assessments that leave them in no doubt that she is in a vegetative state. While she shows sleeping and waking activity patterns, her body is operating on ‘automatic’ and she has no consciousness. She is “incognizant, incapacitated and insensate” (Fenwick 1998, p.86).

Sally’s doctors are aware of a new treatment that, if administered, would move her from the vegetative state to a minimally conscious one. This new state would involve fractured consciousness, a lack of awareness of her condition, an inability to direct her own life and an incapacity for complex thought. Because Sally has no known next of kin and issued no advance directive, the decision on her treatment is left to her medical team.

Should the doctors in this hypothetical scenario administer the treatment to Sally? Continue reading

Oxford Uehiro Prize in Practical Ethics: Can it be Wrong For Victims to Report Crimes?

This essay was the winning entry in the graduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student, Maya Krishnan.

 

Introduction

Late one night in Managua, Nicaragua, a man punched Leslie Jamison in the face and then ran away with her camera. Jamison called the police. Forty minutes later, a police truck pulled up with a man in the back. A sense of discomfort informs Jamison’s subsequent narration of the incident in her essay collection, The Empathy Exams (2014). Jamison found herself occupying a morally fraught role: that of a white American in Nicaragua who got the police to try to hunt down a likely significantly poorer man. Had she done something wrong by calling the police? Continue reading

Oxford Uehiro Prize in Practical Ethics: Can Science Ethically Make Use Of Data Which Was Gathered By Unethical Means?

This essay was the runner up in the undergraduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics

Written by University of Oxford student Toby Lowther

In this paper, I discuss the question of whether science can ethically make use of data which has been gathered by unethical means in seeking scientific and medical advances to alleviate future suffering. This is an ever-controversial issue of practical ethics, and although the American Medical Assosciation provides firm guidelines on the matter (AMA, 1995), the ethical question remains complex. I will begin by laying out the core issue: the conflict between the desire to censure unethical practices used in gathering such data and the desire to use all data available to bring about the greatest good for society. I will present arguments either side, leading to an ethical stalemate, before presenting how issues of practical consideration for scientific methodology resolve the conflict. I conclude that science cannot make use of data gathered by unethical means, because such data cannot ethically be replicated, and reproducibility is necessary for the validity of the scientific method. I leave open the question of whether it is ethical for the findings of such unethical experiments to guide future, ethical research. Continue reading

Oxford Uehiro Prize in Practical Ethics: Why Is Virtual Wrongdoing Morally Disquieting, Insofar As It Is?

This essay was the winning entry in the undergraduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student, Eric Sheng.

In the computer game Red Dead Redemption 2 (henceforward, RDR2), players control a character in a virtual world. Among the characters represented by computer graphics but not controlled by a real-world player are suffragettes. Controversy arose when it became known that some players used their characters to torture or kill suffragettes. (One player’s character, for example, feeds a suffragette to an alligator.) In this essay, I seek to explain the moral disquiet ­– the intuition that things are awry from the moral perspective – that the players’ actions (call them, for short, ‘assaulting suffragettes’) provoke. The explanation will be an exercise in ‘moral psychology, philosophical not psychological’:[1] I seek not to causally explain our disquiet through the science of human nature, but to explain why things are indeed awry, and thus justify our disquiet.

My intention in posing the question in this way is to leave open the possibilities that our disquiet is justified although the players’ actions are not wrong, or that it’s justified but not principally by the wrongness of the players’ actions. These possibilities are neglected by previous discussions of virtual wrongdoing that ask: is this or that kind of virtual wrongdoing wrong? Indeed, I argue that some common arguments for the wrongness of virtual wrongdoing do not succeed in explaining our disquiet, and sketch a more plausible account of why virtual wrongdoing is morally disquieting insofar as it is, which invokes not the wrongness of the players’ actions but what these actions reveal about the players. By ‘virtual wrongdoing’ I mean an action by a player in the real world that intentionally brings about an action φV by a character in a virtual world V such that φV is wrong-in-V; and the criteria for evaluating an action’s wrongness-in-V are the same as those for evaluating an action’s wrongness in the real world.[2] Continue reading

Cross Post: Flouting Quarantine

Written by Dr Thomas Douglas

Dr Tom Douglas has recently published a fascinating article on the Stockholm Centre, For the Ethics of War and Peace blog:

As I write this, COVID-19, an illness caused by the new coronavirus SARS-CoV-2, is sweeping the globe. Over 15,000 people have died, and it is likely that at least one hundred times this many have been infected with the virus.[2]

The outbreak has brought the ethics of quarantine, isolation and enforced social distancing to public attention. Singapore, Hong Kong, Taiwan, South Korea and China have been praised in the press for their rigorous deployment of quarantine and other liberty-restricting measures. By contrast, the US and UK have been widely criticised for their relatively lax approach.

There are differences between quarantine (which applies to individuals who may have been exposed to an infection), isolation (which applies to individuals who are ill) and enforced social distancing (which largely preserves freedom of movement), but for the purposes of this post, I’ll treat all three together under the heading of ‘quarantine’. I’ll use this term loosely to refer to all interventions that significantly constrain a person’s freedom of movement and/or association in order to lower the risk that the person will infect others.

See here to read the full article, and to join in the conversation.

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