ethics

We Should Vaccinate Children in High-income Countries Against COVID-19, Too

Written by Lisa Forsberg, Anthony Skelton, Isra Black

In early September, children in England, Wales and Northern Ireland are set to return to school. (Scottish schoolchildren have already returned.) Most will not be vaccinated, and there will be few, if any, measures in place protecting them from COVID-19 infection. The Joint Committee on Vaccination and Immunisation (JCVI) have belatedly changed their minds about vaccinating 16- and 17-year olds against COVID-19, but they still oppose recommending vaccination for 12-15 year olds. This is despite considerable criticism from public health experts (here, here, and here), and despite the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) declaring COVID-19 vaccines safe and effective for children aged 12 and up—Pfizer/BioNTech in the beginning of June, and Moderna the other week.

In Sweden, children returned to school in the middle of August. As in the UK, children under 16 will be unvaccinated, and there will be few or no protective measures, such as improved ventilation, systematic testing, isolation of confirmed cases, and masking. Like the JCVI in the UK, Sweden’s Folkhälsomyndigheten opposes vaccination against COVID-19 for the under-16s, despite Sweden’s medical regulatory authority, Läkemedelsverket, having approved the Pfizer and Moderna vaccines for children from the age of 12. The European Medicines Agency approved Pfizer and Moderna in May and July respectively, declaring that any risks of vaccine side-effects are outweighed by the benefits for this age group.

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Judgebot.exe Has Encountered a Problem and Can No Longer Serve

Written by Stephen Rainey

Artificial intelligence (AI) is anticipated by many as having the potential to revolutionise traditional fields of knowledge and expertise. In some quarters, this has led to fears about the future of work, with machines muscling in on otherwise human work. Elon Musk is rattling cages again in this context with his imaginary ‘Teslabot’. Reports on the future of work have included these replacement fears for administrative jobs, service and care roles, manufacturing, medical imaging, and the law.

In the context of legal decision-making, a job well done includes reference to prior cases as well as statute. This is, in part, to ensure continuity and consistency in legal decision-making. The more that relevant cases can be drawn upon in any instance of legal decision-making, the better the possibility of good decision-making. But given the volume of legal documentation and the passage of time, there may be too much for legal practitioners to fully comprehend.

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No jab, no job? Vaccination requirements for care home staff

Written by Lisa Forsberg and Isra Black

Last night the Guardian was first to report that staff working in older adult care homes will be required to get vaccinated against Covid-19. According to BBC News, ‘Care staff are expected to be given 16 weeks to have the jab—or face being redeployed away from frontline care or losing their jobs’. This announcement follows news reports over the last few months that the government have been considering making Covid-19 vaccination mandatory for staff working in older adult care homes in England. As part of this process, an open consultation on vaccination for older adult care home staff was held in April and May of this year, to which we responded.

While we think a vaccination requirement for older adult care home staff may be a necessary and proportionate measure, we nevertheless have concerns about the government’s proposed policy.

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Imposter Syndrome And Environmental Sampling

Written by Rebecca Brown

Imposter syndrome has received recent, though still fairly limited, philosophical discussion. Scholars such as Katherine Hawley (and, drawing upon Hawley in a recent and excellent podcast, Rebecca Roache), amongst a handful of others have illuminated issues such as how we can develop a useful definition of imposter syndrome, the extent to which imposter syndrome may be adaptive, and the relationship between imposter syndrome beliefs and rationality. I want to pick up on this last question and suggest a further way in which people might rationally adopt ‘imposter attitudes’.

Imposter syndrome, as described by Hawley, involves believing that the external markers of esteem and success one receives are undeserved, and feeling at risk of being exposed as a fraud. Imposter attitudes refer to the negative attitudes one might hold regarding one’s own ability. Hawley challenges the common assumption that those suffering from imposter syndrome are simply too unconfident. She describes how people might justifiably (though mistakenly) hold imposter attitudes as a result of ‘hostile social environments’. This includes, for instance, people who are less likely to receive positive feedback in their work environment, or have reason to believe that any positive feedback they receive is insincere. For such people, although they have some evidence of their talent (e.g. publishing papers or winning awards), they have other evidence that this could be undeserved (e.g. lack of positive feedback from colleagues). Hawley is particularly concerned about minority groups who she suggests are more likely to experience hostile social environments and feel like impostors. Continue reading

Cross Post: End-of-Life Care: People Should Have the Option of General Anaesthesia as They Die

Written by Dominic Wilkinson and Julian Savulescu

Dying patients who are in pain are usually given an analgesic, such as morphine, to ease their final hours and days. And if an analgesic isn’t enough, they can be given a sedative – something to make them more relaxed and less distressed at the end of life. We have recently written about a third approach: using a general anaesthetic to ensure that the dying patient is completely unconscious. This has been described previously, but largely overlooked.

There are two situations when a general anaesthetic might be used in dying patients. The first is when other drugs have not worked and the patient is still distressed or in pain. The second is when a patient has only a short time to live and expresses a clear wish to be unconscious. Some dying patients just want to sleep. Continue reading

Cross Post: COVID: Is it OK to manipulate people into getting vaccinated?

Written by Maximilian Kiener, University of Oxford

Bored Panda, a website that publishes “lightweight and inoffensive topics”, reports an allegedly true case from the US of a woman who refused to have her child vaccinated. The woman, who is described as a “conspiracy theory magnet”, provided 15 reasons why vaccines are more harmful than the disease they protect against.

When the doctor realised that he wouldn’t be able to dissuade her of her beliefs, he decided to present her with another one:

Have you considered the possibility that anti-vaccine propaganda could be an attempt by the Russians or the Chinese to weaken the health of the United States population?

The doctor deliberately deceived the woman and probably reinforced her belief in conspiracy theories by pretending to find them plausible himself. But the tactic worked. The mother consented to have her child vaccinated.

Right now, vaccination is key to overcoming the COVID-19 pandemic and regaining safe individual freedom. Yet a minority of people, like the woman in our example, still refuse vaccination on mistaken beliefs. But how far can we go to change their minds?

Would the doctor be justified in using similar tactics to make the woman consent to her own COVID-19 vaccination? Continue reading

Cross Post: There’s no Need to Pause Vaccine Rollouts When There’s a Safety Scare. Give the Public the Facts and Let Them Decide

Written By: Julian Savulescu, University of Oxford; Dominic Wilkinson, University of Oxford;

Jonathan Pugh, University of Oxford, and Margie Danchin, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

 

When someone gets sick after receiving a vaccine, this might be a complication or coincidence. As the recent rollout out of the AstraZeneca vaccine in Europe shows, it can be very difficult to know how to respond.

For instance, reports of blood clots associated with the AstraZeneca vaccine led to several European countries suspending their vaccination programs recently, only to resume them once these clots were judged to be a coincidence. However, authorities couldn’t rule out increased rates of a rare brain blood clot associated with low levels of blood platelets.

There are also problems with the Pfizer and Moderna vaccines. By early February 2021, among the over 20 million people vaccinated in the United States, there have been 20 reported cases of immune thrombocytopenia, a blood disorder featuring a reduced number of platelets in the blood. Experts suspect this is probably a rare vaccine side-effect but argue vaccination should continue.

So what happens with the next safety scare, for these or other vaccines? We argue it’s best to give people the facts so they have the autonomy to make their own decisions. When governments pause vaccine rollouts while investigating apparent safety issues, this is paternalism, and can do more harm than good. Continue reading

Oxford Uehiro Prize in Practical Ethics: Should Feminists Endorse a Universal Basic Income?

This essay was the joint runner up in the graduate category of the 7th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Rebecca L Clark

  • 1 Introduction

A UBI is a regularly remitted, non-means-tested cash grant which is given to every individual with no conditions attached.[1] Within these constraints, UBI proposals can differ considerably. Firstly, there is a Question of Scope – namely, who constitutes ‘every individual’? Secondly, there is a Question of Specification, which can be broken down into three interrelated issues:

  1. At what level of income should a UBI be set?
  2. Should a UBI supplement or replace existing welfare structures?
  3. How should a UBI be funded?

I will set aside the complexities raised by the Question of Scope and focus on a UBI given to adult citizens. In response to the Question of Specification, I will consider a UBI set at a liveable wage which supplements existing welfare institutions and is funded through revenues from publicly owned assets.[2] This is for two reasons. Firstly, I take this to be the most appealing version of a UBI; hence a conclusion that feminists should reject this version would suggest that feminists should reject any UBI proposal. Secondly, I am wary of building in hard limits of political or economic feasibility into my analysis since this forecloses utopian theorising, which is valuable precisely because it challenges conventional views about what is possible. Continue reading

Ethics, iBlastoids, and Brain Organoids: Time to Revise Antiquated Laws and Processes

Written by Julian Savulescu
Oxford Uehiro Centre for Practical Ethics and Wellcome Centre for Ethics, University of Oxford
Biomedical Ethics Research Group, Murdoch Children’s Research Institute

Jose Polo and his team at Monash University have successfully reprogrammed human adult cells (fibroblasts – skin cells) to form “iBlastoids”. These are structures which are like early human embryos. Normally when a sperm enters an egg, it produces a new cell, which divides, and these cells divide until a blastocyst is formed in the first week, consisting of 200-300 cells. In normal embryonic development, this would implant in the uterus. However, iBlastoids can’t do this as they lack the normal membrane that surrounds the blastocyst. They cannot by themselves form a fetus or baby.

They will be useful to study early human development and why so many embryos die soon after formation. They can be used to study mutations or the effect of toxins, perhaps developing treatments for infertility. So far, they have only been allowed to develop to the equivalent of a Day 11 Blastocyst. It is not clear whether they can produce the precursors to brain development:

“the developmental potential of iBlastoids as a model for primitive streak formation and gastrulation remains to be determined, and will require an international conversation on the applicability of the 14-day rule to iBlastoids.” (Excerpt from the team’s Nature article)

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Oxford Uehiro Prize in Practical Ethics: Why, If At All, Is It Unethical For Universities To Prioritise Applicants Related To Their Alumni?

This essay was the runner up in the undergraduate category of the 7th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Tanae Rao

Introduction

Most notably in the United States, some prestigious universities[1] consider whether or not a student is closely related to one or more alumni when evaluating her application. In an increasingly competitive university admissions landscape, having legacy status increases an applicant’s probability of being admitted to such a great extent that over a third of Harvard’s undergraduate class of 2022 is composed of legacy students.[2] This has led the New York Times Editorial Board to describe the practice as “anti-meritocratic” and “an engine of inequity”.[3]

Considering the alma mater of a student’s relatives when evaluating their university application seems to be wrong, or unfair, in some way. But what is the central aspect of the legacy admissions policy justifying this reaction? I consider three possible answers to this question. Firstly, I reject the academic qualification view, whereby universities should only consider if applicants will be able to meet academic requirements when making admissions decisions. This view does not reflect the actual state of university admissions today, where the number of qualified applicants often far exceeds the number of available seats. I then reject the popular view whereby universities should minimise their consideration of factors outside of the applicant’s control. Though this criterion appears to meet many of our intuitions regarding university admissions, I argue that it is too restrictive, preventing reasonable factors from being considered by universities. Finally, I propose a consequentialist view, whereby admissions decisions should be based on their expected consequences to admitted students and society as a whole. This view—I contend—is a plausible explanation of why legacy admissions should be discontinued, contingent on some evaluative questions. Continue reading

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