Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

Dr Jonathan Pugh’s St Cross Special Ethics Seminar on 12 November 2015 is now available at http://media.philosophy.ox.ac.uk/uehiro/MT15_STX_Pugh.mp3

Speaker: Dr Jonathan Pugh

Although a central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to that intervention, there are some circumstances in which it seems that this moral requirement may be trumped. For instance, in some circumstances, it might be claimed that it is morally permissible to carry out certain sorts of non-consensual interventions on competent individuals for the purpose of infectious disease control (IDC). In this paper, I shall explain how one might defend this practice, and consider the extent to which similar considerations might be invoked in favour of carrying out non-consensual medical interventions for the purposes of facilitating rehabilitation amongst criminal offenders. Having considered examples of non-consensual interventions in IDC that seem to be morally permissible, I shall describe two different moral frameworks that a defender of this practice might invoke in order to justify such interventions. I shall then identify five desiderata that can be used to guide the assessments of the moral permissibility of non-consensual IDC interventions on either kind of fundamental justification. Following this analysis, I shall consider how the justification of non-consensual interventions for the purpose of IDC compares to the justification of non-consensual interventions for the purpose of facilitating criminal rehabilitation, according to these five desiderata. I shall argue that the analysis I provide suggests that a plausible case can be made in favour of carrying out certain sorts of non-consensual interventions for the purpose facilitating rehabilitation amongst criminal offenders.

Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human

The 2015 Loebel Lectures in Psychiatry and Philosophy were delivered by Professor Steven E. Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard as well as Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology. Both the lecture series and the one-day workshop proved popular and were well-attended. Continue reading

Guest Post: Vampire Judges and Blood Money: Blood Donation as Criminal Sanction?

Written by Christopher Chew

Monash University

Early one September morning, plaintiffs at a rural Alabama County court in the US, were greeted with an unexpected and highly unusual offer. To quote presiding Judge Marvin Wiggins:

“There’s a blood drive outside, and if you don’t have any money, and you don’t want to go to jail, as an option to pay it, you can give blood today…bring in a receipt indicating you gave blood…as a discount rather than putting you in jail…or the sheriff has enough handcuffs for those who do not have money.” Continue reading

Some thoughts on reparations

Consider the following case. Imagine you inherit a fortune from your parents. With that money, you buy a luxurious house and you pay to get a good education, which later allows you to find a job where you earn a decent salary. Many years later, you find out that your parents made their fortune through a very bad act—say, defrauding someone. You also find out that the scammed person and his family lived an underprivileged life from that moment on.

What do you think you would need to do to fulfill your moral obligations?

Continue reading

1 in 4 women: How the latest sexual assault statistics were turned into click bait by the New York Times

by Brian D. Earp / (@briandavidearp)

* Note: this article was originally published at the Huffington Post.


As someone who has worked on college campuses to educate men and women about sexual assault and consent, I have seen the barriers to raising awareness and changing attitudes. Chief among them, in my experience, is a sense of skepticism–especially among college-aged men–that sexual assault is even all that dire of a problem to begin with.

“1 in 4? 1 in 5? Come on, it can’t be that high. That’s just feminist propaganda!”

A lot of the statistics that get thrown around in this area (they seem to think) have more to do with politics and ideology than with careful, dispassionate science. So they often wave away the issue of sexual assault–and won’t engage on issues like affirmative consent.

In my view, these are the men we really need to reach.

A new statistic

So enter the headline from last week’s New York Times coverage of the latest college campus sexual assault survey:

1 in 4 Women Experience Sex Assault on Campus.”

But that’s not what the survey showed. And you don’t have to read all 288 pages of the published report to figure this out (although I did that today just to be sure). The executive summary is all you need.

Continue reading

Guest Post: Mental Health Disorders in Prison: Neuroethical and Societal Issues

 Guest post by Barbara Sahakian,

FMedSci, DSc, a professor in the department of psychiatry at the University of Cambridge,

and president of the International Neuroethics Society.

This article was originally published on the Dana Foundation Blog, and can be read here: http://danablog.org/2015/07/28/mental-health-disorders-in-prison-neuroethical-and-societal-issues/

More than half of all prison and jail inmates have a mental health problem.[i] In addition, according to a 2010 report released by the Treatment Advocacy Center and the National Sheriffs’ Association,[ii] more mentally ill persons are in jails and prisons than in hospitals, and many of those remain untreated. Those in prison have a higher risk of substance abuse, and suicide rates are four to five times higher than within the general population.[iii] Deaths are also increased upon release, with the most common reasons being drug overdose, cardiovascular disease, homicide, and suicide.[iv]

Many people in prison have lower than average IQs, and it is well-established that lower IQ is a known risk factor for mental health problems.[v] Rates of problems for children in the youth justice system are at least three times higher than within the general population, and are highest amongst children in custody.[vi] Almost a quarter of children who offend have very low IQs of less than 70.[vii]

At the International Neuroethics Society Annual Meeting 2015 in Chicago (Oct. 15-16), there will be a panel entitled, “Mental health disorders in prison: Neuroethical and societal issues,” which will consider vulnerabilities to mental health problems of those in prison, and whether there are inequalities in access to psychiatrists, psychologists, and other professionals for diagnosis and treatment. This panel will also reflect on what steps, in terms of improving cognition, functionality, and wellbeing, society should be taking to ensure better life trajectories when inmates with mental health problems are released.

For example, suicide mortality is reduced by antidepressant treatment,[viii] and there is evidence that for at least some disorders, such as attention deficit hyperactivity disorder (ADHD), treatment leads to a significant reduction in criminality rates in men (Lichtenstein et al, 2012).[ix] Effective treatment of neuropsychiatric disorders and education, including skill training in prisons, could help to increase cognitive reserve and resilience, helping prisoners successfully address the many challenges encountered on release.[x]

The highly distinguished panel includes Dr. James Blair, Dr. Laurie R. Garduque, and Professor Hank Greely. The panel’s moderator, Dr. Alan Leshner, has been director of the National Institute on Drug Abuse, deputy director and acting director of the National Institute of Mental Health, and chief executive officer of the American Association for the Advancement of Science. He was one of the first to highlight the neuroscientific evidence of brain changes in addiction.

[i] James DJ, Glaze LE (2006) Mental health problems of prison and jail inmates. Bureau of Justice Statistics, NCJ 213600

[ii] Torrey E, Kennard A, Eslinger D, Lamb R, Pavle J (2010) More Mentally Ill Persons are in Jails and Prisons than Hospitals: A Survey of the States. Treatment Advocacy Center.

[iii] Fazel S, Grann M, Kling B, Hawton K (2011) Prison suicide in 12 countries: An ecological study of 861 suicides during 2003–2007. Soc Psychiatry Psychiatr Epidemiol, 46, 191-195.

[iv] Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, Koepsell TD (2007) Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165.

[v] Barnett JH, Salmond CH, Jones PB, Sahakian BJ (2006) Cognitive reserve in neuropsychiatry. Psychological Medicine, 36, 1053-1064.

[vi] Hagell A (2002) The mental health needs of young offenders—a report commissioned by the Mental Health Foundation MHF: London.

[vii] Harrington R, Bailey S (2005) Mental health needs and effectiveness of provision for young offenders in custody and in the community YJB: London.

[viii] Morgan OWC, Griffiths C, Majeed A (2004) Association between mortality from suicide in England and antidepressant prescribing: an ecological study. BMC Public Health, 4.

[ix] Lictenstein P, Halldner L, Zetterqvist J, Sjolander A, Serlachius E, Fazel S, Langstrom N, Larsson H (2012) Medication for attention deficit-hyperactivity disorder and criminality. The New England Journal of Medicine, 367.

[x] Beddington J, Cooper CL, Field J, Goswami U, Huppert FA, Jenkins R, Jones HS, Kirkwood TB, Sahakian BJ, Thomas SM (2008) The mental wealth of nations. Nature, 23, 1057-1060.

Stopping the innocent from pleading guilty

Written by Dr John Danaher.

Dr Danaher is a Lecturer in Law at NUI Galway. His research interests include neuroscience and law, human enhancement, and the ethics of artificial intelligence.

A version of this post was previously published here.

Somebody recently sent me a link to an article by Jed Radoff entitled “Why Innocent People Plead Guilty”. Radoff’s article is an indictment of the plea-bargaining system currently in operation in the US. Unsurprisingly given its title, it argues that the current system of plea bargaining encourages innocent people to plead guilty, and that something must be done to prevent this from happening.

I recently published a paper addressing the same problem. The gist of its argument is that I think that it may be possible to use a certain type of brain-based lie detection — the P300 Concealed Information Test (P300 CIT) — to rectify some of the problems inherent in systems of plea bargaining. The word “possible” is important here. I don’t believe that the technology is currently ready to be used in this way – I think further field testing needs to take place – but I don’t think the technology is as far away as some people might believe either.

What I find interesting is that, despite this, there is considerable resistance to the use of the P300 CIT in academic and legal circles. Some of that resistance stems from unwarranted fealty to the status quo, and some stems from legitimate concerns about potential abuses of the technology (miscarriages of justice etc.). I try to overcome some of this resistance by suggesting that the P300 CIT might be better than other proposed methods for resolving existing abuses of power within the system. Hence my focus on plea-bargaining and the innocence problem.

Anyway, in what follows I’ll try to give a basic outline of my argument. As ever, for the detail, you’ll have to read the original paper. Continue reading

McMahan’s Hazardous (and Irrelevant) Thought Experiment

Written by Professor Allen Buchanan and Professor Lance K. Stell  


This is a response to an earlier post, by Jeff McMahan, about the right to carry guns, http://blog.practicalethics.ox.ac.uk/2015/04/a-challenge-to-gun-rights.

Before we criticize McMahan’s argument, it is important to ascertain its implications: Assuming that, as McMahan thinks, there is no moral right to gun ownership, what follows, practically speaking? One might think that, given the number of gun deaths, it follows that there should be a legal ban on gun ownership. As we shall show, however, that conclusion does not follow.  Whether or not gun ownership should be banned is independent of whether there is a moral right to gun ownership. We will show that McMahan has not established that there is no moral right to gun ownership, but that even if he had, he would not have thereby shown that there should be a ban on gun ownership. Continue reading

Born this way? How high-tech conversion therapy could undermine gay rights

By Andrew Vierra, Georgia State University and Brian D Earp, University of Oxford

This article was originally published on The Conversation.
Read the 
original article.


Following the death of 17-year-old Leelah Alcorn, a transgender teen who committed suicide after forced “conversion therapy,” President Barack Obama called for a nationwide ban on psychotherapy aimed at changing sexual orientation or gender identity. The administration argued that because conversion therapy causes substantial psychological harm to minors, it is neither medically nor ethically appropriate.

We fully agree with the President and believe that this is a step in the right direction. Of course, in addition to being unsafe as well as ethically unsound, current conversion therapy approaches aren’t actually effective at doing what they claim to do – changing sexual orientation.

But we also worry that this may be a short-term legislative solution to what is really a conceptual problem.

The question we ought to be asking is “what will happen if and when scientists do end up developing safe and effective technologies that can alter sexual orientation?”

Continue reading

A Challenge to Gun Rights

Written By Professor Jeff McMahan


On this day in the US, around thirty people will be killed with a gun, not including suicides.  Many more will be wounded.  I can safely predict this number because that is the average number of homicides committed with a gun in the US each day.  Such killings have become so routine that they are barely noticed even in the local news.  Only when a significant number of people are murdered, particularly when they include children or are killed randomly, is the event considered newsworthy.


Yet efforts to regulate the possession of guns in the US are consistently defeated. Continue reading