medical ethics

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.”

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Genome editing – the key ethical issues

Written by Dr Christopher Gyngell

This article originally appeared on the OMS website

The Nuffield Council of Bioethics released a report last Friday outlining the key ethical issues raised by genome editing technologies.

Genome editing (GE) is a powerful, and extremely rapidly developing technology. It uses engineered enzymes to make precise, controlled modification to DNA. It has the potential to radically transform many industries, including medicine, agriculture and ecology.  Despite only being developed in the past few years’, GE has already been used to create malaria-fighting mosquitoes, drought resistant wheat, hornless cows and cancer killing immune cells. The potential applications of GE in a decade are difficult to imagine. It raises a wide range of ethical issues that require careful scrutiny. Continue reading

Cross Post: We have a moral obligation to allow drug analysis at music festivals

This article was originally published in The Conversation

Written by Julian Savulescu Sir Louis Matheson Distinguishing Visiting Professor at Monash University,

Uehiro Professor of Practical Ethics, University of Oxford

Connor Rochford Medical Student, Monash University

Daniel D’Hotman Medical Student, Monash University

Drug analysis would be a safe, ethical and cost-effective way to reduce harm to young people. Shutterstock

At the Stereosonic festival last year, Sylvia Choi died after consuming a contaminated ecstasy tablet. Unfortunately Sylvia’s narrative is all too familiar – a bright future extinguished at a music festival that will be remembered for all the wrong reasons.

This summer, many young people will also choose to consume various illegal substances in pursuit of a good time. Regardless of their personal choice to break the law, most would agree that they should not have to die for it. Continue reading

Article Announcement: Should a human-pig chimera be treated as a person?

Professor Julian Savulescu has recently published an article on the treatment of Human-Pig Chimera in the online Aeon Magazine.  To read the full article and join in the conversation please follow this link:   Professor Savulescu has written on this topic in the Practical Ethics in the News blog previously:

Cross Post: Next time you ask the doctor for some antibiotics – consider whether you’re being immoral

Written by Alberto Giubilini, Postdoctoral Research Fellow, Oxford Uehiro Centre for Practical Ethics

This article was originally published in The Conversation

Antimicrobial resistance is the ability of microorganisms causing infections to survive exposure to antimicrobial drugs such as antibiotics. This is considered by some to be a slowly emerging disaster. According to the recently released Review on Antimicrobial Resistance commissioned by the UK government, by 2050 some 10m lives a year will be at risk because of drug resistant infections.

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Event: St Cross Special Ethics Seminar: The role of therapeutic optimism in recruitment to a clinical trial: an empirical study, presented by Dr Nina Hallowell

On Thursday 12 May 2016, Dr Nina Hallowell delivered the first St Cross Special Ethics Seminar of Trinity Term.  The talk is available to listen to here

Title:  The role of therapeutic optimism in recruitment to a clinical trial: an empirical study Continue reading

Guest Post: Scientists aren’t always the best people to evaluate the risks of scientific research

Written by Simon Beard, Research Associate at the Center for the Study of Existential Risk, University of Cambridge

How can we study the pathogens that will be responsible for future global pandemics before they have happened? One way is to find likely candidates currently in the wild and genetically engineer them so that they gain the traits that will be necessary for them to cause a global pandemic.

Such ‘Gain of Function’ research that produces ‘Potential Pandemic Pathogens’ (GOF-PPP for short) is highly controversial. Following some initial trails looking at what kinds of mutations were needed to make avian influenza transmissible in ferrets, a moratorium has been imposed on further research whilst the risks and benefits associated with it are investigated. Continue reading

Cross Post: Ideas for Australia: Rethinking funding and priorities in IVF – should the state pay for people to have babies?

Written by Professor Julian Savulescu and Professor Kelton Tremellen

This is a cross posting of an article which was originally published at The Conversation

How much should the state spend on helping people to have children? At present, government support for infertility treatment is approximately A$240 million a year. The success of fertility treatments such as IVF is good if you are under 35 years of age, but once a woman hits 40 it plummets, falling to an almost futile one-in-80 chance of producing a baby for women 45 years and older. This raises the question – is IVF a cost-effective use of taxpayers’ money? And what about for older women?

Decisions about funding are usually made on grounds of cost-effectiveness. In Australia, the cost-effectiveness threshold is about A$40,000 per “QALY”. A QALY is a quality adjusted life year. Thus the government will spend, for example, A$40,000 to add a year of full health, or improve the quality of life by 10% for 10 years.

Is IVF cost-effective? It depends on how we measure it. Continue reading

Oxford Uehiro Prize in Practical Ethics: “The Justice of Punitive Wars” written by Benjamin Koons

This essay received an Honourable Mention in the graduate category of the Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford, Oriel College student Benjamin Koons

  1. Introduction

Contemporary just war theory has largely abandoned punishment as one of the just causes for war, but I intend to show that if one accepts the justice of defensive wars then punitive wars are plausibly justified. I defend this thesis:

Punishment as Just Cause (PJC): It is a just cause for international treaty organization X to initiate a war with member-state Y so as to punish Y for an injustice against state Z. Continue reading

Using birth control to combat Zika virus could affect future generations

Written by Simon Beard
Research Fellow in Philosophy, Future of Humanity Institute, University of Oxford

This is a cross post of an article which originally appeared in The Conversation.

In a recent article, Oxford University’s director of medical ethics, Dominic Wilkinson, argued that birth control was a key way of tackling the Zika virus’s apparently devastating effects on unborn children – a strategy that comes with the extra benefit of meeting the need for reproductive health across much of the affected areas.

However, although this approach might be one solution to a medical issue, it doesn’t consider the demographic implications of delaying pregnancy on such an unprecedented scale – some of which could have a significant impact on people and societies. Continue reading


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