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.
Just out today is a podcast interview for Smart Drug Smarts between host Jesse Lawler and interviewee Brian D. Earp on “The Medicalization of Love” (title taken from a recent paper with Anders Sandberg and Julian Savulescu, available from the Cambridge Quarterly of Healthcare Ethics, here).
Below is the abstract and link to the interview:
What is love? A loaded question with the potential to lead us down multiple rabbit holes (and, if you grew up in the 90s, evoke memories of the Haddaway song). In episode #95, Jesse welcomes Brian D. Earp on board for a thought-provoking conversation about the possibilities and ethics of making biochemical tweaks to this most celebrated of human emotions. With a topic like “manipulating love,” the discussion moves between the realms of neuroscience, psychology and transhumanist philosophy.
Earp, B. D., Sandberg, A., & Savulescu, J. (2015). The medicalization of love. Cambridge Quarterly of Healthcare Ethics, Vol. 24, No. 3, 323–336.
Written By Johanna Ahola-Launonen
University of Helsinki
Chronic diseases, their origins, and issues of responsibility are a prevalent topic in current health care ethics and public discussion; and obesity is among one of the most discussed themes. Usually the public discussion has a tendency to assume that when information about health lifestyle choices exist, the individual should be able to make those choices. However, studies increasingly pay attention to the concept of food environment and its huge influence. If obesity really is that serious an issue to public health, health care costs, and economy as many suggest, focus should be directed to the alteration of food environment instead of having the individual as the primary target of intervention. Continue reading
New open access publication: announcement:
In a recently published article, Hannah Maslen, Roi Cohen Kadosh, Julian Savulescu and I present an argument about the permissible (and not-so-permissible) uses of non-invasive brain stimulation technology in children. We consider both children who may be suffering from a specific neurological disorder, for whom the stimulation is intended as a ‘treatment’, and those who are otherwise healthy, for whom the stimulation is intended as ‘enhancement’. For the full article and citation, see here:
Maslen, H., Earp, B. D., Cohen Kadosh, R., & Savulescu, J. (2014). Brain stimulation for treatment and enhancement in children: An ethical analysis. Frontiers in Human Neuroscience, Vol. 8, Article 953, 1-5. Continue reading
The paper, “The Medicalization of Love” by Brian D. Earp, Anders Sandberg, and Julian Savulescu, has been accepted for publication at the Cambridge Quarterly of Healthcare Ethics. Scholars interested in submitting a short reply paper or peer commentary are encouraged to contact the editor, Tomi Kushner, at firstname.lastname@example.org.
The final deadline for commentaries/ papers is September 1st. The abstract for the paper is below; the accepted manuscript is available at this link. Inquiries to the editor should be sent as soon as possible.
Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”
* image from http://www.metalsucks.net/2014/02/16/sunday-lurve/.
Another article discusses the morality of different methods of organ transplant. Strangely absent from the discussion, is any indication of the scale of the problem – something that should be front and centre. The numbers are strangely hard to find, but seem to lie between 400 and 1000 deaths per year, with many more suffering from pain and reduced quality of life because of the lack of available organs.
That should be the main focus of the discussion – those people who would now be living, breathing, enjoying life, contributing to the world and spending time with their friends and family, had they got the organ they needed. It matters not whether our ‘system of organ donation [is] based on generosity and compassion’ – the point is not to show personal virtue for the donor, but to save lives. It is truly bizzare to argue that we must ensure, on compassionate grounds, that more people must die. If you truly want to show generosity and compassion, there are no lack of methods to do so.
As for the argument that changing systems would make our bodies become the property of the state – it’s important to ignore the appeal to emotion, and focus on what’s happening here. We are talking about allowing doctors to take organs from people who are already dead, and using them to keep living people alive. That’s it. Nothing more. And it all happens under a system of presumed consent, so that if you really felt strongly about it, you could opt out entirely.
Remember – if your organs aren’t the property of the state after your death, then they’re usually the property of the worms.
By Charles Foster
I have just finished writing a book about dignity in bioethics. Much of it was a defence against the allegation that dignity is hopelessly amorphous; feel-good philosophical window-dressing; the name we give to whatever principle gives us the answer to a bioethical conundrum that we think is right.
This allegation usually comes from the thoroughgoing autonomists – people who think that autonomy is the only principle we need. There aren’t many of them in academic ethics, but there are lots of them in the ranks of the professional guideline drafters, (look, for instance, at the GMC’s guidelines on consenting patients) and so they have an unhealthy influence on the zeitgeist.
The allegation is ironic. The idea of autonomy is hardly less amorphous. To give it any sort of backbone you have to adopt an icy, unattractive, Millian, absolutist version of autonomy. I suspect that the widespread adoption of this account is a consequence not of a reasoned conviction that this version is correct, but of a need, rooted in cognitive dissonance, to maintain faith with the fundamentalist notions that there is a single principle in bioethics, and that that principle must keep us safe from the well-documented evils of paternalism. Autonomy-worship is primarily a reaction against paternalism. Reaction is not a good way to philosophise. Continue reading