medical ethics

Guest Post: Crispr Craze and Crispr Cares

Written by Robert Ranisch, Institute for Ethics and History of Medicine, University of Tuebingen

@RobRanisch

Newly discovered tools for the targeted editing of the genome have been generating talk of a revolution in gene technology for the last five years. The CRISPR/Cas9-method draws most of the attention by enabling a more simple and precise, cheaper and quicker modification of genes in a hitherto unknown measure. Since these so-called molecular scissors can be set to work in just about all organisms, hardly a week goes by without headlines regarding the latest scientific research: Genome editing could keep vegetables looking fresh, eliminate malaria from disease-carrying mosquitoes, replace antibiotics or bring mammoths back to life.

Naturally, the greatest hopes are put into its potential for various medical applications. Despite the media hype, there are no ready-to-use CRISPR gene therapies. However, the first clinical studies are under way in China and have been approved in the USA. Future therapy methods might allow eradicating hereditary illnesses, conquering cancer, or even cure HIV/AIDS. Just this May, results from experiments on mice gave reason to hope for this. In a similar vein, germline intervention is being reconsidered as a realistic option now, although it had long been considered taboo because of how its (side)effects are passed down the generations. Continue reading

Cross Post: Italy has introduced mandatory vaccinations – other countries should follow its lead

Written by Alberto Giubilini

This article was originally published on The Conversation 

In the first four months of this year, around 1,500 cases of measles were reported in Italy. As a response to the outbreak, the Italian government introduced a law making 12 vaccinations mandatory for preschool and school-age children.

Parents will have to provide proof of vaccination when they enroll their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of “conscientious objection”. Continue reading

Oxford Uehiro Prize in Practical Ethics: Secondary Intentions in Euthanasia, written by Isabel Canfield

This essay received an Honourable Mention in the Undergraduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Isabel Canfield

The debate about the moral permissibility of euthanasia is often presented as hinging upon the distinction between killing and letting die. This debate is often focused around a discussion of intention. This paper will attempt to answer the question, is there an additional level of intention, that has not been considered in the current debate on the moral permissibility of euthanasia, that should be considered?

It will be helpful to begin by outlining some of the terms that I will use throughout this paper. To this end, “euthanasia” is the act of killing someone else with the intention of avoiding the harm of living a continued life that is worse than death.[1 2] The distinction between active and passive euthanasia is complicated and at times not entirely clear. Typically, and for the purposes of this paper, active euthanasia is defined as an act that requires the agent who brings about death to do so purposefully. This purposeful action can be the completion of some task or tasks to accomplish this specific end. Meanwhile, passive euthanasia comes about when the agent who brings about death, if an agent can be said to bring about death at all in these cases, does so by purposefully not acting to continue to sustain the life of the person who dies.[3] Continue reading

Video Series: Tom Douglas on Using Neurointerventions in Crime Prevention

Should neurointerventions be used to prevent crime? For example, should we use chemical castration as part of efforts to prevent re-offending in sex offenders? What about methadone treatment for heroin-dependent offenders? Would offering such interventions to incarcerated individuals involve coercion? Would it violate their right to freedom from mental interference? Is there such a right? Should psychiatrists involved in treating offenders always do what is in their patients’ best interests or should they sometimes act in the best interests of society? Tom Douglas (Oxford) briefly introduces these issues, which he investigates in depth as part of his Wellcome Trust project ‘Neurointerventions in Crime Prevention’ (http://www.neurocorrectives.com).

Cross Post: Why we should tax meat that contains antibiotics

Image 20170404 5732 1qmjs29

Alberto Giubilini, University of Oxford

The use of antibiotics in meat production is a major contributor to one of the biggest threats facing human health in the 21st century: antibiotic resistance. Finding a solution to this requires us to start taking responsibility for our actions. While one person eating meat has an imperceptible effect on antibiotic resistance, multiply that by millions of people around the world and you have a global crisis. Continue reading

The Ethics of Regulation

The New York Times just ran a fairly lengthy article that reported the use of psilocybin, a hallucinogenic drug, in a controlled experiment aimed at reducing anxiety and depression in cancer patients. (http://www.nytimes.com/2016/12/01/health/hallucinogenic-mushrooms-psilocybin-cancer-anxiety-depression.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news)

A few days earlier the New York Times ran a story on trials using MDMA (i.e., ecstasy) to treat post traumatic stress disorder. (http://www.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html)

Why are these stories news? Continue reading

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.”

Continue reading

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: http://bit.ly/29NUj1c   Professor Savulescu has written on this topic in the Practical Ethics in the News blog previously: http://blog.practicalethics.ox.ac.uk/2016/06/organ-mules/.

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