responsibility

Responsibility, Healthcare, and Harshness

Written by Gabriel De Marco

Suppose that two patients are in need of a complicated, and expensive, heart surgery. Further suppose that they are identical in various relevant respects: e.g., state of the heart, age, likelihood of success of surgery, etc. However, they differ on one feature: for one of these patients, call her Blair, the need for the heart surgery is due to her lifestyle (suppose she was a smoker), whereas the other, Ingrid, has not had this lifestyle, nor any other that would lead to the need for the surgery.

Some people think that:

  1. We can be responsible and blameworthy for our actions and their consequences.

Some of those people also think that:

  1. We can, or should, take this into account when making decisions about how to distribute healthcare resources.

For the purposes of this blog post, let’s assume 1 and 2 are true. Commonly, it is thought that, in order to be blameworthy for something, one must be responsible for it. Further, it is commonly thought that, whatever the appropriate response is to blameworthiness for something or other (assuming that there is an appropriate response), it will be negative in some sense or other. Now further suppose that Blair is blameworthy for her illness. Given 1 and 2, this fact about Blair, combined with the fact that Ingrid is innocent with regard to her illness, suggests that, at least in some contexts, we should treat them differently (or at least it would be permissible to do so). Call a healthcare policy that adopts, and reflects, 1 and 2 a Responsibility-Sensitive Policy, or RSP for short.

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Health vs Choice? The Vaccination Debate.

On Sunday 3 November, OUC’s Dr Alberto Giubilini participated in a debate on compulsory vaccination at 2019 Battle of Ideas Festival (Barbican Centre, London). Chaired by Ellie Lee, the session also featured Dr Michael Fitzpatrick (GP and author, MMR and Autism: what parents need to know and Defeating Autism: a damaging delusion); Emilie Karafillakis (Vaccine Confidence Project); and Nancy McDermott (author, The Problem with Parenting: a therapeutic mode of childrearing).

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Responsibility Over Time And Across Agents

Rebecca Brown and Julian Savulescu

Cross-posted from the Journal of Medical Ethics blog, available here.

There is a rich literature on the philosophy of responsibility: how agents come to be responsible for certain actions or consequences; what conditions excuse people from responsibility; who counts as an ‘apt candidate’ for responsibility; how responsibility links to blameworthiness; what follows from deciding that someone is blameworthy. These questions can be asked of actions relating to health and the diseases people may suffer as a consequence. A familiar debate surrounds the provision of liver transplants (a scarce commodity) to people who suffer liver failure as a result of excessive alcohol consumption. For instance, if they are responsible for suffering liver failure, that could mean they are less deserving of a transplant than someone who suffers liver failure unrelated to alcohol consumption.

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What’s Wrong With Simulation in Football?

Written by Doug McConnell

The 2018 edition of the football world cup has brought with it a renewed bout of hand wringing over ‘simulation’, e.g. players falling, diving, and tumbling under imaginary fouls, rolling around in mock pain, or clasping their faces pretending to have been hit. Stuart James writes in the Guardian that “play-acting has been commonplace at this World Cup. It’s become a cancer in the game, not just a stain on it, and Fifa needs to find a cure.” But what exactly is wrong with this behaviour? Why is the rise of this behaviour ‘a cancer in the game’? Continue reading

Addiction, Desire, and The Polluted Environment – Richard Holton’s 2nd Uehiro Lecture

By Jonathan Pugh

 

In the second of his three Uehiro lectures on the theme of ‘illness and the social self’, Richard Holton turned to the moral questions raised by addiction. In the first half of the lecture, he outlined an account of addictive behaviour according to which addictive substances disrupt the link between wanting and liking. In the second half of the lecture, he discusses the implications of this account for the moral significance of preferences, and for how we might structure environments to avoid triggering addictive desires.

 

You can find a recording of the lecture here

 

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Mind Control, Free Will, and Jessica Jones

By Hazem Zohny

In the first season of the Netflix show Jessica Jones, our traumatized, alcoholic protagonist is up against a particularly nasty villain: Kilgrave. He is a mind-controller and complete psychopath. A virus he emits compels people around him to do whatever he commands.

Early in the season, he makes a young woman, Hope, kill her parents in front of Jessica just to spite her. Jessica, who knows all too well what it’s liked to be “Kilgraved,” consoles Hope by repeatedly telling her, “It’s not your fault.”

And it surely isn’t her fault. Once Kilgrave commanded Hope to kill, she could in no way have done otherwise. More than that, she was not in any meaningful sense the source or author of her murderous act, which was completely incongruous with her past behaviours and with her love for her parents.

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Neuroblame?

Written by Stephen Rainey

Brain-machine interfaces (BMIs), or brain-computer interfaces (BCIs), are technologies controlled directly by the brain. They are increasingly well known in terms of therapeutic contexts. We have probably all seen the remarkable advances in prosthetic limbs that can be controlled directly by the brain. Brain-controlled legs, arms, and hands allow natural-like mobility to be restored where limbs had been lost. Neuroprosthetic devices connected directly to the brain allow communication to be restored in cases where linguistic ability is impaired or missing.

It is often said that such devices are controlled ‘by thoughts’. This isn’t strictly true, as it is the brain that the devices read, not the mind. In a sense, unnatural patterns of neural activity must be realised to trigger and control devices. Producing the patterns is a learned behaviour – the brain is put to use by the device owner in order to operate it. This distinction between thought-reading and brain-reading might have important consequences for some conceivable scenarios. To think these through, we’ll indulge in a little bit of ‘science fiction prototyping’.

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2017 Annual Uehiro Lectures in Practical Ethics: Audio Recordings Now Available

We were extremely honoured to welcome Professor Larry Temkin (Rutgers University) to Oxford to deliver the 2017 Annual Uehiro Lectures on 6, 8 and 10 November.  The engaging lectures were fully booked well in advance, and were each followed by a lively discussion.  Continue reading

Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Should we pay people to quit smoking or lose weight? Would paying them amount to coercion?  Is there a risk that if we start paying for healthy behaviour, its value will be corrupted? Is paying unhealthy people unfair to those who already lead healthy life styles? In this video interview (with Katrien Devolder),  Dr Rebecca Brown from the Oxford Uehiro Centre for Practical Ethics responds to these and other concerns and defends the use of financial incentives as a tool for health promotion.

Flu Vaccination for Kids: a Moral Obligation?

Written by Ben Bambery and Julian Savulescu

Rosie Anderson, aged 8, died from influenza infection last Friday the 15th of September. Her tragic death followed the recent death of young father, Ben Ihlow, aged 30, who died suddenly on Father’s Day this year, also from influenza infection.

Contrary to public perception, “the flu” is a deadly disease. In Victoria this year, at least 97 people have lost their lives to influenza. The majority of these deaths are amongst the elderly, who are particularly vulnerable to severe disease, but as made painfully clear by Rosie and Ben’s deaths, the flu kills young people too. Continue reading

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