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‘Waiver or Understanding? A Dilemma for Autonomists about Informed Consent’

by Roger Crisp

At a recent New St Cross Ethics seminar, Gopal Sreenivasan, Crown University Distinguished Professor in Ethics at Duke University and currently visitor at Corpus Christi College and the Oxford Uehiro Centre, gave a fascinating lecture on whether valid informed consent requires that the consenter have understood the relevant information about what they are being asked to consent to. Gopal argued that it doesn’t. Continue reading

Guest Post: Frances Kamm- Harms, Wrongs, and Meaning in a Pandemic

Written by F M Kamm
This post originally appeared in The Philosophers’ Magazine

When the number of people who have died of COVID-19 in the U.S. reached 500,000 special notice was taken of this great tragedy. As a way of helping people appreciate how enormous an event this was, some commentators thought it would help to compare it to other events that involved a comparable number of people losing their lives. For example, it was compared to all the U.S lives lost on the battlefield in World Wars 1 and II and the Vietnam War (or World War II, the Korean War, and Vietnam). Such comparisons raise questions, concerning dimensions of comparison, some of which are about degrees of harm, wrong, and meaningfulness which are considered in this essay. (Since the focus in the comparison was on the number of soldiers who died rather the number of other people affected by their deaths, this discussion will also focus on the people who die in a pandemic rather than those affected by their deaths.)

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A Juror’s Guide to Going Rogue

Written by Doug McConnell

A jury recently acquitted several activists charged with causing £25,000 worth of damage to Shell’s HQ in London despite the defendants admitting that they caused the damage and the judge informing the jury that the defendants had no legal defence. In other words, if the law were applied correctly, the jury had no choice but to find them guilty. When juries deviate from the law and “go rogue” like this, it is known as “nullification”. But when, if ever, should juries behave in this way? Continue reading

Making Universities (Even) More Unfair

Written by Neil Levy

Unsurprisingly, I’m a big believer in universities and higher education. I think research, of all kinds, is important for a whole range of reasons and that being educated is very often conducive to a good life. But we shouldn’t pretend that universities are institutions wholeheartedly devoted to genuine education and to research. They’re also businesses, and their business motivations often play a more important role in their decisions than any academic considerations. Beyond that, they play a role in society that’s independent of their role as educators, and that role explains some of their grubbier behavior. Continue reading

Crosspost: Learning to live with COVID – the tough choices ahead

By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu

This work was supported by the UKRI/ AHRC funded UK Ethics Accelerator project, grant number AH/V013947/1. The UK Ethics Accelerator project can be found at https://ukpandemicethics.org/

 

As mass vaccination continues to be rolled out, the UK is beginning to see encouraging signs that the number of COVID deaths is reducing, and that the vaccines may be reducing the transmission of coronavirus.

While this is very welcome news, a mass vaccination programme is unlikely to be enough to eliminate the virus, so we need to turn our thoughts towards the ethics of the long-term management of COVID-19.

One strategy would be to aim for the elimination of the virus within the UK. New Zealand successfully implemented an elimination strategy earlier in the pandemic and is now in a post-elimination stage.

An elimination strategy in the UK would require combining the mass vaccination programme with severe restrictions on international travel to stop new cases and variants of the virus being imported. However, the government has been reluctant to endorse an elimination strategy, given the importance of international trade to the UK economy.

One of the main alternatives to the elimination strategy is to treat coronavirus as endemic to the UK and to aim for long-term suppression of the virus to acceptable levels. But adopting a suppression strategy for the long term will require us to make a societal decision about the harms we are and are not willing to accept.

 

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Oxford Uehiro Prize in Practical Ethics: Why, If At All, Is It Unethical For Universities To Prioritise Applicants Related To Their Alumni?

This essay was the runner up in the undergraduate category of the 7th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Tanae Rao

Introduction

Most notably in the United States, some prestigious universities[1] consider whether or not a student is closely related to one or more alumni when evaluating her application. In an increasingly competitive university admissions landscape, having legacy status increases an applicant’s probability of being admitted to such a great extent that over a third of Harvard’s undergraduate class of 2022 is composed of legacy students.[2] This has led the New York Times Editorial Board to describe the practice as “anti-meritocratic” and “an engine of inequity”.[3]

Considering the alma mater of a student’s relatives when evaluating their university application seems to be wrong, or unfair, in some way. But what is the central aspect of the legacy admissions policy justifying this reaction? I consider three possible answers to this question. Firstly, I reject the academic qualification view, whereby universities should only consider if applicants will be able to meet academic requirements when making admissions decisions. This view does not reflect the actual state of university admissions today, where the number of qualified applicants often far exceeds the number of available seats. I then reject the popular view whereby universities should minimise their consideration of factors outside of the applicant’s control. Though this criterion appears to meet many of our intuitions regarding university admissions, I argue that it is too restrictive, preventing reasonable factors from being considered by universities. Finally, I propose a consequentialist view, whereby admissions decisions should be based on their expected consequences to admitted students and society as a whole. This view—I contend—is a plausible explanation of why legacy admissions should be discontinued, contingent on some evaluative questions. Continue reading

Suspending The Astra-Zeneca Vaccine and The Ethics of Precaution

By Jonathan Pugh, Dominic Wilkinson, and Julian Savulescu

The authors are working on the UK Pandemic Ethics Accelerator project – @PandemicEthics_. This project was funded by the Arts and Humanities Research Council (AHRC) as part of UKRI’s Covid-19 funding.  All authors are affiliated to the University of Oxford.

 

Summary Points

  • Preliminary Reviews suggest that the number of thrombotic events in individuals who have received the Astra Zeneca vaccine is not greater than the number we would normally expect in this population.

 

  • It is crucial that we closely monitor these adverse events. The regulation of new medical interventions always requires us to manage uncertainty.

 

  • A precautionary approach to managing this uncertainty may be important for ensuring continued confidence in vaccination.

 

  • Regulators must weigh the potential risk suggested by these reports of adverse events following vaccination against the harm that suspension of the vaccine could have.
  • The harm of suspending the use of the Astra Zeneca vaccine depends on how many preventable deaths we can expect by suspending its use.

 

  • Amongst other things, this will depend on (i) how many people will be delayed in receiving a vaccine as a result (ii) the mortality risk of the people who would be prevented from receiving a vaccine, (iii) the prevalence of the virus at the time of the suspension, and (iv) the number of people who have received one dose of the Astra Zeneca vaccine, but not a second.

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Cross-Post: Self-experimentation with vaccines

By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu.

This is a crosspost from the Journal of Medical Ethics Blog.

This is an output of the UKRI Pandemic Ethics Accelerator project.

 

A group of citizen scientists has launched a non-profit, non-commercial organisation named ‘RaDVaC’, which aims to rapidly develop, produce, and self-administer an intranasally delivered COVID-19 vaccine. As an open source project, a white paper detailing RaDVaC’s vaccine rationale, design, materials, protocols, and testing is freely available online. This information can be used by others to manufacture and self-administer their own vaccines, using commercially available materials and equipment.

Self-experimentation in science is not new; indeed, the initial development of some vaccines depended on self-experimentation. Historically, self-experimentation has led to valuable discoveries. Barry Marshall famously shared the Nobel Prize in 2005 for his work on the role of the bacterium Helicobacter pylori, and its role in gastritis –this research involved a self-experiment in 1984 that involved Marshall drinking a prepared mixture containing the bacteria, causing him to develop acute gastritis. This research, which shocked his colleagues at the time, eventually led to a fundamental change in the understanding of gastric ulcers, and they are now routinely treated with antibiotics. Today, self-experimentation is having something of a renaissance in the so-called bio-hacking community. But is self-experimentation to develop and test vaccinations ethical in the present pandemic? In this post we outline two arguments that might be invoked to defend such self-experimentation, and suggest that they are each subject to significant limitations. Continue reading

An Ethical Review of Hotel Quarantine Policies For International Arrivals

Written by:

Jonathan Pugh

Dominic Wilkinson

Julian Savulescu

 

This is an output of the UKRI Pandemic Ethics Accelerator project – it develops an earlier assessment of the English hotel quarantine policy, published by The Conversation)

 

The UK has announced that from 15th Feb, British and Irish nationals and others with residency rights travelling to England from ‘red list’ countries will have to quarantine in a government-sanctioned hotel for 10 days, at a personal cost of £1,750. Accommodation must be booked in advance, and individuals will be required to undergo two tests over the course of the quarantine period.

Failure to comply will carry strict penalties. Failing to quarantine in a designated hotel carries a fine of up to £10,000, and those who lie about visiting a red list country are liable to a 10-year prison sentence.

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