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2012

Dangerous Doctors and Immoral Doctors

In general, if you know someone to be a danger to others you have a duty to do something about it. Exactly what you are obliged to do depends on the person, the situation and you. At the very least you ought to warn others.

In general, and apart from such basic duties as not to interfere with others (more pompously, to respect their autonomy), to keep your promises to them, not to harm them and not to burden them, your strongest duties are those you take on voluntarily, such as those you acquire by taking up a profession.

The professions hold themselves out to us as entitled to special privileges because of their special knowledge. We trust them, we rely on them, we place ourselves in their hands for specific purposes, because when paid for their work they promise to look after our interest before their own. Part of that promise is a special duty to hold members of the profession accountable to professional standards and to exclude persons who fail those standards.

So members of the medical profession have both a very strong duty and a special duty to protect us from dangerous doctors. A book has come out showing that doctors are grossly— indeed, grotesquely —derelict in this duty.Read More »Dangerous Doctors and Immoral Doctors

Don’t Give Money to Beggars

I have sometimes given money to beggars. On cold autumn days, when a homeless man has seemed to be in need of some money to buy food or a cup of coffee, I have occasionally dropped him a few coins. Those coins, I have thought, mean much more to him than they do to me, and giving is a nice thing to do. Upon reflection, however, I have come to change my mind, and now I don’t give money to beggars. Let me explain why.

On the one hand, there are the traditional, somewhat cynical, arguments that—in spite of their cynicism—carry some weight.

First, for every dollar that we give to a beggar, the more lucrative we make begging and, comparatively, the less lucrative we make working. This is bad, for we want people to work, not beg. Working is productive; begging is at best neutral and often a burden and a nuisance. Second, there is no guarantee that the beggar who receives the money will spend it in ways that increase the quality of his life. He might well spend the money on alcohol or drugs, and end up financing organized crime.

These objections carry some weight, but they are not decisive. What is decisive is the fact that if you give money to beggars, you almost certainly spend your welfare budget helping the wrong people.Read More »Don’t Give Money to Beggars

Hillsborough, Heysel and the Availability Bias

One of my clearest childhood memories is of seeing images  of the 1989 Hillsborough Disaster on the television news. Ninety-six Liverpool fans died in the crush, with an estimated 766 injured. I lived on the other side of the world, had never been to see a football game, and presumably had little comprehension of what the victims had gone through, yet the images of the crush, and of a few people being hauled to safety from it, made a strong and disturbing impression.Read More »Hillsborough, Heysel and the Availability Bias

Applied Ethics Plus

Reflect for a moment on the place you call home. Perhaps this is the place where you grew up, and where you return to from time to time to see family and old friends. Or maybe it’s somewhere you’ve subsequently settled and built your life. Somewhere, at least, that you have a fondness for, though strangers might not see it in the rosy same light. Now imagine that the policies of those in charge are steadily ruining your home. Left unchecked, the place will eventually be left uninhabitable. Presumably this would alarm you, and that alarm would be reflected in your motivation to do something about it.

Read More »Applied Ethics Plus

Spin city: why improving collective epistemology matters

The gene for internet addiction has been found! Well, actually it turns out that 27% of internet addicts have the genetic variant, compared to 17% of non-addicts. The Encode project has overturned the theory of ‘junk DNA‘! Well, actually we already knew that that DNA was doing things long before, and the definition of ‘function’ used is iffy. Alzheimer’s disease is a new ‘type 3 diabetes‘! Except that no diabetes researchers believe it. Sensationalist reporting of science is everywhere, distorting public understanding of what science has discovered and its relative importance. If media ought to try to give a full picture of the situation, they seem to be failing.

But before we start blaming science journalists, maybe we should look sharply at the scientists. A new study shows that 47% of press releases about controlled trials contained spin, emphasizing the beneficial effect of the experimental treatment. This carried over to subsequent news stories, often copying the original spin. Maybe we could try blaming university press officers, but the study found spin in 41% of the abstracts of the papers too, typically overestimating the benefit of the intervention or downplaying risks. The only way of actually finding out the real story is to read the content of the paper, something requiring a bit of skill – and quite often paying for access.

Who to blame, and what to do about it?

Read More »Spin city: why improving collective epistemology matters

Refusing Treatment to the Overweight: A Case Analysis

It was recently reported that a doctor in Shrewsbury Massachusetts refused to treat a patient named Ida Davidson because she was overweight. Dr. Helen Carter recently decided to stop admitting patients who weighed over 200 pounds to her practice, justifying her decision by citing three incidents in which her co-workers were injured in the course of caring for obese patients. These incidents led Carter to claim that the office in which she carries out her consultations is “unable to accommodate a certain weight”. She also pointed out that the nearby University of Massachusetts has a dedicated obesity centre which is far better equipped and better staffed to deal with obese patents.Read More »Refusing Treatment to the Overweight: A Case Analysis

Chemical castration and homosexuality

Last week the Sydney Herald published details about an Australian Doctor who has been struck off as a GP (although not as a Radiologist) after prescribing Cyprostat to an 18 year man in order to treat his homosexuality.1 Both men were members of the Exclusive Brethren Church and the patient was taken to see Dr Craddock by a member of the church after being advised that there are treatments for homosexuality.

The Medical Council of New South Wales criticized him for not taking an appropriate medical history, not doing a physical examination, not referring his patient for counselling and not ordering medical tests to detect adverse reactions to the drug. Dr Craddock admitted that he did not do these things and, given that his departure from sound clinical skills occurred when using a powerful medical for such a radical purpose, it is not surprising that the court reached a finding of unsatisfactory, professional conduct.Read More »Chemical castration and homosexuality

The deadly dangers of peer review

By Charles Foster

I’m just reading Michael Rosen’s (very good) book, ‘Dignity: Its history and meaning’ (Harvard University Press, 2012). He robustly questions the use of peer review in philosophy. Of course it is an essential part of science, but philosophy is rather different. He writes: ‘If [as he argues] the idea of completeness in philosophical arguments is unattainable, the attempt to be ‘rigorous’ can lead to a defensive tendency to reduce ambitions and to protect some tiny piece of ground against the possible objections of those closest to oneself in background and outlook (one’s natural peer reviewers). What is lost is not just accessibility but also the willingness to call into questions basic assumptions (one’s own and others’), which is precisely what, for many of, the point of doing philosophy was in the first place. Much contemporary philosophy takes place in an atmosphere of what can only be called (however historically unfair that label may be) scholasticism.’  (p. xiv)

Hear, hear. There’s a philosophical culture of scared, paralysed conservatism. (Of course not in Oxford). Much philosophical writing is simple reiteration of old ideas with, at best, some tentative suggestions as to how a footnote to an old paper might be slightly redrafted. Philosophical progress is regarded as necessarily incremental rather than revolutionary. There’s far too much reverence. Nothing should be unthinkable, but almost everything is. All the philosophical emperors are devoutly assumed to be fully and gorgeously clothed. They’re not.  Being creative is assumed to be incompatible with rigour. It’s not.Read More »The deadly dangers of peer review