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Dominic Wilkinson

Pregnancy discrimination: Indirect discrimination against women? (JPE 2(2))

Guest Post by Kasper Lippert-Rasmussen

Professor Lippert-Rasmussen’s paper on indirect discrimination is part of the latest issue of the JPE

December 3, 2014, the US Supreme Court held its first hearing on the case of a former UPS driver, Peggy Young (Young v UPS, 12-1226): “In 2006, UPS forced Young to take an unpaid leave after refusing to accommodate her doctor’s order that she not lift heavy packages during her pregnancy… Young lost not just her income, but her health insurance as well” (http://www.latimes.com/local/abcarian/la-me-ra-supreme-court-pregnancy-discrimination-20141203-column.html#page=1). While UPS requires delivery drivers “to be able to lift packages as heavy as 70 pounds. Young said she rarely handled anything over 20 pounds and dealt almost exclusively with letters that sat on the passenger seat of her van”. Interestingly, however, at the time UPS also had a policy of providing temporary light-duty work to, but also only to, ”employees who had on-the-job injuries, were disabled under federal law or lost their federal driver certification” (http://www.theguardian.com/us-news/2014/dec/01/ups-employee-pregnancy-discrimination-supreme-court). Before taking her case to the Supreme Court, lower courts had dismissed Young’s lawsuit twice.Read More »Pregnancy discrimination: Indirect discrimination against women? (JPE 2(2))

Discriminating happiness. Journal of Practical Ethics 2(2) is out!

by Dominic Wilkinson, Managing editor JPE, @Neonatalethics The latest issue of the journal is out this week: Valerie Tiberius examines the relevance of different theories of wellbeing for the important practical task of providing life-advice to friends. She has posted a short blog on the topic. You can also listen to a great podcast interview… Read More »Discriminating happiness. Journal of Practical Ethics 2(2) is out!

Christine Korsgaard on our Moral Obligations to Animals [Uehiro Lecture 2]

by Karamvir Chadha @karamvirchadha

 What are our moral obligations to animals? This was the subject of Christine Korsgaard’s Uehiro lecture on 2 December 2014, the second of a three-lecture series on the moral and legal standing of animals. (To listen to the lecture follow this link)

Korsgaard argued for the conclusion that animals have moral standing. Her argument for this conclusion was characteristically Korsgaardian: it was both extremely ambitious and grounded in a distinctive interpretation of Kant.Read More »Christine Korsgaard on our Moral Obligations to Animals [Uehiro Lecture 2]

The ethics of DocAdvisor: Is accountability always a good thing?

Dominic Wilkinson @NeonatalEthics

 

In the news this morning, the NHS has released data on individual surgeons’ performance, so called “surgeon report cards”. This represents the latest move towards increased transparency and accountability in the National Health Service. Elsewhere in the media today, there are numerous reports of the UK couple who were apparently charged £100 after posting a negative hotel review on an online website.

These parallel stories highlight one concern about certain types of health accountability: sensitivity to the negative impact of reviews (or poor performance figures) could lead to harmful changes in behaviour. For surgeon report cards, one frequently cited concern is that publishing report cards could lead surgeons to avoid high-risk cases. If surgeons choose patients with lower risk of dying, they will potentially end up with a better report card. However, then the results would be misleading (it would be the equivalent of someone getting a higher mark by choosing to sit an easier test). More worrying, it may mean that some high-risk patients are unable to access surgery.

Should we be worried about the negative effect of report cards on surgeons behaviour?Read More »The ethics of DocAdvisor: Is accountability always a good thing?

Relaxed about dying?

“Now we must wait, wait. These hours…. The gurgling starts again — but how slowly a man dies! …By noon I am groping on the outer limits of reason. …every gasp lays my heart bare.” Erich Maria Remarque, All Quiet on the Western Front

In Remarque’s novel, the agony of the German soldier, witnessing the slow death of an enemy combatant, is heightened by his own guilt (the narrator had stabbed another soldier in self defense). However, his powerful evocation of distress (and guilt) at witnessing a slow dying is very close to the expressed concerns of parents and clinicians who are watching the death of a child.

Read More »Relaxed about dying?

Not-so-lethal – the ethics and costs of extraordinary fetal intervention

By Dominic Wilkinson (@Neonatal Ethics)

Late last month, a paper in the US journal Obstetrics and Gynecology reported the extraordinary case of Abigail Beutler. Abigail is now 14 months old. She was born without kidneys, a condition sometimes called ‘Potter’s syndrome’. Potter’s syndrome is normally universally fatal in the newborn period, because without kidneys the fetus does not produce urine and has little or no fluid around them. Without any fluid around the fetus, their lungs do not develop.

Abigail is the first baby to ever survive with this condition. Doctors infused artificial fluid into the uterus around her (amnioinfusion) on five occasions during the pregnancy. This seemed to allow her lungs to grow. Although she was born 3 months prematurely, she had only minor breathing problems at birth. She has received kidney dialysis since soon after birth, was discharged home after 19 weeks and is now reportedly being considered for a kidney transplant.Read More »Not-so-lethal – the ethics and costs of extraordinary fetal intervention

Practical Ethics Bites

This week at the centre we are excited to be launching a new series of podcasts “Practical Ethics Bites“ These podcasts have been recorded to support secondary school students (particularly A-level students) who are studying philosophy or religious studies and their teachers. They are available to download (free) from the podcast webpage, and you can… Read More »Practical Ethics Bites

“Please randomize me – but don’t tell my family that you did”

Last week various newspapers (see here and here) reported on a planned research study of adrenaline for patients suffering a cardiac arrest outside hospital. The PARAMEDIC 2 trial (full protocol here) involves ambulance officers randomly giving patients either the traditional resuscitation drug adrenaline, or a salt-water solution (placebo). The trial has been strongly criticized by Ruth and Lindsay Stirton, writing in the Journal of Medical Ethics.

There are two main controversial elements to the trial design. The first involves the lack of consent for involvement in the trial, the second involves the researchers’ plan not to inform families of patients who died that their loved one had been in a research trial.

Read More »“Please randomize me – but don’t tell my family that you did”

Carbon caps and IVF

by Dominic Wilkinson @NeonatalEthics Over on the Journal of Medical Ethics blog are a couple of posts that might be of interest to Practical Ethics readers. Last week, the journal published online an article by Cristina Richie on carbon caps and IVF. She argues that the environmental costs of reproduction should lead to carbon caps… Read More »Carbon caps and IVF

Economic arguments and assisted dying.

by Dominic Wilkinson (@NeonatalEthics)

Lord Falconer’s assisted dying bill is being debated today in the House of Lords. In the past week or two there has discussion in the media of many of the familiar arguments for and against such a proposal. As Roger Crisp noted in yesterday’s post, there have been relatively few new arguments. Supporters of the bill refer to compassion for the terminally ill, the difficulty of adequately relieving suffering, and patients’ right to make fundamental choices about the last stage of their lives. Opponents of the bill express their compassion for the terminally ill and those with disabilities, fear about coercion, and the omnipresent slippery slope.

One concern that has been raised about the assisted dying bill is the fear of abuse in the setting of an overstretched public health system. For example, Penny Pepper, writing in the Guardian notes that “Cuts to social care are monstrous…How would the enactment of the Falconer bill work if brought to our harassed NHS?”

Read More »Economic arguments and assisted dying.