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Bioethics

Is smoking morally wrong?

This week, I’ve been thinking about smoking. Full disclosure: My name is Jim and I am a smoker. I have smoked for nearly a decade now – since around 2005 – and I only smoke menthol cigarettes. I am addicted to the sweet menthol smoke, where that touch of red fire at the end of a white stick seems so perfectly suited to almost any occasion from celebration to commiseration. I give up on average for a month or two a year, every year. I always come back, though. The reason I say this is to highlight that I am by no means one of these dour-faced moralizers, condemning smokers for their ‘filthy habit’. Like a snot-nosed child, it may be filthy, but it’s my filthy habit. Most efforts to encourage people against smoking focus on the idea that smoking is personally damaging: it causes illness and death, it costs a lot of money, it harms others, it litters the environment, and so on. This week, however, I’ve been thinking about whether the real concern is that smoking might be morally wrong. (NB: I’m discussing where whether it is morally wrong, not whether it should be legally banned or whether people should have the ‘right’ to smoke – these are distinct questions).Read More »Is smoking morally wrong?

How the Danziger Story Advances the Abortion Debate in America: Actual Futures, Moral Status, and Common Ground

It has become commonplace in recent years to note that the ‘abortion debate’ in America has become entrenched. Indeed, there seem to be few issues in contemporary politics that elicit less common ground than the abortion debate finds in its stalwartly pro-choice and pro-life opponents. It is just as common, if not more so, these days to speak of the ‘attack on Roe v. Wade’ or ‘the attack on women’s rights,’ particularly in light of recent findings that more abortion restrictions were enacted between 2011 and 2013 in the U.S. than in the entire previous decade. Now more than ever, especially for the pro-choice movement, it is necessary to conceptualize novel approaches to the questions of the beginning, end, and quality of life that sit at the heart of the abortion debate. Here I examine a recent case and how it has the potential to advance this debate.Read More »How the Danziger Story Advances the Abortion Debate in America: Actual Futures, Moral Status, and Common Ground

The death of celebrities due to addiction: on helpful and unhelpful distinctions in destigmatising addiction

Philip Seymour Hoffman is dead. Probably due to an overdose of heroin. Hoffman didn’t have to die if he wasn’t so ashamed of his substance use that he did it in secrecy. Because he overdosed alone, no one could call an ambulance on him that would have probably saved his life. http://truth-out.org/news/item/21645-philip-seymour-hoffman-didnt-have-to-die#.UvAI48u3dcc.facebook Some are using the media attention surrounding his death to push for better drug laws. Some want to treat heroin addicts with heroin while some simply want to draw attention to a secret demographic: high educated, rich, white, middle age heroin users. Both attempts try to destigmatise heroin use. Read More »The death of celebrities due to addiction: on helpful and unhelpful distinctions in destigmatising addiction

Female genital mutilation (FGM) and male circumcision: should there be a separate ethical discourse?

Female genital mutilation (FGM) and male circumcision: should there be a separate ethical discourse? This month, the Guardian launched a campaign in conjunction with Change.org (the petition is here) to end “female genital mutilation” (FGM) in the UK—see Dominic Wilkinson’s recent analysis on this blog. I support this campaign and I believe that FGM is impermissible. Indeed, I think that all children, whether… Read More »Female genital mutilation (FGM) and male circumcision: should there be a separate ethical discourse?

Medical ethics are ridiculous

In a blistering letter in the current issue of the British Medical Journal, Miran Epstein identifies some of the factors we should consider in assessing the claims of so-called ‘evidence-based medicine’.[1] Nobody rationally disagrees with the suggestion that medicine should have an evidence base, and everybody should agree that in order for medicine to be based on reliable evidence, it should be free of the following ‘polluters’:

  •  financial conflicts of interest
  •  inadequately rigorous selection criteria, outcome measures and criteria of statistical significance
  • the practice of testing products against placebo or no treatment (rather than current treatment), and then shouting ‘Eureka!’
  • recruiting subjects using financial incentives that introduce outcome bias
  • marketing campaigns masquerading as research

Do we have a right to drink? On Australian thugs and French hedonists

It has been an interesting week awaiting the announced reforms on the alcohol laws in New South Wales, Australia. After another incident with alcohol fuelled violence where a young boy died due to an unprovoked single punch, the family of this young man, Thomas Kelly, submitted a petition asking for intoxication to be taken into account in sentencing as a mandatory aggravating factor, rather than a mitigating factor, which is now sometimes the case. While the government reflected on what to do about alcohol induced violence, the discussion in the media sparked up high.

1. Should intoxication be an aggravating or mitigating factor?

Read More »Do we have a right to drink? On Australian thugs and French hedonists

Marathon mice, enhancement and the will to work out

In his article in the Pacific Standard last week, author Bruce Grierson discusses the emerging scientific evidence that the ‘will to work out’ might be genetically determined. Grierson describes a ‘marathon mouse’, the descendant of a long line of mice bred for their love of exercise, and a 94-year-old woman called Olga, who is an athletic anomaly. Both the mouse and Olga love to work out. The mouse goes straight to his wheel when he wakes up, running kilometers at a time and Olga – a track and field amateur – still competes in 11 different events. Grierson suggests that cracking the code for intrinsic motivation to exercise would lead to the possibility of synthesizing its biochemical signature: ‘Why not a pill that would make us want to work out?’, he asks. Such a possibility adds an interesting dimension to the debate about enhancement in sport, and to enhancement debates more generally.Read More »Marathon mice, enhancement and the will to work out

Doctors: turn off your computer and listen to your gut

‘Between the NHS and social care, there must be total commitment to ensuring that interaction is paperless, and that, with a patient’s consent, their full medical history can follow them around the system seamlessly.‘ So said Jeremy Hunt,the Health Secretary, on 16 January 2013. And NHS England say that: ‘Our vision is for a fully integrated digital patient record across all care settings by 2018’.

It sounds like a good idea. It’s not. Or not in its present form. Many of the concerns that have been expressed relate to privacy/confidentiality. Those concerns are real. But even if they can be satisfactorily addressed, electronic health records have the potential to do great harm. They divert attention from the patient to the screen, and they cause clinical skills to atrophy.

David Loxterkamp recently observed that the computer in the consulting room is a Frankenstein-like creature: ‘….we have created a place in our exam rooms for a computer that needs our care and feeding. It now directs the flow and purpose of an encounter that once unfolded organically according to the particular needs of the patient.’ The electronic servant becomes the master. Read More »Doctors: turn off your computer and listen to your gut