A recent poll says that nearly all General Practitioners in the UK have given placebos to at least one of their patients. The story can be seen here: http://www.bbc.co.uk/news/health-21834440 Everyone loves placebos. If you are a scientist, placebo shows an incredible feat of the human body, and interesting interactions between our psychology and the biology… Read More »The Cultural Cost of Placebo
It is now quite common to draw distinctions between three types of philosophical ethics. Practical ethics is meant to concern substantive moral issues facing many of us each day, such as abortion or climate change. Read More »Practical Ethics and Philosophy
Whatever your view of abortion, there are too many abortions, and too many of them are too late. Even abortion’s fiercest advocates don’t pretend that it’s a Good Thing – just the lesser of two evils.
In 2010 there were 189,574 abortions in England and Wales – an 8% increase in a decade. The tightly policed regime envisaged in 1967, when the Act became law, hasn’t existed for ages, if indeed it ever did. There is abortion on demand, whatever the statute book says.
1967 was a long time ago. There have been many medical advances and societal changes since then. It’s time to take stock of the Act.
That’s what a recently announced cross-party commission, to be chaired by Fiona Bruce MP, will do.
It will focus, rightly, on two issues: medical advances and attitudes to discrimination.Read More »Too long in gestating: an overdue inquiry into the Abortion Act
By Lachlan de Crespigny and Julian Savulescu
An emergency centre doctor working in Germany has claimed 2 nearby catholic hospitals refused to accept a rape victim who needed treatment, in case she was pregnant . This was allegedly in line with their ethics committee’s policy to refuse to examine sexual assault victims in an effort to avoid future treatments such as the morning after pill coming into conflict with the hospital’s catholic ethos. The hospitals claim this was a misunderstanding and await an internal inquiry.
The Catholic Church does not support abortion and includes the morning after pill as an abortifacient. It is in violation of Catholic (ethical) standards. The doctor making the claims says that Cologne’s Cardinal Meisner had been consulted.
The Catholic Church insists life must be protected with the utmost care from the moment of conception. From the first moment of his or her existence, a human being must be recognized as having the rights of a person. But in this case, they did not only deny the rape victim access to legal contraceptives, they refused to treat or examine her in any way for any of the resulting injuries of the rape. They did not treat her in her hour of need as a person who deserved the utmost care.
Read More »Whom Should We Refuse to Treat? Pregnant Rape Victims? Surrogates?
Reproductive technologies such as in-vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD) mean it is currently possible for parents to create a range of embryos and make decisions about which to implant on the basis of their genetic makeup. One interesting possibility is that we will soon be able to use such technologies to influence the intelligence of our future children. It is known that intelligence has at least a moderately important genetic component. Identical twins are significantly more similar in intelligence than dizygotic twins, who are in turn significantly more similar than adopted siblings raised together. In fact, a range of studies indicate that the heritability of intelligence is approximately 0.7, which is only slightly lower than the heritability of height. This means that 70% of the variation we observe in intelligence is due to genetic factors. Once we can identify the genes which explain this variation it will be relatively simple to test embryos for them, meaning it will be technically possible for parents to select embryos on the basis of their likely intelligence.
However scientists are finding it surprisingly difficult to locate the specific genes which affect intelligence. Read More »Where are my smart genes? Searching for intelligence in our DNA
It will be interesting to watch the reception of a recent Court of Protection case, as yet unreported, in which a woman with profound learning difficulties was found to have capacity to decide not to terminate her pregnancy.
As so often, the case decided nothing new. But it is a timely reminder of the trite but often overlooked principle that capacity is not an all or nothing thing. The question: ‘Does she have capacity?’ is always dangerously incomplete. The correct question is always ‘Does she have capacity to decide X?’
There was no doubt that she did not have capacity to manage many aspects of her affairs. She was in the bottom 1% of the population so far as intellectual function was concerned. Deputies were appropriately appointed. But, so far as the continuation of her pregnancy was concerned, so what?
It was decided as a matter of fact that she had capacity to decide whether or not to continue with, or to terminate, the pregnancy. And that meant that the Court of Protection had no jurisdiction to decide the matter. No best interests determination could lawfully be made.Read More »Abortion and the cognitively impaired mother
By the editors of the Practical Ethics blog. What is the best practical ethics book you read this year, and what is so good about it (in 1-3 sentences)? We asked this question to our colleagues at the Oxford Uehiro Centre for Practical Ethics. To our surprise, not a single title received multiple votes. This… Read More »The Best Practical Ethics Books of the Year…
In light of the fact that many readers will have an assortment of Christmas treats tempting them, I thought a post on impulse control would be timely.
In the now paradigmatic Stanford marshmallow experiment, children were given an option – one marshmallow which they could have immediately, or two marshmallows, provided they could wait 15 minutes. This option presents a problem of sorts. Is it better to have a small reward immediately, or a larger one after some delay? Common sense says that waiting is the better option. Doubling your reward whilst only paying a marginal cost of your time seems like the rational thing to do. Children who fail to wait are, therefore, seen as succumbing to temptation. A deficiency in self control leads them to make a poor decision.Read More »When to eat the marshmallow: new perspectives on impulse control
This week there were reports of the amazing advances being made in brain-computer interface (BCI) technology. Following just weeks of training, a 52-year old woman, paralysed from the neck down, was able to use her mind to control a robotic hand to pick up objects on a table, including cones, blocks and small balls, and put them down at another location. She was even able to use the hand to feed herself chocolate.
Having had two arrays of microelectrodes surgically implanted into her left motor cortex, Jan is wired up to a computer that has been programmed to interpret the signals her neurons emit. This computer then passes on the interpreted signals to the robotic arm, which moves in accordance with the signals in real time.
Aside from the awesomeness of the technology, the use of neuroprostheses such as this raises a whole host of interesting philosophical and ethical questions. Particularly as the technology gets more sophisticated and more integrated, the distinction between the machinery being used and the person using it will become increasingly blurred. In the video, Jan already describes how she went from having to ‘think’ the commands (‘clockwise, up, down, forward, back…’) to merely having to ‘look at the target’ to effect accurate movement of the arm. This phenomenon is sometimes labeled ‘transparency of use’, where a tool serves a person’s goals without itself being an object of effortful control.Read More »Mind-controlled limbs and redefining the self
The conclusions of a ‘citizens’ jury’, reported recently in the British Medical Journal [1] shed light on some important weaknesses in the doctrine of ‘informed consent’. The doctrine is commonly thought of as canonical. Be careful about questioning its exalted status: you’ll be branded paternalistic at best, and the indictment may well involve unflattering comparisons with Dr. Mengele.
The ‘jury’, composed of 25 women, commented on how a leaflet on breast cancer screening should be re-drafted. The jury preferred:
– the term ‘overtreatment’ to ‘over-diagnosis’
-to express benefits in the language of lives saved rather than deaths avoided
– to talk about ‘benefits’ and ‘risks’ rather than ‘pros’ and ‘cons’
– to begin the leaflet by an up-beat reference to the numbers of lives saved by screening, followed by the caveat that a small number of women would be over-treated.
What was the priority: reassurance or accuracy? The majority (15), wanted both; 3 thought that reassurance was most important; 7 thought that accuracy was the priority.
How should one list the benefits and harms? Four thought they should be listed together in the same sentence, 8 that they should be listed separately, and 12 for mentioning them first separately and then together.
The point of all this is that there are innumerable different ways, all of which would be smiled on by Bolam [2], in which entirely accurate information can be conveyed. And yet tiny nuances are seen by the receivers of the information as significant.Read More »Informed consent deserves a little less respect
