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Abolish Medical Ethics

Written by Charles Foster

In a recent blog post on this site Dom Wilkinson, writing about the case of Vincent Lambert, said this:

If, as is claimed by Vincent’s wife, Vincent would not have wished to remain alive, then the wishes of his parents, of other doctors or of the Pope, are irrelevant. My views or your views on the matter, likewise, are of no consequence. Only Vincent’s wishes matter. And so life support must stop.’

The post was (as everything Dom writes is), completely coherent and beautifully expressed. I say nothing here about my agreement or otherwise with his view – which is comfortably in accord with the zeitgeist, at least in the academy. My purpose is only to point out that if he is right, there is no conceivable justification for a department of medical ethics. Dom is arguing himself out of a job.Read More »Abolish Medical Ethics

Shamima Begum and the Public Good

Written by Steve Clarke,Wellcome Centre for Ethics and Humanities and Uehiro Centre for Practical Ethics, University of Oxford,

& School of Humanities and Social Sciences, Charles Sturt University

 

Shamima Begum, who left the UK in 2015 at age 15, to join the Islamic State, has been the subject of consistent media attention since she was discovered in the Al-Hawl refugee camp in Northern Syria, in February this year. Soon after being discovered in the refugee camp Begum was controversially stripped of her UK citizenship by Home Secretary Sajid Javid. Citizenship can be removed by the Home Secretary if doing so is deemed to be ‘conducive to the public good’. While it is illegal to render a person stateless, the Home Secretary is entitled to deprive UK citizens of their citizenship if they are also citizens of another country, or if they are eligible for citizenship in another country. Begum may be eligible for citizenship of Bangladesh, given that she has Bangladeshi ancestry, and there is a legal argument that she already is a citizen of Bangladesh.[1]

The Home Secretary’s decision has been much discussed in the media. Some commentators have argued that Begum’s interests should not be trumped by considerations of the public good. Others have questioned the legality of the decision. Still others have complained about the secretive nature of the decision-making process that led the Home Office to recommend to the Home Secretary that Begum be deprived of her citizenship. Here I will be concerned with a different issue. I will set aside considerations of Begum’s interests and I will set aside legal and procedural considerations. I will focus on the question of whether or not it is actually conducive to the public good in the UK to deprive Begum of her citizenship. Like most people, I do not have access to all of the information that the Home Secretary may have been apprised of, regarding Begum’s activities while she was living in the Islamic State, which would have informed his decision. So what I will have to say is necessarily speculative.

Read More »Shamima Begum and the Public Good

Arbitrariness as an Ethical Criticism

Written by Ben Davies

We recently saw a legal challenge to the current UK law that compels fertility clinics to destroy frozen eggs after a decade. According to campaigners, the ten-year limit may have had a rationale when it was instituted, but advances in freezing technology have rendered the limit “arbitrary”. Appeals to arbitrariness often form the basis of moral and political criticisms of policy. Still, we need to be careful in relying on appeals to arbitrariness; it is not clear that arbitrariness is always a moral ‘deal-breaker’.

On the face of it, it seems clear why arbitrary policies are ethically unacceptable. To be arbitrary is to lack basis in good reasons. An appeal against arbitrariness is an appeal to consistency, to the principle that like cases should be treated alike. Arbitrariness may therefore seem to cut against the very root of fairness.

Read More »Arbitrariness as an Ethical Criticism

Should Meat Be Excluded From the UK’s Value Added Tax?

The idea of using a meat tax to improve human health and protect the environment has been getting a fair amount of attention from prominent scientists in the media. Professor Mike Rayner was quoted last year as saying, “I would like to see a tax on red meat and meat products. We need incentives to cut down on meat and dairy consumption.” Marco Springmann told the Guardian, “Current levels of meat consumption are not healthy or sustainable. The costs associated with each of those impacts could approach the trillions in the future. Taxing meat could be a first and important step.” And Joseph Poore suggested that taxing meat will likely be necessary to avoid serious environmental problems.

Taxing food products to promote human health is controversial. It has been suggested that introducing taxes to limit particular food consumption behaviors is a troubling shift towards a “nanny state,” involves paternalistically imposing “alien values” on people, and interferes with the free market by picking and choosing winners and losers among different products. A decision to impose a dedicated tax specifically targeting meat would need to adequately address all of these concerns.Read More »Should Meat Be Excluded From the UK’s Value Added Tax?

The Re-Greening of Abraham

By Charles Foster

Some odd alliances are being forged in this strange new world,

I well remember, a few years ago, the open hostility shown by dreadlocked, shamanic, eco-warriors towards the Abrahamic monotheisms. They’d spit when they passed a church.

The rhetoric of their distaste was predictable. The very notion of a creed was anathema to a free spirit. ‘No one’s going to tell me what to think’, said one (we’ll call him Jack), the marks on his wrists still visible from where he’d been chained to a road-builder’s bulldozer. And the content of the creeds, and the promulgators-in-chief, didn’t help. ‘I’m certainly taking no lessons’, Jack went on, ‘from some patriarchal sky-god represented by a paedophilic priest.’

But it’s changed. Jack still heaves bricks through bank windows (he says), and still copulates inside stone circles, but now he’s mightily impressed with Jesus, has a Greek Orthodox icon of the resurrection next to his bong, and pictures of Richard Dawkins and Sam Harris on his dartboard. He’s not alone. He’s part of a widespread movement that is reclaiming and recruiting the intrinsic radicalism of Judaism, Christianity, and Islam in the fight against Neo-Liberalism and the destruction of the planet.Read More »The Re-Greening of Abraham

Entitlement

Written by Stephen Rainey

It is often claimed, especially in heated Twitter debates, that one or other participant is entitled to their opinion. Sometimes, if someone encounters a challenge to their picture of the world, they will retort that they are entitled to their opinion. Or, maybe in an attempt to avoid confrontation, disagreement is sometimes brushed over by stating that whatever else may be going on, everyone is entitled to their opinion. This use of the phrase is highlighted in a recent piece in The Conversation. There, Patrick Stokes writes,

The problem with “I’m entitled to my opinion” is that, all too often, it’s used to shelter beliefs that should have been abandoned. It becomes shorthand for “I can say or think whatever I like” – and by extension, continuing to argue is somehow disrespectful.

I think this is right, and a problem well identified. Nevertheless, it’s not like no one, ever, is entitled to an opinion. So when are you, am I, are we, entitled to our opinion? What does it take to be entitled to an opinion?

Read More »Entitlement

Listen Carefully

Written by Stephen Rainey, and Jason Walsh

Rhetoric about free speech as under attack is an enduring point of discussion across the media. It appears on the political agenda, in various degrees of concreteness and abstraction. By some definitions, free speech amounts to an unrestrained liberty to say whatever one pleases. On others, it’s carefully framed to exclude types of speech centrally intended to cause harm.

At the same time, more than ever the physical environment is a focus of both public and political attention. Following the BBC’s ‘Blue Planet Two’ documentary series, for instance, a huge impetus gathered around the risk of micro-plastics to our water supply, and, indeed, how plastics in general damage the environment. As with many such issues people have been happy to act. Following, belatedly, Ireland’s example, plastic bag use has plummeted in the UK, helped along by the introduction of a tax.

There are always those few who just don’t care but, when it comes to our shared natural spaces, we’re generally pretty good at reacting. Be it taxing plastic bags, switching to paper straws, or supporting pedestrianisation of polluted areas, there is the chance for open conversations about the spaces we must share. Environmental awareness and anti-pollution attitudes are as close to shared politics as we might get, at least in terms of what’s at stake. Can the same be said for the informational environment that we share?Read More »Listen Carefully

The Dangers Of Deferring To Doctors

By Charles Foster

(Image: tctmd.com)

There is a dizzying circularity in much medical law. Judges make legal decisions based on the judgments of rightly directed clinicians, and rightly directed clinicians make their judgments based on what they think the judges expect of them. This is intellectually unfortunate. It can also be dangerous.

There are two causes: Judges’ reluctance to interfere with the decisions of clinicians, and doctors’ fear of falling foul of the law.

In some ways judicial deference to the judgment of professionals in a discipline very different from their own is appropriate. Judges cannot be doctors. The deference is best illustrated by the famous and ubiquitous Bolam test, which is the touchstone for liability in professional negligence cases.1 A doctor will not be negligent if their action or inaction would be endorsed by a responsible body of professional opinion in the relevant specialty.

In the realm of civil litigation for alleged negligence this deference is justified. The problem arises when the deference is exported to legal arenas where it should have no place. The classic example relates to determinations of the ‘best interests’ of incapacitous patients. Something done in relation to an incapacitous patient will only be lawful if it is in that patient’s best interests.Read More »The Dangers Of Deferring To Doctors

What’s Wrong With Simulation in Football?

Written by Doug McConnell

The 2018 edition of the football world cup has brought with it a renewed bout of hand wringing over ‘simulation’, e.g. players falling, diving, and tumbling under imaginary fouls, rolling around in mock pain, or clasping their faces pretending to have been hit. Stuart James writes in the Guardian that “play-acting has been commonplace at this World Cup. It’s become a cancer in the game, not just a stain on it, and Fifa needs to find a cure.” But what exactly is wrong with this behaviour? Why is the rise of this behaviour ‘a cancer in the game’?Read More »What’s Wrong With Simulation in Football?

The Psychology of Uncertainty, Vaccinations, and Protecting the Most Vulnerable: Was Rawls Right After All?

written by Andreas Kappes (@AnKappes), Anne-Marie Nußberger (@amnussberger ), Molly Crockett (@mollycrockett ) & Julian Savulescu  (@juliansavulescu)

Measles is making a comeback in Britain and Europe with numbers rising to record levels this year. Last year in Europe, measles killed 35 people, including young children . The re-emergence of measles can be traced to falling rates of vaccination and might make you want to re-think your summer plans. Crowded environments with low levels of hygiene, also known as summer festivals, are something to avoid if unsure about whether you have been properly vaccinated. And maybe re-think going for holidays to Romania, Italy and Greece, the countries with the highest rates of measles outbreaks this year.

But of course, even if you are not vaccinated, your chances of getting measles are low. And if you are infected, dying from measles is rare. The people that die during measles outbreaks are vulnerable babies that are too young to be vaccinated and unvaccinated people with compromised immune systems. And what are the chances that you infect one of these vulnerable people? Extremely low. Your intuition then might be that even if you are unsure about your vaccination status, the low odds don’t seem to justify the effort to engage with the NHS or any other health care provider. Maximize your benefits, and others will surely be fine. Individually, this feels right, but for the communities and countries we live in, this is disastrous, slowly eroding herd immunity that protects the most vulnerable.

Read More »The Psychology of Uncertainty, Vaccinations, and Protecting the Most Vulnerable: Was Rawls Right After All?