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Decision Making

Shouldering the burden of risk

By Dominic Wilkinson @NeonatalEthics

 

The UK supreme court last week awarded a woman £5 million in compensation after her obstetrician failed to warn her of a risk that she would have difficulty delivering her baby. Over on the JME Blog Kirsty Keywood discusses some interesting and important legal elements of this judgment for the practice of informed consent and how this will be evaluated in negligence claims.

However, the case raises one important ethical issue. Several expert witnesses in the Montgomery case testified that informing women of even very low risks of complications of vaginal birth would likely lead to a significant increase in the number of women choosing elective caesarean section.

If that is true, would it be justified for doctors to deliberately not discuss such risks?Read More »Shouldering the burden of risk

How people are wrong about cognitive enhancement and how to fix it

During my master’s research on human enhancement I did a lot of talks about cognitive enhancement to the general public. Back then I compiled a list of recurring biases I noticed during the subsequent discussions, as well as some tentative techniques to solve them. The paper “Cognitive biases can affect moral intuitions about cognitive enhancement” already explores the possible effects of some of the biases on my list: status quo bias, loss aversion, risk aversion and omission bias; besides those four, the ones that I more often came across were:

Zero risk bias
This was by far the most glaringly recurring one. It might be a mixture of status quo bias and risk aversion, but I don’t know the name of any bias in the cognitive bias literature which specifically matches it. So this might be one likely to be overlooked.wrong and dangerous
People would compare cognitive enhancer’s risks with absence of risks. If it had a risk greater than zero, they would mentally classify it as risky. However, this overlooks two things. Firstly, not taking a cognitive enhancement also has several risks. Sandberg, A., & Savulescu, J. (2011) notice how many deaths, accidents, injuries and so on are caused by decisions of cognitive deprived individuals. Secondly, most people committing this bias were already on a cognitive enhancer, which was known to be pretty risky, namely, caffeine.Read More »How people are wrong about cognitive enhancement and how to fix it

‘He was looking at me funny’: The (limited) rationality of the hostile attribution bias

Last week, an article in the Pacific Standard discussed the evolutionary origins and present-day disutility of the Hostile Attribution Bias (HAB). The HAB is exhibited when an individual automatically attributes malicious intentions to another, often in cases where that person’s behavior is ambiguous.  For example, when someone uses the colloquial phrase ‘he was looking at me funny’ as a justification for their own hostility, this is meant to imply that the utterer interpreted another person’s gaze as judgmental or even threatening; in fact, though, it may have been neither. Given that those with a propensity towards exhibiting this bias are also more likely to engage in aggressive behavior on its basis, the bias is widely seen not only to be irrational, but also detrimental. Indeed, the author of the aforementioned article says: ‘The trouble is, the more we sense hostility in others, the more aggressive we tend to be in return. And in many social contexts, hostile attribution bias is, as psychologists put it, highly “maladaptive.”’

In what way is the bias ‘highly maladaptive’? Is it wholly irrational? Read More »‘He was looking at me funny’: The (limited) rationality of the hostile attribution bias

Aboriginal rights and refusal of treatment in Canada

Consider:

An 11 year-old girl, J.J., is diagnosed with high-risk acute lymphoblastic leukemia, a type of cancer that arises in the bone marrow. She is put on a 32-day course of chemotherapy with an estimated success rate of over 90%. Her doctors don’t know of anyone who has survived this illness without such a course of treatment. However, after just 10 days, her mother withdraws her consent to J.J.’s chemotherapy in order to pursue alternative, non-western remedies. J.J. doesn’t object, but both of her doctors believe that J.J. doesn’t understand either her illness or the importance of the treatment she is on. In all matters, she defers to her mother who is also her surrogate decision maker. The hospital in which J.J. is a patient appeals to Child Services, stating that by ceasing treatment J.J.’s mother has put J.J. into the position of a child in need of protection. Such a status would permit the hospital to continue treatment despite disagreement from J.J’s mother (in her capacity as surrogate decision maker). The case goes to trial, and a ruling is made in favour of J.J.’s mother. J.J. is taken out of the hospital in order to pursue non-western treatment alternatives. It is very likely that J.J. will die.Read More »Aboriginal rights and refusal of treatment in Canada

What are the ethics of using brain stimulation technologies for ‘enhancement’ in children?

New open access publication: announcement:

In a recently published article, Hannah Maslen, Roi Cohen Kadosh, Julian Savulescu and I present an argument about the permissible (and not-so-permissible) uses of non-invasive brain stimulation technology in children. We consider both children who may be suffering from a specific neurological disorder, for whom the stimulation is intended as a ‘treatment’, and those who are otherwise healthy, for whom the stimulation is intended as ‘enhancement’. For the full article and citation, see here:

Maslen, H., Earp, B. D., Cohen Kadosh, R., & Savulescu, J. (2014). Brain stimulation for treatment and enhancement in children: An ethical analysis. Frontiers in Human Neuroscience, Vol. 8, Article 953, 1-5.Read More »What are the ethics of using brain stimulation technologies for ‘enhancement’ in children?

Milk Round success is tragic, culpable failure

Several times this term I’ve staggered out onto Oxford station, cramped and queasy from Cattle Class, and seen packs of sleek suits ooze out of First Class, briefcases in their hands and predatory gleams in their eyes. ‘Let’s go hunting’, one floppy-haired account manager said to his confederates. They climbed into cabs, which they saw as safari Land Rovers heading to the bush, and went off to a panelled room in some college.

To that room, lured by canapés and Mammon, lots of undergraduates will have come. Fizz (far more expensive than the students would ever buy themselves, but not of a standard that would be tolerated in the hunters’ own Esher homes) will have been waiting on silver trays. Vol au vents will have been smilingly circulated by bought-in labour (or possibly by the  hunters’ own menials, in their best suits, slightly creased from travelling with me in Cattle). Read More »Milk Round success is tragic, culpable failure

C. S. Lewis as a moral philosopher

Tomorrow it is C.S. Lewis’s birthday. He’d have been 116. He died 51 years ago, his death pushed out of the headlines by the deaths of JFK and Aldous Huxley. He’s had far more influence than either.

He’s remembered mainly as a children’s writer (the most dogmatic atheists, terrified or disgusted by the roar of Aslan, nonetheless bring their children to stroke the lion’s mane), and as a Christian apologist. He, irony upon irony, a beer-quaffing, chain-smoking, divorcee-marrying intellectual, living and breathing high pagan culture along with his pipe-smoke, is the darling of American evangelicals. And that’s why he’s neglected by serious philosophers.1 It’s understandable. We tend to judge people by the company they keep. But in the case of Lewis it’s unfair. Evangelicals might queue up at his door, but he’d never let them in.  Apart from their membership of the species, he’d have loathed everything about them; their chauvinism, their ludicrous literalism, their self-righteousness, their belligerence, their metaphor-phobia, their elastic-waisted trousers, their historical blindness, their pant-soiling fear of scholarship, their teetotalism, their humourlessness. He had a fastidious nose for inconsistency: imagine how that nose would have twitched when it sniffed a Louisianan zealot who was keen on topping adults but outraged by abortion. In a different context (he was lambasting liberal intellectuals who say that that they can read nuances between the lines, but fail to see the huge themes rampaging through the  Christian story) he denounced those who ‘claim to see fern-seed and can’t see an elephant ten yards away in broad daylight.’)2 He’d have similarly scourged those who have the KJV with their MSG for breakfast, and yet scream for judicial execution in the name of a man who was himself judicially executed, and who, in the name of a man who urged the turning of a cheek and the loving of enemies, say that every (white) citizen should have a gun and that every inconveniently non-compliant nation should have its ass whipped reeeeeeeel good.Read More »C. S. Lewis as a moral philosopher

Statistical Victims and the Value of Security

As illustrated by several recent events, Mexico suffers from a lack of security.  The country holds the world record in kidnappings, with an estimated number of 123,470 people kidnapped just in 2013. In August 2014, the official number of missing people was 22,320.  Citizens are fed up and are demanding security, perhaps the most basic good a government should provide.  I’ll here discuss what appears to me to be one philosophical mistake about the value of security for people.  It’s useful to observe and avoid this mistake, since it pertains to wide range of practically important choices (which I’ll mention at the end).

Read More »Statistical Victims and the Value of Security

The Wrongness of Do Not Resuscitate Orders Being Ignored

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Guest Post by Joseph Bowen

Joseph is a BPhil Student studying at Oxford University.

Following a surprise inspection of Colchester General Hospital by the Care Quality Commission (CQC) on Friday 14th November, it was reported that inspectors had found that some patients (“elderly people, some [suffering from] dementia”) had been inappropriately restrained, and/or sedated without consent, and that ‘Do Not Resuscitate’ (DNR) notices were being disregarded. What struck me about this case is that, while all are horrible practices, the DNRs being ignored seemed worse than the inappropriate restraint and sedation without consent.Read More »The Wrongness of Do Not Resuscitate Orders Being Ignored

Doing Good by Doing Nothing?

@JimACEverett

 www.jimaceverett.com

 

A common theme running through debates on combating global problems like poverty and common change is the idea that something must be done. Usually, this is taken to mean that some prosocial behaviour must be actively encouraged and sought out: for example, encouraging people to recycle, or having public health campaigns to encourage people to vaccinate. These solutions typically require individuals going out of their way to do what is often a costly behaviour, and consequently, have only limited success. But what if prosocial behaviour could also be encouraged by making use of the passivity of human nature? What if people could do good by doing nothing?

Read More »Doing Good by Doing Nothing?