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Decision Making

Organ Donation Euthanasia

by Dominic Wilkinson and Julian Savulescu

There are 8000 patients on transplant waiting lists in the UK. Every year 400 patients die while waiting for an organ to come available.
We are all far more likely to be in need of an organ transplant than to be a donor. Most of us expect that if we needed a transplant that someone would donate one. On the basis of the ethical golden rule – do unto others as you would want them to do for you, we should all think seriously about whether and how we could donate our organs if we no longer need them.

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Embrace the controversy: let’s offer Project Prevention on the NHS

A controversial US-based charity that pays drug addicts to undergo sterilisation or long-term contraception has recently opened for business in the UK. Project Prevention pays drug users $300 if they provide a medical certificate of drug dependency and another certifying that they have had tubal ligation, vasectomy or a contraceptive implant. The founder of the charity points to the significant physical and psychological problems in children born to drug-using parents. Noone would deny that it would be good to avoid these problems. Drug counselling often includes advice about contraception, and encouragement of those who are interested to take up options including long term contraception or sterilisation – we don’t think that that is a particular problem. So what is wrong with Project Prevention?

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The equal air-time solution for controversial research

When are placebos ethical in medical research? One common answer is that it is only appropriate to use placebos in research when there is no proven effective treatment for the condition (1). On this view, if there is a proven treatment placebos would be unethical, and any trial should compare new drugs or treatments with the existing proven one. But what if the question of ‘proof’ is in dispute? For new medical treatments there often comes a point where some researchers and doctors are convinced that the new treatment is effective and safe while others remain unconvinced. When placebo-controlled trials take place in this setting they are often controversial.

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Volcano Ethics: Should we be Flying the Unfriendly Skies?

An ash cloud produced by the eruption of the Eyjafjallajoekull volcano in Iceland has led to the severe disruption of airline transportation in the UK and across a wide swathe of Europe, with UK airspace almost completely closed since midday last Thursday. Passengers, freight importers and exporters, and airlines are just some of those affected by the disruption; some British employers are also taking a hit due to absent workers who went abroad for their Easter holidays and then found themselves stranded and unable to get home. The reasons for grounding the planes are non-trivial: as the International Civil Aviation Organization (ICAO) wrote in a press release last week: “Since volcanic ash is composed of very abrasive silica materials, it can damage the airframe and flight surfaces, clog different systems, abrade cockpit windows and flame-out jet engines constituting a serious safety hazard.”

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Metaphors We Moralize By

“He has a heart of gold.” “There’s
not a mean bone in her body.” “They’re rotten to the core.”
“We’re going to show them what we’re made of.”

What do all these statements have in
common? They all cluster around the idea that people contain fundamental
moral properties that define who they are and determine how they behave.
In other words, they form a conceptual metaphor that understands morality
as essence. There are other common conceptual metaphors for morality
as well: morality as bounds (leading astray, deviating
from the path, transgressing bounds) or morality as uprightness
(an upstanding citizen, a lowly thing to do). These moral
metaphors can tell us quite a lot, according to George Lakoff, a cognitive
linguist and author of numerous influential books like Metaphors We
Live By and Moral Politics. In fact, Lakoff argues, metaphors may be
the key to understanding much of politics, culture, and human thought
itself.

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The worth of a life and a life worth living

There has been a lot of discussion about health care rationing in the North American media over the last year, much of it hysterical and barely coherent. A number of respected ethicists have tried to make the case for rationing, including Peter Singer in the New York Times last year, and recently John Freeman.

This week Newsweek Science Editor Sharon Begley asked ‘What is a Life Worth?’ drawing on a recent study presented at the American Society for Maternal-Fetal Medicine meeting. Begley noted

“This is the kind of news that unleashes hysteria about "death panels" and "health-care rationing," but here goes: an analysis of genetic screening for an incurable, untreatable disease called spinal muscular atrophy shows that it would cost $4.7 million to catch and avert one case, compared with $260,000 to provide lifetime care for a child born with it. So here's the question: do we say, "Damn the cost; it is worth any price to spare a single child the misery of being unable to crawl, walk, swallow, or move his head and neck"—or do we, as a society, put on the green eyeshades and say, "No, sorry, we can't afford routine screening"?”

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Is the brain half full – or half empty?

There have been dramatic headlines in the media ('Coma Man. I think…I’m alive') following the publication yesterday of a new study using brain scans to detect consciousness in profoundly brain damaged patients. For the first time scientists and doctors have demonstrated that some patients diagnosed with persistent vegetative state may be able to communicate using functional magnetic resonance imaging (fMRI).

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The judge is out on juries

Is the traditional jury system in trouble? The first crown court criminal trial in England and Wales without a jury in 350 years is being held right now, dealing with the Heathrow robbery of 2004. The Guardian discusses the problem of keeping potentially prejudicial Internet information from modern juries. Are we seeing an erosion of having fair trials by one's peers, or the start of updating an old system to modern standards?

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Of Mothers and Fetuses and Abortionists

Two recent articles highlight the powerful influence that language has over the way people think. Word choice is at the centre of an article about USA ‘abortionist’ Warren Hern . He hates the word abortionist: ‘the opponents of abortion have turned it into a degrading and demeaning word that has the same negative connotations as the most despicable racial epithet’.

But the author argues that it is the right word, an accurate word, and our discomfort with it is only a measure of how poisoned the language of abortion has become. The article does not refer to Hern by his name but uses the poisoned word, the ‘abortionist’, ignoring both the normal convention referring to people the way they want plus Hern’s abhorrence of the word. This produces an accusatory tone that suggests that the author is antagonistic towards Hern, although other that name calling the author does not seem unsupportive of him. Perhaps the author is expressing his mixed feelings. 

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