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Decision Making

Status quo bias and presumed consent for organ donation

Yesterday the UK organ donation taskforce released its report on a
presumed consent (opt-out) system for organ donation. To the
consternation of the chief medical officer and the Prime Minister the
taskforce advised against the introduction into the UK of such a system.

In an editorial in today’s Guardian, it was observed that both the low
rates of consent in the UK – and the taskforce’s response to the
question of presumed consent may represent an irrational preference for
the default position. They may both be examples of the status quo bias.

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The paradox of organ donation consent

In Australian newspapers today a Melbourne intensive care physician,
Jim Tibballs is reported as criticising current organ donation
guidelines on the grounds that donors are not actually dead at the time
that organs are removed. Other doctors have called Professor Tibballs’
comments “irresponsible” on the grounds that they might cause a
significant fall in organ donation rates.

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Fishing outside the reef: the illusion of control and finance

Humans regularly see patterns where there are none, but stress makes this tendency worse. Some new studies suggest this may be making the current market troubles worse. Jennifer Whitson and Adam Galinsky (Lacking Control Increases Illusory Pattern Perception, Science 3 October 2008 Vol. 322. no. 5898, pp. 115-117) demonstrated that when people feel they lack control, they see more  illusory patterns in noise and stock market information, perceive conspiracies and accept superstitions more readily. But is this the key to understanding the financial turmoil?

Read More »Fishing outside the reef: the illusion of control and finance

Knowledge may be power, but is it healing?

The
explosion of medical information on the internet is a good thing,
right?  Patients worried that their condition
is not being taken seriously, those who want a second opinion but are worried
about upsetting their GP by asking for it, and those with symptoms too trifling
or embarrassing to take to a doctor—all these people who, fifteen years ago, may
have felt at a dead end with the medical profession can now use
the internet to research their conditions from the comfort of their own homes.

Read More »Knowledge may be power, but is it healing?

Testing choices: weighing up risks of death and Down syndrome for fetuses

In the Observer yesterday, researchers from a major disability charity
have claimed that the risks of screening for Down syndrome during
pregnancy have been underestimated. The researchers suggest that for
every 3 fetuses with Down syndrome that are detected by screening 2
unaffected fetuses miscarry as a complication of the testing process.
Should screening be stopped? If screening continues how should
prospective parents weigh up this risk?

Read More »Testing choices: weighing up risks of death and Down syndrome for fetuses

‘Anyone who thinks the Large Hadron Collider will destroy the world is a t**t.’

This week is Big Bang Week at the BBC, with various programmes devoted to the switch-on of CERN’s Large Hadron Collider (LHC) on Wednesday morning.  Many of these programmes are covered in this week’s issue of the Radio Times—the BBC’s listings magazine—which also features a short interview with Professor Brian Cox, chair of particle physics at the University of Manchester.  Asked about concerns that the LHC could destroy the earth, he replies:

‘The nonsense you find on the web about “doomsday scenarios” is conspiracy theory rubbish generated by a small group of nutters, primarily on the other side of the Atlantic.  These people also think that the Theory of Relativity is a Jewish conspiracy and that America didn’t land on the Moon.  Both are more likely, by the way, than the LHC destroying the world.  I’m slightly irritated, because this non-story is symptomatic of a larger mistrust in science, particularly in the US, which includes things like intelligent design. [… A]nyone who thinks the LHC will destroy the world is a t**t.’ (Final word censored by Radio Times.) [1]

Read More »‘Anyone who thinks the Large Hadron Collider will destroy the world is a t**t.’

Abortion is No Place for the Law

Victorian politicians are debating how to reform law on abortion. In Victoria, as in other states, abortion remains a crime. This is inconsistent with what happens. There are nearly 100 000 abortions every year in Australia.

The Victorian government will decide between 2 Models. According to Model B, abortion will be available on request until 24 weeks of pregnancy, but after that point 2 doctors must agree that it is indicated. Doctors who fail to comply with the law would receive professional and other sanctions. On Model C, abortion is available on request all through pregnancy. Premier Brumby and a majority of politicians support Model B.

Why is the imposition of sanctions on doctors who provide abortions so attractive? Firstly, abortion is an undesirable means of birth control. Most people would prefer to find other ways of not having unwanted children. Secondly, many people believe that as the fetus grows, and looks more like a baby, its moral status increases. After 24 weeks, some fetuses are even capable of living in intensive care units, outside the womb, as extremely premature newborns.

Despite its superficial attractiveness, Model B is deeply morally flawed. According to Model B, the moral status of the fetus, and whether it is kept alive or aborted, depends on the judgement of 2 doctors. Their decisions will usually be based on whether there is a disease or disability present. But this implies that fetuses with disabilities have less of a right to life than those which do not have disabilities. This is discrimination against the disabled and those with diseases. We would not allow 2 doctors to kill a child just because it had spina bifida. Why would we think the presence of spina bifida should change the moral standing of a fetus? Doctors can withdraw medical treatment leading to the deaths of their patients, but only when the patient’s life is no longer worth living. This is not the case in virtually all abortions.

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Doctors or Resource Allocators?

A recent survey by Myeloma UK, and reported on the BBC website, suggests that many doctors do not tell patients about drugs that may be beneficial and which are licensed in the UK. The trouble is that the drugs have not yet been approved by NICE and so may be difficult to obtain on the NHS. This seems to suggest that something is wrong with the way in which NICE functions with respect to licensing and that doctors are in some way complicit.

Read More »Doctors or Resource Allocators?