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Ethics

Medical ethics are ridiculous

In a blistering letter in the current issue of the British Medical Journal, Miran Epstein identifies some of the factors we should consider in assessing the claims of so-called ‘evidence-based medicine’.[1] Nobody rationally disagrees with the suggestion that medicine should have an evidence base, and everybody should agree that in order for medicine to be based on reliable evidence, it should be free of the following ‘polluters’:

  •  financial conflicts of interest
  •  inadequately rigorous selection criteria, outcome measures and criteria of statistical significance
  • the practice of testing products against placebo or no treatment (rather than current treatment), and then shouting ‘Eureka!’
  • recruiting subjects using financial incentives that introduce outcome bias
  • marketing campaigns masquerading as research

Marathon mice, enhancement and the will to work out

In his article in the Pacific Standard last week, author Bruce Grierson discusses the emerging scientific evidence that the ‘will to work out’ might be genetically determined. Grierson describes a ‘marathon mouse’, the descendant of a long line of mice bred for their love of exercise, and a 94-year-old woman called Olga, who is an athletic anomaly. Both the mouse and Olga love to work out. The mouse goes straight to his wheel when he wakes up, running kilometers at a time and Olga – a track and field amateur – still competes in 11 different events. Grierson suggests that cracking the code for intrinsic motivation to exercise would lead to the possibility of synthesizing its biochemical signature: ‘Why not a pill that would make us want to work out?’, he asks. Such a possibility adds an interesting dimension to the debate about enhancement in sport, and to enhancement debates more generally.Read More »Marathon mice, enhancement and the will to work out

Doctors: turn off your computer and listen to your gut

‘Between the NHS and social care, there must be total commitment to ensuring that interaction is paperless, and that, with a patient’s consent, their full medical history can follow them around the system seamlessly.‘ So said Jeremy Hunt,the Health Secretary, on 16 January 2013. And NHS England say that: ‘Our vision is for a fully integrated digital patient record across all care settings by 2018’.

It sounds like a good idea. It’s not. Or not in its present form. Many of the concerns that have been expressed relate to privacy/confidentiality. Those concerns are real. But even if they can be satisfactorily addressed, electronic health records have the potential to do great harm. They divert attention from the patient to the screen, and they cause clinical skills to atrophy.

David Loxterkamp recently observed that the computer in the consulting room is a Frankenstein-like creature: ‘….we have created a place in our exam rooms for a computer that needs our care and feeding. It now directs the flow and purpose of an encounter that once unfolded organically according to the particular needs of the patient.’ The electronic servant becomes the master. Read More »Doctors: turn off your computer and listen to your gut

Computer consciousness and ethics

Nature, the prestigious international science journal, often publishes short science fiction stories in a column called “Futures.” According to Nature, “Featuring short stories from established authors and those just beginning their writing career, Futures presents an eclectic view of what may come to pass.” (see here)

As many philosophers and ethicists have recognized, eclectic views of what may come to pass can be philosophically and ethically useful. They may, for example, suggest possible future scenarios that raise difficult ethical questions – questions we ought to begin to sort through now. They may also stimulate insight into important ethical and conceptual questions at the heart of current ethical debates. Consider, for example, a story recently published by Eric Schwitzgebel and R. Scott Bakker. I won’t spoil the story (do read it here), but I want to lift an element of the plot out of context, so I need to say something about it. It involves the creation of consciousness on a computer. More specifically, it involves the generation of a whole society of interacting conscious agents – people like you or me, living in a world they experience, pursuing goals and relationships and all the rest.Read More »Computer consciousness and ethics

Three Arguments Against the Belgian Child Euthanasia Bill Criticised

By Luke J Davies. Follow Luke on Twitter.

Last week the upper house of the Belgian Federal Parliament voted (50 to 17) that euthanasia should be legal for children suffering from a terminal illness that is causing severe physical pain. [1] The bill legalizing the practice requires that the child understand what euthanasia is, and that parents provide their written consent. Unlike the Netherlands, which allows euthanasia for children over the age of 12, there will be no minimum age in Belgium. (Find the story here, here, here, and here.)

The passing of this bill, which has yet to be turned into a law [2], has been met with severe criticism in Belgium and abroad, mostly from religious and conservative groups. From what I have read, there are three main lines of argument against allowing euthanasia for children. The first maintains that allowing euthanasia for children is the first in a long series of steps that will lead to some Third Reich-like eugenics program. The second maintains that children do not have the capacity to make a decision to be euthanized. The third maintains that the legalization of euthanasia for children would lead to parents or health care professionals putting pressure on children to opt for that choice. I believe that each of these arguments fails to demonstrate that the bill should not pass, and will spend the remainder of this post explaining why.  

Read More »Three Arguments Against the Belgian Child Euthanasia Bill Criticised

Tis’ the season of pardons

This year Alan Turing got a posthumous royal pardon for his conviction of homosexuality. Justice Minister Chris Grayling said: “Turing deserves to be remembered and recognised for his fantastic contribution to the war effort and his legacy to science. A pardon from the Queen is a fitting tribute to an exceptional man.” Last year I blogged here on why asking for a pardon of Alan Turing might be a mistake. I still stand by my criticism: the fact that Turing was exceptional doesn’t mean he was above the (unjust) law or that he is more morally deserving than any other victim of that law.

Meanwhile in Russia, an amnesty has been called for 20,000 prisoners. This includes plenty of political prisoners, most notably members of Pussy Riot and Mikhail Khodorkovsky. The official reason for this seems to be the 20th anniversary of the adoption of Russian constitution, but in practice it might of course be a festive way of defusing some criticisms before the winter Olympics. Should the freed dissidents and their supporters now feel grateful to Putin?

Read More »Tis’ the season of pardons

Happiness, meaning and well-being

If someone were to ask you what you want from life, how would you reply? Plausible answers might include: ‘to be happy’, ‘to be successful’, ‘to make a difference’, or perhaps ‘to experience as much as possible’. Whatever these aspirations mean in their detail, they capture various implicit assessments of what we think it means to live a life that is good for us. A recent psychological study presents interesting data that suggests that two of the things we might want in our lives – happiness and meaning – sometimes do not go together. In fact, some of the things that lead to a life being happy are negatively associated with it being meaningful and some of the things that seem to confer meaning detract from happiness. If this occasional incompatibility is in fact the case, does this mean that we must sometimes make a decision about which to pursue?Read More »Happiness, meaning and well-being

Professor Tim Scanlon: When Does Equality Matter?

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2013 Uehiro Lectures by Professor Tim Scanlon (Department of Philosophy, Harvard University) We are very grateful to Professor Tim Scanlon (Alford Professor of Natural Religion, Moral Philosophy, and Civil Polity, Harvard University) for delivering the 10th Annual Uehiro Lectures in December 2013, entitled “When Does Equality Matter?” Lecture 1: “Equal Treatment”  AUDIO  Lecture 2:”Equal Status” … Read More »Professor Tim Scanlon: When Does Equality Matter?

Oxford Martin School Seminar: Robert Rogers and Paul Van Lange on Social Dilemmas

In a joint event on November 15th, Prof Robert Rogers and Prof Paul van Lange presented their scientific work related to social dilemmas.

Social dilemmas are situations in which private interests conflict with collective interests. This means that people facing a social dilemma have to decide whether to prioritise either their own short-term interests or the long-term interests of a group. Many real-life situations are social dilemmas. For example, as individuals we would (economically) benefit from using public motorways without paying taxes to maintain them, but if all acted according to their self-interest, no motorways would be built and the whole society would be worse off. In the academic literature, the three types of social dilemmas that are discussed most prominently are the Prisoner’s Dilemma, the Public Goods Dilemma, and the Tragedy of the Commons. All three types have been modelled as experimental games, and research from different fields like psychology, neuroscience, and behavioural economics uses these games to tackle the question of under which conditions people are willing to cooperate with one another in social dilemmas, instead of maximising their self-interest. The ultimate goal of such research is to be able to give recommendations about how to solve social dilemmas in society.

Read More »Oxford Martin School Seminar: Robert Rogers and Paul Van Lange on Social Dilemmas