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Health

Is smoking morally wrong?

This week, I’ve been thinking about smoking. Full disclosure: My name is Jim and I am a smoker. I have smoked for nearly a decade now – since around 2005 – and I only smoke menthol cigarettes. I am addicted to the sweet menthol smoke, where that touch of red fire at the end of a white stick seems so perfectly suited to almost any occasion from celebration to commiseration. I give up on average for a month or two a year, every year. I always come back, though. The reason I say this is to highlight that I am by no means one of these dour-faced moralizers, condemning smokers for their ‘filthy habit’. Like a snot-nosed child, it may be filthy, but it’s my filthy habit. Most efforts to encourage people against smoking focus on the idea that smoking is personally damaging: it causes illness and death, it costs a lot of money, it harms others, it litters the environment, and so on. This week, however, I’ve been thinking about whether the real concern is that smoking might be morally wrong. (NB: I’m discussing where whether it is morally wrong, not whether it should be legally banned or whether people should have the ‘right’ to smoke – these are distinct questions).Read More »Is smoking morally wrong?

Another Surprising Side-Effect of Paracetamol: Causing ADHD?

Photo: Colourbox

Taking the popular over-the-counter pain and fever medication paracetamol during pregnancy might affect the unborn child more than we assumed – and hoped for. Recently, research began to link pre-natal exposure of paracetamol (also known as acetominophen) to asthma and poor motor and communication skills in small children. Now, a new study published yesterday suggests that taking paracetamol during pregnancy comes with an increased risk for the baby of developing attention deficit hyperactivity disorder (ADHD) later.

The authors of this study investigated 64,322 Danish children (born 1996-2002) and their mothers. The women were asked whether they have taken paracetamol in computer-assisted telephone interviews three times during their pregnancy and shortly after. To asses ADHD in children, the researchers used different ways: they asked the mothers of 7-year-olds about their child’s behaviour using a standardised ADHD questionnaire. Moreover, they used Danish medical registries to gain information about diagnoses of hyperkinetic disorder, which resembles a severe form of ADHD, and descriptions of ADHD medication to the children.

Read More »Another Surprising Side-Effect of Paracetamol: Causing ADHD?

Are the reasons why people take illegal drugs relevant to sentencing decisions?

The laws that prohibit possession of certain drugs are ostensibly justified because they protect people from the health risks that are associated with uncontrolled or heavy use. Some have argued that criminalizing possession of small quantities of drugs for personal use is overly paternalistic (people should be free to make potentially risky choices as long as they don’t put others at risk) or even counterproductive (criminalizing drug use fuels a black market, many aspects of which present greater dangers to individual drug users and wider society). I find these arguments intuitively persuasive (although clear evidence would be needed to substantiate the claim that criminalization is in fact counterproductive).

So, if there is a justification for putting controls on personal drug use it seems that it ought to appeal solely to the physical and social harms that would result from a policy of drug liberalization. Such an approach is roughly reflected in the UK drug laws: the graded classification system, which determines the maximum penalty for possessing drugs in each class (A to C), considers only the harmfulness of the drug: punishment is linked to risk to health. Criminalization of drug use thus has nothing to do with a moral evaluation of this drug use.

However, a news story this month raises the question of whether moral considerations are sometimes playing a role in the sentencing of those convicted of possessing illegal drugs. Read More »Are the reasons why people take illegal drugs relevant to sentencing decisions?

Should we ban women from smoking while pregnant?

 

In the U.K., a Labour plan has recently been in the news and stimulating some interesting debate – mainly about the over-regulation of smoking.

As can be seen on the BBC news website, Labour peers have “tabled an amendment to the Children and Families Bill detailing their proposal for England, which they said was about “protecting children”. Lord Hunt, who supports the motion, has stated

“Some Lords will argue a car is a private space and that we should not legislate for what happens within such a space. But there are more important principles than that… For one for me is the need for child protection. Unlike most adults, children lack the freedom to decide when and how to travel, they lack the authority most adults have to ask people not to smoke in their company. And in those circumstances I think it is right for Parliament to step in to protect children.”Read More »Should we ban women from smoking while pregnant?

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

“One cup of joe and your brain is ready to go”? – Caffeine as memory enhancer

The first systematic study investigating the effects of caffeine on human performance – sponsored by Coca-Cola – has been published about 100 years ago. Since then, thousands of other studies have been looking at if and in which ways caffeine improves cognitive performance. This question is still debated in science, but there is general consensus that caffeine can be seen as an enhancer for specific functions like mood, attention, concentration and reaction time. These enhancement effects have been shown in studies with the general set-up that participants first took caffeine and then did a performance task. This matches our everyday representation of “wise” caffeine use: if I wanted to enhance my performance with caffeine, I’d take it immediately before the “critical situation”, for example an exam.

Read More »“One cup of joe and your brain is ready to go”? – Caffeine as memory enhancer

Oppressing smokers for fun and profit

According to an article in the New England Journal of Medicine (Prabhat & Peto 2014),

Tripling tobacco tax globally would cut smoking by a third, and prevent  200 million premature deaths this century from lung cancer and other diseases. (here)

This should, of course, be instituted immediately. It is almost the perfect public policy: self-interest dressed up as sanctimony. Not only will we make the lives of non-smokers better at the expense of smokers, but we can do so whilst telling smokers we are doing it for their own good!Read More »Oppressing smokers for fun and profit

Beyond 23andMe’s Shutdown: The Role of the FDA in the Future of Direct-to-Consumer Genetic Testing

Kyle Edwards, Uehiro Centre for Practical Ethics and The Ethox Centre, University of Oxford Caroline Huang, The Ethox Centre, University of Oxford An article based on this blog post has now been published in the May – June 2014 Hastings Center Report: http://onlinelibrary.wiley.com/doi/10.1002/hast.310/full. Please check out our more developed thoughts on this topic there!

The new offence of ‘wilful neglect’ – what’s new?

It was announced last week that a new offence of ‘wilful neglect or mistreatment’ is to be created for NHS hospital staff whose conduct amounts to the deliberate or reckless mistreatment of patients. This offence will be modeled on an existing offence under the Mental Capacity Act which punishes the wilful neglect or ill-treatment of patients lacking capacity. Currently, a medical worker convicted of this offence faces a maximum sentence of five years imprisonment, or an unlimited fine. The sanctions for the proposed new offence are likely to be of a similar severity.

The creation of the offence comes in the wake of the inquiry into the widespread negligence that occurred at Mid Staffordshire hospital. Intended principally to deter healthcare workers from mistreating patients, the new offence has been proposed following review of patient safety. The leader of the review, Professor Don Berwick, emphasized that patient safety must become the top priority and that the measure was needed to target the worst cases of a ‘couldn’t care less’ attitude that led to ‘wilful or reckless neglect or mistreatment’.

Concerns about its impact

Whilst most would agree that patient safety should clearly be a priority, there has been concern that the new criminal sanction could create a ‘climate of fear’ amongst healthcare workers and that individual workers will be penalised for mistakes that are the result of inadequate staffing or simple human error, rather than blameworthy acts of malice.Read More »The new offence of ‘wilful neglect’ – what’s new?