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Should parents decide? The case of RB

In the Family Court yesterday, a controversial case that has been widely reported in the media came to a premature close. The father of baby RB, a severely physically disabled 13 month-old infant, withdrew his opposition to the plan by RB’s mother and doctors to take him off life support. It is believed that in the near future doctors will stop breathing machines and allow RB to die. The court did not, in the end, make a judgement about this case, though a statement of endorsement by Justice Macfarlane yesterday suggests that it would have reached the same conclusion.

Read More »Should parents decide? The case of RB

The ventilator lottery: rolling the dice in the face of difficult choices

As the winter approaches there has been a surge in the number of cases of swine flu, as well as a number of recent deaths in the UK. Although there is hope that the new vaccine will reduce the impact of the pandemic a number of countries including Canada the UK and the  United States have had to face the possibility that health services will not be able to accommodate the predicted surge in demand. Officials have been contemplating guidelines for deciding who should be prioritised for receiving life saving mechanical ventilation. The hope is that such guidelines will enable doctors to save the greatest number of lives in a pandemic.

But one concern about these guidelines is that they are unfair. Should scarce medical resources such as ventilators be allocated using a lottery instead?

Read More »The ventilator lottery: rolling the dice in the face of difficult choices

Longer life, more trouble?

An article in the Times argues that life extension will bring us problems: long-lived people will bankrupt the NHS, pensions would become expensive, the pension age would need to be changed, there would be a pressure for resources and life would become meaningless. It is a surprisingly common criticism that would never be levelled at… Read More »Longer life, more trouble?

Premature death or wrongful death?

A headline in the Daily Mail from yesterday highlights the cost of over treatment for extremely premature and marginally viable infants.

    “Parents cause infant to suffer by forcing doctors to give futile treatment”.

Despite doctors counselling a set of parents that their 22 week gestation premature infant (born 4 ½ months early) had virtually no chance of survival, the parents insisted that Warren* be actively resuscitated and treated in intensive care and threatened legal action if doctors refused. Warren received chest compressions in the delivery room and was put on a breathing machine. He developed holes in his fragile lung and had multiple drain tubes inserted into his chest. Warren’s thin skin tore and broke even with gentle handling, and he developed patches of skin loss, like second degree burns, on his trunk and limbs. He developed bleeding in the centre of his brain, and on the 5th day of life perforated his bowel from infection. He died the following day. Meanwhile, 2 infants born prematurely in the same hospital were unable to be accommodated in intensive care because of lack of beds and had to be transferred to another hospital 1 hour away. One of those infants became unstable during the ambulance transfer and developed additional complications. Lawyers representing Warren are now considering legal action against the doctors and against his parents.

But of course, that wasn’t the real headline or case in the Daily Mail, and legal action such as that described is not likely to take place.

Read More »Premature death or wrongful death?

How not to criticize the NHS

The British National Health Service (the NHS) has been in news a lot recently. First it was the Investor's Business Daily in the US, which claimed that:

'People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.'

This is a particularly ridiculous claim as Stephen Hawking of course has lived in the UK all of his life! He responded saying:

Read More »How not to criticize the NHS

Should we forget about organic food?

A recent
report by the Food Standards Agency argues that organic food doesn’t bring any
substantial nutritional benefits compared to conventionally produced food.
This contradicts the conclusions of previous studies suggesting organic food to
be nutritionally superior. As one might have expected, supporters of organic
farming have been critical of the report, yet it is unfortunate that the media
coverage on this issue often gives the impression that organic food has been
shown to be a sham (some consumer groups thus expect shoppers to now “think
twice before buying organic”)
and that its advocates are now reduced to using any bad argument they can think
of to prove the contrary. This impression is understandable but misleading.

Read More »Should we forget about organic food?

What’s special about selling gametes?

Dominic Wilkinson posted yesterday on the issue of whether payment for egg and sperm donation should be legalised. This question attracted significant media attention yesterday after Lisa Jardine, of the HFEA, called for debate on the existing UK ban on payment for donors. Today's Guardian contains a piece highlighting several ways in which people can already sell their bodily parts or products, ranging from livers to breast milk, and from blood to hair. Sale of many of these bodily parts/products is regarded is ethically problematic, and is, in many cases, illegal. But not in all cases. For example, few would have a problem with the sale of hair for use in wigs.

Read More »What’s special about selling gametes?

Does self-help make you feel worse?

A study
by Canadian researchers published in the latest issue of the journal Psychological
Science (20:7, July
2009, 860-66), as recently reported by BBC news,
discovered that people with low self-esteem paradoxically happened to feel
worse after repeating a series of positive statements about themselves. The
conclusions of this study are interesting, yet one might regret that the BBC
News headline, “Self-help ‘makes you feel worse’”, though certainly
attention-grabbing, is also rather misleading.

 

Read More »Does self-help make you feel worse?

Is it Worth Living Longer?

Research recently published in Nature suggests that the drug rapamycin may have the potential to extend human life span by decades: http://news.bbc.co.uk/1/hi/health/8139816.stm

If the life is of ‘positive’ value, it might seem obvious that the drug is worth taking. But not everyone would agree. The Hellenistic philosopher Epicurus famously argued that, since it marks the end of conscious life, ‘death nothing to us’. Fearing death makes as much sense as regretting you weren’t around for all that time before your birth.

Read More »Is it Worth Living Longer?

Informed consent in the Googlesphere

Here's an interesting snippet

But there's also the fact that Google is stuffed full of people who just love to experiment on its users. For instance, Google Mail uses a very slightly different blue for links than the main search page. Its engineers wondered: would that change the ratio of clickthroughs? Is there an "ideal" blue that encourages clicks? To find out, incoming users were randomly assigned between 40 different shades of links – from blue-with-green-ish to blue-with-blue-ish. It turned out blue-ness encouraged clicks more than green-ness. Who would have guessed? And who would have cared? Google, of course, which wants to get people clicking around the net.

I take this sort of experimentation as utterly, boringly unproblematic

But on one view – this is surreptitious experimentation without consent including randomisation.

Read More »Informed consent in the Googlesphere