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Medical ethics

On the supposed distinction between culture and religion: A brief comment on Sir James Munby’s decision in the matter of B and G (children)

On the supposed distinction between culture and religion: A brief comment on Sir James Munby’s decision in the matter of B and G (children)

By Brian D. Earp (@briandavidearp)

Introduction

What is the difference between “culture” and “religion” … ? From a legal standpoint, this question is important: practices which may be described as being ‘religious’ in nature are typically afforded much greater protection from interference by the state than those that are understood as being “merely” cultural. One key area in which this distinction is commonly drawn is with respect to the non-therapeutic alterations of children’s genitals. When such alteration is done to female children, it is often said to be a “cultural” practice that does not deserve legal protection; whereas, when it is done to male children, it is commonly said to be a “religious” practice – at least for some groups – and must therefore not be restricted (much less forbidden) by law.

Is this a valid distinction?

Read More »On the supposed distinction between culture and religion: A brief comment on Sir James Munby’s decision in the matter of B and G (children)

Mitochondrial disease kills 150 children a year. A micro-transplant can cure it

Imagine that there was a law which prevented 150 children a year suffering from a life threatening liver or kidney failure from receiving a transplant. This would be unethical. But this is precisely the current state of affairs for around 150 children every year in the UK suffering from mitochondrial disease, or mitochondrial failure. From… Read More »Mitochondrial disease kills 150 children a year. A micro-transplant can cure it

New Book: The Ethics of Embryonic Stem Cell Research

There is wide agreement that embryonic stem cell research holds unique promise for developing therapies for currently incurable diseases and conditions, and for important biomedical research. However, as it is currently done, the isolation of embryonic stem cells involves a process in which an early embryo is destroyed, which many find highly problematic.

This has resulted in what I refer to in my book as

The Problem. Either one supports embryonic stem cell research and accepts resulting embryo destruction, or one opposes embryonic stem cell research and accepts that the potential benefits of this research will be foregone.Read More »New Book: The Ethics of Embryonic Stem Cell Research

Conventional and non-conventional medicine and the Placebo Paradox

Alternative medicine is a trendy topic to discuss – both by despising and praising it in a contradictory manner. But there is something controversial in the categorical critique towards it. The controversies and fallacies in the categorical praise are much elaborated and I will mostly leave aside that part.Read More »Conventional and non-conventional medicine and the Placebo Paradox

Review: Beyond The Abortion Wars, by Charles C. Camosy

 

@JimACEverett

 www.jimaceverett.com

I was recently lucky enough to receive an advance copy of Charles Camosy’s forthcoming book to review – ‘Beyond the abortion wars: a way forward for a new generation’. In this book, Camosy masterfully traverses the ‘battleground’ between the ‘pro-life’ and ‘pro-choice’1 camps in order to show that this battleground is in fact no such thing. In fact, as Camosy notes, the majority of the American public actually agree on a middle-ground position on abortion. Despite what one might think from reading certain media outlets and Twitter wars, there is actually a large consensus in the public regarding abortion. This insight is deceptively powerful. By demonstrating the areas of agreement, Camosy is able to help guide us beyond the abortion wars to allow a way forward for a new generation.

Read More »Review: Beyond The Abortion Wars, by Charles C. Camosy

Aboriginal rights and refusal of treatment in Canada

Consider:

An 11 year-old girl, J.J., is diagnosed with high-risk acute lymphoblastic leukemia, a type of cancer that arises in the bone marrow. She is put on a 32-day course of chemotherapy with an estimated success rate of over 90%. Her doctors don’t know of anyone who has survived this illness without such a course of treatment. However, after just 10 days, her mother withdraws her consent to J.J.’s chemotherapy in order to pursue alternative, non-western remedies. J.J. doesn’t object, but both of her doctors believe that J.J. doesn’t understand either her illness or the importance of the treatment she is on. In all matters, she defers to her mother who is also her surrogate decision maker. The hospital in which J.J. is a patient appeals to Child Services, stating that by ceasing treatment J.J.’s mother has put J.J. into the position of a child in need of protection. Such a status would permit the hospital to continue treatment despite disagreement from J.J’s mother (in her capacity as surrogate decision maker). The case goes to trial, and a ruling is made in favour of J.J.’s mother. J.J. is taken out of the hospital in order to pursue non-western treatment alternatives. It is very likely that J.J. will die.Read More »Aboriginal rights and refusal of treatment in Canada

What are the ethics of using brain stimulation technologies for ‘enhancement’ in children?

New open access publication: announcement:

In a recently published article, Hannah Maslen, Roi Cohen Kadosh, Julian Savulescu and I present an argument about the permissible (and not-so-permissible) uses of non-invasive brain stimulation technology in children. We consider both children who may be suffering from a specific neurological disorder, for whom the stimulation is intended as a ‘treatment’, and those who are otherwise healthy, for whom the stimulation is intended as ‘enhancement’. For the full article and citation, see here:

Maslen, H., Earp, B. D., Cohen Kadosh, R., & Savulescu, J. (2014). Brain stimulation for treatment and enhancement in children: An ethical analysis. Frontiers in Human Neuroscience, Vol. 8, Article 953, 1-5.Read More »What are the ethics of using brain stimulation technologies for ‘enhancement’ in children?

“Ravines and Sugar Pills: Defending Deceptive Placebo Use” – New Open Access Publication

A placebo can be understood as a medical intervention that lacks direct specific therapeutic effects on the condition for which it has been prescribed, but which can nonetheless help to ameliorate a patient’s condition. In March 2013, a study by Howick et al. suggested that the vast majority of UK general practitioners (GPs) have prescribed a placebo at some point in their career. This finding was somewhat controversial and received national media coverage in the UK (here and here). Part of the reason for this controversy is that the use of placebos in clinical practice is often deemed to be morally problematic, in so far as it often involves the intentional deception of the patient.Read More »“Ravines and Sugar Pills: Defending Deceptive Placebo Use” – New Open Access Publication

The ethics of DocAdvisor: Is accountability always a good thing?

Dominic Wilkinson @NeonatalEthics

 

In the news this morning, the NHS has released data on individual surgeons’ performance, so called “surgeon report cards”. This represents the latest move towards increased transparency and accountability in the National Health Service. Elsewhere in the media today, there are numerous reports of the UK couple who were apparently charged £100 after posting a negative hotel review on an online website.

These parallel stories highlight one concern about certain types of health accountability: sensitivity to the negative impact of reviews (or poor performance figures) could lead to harmful changes in behaviour. For surgeon report cards, one frequently cited concern is that publishing report cards could lead surgeons to avoid high-risk cases. If surgeons choose patients with lower risk of dying, they will potentially end up with a better report card. However, then the results would be misleading (it would be the equivalent of someone getting a higher mark by choosing to sit an easier test). More worrying, it may mean that some high-risk patients are unable to access surgery.

Should we be worried about the negative effect of report cards on surgeons behaviour?Read More »The ethics of DocAdvisor: Is accountability always a good thing?

Equality and the Clinical Trial Dating Agency

The first advert for the sale of a clinical trial place offers, for $2 million, the chance to participate as a patient in a trial investigating the Farmington virus (FARV) and its potential efficacy in treating certain forms of brain tumours. Meanwhile, Alexander Masters has written convincingly about his idea for a clinical trial dating agency: matching wealthy but sick donors with scientists who have an idea for a cure but no money for a trial (shorter version also available). In Masters’ idea as in the real life case, the proposal is that the wealthy donor will pay not just for himself or herself, but enough for the trial to go ahead with a full complement of those who could not otherwise afford it, recruited on the same basis as any trial.

Predictably, ethical concerns have been raised, perhaps the main one being equality: “In the UK, the principles in participating in clinical trials include open and equal access for those who chose to participate” (Kate Law, director of clinical and population research at Cancer Research UK, quoted in The Telegraph ).

Read More »Equality and the Clinical Trial Dating Agency