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Medical ethics

The NHS Should Make and Sell its own Homeopathic Remedies and Homeopaths Should be Paid the Minimum Wage

In March this year I blogged on the topic of NHS funding for homeopathic remedies. Even though I agreed with the critics of homeopathy, that there is no credible evidence for the efficacy of homeopathic remedies and that it is irrational to use these in preference to medical treatments that have actually been proven to work, I argued that the NHS should continue to subsidise the cost of homeopathic remedies. My basic line of argument was anti-paternalist. People should have the choice to be irrational if they want. What is important is that people are provided with all information relevant to their decision making. However, if they go ahead and choose to behave irrationally, then, provided that they are not harming others, their actions should not be interfered with. It is not the State’s role to prevent people from making such choices.

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Competing against Mutants

Introduction

In a recently broadcasted documentation about gene-doping, multiple award winning Swiss science journalist and author, Beat Glogger, reflected the issue of gene-doping in a sensitive and objective manner. In this Swiss-German co-production Andy Miah, a bold British Bioethicist, argued that gene-doping is supposed to be a natural friendly method of performance enhancement, whereas many other practices in the past weren’t. Simultaneously, he considered athletes no more as natural creatures by arguing: “We have to get rid of the imagination, that athletes are natural human-beings” (freely re-translated from the German version). Despite the fact that this statement is rather an anti-thesis than a substantiation for his strident position, I have to admit that the current development in gene technology tends to construct a sort of athletic hybrid. No doubt, this is a serious future issue we have to face. Nevertheless, Andy Miah’s declaration implies that athletes might kind take on a pioneer role regarding the subject of genetic enhancement. Therefore, is that an issue worth considering or even to achieving?

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Ethicists unite: you have nothing to lose but your non-citation

Yesterday Richard Ashcroft, Professor of Bioethics at Queen Mary College, London, wrote in a Facebook update: ‘I am fed up with being asked to come into science/medicine projects, add a bit of ethics fairy dust, usually without getting any share of the pie, just to shut reviewers up. I am not doing it any more. If they think we are important, treat us with respect. Otherwise, get lost.’

Lots of people liked this. So do I. Ethicists have for too long been the invisible but essential backroom boys and girls of biomedicine; patronised by the practitioners of ‘hard’ science; seen as unimaginative but powerful bureaucrats who have to be kept sweet; as despised social scientists who wield rubber stamps made essential by other zeitgeist-dictating social scientists who want to keep their woolly-headed chums in a job; as factotums who don’t deserve to have their names on the papers any more than the temp who does the photocopying. Why is this? 

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Performance Enhancement – Athletes are Victims not Delinquents

To describe the obvious power dynamic in modern sports industry from my personal point of view, I’m going to make use of a little metaphor. Therefore you have to imagine sport as a squash game played by several opponents. The competitors, hitting the ball from one corner into the other, represent the different stakeholders in elite-sports. Spectators, coaches, sponsors, national and international associations to mention a few. Of course there’s also one tiny ball incarnating the athlete himself as a kind of focal point, trying to satisfy the different demands. As a ball you’re certainly one of the most important parts of the game. But simultaneously you might be very easy to manoeuvre, because your being spherical, which could imply your lack of personal influence. Merely your ability to leave behind a little black marking on the squash court “wall of fame” is your only chance to colour your sport individually. As an elite sportsperson you’ve almost no opportunity to defend yourself against the prevailing key-players in the system. Otherwise you’re going to risk your career or even your status as a moral competitor. In the following lines, I’ll try to explain my position by disclosing the maladministration and mild coercion top-athletes are confronted with, emphasising four different issues of the “sports-system”.

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Greeks and geeks

At Harvard Medical School someone is screaming, reports the Boston Globe. ‘Death!’, he shrieks, ‘Why after all these years have you not appeared?’ He begs for euthanasia, tormented by his pain. Medical students listen to him.

His lines were written by Sophocles, and the students are listening because they have to: it is part of their curriculum.

The remarkable thing is not that Harvard medical students are being marinated in Sophocles, but that the Globe thought it worth reporting. Most medical students in mainstream western universities will get some ethics teaching. Sophocles is just one tool in the teachers’ toolkit. It’s a very effective one, by all accounts, but no different in kind from the lectures and seminars more conventionally deployed. Ethics teaching aims to teach students some problem-solving strategies, and to help them to recognise, evaluate, criticise, cull or cultivate the values that they themselves bring to the wards. 

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Between Life and Death…

A powerful BBC documentary, “Between Life and Death”, screened this evening on BBC One. The documentary (which can be viewed online for the next week in the UK) examined the life and death decisions made for critically ill patients with severe brain injury. Neuro-intensive care provides a way to interrupt the process of dying for such patients. But it raises difficult questions for medical staff and for families about the wishes of patients, the wishes of family members, and about uncertainty. Should treatment continue at the risk of the patient surviving in a severely impaired state? Or should patients be allowed to die, with the risk that perhaps if treatment had continued they may have recovered?

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The Costs of a Right to Demand Treatment

by Bridget Williams

Who has the right to decide when life prolonging treatment
should be withdrawn? Should doctors have the right to refuse to use costly and
scarce resources to continue to treat a permanently unconscious, dying man? Is
there a limit to the medical resources we can reasonably claim for ourselves
and our families when there are others who have the potential to receive much
greater benefits from those same resources?

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Critical Care ethics series – the ethics of maxiple pregnancies

by Dominic Wilkinson Quads, Quins, Sexts, Septs, even Octs! High order multiple pregnancies such as the Suleman octuplets in California generate enormous media attention. However, they also raise some unique ethical questions. In the second of a series of seminars on critical care ethics, the neonatal grand round today looked at ethical questions arising from… Read More »Critical Care ethics series – the ethics of maxiple pregnancies

An Ethical Approach to Abortion

by Julian Savulescu

Abortion should be decriminalised. Early abortion should be freely and easily available on request. Late abortion should be freely and easily available at least for those who have a valid justification: significant fetal abnormality, threat to woman’s health or a serious social reason, for example child pregnancy or rape. Family planning, including safe, free and open abortion services, is an essential part of a civilized society.

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Special Edition: Should we allow late abortion?

There have been a number of articles in the media about abortion in the last few weeks. The British Prime Minister has suggested that the time limit for (relatively) unrestricted access to abortion should be reduced from 24 to 22 or 20 weeks. A survey published tomorrow in an Australian medical journal suggests that the public in Australia support legal access to abortion, and do not believe that doctors should be sanctioned for performing abortion in the later stages of pregnancy if there is a good reason to do so.

This blog collects together resources and media articles relevant to the debate

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