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Quebec legalises assisted-death: should other states follow?

Quebec legalises assisted-death: should other states follow?

Last month Quebec legalised assisted-death. The new law allows ‘medical aid in dying’ for adults at the end of life who suffer “constant and unbearable physical or psychological pain” as a result of a “serious and incurable illness”. The passage of this law makes Quebec the first jurisdiction in Canada to allow assisted-death or euthanasia.

The Bill follows successful legalisation of assisted-dying just south of Quebec last year in the American state of Vermont. Jurisdictions in which the practice is now legal include the Netherlands, Switzerland, Belgium, Luxembourg, Washington, Montana and Oregon.

Surprisingly, the arguments for and against assisted-death and euthanasia haven’t been discussed all that frequently on this blog. So this post will consider: would legalising assisted-death (patient administered) or voluntary euthanasia (physician administered) provide a compassionate exit to those facing decline and suffering and the means to live and die by our own lights, or involve a repugnant devaluation of human life that would put the vulnerable at risk?

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What has Facebook (with some psychologists) done?

In my academic and musty corner of the universe, there has been a lot of talk in the past few days about this publication in the prestigious Proceedings of the National Academy of Sciences. Researchers tweaked a Facebook algorithm such that Facebook users would see a higher proportion of posts with negative or positive emotional content in their feed. They wanted to know whether a user seeing a different proportion would influence the emotional content content of that user’s posts in a positive or negative direction. The news: it did (a little bit).

People are less interested in that, however, and more interested in whether the researchers acted unethically. The BBC has a short round-up of some tweets here, and among other things the Guardian quotes Labour MP Jim Sheridan calling for an investigation here. Slate tagged its story on the issue with the headline ‘Facebook’s Unethical Experiment’ – a headline that shifts blame away from researchers and entirely to Facebook. There are many more news stories on this out by now: you get the picture.Read More »What has Facebook (with some psychologists) done?

JPE 2(1) – The pursuit of sex equality keeps going off the rails

So claims renowned Oxford philosopher and feminist Janet Radcliffe Richards.  Professor Radcliffe Richards is the author of The Sceptical Feminist, Human Nature After Darwin and Careless Thought Costs Lives: the ethics of transplants. She was also listed recently as one of the world’s 50 most important thinkers by Prospect magazine. Writing in the Journal of… Read More »JPE 2(1) – The pursuit of sex equality keeps going off the rails

Horizon 2020 and The Role of Lay People’s Perspectives in Bioethical Reasoning

By Kimberly Schelle & Nadira Faulmüller

Horizon 2020, the European Union’s 2014-2020 largest research programme ever, includes the call to pursue ‘Responsible Research and Innovation’ (RRI). RRI stands for a research and innovation process in which all societal actors (e.g. citizens, policy makers, business and researchers) are working together in the process to align the outcomes with the values, needs, and expectations of the European Society. In a recently published paper on the importance of including the public and patients’ voices in bioethical reasoning, the authors describe, although in other words, the value of the RRI approach in bioethical issues:

“A bioethical position that fails to do this [exchange with the public opinion], and which thus avoids the confrontation with different public arguments, including ones perhaps based in different cultural histories, relations and ontological grounds […], not only runs the risk of missing important aspects, ideas and arguments. It also arouses strong suspicion of being indeed one-sided, biased or ideological—thus illegitimate.”

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Drinking alcohol or using drugs during pregnancy could become a crime

Recently a neuroscientist discovered he was a psychopath. He was studying the brain scans of psychopaths, and intended to use some brain scans of family members and one of himself for the control group. Now one of the brain scans from the control group show clear signs of psychopathy, so he thought he must have misplaced it. He checked the reference number, and found out it was his own brain! This came as a total surprise to him, he never showed any signs of psychopathy, yet, he was very convinced that if his brain scan showed similarities with that of psychopaths, he must be a psychopath himself. Retrospectively his wife admitted that she thought he had some of the signs like lacking in empathy, and he found some famous murderers in his family. Instead of hiding this intimate fact about himself, he wrote a book about it, showing how amazing brain scans are. His book argued that brain scans can detect a psychopath like him, who never had any compelling symptoms of psychopathy.Read More »Drinking alcohol or using drugs during pregnancy could become a crime

Taking Rape Allegations Seriously: How Should We Treat the Accused?

Last week, the Crown Prosecution Service announced that it would not pursue further action against Oxford Union president Ben Sullivan, due to insufficient evidence arising from an investigation into the two accusations of rape and attempted rape made against him. In early May, Sullivan was arrested and released on bail, prompting a chaotic six-week period for the Union as the Thames Valley Police investigated the claims made against him. After Sullivan refused to resign, a number of high-profile speakers, including the UK director of Human Rights Watch, the Interpol secretary-general, and a Nobel Peace prize winner, pulled out of their speaking commitments as part of a larger boycott of Union events.

In an open letter (which has since been taken down) calling for the boycott, students Sarah Pine, who is Oxford University Student Union’s Vice President for Women, and Helena Dollimor wrote, “Remaining in his presidency continues to offer prestige and power to someone who is being investigated for rape. This undermines the severe nature of allegations of sexual offences.” In contrast, Oxford professor A.C. Grayling penned a response to the letter refusing to cancel his scheduled talk at the Union, noting, “I simply cannot, in all conscience, allow myself to act only on the basis of allegations and suspicions, or of conviction by the kangaroo court of opinion, or trial by press…” In this post, I look at the spectrum of responses in the wake of Sullivan’s arrest, of which these two examples represent the poles. More broadly, I consider how we ought to respond – both as individuals and a society – when those in positions of power are accused of rape or other sexual offences.Read More »Taking Rape Allegations Seriously: How Should We Treat the Accused?

Do Not Attempt Resuscitation orders: should you discuss with the patient?

The Court of Appeal has stated that a statement in a capacitous patient’s medical notes that resuscitation should not be attempted (a ‘Do Not Attempt Resuscitation’ Order – DNAR), should usually only be inserted after consultation with the patient: see R (Tracey) v Cambridge University Hospitals NHS Foundation Trust and others [2014] EWCA Civ 822 (17 June 2014).

The facts have been widely aired in the media: see, for example, here.

Mrs. Tracey had terminal lung cancer. Her clinicians indicated in the notes that no attempts at resuscitation should be made. Her family found out about this, and were outraged, saying that the DNAR order should not have been made without consultation with Mrs. Tracey. Their quarrel was not with the medical appropriateness of the determination that resuscitation would not be in Mrs. Tracey’s best interests, but with the procedure  – the failure to consult.  This, they said, violated Mrs. Tracey’s rights under Article 8 of the ECHR.

The Resuscitation Council, intervening, said that a requirement to consult with the patient would interfere with clinicians’ ability to deliver individual and compassionate care. A patient might, for instance, be very distressed by a discussion about a possible DNAR order.

The outcome can be briefly stated:

  • Mrs. Tracey’s Article 8 rights were engaged by recording the DNAR in the notes. This followed from, inter alia, Pretty v UK (2002) 35 EHRR 1.
  • Her Article 8(1) rights were violated by failing to involve her in the process
  • Article 8(2) required the policy adopted by a Trust in relation to DNAR orders to be sufficiently clear and accessible: see Purdy v DPP [2009] UKHL 45; [2010] 1 AC 345.
  • The absence of a mandatory national DNAR policy was not a violation of Article 8. Local policies would, if properly formulated, satisfy the demands of Article 8(2)
  • The concerns of the Resuscitation Council were real, but could be met by an important caveat: there should be consultation with the patient unless the clinician ‘thinks that the patient will be distressed by being consulted and that distress might cause the patient harm.’Read More »Do Not Attempt Resuscitation orders: should you discuss with the patient?

Should Vegetarians Consider Eating Insects?

In the last few years, there has been a push from various bodies—including the UN—to get Western countries to adopt eating insects as an alternative to meat. Insects have been hailed as a type of super food. They are: rich in protein; environmentally friendly to harvest; sustainable; and, they’re already eaten, and enjoyed, in many other parts of the world. There have been a number of occasions recently that I’ve been asked, as a (moral) vegetarian, for my thoughts on eating insects. “What if…?” and “Would you…?” questions are quite a common occurrence for veggies, but this one actually got me thinking.Read More »Should Vegetarians Consider Eating Insects?

Destroying one ecosystem and constructing another: biodiversity offsetting and particular value

Suppose that the government is proposing a new policy regarding buildings of historical significance. Rather than simply banning the destruction of ‘listed’ buildings, the new policy would allow their destruction, provided that whoever destroys the building agrees to construct, somewhere nearby, a new building of a similar size, in a similar style, exhibiting a similar range of architectural innovations, and of a similar level of beauty. Blenheim Palace could be flattened and built over with a shopping mall and carpark, provided that mall developers agreed to construct a replica of the palace somewhere nearby.

Most would be disturbed by such a policy. Part of the reason that they would be disturbed, I presume, is that it seems to manifest a failure to recognise the true value of historical buildings. Not all of the value of historical buildings consists in their possession of generic properties like ‘being beautiful’, ‘being in the baroque style’ or ‘using space to dramatic effect’. Some of their value is value that they have as particular objects, and that could thus not be realised in any other object. Part of the value of Blenheim Palace derives from it’s being the birthplace of Winston Churchill. This value could not be realised in a replica of the palace built 5 miles down the road.

Of course, no-one is proposing a policy of sort I’ve just outlined. I bring it up because I think reflecting on this kind of case may throw some light on recent discussion regarding biodiversity offsetting (see, for example, here, here  and here).Read More »Destroying one ecosystem and constructing another: biodiversity offsetting and particular value