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Howick on What Counts as a Placebo

Howick on What Counts as a Placebo

The use of placebos in medicine raises a large number of serious ethical issues. Do they involve deceiving patients, or violating their autonomy in some way? Are they harmful to certain patients, in research trials where the actual treatment being trialled is thought likely to be successful? Can placebos – if medically warranted – be funded through a health care budget? All these questions require us to be able to say what a placebo is, and that is more tricky than one might think.Read More »Howick on What Counts as a Placebo

Two Tales of Marshmallows and their Implications for Free Will

Patricia Churchland, a prominent Neurophilosopher, just published a book on neuroscience and its ethical implications which led to a rather nasty exchange in the New York Review of Books with fellow philosopher Colin McGinn.  His pointed, to put it mildly, criticism of her work was based on philosophical considerations about the implications neuroscience has, or, as he argues, lacks, for the philosophy of mind. This criticism evoked two sentiments in me. First, I felt a strong sense of hopelessness for a world in which not even two philosophers can engage in a sober, respectful argument about something they disagree on; not even under the tutelage of the editors of the New York Review of Books, one of the so-called sanctuaries of intellectualism. Good luck Palestine and Israel! Thereafter, I remembered the unease I at times felt as a psychologist when hearing or reading about Churchland’s work.

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Reading in a connected age

There is no doubt that the internet has transformed our lives in multiple ways. Here I will focus on the ways in which it has transformed our cognitive environment. I’m writing these words in Australia; as soon as I press “publish” they will be available to readers all over the world. For an academic, the “tyranny of distance” is greatly reduced by the web: it doesn’t matter where I am or where the journal is; I can have immediate access and I can email the author queries as easily from Melbourne as from London. Notoriously, it has made information available in quantities many people report they find overwhelming.Read More »Reading in a connected age

Not cricket? Law, convention, ethics, and that run-out

Sporting contests are philosophically interesting, as well as enjoyable, because sports and games are full of rules and conventions, which inevitably raise issues of interpretation and give rise to passion about ethics and the spirit of the game. The recent run-out of English batsman, Jos Buttler by the Sri Lankan bowler, Sachithra Senanayake in the deciding one-day international match is a case in point. Buttler was run out at the non-striker’s end by the bowler almost in his delivery stride after Buttler had backed up too far The anger, complaint and tutt-tutting in the English media, amounted to a sort of slightly stifled outrage (if that is a possible condition). But there is general agreement that Senanayake did nothing against the laws (rules) of the game, so for those shocked by the run out, there is recourse to such things as violating the spirit of cricket, ungentlemanly behaviour, and the ethics of the matter. (For an interesting discussion of this and other examples of legal but improper behaviour in cricket, such as not “walking” when you know you are “out”, see Samir Chopra and David Coady, “Not Cricket” in Sport in Society: Culture, Commerce, Media, Politics, 2007.)

To be clear on the law, Law 42.11 from the International Cricket Council’s playing regulations for international cricket states that “the bowler is permitted, before releasing the ball and provided he has not completed his usual delivery swing, to attempt to run out the non-striker”.

This could hardly be clearer, so the current debate implicitly or explicitly acknowledges that there is a difference between law and morality, or, less grandly perhaps, the rules and the ethos of an activity. So, it is worth looking more closely at what happened. According to newspaper reports, Buttler had already twice been warned by the bowler when out of his crease as the bowler was about to enter his delivery stride. In spite of this he was well down the pitch when Senanayake broke the bails and appealed. The umpire asked the Sri Lankan captain, Angelo Matthews whether he wanted to withdraw the appeal and he declined to do so. The batsman trudged unhappily from the field, and after the match Alastair Cook, the England captain, when shaking hands with the victorious captain, apparently delivered angry words about the incident.

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Should the NHS fund Weight Watchers schemes?

The National Institute for Health and Care Excellence (NICE) recently recommended that the NHS should learn from commercial weight loss programmes such as Weight Watchers, Rosemary Conley and Slimming World. The NICE guidelines suggested that doctors should take a “respectful” and “non-judgemental” tone when helping patients to lose weight. As well as this, GPs were encouraged to continue to identify overweight patients for referral to state-funded commercial weight loss schemes, run by companies such as Weight Watchers, with obese adults being given priority.

The plan is estimated to cost hundreds of millions of pounds, but is also likely to save the NHS vast amounts in the long run, if successful in reducing obesity. Approximately 1 in 4 adults in the UK are obese, a condition that is linked with other ailments such as diabetes, heart disease and some cancers. The costs to the NHS attributable to people being overweight and obese are projected to reach £9.7 billion by 2050. Figures show that Weight Watchers and similar schemes manage to reduce participant’s body weight by 3 per cent, and NICE believe that even this small amount will help in the long term. Is it right, therefore, that the NHS subsidise the cost of these commercially run weight loss schemes?

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Essendon, Doping and Bad Arguments

By Julian Savulescu. @juliansavulescu

The Australian newspaper ‘The Sunday Age’ reports today that “The Australian Sports Anti-Doping Authority has built a ”non-presence” drug case against 34 Essendon footballers, adopting a strategy similar to the one used to ban Lance Armstrong without a positive test.”

1. What should we think about this latest drugs “scandal” at Essendon, the so called “war on doping” in the Australian Football League (AFL), and in sport in general?

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Morality, science, and Belgium’s child euthanasia law

Originally posted on the OUP blog. Reposted with the permission of the author

Tony Hope is a Uehiro fellow, Emeritus Professor of Medical Ethics at the University of Oxford and the author of Medical Ethics: A Very Short Introduction.
Science and morality are often seen as poles apart. Doesn’t science deal with facts, and morality with, well, opinions? Isn’t science about empirical evidence, and morality about philosophy? In my view this is wrong. Science and morality are neighbours. Both are rational enterprises. Both require a combination of conceptual analysis, and empirical evidence. Many, perhaps most moral disagreements hinge on disagreements over evidence and facts, rather than disagreements over moral principle.

Consider the recent child euthanasia law in Belgium that allows a child to be killed – as a mercy killing – if: (a) the child has a serious and incurable condition with death expected to occur within a brief period; (b) the child is experiencing constant and unbearable suffering; (c) the child requests the euthanasia and has the capacity of discernment – the capacity to understand what he or she is requesting; and, (d) the parents agree to the child’s request for euthanasia. The law excludes children with psychiatric disorders. No one other than the child can make the request.

Is this law immoral?

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“Puppy Farm” or “Commercial Breeder”?

As the diverse range of topics on this blog testifies, philosophical questions concerning practical ethics crop up every day, in a variety of circumstances. Today, I had my own ethical dilemma – this time regarding puppies. Having just moved into my new house, I am now searching for a puppy. When I saw an advert for some puppies for sale in a small village in South Oxfordshire, I became excited: could this be the one?

This morning, after I had arranged an appointment to visit the pups, I began searching online for more details. Specifically, the pups were being sold by what is known as a “commercial breeder”: a business that breeds and sells puppies, primarily for profit. To me, this sounded almost identical to the oft-maligned “puppy farms”, or “puppy mills”. As one website (www.dogstuff.info) describes it, a puppy farm is

 A business that mass-produces dogs for a profit with little or no regard for the health and well-being of the puppies and dogs.   It is a facility where puppies are sold to brokers, pet stores or individuals without regard for the puppy.  They usually have many breeding animals in many different breeds and often, but not always, substandard health, living and socialization conditions.Read More »“Puppy Farm” or “Commercial Breeder”?

Genetically Modifying Mosquitoes to ‘Bite the Dust’? Ethical Considerations

At some point, most people will have questioned the necessity of the existence of mosquitoes. In the UK at least, the things that might prompt us into such reflection are probably trivial; in my own case, the mild irritation of an itchy and unsightly swelling caused by a mosquito bite will normally lead me to rue the existence of these blood-sucking pests. Elsewhere though, mosquitoes lead to problems that are far from trivial; in Africa the Anopheles gambiae mosquito is the major vector of malaria, a disease that is estimated to kill more than 1 million people each year, most of whom are African children.Read More »Genetically Modifying Mosquitoes to ‘Bite the Dust’? Ethical Considerations