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In praise of organ-ised sport

In praise of organ-ised sport

By Dominic Wilkinson (@NeonatalEthics)

The BBC reports today on a recent organ donation initiative in Brazil. This initiative has led to a 400% increase in the numbers of heart transplants in a local hospital. The waiting list for organs in the city of Recife reportedly dropped to zero in the first year after introduction of this innovation.

What sort of initiative could lead to such a dramatic increase in organ donation numbers? Read More »In praise of organ-ised sport

Food packaging matters more than informed consent to treatment

Packets of cigarettes carry pictures showing purchasers what their lungs or their arteries will look like if they carry on smoking. Consumers International and the World Obesity Federation are now suggesting that some foods should bear similar images.

Assume for the sake of argument that the practice would be effective in discouraging the purchase of health-truncating foods. If the images work by telling consumers something about what they are buying that they would not otherwise know, surely there can be no coherent objection to them. Knowledge of that sort is always good – assuming that the consumer has a real choice as to whether to buy the bad product or a better one.

If they work by pushing to the forefronts of consumers’ minds information that their grosser appetites conveniently suppress when they are wandering down the mall, there may be an argument against them. This would presumably be on the broad basis that the images manipulate the person away from being what they authentically are (a fructose-guzzling cardiac-cripple-in-waiting) towards something else. This argument would assert that there’s a sort of ethical imperialism at work: that those would stamp pictures of limbless diabetics on junk sweet packs are tyrannously seeking to impose an arbitrary normative idea of the good life.

I have little sympathy with this second view. If anyone says in a normative voice that it’s good to be diabetic, they’re insane. If anyone says in an empirical voice that it’s better to be diabetic than non-diabetic, they’re misinformed. If anyone says in the voice of a hedonistic utilitarian that the overall pleasure gained by the consumption of lard outweighs the detriments, I’d invite them to get thin, do all the Munros, and then revisit their original judgment. If anyone thinks that they’re more authentically themselves by being ill might have a point once their illness is long-standing and has truly become a defining characteristic. But before the illness is triggered, aren’t they more themselves without clogged arteries or the need to inject insulin five times a day?

If the packaging proposal is adopted, some interesting questions arise. Should good foods be branded with pictures of the condition you’ll be in or the advantages you’ll have if you eat them? Aphrodisiac oysters would display the beaming visages of satisfied sexual partners. Green tea would show lean centenarians on trampolines. Or perhaps those good foods should show the things that they’ll spare you: prostate-preserving tinned tomatoes might show an unoccupied midnight toilet.

Perhaps other, wider concerns should feature. Tins of palm oil should show dead orangutans. Milk should show the mournful face of a calf-less cow alongside the pictures of healthy, non-osteoporotic bone-scans.

While it’s easy to multiply absurdities, the proposal is basically a very good thing. It’s a good thing for at least some of the reasons that the notion of informed consent to medical treatment is endorsed. If you’re keen on informed consent to treatment, a fortiori you’ll be keen on food package images. In fact, I suggest, you should be more keen on those images. They’re more important.Read More »Food packaging matters more than informed consent to treatment

On Canada’s Proposed Bill C-24: The So-called ‘Strengthening Canadian Citizenship Act’

A new bill proposed by the Canadian government’s Citizenship and Immigration Minister, Chris Alexander, has been getting a lot of press recently. (You can find the bill here and the current Act here). Bill C-24, called by its proponents the ‘Strengthening Canadian Citizenship Act,’ is meant to do just that: Strengthen Canadian Citizenship. The changes it proposes to the extant Canadian Citizenship Act are legion, and vary in their significance. Certainly, the changes are not all bad. It calls, for example, for modifications that would allow so-called ‘lost Canadians’ a chance to become citizens. People who, for one reason or another, never received citizenship when they should have. It also introduces more consistently gender-neutral language, rather than favouring the masculine pronoun, and acknowledges common-law partnerships, where the current act only recognizes marriage. These are good things. But, the press hasn’t focused on these gains. This is because a series of changes proposed by the bill will also make Canadian citizenship harder to get and easier to lose. Like others, I’m opposed to the latter set of changes being proposed. However, unlike others, my dissent isn’t based on the introduction of what is being called a distinction between first and second-class citizens. Instead, it is based on the assumption, implicit in proposed bill and explicit in the rhetoric of its defense, that citizenship is a privilege and not a right.Read More »On Canada’s Proposed Bill C-24: The So-called ‘Strengthening Canadian Citizenship Act’

Expert workshop on cognitive enhancement device regulation: Are there ‘two worlds’ of devices?

Last week, we held an expert workshop with key stakeholders to discuss our recent Oxford Martin School policy paper. Our policy paper put forward proposals for how we thought cognitive enhancement devices such as brain stimulators should be regulated. At present, if these sorts of devices do not make medical treatment claims (but instead claim to make you smarter, more creative or a better gamer, say) then they are only subject to basic product safety requirements. In our paper we suggested that cognitive enhancement devices should be regulated in the same way as medical devices and discussed how this could be implemented. Indeed, the devices that are being sold for enhancement of cognitive functions use the very same principles as devices approved by medical device regulators for research into the treatment of cognitive impairment or dysfunction associated with stroke, Parkinson’s disease and depression (amongst other conditions). Being the same sorts of devices, acting via similar mechanisms and posing the same sorts of risks, there seemed to be a strong argument for regulation of some form and an equally strong argument for adopting the same regulatory approach for both medical and enhancement devices.

Having published our paper, we were very keen to hear what people more closely involved in making policy and drafting legislation thought of our proposals. Individuals from the Medical and Healthcare Products Regulatory Agency, the EU New and Emerging Technologies Working Group, a medical devices company, the Nuffield Council on Bioethics, and experts on responsible innovation and on brain stimulation joined us. Overall, the response to our recommendations was positive: all participants agreed that some regulatory action should be taken. There was a general consensus that this regulation should protect consumers but not curtail their freedom to use devices, that manufacturers should not be over-burdened by unnecessary regulatory requirements, and that innovation should not be stifled.Read More »Expert workshop on cognitive enhancement device regulation: Are there ‘two worlds’ of devices?

When the poison is the antidote: risky disaster research

A recent report by Lipsitch and Galvani warns that some virus experiments risk unleashing global pandemic. In particular, there are the controversial “gain of function” experiments seeking to test how likely bird flu is to go from a form that cannot be transmitted between humans to a form that can – by trying to create such a form. But one can also consider geoengineering experiments: while current experiments are very small-scale and might at most have local effects, any serious attempt to test climate engineering will have to influence the climate measurably, worldwide. When is it acceptable to do research that threatens to cause the disaster it seeks to limit?

Read More »When the poison is the antidote: risky disaster research

Was Marx Right?

In The German Ideology, Marx claimed that “the ideas of the ruling class are in every epoch the ruling ideas”. The idea, roughly, is that the way the dominant class frame and view the world comes to be the ideology of the entire society. If the ruling class sees people as divided into castes, for instance, then most people – whether they belong to that class or not – will absorb this way of thinking and see the world in the same way. This explains why – according to Marxists – people may be complicit in their own subordination: it seems natural to them.Read More »Was Marx Right?

On the Ethics of Tipping

At lunch-time, I will often venture out of the office for lunch to a sandwich shop with a friend. In my sandwich shop of choice, the staff have placed a small jar labelled ‘tips’ on the counter.  Now, in the UK at least, sandwich shop staff seem to fall into something of a ‘grey area’ with regards to tipping convention. Whilst we normally tip waiters and waitresses in restaurants, and bartenders (amongst others), we don’t tend to tip people who serve us in other ways. For example, I don’t feel it incumbent upon me to tip my butcher, who arguably does a lot more work in an individual transaction than someone serving me a sandwich. However, this discrepancy is perhaps not surprising; a great deal of research suggests that tipping decisions are influenced by various social norms;[1] tipping waiters and waitresses is simply ‘the done thing’, whilst tipping butchers is not. Perhaps we just lack a clear social norm in the case of sandwich shops.Read More »On the Ethics of Tipping

“The Medicalization of Love” – call for peer commentaries – DUE SEPT 1

Announcement:  The paper, “The Medicalization of Love” by Brian D. Earp, Anders Sandberg, and Julian Savulescu, has been accepted for publication at the Cambridge Quarterly of Healthcare Ethics. Scholars interested in submitting a short reply paper or peer commentary are encouraged to contact the editor, Tomi Kushner, at kushnertk@gmail.com. The final deadline for commentaries/ papers is… Read More »“The Medicalization of Love” – call for peer commentaries – DUE SEPT 1

Can we solve the world’s problems by offering a large enough prize?

On the 22nd of October 1707, more than 1400 British sailors died when a British naval fleet sank in stormy weather off the Isles of Scilly. The disaster was later attributed to failings in navigation and sailors’ difficulty in determining their location at sea. This was a perennial problem at the time, and had persisted despite intense scientific research. Seven years later, the UK government passed the Longitude Act, offering 20,000 pounds (more than 2 million pounds in today’s money) to anyone who could develop a method for reliably determining longitude at sea. The longitude prize was eventually won by John Harrison, a self-educated Lincolnshire clockmaker.

Yesterday, 300 years after the original Longitude act, the UK Technology Strategy Board launched a £10 million pound prize competition, a new ‘Longitude prize’. The money will be awarded to a scientist or group of scientists who come up with a solution to one of a set of major global challenges – inadequate food/clean water supply for everyone, antibiotic resistance, spinal cord injury, dementia, the large carbon impact of air-flight.

The new Longitude prize is the latest in a series of innovation inducement competitions over time. These competitions have offered monetary rewards for solving problems as diverse as the development of butter substitutes, the first trans-Atlantic air flight, reusable aircraft for space flight, or an alternative fertilizer to bird poo. One novel feature of the 2014 Longitude prize is that it is seeking public input into the specific challenge to be targeted. Public voting will decide which of the six global challenges above are to be the focus of the prize.

But are innovation prizes an effective or appropriate way to solve major global scientific challenges?Read More »Can we solve the world’s problems by offering a large enough prize?