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Should the NHS fund Weight Watchers schemes?

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

Girls should do competitive sports to ‘build confidence and resilience’. Really?

The chief executive of the Girls Day School Trust claimed this week that girls should take part in competitive sport as a way to build confidence and resilience.[1] The claim is particularly about taking part in sports where one wins or loses. As far as is reported, these claims are not based on studies showing the psychological effects of participation in competitive sport, but are nonetheless presented as a supplementary argument for girls to do more sports in schools. Obviously, the primary argument will always be that doing sport is good for your health.

Without large scale empirical research, the claim that taking part in competitive sports builds transferable confidence and resilience remains a hypothesis. I am going to suggest that it is not a particularly convincing one (especially when applied to all girls, and in particular to the girls whom Fraser hopes will take up sport) and that any rhetoric accompanying a drive to promote exercise should stick to the more fundamental argument that it improves health.Read More »Girls should do competitive sports to ‘build confidence and resilience’. Really?

If we chose it, would we need it?

An interesting new target has appeared in the discussion on human enhancements: to prevent and halt anthropogenic climate change by the use of moral bioenhancement. The issue of moral enhancements is extensively discussed, for example, in recent American Journal of Bioethics (April 2014, Volume 14, Number 4).

 

Often the object of high hopes is a specific characteristic, such as increasing intelligence or decreasing violence. These are conceptually intrinsic (although, of course with external purposes) goals and easy to understand: were there some meaningful and accessible biological basis for these characteristics, we could try to intervene them. While it is arguable that neither the nature nor nurture will ever be the total and final answer, I believe that the significance placed on the nature in the biomedical enhancement discourse is well beyond reality, although very interesting at the level of a philosophical though-experiment.Read More »If we chose it, would we need it?

Public Sinners: Forgive or Forget?

If you haven’t heard anything about the ongoing saga of Donald Sterling, here is a quick run-down. Sterling owns an NBA team – the Los Angeles Clippers. By most accounts, Sterling is not a morally upstanding person (see here and here). But according to (at least) the court of public opinion, Sterling went too far recently when an audio recording emerged in which Sterling said several horribly racist things. Sponsors began withdrawing support, players threatened to boycott Clippers games, and the NBA reacting swiftly by banning Sterling for life from the NBA and fining him $2.5 million.

Since then things have gotten worse (at least in one sense) for Sterling. Consensus emerged that the NBA could, and would, force Sterling to sell his team – something Sterling said he would not do. But things appear to have been taken out of his hands. Before the NBA had to force Sterling to sell, Sterling was given a diagnosis of Alzheimer’s and was declared mentally unfit to make decisions for his team. At that point his wife decided to sell the team, and is in the process of doing so, for a reported $2 billion.

There are many ‘ethics in the news’ issues here. I’m going to focus on just one. How ought we to think about blame and forgiveness in these kinds of very public cases? What does Sterling owe us (the public), and do we owe Sterling anything? It is easy to find on-line vitriol directed at Sterling, and his largely unapologetic reaction to the whole episode has if anything fanned the flames. Is there a point at which such vitriol is too much? Should the diagnosis – which Sterling challenges – that Sterling is ‘mentally unfit’ influence how we feel about his blameworthiness for this episode? Should his well-documented past behaviour?Read More »Public Sinners: Forgive or Forget?

What if schizophrenics really are possessed by demons, after all?

By Rebecca Roache

Follow Rebecca on Twitter here

 

Is there anything wrong with seriously entertaining this possibility? Not according to the author of a research article published this month in Journal of Religion and Health. In ‘Schizophrenia or possession?’,1 M. Kemal Irmak notes that schizophrenia is a devastating chronic mental condition often characterised by auditory hallucinations. Since it is difficult to make sense of these hallucinations, Irmak invites us ‘to consider the possibility of a demonic world’ (p. 775). Demons, he tells us, are ‘intelligent and unseen creatures that occupy a parallel world to that of mankind’ (p. 775). They have an ‘ability to possess and take over the minds and bodies of humans’ (p. 775), in which case ‘[d]emonic possession can manifest with a range of bizarre behaviors which could be interpreted as a number of different psychotic disorders’ (p. 775). The lessons for schizophrenia that Irmak draws from these observations are worth quoting in full:

As seen above, there exist similarities between the clinical symptoms of schizophrenia and demonic possession. Common symptoms in schizophrenia and demonic possession such as hallucinations and delusions may be a result of the fact that demons in the vicinity of the brain may form the symptoms of schizophrenia. Delusions of schizophrenia such as “My feelings and movements are controlled by others in a certain way” and “They put thoughts in my head that are not mine” may be thoughts that stem from the effects of demons on the brain. In schizophrenia, the hallucination may be an auditory input also derived from demons, and the patient may hear these inputs not audible to the observer. The hallucination in schizophrenia may therefore be an illusion—a false interpretation of a real sensory image formed by demons. This input seems to be construed by the patient as “bad things,” reflecting the operation of the nervous system on the poorly structured sensory input to form an acceptable percept. On the other hand, auditory hallucinations expressed as voices arguing with one another and talking to the patient in the third person may be a result of the presence of more than one demon in the body. (p. 776)

Irmak concludes that ‘it is time for medical professions to consider the possibility of demonic possession in the etiology of schizophrenia’ and that ‘it would be useful for medical professions to work together with faith healers to define better treatment pathways for schizophrenia’ (p. 776).Read More »What if schizophrenics really are possessed by demons, after all?

The Right to Forget the Stock Market’s blemished Past

One of the great pleasures of studying human behaviour is to see that what we find in our experiments, what we theorize in our papers and textbooks – as unlikely and counterintuitive it appears to be – actually predicts what happens in so-called real life. Take, for instance, the current build-up of a stock-market bubble in the UK, happening even more dramatically in the US. In the UK, the FTSE 100 is on its way to surpass the record set during the high times of the dotcom bubble and already surpassed the levels reached during the 2008 financial bubble; in the US the Dow Jones has already reached new record highs. Despite having recently experienced the devastating consequences of a stock market bubble bursting, banks and investors return a few years later to the same hyperbolic forecasts and predictions, and start to build up another bubble. It is as if the past did not exist. Compare this behaviour with the following anecdote, which most business school students probably know.

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