Nonconsensual Neurointerventions and Expressed Disrespect: a Dilemma

Written by Gabriel De Marco and Tom Douglas

This essay is based on a co-authored paper recently published in Criminal Law and Philosophy

Neurointerventions—interventions that modify brain states—are sometimes imposed on criminal offenders for the purposes of diminishing the risk that they will re-offend or, more generally, of facilitating their rehabilitation. A commonly discussed example is the use of hormonal agents to reduce the sex drive of certain sexual offenders. Some suggest that in the future, we will have a wider range of such interventions at our disposal, possibly including, for instance, treatments to reduce aggression or impulsivity, or treatment to enhance capacities for empathy or sympathy.

In a recent paper, we consider an objection to the imposition of such neurointerventions without the offender’s prior agreement. Some object to these ‘nonconsensual neurointerventions’ (or ‘NNs’) by claiming that they express disrespect for the offender. This, according to the objection, gives us reason not to implement them. On a strong version of the objection, NNs are invariably wrong because they always express disrespect. Continue reading

The Neuroscience of a Life Well-lived: New St Cross Ethics Seminar

Professor Morten Kringelbach (Aarhus and Oxford) recently gave a fascinating New St Cross Ethics Seminar on ‘The Neuroscience of a Life Well-Lived’ (YouTube; mp3). Continue reading

Mandating COVID-19 Vaccination for Children

Written by Lisa Forsberg and Anthony Skelton

In many countries vaccine rollouts are now well underway. Vaccine programmes in Israel, the United Kingdom, Chile, United Arab Emirates, Bahrain and the United States have been particularly successful. Mass vaccination is vital to ending the pandemic. However, at present, vaccines are typically not approved for children under the age of 16. Full protection from COVID-19 at a population level will not be achieved until most children and adolescents are inoculated against the deadly disease. A number of pharmaceutical companies have started or will soon start clinical trials to test the safety and efficacy of COVID-19 vaccinations in children and adolescents. Initial results of clinical trials seem promising (see also here and here).

There are strong reasons to inoculate children. COVID-19 may harm or kill them. It disproportionately affects already disadvantaged populations. For example, a CDC study published in August 2020 found the hospitalisation rate to be five times higher for Black children and eight times higher for Latino children than it is for white children. In addition, inoculating children is necessary for establishing herd immunity and (perhaps more importantly), as Jeremy Samuel Faust and Angela L. Rasmussen explained in the New York Times, preventing the virus from spreading and mutating ‘into more dangerous variants, including ones that could harm both children and adults’. Continue reading

It’s Only a Game

Written by Stephen Rainey

Footballers are increasingly prominent in speaking against social and political ills. They can draw attention to serious issues, given their public profile. If more of us followed their example, beyond supporting their causes, we could make a world less accommodating for moral complacency.

Continue reading

Oxford Uehiro Prize in Practical Ethics: May the Use of Violent Civil Disobedience Be Justified as a Response to Institutional Racism?

This essay was the joint runner up in the graduate category of the 7th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Oshy Ray 

The summer of 2020 saw people across the world participating in racial justice protests, demanding the end of state violence against Black people, and calling for the eradication of institutional racism. While these protests were largely peaceful, the use of violence by some protestors was criticised. I argue that some forms of violent civil disobedience—henceforth, VCD— may be justified as responses to institutionalised racism. By “justified,” I mean that something can be made morally permissible—that its outcomes are good enough to warrant the “badness” of its means.

First, I argue that some forms of VCD may be justified as a response to institutional racism. Then, I consider the objection that instrumentally, violence is too uncontrollable to guarantee that desired ends (such as successful social change) may be brought about. In response, I distinguish between violence against persons and violence against objects. Acknowledging that violence against persons may rarely be justified, I claim that violence against objects is more easily justifiable. Finally, I conclude that VCD against objects may be justified as a response to institutional racism. I do not argue that violence can always be a justified response to institutional racism. Rather, my claim is more moderate; I claim that certain forms of VCD may be justified as a response to institutional racism.[1] Continue reading

Press Release: New Tavistock Legal Ruling on Puberty Blockers

The legal decision this morning, in the Family division of the High Court, provides important clarification. It is likely to be a relief to young people with gender dysphoria and their families.
In December, the High Court found that young people under 16 with gender dysphoria were highly unlikely to be able to understand the complexities and uncertainties of puberty blocking treatment. That meant that they could not consent (on their own) to treatment. The court recommended that doctors and families go to court to seek permission to start treatment.
That decision has caused great uncertainty for a large number of vulnerable teenagers with gender dysphoria who had previously been started on treatment or were awaiting treatment. It wasn’t clear whether they would be able to receive puberty blockers.
The decision today clarifies that parents of young people with gender dysphoria can consent to puberty blocking treatment on behalf of the young person. Where the parents, doctors and young person are all in agreement about this, there is no need to go to court.
 
This court decision reinforces a long established ethical approach to medical treatment in children and young people. The views of the child or young person should be sought. If the young person is sufficiently mature they may be able to consent on their own to the treatment in some cases. But where that isn’t the case, parents are able to consent to treatment that would be in the young person’s best interests (ie would be best overall for them). That ethical approach has long been adopted, in this country and others, for young people needing surgery or chemotherapy or other medical treatment. It applies to extremely important life and death decisions (for example about stopping life support). It also applies to puberty blockers.
Debate about the role of puberty blockers in young people and children is likely to continue. But this decision means that where doctors believe that it would be best for the young person to have this treatment, the young person wants the treatment and parents consent, the treatment can legally be provided.”
Professor Dominic Wilkinson
Professor of Medical Ethics, University of Oxford
Consultant Neonatologist

No conflicts of interest

Cross Post: There’s no Need to Pause Vaccine Rollouts When There’s a Safety Scare. Give the Public the Facts and Let Them Decide

Written By: Julian Savulescu, University of Oxford; Dominic Wilkinson, University of Oxford;

Jonathan Pugh, University of Oxford, and Margie Danchin, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

 

When someone gets sick after receiving a vaccine, this might be a complication or coincidence. As the recent rollout out of the AstraZeneca vaccine in Europe shows, it can be very difficult to know how to respond.

For instance, reports of blood clots associated with the AstraZeneca vaccine led to several European countries suspending their vaccination programs recently, only to resume them once these clots were judged to be a coincidence. However, authorities couldn’t rule out increased rates of a rare brain blood clot associated with low levels of blood platelets.

There are also problems with the Pfizer and Moderna vaccines. By early February 2021, among the over 20 million people vaccinated in the United States, there have been 20 reported cases of immune thrombocytopenia, a blood disorder featuring a reduced number of platelets in the blood. Experts suspect this is probably a rare vaccine side-effect but argue vaccination should continue.

So what happens with the next safety scare, for these or other vaccines? We argue it’s best to give people the facts so they have the autonomy to make their own decisions. When governments pause vaccine rollouts while investigating apparent safety issues, this is paternalism, and can do more harm than good. Continue reading

Press Release: Majority of UK public want choice at the end of life – survey

Most people in the UK would like the option of being heavily sedated, having a general anaesthestic or to having euthanasia, if they were dying, according to Oxford research published today in the medical journal PLOS One.

Professor Dominic Wilkinson, Professor Julian Savulescu and colleagues from the Oxford Uehiro Centre for Practical Ethics, surveyed more than 500 adults in August 2020 on their views about the care of a patient who had one week to live.

The study found a high level of support for access to deep sedation in dying patients.
Some 88% said they would like the option of a general anaesthetic if they were dying. Meanwhile, 79% of those surveyed said they would like to have the option of euthanasia.
But just 64% said they would personally choose anaesthetic at the end of life and nearly half said they would not choose euthanasia for themselves or a family member.

The report maintains, ‘This study indicates that a substantial proportion of the general community support a range of options at the end of life, including some that are not currently offered in the UK.’

According to Professor Wilkinson, ‘Previous surveys have shown that a large proportion of the UK public wish to have the option of euthanasia. This study shows an even larger number wish to have the choice of being heavily sedated or even receiving a general anaesthetic if they were dying.’

He continues, ‘Currently, in the UK it is legal for doctors to provide pain relief to dying patients, and to use sedatives if that is not enough to keep a patient comfortable. Heavy sedation is used as an option of last resort. General anaesthesia is not currently considered. But members of the general public value the option of deep sleep and complete relief from pain if they were dying. They believe that patients should be given this choice.’

Meanwhile, Professor Savulescu adds, ‘Patients have a right to be unconscious if they are dying. This survey shows that the general public want to have greater choice at the end of life.’
ENDS

Notes for Editors

For more information, please contact news.office@admin.ox.ac.uk

1. The survey is based on two anonymous online surveys of members of the UK public, sampled to be representative. They were given a scenario of a hypothetical terminally ill patient with one week to live and asked about the acceptability of providing titrated analgesia, gradual sedation, terminal anaesthesia, and euthanasia.
2. Across both surveys, a majority had undertaken higher education, with seven in 10 having A levels or higher qualifications. Meanwhile, just 2.4% overall had no qualifications.
3. Just over half of all respondents said they were religious with 13.8% describing themselves as very religious.

Oxford Uehiro Prize in Practical Ethics: Should Feminists Endorse a Universal Basic Income?

This essay was the joint runner up in the graduate category of the 7th Annual Oxford Uehiro Prize in Practical Ethics.

Written by University of Oxford student Rebecca L Clark

  • 1 Introduction

A UBI is a regularly remitted, non-means-tested cash grant which is given to every individual with no conditions attached.[1] Within these constraints, UBI proposals can differ considerably. Firstly, there is a Question of Scope – namely, who constitutes ‘every individual’? Secondly, there is a Question of Specification, which can be broken down into three interrelated issues:

  1. At what level of income should a UBI be set?
  2. Should a UBI supplement or replace existing welfare structures?
  3. How should a UBI be funded?

I will set aside the complexities raised by the Question of Scope and focus on a UBI given to adult citizens. In response to the Question of Specification, I will consider a UBI set at a liveable wage which supplements existing welfare institutions and is funded through revenues from publicly owned assets.[2] This is for two reasons. Firstly, I take this to be the most appealing version of a UBI; hence a conclusion that feminists should reject this version would suggest that feminists should reject any UBI proposal. Secondly, I am wary of building in hard limits of political or economic feasibility into my analysis since this forecloses utopian theorising, which is valuable precisely because it challenges conventional views about what is possible. Continue reading

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