Trolleyology
In the October edition of Prospect magazine, Practical ethics blogger David Edmonds provides an accessible and thoughtful insight into "Trolley problems"
Trolleyology
Could a ban on homebirth be justified?
Agnes Gereb, a midwife in Hungary, has been imprisoned for performing home births http://www.guardian.co.uk/world/2010/oct/22/hungary-midwife-agnes-gereb-home-birth. She faces various charges, including negligent malpractice and manslaughter (relating to a homebirth in which the baby died after a difficult labour). While home birth is theoretically legal in Hungary, in practice independent Hungarian midwives are not certified as being able to ensure safe conditions for home birth.
Media commentary in this country has on the whole been very sympathetic towards Gereb (for example http://www.bbc.co.uk/programmes/b00vhfg2), implying that the rules which prevent women from giving birth at home are unwarranted restrictions on their freedom. Although in most developed countries home births are the exception rather than the rule, they are generally felt to be something women have a right to choose to have. A plausible reason for this is that birth is seen as a very important, as well as personal, experience which the mother should have control over. Is Hungary justified in challenging the existence of such a right?
Inviting invasion: deep space advertisments and planetary security
The Register warns that Dixons risks future of humanity with Star Wars-themed ads: the electronics chain, not satisfied with merely human customers also as a publicity stunt broadcast its ads into deep space, presumably for aliens to receive. This is done using the firm Deep Space Communications Network, who offers to beam messages into space using their satellite dish. Earlier this year an invitation to the Klingon opera 'u' was beamed towards Arcturus using a Dutch radio telescope. Are these stunts putting mankind at risk?
Read More »Inviting invasion: deep space advertisments and planetary security
Are some temperaments “better” than others?
by Alexandre Erler
Jerome Kagan’s latest book, The Temperamental Thread, is – as usual with Kagan – a fascinating read. It draws on the three decades of research done by Kagan on the topic of human temperament. In a famous series of studies, Kagan examined the way infants reacted to unfamiliar or unexpected events. He found that about 20 per cent of these infants were unusually responsive to such events, exhibiting vigorous motor activity and frequent crying. He calls these infants “high reactives”, and found after following their evolution during their subsequent years that they were biased to become timid, subdued toddlers and shy adolescents who become uneasy when they cannot predict or control the future. About 20 per cent of these high reactives proved unable to cope with their temperament and were subsequently diagnosed with social anxiety disorder, depression, or both. By contrast, another other group of infants showed a high threshold of excitability to the same events. Kagan calls them “low reactives”. They tended to become outgoing, relatively fearless children and relaxed adolescents who like risk and challenge [3]. In the wake of Kagan’s earlier work The Long Shadow of Temperament, The Temperamental Thread paints a rich and detailed picture of the differences between these two psychological types.
Is professional integrity a futile argument?
by Dominic Wilkinson
In an earlier post this week I argued that there are only two substantive reasons for doctors not to provide treatment that they judge futile – either on the basis of a judgement that treatment would harm the patient (a form of paternalism), or on the basis that providing treatment would harm others (on the basis of distributive justice). I rejected the idea that professional integrity provided an additional reason to withhold or withdraw treatment.
Break my bones, but don’t let me die! Should doctors provide ‘futile’ CPR?
by Dominic Wilkinson
Two recent cases in a Toronto hospital illustrate a dilemma that hospital doctors face all too frequently. What should they do if patients or their representatives insist on treatment that the doctor believes would be futile? Should they just go along with the patient despite their misgivings? Alternatively, should they unilaterally withhold treatment if they feel it would be inappropriate to provide it?
Read More »Break my bones, but don’t let me die! Should doctors provide ‘futile’ CPR?
Counterfeit Placebos
Last week it was reported that police in Bangladesh had made a major bust at a factory that was producing counterfeit homeopathic drugs. The counterfeiters were attaching the labels of other drug producers to the remedies they were producing in their own factory. Dhaka's Daily Star reported the bust with the rather ironic headline "Fake Medicine Factory Busted".
Of course, even homeopathic remedies need to be guaranteed safe if they are sold in stores, and counterfeiters are not bound by the same safety controls as other more reputable sources. There are also 'intellectual property' issues concerning the use of other company's labels and trademarks. So I am not here to tell you that this drug bust was unnecessary or ridiculous. In fact I want to challenge The Star's implicit suggestion that homeopathic remedies are by their nature counterfeit therapies.
Is Low Libido a Brain Disorder?
by Julian Savulescu
Update: The same misunderstandings are still in evidence, 2 years on (May 2012), for example: ‘Brain circuitry different for women with anorexia, obesity’
Having started to work in the field of neuroethics a couple of years ago, I have become staggered by the misunderstanding of what neuroscience can tell us. The best example is a recent BBC story which goes by the wonderful title “Libido problems: ‘brain not mind‘” .
Anti Addict Mummy Money
A US group that pays drug addicts to undergo sterilisation visits the UK this week, having recently paid its first British client for undergoing a vasectomy. “Project Prevention” claims that its goal is to make addicts and alcoholics use long-term birth control until they can care for the children they conceive. Founder Barbara Harris has said: “We don’t allow dogs to breed. We spay them. We neuter them. We try to keep them from having unwanted puppies, and yet these women are literally having litters of children.”
The visit has provoked strong responses. Some have compared the group to eugenicists, while supporters point to the cost to the children and society of conception by addicted parents. Dominic Wilkinson has controversially suggested on this blog that a version of the programme could be offered on the National Health Service.
This ethical debate is on the level that Mackie (1977) identifies as first order. However, the issue also highlights second order moral issues about the nature of morality. What are we doing when we express a moral view and how do we know that our views are reliable? One approach to answering these sorts of questions is to understand human morality as an adaptation that contributed to our ancestors’ evolutionary fitness. Without addressing the strengths and weaknesses of such an approach here, if correct, it has the potential to illuminate second, and by implication first, order questions.
Kidneys and the Ultimatum Game
Frequently in life there is some good available if you and I can agree on some split of that good between us. If we cannot agree the good never comes into existence. This fact can be modelled by what is called the ultimatum game. In the ultimatum game somebody offers us £100 to split between us just in case we agree on the split. The rule is that I propose and you dispose. If you accept we get the money split as agreed and if you reject it we both get nothing. Since you are better off whatever positive offer I make, it looks as if it is rational to accept even as little as £1.
Read More »Kidneys and the Ultimatum Game