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Should parents decide? The case of RB

Should parents decide? The case of RB

In the Family Court yesterday, a controversial case that has been widely reported in the media came to a premature close. The father of baby RB, a severely physically disabled 13 month-old infant, withdrew his opposition to the plan by RB’s mother and doctors to take him off life support. It is believed that in the near future doctors will stop breathing machines and allow RB to die. The court did not, in the end, make a judgement about this case, though a statement of endorsement by Justice Macfarlane yesterday suggests that it would have reached the same conclusion.

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Science, drugs, policy and Hume

In this blog last week Anders Sandberg discussed the widely criticised sacking of Professor David Nutt from the government’s advisory council on the misuse of drugs. Professor Nutt had openly criticised government policy, in particular the decision by government to change the classification of cannabis and ecstasy against the advice of the government’s scientific experts. The government claimed that it was not his job to enter the political fray.

In defence of the government, some commentators have sought to distinguish the role of scientists and the role of the politicians. Expert scientists are there to synthesise analyse and present evidence. But politicians have to ultimately decide policy on the basis of values and ethical judgements. Ben Goldacre, writing in the Guardian this weekend replies to this argument by presenting further empirical evidence that is open to scientific enquiry – evidence about the effects of different drug policies on drug use, for example. Goldacre’s argument is that policy questions, as well as medical questions can be assessed scientifically. On this basis, then, perhaps the correct drugs policy can be determined by scientists?

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God and Chance

As Paul Ewart points out in an interesting recent Guardian article ‘Why God Needs Chance’ —
http://www.guardian.co.uk/commentisfree/belief/2009/nov/03/god-chance-philosophy-atheism — chance events which result in certain individuals’ suffering undeservedly raise a version of the traditional ‘problem of evil’ for theists. If God, who is meant to be all-good and omnipotent, were to exist, how could he allow such chance events to occur?

Ewart goes on to argue that, if God is indeed to be omnipotent, chance may in fact be required. Here’s how I understand his argument. If the outcomes of our actions were entirely predictable, and we had free will, we could, in theory, force God to act to prevent some bad outcome. ‘So’, Ewart says, ‘God would no longer be in control – his actions would be determined by ours.’ But, because of chance, we can’t in fact predict the outcomes of our actions for sure, so we’re unable to distinguish what would be an act of God from a random event. So God remains omnipotent, because we can’t force him to act.

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Switzerland gets tough on suicide clinics

The Swiss
government (the Federal Council) has recently announced its intention to crack
down on “suicide tourism” and to severely restrict the activities of suicide clinics like Dignitas and
Exit, which have regularly made the headlines outside Switzerland in the last
few years (particularly Dignitas), as foreigners make up a large proportion of
the hundreds of people they help to die every year. The government is proposing two draft Bills for public deliberation until March. The first option is an outright ban on suicide clinics; were it to become law, clinics like Dignitas and Exit would simply have to close down. Such an extreme measure, however, doesn’t have the favors of most members of the Federal Council, and probably won’t have those of the Parliament either. The second option is more likely to prove popular, and I will thus focus on it: it would involve much stricter regulations – rather than a ban – being imposed on the activities of these clinics. Violations of those regulations would involve sanctions of up to five years in prison.

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Speaking truth to power

The sacking of Professor David Nutt from the Advisory Council on the Misuse of Drugs has led to a spirited row between politicians and scientists. Colleagues in ACMD are resigning, refusing to be used as mere rubber stamps for pre-determined agendas. The home secretary seems to want to reorganize it to his liking.

The origin of the conflict is Nutt's staunch harm-reduction and evidence based policy position: he thinks drugs should be legally classified by the harm they do, not so much by political expediency. Alcohol and tobacco are more harmful than cannabis, taking ecstasy appears to be less risky than horse riding (when counting injuries and death). Hence he has criticised policies ministers for upgrading medically less harmful drugs. While certainly controversial in the anti-drug community his arguments appear to be based on solid science. As a scientist he should also sound the alarm if the government is "devaluing and distorting" the scientific evidence.

Alan Johnson sees things differently: "He was asked to go because he cannot be both a government adviser and a campaigner against government policy." The role of an advisor is only to advice, while the government decides policy. But if the policy is against the evidence, should not the advisor advise to change the policy?

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The least bad mass murderer

By: David Edmonds

One man murdered 270 people, but his release from prison caused only moderate outrage.  Another murdered 13 people and it is unlikely he will ever be released because the public would not stand for it.  Why the difference?

I am puzzled by a comparison of intuitions about Abdelbaset Ali Mohmed al-Megrahi  and the Yorkshire Ripper, Peter Sutcliffe.   Put aside doubts  about al-Megrahi ‘s guilt; let us assume his conviction was sound, and that he did plant the bomb on Pan Am Flight 103.  Did he not cause more harm than Peter Sutcliffe? 

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Authenticity and Enhancement

David Velleman, in the only paper of which I am aware that makes a defensible case against euthanasia, suggests that sometimes expanding our range of options is a bad thing, even if we choose wisely from our options. Velleman gives the example of dueling: I may be better off for lacking (by law) the option of dueling, because were the option available to me, I might be better off accepting a challenge than losing face, but I am better off still if I am never challenged. Velleman’s utilizes this claim in arguing against the legalization of the right to die: if I have the option of dying, then I may feel that I am required to justify my existence, especially when my continuing life is an emotional and financial burden on my family.

What interests me, here, is how an existentialist might respond to this argument and might urge its generalization. Existentialists, in the mould of Jean-Paul Sartre, might say that policies that lead me to think that I must justify my existence are a good thing; they lead me to recognize what was in any case always true. It is bad faith, or inauthenticity, not to face squarely the fact that I implicitly choose, and therefore am responsible for, my existence.

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Will Down syndrome disappear?

There are concerns about the impact of the improving accuracy and availability of low risk cheap prenatal tests such as for Down syndrome (DS). Introduction of a noninvasive maternal serum test is expected that might provide a definitive diagnosis of DS in the first trimester at no risk to the fetus. The authors report that the tests should be virtually universally available and allow privacy of decision making. The authors ask whether the new tests will decrease the birth incidence of DS even further. Indeed, might there be no more DS children born? If so, is that a problem?

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“Trust Me, I’m an Ethicist”

A paper forthcoming in the philosophy journal Mind inquires into perceptions about the ethics of ethicists. The paper reports on a survey that asked philosophers their opinions about the moral behaviour of ethicists compared with the behaviour of philosophers who specialize in other fields. Majorities of both the ethicist and non-ethicist respondents did not think that ethicists behaved any better than other philosophers. While ethicists were somewhat optimistic about other ethicists, with a larger number opining that they behaved better than other philosophers than that they behaved worse, non-ethicists were nearly evenly split between these views. We might reasonably expect that ethicists in general would be, on average, more practiced at moral reflection than other philosophers, and arguably more skilled at it – if not to begin with, then at least as a result of the practice. So the results of the survey suggest that philosophers on the whole do not think that more moral reflection improves moral behaviour. This invites the question: What, then, are ethicists good for?Read More »“Trust Me, I’m an Ethicist”

The ventilator lottery: rolling the dice in the face of difficult choices

As the winter approaches there has been a surge in the number of cases of swine flu, as well as a number of recent deaths in the UK. Although there is hope that the new vaccine will reduce the impact of the pandemic a number of countries including Canada the UK and the  United States have had to face the possibility that health services will not be able to accommodate the predicted surge in demand. Officials have been contemplating guidelines for deciding who should be prioritised for receiving life saving mechanical ventilation. The hope is that such guidelines will enable doctors to save the greatest number of lives in a pandemic.

But one concern about these guidelines is that they are unfair. Should scarce medical resources such as ventilators be allocated using a lottery instead?

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